~ If you are breastfeeding and scheduled for a breast biopsy, you could participate in a groundbreaking research study. Tanya at the Motherwear Breastfeeding Blog explains how “when you make milk, cells from your milk ducts are exfoliated off in the process. These are called epithelial cells, and they’re detectable in your milk. Past research has demonstrated that long before we notice a lump, those epithelial cells start changing in ways that are precursors to the development of breast cancer.” If you participate in the study at no cost to you, your milk sample could help in the development of a non-invasive means of determining breast cancer risk through breast milk.

~ The Health and Wellness Channel here at b5media features its own blog dedicated to breast cancer awareness written by Karen Lynch. To celebrate BCAM, Karen is running a prize giveaway every day this month! Check out Pink Ribbon Review for your chance to win!

~ Boob Maternity and Nursing sells a “Boob Think Pink” nursing top for CDN $65 at Milkface.com. Three Euros from the sale of each tee goes toward breast cancer research.

~ Breastfeeding 1-2-3 features several articles on breastfeeding and breast cancer:

~ Leaking Breast Milk after Surgery for Breast Abscess or Lumpectomy
~ Breast Self-Exams in Lactating Women
~ Video Demonstration of Breast Self-Exam
~ Promising Anti-Cancer Powers of Breast Milk
~ Breast Cancer Testing: X-rays, Mammograms, Ultrasounds, Cat Scans
~ Breastfeeding after Chemotherapy, Radiation and Lumpectomy
~ Breastfeeding Reduces Cancer Risk
~ One-Sided Nursing with Full Supply

Post from: Breastfeeding 1-2-3

While there are many resources online for dealing with breastfeeding initiated after surgery, it is much more difficult to find anything on healing from a lumpectomy or surgery for a breast abscess on a lactating breast. Consultation of several sources of information revealed that there are many options — good ones — for the breastfeeding mother. Armed with information, a mother in this situation can talk to her medical providers for advice and make the best decision for her.

Here is my understanding about healing after surgery on a lactating breast:

1. Continued breastfeeding can be beneficial because it helps prevent engorgement and mastitis (breast infection). By contrast, binding the breast risks complicating the healing with a breast infection.

2. If milk ducts are cut during the surgery, leaking is to be expected.

3. Breast milk has antimicrobial and healing properties that actually can help the wound heal. The leaking breast milk can help keep the area clean and avoid infections common to open wounds.

4. In the case of leaking breast milk, healing takes place from the inside out (rather than from stitches or glue sealing the wound). It helps to understand that healing takes considerably longer (weeks, not days) but that it can happen and not to worry.

5. Gauze can be used to dress the incision. Replace the gauze as needed to keep the area relatively dry (which means replacing it after every feeding, and potentially multiple times in between feedings as necessary). Try to tape the dressing on consistently so that the sides and edges of the wound stay in the same proximity.

6. Consider whether a low-dose prophylactic antibiotic would be helpful. Factors might depend on worry over infection, the mother’s tolerance for antibiotics, and the mother’s tendency to develop thrush (a yeast infection). If the mother does take antibiotics, she should consider taking probiotics/acidophilus/eating yogurt with live cultures to replenish the good bacteria that can keep her from developing thrush.

7. The mother could cut back to nursing just a few times a day on the affected side (say, morning, noon, and before bed) and that will cut back on the milk flow. It would still be necessary to dress the leaking wound with gauze. Once the wound heals, the mother could try to nurse fully again on that side, keeping in mind that it will take a while for the supply to build back up.

8. One-sided nursing is possible. The mother would need to cut back on nursing on the affected side (slowly, so that she does not develop engorgement or mastitis) and nurse considerably more often on the other side (at least twice as often in the beginning), being sure to watch the baby’s urine and stool output and weight gain, to make sure the baby is getting enough milk. Again she could try to re-lactate on that side once the wound heals. One-sided nursing can result in lopsidedness, which may or may not be bothersome. One solution is to use a mastectomy breast prosthesis when it matters.

9. Weaning completely is also an option. Again the mother would want to do so in a manner that limits her risk of breast infection.

Sources for further reading:

1. The Breastfeeding Answer Book, p. 507 on healing after surgery for a breast abscess.

2. Surgery and the Breastfeeding Mother, from Lactation Education Resources.

3. The following discussions, opinions, and personal stories on the breastfeeding professionals’ email listserv Lactnet: one, two, three, and four.

Post from: Breastfeeding 1-2-3

Jonathan is a two-and-a-half year old nursling with leukemia. You can read his story here. Start with the “my story” page then follow his current progress in the family’s “journal.” Before you go, make sure to leave a supportive comment in “guestbook.”

Can you imagine if a nursing toddler were denied the comfort of breastfeeding during treatment? Remember the controversy over the Ronald McDonald House policy on breastfeeding in public?

Post from: Breastfeeding 1-2-3

“Although there are a few studies that report a decrease in the risk of breast cancer after only three or more months of breast-feeding, the evidence for risk reduction becomes more consistent the longer women breast-feed. The most consistent evidence of a relationship between breast-feeding and the risk of breast cancer has been reported in studies of Chinese women who breast-fed for long periods of time. In these studies, women who breast-fed for a total of six years or more (all children combined) over the course of their lives had as much as a 63% decrease in breast cancer incidence compared to women who never breast-fed.”

For more information on breast health and breast cancer, see these articles:

Breast Self-Exams in Lactating Women
Video Demonstration of Breast Self-Exam
Promising Anti-Cancer Powers of Breast Milk
Breast Cancer Testing: X-rays, Mammograms, Ultrasounds, Cat Scans
Breastfeeding after Chemotherapy, Radiation and Lumpectomy
Breastfeeding Reduces Cancer Risk
One-Sided Nursing with Full Supply

Post from: Breastfeeding 1-2-3

Advantages of Breastfeeding for the Baby:

There is good evidence that breastfeeding reduced infants’ risk of ear infections by up to 50 percent, serious lower respiratory tract infections by 72 percent, and a skin rash similar to eczema by 42 percent. Children with a family history of asthma who had been breastfed were 40 percent less likely to have asthma, and children who were not prone to asthma had a percent reduced risk compared to those children who were not breastfed. The risk of developing type 1 diabetes was reduced by about 20 percent. These benefits were seen in infants who were breastfed for three or more months. Breastfeeding also reduced the risk of type 2 diabetes by 39 percent compared to those who were not breastfed.

The report also found that breastfeeding was associated with fewer episodes of diarrhea during infancy, decreased incidence of childhood leukemia, and decreased deaths from sudden infant death syndrome. The report found no clear relationship between breastfeeding and improvement in IQ. In premature infants, breastfeeding decreased the occurrence of necrotizing enterocolitis, a serious gastrointestinal infection that often results in death.

Advantages of Breastfeeding for the Mother:

For health outcomes in mothers, there is good evidence that women who breastfed their infants had up to a 12 percent reduced risk of type 2 diabetes for each year they breastfed. Breastfeeding decreased the risk of ovarian cancer by up to 21 percent. Breastfeeding also decreased the risk of breast cancer by up to 28 percent in those whose lifetime duration of breastfeeding was 12 months or longer. Women who did not breastfeed their infants were more likely to have postpartum depression, but unmeasured factors such as depression that was undiagnosed prior to giving birth may have increased the rate of depression seen in this group. Breastfeeding did not increase the risk of fractures due to osteoporosis. The effect of breastfeeding on a woman’s weight could not be determined based on the available studies.

I didn’t need any additional reasons to breastfeed but I sure am happy to read all the findings of this report!

Post from: Breastfeeding 1-2-3

Even when RMH administrators were reminded of the Texas law protecting breastfeeding in public, they refused to change their unwritten policy restricting breastfeeding to private rooms. They cited a need to respect all of the multicultural residents staying at RMH. I’m not sure what that means, given that mothers around the world breastfeed their children and Americans seem to be among the most prudish about breastfeeding in public.

Jessica felt threatened with being asked to leave (and having to find other accommodations) if she continued to breastfeed in the common area. That fear is very real as unfortunately the law in Texas has a loophole that makes it appear that mothers can be asked under the criminal trespass law to leave a private location. Can you imagine having the stress of caring for a critically ill child be compounded with having to deal with such harassment?

This story highlights the importance of proposed legislation in Texas that would close that loophole. The legislation currently remains pending in committee. If you’re from Texas, please consider writing to your local representatives about this story and your support for the current bill.

The Reluctant Lactivist has been following the story closely with updates here and here. The latest word is that after a face-to-face meeting, the family has been allowed to breastfeed in the communal area as long as Jessica first informs others in the room that she is going to breastfeed, and that the breastfeeding is done discreetly (whatever that means) and that not too many people complain. For goodness sake, what an unsatisfactory and wishy-washy resolution. It’s an okay outcome for the family for now, but it certainly doesn’t bring about the type of change that clearly is necessary. As such, the family has asked that lactivists continue to contact RMH administrators to encourage them to change their unwritten policy. The Reluctant Lactivist states:

“Please, now, write to Naomi Scott, Ronald McDonald House Houston Executive Director and insist that she call for an immediate change in policy, welcoming breastfeeding in all public areas of RMH Houston and make plans to educate all RMH employees about the importance of providing breastfeeding friendly accommodations. Please send copies of your letters to Susie Richard, RMH Houston Director of Operations and to Arlene Whatley, Hollcombe House Director of Operations. If you can, please fax a copy of your letter to Ronald McDonald House Charities headquarters, 630.623.7488, or call 630.623.7048 to register your concern about this situation in Houston. Let them know that families across North America are appalled by what’s happening to this family and demand immediate resolution.”

Post from: Breastfeeding 1-2-3

VideoJug: How to Become Breast Self Aware

Should you and your doctor decide further testing is necessary, see X-Rays and Mammograms for Lactating Women.

Post from: Breastfeeding 1-2-3

First, some fast facts about breastfeeding and cigarette smoke:

~ It is far from ideal to smoke and breastfeed–but it is worse to smoke and not breastfeed. (1)

~ The half-life of nicotine is two hours, meaning that two hours after smoking a cigarette, half of the nicotine released into the body remains in the body. (2)

~ Nicotine decreases production of prolactin, the hormone that stimulates milk production. (3), (4)

~ Maternal smoking cuts breast milk production at two weeks postpartum from 514 milliliters per day to 406 milliliters per day. (5) (Breastfeeding counselors may wish to ask mothers with low supply whether they are smokers).

~ Mothers who smoked before, during, and after pregnancy were 2.18 times more likely not to breastfeed at 10 weeks. Women who smoked 10 or more cigarettes per day postpartum were 2.3-2.4 times more likely to wean their infants before 10 weeks than were nonsmokers. (6) (Remember, exclusive breastfeeding is recommended for 24 weeks and breastfeeding is recommended for at least 52 weeks total).

~ Women who quit smoking during pregnancy were more likely to breastfeed for six months or longer. (7)

~ The breast milk of mothers who smoked during pregnancy contained less of the healthy fats (total lipids and fatty acids) than milk produced by non-smokers. (8)

Second, if you want to see the voting results of the companion poll “Cigarette Smoking and Breastfeeding,” click here.

Third, in this article I’ll answer the questions: Should a smoker breastfeed? What are the effects of nicotine on the baby? How does secondhand smoke affect a baby? Can a nursing mother use smoking cessation medications and products? Where can I find resources on quitting smoking?

Should a smoker breastfeed?
The short answer is yes. The long answer is that a mother who smokes should continue to breastfeed and ideally should attempt to quit smoking. Some mothers may mistakenly believe that if they are smoking it’s better for their babies if they switch to formula. In reality, smoking and formula-feeding is the worst case scenario.

What are the effects of nicotine on the baby?
Breastfed babies of smokers are more likely to experience colic (excessive crying) compared to breastfed babies of nonsmokers. (4)

Also, the Australian Breastfeeding Association notes:

Nicotine is an appetite suppressant and can alter the taste of breastmilk. Babies may express their distaste for the milk by fussing and struggling at the breast or even refusing the breast. If the mother smokes more than 15 cigarettes a day, infants can exhibit symptoms of nicotine poisoning (Bisdom 1937). These symptoms may include vomiting after a feed, grey skin colour, loose stools, an increased heart rate and restlessness. Classically, the infant can be observed to wiggle and squirm, giving the appearance of trying to frantically ‘tread water’ and though they appear very tired they seem to find it hard to keep their eyes shut. Symptoms are slowly reversed when the mother decides to cut back or quit her previous smoking habit. However, infants may also suffer withdrawal symptoms such as sleep disturbances, headaches and irritability.

How does secondhand smoke affect a baby?
The Australian Breastfeeding Association says:

Babies who are “smoked over” are more likely to be hospitalised and to suffer from respiratory and gastrointestinal illnesses. Studies show that these infants are more likely to be colicky and irritable and to experience a wide range of problems from apnoea (short periods when the baby stops breathing), vomiting, poor growth, squint (strabismus, cast or lazy eye), hearing impairment and unexplained death. Smoking depresses the immune system, leaving both the mother and infant more vulnerable to infection, allergy and other immunodeficiency problems (Minchin 1991).

Can a nursing mother use smoking cessation medications and products?
Always consult with your doctor about the safety of any medication for you and your breastfed baby. The general answer is yes, the nicotine patch, nicotine gum and the nicotine inhaler are compatible with nursing. (These items are marketed under the trade names Habitrol, Nicoderm, Nicorette, Prostep, Nicabate, and Nicotinell TTS).

One of the foremost experts on medications and mothers’ milk states:

[T]he absolute infant dose of nicotine and its metabolite cotinine decreases by about 70% from when subjects were smoking or using the 21 mg patch to when they were using the 7 mg patch. In addition, use of the nicotine patch had no significant influence on the milk intake by the breastfed infant. Undertaking maternal smoking cessation with the nicotine patch is, therefore, a safer option than continued smoking.

(2), (9). Note that it’s dangerous to use the patch and continue to smoke–the combination of the two sources of nicotine results in extremely high levels of nicotine which can harm the baby.

While the patch provides a continual low-dose level of nicotine, the gum has a rapid effect on nicotine levels. Therefore, it’s best for women to breastfeed immediately before chewing the gum, then wait another two to three hours before breastfeeding again after chewing the gum.

Where can I find resources for quitting smoking?
There are several on-line resources for quitting smoking. I’ve also linked to one of many books on the subject (the American Lung Association’s book got a five star review from all its reviewers as of the writing of this article).

American Cancer Society’s Guide to Quitting Smoking

American Lung Association’s Resources on Quitting Smoking

Center for Disease Control’s Tobacco Information and Prevention Source

National Cancer Institute’s Quitting and Prevention Help and Information

Nicotine Anonymous (a 12-step fellowship program)

SmokeFree.gov

Smoking Cessation Leadership Center

Sources:
(1) Minchin M.K. “Smoking and breastfeeding: an overview.” J. Hum. Lact. 1991 Dec.;7(4):183-8.

(2) Hale, Thomas W. Ph.D., Medications and Mothers’ Milk, 12th edition, Texas: Hale Publishing (2006), p. 645.

(3) Benowitz N.L. “Nicotine replacement therapy during pregnancy.” JAMA 1991;266(22):3174-3177.

(4) Matheson I., Rivrud G.N. “The effect of smoking on lactation and infantile colic.” JAMA 1989; 261(1):42-43.

(5) Hopkinson J.M. et al. “Milk production by mothers of premature infants: influence of cigarette smoking.” Pediatrics 1992; 90(6):934-938.

(6) Liu J., Rosenberg J.D., Sandoval A.P. “Breastfeeding duration and perinatal cigarette smoking in a population-based cohort.” Am. J. Public Health. 2006 Feb. 96(2):309-14.

(7) Giglia R.C., Binns C.W., Alfonso H.S. “Which women stop smoking during pregnancy and the effect on breastfeeding duration.” BMC Public Health. 2006 Jul. 26;6:195.

(8) Agostoni C. et al. “Earlier smoking habits are associated with higher serum lipids and lower milk fat and polyunsaturated fatty acid content in the first 6 months of lactation.” Eur. J. Clin. Nutr. 2003 Nov. (57)11:1466-72.

(9) Ilett K.F. et al. “Use of nicotine patches in breast-feeding mothers: transfer of nicotine and cotinine into human milk.” Clin. Pharmacol Ther 2003; 74(6)516-524.

Post from: Breastfeeding 1-2-3

1. The “nutrition” posts: Nursing moms want to know whether they can consume chocolate and caffeine and garlic and spicy foods.

2. The “celebrity” posts: Celebrity-watchers were interested in the Fake Photo of Elizabeth Vargas Breastfeeding and how Jennifer Garner Credits Breastfeeding for Weight Loss.

3. The “breast milk 101″ post: The Amazing Ever-Changing Breast Milk.

4. The “Mom-to-Mom” post: Your favorite mom-to-mom question was What Do I Do When One Side Produces More? This post also earns the distinction of having the most comments.

5. The “starting solids” post: Many mothers wanted more information on Starting Your Baby on Solid Foods: When, What and How. See what been-there-done-that mothers chose for their babies’ first solid food.

6. The “fertility” post: Learn about the Lactational Amenorrhea Method of birth control in Are You Willing to Risk Getting Pregnant Again So Soon?

7. The “breast cancer” post: It both breaks my heart and brings me joy that women are looking for information on Breastfeeding after Breast Cancer Treatment.

8. The “carnival” posts: Naturally the blog carnival posts got a lot of traffic. Check out Cost-Effective Gifts for the Breastfeeding Mother and Ten Tips for Breast Health (about how to prevent plugged ducts and mastitis).

9. The “how to” posts: How to Sew Your Own Baby Sling and How to Make Your Own Nursing Necklace, plus nursing necklace safety considerations and a free necklace design and step-by-step instructions.

10. The “nurse-in” posts: Lactivists enjoyed reading about Emily Gillette, the woman kicked off a Delta flight for breastfeeding her baby, and the national nurse-ins that took place in support of her. Read more about the press coverage and the final rally tally, and view some pictures from one of the nurse-ins.

Post from: Breastfeeding 1-2-3

Catharina Svanborg thought that she already knew how remarkable breast milk is. The immunologist had logged hundreds of lab hours documenting ways in which human milk helps babies fight infections. But when the group decided to use cancerous lung cells to avoid the variability shown by normal cells in laboratory tests, Svanborg and her team at Lund University in Sweden were in for a surprise. They applied breast milk to the cancerous lung cells, and all the cells died. Breast milk killed cancer cells.

Once Svanborg stumbled upon this discovery, her team set about to discover which component in breast milk was the cancer-killer. It turned out that the “assassin” was the protein alpha-lactalbumin, which turned lethal when combined with acid. Svanborg named the acidified protein “HAMLET” (human alpha-lactalbumin made lethal to tumors). HAMLET kills 40 different kinds of tumor cells in lab dishes, and human trials of HAMLET for treatment of bladder cancer look “very good” and show no side effects.

Pharmaceutical companies are developing the cancer-fighting breast milk component for clinical use. Clinical studies will reveal whether breast milk constitutes a powerful cancer treatment. Wouldn’t that be amazing? I don’t find it surprising — scientists have long known about potent antibodies in breast milk. However, much remains to be learned about the true protective properties of human milk, and I find this discovery fascinating!

Post from: Breastfeeding 1-2-3