AIDS Awareness ribbons; Photo by Subhadip Mukherjee

WHO now recommends that breastfeeding continue until the infant is 12 months of age, provided the HIV-positive mother or baby is taking ARVs during that period. This will reduce the risk of HIV transmission and improve the infant’s chance of survival.

2. CNN reports on the on-going story of the group of women who stepped in to breastfeed an infant when his mother passed away after giving birth. It’s been 11 months that baby Moses has been nursed by over 20 women. The baby’s father, Robbie Goodrich, said, “It’s been such an incredible outpouring of community love for this child of mine.”

3. Sinead at BreastfeedingMums covers the tragic story of a mother who fell asleep sitting up while breastfeeding her baby and accidentally smothered the child. As Sinead says, it’s important to pay attention to the guidelines for safe co-sleeping.

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Photo courtesy of Nicolas Raymond

1. Heart health for breastfeeding mothers. A study of 140,000 post-menopausal women revealed several heart health benefits of breastfeeding. Women who breastfed their babies had lower incidence of diabetes, high blood pressure and high cholesterol. Women who breastfed for seven months or more were significantly less likely to develop heart disease. Women who breastfed for a cumulative 12 months or more in their lifetimes had a 10% lower incidence of heart attack, stroke, or heart disease later in life.

2. Lower risk of breast cancer for women with family history. The New York Times reported on a new study that found that “for women with an immediate relative, like a mother or a sister, who had breast cancer, those who breast-fed had a 59 percent lower risk of premenopausal breast cancer. That is closer in line with the risk for women who had no disease in the family.” The discovery was made by Dr. Alison M. Stuebe of University of North Carolina. The Motherwear Breastfeeding Blog features a podcast with Dr. Stuebe on the problem with formula company diaper bags.

3. Stem cells in breast milk. Scientists have discovered three different types of stem cells in breast milk. Researcher Dr. Mark Cregan believes the stems cells help each child “fulfill its genetic destiny” as the mother’s breasts take over from the placenta in guiding the infant’s development. This discovery not only highlights the fact that artificial milk is a poor substitute for breast milk, but also opens the door to research on causes of low milk production and drugs that could improve milk supply.

4. Breastfeeding helps prevent multiple sclerosis relapse. A study showed that women who breastfed exclusively for at least two months after giving birth were far less likely to experience a relapse of multiple sclerosis than women who did not breastfeed or started supplemental feedings with artificial milk.

5. Breastfeeding benefits for both baby and mother. In November the American Dietetic Association released an updated position paper promoting and supporting breastfeeding. The paper listed the breastfeeding benefits for babies as:

* Enhanced immune system
* Reduced risk for nonspecific gastroenteritis, severe lower respiratory tract infections and asthma
* Protection against allergies and intolerances
* Promotion of correct development of jaw and teeth
* Association with higher intelligence quotient and school performance through adolescence
* Reduced risk for chronic disease such as obesity, type 1 and 2 diabetes, heart disease, hypertension, hypercholesterolemia and childhood leukemia
* Reduced risk for sudden infant death syndrome.

The paper also listed the breastfeeding benefits for mothers:

* Strong bonding with infant
* Increased calorie expenditure, which may lead to faster return to pre-pregnancy weight
* Faster shrinking of the uterus
* Reduced postpartum bleeding and delays in the menstrual cycle
* Decreased risk for chronic diseases such as type 2 diabetes, breast cancer and ovarian cancer
* Improved bone density and decreased risk for hip fracture
* Decreased risk for postpartum depression
* Enhanced self-esteem in the maternal role
* Time saved from preparing and mixing formula
* Money saved from not buying formula and increased medical expenses associated with formula feeding.

Post from: Breastfeeding 1-2-3

Just a Few Weeks Early
Breastfeeding Challenges in Late-Preterm Infants

Marianne Neifert, M.D.

Until recently, babies born a few weeks early — between 34 and 36 weeks gestation — were referred to as near term infants. However, the designation, near term, implies that an infant is almost term or almost fully mature, and the misnomer has often caused health professionals and parents to underestimate the medical risks in this large, vulnerable population of infants. Recently, the American Academy of Pediatrics has recommended that infants born at 34, 35, or 36 weeks gestation be referred to as late-preterm infants to emphasize that these babies are physiologically immature and have special health care needs compared to full term infants (born between 37 to 41 weeks). In addition, the mothers of late-preterm infants are more likely to have medical complications themselves, such as gestational diabetes, high blood pressure, or C-section delivery.

The Rising Incidence of Late-Preterm Births

The proportion of all U.S. births that are late preterm has increased over the past 15 years. Late-preterm infants now comprise over 9% of all births, and account for more than 70% of all preterm births (<37 weeks gestation), representing nearly 400,000 babies each year. Although the reason for the increase in late-preterm deliveries is not well understood, one explanation is the increased use of fertility treatments, which has lead to a rise in pregnancies with twins and higher multiples. Half of all twins and 90% of all triplets are born preterm. Other possible contributors to the rise in late-preterm births include the rise in cesarean section births (now 30% of all deliveries), the need to deliver some infants early due to medical complications, and more pregnancies occurring among women at an older age. In addition, performing elective labor inductions or elective cesarean sections for no clear medical or obstetrical reason sometimes leads to the unintentional delivery of a late-preterm infant. Both expectant mothers and obstetricians need to know the importance of avoiding late-preterm delivery unless it is medically necessary.

Medical Complications among Late-Preterm Infants

Because many late-preterm babies are the size of infants born at full term, health care professionals may not always give these at-risk infants the special treatment and careful screening they deserve. Instead, hospital personnel and parents tend to treat these apparently healthy infants as if they were developmentally mature. Late-preterm infants have been called imposter babies because many of these “slightly early” newborns masquerade as full-term infants, appearing to need no special care after birth and being discharged as early as term babies. Yet, babies born even a few weeks early have an increased risk of medical complications after birth and may require a longer hospital stay than full-term infants. Late-preterm infants are more likely to develop low blood sugar, severe jaundice, breathing difficulties, and infections; to have difficulty maintaining their body temperature; and to experience feeding problems and excessive weight loss after birth. Late-preterm infants also are more likely to be re-admitted to the hospital in the early weeks of life for medical complications, including newborn jaundice, breastfeeding difficulties, dehydration, and possible infections.

The brain and nervous system are among the last systems to mature during fetal development, and some studies show that late-preterm infants have a higher risk of developmental and behavioral problems compared to full-term babies. Late-preterm infants also have a higher rate of birth defects and an increased risk of sudden infant death syndrome. For all these reasons, late-preterm infants require close monitoring, evaluation, and follow-up after birth.

Breastfeeding Challenges among Late-Preterm Infants

The initiation of successful breastfeeding can be especially challenging for smaller, developmentally immature, late-preterm infants. These babies often have trouble latching on to the breast correctly and may be unable to breastfeed effectively at first because of their lower muscle tone and tendency to tire easily. Inadequate breastfeeding increases a newborn’s risk for severe jaundice and excessive weight loss.

Providing your baby with skin-to-skin contact immediately after birth and as often as possible while you are rooming-in will help promote infant feeding behaviors and successful breastfeeding. Your hospital lactation consultant can offer valuable assistance with your breastfeeding technique during your hospital stay. Sometimes, using an ultra-thin, soft silicone nipple shield can help your late-preterm baby latch on and stay attached to your breast. Ask to be referred for extra help with breastfeeding after discharge, since it often takes several weeks for a late-preterm infant to be able to breastfeed effectively.

Late-preterm infants seldom are able to drain their mother’s breasts well at first. Ineffective breastfeeding not only increases a baby’s risk of medical complications, a mother’s milk supply can rapidly decrease if her baby removes little milk. If you deliver a late-preterm infant, you can help assure that you bring in and maintain an abundant milk supply by using an effective electric breast pump to express the extra milk your infant leaves behind after breastfeeding. Removing the milk remaining after your baby nurses is known as “insurance pumping” or “prevention pumping” because it helps keep your milk supply generous until your infant is big enough and mature enough to drain your breasts well on her own. Having an abundant milk supply also helps your immature, smaller, less-vigorous baby obtain more milk when she attempts to breastfeed because she can “drink from a fire hydrant” instead of having to work hard to get enough milk. Furthermore, the extra milk you remove with the pump makes the ideal supplement if your baby temporarily requires supplemental feedings. Your surplus pumped milk can be stored for later use (in the refrigerator for 3-5 days; in a separate door freezer for at least 3 months; in a deep freezer for at least 6 months).

After you go home from the hospital, arrange to have your baby followed closely and weighed often to monitor her progress with breastfeeding. Her first pediatric visit should occur 24-48 hours after discharge. A lactation consultant or your baby’s doctor periodically can weigh your baby (identically clothed) before and after breastfeeding to measure how much milk she drinks and monitor her progress with breastfeeding. As your baby matures and gains weight rapidly and becomes able to breastfeed effectively, you gradually can decrease your pumping regimen. Your extra investment of time and effort to safeguard breastfeeding in the early weeks after your baby’s birth will pay off in a thriving infant and a plentiful milk supply that will set the stage for a long-term successful breastfeeding experience.

©2009 Marianne Neifert, M.D., author of Great Expectations: The Essential Guide to Breastfeeding

Marianne Neifert, M.D., author of Great Expectations: The Essential Guide to Breastfeeding, also known as Dr. Mom®, is a popular pediatrician, nationally recognized expert in breastfeeding management, and celebrated author of child-rearing books and magazine articles. In 1985, Dr. Neifert co-founded the Lactation Program in Denver — one of the very first community breastfeeding centers in the nation, sponsored by the Colorado Health Foundation. She is also clinical professor of pediatrics at the University of Colorado Denver School of Medicine. A long-time leader in the field of breastfeeding medicine, Dr. Neifert is a co-founder of the Denver Mothers’ Milk Bank, founding member of the American Academy of Pediatrics Section on Breastfeeding, the International Lactation Consultant Association, and the Health Advisory Council of La Leche League International. Dr Neifert has addressed audiences in forty-six states and has been a guest on countless radio shows and national television programs, including Today, Good Morning America, The Early Show, 20/20 and CNN. She has written for numerous publications, including Parenting, BabyTalk, American Baby, and ParentLife.

For more information please visit http://www.dr-mom.com/

Post from: Breastfeeding 1-2-3

Photo by Anselm

One way would be to point to the scientific studies that back up the safety of home birth. I was so happy to see news of a study showing that home births are safer than hospital births for low risk pregnancies. Yes! Shout it from the rooftops! Do more studies! Spread the word!

Have you seen the movie? What are your thoughts? Have you heard word about when the book the sequel will be released?

P.S. My husband read this post and wants to say the following: “People who are planning a hospital birth can benefit from watching the movie too because it points out common mistakes that hospitals make such as pushing epidurals and other pain medications and unnecessary interventions such as pitocin. The movie can help women and their partners manage the care in the hospital and avoid common pitfalls in hospital births that taint the experience.” (I love that man — he reads my blog AND agrees with me!)

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Photo by Joana Croft

Post from: Breastfeeding 1-2-3

http://www.who.int/nutrition/publications/infantfeeding/WHO_NHD_00.1/en/index.html – see page 10 + 11

Breastmilk does not provide complete nutrition for the second six months of life. I am all for full term breastfeeding (I am still feeding my 18 month old), but I think it is fair to point out that the energy gap between what a baby needs and what breastmilk can provide gets wider from about 6 months.

There are other important nutrients which are also needed – iron stores from birth run out at around six months, so it’s important for babies to get some iron from other foods.

While I think that many doctors are ill informed and try to bully us into pushing solids before the baby is really ready, it’s important for parents to be informed of the facts, so they can make an informed decision.

Baby who resisted rice cereal (Photo by LizaWasHere)

As I replied in the comments section:

“In general I agree that it’s a good idea to start solids around 6 months of age and I certainly believe every mother should do her own research and consult a doctor for medical advice.

When a baby resists solid food and/or has a family history of allergies or shows signs of severe and numerous food allergies, some mothers choose to rely on breast milk for the baby’s sole (if not “complete”) source of nutrition. Kellymom.com says: “Some babies are exclusively breastfed for a year (and occasionally up to two years) with no problems at all. In addition, some doctors recommend that babies with a high risk for allergies be exclusively breastfed for a year.”

Kellymom also notes: “The current research indicates that a baby’s iron stores should last between six and twelve months, depending upon the baby.” Your comment implies that there is no iron in breast milk, although perhaps that is not what you intended. The good news on iron is that “up to 50% of the iron in human milk can be absorbed by the infant, as compared to 10% in cow’s milk, and 4% in iron-fortified formulas.” (LLL fact list). Some (many?) babies might need an additional source of iron (from solid food or vitamin supplements) at some point after 6 months, but not all babies will.

The points I hope to make are that parents need not worry quite as much as some seem to about getting solids into a baby, that breast milk continues to provide the bulk of nutrition, that it’s not always a good idea to push solid food when the baby resists or has allergies, and that there is anecdotal evidence (and perhaps more) that some babies thrive on breast milk alone for up to one year and even beyond.”

Your Thoughts?

Did anyone reading this delay (or stop feeding) solid foods after six months of age? What was your experience and reasoning?

Post from: Breastfeeding 1-2-3

Posing with Dr. Bob Sears after his lecture

La Leche League conferences are great because children are welcome at the lectures. As I chased my 10-month-old around the back of the room (until she finally fell asleep in the sling as you can see above), I managed to take in a lot of valuable information from the lecture. Dr. Sears discussed the occurrence and severity of various childhood illnesses, how vaccinations have affected the prevalence of those illnesses, toxins in vaccines, delayed and alternative vaccination schedules, the debate about vaccines and autism, and how the “same” vaccines vary by manufacturer and brand. I like that he offers an opinion on particular vaccines but does not push vaccination or not vaccinating; it’s all about the parents making an informed decision. If you get an opportunity to hear him speak, it’s well worth it! He stayed long after the lecture ended to answer individual questions, and I took the opportunity to ask him some questions I had about my daughter’s potential reaction to the rotavirus vaccine.

One tip that’s not in The Vaccine Book: Making the Right Decision for Your Child: be wary of any future swine flu vaccination developed for humans. I plan to stay tuned to Dr. Bob’s blog for The Vaccine Book for the latest information on that and other vaccines.

Post from: Breastfeeding 1-2-3

Photo courtesy of Furya

Thus, the CDC urges new mothers to initiate breastfeeding early and to feed frequently. Mothers already breastfeeding should continue to do so, even if they become ill. Formula feeding should be avoided or minimized and breastfeeding maximized. In the Health News Digest, USBC Chair Joan Younger Meek, MD, MS, RD, FAAP, FABM, IBCLC, recommends breastfeedng in emergency situations such as a swine flu outbreak:

Research clearly shows that breastfeeding provides a safe, reliable food source, full of disease-fighting cells and antibodies that help protect infants from germs and illnesses. Mothers exposed to influenza produce specific protection for their infants and transmit this through their breast milk. Infant formula does not provide these specific infection fighting properties. Unnecessary formula supplementation should be eliminated so the infant can receive as much benefit as possible from maternal protective antibodies and other immune protective factors.

Key points from the CDC swine flu guidance include:

1. If a mother is ill with swine flu, she should continue breastfeeding and feed the baby more often. If she is too ill to feed at the breast but can pump, expressed breast milk should be fed to the baby. The risk of transmission of the H1N1 virus through breast milk is unknown, but reports of transmission of the regular, seasonal flu through breast milk are rare.

2. If the baby becomes too ill to feed at the breast, he should receive the mother’s expressed breast milk or donated human milk from a non-profit milk bank.

3. Antiviral medication treatment and prophylaxis are compatible with breastfeeding.

4. All usual precautions against virus transmission should be taken, including hand washing and covering coughs and sneezes.

Post from: Breastfeeding 1-2-3

RotaTeq rotavirus vaccine

Two days after my baby received the vaccine, she started having mild diarrhea. I didn’t think much of it, until 12 hours later when she threw up (and I earned a Mommy Medal by catching it in my hand, thankyouverymuch!) The next day, she spiked a fever of over 102. I am not worried for her. She is generally content and just a bit sleepy. Thank goodness for breastfeeding, which keeps her both hydrated and happy!

I am not “pro-vaccine” or “anti-vaccine.” I am all about the informed decision. I fully recognize that my daughter might not actually have rotavirus, or that she might have rotavirus but have contracted it from a source other than the live vaccine. I do feel though that this diarrhea, vomiting, and fever constitute a potential adverse reaction to the vaccine.

I called the pediatrician to ask her to report my daughter’s reaction to the FDA and CDC using the Vaccine Adverse Event Reporting System (VAERS). Anyone can report to the VAERS but the site suggests asking the doctor for help. At any rate I wanted to mention to the family practitioner what I had learned about the timing of the vaccine. Unfortunately, the call did not go well. I would love it if all doctors would practice the following three phrases:

I don’t know.

I will find out.

I am sorry.

I was not upset; I used a nice voice. When the doctor insisted that only the first dose of the vaccine needs to be given before 32 weeks, I gently reiterated my understanding that it’s actually the last dose that needs to be given before 32 weeks.

No one is perfect. I made a mistake. The pediatrician made a mistake. Let’s learn from our mistakes. In fact, let’s write a blog post about it so others can learn from our mistakes.

Your Thoughts

Has your child ever had a potential adverse reaction to a vaccine? Do you vaccinate fully, not at all, or on a delayed and selective basis?

Post from: Breastfeeding 1-2-3

Photo courtesy of crimfants

Notes on the picture explain that this baby weighed 22 pounds and change at six months of age! Fast forward about six years, and this is the skinny, cute little kid that baby grew up to be!

Photo courtesy of crimfants

Post from: Breastfeeding 1-2-3