Jeannie Babb Taylor: The problem with breastfeeding

Here's a great read that has a lot of info. Jeannie did a great job with it!

(To read the article in it's entirety, click on this link or the one below.)

What if doctors discovered a substance so potent, it could prevent dozens of diseases and even reduce the risk of cancer? What if these benefits extended not only to those who partake of this amazing substance, but also those who serve it? If a pharmaceutical company had developed it, it would be a billion-dollar industry. Breast milk, though, is free. Without a visible profit stream, it also lacks a marketing team.

Numerous studies show that breastfeeding reduces cancer risks for both givers and receivers — yet the American Cancer Society (ACS) has no campaign statement on the importance of breastfeeding. One huge study (147,000 participants) found that American women could cut their breast cancer risk by 33% by increasing the lifetime average of breastfeeding from three months to thirty months, which is the worldwide average. The ACS concluded that significantly increasing breastfeeding duration was “unrealistic” and instead continues to focus on mammograms, cancer prevention drugs and other methods that put money in the pockets of physician groups and pharmaceutical companies.

Although breastfeeding has been shown to reduce sudden infant death syndrome (SIDS) risk by as much as 55%, the National Institute for Child Health (NICH) invests virtually nothing in breastfeeding education. Instead, the NICH organized the “Back to Sleep” campaign encouraging parents to put babies to bed on their backs. The first corporate sponsor of the Back to Sleep campaign was Gerber, a formula and baby food manufacturer. Is it any surprise there is no financial backing to promote breastfeeding as a SIDS prevention tool?

Breastfeeding contributes significantly to child health. According to the American Academy of Pediatrics (AAP) breastfeeding is “as important to preventive pediatric health care as promoting immunizations, car seat use, and proper infant sleep position.” Yet a recent AAP survey found that 45 percent of pediatricians who responded see formula-feeding and breast-feeding as equally acceptable. Once again, we can follow the money to understand this phenomenon. Doctors receive numerous samples, perks, and gifts from formula companies — a practice condemned by the World Health Organization (WHO.)

Formula makers are forced to give lip service to the superiority of breastfeeding. Yet these companies spend millions of dollars per year tripping up new mothers. They have inroads at the obstetrician’s office, the hospitals where babies are born, and the pediatrician’s office. Formula makers ensure that every mother goes home with a couple of cans of formula, so it will be available in the middle of the night when the baby is crying, she is exhausted from lack of sleep and she is vulnerable to the insecurities American society has pressed on her day after day. The result? Even though 70% of mothers start breastfeeding, within a few months the statistics have flipped. Only 11.3% of babies are still exclusively breastfed at six months.

It is difficult to blame American mothers for the failure to breastfeed, when everything is stacked against mothers from the start. Unlike women in most other developed countries, American women receive no paid maternity leave. Only those on welfare receive a stipend to carry them through the first months of mothering. Women who support themselves are forced to return to work, where it is often impossible to bring an infant, and pumping opportunities may be few and far between, with unsanitary conditions.

Rep Carolyn Maloney (D-NY) recently introduced the Breastfeeding Promotion Act of 2007. The bill amends the Civil Rights Act of 1964 to protect breastfeeding women from workplace discrimination. It also gives employers a tax credit of up to $10,000 per year to provide employees with equipment, dedicated space and consultation for pumping breast milk. The bill establishes standards for breast pumps, and creates tax breaks for women who purchase breast pumps in order to maintain employment.

Maloney says, “I have heard many horror stories of women who were fired for trying to figure out a way to express milk at work. My bill clarifies the Pregnancy Discrimination Act to protect breastfeeding under federal civil rights law, ensuring that women cannot be fired or discriminated against in the workplace for expressing (pumping) milk, or breastfeeding during breaks or lunch time.”

At least the welfare moms have the chance to stay home and breastfeed — after all, their babies comprise the most high-risk population of infants in terms of health problems, asthma, failure to thrive and learning disabilities. Yet the formula-makers find these mothers, too. Government programs take away one of the incentives for breastfeeding by shelling out $600 million per year to put low-income infants on the bottle. Taxpayers also foot the bill for the increased healthcare cost of these children.... Click here to read more

Media Release:La Leche League International Encourages Mothers to Recognize Importance of Vitamin D

(October 16, 2008) Schaumburg, IL - La Leche League International encourages all mothers to recognize the importance of vitamin D to the health of their children. Recent research shows that due to current lifestyles, breastfeeding mothers may not have enough vitamin D in their own bodies to pass to their infants through breastmilk.

In October 2008, the American Academy of Pediatrics recommended that infants receive 400 IU a day of vitamin D, beginning in the first few days of life. Children who do not receive enough vitamin D are at risk for rickets and increased risk for infections, autoimmune diseases, cancer, diabetes, and osteoporosis.

Vitamin D is mainly acquired through exposure to sunlight and secondarily through food. Research shows that the adoption of indoor lifestyles and the use of sunscreen have seriously depleted vitamin D in most women. The ability to acquire adequate amounts of vitamin D through sunlight depends on skin color and geographic location. Dark-skinned people can require up to six times the amount of sunlight as light-skinned people. People living near the equator can obtain vitamin D for 12 months of the year while those living in northern and southern climates may only absorb vitamin D for six or fewer months of the year.

For many years, La Leche League International has offered the research-based recommendation that exclusively breastfed babies received all the vitamin D necessary through mother’s milk. Health care professionals now have a better understanding of the function of vitamin D and the amounts required, and the newest research shows this is only true when mothers themselves have enough vitamin D. Statistics indicate that a large percentage of women do not have adequate amounts of vitamin D in their bodies.

La Leche League International acknowledges that breastfeeding mothers who have adequate amounts of vitamin D in their bodies can successfully provide enough vitamin D to their children through breastmilk. It is recommended that pregnant and nursing mothers obtain adequate vitamin D or supplement as necessary. Health care providers may recommend that women who are unsure of their vitamin D status undergo a simple blood test before choosing not to supplement.

Parents or health care providers who want more information on rickets, vitamin D in human milk, or other information on breastfeeding issues may call La Leche League International at (847) 519-7730 or visit our Web site at www.llli.org.

CDC and Swine Flu and Breastfeeding

Recomendations (from CDC)
&
from Breastfeeding Pharmacology
Thomas W. Hale, R.Ph. Ph.D.Professor of Pediatrics)

Infants who are not breastfeeding are particularly vulnerable to infection and hospitalization for severe respiratory illness. Women who deliver should be encouraged to initiate breastfeeding early and feed frequently. Ideally, babies should receive most of their nutrition from breast milk. Eliminate unnecessary formula supplementation, so the infant can receive as much maternal antibodies as possible.

If a woman is ill, she should continue breastfeeding and increase feeding frequency. If maternal illness prevents safe feeding at the breast, but she can still pump, encourage her to do so. The risk for swine influenza transmission through breast milk is unknown. However, reports of viremia with seasonal influenza infection are rare.

Expressed milk should be used for infants too ill to feed at the breast. In certain situations, infants may be able to use donor human milk from a certified milk bank.

Antiviral medication treatment or prophylaxis is not a contraindication for breastfeeding.

Breastfeeding—Starting Out Right

www.drjacknewman.com

Breastfeeding is the natural, physiologic way of feeding infants and young children, and human milk is the milk made specifically for human infants. Formulas made from cow’s milk or soybeans (most formulas, even “designer formulas”) are only superficially similar, and advertising which states otherwise is misleading. Breastfeeding should be easy and trouble free for most mothers. A good start helps to ensure breastfeeding is a happy experience for both mother and baby.

The vast majority of mothers are perfectly capable of breastfeeding their babies exclusively for about six months. In fact, most mothers produce more than enough milk. Unfortunately, outdated hospital routines based on bottle feeding still predominate in too many health care institutions and make breastfeeding difficult, even impossible, for too many mothers and babies. For breastfeeding to be well and properly established, a good start in the early few days can be crucial. Admittedly, even with a terrible start, many mothers and babies manage.

The trick to breastfeeding is getting the baby to latch on well. A baby who latches on well, gets milk well. A baby who latches on poorly has more difficulty getting milk, especially if the supply is low. A poor latch is similar to giving a baby a bottle with a nipple hole that is too small—the bottle is full of milk, but the baby will not get much. When a baby is latching on poorly, he may also cause the mother nipple pain. And if he does not get milk well, he will usually stay on the breast for long periods, thus aggravating the pain. Unfortunately anyone can say that the baby is latched on well, even if he isn’t. Too many people who should know better just don’t know what a good latch is. Here are a few ways breastfeeding can be made easy:

1. A proper latch is crucial to success. This is the key to successful breastfeeding. Unfortunately, too many mothers are being "helped" by people who don’t know what a proper latch is. If you are being told your two day old’s latch is good despite your having very sore nipples, be sceptical, and ask for help from someone else who knows. Before you leave the hospital, you should be shown that your baby is latched on properly, and that he is actually getting milk from the breast and that you know how to know he is getting milk from the breast (open mouth wide—pause—close mouth type of suck). See also the website www.thebirthden.com/Newman.html for videos on how to latch a baby on (as well as other videos). If you and the baby are leaving hospital not knowing this, get experienced help quickly (see handout When Latching). Some staff in the hospital will tell mothers that if the breastfeeding is painful, the latch is not good (usually true), so that the mother should take the baby off and latch him on again. This is not a good idea. The pain usually settles, and the latch should be fixed on the other side or at the next feeding. Taking the baby off the breast and latching him on again and again only multiplies the pain and the damage.

2. The baby should be at the breast immediately after birth. The vast majority of newborns can be at the breast within minutes of birth. Indeed, research has shown that, given the chance, many babies only minutes old will crawl up to the breast from the mother’s abdomen, latch on and start breastfeeding all by themselves. This process may take up to an hour or longer, but the mother and baby should be given this time together to start learning about each other. Babies who "self-attach" run into far fewer breastfeeding problems. This process does not take any effort on the mother’s part, and the excuse that it cannot be done because the mother is tired after labour is nonsense, pure and simple. Incidentally, studies have also shown that skin-to-skin contact between mothers and babies keeps the baby as warm as an incubator (see section on skin to skin contact). Incidentally, many babies do not latch on and breastfeeding during this time. Generally, this is not a problem, and there is no harm in waiting for the baby to start breastfeeding. The skin to skin contact is good for the baby and the mother even if the baby does not latch on.

3. The mother and baby should room in together. There is absolutely no medical reason for healthy mothers and babies to be separated from each other, even for short periods.
Health facilities that have routine separations of mothers and babies after birth are years behind the times, and the reasons for the separation often have to do with letting parents know who is in control (the hospital) and who is not (the parents). Often, bogus reasons are given for separations. One example is that the baby passed meconium before birth. A baby who passes meconium and is fine a few minutes after birth will be fine and does not need to be in an incubator for several hours’ "observation."

There is no evidence that mothers who are separated from their babies are better rested. On the contrary, they are more rested and less stressed when they are with their babies. Mothers and babies learn how to sleep in the same rhythm. Thus, when the baby starts waking for a feed, the mother is also starting to wake up naturally. This is not as tiring for the mother as being awakened from deep sleep, as she often is if the baby is elsewhere when he wakes up. If the mother is shown how to feed the baby while both are lying down side by side, the mother is better rested.

The baby shows long before he starts crying that he is ready to feed. His breathing may change, for example. Or he may start to stretch. The mother, being in light sleep, will awaken, her milk will start to flow and the calm baby will be content to nurse. A baby who has been crying for some time before being tried on the breast may refuse to take the breast even if he is ravenous. Mothers and babies should be encouraged to sleep side by side in hospital. This is a great way for mothers to rest while the baby nurses. Breastfeeding should be relaxing, not tiring.

4. Artificial nipples should not be given to the baby. There seems to be some controversy about whether "nipple confusion" exists. Babies will take whatever gives them a rapid flow of fluid and may refuse others that do not. Thus, in the first few days, when the mother is normally producing only a little milk (as nature intended), and the baby gets a bottle (as nature intended?) from which he gets rapid flow, the baby will tend to prefer the rapid flow method. You don’t have to be a rocket scientist to figure that one out, though many health professionals, who are supposed to be helping you, don’t seem to be able to manage it. Note, it is not the baby who is confused. Nipple confusion includes a range of problems, including the baby not taking the breast as well as he could and thus not getting milk well and/or the mother getting sore nipples. Just because a baby will "take both" does not mean that the bottle is not having a negative effect. Since there are now alternatives available if the baby needs to be supplemented (see handout #5, Using a Lactation Aid, and handout #8 Finger Feeding) why use an artificial nipple?

5. No restriction on length or frequency of breastfeedings. A baby who drinks well will not be on the breast for hours at a time. Thus, if he is, it is usually because he is not latching on well and not getting the milk that is available. Get help to fix the baby’s latch, and use compression to get the baby more milk (handout #15, Breast Compression). Compression works very well in the first few days to get the colostrum flowing well. This, not a pacifier, not a bottle, not taking the baby to the nursery, will help.

6. Supplements of water, sugar water, or formula are rarely needed. Most supplements could be avoided by getting the baby to take the breast properly and thus get the milk that is available. If you are being told you need to supplement without someone having observed you breastfeeding, ask for someone to help who knows what they are doing. There are rare indications for supplementation, but often supplements are suggested for the convenience of the hospital staff. If supplements are required, they should be given by lactation aid at the breast (see handout #5), not cup, finger feeding, syringe or bottle. The best supplement is your own colostrum. It can be mixed with 5% sugar water if you are not able to express much at first. Formula is hardly ever necessary in the first few days.

7. Free formula samples and formula company literature are not gifts. There is only one purpose for these "gifts" and that is to get you to use formula. It is very effective, and it is unethical marketing. If you get any from any health professional, you should be wondering about his/her knowledge of breastfeeding and his/her commitment to breastfeeding. "But I need formula because the baby is not getting enough!" Maybe, but, more likely, you weren’t given good help and the baby is simply not getting the milk that is available. Even if you need formula, nobody should be suggesting a particular brand and giving you free samples. Get good help. Formula samples are not help.

Under some circumstances, it may be impossible to start breastfeeding early. However, most “medical reasons” (maternal medication, for example) are not true reasons for stopping or delaying breastfeeding, and you are getting misinformation. Get good help. Premature babies can start breastfeeding much, much earlier than they do in many health facilities. In fact, studies are now quite definite that it is less stressful for a premature baby to breastfeed than to bottle feed. Unfortunately, too many health professionals dealing with premature babies do not seem to be aware of this.

Questions? (416) 813-5757 (option 3) or drjacknewman@sympatico.ca or my book Dr. Jack Newman’s Guide to Breastfeeding (called The Ultimate Breastfeeding Book of Answers in the USA)

Handout #1. Breastfeeding—Starting Out Right. Revised January 2005
Written by Jack Newman, MD, FRCPC. © 2005

False alarms that may cause some moms to worry that their milk supply is low:

False alarms that may cause some moms to worry that their milk supply is low:

1. Baby nurses often... Many babies have a strong need to suck or be in frequent contact with their mothers. If baby is nursing effectively, frequent nursing means that the baby is getting enough--not that there's a lack of milk.

2. Baby seems hungry an hour after or so after being fed... Human milk digests more quickly than formula and places less strain on a baby's immature digestive system, so the breastfed baby needs to be fed more frequently than the formula-fed baby.

3. The baby suddenly increases the frequency and/or length of his nursings... Babies who are very sleepy newborns often "wake up" at about 2-3 weeks of age and begin nursing more frequently. Babies also go through occasional growth spurts more often than usual to bring in more milk to meet their needs.

4. Fussy Babies... Many babies have a fussy period each day, often at about the same time of the day. Some babies are fussy much of the time. Fussiness can be caused by many things other than hunger, but often there is no discernible reason. Many moms are concerned that their babies are fussy because they aren't getting enough milk, but it's the quiet, calm, easygoing baby who is more likely to go longer between feedings, take in less milk and gain weight slowly.

5. The baby was weighed before and after a feeding... Then the mom is told her baby didn't get enough to eat. As mentioned previously, studies have shown that test weighing is not a reliable indicator of whether a baby has breastfed well, because **most** baby scales are not sensitive enough to record such a small change in weight accurately.

6. Baby takes a bottle after nursing... Many babies will suck on a bottle even when they are full, because they like to suck. This is not necessarily a sign that the baby did not get enough at the breast.

7. The Mother cannot express much milk... Milk expression is a learned skill and the amount of milk expressed will increase with practice and the mother's ability to let down her milk to the pump. Pumping effectiveness may also vary depending on the type of pump used, etc. The amount of milk expressed may be totally unrelated to her milk supply.

Breastfeeding Advice - A Help or a Hindrance??

http://www.breastfeeding.com/reading_room/hindrance.html

by Barbara Behrmann, Ph.D.

Many factors likely influence your decision to nurse, how you go about establishing and maintaining your nursing relationship, and how long you keep going. Even if you assert that you are not influenced by others' opinions, your experience, knowledge and values are still influenced by the larger culture and society in which you live.

But how do you figure out who or what to listen to? Say you want to travel to Italy. Do you rely on the advice of someone who has scarcely crossed the state line? Do you read promotional literature about Italy produced by a French tourist agency? Do you go to your own travel agency who specializes in domestic cruises? Maybe, but the helpfulness and reliability would be suspect.

Breastfeeding is not much different. A lot of breastfeeding promotional materials are produced by companies that make formula. (Would you go to Pepsi to find out why you should drink Coke?) On the surface the information may appear sound, but probe a little deeper and it's not always the case.

If you are surrounded by family and friends who have had successful breastfeeding experiences, great! But what if they haven't? How do you react when they ask, "Do you need to feed that baby again? He just ate!" "The poor thing's crying. Do you think you don't have enough milk?" "When are you going to wean that child? She's got teeth already!"

Most of us value input from those who care about us. But with breastfeeding myths and misinformation so prevalent in our society, if we are going to let anyone influence our decisions, perhaps they should be from people who have been there, done that.

This is even true when it comes to medical advice. Some doctors and nurses, for example, know a lot about breastfeeding and have much to offer nursing mothers. But just because someone is a pediatrician or family doctor doesn't make him or her a breastfeeding expert. In fact, studies have documented that medical textbooks on the subject are often filled with errors and misinformation. Many doctors freely admit that they don't have the knowledge, training and experience to adequately council breastfeeding mothers.

Contradictions often result. One mother, for example, had a hard time getting her newborn to breast while recovering from a c-section. She recalls, "Every four hours I had a different nurse. One said don't worry about it; the next said I should be pumping and giving her formula in the meantime; the next said something completely different. One nurse said it's because I wasn't holding her right. There seemed to be no standard. It was very frustrating."

So how do you know who to turn to? How do you know who or what is credible? Here are five suggestions:

General Guidelines

Don't rely on literature produced by and source with an opposing interest. This means any breastfeeding information coming from formula companies probably doesn't have you or your baby's best interest at heart.

If you are reading a magazine or other resource that relies heavily on advertising from formula companies, they may feel a certain limit on how free they are to present certain information.

If you have a partner, obviously he hasn't nursed (unless your partner is female, of course). That doesn't mean you don't want to respect his or her) opinion. But it's important to share information with each other so that your thinking can evolve together.

He or she may be wonderfully supportive and willing to help you in any way possible, but may also be uncomfortable with breastfeeding in general, have concerns about you nursing in public, not want the baby in your bedroom, or may encourage you to wean before you want to. Hopefully you can learn together.Know who you can go to for help before you give birth. Bring their phone numbers with you to the hospital or birth center. Not all lactation consultants are equally trained and some providers may use the title even though they aren't certified. Someone with the initials of IBCLC - International Board Certified Lactation Consultant - has the most expertise and experience counseling nursing mothers.

Choose health care providers who are breastfeeding-friendly. Declaring support for breastfeeding is not enough. Be wary of providers who offices seem to promote formula. Find out ahead of time if your family physician or pediatrician has someone on staff to offer breastfeeding assistance and find out what kind of training they have. You can also ask them what percentage of their new mothers are nursing.

Doing What is Right For You

I think the best advice comes from a woman I know who is now a grandmother. She says, "Whatever the cultural climate is at a given time, you have to be centered in what you want to do because there is no right and wrong. You have to do what's right for you . If you can please yourself, that's wonderful. If you can please yourself and your child? Wow! And your husband? Incredible! And then you want to please all of society? Forget it. You have to be happy with what you're doing because there is no single way and every person and situation is so unique."

A to Z: 26 Reasons to Nurse Your Baby

A to Z: 26 Reasons to Nurse Your Baby

from www.llli.org (La Leche League)

• Amenorrhea
• Bonding
• Colostrum... the perfect first food
• Decreased risk of breast cancer
• Easy baby care
• Few allergies
• Good for the whole family
• Human milk is specially designed for human babies
• Immunities
• Jaw development
• Kids get lots of attention when the new baby is breastfed
• Laundry is a breeze
• Mental development
• Natural
• Oxytocin and prolactin
• Protection against many diseases
• Quick weight loss for mother
• Rest
• Saves money
• Traveling is easy
• Understanding the baby's needs
• Vitamins and minerals
• Working goes smoothly when the nursing relationship is maintained
• eXactly what baby needs
• You get to take care of your baby
• Zero waste

Only the Best Is Good Enough - Breastfeed!