Here are some highlights for May, just in case you missed them:

1. Get the scoop on breastfeeding, anti-depressants, and alternative treatments for depression.

2. A new study shows breastfeeding may cut rheumatoid arthritis risk in half.

3. Check out the poll results on where mothers are giving birth (more than you might think are giving birth at birth centers or at home!) Don’t forget to vote in the new poll on co-sleeping!

4. The crafty among you might enjoy a free pattern for knitting your own nursing tank top.

5. Find out about the latest study to weigh in on the debate over breastfeeding and its impact on children’s intelligence.

Breastfed babies are less likely to have certain cardiovascular disease (CVD) risk factors in adulthood than their bottle-fed counterparts, researchers reported at the American Heart Association’s Scientific Sessions 2007.

“Breastfeeding babies offers them long-term heart-health benefits,” American Heart Association news, November 5, 2007.

Fascinating news out of Perth, Australia, as researchers report that human breast milk contains stem cells that potentially could be harvested to treat all manner of injuries and diseases. ScienceAlert quotes molecular biologist Dr. Mark Cregan:

We already know how breast milk provides for the baby’s nutritional needs, but we are only just beginning to understand that it probably performs many other functions.

Journalist Catherine Madden sums up Dr. Cregan’s theory on the “developmental guidance” that he believes breast milk provides:

He says that, in essence, a new mother’s mammary glands take over from the placenta to provide the development guidance to ensure a baby’s genetic destiny is fulfilled.

Dr. Cregan explains:

The point is that many mothers see milks as identical – formula milk and breast milk look the same so they must be the same. But we know now that they are quite different and a lot of the effects of breast milk versus formula don’t become apparent for decades. Formula companies have focused on matching breast milk’s nutritional qualities but formula can never provide the developmental guidance.

In the coming years scientists will attempt to harvest the stem cells from breast milk for research, thereby avoiding the ethical dilemma of harvesting stem cells from human embryos. Then it will be seen whether the stem cells in breast milk can be “reprogrammed” to form different types of human tissue.

Thanks so much to Kelley for the tip on this amazing story!

Is intelligence determined by nature or nurture? The latest breastfeeding study reveals that nature (genetic makeup) and nurture (breastfeeding) work together to develop a child’s IQ. In children with a particular variant of the FADS2 gene (as 90% of children have), breastfeeding increases intelligence. Breastfed children with the gene variant score an average of seven points higher on intelligence tests than their formula-fed counterparts. For a geneticist’s take on this news, read the clear explanation offered by Dr. Hsien-Hsien Lei at Eye on DNA.

Think hand expression is unnecessary or too difficult? Dr. Jane Morton offers a free video that demonstrates how to teach mothers (or how to learn for oneself) the technique for hand expression of breast milk. When I interviewed Dr. Morton last March, she mentioned new research that suggests that hand expression used in conjunction with pumping in the first three days is much more effective in promoting subsequent milk production than pumping alone. She said if women were taught to hand express in the first three days after giving birth, their milk production could be boosted significantly and fewer women would experience problems (or unnecessary worries) over low milk supply. In the video, Dr. Morton explains that mothers separated from their babies have been shown to produce 80% more milk by using hand expression more than five times each day in the first three days in addition to using the electric pump!

Dr. Morton is Director of Breastfeeding Medicine at Lucile Packard Children’s Hospital (LPCH) and a Clinical Professor at Stanford University School of Medicine. Along with other breastfeeding resources, she offers the seven-minute 33-second video in free streaming video format at LPCH’s Newborn Nursery site, or copies may be purchased through the email address mentioned on that page. Note that it takes a fast internet connection and a little patience to see the entire video. When the video froze occasionally, I needed to manually advance and rewind through those sections to see the entire thing. It’s worth it though!

The American Academy of Pediatrics reports today that there is no link between breastfeeding and early childhood tooth decay. A new study examined data from the 1999-2002 National Health and Nutrition Examination Survey for children aged two to five. Several factors were considered, including oral health and infant feeding. The study “Association Between Infant Breastfeeding and Early Childhood Caries in the United States” found no tie between dental caries and breastfeeding, including prolonged breastfeeding. What was found to increase the risk of dental caries? Maternal smoking. That’s one more piece of information to add to the growing list of facts on cigarette smoking and breastfeeding.

Welcome to September’s Carnival of Breastfeeding (see this month’s entries below)! As a parent I understand how hard the parenting job is. That is why I have a general philosophy of “I’ll do what works for my family and you do what works for yours.” There are just two issues I feel very strongly about: (1) (not) spanking, and (2) whether or not to let a child “cry-it-out” (”CIO”). While there are different methods, names, and sleep trainers out there (Ferber, Ezzo, controlled crying, crying-it-out, just to name a few), CIO is the general practice of leaving a baby to cry in the hopes that he will settle himself to sleep. For this month’s carnival on Breastfeeding and Sleep, I offer the opinion that CIO, in any shape or form, is not the answer for a good night’s sleep. I do not offer my opinion to bash other parents or to attempt to change someone else’s mind (I have no illusions of succeeding at that). This article is for the breastfeeding mother whose family keeps telling her to “let that baby cry!” against all of her mothering instincts, or for the mother who tried letting her baby cry once and now has regrets or mixed feelings.

One other disclaimer: I do not purport to be any sort of expert on sleep (which is why I quote a lot of actual experts in this discussion!) I have struggled with the sleep issue myself and if you are interested you can crawl through all I have written on the sleep category. However, while I may not have the magic solution to a good night’s sleep, I do know that CIO is not the solution. Fortunately, lots of experts in child care, psychiatry, and pediatrics feel the same way. Here are my opinions along with some science to back them up.

I do not believe: “Night-waking to nurse is a habit, not a need.”
I believe: For the first several months of a baby’s life, night-waking to nurse certainly is a physical need. Babies’ tummies are small and breast milk is digested quickly. Forcing an infant to go too long without nursing can lead to failure to thrive (inadequate weight gain, poor physical and mental development). CIO can be downright dangerous!

Advocates of CIO argue that after a certain age, night-nursing is no longer physically necessary and there’s no “need” for it. While I question that (who among us hasn’t gotten thirsty or hungry in the night, and we’re not still growing!), there are also all kinds of needs: physical, emotional, psychological, developmental, and situational. In an article entitled “8 Infant Sleep Facts Every Parent Should Know,” Dr. Sears describes a baby’s need to be parented to sleep and parented back to sleep. Also, the Australian Association for Infant Mental Health notes in its position paper:

AAIMHI is concerned that the widely practiced technique of ‘controlled crying’ is not consistent with what infants need for their optimal emotional and psychological health and may have unintended negative consequences.

I do not believe: “Babies need to learn to self-soothe.”
I do believe: Why do babies need to learn to self-soothe, exactly? It seems more that the parents need the babies to learn to self-soothe. Babies who night-nurse barely cry, if at all, and often settle back to sleep quickly and peacefully.

Besides, when a baby is made to CIO and the baby falls back asleep, it’s not accurate to say the baby “self-soothed.” Dr. Ben Kim’s site describes a study of children ages one to two who were separated from their mothers and left to cry it out:

Results showed a predictable sequence of behaviours: The first phase, labeled “protest”, consists of loud crying and extreme restlessness. The second phase, labeled “despair”, consists of monotonous crying, inactivity, and steady withdrawal. The third phase, labeled “detachment”, consists of a renewed interest in surroundings, albeit a remote, distant kind of interest. Thus, it appears that while leaving babies to cry it out can lead to the eventual dissipation of those cries, it also appears that this occurs due to the gradual development of apathy in the child. The child stops crying because she learns that she can no longer hope for the caregiver to provide comfort, not because her distress has been alleviated.

I do not believe: “It’s short-term pain for long-term gain.”
I do believe: First of all, I’m not interested in any short-term pain for me or my child. Nor do I believe the pain is short term. Parents who implement CIO often find that they have to do so repeatedly as a child starts to night-wake again during developmental spurts, teething, and illness.

Furthermore, there’s plenty of evidence of long-term harm rather than long-term gain. Psychiatrists at Harvard University researched the long-term effects of CIO and found:

[T]he widespread American practice of putting babies in separate beds — even separate rooms — and not responding quickly to their cries may lead to incidents of post-traumatic stress and panic disorders when these children reach adulthood.

The early stress resulting from separation causes changes in infant brains that makes future adults more susceptible to stress in their lives, say Commons and Miller.

“Parents should recognize that having their babies cry unnecessarily harms the baby permanently,” Commons said. “It changes the nervous system so they’re overly sensitive to future trauma.”

Some scientific researchers believe that leaving a baby to CIO can cause brain damage (that the extreme distress of CIO blocks full development of certain areas of the brain and causes production of cortisol in other areas of the brain).

Contrast such findings with those cited by Dr. James McKenna on the long-term effects of co-sleeping. Studies show that co-sleeping promotes confidence, self-esteem, and intimacy, while children who do not bed-share are harder to control, less happy, throw more tantrums, are more fearful, and here’s the kicker — more dependent on their parents.

Please feel free to share your views on breastfeeding and sleep in the comments. Read on for other views (not necessarily consistent with mine!) on Breastfeeding and Sleep:

~ BreastfeedingMums talks about the sleep advantages of breastfeeding over formula-feeding.
~ Mama’s Magic writes about being “So Tired” and considering the end of co-sleeping.
~ The Motherwear Breastfeeding Blog sings the praises of the side-lying position for breastfeeding.
~ Hathor the Cowgoddess shares a comic on the family bed. (Note that while it’s safe for a toddler to sleep next to a sibling, an infant should not sleep next to an older child, only next to his parents.)
~ Leche, Baby! writes about the process of night-weaning.
~ Veggie Way writes about co-sleeping and letting her baby sleep where she wants.
~ Crunchy Domestic Goddess needs co-sleeping for sanity.
~ Life with Twins writes about her use of crying-it-out.
~ The Lactivist laments how each child has different needs.
~ Mama Knows Breast tells the truth about the reality of sleep deprivation.

A preliminary study determined that the administration of recombinant human prolactin (r-hPRL) to non-lactating women triggered the production of breast milk. Noting that other drugs used to augment lactation can have intolerable side effects, researchers at Massachusetts General Hospital and Harvard Medical School studied the use of r-hPRL in a sample of nine women for one week and determined that it warrants further clinical trials for its use as an agent to augment milk production (see Short-term prolactin administration causes expressible galactorrhea but does not affect bone turnover: pilot data for a new lactation agent. International Breastfeeding Journal, July 24, 2007). That short duration of use did not cause bone turnover or disrupt the menstrual cycle. This is promising news for women who have concerns about domperidone and other drugs currently used to induce lactation or increase milk supply.

New scientific research reveals that choosing organic dairy and meat products over conventional products improves the fatty acid content in breast milk. A recent study (PDF) published in the British Journal of Nutrition examined the diets of 312 breastfeeding women from the Netherlands and collected breast milk samples at one month postpartum. Women who reported that they chose organic dairy and meat products over conventional products at least 90% of the time showed a measurable increase in beneficial fatty acids in their breast milk. The study specifically examined the conjugated linoleic acid isomers (CLA) and trans-vaccenic acid (TVA). The Free Press explains:

CLA is a type of fat that is believed to have anti-carcinogenic, anti-atherosclerotic, anti-diabetic and immune-enhancing effects, as well as a favorable influence on body fat composition. For newborns specifically, CLA is believed to especially aid immune system development.

“These findings provide scientific support for common sense, by showing that organic foods are healthier,” says Dr. Lukas Rist, who is the lead author of the study….

What does this mean for the average breastfeeding mother–is this good news or bad news? What I don’t want to happen is for women who have poor nutrition and/or cannot afford organic foods to think that their breast milk is somehow inferior or inadequate. Breast milk is always superior to f*rmula; it is always better for a mother to breastfeed her baby rather than switch to f*rmula. The Breastfeeding Answer Book notes:

Research from developing countries and other parts of the world indicates that even mothers who are mildly malnourished produce an adequate supply of good quality milk for their babies and that only under famine or near famine conditions will a mother’s nutrition affect her milk supply or the composition of her milk.

So, the good news from this research is that mothers can enhance the already superior nutritional value of their breast milk by choosing organic dairy and meat products over conventional. Lucky for us that Carrie at Natural Moms Talk Radio just wrote a helpful article with money saving tips for eating more organic foods without busting the budget!

Recent studies showed that exclusive breastfeeding for six months reduced the risk of HIV transmission from mother to infant down to four percent, whereas supplementation with artificial milk or solid foods posed three or four times that risk of transmission. In developed countries with access to safe water supplies and artificial baby milk, one might wonder why a mother would risk even a four percent chance of transmission. It’s a vital issue though for mothers in undeveloped countries where there are barriers to safe water and affordable artificial milk and where infants are at significant risk of death from diarrhea and other conditions that breast milk helps prevent and treat.

A study just released today provides promise for eliminating the risk of HIV transmission through breast milk altogether. Researchers found that flash-heating expressed milk killed the HIV. Flash-heating is a form of pasteurization that eliminates harmful elements yet retains many of the beneficial antibodies and nutritional properties of the breast milk. It’s similar to pasteurization methods used in human milk banks yet it can be implemented in developing countries with locally-available glass jars, cooking pans and heating elements.

“Many people in this field were skeptical that this would work,” said Barbara Abrams, UC Berkeley professor of epidemiology and maternal and child health, and senior author on the study. “We wanted to be sure that there was scientific evidence that flash-heated milk was truly free of HIV, nutritious and immunologically beneficial. This study was done in response to the concerns of the mothers in Zimbabwe, and in addition provides evidence that field studies are warranted.”

Yang, Sarah. “HIV in breastmilk killed by flash-heating, new study finds.” UC Berkeley News, May 21, 2007.

After the success of this preliminary study, field trials will be conducted in the homes of women in Africa. I can see some people questioning a mother’s ability to hand-express and flash-heat her breast milk, but really, hand-expression is easy to learn and flash-heating seems simple and not very time-consuming at all. Besides, what mother wouldn’t do what it takes to prevent HIV transmission and protect her child from diarrhea and other potentially fatal ailments?