Pediatrician Dr. Bob Sears makes it his business to stay on top of the latest developments and news regarding vaccinations. He is the author of The Vaccine Book: Making the Right Decision for Your Child. He spoke on the topic of vaccines at the La Leche League conference I went to last weekend.

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.

Both the Centers for Disease Control and Prevention (CDC) and the United States Breastfeeding Committee (USBC) have issued strong guidance on the importance of breastfeeding for protection against the H1N1 swine flu. The CDC states, “Infants who are not breastfeeding are particularly vulnerable to infection and hospitalization for severe respiratory illness.”

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.

Researchers have long known that breastfeeding mothers benefit from less incidence of breast and ovarian cancer and type II diabetes than formula-feeding mothers. A new study shows yet more strong correlation between breastfeeding and lower rates of diabetes, heart disease and stroke.

Photo courtesy of Karen Barefoot

Nearly 140,000 post-menopausal women were studied in the Women’s Health Initiative. According to the Vancouver Sun (via One Small Step for Breastfeeding…), the study revealed breastfeeding’s heart health benefits on three levels:

1. Risk Factors. Women who breastfed their babies had lower incidence of the following three risk factors for heart disease: diabetes, high blood pressure and high cholesterol.

2. Cardiovascular Disease. Women who had never breastfed were significantly more likely to develop heart disease than women who breastfed for seven months or more.

3. Heart Attack and Stroke. 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.

Researcher Eleanor Bimla Schwarz, MD told WebMD:

The longer women nursed babies, the less likely they were to develop diabetes, heart disease, or stroke. Any breastfeeding was good, but more was better.

The complete study appears in the May 2009 issue of Obstetrics and Gynecology.

What’s the free postpartum contraceptive option for women? It’s called the Lactational Amenorrhea Method (LAM). I have written about the pros and cons of LAM before, so this time I want to highlight a comprehensive article on LAM (PDF) offered for free by USAID Global Health eLearning Center and the ACCESS Family Planning Initiative.

A little birth control humor by Treyevan

Test your knowledge of how alcohol affects breast milk with these 8 questions! The trivia was derived from studies compiled on the LactMed database as of April 2009. For information about drinking and breastfeeding, see this article on alcohol and the controversial Milkscreen test. For current information on drugs and lactation, visit the LactMed database.

Photo by Steve Woods

1. Nursing after 1 or 2 drinks (including beer) causes the infant to:
a) increase milk intake.
b) decrease milk intake.
c) Milk intake remains unaffected.

2. Nursing or pumping within one hour before ingesting alcohol:
a) does not affect the level of alcohol in the milk.
b) increases the level of alcohol in the milk.
c) decreases the level of alcohol in the milk.

3. Breastmilk alcohol levels are:
a) the same as blood alcohol levels.
b) higher than blood alcohol levels.
c) lower than blood alcohol levels.

4. While food consumption can delay the peak of breastmilk alcohol levels, the peak generally occurs:
a) one hour after ingestion of alcohol.
b) two hours after ingestion of alcohol.
c) three hours after ingestion of alcohol.

5. When a baby nurses after a mother consumes alcohol, the baby sleeps:
a) better.
b) worse.
c) the same.

6. True or false: The American Academy of Pediatrics rates alcohol as “usually compatible with breastfeeding.”
a) True.
b) False.

7. What minimum level of alcohol consumption affects infants negatively and is associated with shortened duration of breastfeeding?
a) Any alcohol consumption.
b) Casual alcohol consumption (1 drink per day).
c) Daily heavy use (more than 2 drinks daily).

8. One study estimated that a breastfed infant received a certain percentage of the mother’s weight-adjusted dosage of alcohol when she consumed 1.5 drinks. That percentage was:
a) between 0.5 to 3.3% of the mother’s weight-adjusted dosage.
b) between 3.3% to 5.0% of the mother’s weight-adjusted dosage.
c) between 5.0% to 8.3% of the mother’s weight-adjusted dosage.

The Answers

1. b. Nursing after 1 or 2 drinks can decrease the infant’s milk intake by 20 to 23% in the 3-4 hours after ingestion of alcohol. However, the infants increase the number of feedings over the next several hours and total milk consumption over 20 hours is the same. Smart babies!
2. c. Nursing or pumping within one hour before drinking alcohol may slightly decrease the amount of alcohol in the milk.
3. a. Breastmilk alcohol levels closely parallel blood alcohol levels.
4. a. Breastmilk alcohol levels peak approximately one hour after ingestion of alcohol, although food consumption can delay the peak.
5. b. Babies slept more frequently for shorter periods of time during the 3.5 to 4 hours after alcohol intake.
6. a. True, the AAP category is “usually compatible with breastfeeding.”
7. c. Heavy drinking is dangerous. Casual drinking is unlikely to cause short- or long-term effects particularly if the mother waits 2 to 2.5 hours per drink before nursing.
8. a. The study showed the breastfed infant received between 0.5 to 3.3% of the adjusted dose.

How did you do? What surprised you the most?

Up to 10% of women experience thyroid problems after giving birth. Postpartum thyroiditis causes fluctuating thyroid hormone levels, first with a period of hyperthyroidism (overactive thyroid with excess thyroid hormone) which might then resolve back to normal or dip into a period of hypothyroidism (low thyroid function). Note that this is different from postpartum Graves’ Disease, which is autoimmune hyperthyroidism in which antibodies attack the thyroid and cause it to overproduce thyroid hormone. Read more

Myth: Breastfeeding chains mothers to a nursing chair for endless hours and smothers them with the weight of a nursing pillow and a needy baby. It’s a burden, a sacrifice made by martyr mothers for the health of their babies (and the health of the mothers, if that is even recognized at all). Reality: Let me tell you what appears to be a well-kept secret. How can I put this? Oh yeah. Breastfeeding is awesome! Sure the health benefits for baby and mother are great, and the secondary benefit of being able to soothe a tired, cranky, or hungry baby is great too. The little-celebrated additional benefit is that breastfeeding also gives mothers the freedom to do activities that they enjoy! Read more

Shortly after my neighbor had her third child, she complained that she kept forgetting things. She couldn’t recall the right word for an object or couldn’t remember the name of the movie she watched the week before.

Photo of three German sisters by Kai Sender

She actually worried that she was suffering from early onset dementia. Well, now that I’ve had my third child, I can assure her that it’s not early onset dementia, it’s third child syndrome! In the last three days, I have forgotten:

1) the name of that television show filmed in Ireland, the one about the Catholic priest tempted by the spunky townswoman, the one I watched for five out of six seasons (it’s Ballykissangel, of course!)

2) the name of that annual flower that comes in orange or yellow, the one that butterflies like (duh, it is the marigold), and

3) the name of the root vegetable that is a little like water chestnut, kind of bland but nice and crunchy, you peel it like a potato and eat it raw (jicama!)

Third child syndrome frustrates me to no end! I had to write down the above list of three things I had forgotten, for fear that I would forget the list! I think it’s just that the mother of three children constantly must check the needs of her children — is the homework done for tomorrow, when did the toddler last have a bath, does the baby’s diaper need changing, and so on and so on. There simply isn’t room left in the brain for extraneous facts such as the Spanish word “jicama” for the Mexican potato, also known as the Mexican turnip. Ask me next week and I probably won’t even remember I wrote this post.

Remember when I interviewed Dr. Jane Morton about breastfeeding education for medical professionals? Remember when I mentioned her free online video on hand expression of breast milk? Well today I learned from About.com Breastfeeding that Dr. Morton has another fascinating free video online, this time about increasing breast milk supply when it is necessary to pump for a baby in the NICU or any baby not nursing well at the breast. It is called “Maximizing Milk Production” and in 9 minutes 35 seconds, it explains how to increase milk supply without medication. Dr. Morton recommends and demonstrates such techniques as skin-to-skin contact, breast massage, “hands-on pumping,” breast compressions, and hand expression after pumping. What was really amazing to me was to see how much milk mothers were able to hand express after a pumping session!

From The Breastfeeding Answer Book:

Caused by postpartum hemorrhage so severe that the blood loss irreversibly damages the pituitary gland, Sheehan’s syndrome can cause breastfeeding failure. Other symptoms include loss of pubic and underarm hair, inability to tolerate cold, low blood pressure, and atrophy of vaginal tissue, as well as subsequent infertility.

p. 569. For more see:

~ Birthsource.com
~ “Infant Insufficient Milk Syndrome Associated with Maternal Postpartum Hemorrhage” (abstract) from the Journal of Human Lactation