|
It is unprofessional for healthcare providers, including
lactation consultants, to put a bare finger in your baby's
mouth. There is no way to sterilize underneath the
fingernails, and many, many women carry yeast under their
nails. Thrush is a yeast infection in the baby's mouth and
mother's breast ducts that can be very painful for both mother and
baby; it is easily transmitted by bare fingers in the mouth.
Every professional should don gloves before putting fingers in the
baby's mouth or touching the mother's breast. If the baby is less
than 24 hours, then the gloves should be sterile, so as not to
interfere with the baby's colonization of skin and gut from mom's
flora.
Corrolary:
If you want baby's mouth to go on mom's breast, then bare
fingers shouldn't touch mom's breast either!
Breast Milk Stem Cells: Current Science and Implications for
Preterm Infants
Carrie-Ellen Briere 1, Jacqueline M McGrath, Todd Jensen, Adam
Matson, Christine Finck
Review Adv Neonatal Care. 2016 Dec;16(6):410-419. doi:
10.1097/ANC.0000000000000338.
Implications for practice: There is much to learn about breast
milk stem cells. Given the potential impact of this research,
healthcare professionals should be aware of their presence and
ongoing research to determine benefits for infants.
Implications for research: Extensive research is needed to further
characterize stem cells in breast milk (full-term and preterm),
throughout the stages of lactation, and most importantly, their
role in the health of infants, and potential for use in
regenerative therapies.
ACOG's
Breastfeeding Toolkit - It's about
time! Don't underestimate the power of making
it easier for OBs to bill for breastfeeding care. This may
be all the impetus they need to pursue the necessary training.
The
USBC e-Newsletter, Staying
Abreast, is published in a weekly news brief format,
called the Weekly Wednesday Wire. Past
issues are archived on the USBC website. [Ed: They also
get my award for Best Newsletter Name - Staying Abreast.
Wow! Kudos to the one who thought that up!]
Health Care Reform Boosts Support for Employed Breastfeeding Mothers
Breastfeeding Rooms at Work—It's the Law
The new health care bill that President Obama signed into law may
make life for working and nursing moms a little easier. With
support from the U.S. Breastfeeding Committee, who outlined the
provisions in the law, employers (with more than 50 employees)
will be required to provide "a place, other than a bathroom, that
is shielded from view and free from intrusion from co-workers and
the public, which may be used by an employee to express breast
milk." That's good news! This new measure gives mothers more
incentive and support to continue breastfeeding after returning to
work. Learn more by reading the
full text of the bill.
The impact of
traumatic birth experiences on breastfeeding.
Lack
of
breastfeeding
costs
lives,
billions
of dollars - If most new moms would breastfeed their babies
for the first six months of life, it would save nearly 1,000 lives
and billions of dollars each year, according to a new study
published Monday in the journal Pediatrics.
Working
Moms Have New Breastfeeding Rights Under the ACA (8/6/14) -
Under the Affordable Care Act, employers must provide time and
space for new mothers to express milk for their babies until the
child turns one year old.
The lives of nearly 900 babies would be saved each year, along with billions of dollars, if 90 percent of U.S. women breast-fed their babies for the first six months of life.
Published online April 5, 2010
PEDIATRICS (doi:10.1542/peds.2009-1616)
The
Burden
of
Suboptimal
Breastfeeding
in
the United States: A Pediatric Cost Analysis
Melissa Bartick, MD, MSca, Arnold Reinhold, MBAb
Conclusions Current US breastfeeding rates are suboptimal and result in significant excess costs and preventable infant deaths. Investment in strategies to promote longer breastfeeding duration and exclusivity may be cost-effective.
Peaceful
Revolution:
Motherhood
and
the
$13
Billion Guilt by Melissa Bartick
This great article explains the difference between a birth
environment and healthcare system that is truly supportive of
breastfeeding and the
one that is common in most places in the U.S. today. Then it
asks, "Do you feel guilty for not breastfeeding? Or do you
feel angry because it didn't have to be this way? "
Engorgement and edema in breast tissue can lead to breastfeeding
challenges which may contribute to early weaning. . . . Women who
received IV fluids during labour had higher levels of edema
postpartum and rated their breasts as firmer as and more tender
than women who did not receive IV fluids.
Mother's
milk made to order for boys, girls - "Mothers are producing
different biological recipes for sons and daughters," says Katie
Hinde, an evolutionary biologist at Harvard University.
Studies in humans, monkeys and other mammals have found a variety
of differences in both the content and the quantity of milk
produced. One common theme: baby boys often get milk that is
richer in fat or protein - and thus energy - while baby girls
often get more milk.
The results challenge both dogma and data linking supplementation with early weaning, call into question the Joint Commission’s exclusive breastfeeding quality metric, and will no doubt inspire intimations of a formula-industry conspiracy. Before we use this study to transform clinical practice, I think it’s worth taking a careful look at what the authors actually found.
I hate to be cynical, but is it possible that this is related to
the financial relationship between the AAP and the makers of
Enfamil formula?
It has come to my attention that the AAP has contracted with Mead Johnson to provide AAP-branded materials as part of the formula manufacturer’s maternity discharge pack!
The A.A.P. has a financial relationship with several companies that manufacture formula. Enfamil’s maker, Mead Johnson, currently supports a grant for the academy’s educational perinatal pediatrics conferences, conducted for training physicians specializing in newborn care. Mead Johnson also supports the organization’s annual Neonatal Education Awards. Abbott Nutrition, the maker of Similac, is another big supporter of the A.A.P., donating toward the academy’s journal, Pediatrics in Review, through an educational grant. The Nestlé Nutrition Institute, the parent company of the infant formula maker Gerber, funds the American Academy of Pediatrics’ Healthy Active Living for Families program.
Ultrasound
reveals breastfeeding mechanics - Although it might look
like a baby is chewing on the mother's nipple, ultrasound images
show that the infant actually removes milk by sucking
To
Succeed At Breast-Feeding, Most New Moms Could Use Help by Nancy
Shute [9/23/13]
Will
my insurance cover a lactation consultation?
Sign On to Support Breastfeeding: A Vision for the Future! from The United States Breastfeeding Committee (USBC)
The Vision is aimed to increase awareness of the importance of breastfeeding and these nine crucial objectives that must be met in order to fully address the barriers faced by mothers:
1. Meet and exceed the Healthy People objectives to increase the
proportion of mothers who breastfeed.
2. Implement maternity care practices that foster normal birth and
breastfeeding in every facility that cares for childbearing women.
3. Ensure that health care providers provide evidence-based,
culturally competent birth and breastfeeding care.
4. Create and foster work environments that support breastfeeding
mothers.
5. Ensure that all federal, state, and local laws relating to
child welfare and family law recognize the importance of
breastfeeding and support its practice.
6. Implement curricula that teach students of all ages that
breastfeeding is the normal and preferred method of feeding
infants and young children.
7. Reduce the barriers to breastfeeding imposed by the marketing
of human milk substitutes.
8. Protect a woman’s right to breastfeed in public.
9. Encourage greater social support for breastfeeding as a vital
public health strategy.
David Stark is working on a breastfeeding
DVD, which promises to be fabulous! Check out the
preview!
Everyone interested in breastfeeding should be familiar with the work of Dr. Nils Bergman about "Kangaroo Mother Care." As he says, "breastfeeding is brain wiring".
Kangaroo Mother Care Promotions aims to promote the spread and implementation of Kangaroo Mother Care as the standard method of care for all newborn babies, both premature and full term. This is the website of Dr. Nils Bergman.
mymilkies.com offers a
milk saver for milk dripping from the "other" breast.
Research in human lactation is sometimes rather limited by a shortage of eligible volunteers. This registry has been developed to provide the scientific community with a registry of potential volunteers for studying human lactation under special circumstances. These circumstances include certain medical conditions, problems with lactation, and use of specific drugs during breastfeeding. Women who are currently breastfeeding, and/or women planning to breastfeed after delivery, are included in this registry.
They are looking for moms with:
Hepatitis C
Hepatitis B
Cystic Fibrosis
"Suspected Yeast Infections of Nipple"
Insufficient Milk Supple
Persistent plugged ducts (>3/week)
Polycystic Ovarian Syndrome
Milk coagulates on storage
Planned Pregnancy while lactating
Chronic breast pain
Raynaud's of the nipple
Breast implants
Breast reduction
Fibrocystic breast disease
Galactocele
Rusty-pipe syndrome
Pathological breast engorgement
Infant with PKU
Lactation failure of unknown origin
Growth faltering after 4-6 months
or who are taking :
Celexa (citalopram)
Enbrel (etanercept)
Fenugreek
Flagyl (metronidazole)
Interferons (Betaseron, etc)
Lamictal ( lamotrigine)
Lithium
Milk thistle
Motilium (domperidone)
Neurontin (gabapentin
Paxil (paroxetine)
Prilosec (omeprazole)
Prozac (fluoxetine)
Reglan (metoclopramide)
Relafen (nabumetone)
Ritalin (methylphenidate)
Sage
St. John's Wort
Vioxx (rofecoxib)
Zoloft (sertraline)
Gerber has a 24-hour breastfeeding hotline with a Lactation
Educator - 1-800-4-GERBER, i.e. 1-800-443-7237
|
Breastfeeding exclusively for 6 months, breastfeeding for at least a year, and breastfeeding for "as long as mutually desired by mother and child,"
Instituting Baby-Friendly practices in hospitals such as skin-to-skin contact at birth, supplementation only when medically necessary, no provision of formula samples or coupons,
Training FPs so that they can educate women about breastfeeding and provide breastfeeding mothers appropriate care.
Motherwear's
Breastfeeding Blog Podcasts
Reducing Infant Mortality and Improving the Health of Babies - this is a 15-minute, landmark video seminar about improving maternity care in the United States.
"In the US, after taking away the preterm babies, after taking
away babies that had cancers and heart defects and things like
that, babies who were fed anything other than breastmilk had about
a 60% increase in death as compared to those that were breastfed."
The International Lactation
Consultant Association (ILCA) is the professional
association for International Board Certified Lactation
Consultants (IBCLCs) and other health care professionals who care
for breastfeeding families.
Our local lactation consultant raves about these products:
snappies makes bottles (80 ml i think) to pump into, with attached caps. they actually make a tight seal with medela pump, unlike medela's own bottles. tight seal really seems to make a difference.
pumpinpal makes flanges that fit into medela or ameda flanges. they are angled so a mom can sit back a little, vs having to sit upright. 3 different sizes, very reasonable prices.
simple wishes is a great pump bra - adjustable in several different ways so no need to buy another bra or use safety pins or other things.. and only $35. great product.
i know in a perfect world we'd all love to see all babies nurse
nurse nurse. but when getting supply/keeping supply going is
important and will help a mom keep going - glad there are good
products.
THE BABY'S PERSPECTIVE
- "A course for experienced doulas, RN's, LVN's, LC's, CLE's &
Infant Care Specialists who have been working as doulas for a
while and want to learn the baby's perspective." Started by
Kittie Frantz, RN, CPNP-PC
She has written a book incorporating the new information we have about Laid-Back Breastfeeding or Biological Nurturing:
Benefits Of Breastfeeding Outweigh Risk Of Infant Exposure To Environmental Chemicals In Breastmilk
ScienceDaily (Dec. 20, 2008) A study comparing breastfed
and formula fed infants across time showed that the known
beneficial effects of breastfeeding are greater than the potential
risks associated with infant exposure to chemicals such as dioxins
that may be present in breastmilk, according to a new report.
This compelling study encompassed an historical review of the
medical literature and included time periods when levels of
environmental chemicals were higher than they tend to be at
present.
The authors of the report, Judy LaKind, PhD (LaKind Associates,
Catonsville, MD), Cheston Berlin, Jr, MD (The Milton S. Hershey
Medical Center, PA), and CAPT Donald Mattison, MD (National
Institutes of Health), advise health care providers to continue to
encourage new mothers to breastfeed their babies. In agreement
with the World Health Organization's (WHO's) continuing support of
breastfeeding, this study's findings, based on epidemiologic data,
do not downplay the adverse effects of exposure to dioxins and
other environmental toxins. However, the authors distinguish
between the statistical significance of risk/benefit assessments
in an individual compared to population effects.
"When breastmilk was chosen by regulatory agencies as a handy
medium for measuring environmental toxins, the public became
alarmed that breast milk was contaminated. The authors, eminent
authorities on the subject have put these fears to rest," says
Ruth A. Lawrence, MD, Editor-in-Chief of Breastfeeding Medicine,
from the Department of Pediatrics, University of Rochester School
of Medicine and Dentistry.
More
Breast-Feeding Could Save Billions and Prevent Thousands of
Breast-Cancer Cases [6/7/13]
ABCs
of Breastfeeding - a nice pictorial guide. Thank you
to Dr. Jane Morton at Stanford and her team.
Hand Expression of Breastmilk - great video with Jane Morton, chair of the Stanford Department of Breastfeeding Medicine. They have a nice section on Getting Started with Breastfeeding.
Report from PH at the breastfeeding conference, 200:
"Jane Morton, MD (she developed the Breastfeeding Medicine Program at Stanford) - spoke about increasing milk supply. She says that "hands-on pumping" - her term for expression/compression during pumping - will greatly increase supply, and that babies find it easier to learn to nurse if milk flows and that volume is the determinant of flow.
First 3 days - hand express and feed with spoon. When baby at breast - "compress compress compress" - it wakes the baby up to spur him to keep sucking. her analogy: we help babies learn to walk by holding their hands, we help them learn to ride bikes by holding the bike - we should help them learn to nurse!
her website for step by step teaching about Hand Expression of Breastmilk and Maximizing Milk Production with Hands On Pumping
useful products: Cryovial by Econo-Lab, Inc.
easyexpression.com for
halter top
new pump bra available in may - adjustable. www.simplewishes.com
video:
"Making Enough Milk"
www.breastmilksolutions.com
Also - another reminder about lightbulbs/glasses that block blue
lights at night. "
How to Nurture a Mother -
Mothers need to be nurtured so they can nurture their
newborn. A mother who isn't resting and eating/drinking well
is more likely to have breastfeeding problems. If you're
trying to help a family member or friend with breastfeeding
issues, start with bountiful nurturance.
NOTE - Dr. Jack Newman has moved his website to ibconline.ca/
Dr. Jack Newman is perhaps the best expert on
breastfeeding. He and Teresa Pitman have co-written The
Ultimate
Breastfeeding
Book
of
Answers
: The Most Comprehensive Problem-Solution Guide to Breastfeeding
LACTATION
MEDICINE PROGRAM - The International Breastfeeding Centre’s
Centre for Breastfeeding Education provides the Lactation Medicine
Program. The program offers high quality lactation education made
up of a theoretical component and an optional practical component.
Dr. Newman's
Breastfeeding Handouts / Information Sheets and Video
Clips by Dr. Jack Newman
Breastfeeding - Starting Out Right
Is My Baby Getting
Enough Milk?
The
CDC Guide To Breastfeeding Interventions offers guidance to
policy and program professionals in selecting promising
breastfeeding promotion and support activities. [June, 2005]
Inspired by a recent article in the Herald Sun (Australia)
reporting that young women are reluctant to breastfeed their
babies due to fear of public embarrassment, the Holistic Moms
Network has launched a new project to highlight the beauty and
confidence of breastfeeding women. HMN members from across
North America submitted photos of themselves proudly breastfeeding
their children – everywhere from the Eiffel Tower to the Brooklyn
Bridge – for the Nursing
Our Future video featured on the organization’s website. [Or
try YouTube]
Efficacy
of
breastfeeding
support
provided
by
trained clinicians during an early, routine, preventive visit: a
prospective, randomized, open trial of 226 mother-infant pairs.
Labarere J, Gelbert-Baudino N, Ayral AS, Duc C, Berchotteau M,
Bouchon N, Schelstraete C, Vittoz JP, Francois P, Pons JC.
Pediatrics. 2005 Feb;115(2):e139-46.
This study provides preliminary evidence of the efficacy of
breastfeeding support through an early, routine, preventive visit
in the offices of trained primary care physicians. Our findings
also suggest that a short training program for practicing
physicians might contribute to improving breastfeeding outcomes.
Multifaceted interventions aiming to support breastfeeding should
involve primary care physicians
The Milky Way, the newsletter of MOMS
Making Our Milk Safe (MOMS),
the parent organization
LLL Breastfeeding
Helpline -- US - The breastfeeding community throughout the
United States has access to a 24 hour toll free helpline service
by calling 1-877-4-LALECHE (1-877-452-5324). This helpline
provides information, education, and support for women who want to
breastfeed, and to healthcare providers and others.
Common Sense Breastfeeding -
Breastfeeding carries with it a whole series of built-in
instincts, and it makes sense to listen to them. These pages may
help you hear yourself.
CAM Region 3 Meeting Notes on Breastfeeding
from Ami Burnham - April 16, 2010
Laughter
improves breast milk's health effect - FAMED for its
restorative powers, it now seems that laughter also helps breast
milk to fight skin allergies. Breastfed babies with eczema
experienced milder symptoms if their mothers laughed hours before
feeding them, according to a study by Hajime Kimata at the
Moriguchi-Keijinkai Hospital in Osaka, Japan.
Welcome to Mom's
Breastaurant! - At Mom’s Breastaurant our mission is to
promote a breastfeeding culture by giving breastfeeding moms a
safe, comfortable, clean place to nurse during outdoor events such
as street fairs, festivals, and concerts. Our tents are
temperature controlled, have comfortable chairs and offer clean
diaper changing stations.
The Academy of Breastfeeding
Medicine
I love this
t-shirt
for mamas that reads, "I Make Milk - What's Your Super
Power?" Right on!!!
Why
African Babies Don't Cry by J. Claire K. Niala (12/31/10)
"My Grandmother's gentle wisdom:
1. Offer the breast every single moment that your baby is upset –
even if you have just fed her.
2. Co-sleep. Many times you can feed your baby before they are
fully awake, which will allow them to go back to sleep easier and
get you more rest.
3. Always take a flask of warm water to bed with you at night to
keep you hydrated and the milk flowing.
4. Make feeding your priority (especially during growth spurts)
and get everyone else around you to do as much as they can for
you. There is very little that cannot wait.
Read your baby, not the books. Breastfeeding is not linear—it goes
up and down and also in circles. You are the expert on your baby's
needs."
And, of course, how could we go through life without a Dr. Seuss-style verse about breastfeeding:
Would you nurse her at the park?
Would you nurse him in the dark?
Would you nurse him with a boppy?
And when your boobs are feeling floppy?,
etc.
Mandy
&
Matt:
A
solution
for
breastfeeding attachment through co-bathing by Midwifery
Birthing Services - Shows how the techniques can be adapted and
used when mother and baby are having problems establishing
breastfeeding. If the first hours after birth have been disturbed
and mother and baby have not been able to learn together how to
breastfeed, resulting problems can be corrected by creating the
conditions that trigger the innate reflexes in the baby, thus
enabling the baby to relearn how to find the nipple, attach and
suck successfully.
Babies have mirror neurons (also called mimc neurons) that cause them to mimic others' actions. So if you want your baby to open the mouth in a nice, wide gape to latch on, show your baby what you mean, and really stretch that mouth wide open!!! (Yes, this is the basis for the old "monkey see, monkey do" truism!)
Neural
mechanisms of imitation.
Iacoboni M.
Curr Opin Neurobiol. 2005 Dec;15(6):632-7. Epub 2005 Nov 3.
Does
continuity
of
care
by
well-trained
breastfeeding counselors improve a mother's perception of
support?
Ekstrom A, Widstrom AM, Nissen E.
Birth. 2006 Jun;33(2):123-30.
" . . . the mothers were more satisfied with emotional and
informative support during the first 9 months postpartum. The
results lend support to family classes incorporating continuity of
care."
A
Mother's Feelings for Her Infant Are Strengthened by Excellent
Breastfeeding Counseling and Continuity of Care
Anette Ekström, PhD, RNM and Eva Nissen, PhD, RNMTD
PEDIATRICS Vol. 118 No. 2 August 2006, pp. e309-e314
(doi:10.1542/peds.2005-2064)
CONCLUSION. . . . guaranteed continuity of care strengthened the
maternal relationship with the infant and the feelings for the
infant.
LLLI
Responds to AAP Policy Statement on Sudden Infant Death Syndrome
Massachusetts
Breastfeeding
Coalition's
Response
to
AAP
SIDS Recommendations
Breastfeeding
Is
Associated
with
a
Lower
Risk of SIDS According to The
Academy
of
Breastfeeding
Medicine
How to Find Lactation Consultants
15 Years
After Innocenti Declaration, Breastfeeding Saving Six Million
Lives Annually - Unicef Press release [22 November 2005] –
Six million lives a year are being saved by exclusive
breastfeeding, and global breastfeeding rates have risen by at
least 15 per cent since 1990.
Clinical Protocols
from The Academy of Breast
Feeding Medicine
Breastfeeding
Rates
in
US
Baby-Friendly
Hospitals:
Results of a National Survey
Anne Merewood, MA, IBCLC*,{ddagger}, Supriya D. Mehta, PhD,
MHS§, Laura Beth Chamberlain, BA, IBCLC{ddagger}, Barbara L.
Philipp, MD*,{ddagger} and Howard Bauchner, MD, MPH*,||
PEDIATRICS Vol. 116 No. 3 September 2005, pp. 628-634
(doi:10.1542/peds.2004-1636)
Conclusion. Baby-Friendly designated hospitals in the United States have elevated rates of breastfeeding initiation and exclusivity. Elevated rates persist regardless of demographic factors that are traditionally linked with low breastfeeding rates.
Here's the list of Baby-Friendly
Hospitals and Birth Centers.
Nurse-N-Glow Pillow - an all-in-one night-time nursing aid. Seems like a great shower gift to me, and no, I'm not making any money off this recommendation . . . I'm just *so* impressed that someone would design something that is so obviously designed to make nightime nursing and co-sleeping easier. Thank you!!!
Wow! I can't believe I'm raving about this product because
it's not the bells and whistles that produce the breastmilk, but
it seems really well designed and really, really useful!
Back Buddy® maternity support
pillow is an award-winning back support pillow, designed by
a Chiropractor and a mother of three.
I really like that it's made in the USA from non-toxic
materials. And I think the small arm rests on the side are
brilliant. However, I take issue with their implications
that you need this for breastfeeding. In fact, this pillow
is incompatible with sidelying and laid-back-nursing
positions. However, many first-time moms need to start with
upright breastfeeding for the first few days, at least, and this
could help alleviate the back and shoulder soreness that is
common. It also MIGHT help the moms remember to bring the
baby to the breast, rather than the other way around. I do
worry that it's incompatible with wrap-around nursing pillows such
as My Brest Friend and the Boppy Pillow.
Breast
is
Best,
but it Could Be Better: What is in Breast Milk That Should Not
Be? [Medscape registration is free] This article
provides many helpful tips about avoiding toxic chemicals that
could be passed to your baby through breastmilk. [NOTE - Compounds
found
in
air
in
the
home could pose more of a health risk to breast-fed babies
than chemicals they are exposed to through their mother's milk,
researchers in the United States said on Tuesday. They found
that a nursing infant's exposure to gases known as volatile
organic compounds (VOCs) from indoor air was 25-135-fold higher
than from breast milk.]
Levels
of
Lead
in Breast Milk "Quite Low" Even With High Maternal Lead Exposure
AAP Releases Revised Breastfeeding Recommendations (Feb., 2005)
The policy recommendations include:
* Exclusive breastfeeding for approximately
the first six months and support for breastfeeding for the first
year and beyond as long as mutually desired by mother and child.
* Mother and infant should sleep in proximity
to each other to facilitate breastfeeding;
* Self-examination of mother's breasts for
lumps is recommended throughout lactation, not just after weaning;
* Support efforts of parents and the courts to
ensure continuation of breastfeeding in cases of separation,
custody and visitation;
* Pediatricians should counsel adoptive mothers
on the benefits of induced lactation through hormonal therapy or
mechanical stimulation.
* Recognize and work with cultural diversity in
breastfeeding practices
* A pediatrician or other knowledgeable and
experienced health care professional should evaluate a newborn
breastfed infant at 3 to 5 days of age and again at 2 to 3 weeks
of age to be sure the infant is feeding and growing well.
Of particular interest to midwifery and natural childbirth advocates are changes from the 1997 policy. In particular, the policy includes as additional ways to support breastfeeding avoiding procedures that interfere with breastfeeding or traumatize the infant, including unnecessary, excessive and overvigorous suctioning of the oral cavity etc. Under immediate postpartum care, health care professionals are urged to allow skin to skin contact immediately upon delivery and continuing until the first feeding is completed. The policy states that a few assessment measures can be accomplished while the newborn is with the mother and lists others that should be delayed (weighing, measuring, bathing, etc.) until after the first feeding, and that the mother is an "optimal heat source for the infant." These policy statements are right in line with what midwives already try to do!
Breastfeeding
and
the
Use
of
Human
Milk - Policy Statement from the AAP Section on Breastfeeding
PEDIATRICS Vol. 115 No. 2 February 2005, pp. 496-506
(doi:10.1542/peds.2004-2491)
Breastfeeding
and
the
use
of
human
milk from the National Guideline Clearinghouse, and a version highlighted by
a lactation consultant.
In addition to its many known bonding and health benefits, breastfeeding appears to lower the risk of a baby dying during its first year of life, US research indicates. "Breastfed infants in the United States have lower rates of morbidity, especially from infectious disease, but there are few contemporary studies in the developed world of the effect of breastfeeding on postneonatal mortality," the researchers observe. To address this issue, Aimin Chen and Walter Rogan, from the National Institute of Environmental Health Sciences in North Carolina, analyzed data from the 1998 National Maternal and Infant Health Survey. They compared breastfeeding patterns between 1204 infants who suffered postneonatal death-between 28 days and 1 year of age, for reasons other than cancer and congenital anomaly-and 7740 who were still alive aged 1 year. Children who had ever been breastfed were 21 percent less likely to die during the postneonatal period than those who had never been breastfed, and the risk declined with increasing duration of breastfeeding. In addition, the level of protection provided by breastfeeding varied with cause of death, ranging from an odds ratio of 0.59 for injuries to 0.84 for sudden infant death syndrome. Chen and Rogan conclude that "assuming causality... promoting breastfeeding has the potential to save or delay approximately 720 postneonatal deaths in the USA each year."
We have known for a long time that breastfeeding offers very
significant health advantages to babies and children. It is
time that the evaluation of all aspects of perinatal care
integrate this factor in assessing safety. For example,
homebirth is exemplary in promoting breastfeeding . . . there is
no separation of mother and baby as observation of unstable
newborns takes place right in mother's arms, suctioning that might
affect breastfeeding is kept to the minimum necessary for safety,
and babies aren't subjected to the hospital germs which could make
them sick and unable to nurse. The
negative effects of circumcision on breastfeeding must also
be considered a specific danger of circumcision.
Fentanyl during labor may impede breastfeeding
The impact of intrapartum analgesia on infant feeding
Sue Jordana, Simon Emeryb, Ceri Bradshawa, Alan Watkinsc Wendy
Friswellb
BJOG: An International Journal of Obstetrics & Gynaecology
112 (7), 927-934.
Conclusions A dose response relationship between fentanyl
and artificial feeding has not been reported elsewhere. When
well-established determinants of infant feeding are accounted for,
intrapartum fentanyl may impede establishment of breastfeeding,
particularly at higher doses.
Breast milk protects against diarrhea [10/25/04] - The Journal of Pediatrics 2004; 145: 297-303
Research findings suggest another positive reason for mothers to breast-feed their babies.
Oligosaccharides in breast milk can help to protect infants
against diarrhea, researchers have found, providing more evidence
in support of breast-feeding.
Milk storage diminishes antioxidant activity [10/25/04] - Archives of Disease in Childhood Fetal and Neonatal Edition 2004; 89: F518-20
Assessing the effect of storage conditions on the antioxidant content of human and formula milk.
Breast milk loses its antioxidant activity if stored for longer than 48 hours, study findings indicate, although refrigeration is better than freezing and thawing in this regard.
N. Hanna (Robert Wood Johnson Medical School, New Jersey) and co-workers measured the antioxidant activity of a range of human term and preterm milk, as well as five brands of formula milk, stored for different periods at various temperatures.
Fresh human milk had the highest antioxidant capacity of all the samples, irrespective of whether the mother had delivered prematurely or at term.
Furthermore, fresh human milk had significantly higher antioxidant activity than all formula milks tested.
With respect to storage of human milk, however, antioxidant
activity was reduced if milk was kept at either -20°C or
4°C.
Few Mothers Meet Breastfeeding Goals, Study Shows - 8/5/04 - Only 14 percent of U.S. mothers exclusively breastfeed their babies for the minimum recommended six months, according to government data released on Thursday.
I personally find this statistic incredibly shocking. Breastfeeding is arguably the most important way to protect a baby's health, yet our healthcare system is doing so little to support it. We have routine separation of mothers and babies in hospitals and the pushing of all sorts of interventions that are harmful to the breastfeeding relationship but are supposedly done for the baby's own good. I don't think so!
In homebirth practices, the breastfeeding rate is over 95%.
These lucky babies will get immeasurable benefits beyond the 20%
reduction in mortality. Why doesn't our healthcare system
support midwife-attended-homebirth as the surest way to protect a
baby's health?
It still amazes me that hospitals cannot provide breastfeeding
support 24 hours/day for such a life-saving matter.
But nobody makes money off of healthy babies. This is no
exaggeration. I recently attended a CIMS Forum and was talking
with someone about the title of the talk - "Economic Disincentives
for Mother-Friendly Care," the woman said that they had closed the
highly successful lactation center at her hospital. When she asked
a hospital admin why, that was his reply.
Report warns of continuing violations of code on breast milk substitute marketing - [BMJ 2004;328:1218 (22 May)] - "[T]he Switzerland based company Nestlé was responsible for more violations than any other company,"
http://www.babymilkaction.org/ has lots of information about the worldwide boycott, and they have a list of Nestlé subsidiaries, including the obvious ones like Nescafe, Nesquik and Nestea, but also including some surprising ones - Carnation, Alcon, Purina and Friskies. Breastfeeding.com offers a great handy visual list of Nestlé affiliates.
If I can boycott Nestle, so can you!
If you need more motivation to boycott Nestle, then read breastfeeding.com's Stuff That Will Make You Mad
"Mr Ian Smith of York, gave his account of the company's ethics:
"As one the members of Synod from York, where we have a
significant Nestlé presence, I was invited, before the last
debate on this subject in 1994, to meet some of their directors to
discuss the issue. At that time they freely admitted that they
were the market leaders of a trade that was being mishandled in
some parts of the world. I observed that this resulted in many
thousands of infant deaths. The response was that if they didn't
sell the product someone else would. We've heard that line
with regard to landmines recently: In other words, it's better
that they're killed by our products rather than someone else's.
Nestlé admitted that the business has its unethical side,
but they still push it hard. They say they will stop - if others
do too."
Feedback:
"People need to understand that when they're deciding between
breastmilk and formula, they're not deciding between Coke and
Pepsi... they're choosing between a live, pure substance and a
dead substance made with the cheapest oils available." -Lactation
Consultant Chele Marmet
Some wonderful articles by Sarah J. Buckley, MD, from the section on Mothering - Care of the Newborn at Women of Spirit
Food for Thought - Call It "Early Breastmilk", not Colostrum
I have attended quite a few breastfeeding workshops in the past 3
years and they have all said that the new attitude toward early
breastmilk is NOT to refer to it as colostrum, but to call it what
it is - breast milk. The people from whom I learned this
were (on three occasions) Certified Lactation Consultants.
They were teaching primarily to hospital personnel and were very
concerned about changing the image that the first milk is somehow
not breastmilk. This milk HAS protein and all the other
components which define milk. So it is not something OTHER
than milk.
Falling
in
Love:
The
Chemistry
of
the First Breastfeed
Breastfeeding
and
CranioSacral
Therapy:
When
It
Can Help by Dee Kassing, BS, MLS, IBCLC
Breastfeeding
Foundations for Nurses and Midwives - a fantastic online
course from Australia.
First-Time
Mothers
at
Greater
Risk
of
Breast Abscess [Medscape registration is free]
The
deadly
influence
of
formula
in
America by Dr. Linda Folden Palmer [A Natural Family Online
Special Report:]
The World Alliance for
Breastfeeding Action (WABA) is a global network of
individuals and organisations concerned with the protection,
support and promotion of breastfeeding.
Excerpt
from Nursing the Caesarean Born, by Michel Odent, MD -
Midwifery Today Issue 69
Nursing Family
Newsletter's Resources and Links
Breastfeedingonline.com
hopes to help empower women to choose to breastfeed and to educate
society at large about the importance and benefits of
breastfeeding. - the web site of Cindy Curtis, RN, IBCLC!
Latching
and Positioning Resources from kellymom.com. Great set
of Latch-on
pictures with description
The World of Latch-On: One Leader’s Journey by Diane Wiessinger, MS, IBCLC
"Watch
your language!" By Diane Wiessinger, MS, IBCLC
nursingmother.com now
has online
How-To
videos so that you can see what it looks like when the baby
is on right and what it looks like when you have it wrong.
The International
Lactation Consultant Association offers a great document - Evidence-based
Guidelines for Breastfeeding Management During the First
Fourteen days (1999) - this is a terrific document available
as a FREE download. The guide provides 24 key strategies to guide
health professionals in providing optimal care to mothers and
infants during the crucial first 14 days. [Another link to this
same document.]
Milky Way Press's Breastfeeding
Basics and Beyond(TM) series: Reading
Your Baby's Body Language and Breastfeeding's
Number
One Question:How Will I Know My Baby Is Getting Enough Milk?by
Beverly Morgan,
Lactation consultant, lactation educator, author, speaker.
Welcome
to Lactation Consultant.Info - Breastfeeding Help and
Information from Marie Davis, R N, IBCLC
Best
practice
guide
to
common
breastfeeding
problems from Australia
Feeding
Frenzy
How big business and politics conspire against breastfeeding
mothers
by Maureen Turner - April 15, 2004
IUDs:
Great
Contraceptive,
But
Not
For
Nursing Moms from Dr. Dean Edell
Medications and Lactation: What PNPs Need to Know [Medscape registration is free.]
"Breast milk has consistently been confirmed to provide infants
and children with unique, species-specific nutrients that are
ideal for infants' immune protection, growth, development, and
emotional well-being. Few maternal medications are contraindicated
for lactating mothers and their breastfeeding infants "
Breastfeeding
Pharmacology - from the web pages of Dr. Tom Hale, author of
Medications and Mothers’ Milk
Breastfeeding
Difficulties from ivillage.com
motheringfromtheheart.com
carries a diverse product line, including breast pumps and
specialty feeding devices, such as the Hazelbaker™
FingerFeeder. (The FingerFeeder allows baby to be in
control and pace the feed. It is the only special feeding method
that provides the touch of the human skin. [Ed: Although you would
want to be really sure the human finger doesn't carry yeast!
You don't want to add thrush to an already difficult situation!])
Spectra
seems to be an Australian breast pump manufacturer; their pumps
are starting to become available in the US. From a very
satisfied mom: "spectra s1 is wayyyy better than either medela or
ameda ... I get more ounces, it's portable and way less noisy and
way more comfortable. and it is a closed system which medela is
not."
2010 - Lactation consultants are raving about Hygeia’s breastpumps, including EnJoye™, the only green breastpump.
Gerber has a new Massaging Manual Breast Pump
Encouraging Patients to Use a Breast Pump (after returning to work) - great article from Medscape [Medscape registration is free]
Pumping Moms Information Exchange
White River Concepts - "Medical study rates WRC pump equal to nursing babies for stimulating milk production" - An unusual pump for people who don't letdown to the usual top-of-the-line hospital pumps. It uses compression as well as suction and is much more like baby.
Breast Pump Comparisons - this compares features of some major brands.
Medela has a web page on how
to
find out which breastpump is right for you. And they have a
very helpful rental
location finder.
http://www.hollister.com/us/mbc/breastfeeding/
Motherwear wants to help women like you find the support and confidence to breastfeed whenever and wherever your babies are hungry. Free breastfeeding guides, along with clothes that were designed and made with you and your baby in mind.
Mother's Nature carries Nursingwear, Nursing Bras (Medela, Bravado), Medela Breastpumps and Accessories, Breastfeeding Accessories, Over the Shoulder Baby Holder Sling, Cloth Diapers, Toys, Books for Pregnancy and Childbirth. There are also new Auction Pages!!
NURTURED BABY Organic Cotton Bras, Bravado Nursing/Maternity Bras and Maternity Underwear
Clothes
for the Nursing Mother
Australian
Breastfeeding Association - formerly the Nursing Mothers'
Association of Australia
Breastfeeding.com -
We are here to give you the best in breastfeeding information,
support, humor, news, supplies, advocacy, stories, attitude and
more. [This site has good general breastfeeding information.
They will also send you a lovely poster with the top 12 reasons to
breastfeed.]
BestFed.com -
"Breastfeeding for as long as your child wants to is
probably THE most important thing you can do for the health and
wellbeing of your child after birth."
1998
Breastfeeding Resource Guide - San Diego County
Breastfeeding Coalition
Lactnet Archives - http://community.lsoft.com/archives/LACTNET.html
NURSING MOTHER’S COUNSEL (Fort
Wayne, Indiana, USA - Local Chapter)
NURSING MOTHER’S COUNSEL
National Organization
Management of nipple pain and trauma - by Wendy Nicholson RM IBCLC 5.4.98
Joy
Johnston's Resource Centre - Midwifery Care and
Breastfeeding - Lactation consultation
This site has some really terrific articles on breastfeeding.
Baby-friendly
Hospital Initiative (launched by WHO and UNICEF in 1991) -
The BFHI, sponsored by the World Health Organization and UNICEF,
is a world-wide effort to improve breastfeeding rates. Based on
the ten steps to successful breastfeeding, the initiative
encourages hospitals to examine their practices, make the
appropriate changes and then apply for recognition as a Baby
Friendly Hospital.
World
Health Organization (WHO) on Breastfeeding
Kathy Dettwyler's Thoughts
on Breastfeeding and her supporting
medical references
INFACT Canada - The Infant
Feeding Action Coalition - Canada home page
The
Parent-L Breastfeeding Resources Page:
The Bright Future Lactation
Resource Centre is an education and motivation resource for
Lactation Consultants and others providing parents with infant
feeding information.
Fenugreek:
One
Remedy
for
Low
Milk
Production By Kathleen E. Huggins, RN, MS
Kathleen Huggins is a Director of the Breastfeeding Clinic at San
Luis Obispo General Hospital, CA. She is the author of The
Nursing Mother's Companion and coauthor of The Nursing
Mother's Guide to Weaning.
How
to Know a Health Professional is not Supportive of Breastfeeding
by Jack Newman, MD.
The purpose of MOBI (Mothers Overcoming
Breast feeding Issues) is to give women a place to discuss
their emotions over not being able to breast feed successfully.
The Human Milk Banking
Association of North America, Inc. represents all of the
North American human milk banks which collect, pasteurize, and
distribute donated mother's milk.
Project "Got
Breastmilk?" - beautiful photographs of breastfeeding
mothers and babies
Smoking
leaves
taste
in
breast
milk
-U.S. study
New England Journal of Medicine, Nov., 1998
Effects of Mag. Sulfate on
Breastfeeding
I've heard that in India, breastfeeding mothers are encouraged to
follow a special diet for the first 8-12 weeks, as food eaten
during that time has a lifelong influence on the baby's
tastes. (Please
contact me if you have more information about this.
Thanks.)
Veg
Pregnancy & Breastfeeding - from vegetarianbaby.com
Midwifery and
Breastfeeding Bumper Stickers - Texas Sticker Company &
Label Exchange
An
Overview of Milk - Biology of Lactation
A
New Approach: Biological Nurturing and Laid-Back Breastfeeding
By Jeanne Batacan, CMA, ICCE, CLC, CD - this lovely article gives
a nice, short description of easy self-attachment for baby's first
breastfeeding session as well as subsequent feedings.
"A study of 40 mothers breastfeeding in different positions found
that babies' natural reflexes kicked in more easily when the
mothers were lying down. . . . Dr Suzanne Colson, senior midwifery
lecturer at Canterbury Christ Church University, advises women on
a technique called biological nurturing where the mother lies down
and lets the baby lie on its tummy on top of her. . . . She
spotted 17 reflexes in babies when they were breastfed lying down,
including reflexes normally associated with other mammals who feed
their babies in this way. Breastfeeding in a sitting-up position
only promoted the three normally seen reflexes - routing, latching
and sucking. Mothers who breastfed lying down seemed to have more
success and, although the majority of women in the study had
initially reported problems with breastfeeding, after using the
technique all the women continued breastfeeding."
Womb to
World: A Metabolic Perspective by Suzanne Colson has a nice
section on Biological Nurturing
Here are some other articles by Suzanne Colson:
Bringing nature to the fore - Suzanne Colson argues that it is time to draw up breastfeeding competencies in order to promote the ‘nature’ perspective within early breastfeeding support
Colson S., (2005) Maternal breastfeeding positions: Have we got it right? - Part 1 (The Practising Midwife 8:10;24-27)
Colson S., (2005) Maternal breastfeeding positions: Have we go it right? - Part 2 (The Practising Midwife 8:11; 29-32)
‘White blood’: dose benefits of human milk
and Biological
Nurturing Resources - DVD, posters and handouts
Here's a neat biological basis for why biological nurturing or self-attachment works:
A single
postnatal injection of oxytocin rescues the lethal feeding
behaviour in mouse newborns deficient for the imprinted Magel2
gene.
Schaller F, Watrin F, Sturny R, Massacrier A, Szepetowski P,
Muscatelli F.
Hum Mol Genet. 2010 Dec 15;19(24):4895-905. Epub 2010 Sep 28.
"The onset of feeding at birth is a vital step for the adaptation of the neonate to extra uterine life. . . . [I]njection of a specific oxytocin (OT) receptor antagonist in wild-type neonates recapitulated the feeding deficiency seen in Magel2 mutants, and a single injection of OT, 3-5 h after birth, rescued the phenotype of Magel2 mutant pups, allowing all of them to survive. Our study illustrates the crucial role of feeding onset behaviour after birth. We propose that OT supply might constitute a promising avenue for the treatment of feeding difficulties in PW neonates and potentially of other newborns with impaired feeding onset."
This also explains why it's so important for the baby to nurse
within the first hour after birth, when the oxytocin levels in
both mother and baby are still high!
Delivery Self
Attachment by Lennart Righard, M.D. - This video depicts a
newborn's ability at birth to crawl up to a breast and ATTACH
HIMSELF UNASSISTED!
OK!!! I have FIRST-hand experience with this. Sometime last year in an issue of Mothering magazine, there was an entire article on the phenomenon....even with pictures. It was really neat. I remember showing it to DH and saying....wow...that is really cool, but at the SAME TIME I told him....well...I am so excited about other things RIGHT after the birth that I am not really interested in repeating the experiment......but it really is neat.
WELL....after my baby was born....we were all laughing and crying and I was talking with the MW's when they got there and I didn't really notice, but my baby WAS crawling/inching her way along up my abdomen. I DID notice because all of the sudden I said "HEY!!!" and I looked down and she had ATTACHED her mouth to MY NIPPLE and was SUCKING!!! It was the COOLEST thing!!!
I think this happened because as this was my first HB, no nurse or OB was RUSHING to cut the cord and take her off of me. And secondly, this was an unassisted and there WERE NO MW's for about 10 minutes, so I said to DH and everyone, let's just keep her on my belly with the warm towels on top of her and then when the MW's get here THEY can cut the cord and all. So...my baby was on my belly for a significant amount of time....and I think THAT is what enabled the experiment to be a success even though we weren't even trying!!!
One other significant thing I remember from the article is that
it is very important if you want to repeat the experiment is that
you do not wash the baby's hands at ALL. They say that the
baby needs to be able to smell the amniotic fluid on their hands
and that the nipple smells like amniotic fluid too and that is why
they are attached to it.
Initiation of
Breastfeeding by Breast Crawl - this is similar to the
Breast Self Attachment video.
YOUR
BABY KNOWS HOW TO LATCH-ON - Great 5-minute video from
ameda.com
See also: Birth Trauma and
Breastfeeding Difficulties
I was reading through a copy of my baby's hospital records, and
was flabbergasted by the "Infant Recovery Record", which is a
record of baby's first hour. There were some pre-fab options
for the "Activity" column, and it did not include
breastfeeding! The options were Active, Active When
Stimulated, Irritable, Lethargic, Quiet, and Sleeping. Sigh.
Wow! This is really sad. At my homebirth, the
midwives charted the important details of breastfeeding: Rooting,
Latching, Time of first latch, duration of latch, and even which
breast he was on! And the followup care papers had a
separate, fairly detailed section for breastfeeding assessment at
each followup appointment.
It's important to consider birthing practices that affect breastfeeding because they have a strong effect on the baby's ultimate health:
Drugs
Cesarean
Separation of mother and baby
Circumcision
There's a great book about this, Impact of Birthing Practices on Breastfeeding: Protecting the Mother and Baby Continuum by Mary Kroeger. You can also get this book from the La Leche League Store.
The breastfeeding rates in my homebirth practice are close to
100%, and if you consider how significantly this increases
birthing safety, it makes homebirth significantly safer than
hospital birth.
Alta
Vista
search
for
information
about
"birthing practices" AND breastfeeding
Effect of
labor epidural analgesia with and without fentanyl on infant
breast-feeding: a prospective, randomized, double-blind study.
Beilin Y, Bodian CA, Weiser J, Hossain S, Arnold I, Feierman DE,
Martin G, Holzman I.
Anesthesiology. 2005 Dec;103(6):1211-7.
CONCLUSIONS: Among women who breast-fed previously, those who
were randomly assigned to receive high-dose labor epidural
fentanyl were more likely to have stopped breast-feeding 6 weeks
postpartum than woman who were randomly assigned to receive less
fentanyl or no fentanyl.
Changing
hospital
practices to increase the duration of breastfeeding. - an
oldie but a goodie!
WHO/UNICEF
Baby-Friendly Hospital Initiative
Hospital
Support
for
Breastfeeding
and
Associated
Outcomes
BMJ Open. 2016 Aug 8;6(8):e010551. doi: 10.1136/bmjopen-2015-010551.
RESULTS: Home birth was found to be significantly associated with breast feeding at all examined time points, including at birth, 8 weeks, 6 months and breast feeding exclusively at 6 months. In GUI, adjusted OR was 1.90 (95% CI 1.19 to 3.02), 1.78 (1.18 to 2.69), 1.85 (1.23 to 2.77) and 2.77 (1.78 to 4.33), respectively, and in UKMCS it was 2.49 (1.84 to 3.44), 2.49 (1.92 to 3.26), 2.90 (2.25 to 3.73) and 2.24 (1.14 to 4.03).
CONCLUSIONS: Home birth was strongly associated with improved
breast feeding outcomes in low-risk deliveries. While the
association between home birth and breast feeding is unlikely to
be directly causal, further research is needed to determine which
factor(s) drive the observed differences, to facilitate
development of perinatal care that supports breast feeding. [Ed: I
believe that homebirth *IS* directly causal. For all the
reasons that it's easier for a woman to labor and give birth
without interventions at home, it's also easier for a woman to
breastfeed without interventions.]
In this study, 89.7 percent of babies were fully breastfeeding at six weeks.
Outcomes
of
planned
home
births
with
certified professional midwives: large prospective study in
North America [Full-text
article]
Kenneth C Johnson, senior epidemiologist, Betty-Anne Daviss,
project manager
BMJ 2005;330:1416 (18 June),
doi:10.1136/bmj.330.7505.1416
Conclusions: Planned home birth for low risk women in North
America using certified professional midwives was associated with
lower rates of medical intervention but similar intrapartum and
neonatal mortality to that of low risk hospital births in the
United States. [NOTE - CPMs are equivalent to
Licensed Midwives in California and some other states.]
What is the single most positive contributing factor for the successful establishment of breastfeeding?
Homebirth.
I assume the gentle birth, the avoidance of tubes down the baby's throat, the time to allow for baby-led nursing, and the general calm and quiet help a lot. But the studies say it's the simple fact that the midwife shows up at the home at 24 hours, 3 days, 5 days, whatever it takes to get that mom and baby nursing well.
This is the sort of thing I fret about when I hear people talking about extending hospital stays for new moms and babies.
I'm thinking - get them out of that hospital and away from the
infection threats as soon as possible. Instead, use the money from
the cost of an extra day in the hospital to pay for three home
visits from a birthing professional and a week's worth of
household help. This would go a long way towards helping
breastfeeding.
The following information is from Volume 3, Issue 3 of Research Summaries for Normal Birth, July 2006, from the Lamaze Institute for Normal Birth:
Summary: The first of a series of new pediatric growth charts have been released by the World Health Organization (WHO). The new growth standards were developed to replace existing pediatric growth charts based on growth patterns in predominantly formula-fed populations. Beginning almost a decade ago, the WHO undertook a detailed and elaborate statistical study, sampling thousands of infants from eight ethnically diverse, economically stable nations where at least 20% of women had access to breastfeeding support and followed WHO infant feeding guidelines. The healthy, term infants who participated were followed by trained researchers biweekly for 2 months, monthly up to 12 months, and bimonthly up to 24 months. An additional sample of children was followed up to 71 months. Breastfeeding support was provided as needed. Data were collected on infant growth patterns and achievement of motor skills.
The resulting infant growth standards offer pediatric providers and parents the first evidence-based information on how children should grow under optimal conditions. The researchers found that there was very little ethnic variability in average growth or achievement of motor skills, suggesting that poverty and sub-optimal nutrition are responsible for previously observed regional variability in infant growth.
Significance for Normal Birth: The WHO infant growth charts are an important step in positioning breastfeeding as the norm and reversing decades of erroneous advice to parents of breastfed infants who were told that their infants were failing to thrive because they gained weight more slowly than formula fed infants. Now, more formula fed babies will be seen to “fall off the curve” by gaining weight too rapidly, an important predictor of childhood obesity.
The results of the WHO Multicentre Growth Reference Study provide
solid evidence that breastfeeding contributes to the optimal
growth and motor development of infants. Interventions in normal
birth, including cesarean surgery and unnecessary separation of
mothers and babies impede women’s ability to initiate successful
breastfeeding with their newborns thereby contributing to less
than optimal infant growth and development.
Average Growth Patterns of Breastfed Babies from kellymom.com, with a great list of related references and resources.
"The 2000
CDC growth charts can be used to assess the growth of
exclusively breast-fed infants, however when interpreting the
growth pattern one must take into account that mode of infant
feeding can influence infant growth. In general, exclusively
breast-fed infants tend to gain weight more rapidly in the first 2
to 3 months. From 6 to 12 months breast-fed infants tend to weigh
less than formula-fed infants." [from the CDC Growth Charts
FAQ]
Baby growth charts to be revised - The World Health Organization is to issue new guidelines on measuring the growth rates of babies.
Current charts are based on calculations using the growth
patterns of babies fed largely on formula milk from 20 years ago.
But bottle-fed babies put on weight more quickly than those that
are breast-fed, meaning breast-fed children could be shown as
underweight.
The new recommended charts are based on data from breast-fed
babies.
LactMed:
A
New
NLM
Database
on
Drugs and Lactation is a peer-reviewed and fully referenced
database of drugs to which breastfeeding mothers may be exposed.
The database was produced by the National Library of Medicine as
part of the Toxicology Data Network. Among the data included are
maternal and infant levels of drugs, possible effects on breastfed
infants and on lactation, and alternate drugs to consider. The
database is searchable by drug name.
Breastfeeding
and Drugs - from motherisk.org
Drugs
in Pregnancy and Lactation from Harbor UCLA Medical Center
CARE Northwest gives free telephone advice to pregnant and
breastfeeding women about the possible effects of drug and
chemical exposure. Call Monday through Friday, 8 a.m.-4 p.m.:
888-616-8484.
What about
drinking alcohol and breastfeeding? from La Leche League
Breastfeeding
And Alcohol from breast-feeding-information.com
The Breast Milk Cocktail -- the
author finds contradictory info on alcohol and caffeine By
Elizabeth Agnvall
Beer, Alcohol And Breastfeeding
Alcohol,
breastfeeding,
and
development
at
18
months. [ Full
text ]
Little RE, Northstone K, Golding J; ALSPAC Study Team.
Pediatrics. 2002 May;109(5):E72-2.
DISCUSSION: We were unable to replicate the earlier deficit in
motor skills associated with lactation alcohol use. One reason may
be that the dose of alcohol reaching the lactating infant is
small, and tests of infants and toddlers have limited ability to
pick up small effects. Studies of older children may resolve the
question of the safety of drinking while nursing.
Breastfeeding and alcohol from Britain's National Childbirth Trust:
"Hale (Dr Thoms Hale in Medications and Mothers Milk, the international textbook on this topic, all research based) says the mother needs to have a blood level of 300 mg alcohol per decilitre of blood before her infant shows significant side effects (mainly sedation).The legal drink driving limit in the UK is 80mg of alcohol per 100ml of blood.
100ml is a decilitre so this means you would have to be between 3 and 4 times the legal limit for driving before the alcohol you were drinking had significant effects on your baby....and actually feeding at the time you were affected, too.
Alcohol reaches the breastmilk shortly after it reaches the bloodstream - so fairly quickly, in other words, but in dilute quantities. Hale says 'the absolute amount transferred into milk is low'.
You can be sure your breastmilk is clear of alcohol when your bloodstream is clear of it, and the usual guide for this is that the body processes alcohol at a rate of one and a half to two hours per unit.
Just as your body deals with alcohol, and any effects of it are temporary (apart from people who drink chronically over years, whose brain and liver are affected) , your baby's body deals with the very small traces of alcohol in the milk.
There are reports in Hale of effects on milk supply, let down and taste, but these will be temporary."
Breast-Feeding
Can
Help
Mom's
Heart
Decades
Later
Duration of
Lactation and Incidence of the Metabolic Syndrome in Women of
Reproductive Age According to Gestational Diabetes Mellitus
Status: A 20-Year Prospective Study in CARDIA--The Coronary
Artery Risk Development in Young Adults Study.
Gunderson EP, Jacobs DR Jr, Chiang V, Lewis CE, Feng J,
Quesenberry CP Jr, Sidney S.
Diabetes. 2009 Dec 3. [Epub ahead of print]
Conclusions: Longer duration of lactation was associated with
lower incidence of the metabolic syndrome years post-weaning among
women with a history of GDM and without GDM controlling for
preconception measurements, BMI, socio-demographic and lifestyle
traits. Lactation may have persistent favorable effects on women's
cardiometabolic health.
Learn more about the benefits of breast-feeding from the National
Women's
Health Information Center.
Breastfeeding
and
the risk of postneonatal death in the United States.
Chen A, Rogan WJ.
Pediatrics. 2004 May;113(5):e435-9.
OBJECTIVE: Breastfed infants in the United States have lower rates of morbidity, especially from infectious disease, but there are few contemporary studies in the developed world of the effect of breastfeeding on postneonatal mortality. We evaluated the effect of breastfeeding on postneonatal mortality in United States using 1988 National Maternal and Infant Health Survey (NMIHS) data. METHODS: Nationally representative samples of 1204 infants who died between 28 days and 1 year from causes other than congenital anomaly or malignant tumor (cases of postneonatal death) and 7740 children who were still alive at 1 year (controls) were included. We calculated overall and cause-specific odds ratios for ever/never breastfeeding among all children, conducted race and birth weight-specific analyses, and looked for duration-response effects. RESULTS: Overall, children who were ever breastfed had 0.79 (95% confidence interval [CI]: 0.67-0.93) times the risk of never breastfed children for dying in the postneonatal period. Longer breastfeeding was associated with lower risk. Odds ratios by cause of death varied from 0.59 (95% CI: 0.38-0.94) for injuries to 0.84 (95% CI: 0.67-1.05) for sudden infant death syndrome.
CONCLUSIONS: Breastfeeding is associated with a reduction in risk
for postneonatal death. This large data set allowed robust
estimates and control of confounding, but the effects of breast
milk and breastfeeding cannot be separated completely from other
characteristics of the mother and child. Assuming causality,
however, promoting breastfeeding has the potential to save or
delay approximately 720 postneonatal deaths in the United States
each year.
Here's a new one!
Teens
Breast-fed
as Infants Have Stronger Leg Muscles
They did better on horizontal jump, "explosive strength" tests,
study finds
Longer
breastfeeding is associated with increased lower body explosive
strength during adolescence.
Artero EG, Ortega FB, et al.
J Nutr. 2010 Nov;140(11):1989-95. Epub 2010 Sep 22.
"Significant differences among the categories of breastfeeding
duration were tested using ANCOVA after adjusting for a set of
potential confounders: gestational and current age, birth weight,
sexual maturation, fat mass, fat-free mass, maternal education,
parental weight status, country, smoking behavior, and days of
vigorous physical activity. Longer breastfeeding (either any
or exclusive) was associated with a higher performance in the
standing long jump test in both boys and girls (P <
0.001), regardless of fat mass, fat-free mass, and the rest of
potential confounders. In adolescents who were breastfed for 3-5
mo or ?6 mo, the risk of having a standing long jump performance
below the 5th percentile was reduced by half compared with those
who were never breastfed [odds ratio (OR) = 0.54, 95% CI =
0.30-0.96, P < 0.05; and OR = 0.40, 95% CI = 0.22-0.74, P <
0.01, respectively). These findings suggest a role of
breastfeeding in determining lower body explosive strength during
adolescence."
Delayed
Breastfeeding
Initiation
Increases
Risk
of
Neonatal Mortality
PEDIATRICS Vol. 117 No. 3 March 2006, pp. e380-e386
(doi:10.1542/peds.2005-1496)
CONCLUSIONS. Promotion of early initiation of breastfeeding has the potential to make a major contribution to the achievement of the child survival millennium development goal; 16% of neonatal deaths could be saved if all infants were breastfed from day 1 and 22% if breastfeeding started within the first hour.
This is a pretty amazing statistic, and it's important to consider this anytime you're also considering the safety of birthing practices that affect breastfeeding:
Drugs
Cesarean
Separation of mother and baby
Circumcision
There's a great book about this, Impact of Birthing Practices on Breastfeeding: Protecting the Mother and Baby Continuum by Mary Kroeger
The breastfeeding rates in my homebirth practice are close to
100%, and if you consider how significantly this increases
birthing safety, it makes homebirth significantly safer than
hospital birth.
A
new paradigm for depression in new mothers: the central role of
inflammation and how breastfeeding and anti-inflammatory
treatments protect maternal mental health
Kathleen Kendall-Tackett
International Breastfeeding Journal 2007,
2:6 doi:10.1186/1746-4358-2-6
Breastfeeding fights depression
08 May 2007
International Breastfeeding Journal 2007; 2: 6
MedWire News: Breastfeeding can help new mothers fight depression, research shows.
Kathleen Kendal-Tackett (University of New Hampshire) says that depression is common among new mothers, and affects anywhere from 10 percent to 20 percent of postpartum women.
"Since depression has devastating effects on mother and baby, it's vital that it be identified and treated promptly," she adds.
Kendal-Tackett says that new mothers experience an increase in inflammation due to high levels of pro-inflammatory cytokines.
Common experiences associated with new motherhood such as disturbed sleep and postpartum pain can also act as stresses that cause pro-inflammatory levels to rise, she says.
Breastfeeding can reduce women's stress levels so that their inflammatory response systems remain inactive. This then reduces their risk of depression.
But Kendal-Tackett notes this is only true when breastfeeding is "going well."
"When breastfeeding is not going well, particularly if there is pain, it becomes a trigger to depression rather than something that lessens the risk."
She concludes: "Mother's mental health is yet another reason to
intervene quickly when breastfeeding difficulties arise."
Higher Concentration of Vitamin C in Breast Milk Linked to Lower Rate of Infant Atopy CME
Vitamin
C
in
breast
milk
may
reduce the risk of atopy in the infant.
Hoppu U, Rinne M, Salo-Vaananen P, Lampi AM, Piironen V, Isolauri
E.
Eur J Clin Nutr. 2005 Jan;59(1):123-8.
CONCLUSION: A maternal diet rich in natural sources of vitamin C
during breastfeeding could reduce the risk of atopy in high-risk
infants.
"If you breast-feed for at least 4 months, your child will experience one-third the risk of hospitalization for lower respiratory disease,'' lead author Dr. Virginia Bachrach, a community pediatrician in Palo Alto, California, told Reuters Health. The protection seems to last for the first year of life, Bachrach noted.
Bachrach said that 6% of all US infants less than 1 year of age
are hospitalized annually for lower respiratory tract disease,
which elevates their risk for later illnesses such as asthma and
creates a costly healthcare burden.
Ayala Ochert wrote a fabulous article, "The Science of Mother's
Milk", in La Leche League's journal, New Beginnings, Issue 3,
2009. "Breastmilk contains literally thousands of different
components that support the immune system in some way." To
read more about this topic, search
for oligosaccharides and her reference, L. A. Hanson's Immunobiology
of
Human
Milk:
How
Breastfeeding
Protects Babies.
Association
of
Breastfeeding
With
Maternal
Control
of Infant Feeding at Age 1 Year
Taveras, E. M., mGillman, M. W.
PEDIATRICS (doi:10.1542/peds.2004-0801)
"Mothers who fed their infants breast milk in early infancy and
who breastfed for longer periods reported less restrictive
behavior regarding child feeding at 1 year."
Study:
Breast
Feeding
Cuts
Infant
Death
20 Percent [5/2/04] - Breast-fed children in the United
States are 20 percent less likely to die during the first year of
life than whose who are not nursed.
A response to Target's response:
I understand that you think you were being "fair" in presenting "both sides" of the breastfeeding vs. bottle feeding question. Unfortunately, you neglected the "side" that is most important - the baby's.
A newborn has an immature immune system that is incapable of mounting an adequate defense against many germs, especially the more virulent, antibiotic-resistant bacteria. Nature intended that the breastfeeding mother be an extension of the baby's immune system, providing vital antibodies and macrophages. Every newborn relies on breastfeeding to provide a defense against life-threatening infections.
Next time you wish to expound on the alleged benefits of bottle
feeding, I hope you'll do so from the point of view of the person
most affected - the baby.
The
FDA's "Breastfeeding Best Bet for Babies":
Rachael's page on "Why Breastfeeding is Important":
This contains references to research showing, among other things,
that BF'd children are smarter, healthier, have less risk of SIDS
etc,
The newborn baby has only three demands. They are warmth in the arms of its mother, food from her breasts, and security in the knowledge of her presence. Breastfeeding satisfies all three.Dr. Grantly Dick-Reed
Preliminary
Growth Charts for Breastfed Babies
USDANEWS/Article5/August
1997
-
The
Ideal
Infant
Food - "Loving Support Makes Breastfeeding Work." USDANEWS
GREEN LINE VOLUME 56 NO.7 - AUGUST 1997
UPI Summary of Breastfeeding Advantages
Advantages
of Breastfeeding Links - This page was written in the
interest of supporting and promoting breastfeeding for all moms
and babies. UNICEF states that 1 million babies die each year as a
result of being fed artificial formula, some die from diarrhea and
other intestinal illnesses , some die from malnutrition because
their families can not afford to purchase formula, and some die
from the illnesses that formula fed babies are more likely to
contract.
From: C-upi@clari.net (UPI / LIDIA WASOWICZ, UPI Science Writer)Breastfeeding Protects Against Ear Infections: A study shows babies who drink from the breast rather than the bottle are less likely to develop ear infections. The study by the National Center for Chronic Disease Prevention and Health Promotion shows babies fed nothing but mother's milk were 70 percent less likely to develop ear infections in their first year of life than infants who got formula only. The authors say this study is very important because only 53 percent of U.S. women breastfeed their children. That means 47 percent of babies are at increased risk of ear infections.
Subject: Health Today [Jul 28]
Date: Mon, 28 Jul 1997 0:50:49 PDT
Breast Milk May Reduce Risk of Schizophrenia
"Summary: Scientists have long understood that mother's
milk provides immune protection against some infectious agents
through the transfer of antibodies, a process referred to as
"passive immunity." A research team now shows that mother's milk
also contributes to the development of the baby's own immune
system by a process the team calls "maternal educational
immunity."
"In some instances, our work has shown that immunity [against TB]
is far more effective if acquired through the milk than if
acquired through direct vaccination of the baby."
This is just one more reason why it's so important to tailor birth
practices and postpartum support to make happy breastfeeding
easier.
Maternal
Milk T Cells Drive Development of Transgenerational Th1 Immunity
in Offspring Thymus. [Full
text]
Ghosh MK1, Nguyen V1, Muller HK2, Walker AM3.
J Immunol. 2016 Sep 15;197(6):2290-6. doi:
10.4049/jimmunol.1502483. Epub 2016 Aug 5.
Using multiple murine foster-nursing protocols, thereby
eliminating placental transfer and allowing a distinction between
dam- and pup-derived cells, we show that foster nursing by an
immunized dam results in development of CD8(+) T cells in
nonimmunized foster pups that are specific for Ags against which
the foster dam was immunized (Mycobacterium tuberculosis or
Candida albicans). We have dubbed this process "maternal
educational immunity" to distinguish it from passive cellular
immunity. Of the variety of maternal immune cells present in milk,
only T cells were detected in pup tissues. Maternal T cells, a
substantial percentage of which were CD4(+)MHC class II(+),
accumulated in the pup thymus and spleen during the nursing
period. Further analysis of maternal cells in the pup thymus
showed that a proportion was positive for maternal
immunogen-specific MHC class II tetramers. To determine the
outcome of Ag presentation in the thymus, the maternal or foster
pup origin of immunogen-responding CD8(+) cells in foster pup
spleens was assessed. Whereas ∼10% were maternally derived in the
first few weeks after weaning, all immunogen-responding CD8(+) T
cells were pup derived by 12 wk of age. Pup-derived
immunogen-responsive CD8(+) cells persisted until at least 1 y of
age. Passive cellular immunity is well accepted and has been
demonstrated in the human population. In this study, we show an
arguably more important role for transferred immune cells: the
direction of offspring T cell development. Harnessing maternal
educational immunity through prepregnancy immunization programs
has potential for improvement of infant immunity.
Although this study was published in 2006, it appears that it was
based on data collected in 1979; it is hard to know whether the
data collection standards from 1979 would hold up against today's
standards.
"Setting: 1979 US national longitudinal survey of youth."
Effect
of
breast
feeding
on
intelligence
in children: prospective study, sibling pairs analysis, and
meta-analysis
Geoff Der 1*, G David Batty 1, Ian J Deary 2
BMJ, doi:10.1136/bmj.38978.699583.55 (published 4 October 2006)
Conclusions Breast feeding has little or no effect on
intelligence in children. While breast feeding has many advantages
for the child and mother, enhancement of the child's intelligence
is unlikely to be among them.
On the other hand, this 2004 study showed that although parental intelligence is also correlated, it appears that breastfeeding, in and of itself, also increases intelligence.
Influence
of
breast-feeding
and
parental
intelligence
on cognitive development in the 24-month-old child.
Gomez-Sanchiz M, Canete R, Rodero I, Baeza JE, Gonzalez JA.
Clin Pediatr (Phila). 2004 Oct;43(8):753-61.
"The results of multiple linear regression analysis showed that
infants breast-fed for longer than 4 months scored 4.3 points
higher on the mental development scale than those breast-fed for
less time. No differences were found in psychomotor development as
a function of feeding regimen or duration. The positive linear
correlation observed between parental IQ and mental development
scores at 24 months was also statistically significant (mother: r
= 0.39; p < 0.001; father: r = 0.43; p < 0.001). It may be
concluded that breast-feeding for longer than 4 months has a
positive effect on the child's mental development at 24 months of
age. Parental intelligence also appears to influence cognitive
development."
Breast
Milk May Reduce Risk of Schizophrenia
Breastfeeding
in Whose Public? by Peggy O'Mara, editor of Mothering Magazine
A Current
Summary of Breastfeeding Legislation in the U.S. - a
state-by-state guide to breastfeeding laws in the U.S. from La
Leche League.
California Governor Signs Bill Assuring
Right to Breastfeed in Public
Hollis and Wagner announced their lab has determined that
lactating mothers need at least 3,600 IU a day of cholecalciferol
(the natural form of vitamin D) to maintain their own and their
infant’s vitamin D levels. 2,000 IU was inadequate. Only when
Hollis and Wagner gave lactating mothers 3,600 IU of
cholecalciferol did the mother have enough vitamin D to maintain
their own and their infant’s blood levels. 3,600 IU of vitamin D
is about 10 times what the federal government says lactating women
should get and is almost twice what the federal government says
may be toxic.
Sunlight and
Vitamin D: Exposing the Benefits from La Leche League
Sunlight
Deficiency:
Helping
Breastfeeding
Mothers
Find
the Facts from La Leche League
From what I have learned it is not necessary to supplement your
diet with vitamin D alone. As long as you are nursing your baby,
it is however important to continue taking your prenatal vitamins.
What I recommend to clients is to also ensure eating ample
varieties of foods that are high in vitamins and minerals. A food
is an immediate source of nutrition and should not be regarding as
only filling your belly when your hungry. Foods such as dairy
products- milk, cheese-, eggs, fatty saltwater fish (such as
halibut and tuna), oatmeal, sweet potatoes, vegetable oils and
dandelion greens. Herbs high in vitamin D are nettle, alfalfa,
horsetail and parsley. Although, I do not recommend taking parsley
at all while nursing unless you wish to decrease your breast milk
production. Another very simple way of implementing vitamin D into
your system is just a few minutes of sunlight a day. When the skin
is exposed to the sun's ultraviolet rays, a cholesterol compound
in the skin is transformed into a precursor of vitamin D.
Vitamin D
Supplementation of Breast-Fed Infants [Medscape registration
is free]
Vitamin supplements in children - Are they necessary? Are they
good? A study published in Pediatrics this month suggests that
multivitamin supplementation may be associated with an increased
risk of babies developing asthma and food allergies. [More
information about Supplements
for Kids]
Do
your children need nutritional supplements? Part II [5/8/11]
Rachael's page on
"Breastfeeding and Returning to Work":
Workplace
Breastfeeding Programs: Employer Case Studies is designed to
help employers create programs and policies that encourage new
moms to breastfeed after they return to work.
Storing
Human Milk from LLL
Re: Stinky Milk
"Sometimes thawed milk may smell or taste soapy. This is due to the breakdown of milk fats. The milk is safe and most babies will still drink it. If there is a rancid smell from high lipase (enzyme that breaks down milk fats) activity when the milk has been chilled or frozen, the milk can be heated to scalding (bubbles around the edges, not boiling) after expression, then quickly cooled and frozen. This deactivates the lipase enzyme. Scalded milk is still a healthier choice than commercial infant formula."
Breastmilk
Storage & Handling from kellymom
Proper
Storage and Preparation of Breast Milk
Spirulina is fantastic for nursing mothers! It is filled with
chlorophyll, rich in protein, contains all 8 amino acids and has
B12 (important source for vegetarians). The chlorophyll nourishes
blood (a precursor to breast milk in Chinese Medicine) and helps
remineralize the body--including calcium, which is obviously lost
during lactation & pregnancy. Spirulina helps balance blood
sugar and helps with energy and stamina. I recommend a product
called Pure
Synergy for all my patients including pregnant and nursing
moms. There's more in it than spirulina.
If a baby consistently prefers one side, it's worth considering
the possibility that they are having some pain when nursing on the
other side, possibly due to some residual birth trauma. Try
a different hold on the side they usually don't like, e.g. try the
football hold, or sidelying from the top breast, or lying flat on
your back with the baby on your belly. If the baby suddenly
is interested in the breast that they previously avoided, it makes
sense to take them for a chiropractic or craniosacral
evaluation. This goes double for a baby who won't nurse well
at all. Compressed skull bones can make it painful to open
their mouth wide enough to latch on
I don't think that the problem that I'm going to post about is
GBS because these moms haven't had PROM or any of the other
symptoms. But once in a while and just this last week I had the
experience again, are those darned babies that refuse to nurse for
hours after birth. Then the worry about hypoglycemia, dehydration
etc. It seems that you just can't get anything down them at all.
This last one seemed to thrust her tongue when anything was put in
her mouth. She wouldn't even take my finger. We really worked with
this one and finally but these babies every once in a while are
what make me want to pull my hair out. You just can't get them to
nurse for anything.
I agree, this is a really tough situation. I have had similar difficulties with babies in the past. I have not seen it as the result of any infectious process. I generally try the suggestions below. Perhaps this info will help you out next time.
Sometimes these babies seem to have gotten into the habit of sucking something like a fist or the side of their hand in utero ( I check their hands for a little blister like area) which seems to make them prefer to suck with the tongue thrust, and resist anything (finger, breast) deeper into their mouth. It takes quite a bit of patience and gentleness to get them to accept the finger. I try gentle stroking of the face and lips to stimulate baby and then try 'tongue walking' -walking my finger slowly from tip towards back of tongue drawing it down and forward with pad of my index finger.
Sometimes they are just what is sometimes called an 'aggressive
non-nurser' - they arch away from the breast and scream and refuse
to nurse. With these babies, I try to gently curl them into 'C'
shape which is neurologically more conducive for feeding. Then I
would try the facial stroking- starting from the nose, and
stroking out towards cheek and then down towards chin- and from
midline upper lip- around and down too chin and lower lip. Then
try positioning them in the clutch/football hold for nursing- to
maintain the 'C' curl. See if this helps.
When I worked as a hospital nurse, I used to see a great deal more of what you are describing. Some babies are born reluctant nursers. Sometimes the circumstances of birth can play a role too, as in a very long, difficult birth or sometimes, even an extremely rapid birth.
Babies who are deeply suctioned at birth (sometimes necessary if there is mec) can develop oral aversions. Also some kiddos seem to develop habits in utero that contribute to nursing problems. Last April, we had a little one born who, first of all, was somewhat depressed and needed some active resuscitation post-birth, then had some tachypnea and transient nasal flaring and grunting. Things settled down quickly but the baby did not nurse for a good 12 hours post-birth. Fortunately, the parents gave birth at my partners house, and stayed the night because they were so tired, and this allowed us more time to work with them. Finally, the other thing I discovered the following morning, was that the baby had developed the habit of sucking on her lip and was very resistant initially to the breast.
When I have babies who don't exhibit interest in nursing in the first few hours, I always look for reasons (difficult birth, any signs of distress, maybe too much environmental stimuli, and so on). I encourage skin to skin contact and consistent gentle efforts to offer to nurse. As far as getting babies to take my finger, I have found that it is helpful to be very gentle about this...... I tickle the lips with my finger just as I would have mom do with her nipple, and let the baby set the pace with accepting my finger. This seems to work well most of the time.
Finally, if baby continues to be reluctant and it is getting on
to be 24 hours, I try to get mom set up with a hospital grade
electric breast pump to start stimulating milk production,
continue with skin to skin, etc. If mom can get some colostrum, it
can be cup fed to the baby or an eye dropper can be used. If I
can't get the mom to pump or get any colostrum, I would consider
using formula at that point in a cup (just small amts). Sometimes,
once the baby gets a little something in his or her tummy, they
figure out that they want to eat.....
I wouldn't worry TOO much about them if all else seems normal.
Some babies just don't want to nurse till they get hungry and it
really doesn't hurt them to go for a while. (Remember the huge
controversy in the 60s about "early feeding", when it was
considered unhealthy to allow feeds before 24 hours?). If a baby
is showing any signs of hypoglycemia - and wont nurse or take a
bottle - then you can correct it easily with a tiny bit of syrup
or Karo on your finger.
I would just keep an eye on these kids, keep attempting every couple hours. They might take a day or two to get the hang of life outside the womb where they have to work for their supper!
IF ALL ELSE IS NORMAL, they probably will become ravenous on day
two or three when the milk comes in...
This last baby that didn't nurse finally started at 18 hours. I
had the parents giving her sterile water w/sugar. This seemed to
get her interested and all is well now. No I don't remember in the
60's about the delayed feeding. I think I was in high school and
not even thinking about this. But I'm glad to hear it. Thanks.
You said that she's too exhausted to suck. Babies with
jaundice are often very sleepy babies; one of my babies slept a
lot when she had jaundice too. Getting a sleepy baby to wake
up can increase nursing which will also lead to pooping
eventually. Here are some things we found to help wake her
up:
1) dress her only lightly -- we had to take her hat and
long-sleeved outfit off. Of course, you don't want a newborn
to get too cold (and it is chilly outside now), but for our baby
it was really helpful to just have her dressed in just her
diaper. We would sit by the window in the sunlight in just
her diaper and nurse as much as possible.
2) rub her feet, or even give her a gentle all-over massage while
she nurses
3) switch breasts whenever she starts to fall asleep, even when
she's not done on one side.
4) breast compressions -- if I would help push the flow of milk
out to her, she would wake up a little to take in the extra milk
5) if she really, really doesn't want to wake up or can't stay
awake to nurse, something very very cold on her feet, back, or
belly can do it. We used cold wet washcloths, items out of
the refrigerator or even the freezer when it got really bad.
6) we had to set an alarm that went off every 3 hours, and we
would wake her up to nurse whether she asked for it or not.
This isn't something that a newborn without jaundice typically
needs, but it is pretty important for a baby with jaundice, though
eventually (in a couple weeks) you won't need to be quite so rigid
anymore. The trick is to keep going back to bed between
nursings until you have had a full amount of sleep; then you can
manage to get enough rest even though you're waking up multiple
times during your "night".
People are worried about the baby not pooping because it probably means there isn't enough incoming milk to push it out. I would focus on creating an ideal environment for the baby to nurse and don't focus on trying to make the baby poop. The baby is not constipated. I guarantee it. Babies don't have enough intestinal flora to form solid stool until they're around 10 days old.
So, ideally you could get help from a lactation assistant:
Otherwise, follow these steps:
Help mom to relax in a reclining position, with a warm blanket behind her and around her shoulders but naked from the waist up and with her chest and belly exposed to the baby. Get baby naked. Make sure the room is not too hot. (A hot baby is too lethargic to want to nurse.) While you are trying to get baby to nurse, it is fine for baby to be a little cooler. This will raise the baby's adrenaline to give them more energy to nurse, and they will be more interested in mom's body as a source of warmth. (It's fine if baby has a diaper on, but absolutely naked is even better since diapers impede babies movement.) Place baby on mom's chest, with the baby's head between her breasts and the baby's feet towards her feet. Let the baby find the way to the breast to latch on.
If the weather is very warm, you may need to have a fan creating a gentle breeze on the baby.
This works 9 times out of 10.
See Biological Nurturing and Newborn Self-Attachment
Thanks for the tons of suggestions I got over the weekend. Almost
all of the suggestions worked - removing her diaper during feeding
worked the most. Light massage with olive oil also stimulated her
to feed more. [Ed: Note that this may be related to the oxytocin
surge.]
Slow weight gain has the potential to be serious...but with close
monitoring and good breastfeeding management it can be turned
around. Mom and baby can continue to have a happy nursing
relationship.
You can boost baby's caloric intake using the settled fat from mom's own expressed milk. The mom can express some of that copious milk supply, leave it to stand then skim off the fat layer that settles out and mix it with a small portion of the thinner milk, this would supply baby with a great caloric boost to try and up the weights.
A mom with lots of milk is doing something right to keep the
supply going strong. I agree that baby should be encouraged to
nurse more often and as long as possible on the one breast as
possible, only switching when baby seems completely done and
uninterested in "working" the breast. Offering the second breast
that will supply and easy "slurp" is good for a top off.
Just a little note of correction here, no baby should ever be given sugar water under any circumstance. If they are not nursing and you are simply concerned about dehydration, simple water is best. If they are not nursing or not nursing sufficiently, they should be given formula (by bottle, cup, syringe, finger, whatever). Giving a baby glucose water is like feeding them cocacola. Not good. It leads to destabilized blood glucose levels because they put out a lot of insulin when they first get the sugar and then can drop their blood glucose levels precipitously as they metabolize the sugarload. These kind of blood sugar surges and declines can lead to mild behavior changed (such as irritability and difficulty nursing -- just what you are trying to fix) all the way to coma and brain damage in a susceptible baby whose well meaning parents feed it too much sugar water.
The American Academy of Pediatrics stated a few years ago unequivocally that infants should never be fed sugar water. Regular water for dehydration prevention or to stimulate nursing is sufficient in most cases. A non-nurser needs whole calories such as that provided by pumped breast milk or formula, not the "empty" calories and sugar rush provided by glucose water.
If you are still not convinced, the next time you have to do a three hour glucose test on a woman, ask her how she feels an hour after the 100 gm glucose load on an empty stomach. Most of my clients say they feel flushed and lightheaded. Then ask them how they feel at the end of the test. Most of my clients say they feel tired and listless. Is this really what you want to put a newborn through?
I do not mean to sound harsh, I know that midwives who recommend sugar water are doing what they think is right, but I urge all of you who still recommend sugarwater to reconsider this advice and gather whatever information you need to convince yourself and you clients that pumped breastmilk or formula is best.
I cringe every time I enter the newborn nursery at my back-up
hospital and see the cases of glucose water. Can't seem to
convince them.
With regards to giving a newborn sugar water, I attended a
Perinatal conference in Texas in 1996 and heard a speaker refer to
just that! The speaker said that research has shown that
supplementing with oral sugar water may actually delay the
excretion of bilirubin in a newborn's immature digestive system! I
am so glad you brought this subject up!
Suck
Training can help with latch problems.
During my training as an LC, we learned of the correlation between receiving IVs and poor latch (not just with narcotics). The excessive fluids the mom received can cause edematous nipples (which are usually not noticeable by one who doesn't know what they are looking for). So they explained the importance of getting a full birth hx on a mom with nursing difficulties. One thing to ask is if she was pitted (or had any IVs). With such a large, edematous nipple, latching is often more difficult for the baby. This usually takes 24-72 hours to resolve, but as we know, if there isn't help with poor latching the first day, nursing difficulties can be long-term. I think if a mom is aware of what the problem might be and is given tips to work with the issue, she is more likely to be armed to deal with the problem.
This helps us to remember that ANYTHING we do that interferes
with the nl process of birth may cause problems later, so we all
need to choose our interventions wisely and be prepared for the
potential consequences. I would never have thought of a pit
IV as having problematic sequelae for latching.
There are a number of reasons why latch problems might appear after baby has been nursing fine for several months.
Developmentally, babies start to become more interested in the
world around them; you may need to minimize distractions to keep
baby latched on well.
Also, as babies get heavier, their position often changes; their
weight may be pulling them off the breast. Better support
with pillows may be needed.
Also, last but definitely not least, as a woman's fertility
cycles return, she may notice breast sensitivity at certain times
in her cycle. Some women will say that nipple soreness
around the time of ovulation was their first inkling that
fertility was returning.
Ankyloglossia
from Newborn
Photo Gallery from Stanford Med School
Should you feel a large speed bump that you can get past with a little more effort, it is most likely a “tree trunk” frenulum, a short, wide band of tissue buried in the floor of the mouth and attached to the base of the tongue. It usually, though not always, restricts tongue movements and causes latch problems even though it looks like there isn’t enough there to be a problem.
When you can’t sweep your finger across without pulling it back to “jump over a fence,” the frenulum is a fibrous band attached closer to the front of the tongue. It may be buried underneath the floor of the mouth or visible as an external web. If you see a narrow white streak running down the middle of the floor of the mouth that feels like a wire, it usually extends to the front of the tongue like a string. Pushing your finger into this “piano wire” frenulum will often cause the tip of the tongue to tilt downward and the center if the tongue to pill down and crease along the middle. “Tree trunk, “fence,” and “piano wire” frenulums are red flags for significant tongue function impairment.
For comprehensive, evidenced-based guidelines on breastfeeding management, check out ABM’s Clinical Protocols, including our protocol for managing Neonatal Ankyloglossia.
This tip and other gems come from the Association for Breastfeeding Medicine
For comprehensive, evidenced-based guidelines on breastfeeding
management, check out ABM’s
Clinical Protocols.
Frenectomy Exercises with
Melissa Cole of Luna Lactation
Apparently the o-ball can be used to encourage baby to stretch the
tongue? One mama couldn't get her baby to use it but as a
last-ditch attempt to soothe a cranky baby while cooking dinner,
she gave her daughter a wire whisk to play with; the happy baby
started playing with it with her tongue. What baby could
resist all those interesting wires?
Thanks to Marsha Bearden RN, IBCLC, a lactation consultant in Alabama, who wrote to tell me that her web site offers the Niplette for sale!
Avent sent me a sample when I faxed them a request on my midwife letterhead. I can see that it would work well, and it's got some rave reviews on some of the lactation lists. Combined with the research, I'd say it's definitely worth a try. However, it is pricy - $50 retail.
The sample came with a brochure listing a toll-free number; it didn't work when I tried it, but here it is, just in case: 1-888-Niplette (647-5388). Their main number is 800-542-8368, and you can theoretically order the Niplette from that number. Good luck. The Avent America site has a Store Locator Page.
Most references to the Niplette appear to be British. I did
find some sites with pictures of the product in use: Here's
a British
Avent site, a French
Avent site and a Dutch site .
The "Niplette": an instrument for the non-surgical correction of inverted nipples.
McGeorge DD
Br J Plast Surg 1994 Jan;47(1):46-9
Inverted and non-protractile nipples are a common problem which cause psychological distress and interfere with a woman's ability to breast feed. A new instrument, the "Niplette", readily corrects the defect without the need for surgery. It is cheap and all patients found it comfortable and easy to use. Breast feeding is possible after treatment. The device should replace surgery in medical practice for this common condition.
Interesting articles from Lactnet about the Niplette:
Hoffmann's hypothesis, shells and Niplette
I have heard of the nipplette and it seems to work fairly well but is outrageously expensive. There is another product on the market that is better in my opinion. It is called Evert (?) and was invented by Edie Armstrong. You can reach her at: Edie Armstrong BSN, IBCLC, Fairfax, mailto:earmstr@erols.com
There is also an easy way to make something similar yourself: Take a 10cc syringe and cut off the end where the needle goes. A hacksaw works well. (Take off the needle first!) Take the plunger and insert it into the end you just cut off. The uncut end fits over most nipples. Have the mom place it over her nipple and gently have her pull back on the plunger. This pulls the nipple out very well and its cheap!
Another thing to do is have the mom use the Hoffman technique. Have the mom place her thumbs on the areola at 12 & 6 and gently pull her thumbs apart. Tell her to work all around the areola and do it 2-3 X a day. This helps break the adhesions that are holding the nipple in.
I have moms do these and using nipple shells starting about 30
weeks. If you don't catch the inverted nipples until after the
baby is born they still work. Using the syringe right before the
baby latches will really help.
Treatment
of
inverted
nipples
using
a
disposable syringe.
Kesaree N, Banapurmath CR, Banapurmath S, Shamanur K
J Hum Lact 1993 Mar;9(1):27-9
Seven mothers who had inverted nipples were helped to breastfeed their infants with the assistance of a simple device made from a 10 ml disposable syringe. These women were able to successfully breastfeed within one week. On follow-up, these mothers were able to sustain adequate breastfeeding.
Preparing
for
breast
feeding:
treatment
of
inverted and non-protractile nipples in pregnancy. The MAIN
Trial Collaborative Group.
Midwifery 1994 Dec;10(4):200-14
CONCLUSIONS: in the light of the findings from this and a previous single centre trial, there is no basis for recommending the use of either Hoffman's nipple stretching exercises or breast shells as antenatal preparation for women with inverted and nonprotractile nipples who wish to breast feed. Given the lack of evidence to support these and other antenatal preparations there are no grounds for midwives to continue routine breast examination in pregnancy for this purpose.
Randomised
controlled
trial
of
breast
shells
and Hoffman's exercises for inverted and non-protractile
nipples.
Alexander JM, Grant AM, Campbell MJ
BMJ 1992 Apr 18;304(6833):1030-2
CONCLUSIONS--Recommending nipple preparation with breast shells may reduce the chances of successful breast feeding. While there is no clear evidence that the treatments offered are effective antenatal nipple examination should be abandoned.
You can order the Evert-It
Nipple Enhancer (here's a picture)
- item No 441-21, $19.95 in the Accessories section of the online La
Leche League Store.
Larry McMahan's Flat/Inverted Nipple F.A.Q. - A summary of a devoted dad's research into inverted nipples
See also: Nasal
Oxytocin Spray for cases of stubborn engorgement that
persists beyond one week and doesn't respond to improvements in
baby's latch and breastfeeding patterns.
NOTE - One of my clients found that nighttime engorgement was
waking her even before her baby needed to nurse, even some weeks
after the birth. She figured out that it seemed to be
related to her carbs intake late in the evening. When she
had carbs, the engorgement woke her. Without the carbs, she
did not get severe engorgement and was able to sleep longer.
Heh, it's worth a try!
This actually makes me wonder if there is such a thing as
"lactational diabetes". It makes sense to me that an animal
who has recently given birth might want to extract as many
calories as possible in those first days after the birth, when she
is resting and needing to stay close to the next to guard the
offspring. And since lactation requires even more calories
than gestation, it would make sense to me that this condition
could continue for several months after the birth.
In any case, for women who have severe engorgement and ongoing lumps, it might be worth trying a low-carb diet for a few days to see if things improve.
A
Well-Oiled Machine by Jill Stansbury, N.D. - The
little-studied and underappreciated lymph system keeps internal
fluids flowing and contributes mightily to immune function.
[Although this isn't directly about breast engorgement, I think
it's a good explanation of the lymph system, which is largely
discounted in Western medicine.]
Oketani Breast Massage - relieves engorgement and improves milk quality
Composition
of
milk
obtained
from
unmassaged
versus massaged breasts of lactating mothers
FODA Mervat I. (1) ; KAWASHIMA Takaaki (2) ; NAKAMURA Sadako (2) ;
KOBAYASHI Michiko (3) ; OKU Tsuneyuki (2) ;
Background: The Oketani method is a program of breast massage and clinical counseling developed by the midwife Satomi Oketani. The purpose of this study is to examine the effects of the method on the quality of breast milk by determining the chemical composition of the milk before and after massage. Methods: Milk samples were obtained immediately before and after massage from healthy, exclusively breast-feeding Japanese mothers at two different periods of lactation one <3 months the other >3 months after parturition. Lipids, whey protein, casein, lactose, ash, and total solids in milk were measured in milk samples. The gross energy content of milk was estimated. Results: Breast massage significantly increased lipids in the late lactating period but not in the early lactating period. In the early lactating period casein was increased by breast massage but was not significantly affected in the late lactating period. Breast massage caused a significant increase in total solids from the first day to 11 months post partum. The gross energy in the late lactating period was significantly increased by breast massage but not in the early lactating period. Lactose was not significantly changed by breast massage. Conclusions: Breast massage improves the quality of human milk by significantly increasing total solids, lipids, and casein concentration and gross energy. The milk of mothers treated by Oketani breast massage may improve the growth and development of infants.
More information about Oketani massage at:
http://peach.ease.lsoft.com/scripts/wa.exe?A2=ind0606d&L=lactnet&D=0&T=0&P=11233
Treatments
for breast engorgement during lactation.
Snowden H, Renfrew M, Woolridge M.
Cochrane Database Syst Rev. 2001;(2):CD000046.
"AUTHORS' CONCLUSIONS: Cabbage leaves and gel packs were equally
effective in the treatment of engorgement. Since both cabbage
extract and placebo cream were equally effective, the alleviation
in symptoms may be brought about by other factors, such as breast
massage. Ultrasound treatment is equally effective with or without
the ultra-wave emitting crystal, therefore its effectiveness is
more likely to be due to the effect of radiant heat or massage.
Pharmacologically, oxytocin was not an effective engorgement
treatment while Danzen and bromelain/trypsin complex significantly
improved the symptoms of engorgement. Initial prevention of breast
engorgement should remain the key priority."
The use of cabbage leaves is a very old treatment, having been used in England as far back as 25 years ago. Cabbage leaves have also been used for various other complaints over the years.
The cabbage belongs to the "Brassicacae Family" and contains
mustard oil, magnesium, oxalate and sulphur heterosides. Sulphur
in amnio acid methionine acts as an antibiotic and anti-irritant,
which in turn draws an extra flow of blood to the area. This
dilates the capillaries and acts as a counter irritant, thus
relieving the engorgement and inflammation and allowing milk to
flow freely.
Can anyone give me some information on the use of cabbage leaves
for breast engorgement when lactation first gets going? I've heard
about it but know very little.....how and why does it work? Does
it matter what type of cabbage?
In the unit where I work in Victoria, Australia, we use fresh,
cold cabbage leaves frequently for the postnatal women for breast
engorgement. It works fantastically and feel very soothing as well
as reduces the supply.
A
comparison of chilled and room temperature cabbage leaves in
treating breast engorgement.
Roberts KL. Reiter M. Schuster D .
Journal of Human Lactation. 11(3):191-4, 1995 Sep.
ABSTRACT: This study compared the effectiveness of chilled and
room temperature green cabbage leaves in reducing the discomfort
of breast engorgement in postpartum mothers. Twenty-eight
lactating women with breast engorgement used chilled cabbage
leaves on one breast and room-temperature cabbage leaves on the
other for a two-hour period. Pre-treatment pain levels were
compared with post-treatment levels for both conditions. There was
no difference in the post-treatment ratings for the two
treatments; mothers reported significantly less pain with both
treatments. We concluded that it is not necessary to chill cabbage
leaves before use.
Kvist LJ1, Hall-Lord ML, Rydhstroem H, Larsson BW.
Midwifery. 2007 Jun;23(2):184-95. Epub 2006 Oct 18.
KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: if acupuncture
treatment is acceptable to the mother, this, together with care
interventions such as correction of breast feeding position and
babies' attachment to the breast, might be a more expedient and
less invasive choice of treatment than the use of oxytocin nasal
spray. Midwives, nurses or medical practitioners with
specialist competence in breast feeding should be the primary care
providers for mothers with inflammatory symptoms of the breast
during lactation. The use of antibiotics for inflammatory symptoms
of the breast should be closely monitored in order to help the
global community reduce resistance development among bacterial
pathogens.
Cabbage leaves are commonly used to treat engorged breasts. I advise women to separate two fresh (not cooked) leaves and gently bruise the inner side with a kitchen utensil i.e. rolling pin. Then one leaf is placed on each breast for 15- 20 minutes. This can be repeated as often as desired. There have been a few studies that demonstrate efficacy, but they have had small numbers.
Other advice for engorgement or mastitis include hot compress before feeding and cold afterwards.
A randomized, controlled trial was conducted to evaluate the effect of cabbage leaves on mother' perceptions of breast engorgement and the influence of this treatment on breastfeeding practices. The subjects, 120 breastfeeding woman 72 hours postpartum, were randomly allocated to an experimental group who received application of cabbage leaves to their breasts, or to a control group who received routine care. The experimental group tended to report less breast engorgement, but this trend was not statistically significant. At six weeks. woman who received the cabbage leaf application were more likely to be breastfeeding exclusively, 76 and 58 percent (36/35 vs. 29/50;P=0.09) and their mean duration of exclusive breastfeeding was longer. (36 vs. 30 days; P=0.04) The greater breastfeeding success in the experimental group may have been due to some beneficial effect of the cabbage leaf application, or may have been secondary to reassurance and improved confidence and self esteem in these mothersBIRTH 20:2 June 1993
Growth
spurts from kellymom.com
Breastfeeding
During a Baby's Growth Spurt from about.com
How
to Increase Your Breastmilk Supply - The Summarized Version
By Pam Caldwell at HerbLore
How does
milk production work? from kellymom.com - Excellent article
including information that was new to me. Breasts make more
milk when they're emptier, which is why emptying the breast
frequently builds up the supply.
NOTE - Recent insertion of an IUD with hormones might reduce your milk levels.
NOTE - If you think you need to increase your milk supply because the baby has suddenly seemed hungry all the time, needing to nurse every hour or so, consider that the baby is having a growth spurt and may be ramping up the milk production through the increased nursing; then you don't need to do anything but nurse the baby and keep up the nutrition, hydration and rest that allow your body to make all the milk that your baby needs.
NOTE - If a woman doesn't respond to efforts to increase her milk
supply as expected, consider the possibility that there may be
underlying thyroid problems. Even if she's already had her
thyroid tested in this pregnancy, consider doing another thyroid
test or referring to a physician for evaluation.
The Breastfeeding Mother's Guide to Making More Milk: Foreword by Martha Sears, RN (Breastfeeding Mothers Guide) by Diana West and Lisa Marasco
One of our local doulas strongly recommends this book: "This book
is excellent for figuring out why there is low milk production
(which is the first step) and how to bring it back up. Out of all
the lactation books that are for problem solving this is the best
I have read so far. Organized and clear with a lot of problem
solving ideas and multiple routes to solutions that are specific
to the problem. The only thing that I did not like is that one of
the websites it refers to throughout the book is no longer
supporting the text it refers to."
I like MegaMam
from Tri-Light Health; it's a tasty glycerine formula so my
clients will actually take it! and they like not taking
alcohol-based herbs while breastfeeding.
Has anyone tried Go-Lacta™?
It's
the
leaves
of
the
Malunggay tree (moringa oleifera), an Asian lacatagogue from
Sugarpod Organics.
These suggestions can be found in After the Baby's Birth by Robin Lim and Earl Mindell's Herb Bible:
Alfalfa - 3 to 6 daily (capsules) or 1 tablsepoon with 8 ouces
hot water brewed into tea daily.
Anise - 1 teaspoon powder (crush seeds) in 1 cup boiling water 3
times daily.
Borage
Dill - 2 teaspoons seeds steeped in 1 cup hpt water for 10-15
minutes.
Strain. Take 1/2 cup 2 to 3 times daily.
Comfrey
Fennel - 10 to 20 drops in water of extract daily. Can
purchase as a tea.
Fenugreek - 2 capsules 3 times a day
Red raspsberry leaf tea
Blessed Thistle - 2 capsules 3 times a day
Caraway - 3 to 4 drops of extract mixed in liquid 3 to 4 times a
day. Can brew herb into tea.
Brewer's yeast - 2 capsules 3 times a day.
Shatavari - an Ayurvedic herb. up to 3 grams of powder in a cup of
warm milk with honey and ghee.
Can buy a variety of prepared commercial products:
Mother's Milk Tea by Traditional Medicinals
Magnetic Mama Lactation Tea with blessed thistle, borage, alfalfa, red clover, raspberry, fenel, nettles, hops, peppermint from Moonflower
Midwife Formula 6-L: Mega mam with milk thistle, chast tree,
fennel, borage, red raspberry, lemon balm from Spirit Led
Fennel is a good lactation stimulant and one of the easiest ways
to take it in quantity is the candy coated seeds you get from
Indian food shops. If you've no Asian food shop close (and it has
to be the sort frequented by Asians, rather than the Asian run
corner shop) just boil normal fennel seeds for five minutes,
strain and add honey if you want. If she doesn't like the taste of
fennel, other lactation stimulants are fenugreek, celery and
nettle.
Sometimes a mom's milk supply appears not to come in because she's having so much difficulty relaxing during a feed. This can be the result of a difficult previous birth or breastfeeding experience, ambivalent feelings about breastfeeding or body image, or whatever. Obviously, you want to address the basics - helping her to get completely relaxed, maybe nursing baby in a warm bath or with her feet in warm water or wrapped in a warm blanket, aromatherapy, lots of warm loving support, and . . . music, music, music!
I was delighted with the results we got when a mom started
listening to Renee
Smith's music - it's a wonderful combination of more
traditional lullaby styles with more nurturing lyrics. My
personal favorite is her Angels & Mermaids
CD, with her Lullabies
For My Little Angels a very close second. Her Seeds & Songs To
Make 'em Grow is a wonderful collection for "older
children", i.e. toddlers and pre-schoolers, not to mention their
parents! I don't know what it is about this music, but it
always makes me so happy! Cheaper than therapy and lots more
fun.
The first case was a women who went to the chiropractor on the referral of her midwife. She had given birth 10 days earlier to her second child and unlike her first, she was unable to establish a milk supply for her second baby. The patient had no other medical issues other than difficulty in swallowing a glass of water.
An examination determined that she had a subluxation, and specific chiropractic care was initiated to correct that issue. After her second visit the patient commented that she found it much easier to swallow. By the third visit she noticed visible changes in her breast and the production of milk. This improvement resulted in a positive weight gain for the infant who was forced to depend of formula until the mothers milk issues were resolved.
The second patient went to the chiropractor for upper back pain but was also unable to produce sufficient milk to feed her one month old infant. Her examination showed no medical history for her problems, however, the chiropractic portion of her exam showed subluxations. She began a series of specific chiropractic adjustments for subluxation correction. By the forth visit the patient was noticing breast enlargement and the production of milk. She also became pain free from the upper back pain she was experiencing.
The third case was a women who came into the chiropractor's office with her daughter six days after birth. She was sent there on the recommendation of the hospital lactation consultant. As in the previous cases, subluxations were found and care was initiated to correct them. In this case it took only 24 hours for the positive results to show, and for this mother to be able to feed her infant naturally.
Based on their case studies and the volumes of previous research,
these researchers concluded that subluxations and the neurological
interference they cause play a major role in Hypolactation.
The researchers suggest, "Chiropractic evaluation for subluxations
would be a key element in the holistic assessment of the failure
to establish milk supply in the postpartum patient."
Ellen
Roos - Passion
Flower Music - Songs that see and stir, love and forgive,
lift, bless and free! Her first album is Lavender and
Morning Sun.
Klaire Labs website requires you to provide a consultant's
prescription number of sorts.
One of our local midwives shared that one of her clients had a
bleb for over a month that disappeared within five days of
starting on this probiotic supplement. An update a couple of weeks
later was that the probiotics seemed to be working even better
than the lecithin. HALLELUJAH!
The FDA just issued a black box warning about the prolonged use of Reglan. Basically it has been found to induce tardive dyskinesia symptoms in rare patients AFTER several months of use.
I would suggest that mothers use Reglan only for a month or 2 at most and then taper off of it.
Tom Hale Ph.d., 6/21/09
Galactagogues
from Dr.
Thomas Hale's web pages, including discussions of
domperidone, reglan, blessed thistle, fenugreek, oxytocin nasal
spray, lovonox.
Herbal
Galactagogues Compiled by Gretchen Humphries [March 02,
2000]
Mamatini is a
great-tasting organic herbal infusion specifically designed to
meet the needs of pregnant and nursing moms. Mamatini is
doctor-designed to give you the confidence, energy, and strong
milk supply you need to raise a healthy baby. [Ed:
Convenient but pricey!]
This makes 2-3 quarts - enough for a week or two unless correcting a real problem with supply. Steep in a closed jar at overnight. I like to give moms a little baggy of it for mental support that first time they think "ACK, no milk". The few that really need it buy more on their own.
I don't add raspberry leaf - I think someone mentioned it counteracts milk-supporters to some degree. Anyone else heard this?
I suppose you could take BT in capsule form if more was needed, but have never encountered that degree of problem.
To increase milk try any of these (or combo): fennel seed tea or
capsules, hops tea (or good quality non-alcoholic beer), two
500-mg capsules morning/evening of vitex (chaste berry), blessed
thistle, aniseeds, nettles, raspberry leaf tea/capsules,
fenugreek, nurse often, marshmallow root, alfalfa, brewer's yeast
pills, zinc, selenium, vit E, iron, soy, wild yam, and a lot of
fruits and vegetables.
I've had moms use Blessed Thistle to increase the fat content of
breastmilk and had it work wonders.
From our local herbalist:
I have much experience with this (the Fenugreek part anyway!). The dose of Fenugreek depends on her situation (i.e. how much milk she's already making and how much increase she needs). I recommend starting with a low dose of 3 caps three times a day. With our Fenugreek, she should see results within 24 hours or less. If the increase hasn't been achieved, then she can go up to 4 caps 4 times a day. Fenugreek should be taken as a "single" meaning not blended with anything else. This is because the Fenugreek dose needs to be consistent and regulated for best results. When it's in a blend, it's nearly impossible to regulate how much FG is in each dose, which can cause an up and down supply, or for some, a decrease. When she's achieved her goal and her supply is stable, she can then slowly wean down from it and be done. Here's more on Fenugreek and how to use it correctly. We have it in vegi-cap and tincture (liquid extract) - it's organic, very fresh and according to our clients, works much better than any FG gotten off a store shelf. This is probably a freshness issue. Here's the link:
http://herblore.com/service/index.php?pg=info_fenugreek
And for more ideas on how to increase milk production:
http://herblore.com/service/index.php?pg=article_breast_feeding
She may not necessarily need FG. Once she starts, she needs
to be consistent until ready to wean down. I do a lot of
this work, and would be happy to talk to her about her situation
and what would be most helpful for her. In order to have it
affect her blood sugar, she would need to take very large amounts
of it - grams. I tend towards low blood sugar, and I did not
notice any effects when I was taking FG. It should not
be a problem at all. Again, I'm happy to speak with
her about this.
"A new mother may experience great stress if her new baby has
difficulty with breastfeeding. This stress often becomes part of a
vicious cycle, further exacerbating the problem. Homeopathic
Silicea (taken by Mom and imparted to baby through the breast
milk) helps the delicate infant who needs appetite stimulation,
and helps with watery stools and vomiting after nursing."
For other tips on homeopathics for nursing and newborn care, see
the EMAZING.com
archives
of the Homeopathic Health Tip of the Day
Herbs
to Avoid During Lactation from HerbLore (scroll down the page)
I have personal experience with it and have done much of my own research. I recommend looking at what Jack Newman has to say- he is definitely an authority on the subject. Also, read Medications and Mother’s Milk, by Thomas Hale.
As for how it will work, if her supply is low due to a hormonal issue, it is likely to work as it increases prolactin. Sometimes there is no way to know the cause and the only way to know if something works is to try it. I second what others said about Reglan…I would definitely steer clear of that! Domperidone is not available in the US, which is why Reglan is often prescribed, but Domperidone is easy to get from overseas through www.inhousepharmacy.com. My understanding of why it has not been approved in the US is because there was an incidence of heart failure associated with BUT it had been given through an IV to an immuno-compromised person. It has been used for quite some time to increase milk production with apparently good/ safe results. I, myself, had a good experience with it. I tend to be pretty anti-pharmaceuticals and given my situation, I was pretty comfortable taking it. In my case, I took it for about 4 or 5 mos and once I weaned off of it, I was able to maintain the supply I had while taking it with no problem. I also used many herbs, acupuncture, etc. first and decided to try Dom when they weren’t quite getting me to where I needed to be.
Lastly, I recommend any mom who is truly struggling with low milk
supply (or any other unusual BF difficulty) to join the Mothers
Overcoming Breastfeeding Issues yahoogroup.
(mobi@yahoogroups.com). This group has been an amazing
wealth of support and information and she will hear all kinds of
research and personal experiences with Dom on this list. The
author of Making More Milk is also a regular on the MOBI list.
The majority of my moms have excellent results even after a few
days. A few have felt a little dizzy or off, but once they
adjusted the dose things cleared up. Dr. Jack Newman uses it
routinely for supply issues. (Also check his website out) and it
is widely accepted and used in Canada. Thomas Hale’s
Mediations in Mothers Milk 2008 edition has some good information
about the drug also. I agree that Reglan has been a
nightmare for most of the moms I work with. The CNS side
effects are not pleasant and who needs more anxiety and depression
after having a baby.
Prevention
of and therapies for nipple pain: a systematic review.
Morland-Schultz K, Hill PD.
J Obstet Gynecol Neonatal Nurs. 2005 Jul-Aug;34(4):428-37.
CONCLUSIONS: No one topical agent showed superior results in the
relief of nipple discomfort. The most important factor in
decreasing the incidence of nipple pain is the provision of
education in relation to proper breastfeeding technique and
latch-on as well as anticipatory guidance regarding the high
incidence of early postpartum nipple pain.
[Lansinoh
in the treatment of sore nipples in breastfeeding women]
Tanchev S, V?lkova S, Georgieva V, Gesheva Iu, Tsvetkov M.
Akush Ginekol (Sofiia). 2004;43 Suppl 3:27-30.
CONCLUSION: Lansinoh is purified lanolin suitable for
prophylactics and treatment of sore nipples.
One thing that bothers me about lactation consulting and "experts" in nursing is the premise that breastfeeding is always comfortable (ie not painful). All I ever see is unmedicated babies and mothers. 100% of the time breastfeeding hurts at first. This is with a good latch and well-educated mothers in advance of the birth. I am of the mind that it's supposed to hurt and that telling the mother that something is wrong when it hurts is very undermining. I think the idea of painless, comfortable first week nursing is a result of most babies being born medicated out of their little minds. The anaesthetized baby does not suck like a barracuda.
Just as birth does not progress at home in a watertub the way
"they" say it "should", breastfeeding with a conscious mother and
baby is very different from what I read in books and
articles. Naturally born babies, whose cords are left to
pulse, and who find the breast for the first time in a relaxed,
easy way
1. don't lose any weight
2. bring the milk in on Day 2
3. cause some initial soreness and trauma to the nipple that is
unavoidable
I'd like to hear from others on your observations. I think we
need to be cautious in telling mothers that something's wrong if
breastfeeding hurts at first. With good positioning (close
to chest, tummy to tummy; ear-shoulder-hip in straight line) the
mother/baby pair will sail through that initial soreness without a
big deal and the nipples will toughen. I've just had a
client who was advised that it should NEVER hurt and she is
essentially bottle-feeding now because she was told that the latch
was wrong whenever she expressed discomfort to her lactation
consultant. It all looked fine and normal to me and I was of
the mind to just persevere on through. I'm very upset that
her breastfeeding confidence was so undermined and am now of the
mind to ban lactation consultant advice for the first week. The
lactation cons. involved is someone I greatly admire and I know
she has done wonders for women in her area but I think she's just
not used to naturally born barracudas (oops I mean babies!).
I tell my clients that the baby's job is to suck, suck, suck to
bring the milk in and that babies who do this are very smart
babies. They know that by bringing the milk in as quickly as
possible, they'll have milk before they exhaust their birth
resources. I reassure them that once the milk is in, the
baby won't need to nurse as strongly or as much, because the
luscious, nutritious milk will just flow into their mouths with
gentle sucking. And it's almost always true.
One mom was generous enough to write up her recommendations for dealing with pain:
Since I have gone through similar (but probably not identical) issues, here are a few ideas to throw into the mix. Some might apply to you, some might not.
1) nipple pain plus burning deep in the breast -> need to check for thrush. The diagnosis is not necessarily easy, and it treating both mother and child need to be treated.
2) for cracks, Newman's All-Purpose Nipple Ointment is a godsend. Even without thrush it will help with inflammation (the hydrocortisone) and healing (the antibiotic will prevent infections). On top of that, lanolin, lanolin and more lanolin. Keep it in a back pocket so that it is warm and runny, not cold and stiff, when you try to apply it to injured nipples.
3) my oldest had a really bad latch which, since it was preceded by a few scary days of no latch, no milk, weight loss > 10% and jaundice, I ignored way too long. The actual underlying cause was only identified after about 4 weeks of me gritting my teeth and a second trip to the LC: overactive letdown. My milk was flowing so fast that my son was sliding down the nipple (bad latch = decreased flow) and clamping his teeth in a attempt to tame the flood.
There is a whole different bag of tricks to handle that (and since some attempt to decrease your milk supply they should be applied progressively and carefully). See Forceful Let-down (Milk Ejection Reflex) & Oversupply from kellymom for the details. I used positioning and block nursing, mostly.
I will note that I never had oversupply (no engorgement) although both my sons gained weight very fast (3 1/2 pounds and 4 pounds the first month, respectively).
4) another thing that led to nervous baby clamping down on nipple: being in so much pain and anticipating the pain so much that I was contracting every muscle in my body before putting my son to the breast. It turns out that clamping my hand too hard on his head led him to clamping his jaw on my nipple in return. Letting him handle the latch (side lying, which I only figured out for #2, or him lying down on the breast friend) helped with that.
5) at some point I thought I had thrush,
with shooting pain in the breast when my son started nursing. It
took going back to work and pumping to realize that was just the
way I experience letdown -- while nursing over cracked nipples I
was not able to separate the sources of pain very well.
Apparently, there is some controversy about this, but many moms do seem to find relief from lanolin or hydrogel pads:
Hydrogel dressings in the British Journal of Midwifery [8/15/09] — Elizabeth Jay - Researchers who were blind to the treatment group rated nipples as healing significantly better when women used lanolin with breast shells, rather than hydrogel dressings.
A moist environment is critical for epithelization, the proliferation and migration of epithelial cells across the surface of a wound during healing. Nipple wounds also heal by this process. Using a particular type of wound dressing, a hydrogel sheet wound covering, on a nipple wound offers several advantages. These dressings help maintain a moist environment, decrease the chance of bacterial infection, are easy to use, and provide immediate pain relief.
Comparing the use of hydrogel dressings to lanolin ointment with lactating mothers.
J Obstet Gynecol Neonatal Nurs. 2003 Jul-Aug;32(4):486-94.
Dodd V1, Chalmers C.
CONCLUSION:
Hydrogel dressings are a safe, available treatment that provided more effective pain management for nipple soreness than the common intervention of lanolin ointment.
Nipple
Pain, Damage & Infections from the San Diego Breastfeeding
Coalition at breastfeeding.org - Wolfrum recommended
using lanolin and breast milk mix and hydrogel gel pads together,
“Mothers often ‘ahhhhhh’ with use of hydrogels!”
Medela
Hydrogel pads - If you’re breastfeeding and have sore or
cracked nipples, Medela hydrogel pads support healing and offer
instant, soothing relief.
Some people are using ClearSite - a gel dressing. Call Sue
Cornell at 1-800-765-8375 ext 2391 to request samples.
You can search Amazon or Google for vegan nipple creams.
I have used this or another type on 2 women now with really good results. Both loved the way it feels, immediate relief from the pain of severely cracked nipples. I have also used it in conjunction with Lansinoh.
I have just cut them to fit around the site of the crack. I do not cover the whole nipple. So far it has worked just to tuck them into the moms bra. With a woman with smaller breasts I would have to play around and see what would work, tape maybe? I try to be sure that we have corrected the problem that has caused the crack and have the mom be fanatical about correct positioning.
So far I have been really happy with the results and have not
seen a problem from the continual moisture. Small sample, I know,
but I haven't heard any bad reports from lactnet either.
Geranium leaves for intractable cracked nipples. Lansinoh is also very good.
Lansinoh Samples Call (in the USA) 1-800-292-4794 and Lansinoh Laboratories will send you free samples with an informational brochure that includes LLLI's endorsement, history and phone number. They will send you a supply monthly.
Vasospasm suggests overactive muscles in the ducts; this could be
the result of a magnesium deficiency, and increasing magnesium is
one of the simplest remedies to a lot of problems stemming from
muscular overactivity or calcium/magnesium imbalance. [NOTE
- Magnesium oxide will cause your stool to be looser; magnesium
citrate has less effect on your bowels.]
Vasospasm
and Raynaud’s Phenomenon - excellent resource from Dr. Jack
Newman at breastfeedinginc.ca
Sore
Nipples by Dr. Jack Newman
Treatments for sore nipples and sore breasts: All-Purpose
Nipple Ointment by Dr. Jack Newman
Seeking
Relief - Excellent page from LLL site about diagnosis and
simple and more complicated treatments for nipple vasospasm
Raynaud's Phenomenon of the Nipple May Cause Painful Breastfeeding by Laurie Barclay, MD [Medscape]
Prompt treatment allows mothers to continue to breastfeed
pain-free, and it avoids unnecessary antifungal therapy for
misdiagnosed C albicans.
[Editor's note - Gentian violet is not a plant product; is it a toxic, carcinogenic product which may be useful as a treatment of last resort, but please don't make it the first remedy you try!]
This article has some helpful points about diagnosing thrush. In particular, they write, "The pain caused by a Candidal infection is generally different from the pain caused by poor positioning and/or ineffective suckling. The pain caused by a Candidal infection . . . Frequently lasts throughout the feeding, and occasionally continues after the feeding has ended. This is in contrast to the pain due to other causes that usually hurts most when the baby latches on, and gradually improves as the baby sucks."
This article on Seeking
Relief gives a good description of Raynaud's or nipple
vasospasm.
If you're trying to find a doctor who will prescribe Nifedipine,
you should start with your family doctor, OB or
pediatrician. If they're reluctant, show them the
research paper.
Hi. I have a client who describes a painful let down.
This is the third baby, she has successfully BF the other two with
no problem. She says this is not a latch issue, and I have
checked and it looks great. The let down is painful.
Any one have any information or insight or suggestions.
I have a client who is currently mid-pregnancy. With her previous baby, she weaned early because of EXTREME pain with let-down. She described normal early tenderness with initial latches that subsided with time, but increasing intense pain with let-down so that pain extended from the breast through to her back. She confirmed there was no pain with suckling, no nipple pain, only with let-down and this included let-down from sexual stimulation and simple showering in warm water (even described as "contractions" in the breast, feeling the milk flow as "burning"). She is eager to nurse this next baby but is wary of the same experience. She has not had issues with yeast in the past and did not describe symptoms that would jibe with thrush (in my practical experience).
Can anyone share a similar experience and how I might help her
with this?
I think it always makes sense to treat persistent pain (beyond
the first week or ten days) with holistic thrush treatments.
In addition, you want to rule out Raynaud's. You can also
try lobelia for spastic letdown similar to the spastic cervical
dilation during labor.
I have experienced this. It was like "pins & needles"
with let-down. I simply used labor breathing and relaxation
to get through let-down, and it did get better as baby got older.
By 18mo it was gone. [Ed. This sounds like a much milder version
of the EXTREME PAIN that others experience.]
Treatments for Raynaud’s Phenomenon (blanching of the nipple) [search about halfway down on this page] - "The first choice for treatment is:
* Vitamin B6. This has shown to work by trial and error, but it does seem to work. There is no scientific evidence that it works, but it does nevertheless. It is safe and will do no harm. The dose is 150 mg/day once a day for four days, followed by 25 mg/day once a day. The mother continues it until she is pain free for a few weeks. It can be restarted if necessary.
If vitamin B6 does not work within a few days, it probably won’t. It is then useful to try:
* Nifedipine. This is a drug used for hypertension. One 30 mg tablet of the slow release formulation once a day often takes away the pain of Raynaud’s phenomenon. After two weeks, stop the medication. If pain returns (about 10% of mothers), start it again. After two weeks, stop the medication. If pain returns (a very small number of mothers), start it again. Very few mothers I am aware of took more than three courses. Side effects are uncommon, but headache does occur. "
Raynaud's Syndrome and Breastfeeding from breastfeeding.com
Nipple blanching and vasospasm
NIPPLE VASOSPASM - A MANIFESTATION OF RAYNAUD’S PHENOMENON AND A PREVENTABLE CAUSE OF BREASTFEEDING FAILURE - A good comprehensive site
Raynaud's Phenomenon, and High Arched Palate from The Compleat Mother archives. [This contains some overlap material from the above sites.]
Nipple Pain And Vasospasm from multiplebirthscanada.org
Raynaud's
phenomenon
of
the
nipple:
a
treatable cause of painful breastfeeding. [Free
full text article]
Anderson JE, Held N, Wright K.
Pediatrics. 2004 Apr;113(4):e360-4.
" . . . Raynaud's phenomenon has been reported to affect the
nipples of breastfeeding mothers and is recognized by many
lactation experts as a treatable cause of painful breastfeeding. .
. . Because the breast pain associated with Raynaud's phenomenon
is so severe and throbbing, it is often mistaken for Candida
albicans infection. . . . To diagnose Raynaud's phenomenon
accurately, additional symptoms such as precipitation by cold
stimulus, occurrence of symptoms during pregnancy or when not
breastfeeding, and biphasic or triphasic color changes must be
present. . . . Treatment options include methods to prevent or
decrease cold exposure, avoidance of vasoconstrictive
drugs/nicotine that could precipitate symptoms, and pharmacologic
measures. . . . Nifedipine, a calcium channel blocker, has been
used to treat Raynaud's phenomenon because of its vasodilatory
effects. Very little of the medication can be demonstrated in
breast milk and thus is safe to use in breastfeeding mothers. Of
the 12 mothers in our series, 6 chose to use nifedipine, and all
had prompt relief of pain. Only 1 mother developed side effects
from nifedipine. Pediatricians and lactation consultants should be
aware of this treatable cause of painful breastfeeding and should
specifically question their patients, because most mothers will
not provide this information to the breastfeeding consultant. Prompt
treatment will allow mothers to continue to breastfeed pain free
while avoiding unnecessary antifungal therapy."
Nipple
vasospasms, Raynaud's syndrome, and nifedipine. [Full text]
Garrison CP.
J Hum Lact. 2002 Nov;18(4):382-5.
This case report describes a situation in which a mother who
experienced prolonged nipple pain with her first child sought help
from a lactation consultant at the birth of her second child.
Despite being very attentive to positioning and latch, similar
pain was experienced from the first feeding with the second baby.
The mother's history and symptoms were explored, and nipple
vasospasms related to Raynaud's syndrome were suspected. After
reviewing the literature and consulting with her personal
obstetrician, the mother (a pediatrician) chose to treat with
nifedipine. The mother was pain free after a 2-week course and
nursing without difficulty at 4 months postpartum.
I once had a patient with painful/burning latch. As an
IBCLC I see a lot of yeast problems, latching problems and I've
even seen a handful of Raynaud’s, but this patient didn't have any
of that. The baby was four months old, she had the exact
same thing with her first child. The kid had a perfect
latch, she underwent a course of nystatin, followed by two courses
of Diflucan (200/100 x 10 then 400/200 x 10), both she, her milk
and her newborn cultured negative for yeast or bacteria. We
did a course of procardia without relief and there was no
blanching with cold (even when I tried ice, no blanching).
In the end I figured it sounded more like neuropathy than anything
else. I consulted with our neurologist who agreed that ANY
nerve can present with neuropathy. We started her on a
course of Neurontin and IT WORKED. It took a little fiddling
to find the right dose that would give her some relief. The
pain never completely resolved, but it did get much better.
In the end she nursed for six months and then stopped both nursing
and the neurontin.
I also tend to association burning deep in the breast with yeast when it is beyond the normal "pins-and-needles" sensation.
Had a client recently who seemed to have BOTH problems. Deep burning in the breast - to the point of making her weep. And excruciatingly worse with cold that seemed like Raynaud’s. No particular pain with latching and as far as we could see - everything looked completely normal.
Her breasts looked completely normal and the baby was gaining, so
it took a little while before we all figured it out (we being a
pediatrician, two midwives and a lactation consultant). The
Diflucan helped some, but not enough and she ended up weaning
early.
Feverfew can help with migraines, but can also bring on the
period (with a vengeance, I might add). The best herbs for
Raynaud's is Ginkgo, as it helps bring blood flow to the
peripheral areas, including the nipple tips. It's fine to
use during breastfeeding. Niacin (one of the B Vitamins)
also helps, for the same reason, but too much can cause
"flushing", making the skin hot and red, due to the increase in
blood flow. Niacinamide does not have this flushing effect,
but I'm also not sure if it's as effective for Raynaud's.
Ginkgo is the better choice. [from a well-respected
herbalist]
ou are correct in that Ginkgo does increase blood flow, which is what makes it so helpful for vasoconstriction and spasm, as well as helping correct memory problems, senility or dementia (increases the blood flow bringing more oxygen to the brain), and helping to prevent stroke and other diseases related to emboli. It can increase bleeding time and decrease platelet aggregation. It's also helpful for migraines "due to its ability to stabilize platelets and serotonin levels in the brain, thereby normalizing blood flow".
So in cases where there is a fear of or potential for bleeding,
such as your example of birth head trauma or hemophilia, then I
would advise against the use of Ginkgo until the wound is
completely healed (or never in cases of hemophilia). In my
estimation, unless there is a bleeding issue (lack of clotting)
already known or present, if this were ME having the problem and
thinking about taking the herb, I would take it. The
suggested dose is 1 tablespoon of the dry herb per cup of water
(2-3 cups of tea per day), or 1-2 droppersful of the tincture 2-3
times a day. (Note: it's thought that Ginkgo can
prevent ovulation through its activity as a PAF antagonist and
create anovulatory menstrual cycles. PAF is secreted by the
ovary to allow release of the egg.)
see also: Candidiasis/Yeast
Infections
see also: Hazards of Gentian Violet
Information
Sheet
and
Care
Plan
for
Yeast (Candida) from breastfeeding-basics.com
Candida
Protocol from Dr. Jack Newman [Note Hazards of Gentian Violet]
Adding caprylic acid to the mother's diet can be helpful as
caprylic acid is an anti-fungal made from goat's milk or other
organic products.
Grapefruit seed extract (sometimes called Citricidal) is also
very helpful in knocking out thrush and other candida infections.
This is from a very respected lactation consultation:
I have worked with hundreds of mom/baby pairs with thrush over
the past 20 years and I have to say it has become a major problem
and the reason why moms choose to stop breastfeeding. This
does not have to be the case. Mom or baby can be asymptomatic, but
one can give it to the other. Both must be treated. Also,
over 50% of the strains of yeast that cause thrush can be
resistant to the Nystatin. If not resistant, many parents
are applying it incorrectly and not swabbing directly on the
tongue, checks and gums of the infant or they are not doing it
often enough. I would suggest that the parents see a Naturopathic
Doctor to work on their immune system and look at their diet. Take
a good ProBiotic (45 Billion Live Organisms) we use/sell the
Kendy’s Brand it is not grown on Dairy, put some on the nipples
before feeds and sprinkle some in the diaper area. Most moms end
on Difulcan/Fluconazole with a loading dose of 400 mg, then 200mg
there after for at least 2 weeks with one refill. Some moms
have to take it for longer. They also need to take it until
the last symptom (for mom or baby) has been gone for at least 7
days. Baby needs to be treated also. The amount of Diflucan
that passes through the breastmilk is not therapeutic at all and
will do nothing for the baby. The baby may be put on the same
medication for the same length of time, if no response to the
Nystatin. Also, we need to watch for a secondary infection
such as Staph. When we have that much tissue break down it
can happen and treatment needs to happen. Many doctors will
prescribe Dr. Jack Newman’s APNO
(All purpose Nipple Ointment) for the mom to apply to the
nipple to take care of this potential problem and help speed
healing.
[Editor's note - Gentian violet is not a plant product; is it a toxic, carcinogenic product which may be useful as a treatment of last resort, but please don't make it the first remedy you try!]
This article has some helpful points about diagnosing thrush. In particular, they write, "The pain caused by a Candidal infection is generally different from the pain caused by poor positioning and/or ineffective suckling. The pain caused by a Candidal infection . . . Frequently lasts throughout the feeding, and occasionally continues after the feeding has ended. This is in contrast to the pain due to other causes that usually hurts most when the baby latches on, and gradually improves as the baby sucks."
This article on Seeking
Relief gives a good description of Raynaud's or nipple
vasospasm.
We fought thrush for the first 12 weeks of my daughter's
life. Nystatin didn't work. It was awful. Here's
what I did that finally worked: 1) I gave my baby Jarrow
Baby Acidophilus (mixed with water to make a paste) on my finger
and rubbed it on her cheeks (check with your doc, mine said it was
fine) and 2) I took a mega dose of acidophilus. One
container of Bio K acidophilus (at whole foods in the cooler) a
day. It was great and worked and ended the nightmare. This
stuff is THE BEST and was a lifesaver for us. 3) You can dip
your nipples in apple cider vinegar/water mix after feeding.
4) Look up thrush prevention on kellymom.com.
My
doc
also
said
it
usually takes care of itself by 6mo when the babies immune system
kicks in.
Natren produces a probiotic product designed specifically for
infants. Life
Start is made with Bifidobacterium infantis - the beneficial
bacteria which is most prominent in infants. This can be
beneficial for newborn thrush, newborn diarhea or diaper rash.
BioFlora makes a product called Infantiflora,
containing B. infantis, which colonizes the baby's mouth with
probiotics that suppress yeast.
The makers of Floradix also make an Infant's
Blend Probiotic Blend, containing B. infantis, which
colonizes the baby's mouth with probiotics that suppress yeast.
If seeking help for your baby from a pediatrician, you may run into the problem that they will not also treat the yeast in the mom's breasts!
There are some options that this new mom can take. She can
get help from a lactation consultant who can be the third party to
educate her existing pediatrician that mom needs to be treated
too, or she can be her own advocate and provide her pediatrician
with the necessary literature so that the pedi will learn as well
the importance of treating both mom and baby. The lactation
consultant here gave me literature on Breastfeeding and Thrush
that I would be happy to fax to you. It's not uncommon for this to
happen with healthcare providers. Our Lactation Consultants
are constantly educating Pedi's and OB's on solutions to
breastfeeding problems.
Yeast/Thrush
from Breastfeedingonline
Identifying
and Treating Thrush by Cheryl Taylor White, CBE from Dr Jay
Gordon's information
It can be difficult to diagnose yeast. A trivia-mad medical
student sent me the tip that yeast fluoresces under black light.
Great all inclusive thrush information - http://www.breastfeed-essentials.com/thrush.html
Good News for
Breastfeeding Moms: Treating and Preventing Thrush By Chris
Hafner-Eaton
Alternate
Tx
for
thrush - Feb 03, 2004g - In my practice, I rely on essential
oil of rosemary when treating thrush & coincident candidal
infection of a nursing mom. An herbalist who I'd taken care of
told me about this. It has been reliable, pleasing to the infant's
taste buds and not messy. I have the mom dilute 2 drops of
essential oil of rosemary in 1/4 tsp. olive oil, mix well then
swab the tongue & buccal mucosa with this three times a day.
Mom can just use her finger to do this. I also ask that the mom
purchase cocoa butter and add 2 drops of rosemary to 1/4 tsp.
cocoa butter (warmed in the hands to soften it). This mix massaged
into the nipple and 1 1/4 inch radially of the surrounding breast
up to 6 times/day has both addressed the candida infection and
helped heal up the raw areola in my experience.
My favorite remedy is for thrush/yeast infections. It is oil of
oregano. Two drops in a teaspoon of olive oil rubbed on baby's
feet can treat them. That same solution can be applied topically
to the nipple. Most use two drops under the tongue (mom's, NOT
baby's) three times a day.
Midwives (and all care providers!) need to be aware that putting
our bare fingers in a baby's mouth may be the transmission vector
for yeast, which then becomes thrush. I think we're kidding
ourselves if we think we're not carrying yeast under our
fingernails!
Thrush can be hard to diagnose - sometimes the signs are really
obvious, but it can still be making it painful for baby to
nurse. If baby nursed really well for the first few days and
then things fell apart, it may be that a sub-clinical thrush
infection is causing baby pain with sucking and swallowing.
Especially if mom is also having strange stabbing pains in the
breast, it could be thrush. Try mild treatments for thrush
and see if things improve.
I used the baking soda treatment on my breasts and in my son's mouth after every feeding, I cut out refined sugars from my diet, and washed sheets and underwear with an apple cider vinegar rinse. I think it's very important to keep hands very clean--washing them before and after nursing. You can use diluted apple cider vinegar on your breasts too after each feeding. My son had a yeast rash as well as in his mouth (the yeast will eventually travel to baby's bottom--just a matter of time) so I gave him frequent baths in diluted apple cider vinegar and let him go without a diaper as much as possible.
Acidophilus capsules work really well too, but I found just
eating plain yogurt everyday helped tremendously.
Acidophilus, like all live cultures, can be terrific but babies
don't manufacture the same bacteria in their guts that grown ups
do, including acidophilus. Their system are much more
regulated by bifidus, which would be a terrific thing for thrush.
Also, homeopathic Borax I've seen used with some degree of
success. I would also hold off on the gerber foods until you
figure out the thrush because a lot of canned foods already have a
high yeast content as well as extra sugars that yeast thrives on.
Yes. Have you tried a solution of baking soda? You dissolve a teaspoon of baking soda in a cup of water. After each nursing, swab baby's mouth firmly and thoroughly, under the tongue, inside the cheeks, and on the gums. Use a fresh cotton swab each time. This removes the milk and gives the thrush fungus less to live on. Also after each nursing, wash your nipples (gently) with this solution from a separate cup labeled for yourself. Apply a light coating of lanolin or petroleum jelly to counteract dryness. Don't suspect that you aren't carrying the fungus just because you don't exhibit the miserable pain some mothers do. Make a fresh solution each day and don't give up until baby is completely well.
This is an old LLL tip I always recommend to my mothers both past
and present. I hope you'll get this thing
licked...thrush can be a very persistent annoyance!
ah, I meant to mention this step too. I warned about blankets,
t-shirts and bibs, but didn't say what to do about it. Vinegar
makes a good rinse. I've heard baking soda can also be used --
anything to change the normal Ph. And bleach should work to
sterilise -- if your clothes can handle it.
I have found that using lanolin at any point during a thrush
infestation only furthers the problem, even after a good
cleansing, as it lives down in the cracks and crevices. It's great
for sore nipples, but is a hindrance in the battle of
thrush. I suggest using acidophilus. Get a gauze 4x and dip
it in a little of the acidophilus and swab the baby's mouth really
well, and then the mothers nipples. Lots of stuff will come off of
the baby's mouth.
If you're using a bottle to have the dad give the baby some
expressed breastmilk, it's very important to make sure that you
boil all bottle nipples and if you are using pacifiers those
also. (I would add a couple of T. of apple cider vinegar to
the boiling water. All plastic bottles, nipples, etc. are
notorious for helping keep thrush alive. You have to treat
both you and the baby or it does no good to treat one of you.
I battled thrush for ten months with my nursing son. I
tried it all, vinegar, gentian violet 2%
topically and dietary changes. Eventually I tried Nystatin and
Diflucan all to no avail. What worked was the Beat the Yeast
triple kit of herbal tinctures from The
Herbalist (6500 20th NE Seattle, WA., 98115). I took
the tinctures as advised and in days the thrush was markedly
better. I quit the herbs, the thrush came back. I took
the tincture regularly for two months with no recurrences and take
it now as needed for vag yeast infections. Combining herbs
with a sugar and simple carbo free diet finally worked. It
was miserable!
A few ideas:
Mom and baby should probably both be taking acidophilus; Primidophilus or ABC dophilus (sp?) for baby.
Garlic rubbed on nipples, unless it stings from being too cracked.
Tea Tree Oil on the nipples. [NOTE - There is serious concern that tea tree oil may be harmful to the nursing newborn.]
Watch for secondary staph infection in nipples.
Oral Nystatin powder rather than the suspension. Costs more, tastes nasty, but it works. Dip damp finger in water, then in the Nystatin and rub around baby's mouth.
Expose nipples to brief periods of sunlight, if possible.
Plantain seeds or psyllium seeds may be soaked overnight (a
teaspoon at a time) in the frig. The mucilagenous goo that results
is antifungal. Can also be used on a yeast rash. Nice and cool.
You can use just the goo and leave the seeds.
Pediatrician gave me this formula:
Nizoral 1/4 tab crushed once a day for 4 days for the baby
Diflucan 150 mg daily for mother - usually 7 to 10 days will do
it. It's a hard problem to fix.
I had a tough time with thrush and after 14 months of nursing I still have to take a few daily measures to keep the infection under control. My infection impacted both my nipples, my milk ducts (also known as intraductal yeast), my son's mouth, and his bottom. So here's my experience, I hope it's helpful. I felt all measures were worth it to continue nursing. By the time the infection was visibly apparent to doctors, I was in agony. So if you have symptoms (burning and itching on either nipples or breasts, shooting pains in breasts, other fungal infections elsewhere on your body, baby has white tongue, or baby has red dotted diaper rash) try some of the measures to see if your symptoms improve.
Daily maintenance to keep infection in mother at bay:
Yogurt (Unsweetened, I prefer Trader Joe's Greek Style or Fage,
don't bother with lowfat, you'll need the calories and flavor) -
1x/day.
Soy Lecithin (Improves milk flow, prevents plug ducts, reduced
burning in breasts) - 1.2g gelcaps 2x/day [Those avoiding soy will
be happy to know you can also get sunflower lecithin.]
Candex (dietary enzymes which breakdown yeast) - 2 capsules/day
ProOmega Fish Oil - 1g gelcaps 2x/day with food
Diet - Avoid sugar (including baked goods), and cheese
Effective measures taken to treat intraductal and nipple
infection in mother:
Prescriptions
Diflucan (fluconazole) - 200mg loading dose followed by 100 mg for
7 days. I took this for over 30 days, it is an exceptionally high
dose that should only be required for intraductal yeast.
Diet and Supplements
Yogurt (Unsweetened, I preferred Trader Joe's Greek Style or Fage)
- 2 cups/day
Soy Lecithin (Improves milk flow, prevents plug ducts, reduced
burning in breasts) - 1.2g gelcaps 3x/day
Candex (dietary enzymes which breakdown yeast) - 2 capsules 2x/day
ProOmega Fish Oil - 1g gelcaps 2x/day with food
Diet - Avoid sugar (including baked goods), breads, pastas,
certain vinegars, processed foods, potatoes, and cheese
Jarro-dophilus (refridgerated acidophilus) - 2 capsules 3x/day
Sepia (homeopathic) - 6C 2-3 pellets dissolved under tongue 3x/day
20 minutes before or after eating
Echinacea - Standard dosage.
Nipple Hygiene
Gentian violet - dilute to 0.5% and apply to nipples 2x/day, Shout
will usually remove purple stains in clothing if applied and
washed. within 1 day (may have to try more than once).
White vinegar - Mix 1 tbsp vinegar with 1 cup of water and
apply to nipples using a cotton ball after nursing to kill yeast.
Monistat cream (3 day vaginal cream can be used for nipples) -
apply to nipples after nursing, wash off before nursing.
Natural Nipple Butter (Earth Mama Angel Baby, excellent for
burning) - apply after nursing in conjunction with Monistat, wash
off before nursing.
Baking soda - applied to nipples and feet each day while
showering.
Other Measures
Laundry - Add 1/4 cup vinegar to each load of laundry to kill
yeast.
Sterilization - Sterilize pacifiers, bottles, and breast pump
equipment each day. Sunlight kills yeast, so alternatively I would
set clean dishware on a sunny windowsill.
Effective measures taken to treat mouth and diaper rash infection
in baby:
Jarro-Dophilus for Baby (refridgerated acidophilus powder) - 1/4
tsp in breastmilk 1x/day, express milk into a tablespoon and mix,
or add to bottle.
Gentian violet - dilute to 0.5% and apply to tongue 2x/day, Shout
will usually remove purple stains in clothing if applied and
washed within 1 day, use a small amount on a Q-tip and apply to
tongue. Be careful a little goes a long way. A study showed a weak
link between Gentian Violet and certain cancers, my pediatrician
and dermatologist said it was fine to use.
Vusion diaper rash cream (prescription) - absolutely the only
effective diaper rash cream I found.
Ineffective measures taken to get infection under control in baby
or mother:
Grapefruitseed extract - 250 mg capsules 3x/day. When passed on in
breast milk it didn't agree with baby.
Odorless Garlic - 2-3 capsules 2x/day. When passed on in breast
milk it didn't agree with baby.
Nystatin suspension - As prescribed, I found this worsened the
condition, it's in a sugar suspension which feeds yeast, I think
Dr. Sears says it is effective in only about 40% of cases.
Lansinoh nipple cream - didn't do much for me.
Lotrimin - over the counter cream) - apply to bottom 2x/day,
further irritated babies bottom.
All the supplements can be purchased at Whole Foods Market, with the exception of Candex which I purchased online, and Gentian Violet which was purchased at the O'Connor Hospital Pharmacy.
The prescriptions were obtained from Dr. Honor Fullerton, she was the only doctor in that I found who was able to treat me for intraductal yeast (infection that has gone into the milk ducts). My OB, general practitioner, and previous dermatologist did not understand the nature of this infection.
Dr. Honor Fullerton
Menlo Dermatology Medical Group
888 Oak Grove Ave., Suite 8
Menlo Park, CA 94025
650-325-1511
”
Health
Canada warns Canadians of potential cancer risk associated with
gentian violet [6/12/19] - Health Canada has completed a
safety review of human health products and veterinary drugs
containing gentian violet and has found that exposure to these
products may increase the risk of cancer. Given the seriousness of
this risk, Health Canada is advising Canadians to stop using all
human and veterinary drug products containing gentian violet.
Is
gentian violet safe? [Related
Articles]
Phillips V.
J Hum Lact. 1993 Mar;9(1):7-8.
The FDA's 2006 Over-The-Counter List:
ANPR PR FR
IIIE
IIE pending
Adverse
effects of topical gentian violet - possible carcinogen,
although perhaps not in very short term use???? [Medline is
disappointing on this topic - there are no abstracts for the few
relevant papers. However, the titles in the Cambridge
Environmental
Publications List are pretty scary. There are more
scary references at The
Carcinogenic
Potency Project.]
My research shows that there is no consensus on the safety of
gentian violet on a mother's nipple or a baby's mouth. The
baby's mouth is a mucous membrane, which is less protective than
skin. It makes sense to try other remedies first, and if a
clear diagnosis of thrush has been made, and the thrush is not
responsive to any other treatments, then the benefits of using
gentian violet may outweigh the risks.
Gentian Violet (Topical) from Medline Plus
"Breast-feeding—Gentian violet topical solution has not been
reported to cause problems in nursing babies."
From noaa.gov
- "May cause skin irritation. Harmful if swallowed. May cause
respiratory and digestive tract irritation. May cause severe eye
irritation and possible injury. May cause reproductive and fetal
effects."
Another
NOAA page "Harmful if swallowed."
From Solving
Common Breastfeeding Problems::
The use of aqueous gentian violet 0.5 per cent in the treatment of
nipple thrush is no longer recommended, as recent studies suggest
it is a potential animal carcinogen. It can now only be obtained
by prescription.
Thrush
- Treatment - from the Royal New Zealand College of General
Practitioners
"The use of aqueous gentian violet 0.5 per cent in the treatment
of nipple thrush is no longer recommended."
Subpart
B--Listing
of
Specific
Substances
Prohibited
From Use in Animal Food or Feed
Sec.
589.1000 Gentian violet.
The Food and Drug Administration has determined that gentian violet has not been shown by adequate scientific data to be safe for use in animal feed. Use of gentian violet in animal feed causes the feed to be adulterated and in violation of the Federal Food, Drug, and Cosmetic Act (the act), in the absence of a regulation providing for its safe use as a food additive under section 409 of the act, unless it is subject to an effective notice of claimed investigational exemption for a food additive under 570.17 of this chapter, or unless the substance is intended for use as a new animal drug and is subject to an approved application under section 512 of the act, or an index listing under section 572 of the act, or an effective notice of claimed investigational exemption for a new animal drug under part 511 of this chapter or 516.125 of this chapter.
[72 FR 69131, Dec. 6, 2007]
From an FDA site:
LIB
4395
Analyses
of
Crystal
Violet
& Brilliant Green
Laboratory
Information Bulletin
LIB
No. 4395
Volume
23, May 2007
Quantitative
and
Confirmatory
Analyses
of
Crystal
Violet (Gentian Violet) and Brilliant Green in Fish
from FDA
Import
Alert 16-131
Moreover, prolonged exposure to nitrofurans, malachite green, and
gentian violet has been shown to have a carcinogenic affect.
from The
National
Center
for
Toxicological
Research
(NCTR), FDA's internationally recognized research center
from FDA
document,
CPG
Sec.
578.600
Unapproved
Additives for Exported Grains
"Studies at the National Center for Toxicological Research have
shown gentian violet to be a carcinogen for laboratory animals."
Chronic
toxicity
and
carcinogenicity
studies
of
gentian violet in mice.
Littlefield NA, Blackwell BN, Hewitt CC, Gaylor DW.
Fundam Appl Toxicol. 1985 Oct;5(5):902-12.
"Gentian violet is a dye belonging to a chemical class known as
the di- and triaminophenylmethanes. . . . [G]entian violet
appears to be a carcinogen in mice at several different organ
sites."
From the AAP Policy Statement on "Inactive"
Ingredients in Pharmaceutical Products: Update (Subject Review)
Contact dermatitis has been associated with neutral red,[126,127]
D&C Yellow No. 11,[128,129] indigo carmine (FD&C Blue No.
2),[130] quinoline yellow,[129] and gentian violet (CI Basic
Violet No. 3).[131,132]
Gentian
Violet
Policy
Withdrawn - from VETERINARY NOTES - "Gentian violet is not
GRAS [Generally Regarded as Safe] or GRAE for any veterinary drug
use, and therefore is a new animal drug subject to section 512 of
the Act."
Obstructive
laryngotracheitis
secondary
to
gentian
violet
exposure.
Baca D, Drexler C, Cullen E.
Clin Pediatr (Phila). 2001 Apr;40(4):233-5.
Gentian Violet can be great but it can also cause some secondary problems. I ended up in the ER with a subsequent hospital stay with my 3 week old daughter after she had an allergic reaction to GV and her esophagus got so swollen she couldn't breath well. I had never heard of it before but then had a client a few months later whose baby had the same reaction. When I put it out to my online mothering group, a few other mothers came forward with similar experiences.
I'm not saying not to use it, just make sure you're watching the
baby carefully over the next few days (assuming you find the GV)
to make sure he isn't having a reaction to the treatment.
I just want to throw out a cautionary note about gentian violet.
Its name is confusing and makes it sound like an herb, kind of
like calendula. But it's not from a plant. It's
a chemical compound and is potentially carcinogenic.
There may be times where the benefits outweigh the risks, but I
wouldn't rush to use it.
Old Information about Gentian
Violet
Lots of moms are very conscientious about drinking lots of fluids
while they're nursing; there's a chance that this may stimulate
additional letdown. So if you're trying to reduce the
letdown, consider NOT drinking fluids right while you're nursing
and notice how this changes your letdown. Note that
there is a difference between overactive letdown and oversupply.
Over active let down in 2 months old baby is not supposed to
bother the baby in terms of latch, swallow and breathing while
nursing.
However it can cause to an imbalance between foremilk and hind
milk which can lead to imbalance between the milk components
especially lactose and fat in a feeding. That can be related to
fussiness, gassy, green stool and problems with weight gain.
To take care of the over active let down hold your breast like a
sandwich, press hard on the edge of the aureola but not too hard
that will cause you pain. The rationale of this holding is to
squeeze the ducts right above the nipple pores to make the milk
flow to slow down.
Lay back can be helpful as well. Google "biological
nurturing" and try to use the position, it has many advantages and
can help you with the let down.
You can also express your milk with your hands for 1-2 minutes
before nursing to release the pressure.
The current and most updated recommendation is to feed from one
side each feeding. The reason is to keep the milk components in
the right balance for your baby.
Case
Report:
Overabundant
Milk
Supply:
An
Alternate Way to Intervene by Full Drainage and Block Feeding
- C. GA van Veldhuizen-Staas
Overactive Let-Down: Consequences and Treatments by Mary Jozwiak
Very helpful
information about oversupply from La Leche League
Oversupply
Syndrome
Colic
Or Foremilk - Hindmilk Imbalance from Marie Davis, R N,
IBCLC
Oversupply:
Too
Much
Milk
By
Anne
Smith - IBCLC
Oversupply
from parentsplace.com
Sometimes and oversupply/engorgement issue can be due to an
improper latch and poor milk transfer. With baby having been
in the NICU there is probability of some latch/transfer
concerns. That being said, here are some of my immediate
thoughts for this Momma and answers to your questions.
First of all, if an oversupply is the issue, the pumping is only exacerbating the problem. Mom can hand express for some relief, but def should not be draining the breast with a pump. If the hand expression isn't enough relief, mom can use the pump for just a few minutes until breast is a bit softer (should probably only need to express 1 oz or so) and should limit the stimulation to the breasts as much as possible. Mom should try and nurse baby on one side only at each feeding and may even want to explore "block nursing" where she only nurses on one breast for a certain amount of time.
Pumping in general will increase her milk supply, so instead of
pumping to relieve pressure, she can try hand expressing. If
pumping is a must, then limit it to 10 minutes. Kelly
mom has another great article on Engorgement and what to do
before, during and after nursing to alleviate the discomfort and
help baby latch.
The main highlights of this article are to use a cool compress up
to 20 minutes before nursing and then a warm-moist towel or warm
water for just a minute or so right before nursing to allow the
milk to flow.Avoid heat on the breast between feedings since this
can cause more edema and inflammation. Instead continue to use
cool compresses between feedings to help reduce swelling. During
the feeding session she can massage her breasts and use
compression to keep the milk flowing and discourage plugged ducts
from forming.
Also, explain to this mama, that although pumping "fixes" the
discomfort of being full temporarily, it will only perpetuate the
discomfort, since pumping on top of feeding is basically telling
her breasts to produce more! Sometimes moms forget that milk is
produced on a supply and demand basis, so a reminder never hurts
:-)
You might want to try some of the suggestions below, for
suppressing lactation, but use these techniques in moderation.
Otherwise, you may reduce your milk supply so that it is not
enough for your baby.
“Dry
up pills” and breast cancer from Midwifery Today - about
possible carcinogenic effects of DES; Parlodel and
Chlorotrianisene (Tace).
Lactation
Suppression: Forgotten Aspect of Care for the Mother of a Dying
Child [Medscape is free]
Lactation
Suppression from Breastfeeding Basics
The
effects
of
immersion
and
exercise
on prolactin during pregnancy
Katz VL, et al.. (Eur J Appl Physiol. 1990)
Immersion in water, especially deep water immersion, reduces
prolactin levels. Women who are trying to suppress lactation
may want to take frequent, long baths. (Women immediately
postpartum should consult with their care providers about the
advisability of immersion.) Since hot water can stimulate
lactation, the water should preferably be on the cooler
side. A swimming pool would be ideal.
Why
cabbage leaves while weaning? from ParentsPlace
Lactatation
Consultant Debbi Donovan , IBCLC
I would really advise that she try cabbage leaves inside her bra
for suppressing lactation. To use a cabbage leaf compress, put one
layer of chilled, washed fresh green cabbage leaves inside her bra
cups so that the breasts are completely covered. Leave them
in until they "cook"-become soft, fragrant and translucent and
start to wilt. They should then be replaced. This has been shown
to be super effective and a bit smelly.
Other suggestions, were not to stimulate the breasts (hot
water, or other ways:), and to use ice packs, or frozen green peas
wrapped in cloth molded to the breasts.
Eating parsley can reduce milk supply.
Homeopathic remedies include lac caninum and sometimes
pulsatilla. Some people recommend Urtica Urens 1X, every 6 hours
to suppress milk flow.
See also: Probiotics
for Breastfeeding
Plugged
Ducts and Mastitis by Kelly Bonyata, BS, IBCLC from
kellymom.com.
If you’ve ever experienced a plugged duct, you may be surprised
to learn that the tender lump in your breast is NOT the plug. It’s
the milk backed up behind the plug. If you have a plugged duct,
don’t massage BEHIND the plug. Instead, massage in FRONT of the
lump of milk and towards the nipple, as if trying to clear a
pathway. Imagine if there was a traffic jam and you could
magically clear the cars away: Would you start pushing forward at
the end of the line (and risk causing more of a blockage) or start
at the beginning of the line and work your way back?
Begin by kneading close to the nipple, pushing towards it. Then
change the starting point so that you knead a little further back,
moving closer to the lump of milk but always pushing towards the
nipple. Press your other hand on the opposite side of your breast
as counter-pressure. Optional: Apply a small amount of edible oil
to your hands before massaging to reduce friction.
Massaging in front of the plug is less painful and more effective
than using the lump of milk behind it as a battering ram against a
long stringy dried plug. Keep working it little by little because
it took awhile to get there and it will take awhile to clear.
FUN FACT: Have a milk bleb? A bleb represents an actual blocked
duct, similar to the tip of white Elmer’s glue that has solidified
with exposure to air.
Credit: Dr. Smillie, “From the Perils of Block Feeding to the
Magic of Milkshakes”
The
role
of
bacteria
in
lactational
mastitis and some considerations of the use of antibiotic
treatment
Linda J Kvist, Bodil Wilde Larsson, Marie-Louise Hall-Lord , Anita
Steen and Claes Schalen
International Breastfeeding Journal 2008,
3:6doi:10.1186/1746-4358-3-6
Published: 7 April 2008
With my twins, I was pumping so much and I stopped counting how
many times I got mastitis after about 25 or so. I became
somewhat of an expert on how to get rid of it and I never had a
case that lasted more than 48 hours and I never had to go on
antibiotics. I strongly recommend the Poke Root, which was
mentioned earlier. I also got mine through www.herblore.com. Pam
Caldwell is a fantastic herbalist and she can help you (by phone)
with your mastitis and other breastfeeding questions. You
can also take echinacea and lots of vitamin C. Before
breastfeeding or pumping, I would wet a towel and microwave it to
warm it up (maybe 15-30 seconds), wrap it around your breasts and
then nurse or pump. Get in the hot shower and try to hand
express. It will hurt a lot, but it is important to work
that milk out. Drink tons of water and rest, rest,
rest. I also had to be very careful to clean my pump
regularly and I would spread a little breastmilk around my nipple
after I was done nursing or pumping to try and kill any bacteria.
With twins, I had to rely heavily on other people to take care of
my babies when I had the mastitis. Most of my cases happened
in the first few months and then a few times toward the end when I
was weaning. i finally resorted to sage tincture to stop my
milk production because I kept getting plugged ducts when I would
try to go longer in between pumpings. After 2 days of the
liquid sage (also an herblore product), my milk was totally dried
up. Hang in there.
I had a bad case with my then 4 month old. My mom is a nurse and
she told me hot showers/compresses and make sure you completely
empty your breast, even if you have to pump. Keep your pump super
clean if you are using it and eat extra healthy. Vitamin C is a
major plus. However she said if it didn't go away in a day or so
then I would need to see my dr. I called the dr. and they told me
the same things :) Good luck.
We've seen a huge difference in women who drink at least a gallon
of water a day. Sounds like a lot but it works! I personally
have seen a difference with my 2 y.o and the 2 breast infections I
got. Yes, I let the water go and yes, I got a hunkin' breast
infection. Sounds so simple but we both swear by it!
I'm not a certified Lactation Consultant but I did do some LC training. However, most of my experience with mastitis comes from my own personal experience. I was prone to it, including the systemic symptoms. I had 5 or 6 bouts like this over a 9 year nursing history. I think some women are anatomically prone to it. For me it was almost always my right breast that caused the problem. I ended up with a tiny lump of scar tissue after one particularly bad bout.
I never took antibiotics or acetaminophen. I did go to bed (couldn't do anything else as totally out of it, delirious). Dragged myself to the tub and soaked the breast in hot, hot water. Took lots of vitamin C and nursed, nursed, nursed in all positions. Especially with baby's chin in direction of sore spot. This ended up in some pretty weird configurations of bodies.
I found that the fluishness always passed within 24 hours. The tender spot remained longer but I made a concerted effort to pay attention to it with the old Heat, Rest and Empty Breast. For the women I have helped this has always done the trick. I don't know of any who have taken antibiotics including one woman who had the most massive, blackest "bruise" I have ever seen. I did not counsel this woman and only saw her after the worst was over. She got through it without antibiotics.
I am not convinced that antibiotics are the answer to mastitis. I think it might be similar to Mendelson's comment about [name the affliction] "if you take antibiotics it will be gone in a week. If you don't take the antibiotics it will be gone in 7 days." It is possible they could contribute to the problem by not letting the body have a chance to fight infection off itself.
Echinacea was not "on the scene" yet when I was nursing. It may be helpful if taken at the onset. But it is an immune strengthener and while the immune system becomes involved in mastitis, it is the cause that needs to be treated, i.e. the "plug".
For this woman I would suggest all the other things you have
suggested already. Now that she has experience with it, she should
be able to recognize that sore, bruised feeling immediately and
take measures to minimize its progress. I think the rest component
is absolutely essential. I have found that women really need to
pay attention to slowing down before mastitis resolves.
If you use homeopathic remedies at all Phytolacca and Belladonna are the two biggest mastitis remedies to consider. We often use cold packs alternating with the hot ones; also liquid chlorophyll, echinacea and one of my new favorite "natural" remedies Nutribiotics which is found in health food stores. It is a grapefruit seed extract that really knocks infections down quick!!! Can be bought in combination with Echinacea. As well as increased Vitamin C - increased Vitamin A - 50,000 to 100,000 iu for about 3 days only. That last recommendation is from a Clinical Nutritionist who says it isn't toxic this high if only using it for a short period (she says no more than 5 days at 100,000) I usually only do it for 3 days and don't need it more than that, also will usually only go up to about 50,000 or 75,000. My policy on that one is this: I use it at that high of dosage on myself and my family, no problems with it, usually only a couple of times a year when we're really battling something. I tell my clients about it and say they would have to make their own decision on it, also sharing about how FDA, AMA says Vitamin A is too toxic in that high of dosage. Definitely don't do this during pregnancy, but have seen it help in mastitis.
Since this is cold & flu season, I'll also share info about
Engystol-M from -Heel Co. Have to buy it direct. This is fantastic
for viruses. It helped a friend of mine get over Mononucleosis in
record time.
Sudden onset mastitis is vicious! I use Echinacea 4-6 caps with
Vit. C 1000 every two hours along with the things you had her do.
Babe is the best pump. No lying down to nurse unless the baby is
on mum's right side and she nurses the left breast. (Almost lying
on the child but drains even up into the arm pit if she can manage
the position.) The other thing I ran into was a woman who had 5
infections in a row, antibiotics et al. She would start feeling
better and come down again. It turned out that her bra style had
seams coming diagonally across the cup from the arm pit toward
center. It made a VERY FAINT line as her bra wasn't very tight but
enough to block off part of the flow on each side to some of the
ducts. I had her change her bra style and she never had another
one.
We have used garlic and echinacea with great success, at the very
first sign of possible infection we have them start taking 2 tabs
of garlic and one droppersful of echinacea every 15 min plus
drinking 1/2 gal of water within the next 2 hours and rest.
usually knocks it by then.
Poke root is an absolute wonder cure for breast infections!
The homeopathic version (phytolacca) is also great!
Mastitis Treatment:
Lifestyle:
Midwifery Today Summer 1992 Mastitis: positive Interventions by J. dever. She says that:
other things mentioned
sounds like the things that caused the breast infection are the
same things that are preventing it from disappearing even with use
of anti-biotics. Is she resting a lot? I know of midwives who tell
their clients who are beginning to get signs of a plugged duct to
get into bed with their baby and stay there until all signs have
gone.
From an herbalist: Generally when a breast infection
(mastitis) appears, it is all too often because the mother is run
down and needs rest. The number one thing is to get rest, and bed
rest is suggested but more often than not for most, unrealistic.
Next, be sure to nurse on the affected side as much as possible,
keeping the breast as empty as you can, thereby allowing the
infection to clear. Taking immune boosting herbs is important such
as echinacea, propolis, astragalus, lemon balm, oatstraw,
fenugreek, etc. These may be administered via infusion (tea),
liquid extract or capsule--which ever way the client is inclined
to take her protocol. Foods are important to remember also;
alliums are great for boosting the immune system. Garlic, onions,
chives- also burdock root, dandelion root and dandelion greens are
highly nutritious and splendid sources of nutrients and minerals
to boost immunity and lymph health. I always recommend a cabbage
poultice to any woman experiencing breast tenderness and surely
for Mastitis. It works wonders for clearing blockage and
infection. Simply place a raw cabbage leaf (or a few) on the
affected breast. I like to say you should treat both breasts, as
with ear infections, it's very common for the infection to go from
one side to other and then back again, just when you think it is
clearing up. If you would like to soak a few of these cabbage
leaves in warm water, that is fine too. Warmth will soothe the
tender breast as well. Cabbage leaves are a perfect shape for
cupping the breast, it's neat to think of their nature and how
they work so effectively for this cause. Worst case scenario, poke
root is great for clearing breast infection. Poke root is a highly
heroic herb, a little -- I mean a little, like 5 drops extract
max, goes a long way. It has been known to clear even the most
persistent infection up readily; although I only go there for last
resort.
I might add to massage the plug towards the nipple when nursing,
kind of like squeezing cottage cheese through a straw, and
position the baby's chin towards the plug, so the strong suction
of the baby's tongue will help with this.
Potatoes (adapted from Bridget Lynch, RM, Community Midwives of
Toronto). Within the first 24 hours of your symptoms beginning,
you may find that applying slices of raw potato to the breast will
reduce the pain, swelling, and redness of mastitis.
Cut 6 to 8 washed raw potatoes lengthwise into thin slices.
Place in a large bowl of water at room temperature and leave for
15 to 20 minutes.
Apply the wet potato slices to the affected area of the breast and
leave for 15 to 20 minutes.
Remove and discard after 15 to 20 minutes and apply new slices
from the bowl.
Repeat this process two more times so that you have applied potato
slices 3 times in an hour.
Take a break for 20 or 30 minutes and then repeat the procedure.
Mastitis & Plugged Ducts By Pam Caldwell at HerbLore
Sometimes using the flat side of an electric toothbrush over a
superficial duct plug in the breast helps them break up, a poor
man’s ultrasound therapy. -Amy Evans, California
Anatomy
of the Breast shows the overall breast anatomy, including
the suspensory ligament, and here's the
lymphathic
system. Notice the main drainage pathways, which can
help identify plugged ducts.
Add lecithin to her diet - works wonders for clogged ducts - the
best form is the granular form - 1600 mg daily for alleviation and
prevention of clogged milk ducts.
Blocked Ducts and Mastitis from Dr. Jack Newman - discusses the use of ultrasound for a blocked duct:
If a blocked duct has not settled within 48 hours (unusual), therapeutic ultrasound often works. This can be arranged at a neighbourhood physiotherapy office or sports medicine clinic. Many ultrasound therapists are not aware of this use for ultrasound. The dose is:2 watts/cm², continuous, for five minutes to the affected area, once daily for up to two doses.
If two treatments on two consecutive days have not worked, there is no point in continuing with ultrasound. Get the blocked duct re-evaluated at the clinic or by your own physician. Usually, however, if ultrasound is going to work, one treatment is all that is needed. Ultrasound also seems to prevent recurrent blocked ducts that always occur in the same part of the breast. Lecithin, one capsule (1200 mg) 3 or 4 times a day also seems to prevent recurrent blocked ducts, at least in some mothers.
I am a labor and delivery nurse and recently had my third
child. I breastfed successfully with the first two
children. I developed a persistent and recuring problem with
blocked nipple pores and clogged milk ducts. Very
Painful!! I consulted everyone at the hospital, including
lactation consultants etc... I read books and tried
everything offered. Nothing worked. Finally one of the
female MD's who used to work with midwives told me to try putting
cabbage leaves in my nursing bra to soften breast tissue. Everyone
laughed and thought she was crazy. Needless to say, I was
very skeptical and felt a bit silly. However, I was desperate. It
worked like a charm!!!
My first action, would be to eliminate all refined sugars and
flours, treat with acidophilus, increase raw foods, alternate
hot/cold packs (hot before nursing and cold after). Is she
running a fever, even a low grade fever? Yeast overgrowth is
many times revealed in recurring breast infections. I would
personally use echinacea and either golden seal or oregon grape
root. Check the baby's mouth for thrush also. If the
latch has changed, then it could be due to undetected
thrush. I would also revert back to early nursing days,
getting back into bed to rest, nurse and drink lots of good
water. Outside of these steps, I would consult a reputable
lactation consultant.
A good friend of mine needs help with clogged ducts. She is nursing her one year old baby, and has had trouble with painful swollen clogged ducts for a full two months now. She has tried everything we can think of, and now we need your suggestions.
Two months ago a duct clogged and caused a swollen hot area under her arm the size of a cigarette pack! This original area has gone up and down, but never resolved completely. She has also shown no signs of infection in that two months. Within the two months this spot has been a problem, other ducts have clogged and unclogged with her efforts. (all on the same side)
She has tried cabbage leaves, ginger poultices, hotpacks, no bra, two bras, massage, nursing in every funky position she can think of, and now she's been having ultrasound treatments of the affected breast. Sometimes after a treatment, she'll be nursing and a clog will suddenly resolve itself. But never this original one. And other clogs continue to come and go.
She's talked to three lactation consultants, and her midwife. None have any advice that's worked. She suspects his latch has changed??? But why at one year would he have this problem, why only one breast, and how can she fix it? She does not want to wean entirely, and even wants to avoid weaning off the affected breast due to concerns about lop-sidedness.
my thoughts are that since the worst area continues to be
swollen, sometimes worse than others, but never resolved
completely.... It seems some milk keeps getting through, otherwise
the duct would have dried up completely by now, right?
I too had a blocked duct in my left armpit while nursing my newborn son (he's 3 months now and the problem is gone) mine was more the size of a golf ball this is what I did via the advice of my LLL leader.
1) apply heat 5-10 min prior to nursing (warm bath water, hot
pack)
2) ice in between nursing, oddly this felt soooo good
3) nursed this side frequently and hand expressed the other to
keep milk up
in both breasts
4) took as much bed rest as possible (had 2 infections that
knocked me out,
nice bonding time with baby to lay in bed together all day,
getting up had
me in tears)
5) constant self massage, though I was advised that if it didn't
clear up to
call a massage therapist who is skilled in lymphatic drainage
6) in the big ball I could feel the smaller duct, I squeezed this
and found
backed up milk coming out of the pore above it. totally
relieved the
pressure at times.
Anyway, the swollen duct shrunk in size by the end of the
week. Every now and then I feel it building slightly, but
not with the swelling. Good luck to your friend.
One of my clients who nursed twins gave me some really good
advise about plugged ducts. She said she would put baby on
the floor and nurse hanging from above so that the breast was
completely hanging straight down. (She was on all fours).
She said that always took care of the problem.
I tell my mamas that they should be humming "rock around
the clock" when using this breastfeeding position. The beauty of
it is that the mom can rotate (like the hands of the clock) and
make slight or major changes in where the pressure is felt on her
nipple as well. Mom might well wind up in a position
impossible to create while seated or lying down unless she wants
to try and have her baby wrap his/her legs around her neck!!
LOL Oh one more thing. When I advocate something like this I also
quickly grab one of my baby dolls and demonstrate/model it for
them.
She might want to look very closely at her nipple and see if
there is a tiny white bump under the skin anywhere. There might
even be a little clear blister over it. She may want to try
lifting the clear skin and giving it a tiny squeeze and there is a
chance that a calcified piece of milk with come out. This
sometimes happens and creates the blocked duct. You can also take
lecithin to help prevent these calcifications. At one time this
was in the LL literature.
There may be some blood in her milk from a plugged duct that is clearing. Milk can dry and crystallize, which is why plugs hurt, but tell her to keep nursing and it'll flow out. (Baby is more efficient than the pump, too, so encourage her to get baby to the breast.)
Now if it's lots of blood, she should see a doctor or LC
immediately, but it's likely it'll go away with a feeding or two.
The Adiri™ Natural Nurser™
Ultimate Baby Bottle is soft, safe and simple. With an easy
to use and dishwasher safe Fill, Twist and Feed™ system, the only
nipple truly shaped like a mother's breast, soft
polycarbonate-free and bisphenol-A free materials, and a
unique Petal™ vent that helps reduce colic, the Adiri Natural
Nurser enables the ultimate safe bottlefeeding experience.
If you're planning to give your baby expressed/pumped breastmilk
at some time after 3 weeks of age, please be aware that plastic
baby bottles have recently been shown to disrupt a baby's
hormones; glass bottles are safe.
Toxic
Baby
Bottles
-
Scientific
Study
Finds Leaching Chemicals in clear plastic baby bottles
I switched to glass bottles a few months ago and I LOVE
them. Throw them in the dishwasher and they clean up so
nicely. You can buy them at Babies R Us, but I ordered mine
through Amazon.com. It looks like Amazon is only selling the
4oz size right now, so I also know you can order them online
through Radiant Life :
http://www.radiantlifecatalog.com/prod.cfm/ct/4/pid/1267
The glass bottles are made by Evenflo. They have all the sizes available. I was shocked and happy to see them at Babies R Us when I went there a few months ago.
The nipples that come w/ the glass bottles are not great (in my opinion) but you can substitute just about any standard nipple. I put the Dr. Brown's nipples on mine and they worked fine.
The "safe" plastic bottles that you are referring to are at: http://newbornfree.com/
WF's sells a new brand of baby bottle called "Born Free' that
does not contain the chemical. They also make sippy cups.
http://naturalbaby.stores.yahoo.net/realglasbabb.html
http://www.babysupermall.com/main/products/eve/eve10103.html
etc. etc.
And from Mothering mag:
I am planning on breastfeeding but wanted to know which
baby bottles are best for when I will need to pump. Any insight
would be appreciated.
Recent, studies have raised concerns about certain types of
baby bottles. Fortunately there are plenty of safe options readily
available to new mothers. The following tips will make it easy to
know which products to look for and which to avoid.
Products to avoid
Polycarbonate bottles: Bisphenol-A is a component of #7
polycarbonate plastic, the clear, rigid variety of plastic from
which many baby bottles are made. This substance has been shown to
be "estrogenic": it is an endocrine-disruptor in lab animals,
altering reproductive organs and functions. Bisphenol-A can leach
from polycarbonate, especially when exposed to high temperatures
and repeated washings.
Rubber Nipples: Many bottle nipples are made of rubber,
which may contain low levels of contaminants known as
nitrosamines. These substances, found also in some foods and in
tobacco, cause cancer in lab animals and contribute to
tobacco-related cancers in people. Nitrosamines can be ingested
through bottle nipples; however it is unknown whether this kind of
exposure increases the risk of cancer. Because of cancer concerns,
The Food and Drug Administration regulates the amount of
nitrosamines allowable in rubber nipples, but low levels are still
permissible.
Products to look for
Glass bottles: Because the risks to humans of bisphenol-A are
unknown, it makes sense to limit your baby's exposure to it. Glass
baby bottles are a time-tested alternative to polycarbonate
plastic. Glass is a renewable resource, easily recyclable, and
does not leach toxic chemicals. Glass bottles are, of course,
subject to breakage, and there are risks of serious cuts to your
child. Additionally, glass can chip or crack, and can break when
sterilized, allowing glass splinters to end up in baby's beverage.
The American Academy of Pediatrics urges parents not to let babies
go to sleep with a bottle, and toddlers should not be allowed to
walk around with a bottle. These precautions help prevent tooth
decay and mouth injuries; they also help prevent breakage and
injuries from glass bottles. As with plastic, careful and regular
inspections of the bottle allow parents to detect any flaws in the
glass. Recycle any scratched, cracked, or chipped glass bottle.
Safe plastics: Although polycarbonate bottles containing
bisphenol-A are the most common kind of baby bottle on the market,
there are other plastic baby bottles available that do not contain
bisphenol-A. These opaque bottles are made of polypropylene and
polyethylene, which are not known to leach carcinogens or
endocrine disruptors. Recycling symbols can provide some
information about the plastic: polyethylene has #1, #2, or #4 on
the underside, and polypropylene has #5. The surest way to know
whether a bottle is made of polycarbonate is to call the
manufacturer. Keep in mind, though, that all plastic bottles are
petroleum products, requiring the use of non-renewable resources.
Silicone nipples: Replace standard rubber nipples
(amber-colored) with clear, silicone nipples. Not only are
silicone nipples free of cancer-causing nitrosamines, but they
last longer. Inspect nipples regularly and discard any with cracks
or tears, which can harbor bacteria and also pose a choking
hazard.
Shopping Suggestions
Baby Bottles (#5 Plastic)
Rubbermaid Chuggables Bottles
Rubbermaid Sippin' Sport Bottles
Evenflo Colored Baby Bottles
Evenflo Baby Bottles (opaque, pastel)
Gerber Baby Bottles (colors)
Medela Baby Bottles
Baby Bottles (Glass)
Lansinoh Glass Baby Bottles
Lamby Glass Baby Bottles
Evenflo Glass Baby Bottles
One word of caution - the glass bottles cracked the plastic part
of my breast pump that you screw the bottle onto. I noticed
the suction slowly getting to be less and less until it basically
didn't work. When I called Ameda to see what was going on,
one of the questions they asked me was if I used glass bottles
with it. The cracking is very fine, so you don't really
notice it.
I tell each mother that latching on is like riding a bicycle. At some point she will look down and realize that her baby latched on without any conscious effort on her part. When latching on gets to be that easy is when she can consider introducing a bottle. I say that for many mothers that is around six weeks but it might be earlier or later for her.
In the case of separation, La Leche League's recommendation is to start preparing 2 weeks before you will need to be separated from baby. I usually try not to be any more specific than that because babies have their own personalities. Some babies will never take a bottle, some will decide a bottle is easier if started too soon, and some babies will quite happily take a bottle at 2 weeks and then reject it completely at six weeks.
I haven't seen any research indicating that daily bottles are more or less effective at keeping babies willing to take bottles. Anecdotally, I've heard from a fair number of mothers who did give daily bottles only to have baby reject bottles later on anyway and they sometimes wonder why they went through such a hassle when it didn't work. So I try to feel out where the mother is - if she's stressed about the logistics of leaving baby, daily bottles might be comforting to her. If she's stressed about the emotional impact of leaving baby, daily bottles might take away what little time she feels she has.
I also make sure to present other options, such as grandmother
going with daughter and baby to school so daughter can breastfeed
before and after class - this works if she has a one or two hour
class and then a break. Also easier than trying to find a place to
pump, as many schools are way behind places of employment in terms
of offering pleasant places to pump and store milk. Or if
baby is at a baby sitter's, feeding right before class and
checking in right after. There are also the alternatives to
offering a bottle: cups, syringes, finger feeding.
Although the research on cups doesn't indicate it avoids "nipple"
confusion, at least cup feeding avoids the superstimulus on the
roof of baby's mouth that seems to be one of the problems with
switching back and forth from breast to bottle.
I have spent most of my adult life around long term breastfeeders. Most kids will reach out for food on mothers plate by about 8-9 months but , obviously as not all kids are the same , some show no interest. My own daughter barely ate food till 14 months and I know lots of woman whose kids started 'socially developing' their own need to eat solids past the 'usual' age. It seems to be a question of child led or not. Children are capable of deciding when they are ready to involve themselves in 'social' activity.
If you question most woman further you will find that the child does eat solid food but is getting the majority of nutrition form breastmilk. This means that they pick at bits of food and will entertain finger foods but do not sit down to what we in the Western world consider 'a meal' with a bowl and a specially prepared tin of something or even a hand ground organic something!!
The principle of what to give a one year old is the same as at 6 months ,although by one year there is less worry about milk allergy so that gives more choice. The only thing that is of any concern in my opinion is past 6 months the breastmilk does not have enough iron. In the areas where i lived (home birth rate of over 50% and long term BF normal, there was quite a high incidence of anaemia. It is routine to check babies for anaemia in California and apparently 20% of all kids have deficiency so my area may not have been higher than general population because they were long term breast feeding. I have commented a couple of years ago on the list about the difference between kids born to home birth midwives who do not cut cord till placenta out and those who do the cut cord immediately technique (which is most common here in the UK). When a cord is not cut the child gets more blood and therefore logically has more iron stores.
Finger foods such as apricots and mushy dark greens etc. are good sources of iron. I actually gave my daughter a teaspoon of floradix twice a week from 6 months onward until i knew she was eating enough solid compared to breastmilk. There are lots of website and books. Look under 'natural' baby.
Someone mentioned jaw development ,but I have never been able to find any evidence about the validity of this assertion save for one small research article which i am not able to locate right now. I know that Jack Newsman will definitely have it at his fingertips and his web articles can be found by searching under his name. This will also bring up lots of good web sites on breastfeeding and they almost always have info on weaning. Jack Enkins book for mums is brilliant - the best i have found.
The 'jaw development' and 'child will be a late speaker' is a purely British thing that health visitors tend to mention and IMO its an urban myth and perhaps dare I say it, yet more shroud waving.
Research does show that breastfeeders have better jaw development and speak sooner than non breastfed babies.
For email support , the Natural Nurturing Network has an email list if you join the organisation. She may want to consider this attachment parenting organisation. It is one of the only ones in Britain and the majority of members (currently over 300) have all been in the same boat.
The term "extended breastfeeding" implies that a shorter period
is more physiological. This same issue comes up with
physiological clamping of the cord: is early clamping "premature"
or late clamping "delayed"? I like the idea of
"breastfeeding to term", a phrase similar to "carrying to term"
for gestation. I like the term "natural weaning" suggested
by an article below.
Breastfeeding
in the Land of Genghis Khan By Ruth Kamnitzer (2/28/11) from
InCultureParent - This is a great description of a culture that is
wholeheartedly supportive of breastfeeding as best for babies and
mamas.
A Natural
Age of Weaning by Katherine Dettwyler, PhD. Another
article, When to Wean, contains amazing information about what the
actual optimal length of breastfeeding is for placental mammals.
[This last article is available at birthlove.com, a subscription
site that is well worth the small cost!] "The minimum
predicted age for a natural age of weaning in humans is 2.5 years,
with a maximum of 7.0 ..." [Ed: birthlove.com is not
available at this time.]
So
You Want to Night Wean Your Toddler
From
Breast
Milk to Solid Food: When's the Best Time to Make the Switch
By Colleen Huber, Naturopathy
Works
In my experience as a midwife, it seems that nature intended most
pregnancies to take place while the mother is still nursing an
older child . . . this causes an increase in normal toning
contractions (unfortunately, often mistaken for preterm labor),
and in the baby's coming a few days earlier, thus resulting in a
much easier labor and birth.
Nursing
During Pregnancy and Tandem Nursing and Breastfeeding
& pregnancy - from Kelly's AP web site.
Tandem
Nursing from Mothering Magazine by Karen Plomp
La Leche League's FAQ
on
Tandem Nursing
I'm not advocating using formula but found this interesting if it's needed for some reason:
Healthy
Alternative
to
Conventional
Infant
Formula
Part 1 (from Dr. Mercola)
This section has been moved to: Miscellaneous Newborn Care/Natural Infant Hygiene aka Elimination Communication
