We Are ALL Mom Enough, and We Call a TruceThe so-called "Mommy Wars" are over. It is TIME to get with the program, which is no longer about pitting moms and their parenting decisions against one another for the sake of profit. In case you haven't noticed, it's pretty darned hard to be a mom in the U.S.: even those moms fortunate enough to have comprehensive health care coverage, and affordable child care, still don’t have paid family leave (CA and NJ are the only exceptions). The real story here is a culture that doesn’t really value mothers and families beyond Mother's Day.In the past, we've let the media-created "Mommy Wars" get us bogged down in judging others' decisions or feeling guilty about our own. But we've had enough! Moms are uniting to call for the real and permanent change that will make a difference: whether you're in the workforce or your full time work is parenting your kids, cry-it-out believer or attachment parenting subscriber, breastfeeding or formula feeding family. Moms do their best with the information and support available to them, with the operative word being "available." Every family should have the opportunity to make informed choices, and be supported in those choices. That's not our current reality: but fake "wars", blame, guilt, and judgment are not the answers. Instead, moms are working together to demand the support they need and deserve. And we are uniting to ask TIME to cover the real stories, the hard truths. Instead of "Are you mom enough?" we want to see TIME ask "Are we family-friendly enough?" Instead of "How should we parent?" we want to read articles about "How do we support and value parenting in our society?" Those are the stories that will get real moms to buy magazines. TIME, we reject the guilt trip implied by your cover headline. But we thank you for reminding us that, although we continue to be failed by the lack of societal support for the health and wellness of families, we can still support each other. Never underestimate the power of a group of committed moms to effect change in policy and in our society (so that all mothers can parent to the best of their ability). Because we are ALL Mom enough! -The United States Breastfeeding Committee -MomsRising -National Partnership for Women & Families | ||
Professional breastfeeding education and support. Breastfeeding, childbirth and baby care issues.
Tuesday, May 29, 2012
US Breastfeeding Committee response to TIME mag.
AAP's take on sensory-based therapies
AAP Recommends Careful Approach to Using Sensory-Based Therapies
5/28/2012For Release: May 28, 2012
Sensory-based therapies using brushes, swings, balls and other equipment are
increasingly used by occupational therapists to treat children with
developmental and behavioral disorders. However, it’s unclear whether children
with sensory-based problems have an actual disorder related to the sensory
pathways of the brain, or whether these problems are due to an underlying
developmental disorder. In a new policy statement, “Sensory
Integration Therapies for Children With Developmental and Behavioral
Disorders,” published in the June 2012 Pediatrics (published online May 28),
the American Academy of Pediatrics (AAP) recommends that pediatricians not use
sensory processing disorder as an independent diagnosis. When sensory problems
are present, health care providers should consider other developmental
disorders, including autism spectrum disorders, attention deficit/hyperactivity
disorder, developmental coordination disorder and anxiety disorder. Occupational
therapy with the use of sensory-based therapies may be acceptable as one
component of a comprehensive treatment plan. The AAP recommends pediatricians
communicate with families about the limited data on the use of sensory-based
therapies, and help families design simple ways to monitor the effects of
treatment and discuss whether the therapy is working to achieve their goals for
their child. Occupational therapy is a limited resource and families should work
with pediatricians to prioritize treatments based on problems that affect a
child’s ability to perform daily functions.
Monday, May 21, 2012
Breastfeeding helps prevent obesity
Science You Can Use: Study says the act of breastfeeding, not the milk, is what protects against obesity.
| By Tanya Lieberman, IBCLC | Posted on May 19, 2012 | No Comments | |  |
When it comes to obesity and breastfeeding, here’s what we know: Not breastfeeding increases the risk of childhood obesity (a 32% excess risk, according to the Surgeon General).And here’s what we don’t know: Why and how? Is it something in the milk? Is it something about the feeding method? Is it something in formula?
A new study, which confirms prior research, investigated the relationship between obesity risk and breastfeeding, bottle-feeding, and what goes in the bottles, and concludes that feeding method plays a key role in the amount of weight babies gain and their future risk of childhood obesity.
This longitudinal CDC study followed nearly 2,000 babies from birth to one year, gathering at least three weight measurements. Babies were categorized into one of six feeding method categories. Here’s what the study found:
Compared with strictly breast-fed infants, babies who exclusively bottle-fed gained 71 or 89 g more per month when fed either nonhuman milk only (P < .001) or expressed human milk only (P < .02), respectively. But, “they gained only 37 g more per month when fed both expressed human milk and nonhuman milk (P = .08).”Why would it be that the effect of breastfeeding would be different when feeding pumped milk? The authors suggest: “In contrast to infants fed at the breast who may need to actively suckle, formula-fed infants are more likely to be passive in the feeding process, and caregivers’ control might undermine infants’ capability for self-regulation to balance energy intake against internal cues of hunger and satiety.” This is consistent with earlier preliminary research suggesting that found that breastfed children could more easily determine when they were full.
The researchers also determined that babies who breast-fed and drank expressed human milk from bottles gained weight in a similar manner to infants who exclusively breast-fed, whereas infants who both breast-fed and drank from bottles of nonhuman milk gained 45 g more per month (P < .001), suggesting that “supplementing breastfeeding with expressed breastmilk would be preferable to supplementing breastfeeding with nonhuman milk.”
In other words, when parents are in control of feeding, we tend to push babies to eat past the point of fullness. You could call this the “just finish it!” instinct.
(And I wonder – with no evidence but my own pumping experience and that of moms I’ve worked with - if this urge might be particularly strong for mothers who have done the dreary work of pumping and don’t want to see a single drop go to waste.)
The take home message: It’s not just about the milk. The act of feeding itself may play an important role in establishing a healthy weight and healthy self-regulation of food intake.
What to do if you’re a bottle-feeding mom? If you want to practice bottle-feeding which supports healthy weight and feeding behavior, please check out our post, “How to Bottlefeed as You’d Breastfeed.”
Did you bottle and breastfeed? Ever find yourself resisting the urge to make your baby finish a bottle? If you breastfed, do you think your baby could recognize when he/she was full?
Friday, May 18, 2012
Thursday, May 17, 2012
How long to breastfeed?
"How Long Should I Nurse?"
BREASTFEEDING IS BESTFEEDING. Nursing for even a day is the most precious gift you can give to your baby. How long should you nurse? These guidelines may help you decide.
IF YOU NURSE FOR JUST A FEW DAYS, he will have received your colostrum, or early milk. Packed with nutrition and antibodies, it helps get your baby's digestive system going and gives him his first and easiest "immunization". Breastfeeding gives your baby a great start and helps your own body recover from the birth, too. Taking time to relax and nurse is a lovely way to get to know your baby.
IF YOU NURSE FOR 4 TO 6 WEEKS, you will ease him throught the most critical part of infancy. Breastfed newborns are rarely sick or hospitalized and have few digestive problems. It takes 4 to 6 weeks to establish your milk supply and a good nursing relationship. Your body will recover naturally from childbirth. Remember - nursing mothers usually lose weight more easily! As an added bonus, prolactin, the "mothering hormone" that is produced every time you nurse, will help you and your baby form a special bond.
IF YOU NURSE FOR 3 TO 4 MONTHS, baby's digestive system will have matured a great deal, and he will be much better able to tolerate the foreign substances in commercial formulas. If there is a family history of allergies, though, you will greatly reduce his risk by waiting a few more months before adding anything at all to his diet of breastmilk. And giving nothing but your milk for the first 4 months gives strong protection against ear infections for a whole year.
IF YOU NURSE FOR 6 MONTHS, you will supply all your baby's nutrtional needs for the first half year of his life. At this point, he may be ready to try some other foods. Nursing continues to ensure good health by providing antibodies to all the bacteria and viruses to which you or your baby are exposed. One study indicates that continued nursing reduces the risk of both childhood and some adult cancers.
IF YOU NURSE FOR 9 MONTHS, you will have seen him through the fastest and most important brain and body development of his life on the food that was designed for him - your milk. Nursing for at least this long will help ensure better performance all through his school years. Weaning may be fairly easy at this age... but then, so is nursing! If you wanat to avoid weaning this early, be sure you've been available to nurse for comfort as well as for food.
IF YOUR NURSE FOR A YEAR, you will have saved enough money to buy a major appliance! Your baby is now ready to try a whole range of new foods. This year of nursing has given your child many health benefits that will last his whole life. He will have a stronger immune system, for example, and is less likely to need orthodontia or speech therapy. The American Academy of Pediatrics recommends nursing for at least one year to ensure the best possible nutrition and health for your baby.
IF YOU NURSE PAST ONE YEAR, you will continue to provide the highest quality nutrition and superb protection against illness at a time when infections are common. A toddler picks up everything! he is eating a variety of table foods and has had time to form a solid bond with you - a healthy starting point for his growing independence. Together you can work on the weaning process, progressing at a pace that he can handle. A former U.S. Surgeon General has said, "it is a lucky baby... who continues to nurse until he's two."
IF YOU NURSE UNTIL HE OUTGROWS THE NEED, you can feel confident that you ahve met your baby's physical and emotional needs in the most natural and healthy way possible. In cultures where there is no pressure to wean, children tend to nurse for at least 2 years. The World Health Organisation and UNICEF strongly encourages breastfeeding through toddlerhood. Your milk provides antibodies and other protective substances as long as you continue to nurse. Families of nursing toddlers often find that their medical bills are lower for years to come.
Children who were nursed long-term tend to be very secure. Nursing can help ease both of you through the tears, tantrums, and tumbles of toddlerhood, while illnesses are milder and easier to handle. It is an all-purpose mothering tool that you won't want to be without! Don't worry that your child will nurse forever. All children eventually wean, no matter what yo do, and there are more nursing toddlers around than you might guess.
WHETHER YOU NURSE FOR A DAY OR FOR SEVERAL YEARS, the decision to nurse your child is one you need never regret. And whenever weaning takes place, remember that it is a big step for both of you. If you choose to wean before your child is ready, be sure to do it gradually, and with love.
(C) Diane Wiessinger, MS, IBCLC 136 Ellis Hollow Creek Road Ithaca, NY 14850
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US' breastfeeding report card
United States Ranks Last on Breast-Feeding Support
By KJ DELL'ANTONIA
Does the United States — do we — really want women to breast-feed their infants?
The American Academy of Pediatrics certainly does. As do the Surgeon General and the Centers for Disease Control and Prevention’s Division of Nutrition, Physical Activity and Obesity, which clearly have the ring of officialdom about them.
But as many mothers can attest, the awarding of a smiley-face sticker for diligent nursing does nothing to make up for inadequate support for women who want to breast-feed their babies while simultaneously remaining employed outside the home. It’s possible to do both, and many women do — but very few would argue that the federal or state government offered much, if any, help.
Last week, Save the Children released its State of the World’s Mothers Report for 2012, and in it, amid the detailed discussion of successes and failures of all the world’s nations with respect to taking care of mothers and infants, was this:
As others have said before me, increasing breast-feeding rates might only incrementally alter the health picture for any one child, but it holds the possibility of dramatic change nationwide with respect to the number of children affected by those problems, and the cost of their treatment.
But if that’s the case, then why not support policies that make breast-feeding as easy as possible?
As the Surgeon General’s report notes, rates of breast-feeding are lower among employed mothers, and women with longer maternity leaves, those who can work part time and those with breast-feeding support programs in the workplace nurse longer. But for many, if not most, women, those supports aren’t available.
I’ve written before that breast-feeding isn’t free. Breast-feeding for six months or more is associated with a loss of earnings: women who nurse long-term spend more time out of the workforce, and work fewer hours, and the result seems to impact their earnings beyond even the time with an infant at the breast. That may be because women who nurse longer are also more likely to have made a conscious choice to stop working or cut back on their hours, but there’s more to that story as well. Faced with a different work environment, women might make different choices.
But if that different work environment is to include laws requiring more support of breast-feeding, many women have doubts about that as well. The costs may shift, but breast-feeding will never be “free” — there will always be a cost in terms of lost hours of productivity with respect to the financially remunerative work, and the return on that investment will never be in kind.
We’ve collectively embraced the benefits of breast-feeding, but we still have no way to value those benefits within our economy. The result is that many women fear that laws that place the economic burden of breast-feeding on the employers will have a cost to all women (regardless of whether they ultimately breast-feed a child) in terms of hiring and promotion — one more way that a woman employee may be different from a man.
So, do we as a country really want every woman (not just those who can bear the costs themselves) to breast-feed her infant? One reason we’re ranked at the bottom of the worldwide “Breastfeeding Policy Scorecard” is that we don’t have a good answer to that question.
The American Academy of Pediatrics certainly does. As do the Surgeon General and the Centers for Disease Control and Prevention’s Division of Nutrition, Physical Activity and Obesity, which clearly have the ring of officialdom about them.
But as many mothers can attest, the awarding of a smiley-face sticker for diligent nursing does nothing to make up for inadequate support for women who want to breast-feed their babies while simultaneously remaining employed outside the home. It’s possible to do both, and many women do — but very few would argue that the federal or state government offered much, if any, help.
Last week, Save the Children released its State of the World’s Mothers Report for 2012, and in it, amid the detailed discussion of successes and failures of all the world’s nations with respect to taking care of mothers and infants, was this:
The United States ranks last on the Breastfeeding Policy Scorecard. It is the only economically advanced country – and one of just a handful of countries worldwide – where employers are not required to provide any paid maternity leave after a woman gives birth. There is also no paid parental leave required by U.S. law. Mothers may take breaks from work to nurse, but employers are not required to pay them for this time. Only 2 percent of hospitals in the United States have been certified as “baby-friendly” and none of the provisions of the International Code of Marketing of Breast-Milk Substitutes has been enacted into law. While 75 percent of American babies are initially breast-fed, only 35 percent are being breast-fed exclusively at 3 months.Save the Children makes the point that women in developing countries don’t need to breast-feed in the way that women in impoverished countries do. We have ready access to nutritious alternatives and clean water. But the science that’s trumpeted by the Surgeon General, A.A.P. and the C.D.C. suggests that breast-feeding, when possible, has benefits that aren’t matched by those alternatives — in its “Call to Action to Support Breastfeeding,” the Surgeon General’s office notes that breast-feeding reduces the risks of some infections and diseases, and of type 2 diabetes, asthma and childhood obesity.
As others have said before me, increasing breast-feeding rates might only incrementally alter the health picture for any one child, but it holds the possibility of dramatic change nationwide with respect to the number of children affected by those problems, and the cost of their treatment.
But if that’s the case, then why not support policies that make breast-feeding as easy as possible?
As the Surgeon General’s report notes, rates of breast-feeding are lower among employed mothers, and women with longer maternity leaves, those who can work part time and those with breast-feeding support programs in the workplace nurse longer. But for many, if not most, women, those supports aren’t available.
I’ve written before that breast-feeding isn’t free. Breast-feeding for six months or more is associated with a loss of earnings: women who nurse long-term spend more time out of the workforce, and work fewer hours, and the result seems to impact their earnings beyond even the time with an infant at the breast. That may be because women who nurse longer are also more likely to have made a conscious choice to stop working or cut back on their hours, but there’s more to that story as well. Faced with a different work environment, women might make different choices.
But if that different work environment is to include laws requiring more support of breast-feeding, many women have doubts about that as well. The costs may shift, but breast-feeding will never be “free” — there will always be a cost in terms of lost hours of productivity with respect to the financially remunerative work, and the return on that investment will never be in kind.
We’ve collectively embraced the benefits of breast-feeding, but we still have no way to value those benefits within our economy. The result is that many women fear that laws that place the economic burden of breast-feeding on the employers will have a cost to all women (regardless of whether they ultimately breast-feed a child) in terms of hiring and promotion — one more way that a woman employee may be different from a man.
So, do we as a country really want every woman (not just those who can bear the costs themselves) to breast-feed her infant? One reason we’re ranked at the bottom of the worldwide “Breastfeeding Policy Scorecard” is that we don’t have a good answer to that question.
Wednesday, May 16, 2012
Healthy Birth Hospital Practices
This is one of the Lamaze
Healthy Birth Practices.
Download a print-friendly PDF. Jeannette Crenshaw, MSN, RN, NEA-BC, IBCLC, LCCE, FACCE After giving birth, a woman held her healthy newborn baby for a few minutes. Then, hospital staff took her baby to the well-baby nursery and moved the mother to her hospital room. During the day, the mother and her baby stayed together in the hospital room; during the night, however, the baby stayed in the nursery because, as hospital staff advised the mother, she would get more sleep this way. The mother realized she had spent a lot of time apart from her baby, and she wondered if the hospital’s routine procedure truly met the needs of mothers and babies after birth. Years ago, when birth moved from homes to hospitals, most babies didn’t stay with their mother. The mother went to a hospital room, while her baby was cared for in a nursery. Mothers waited long hours to see their baby, and their baby’s visits were often only during feeding times. The medical community thought that when babies were cared for in the nursery, the babies were safer and healthier and the mothers were more rested.  Yearning for Closeness As an essential resource for helping you understand how decisions about your care during pregnancy and childbirth can positively affect you and your baby, Lamaze International offers scientific evidence about why keeping your baby close after birth is important for both of you. Since the beginning of time, women have needed and wanted their baby close to them. In their arms following birth, and while resting or sleeping, women kept their baby safe, warm, and nourished. Today, we know this “yearning for closeness” is a physical and emotional need shared by mothers and babies. In recent years, studies have shown that it’s best for mothers and their healthy baby to stay together after birth (Bergman, Linley, & Fawcus, 2004; Bystrova, Matthiesen, et al., 2007; Bystrova, Widstrom, et al., 2007; Christensson et al., 1992; International Lactation Consultant Association, 1999; Moore & Anderson, 2007; Moore, Anderson, & Bergman, 2007; World Health Organization [WHO], 1998). And e xperts agree that unless a medical reason exists, healthy mothers and babies shouldn’t be separated after birth or during the early days following birth ( Academy of Breastfeeding Medicine [ABM] Protocol Committee, 2007; American Academy of Family Physicians, 2007; American Academy of Pediatrics [AAP] Expert Workgroup on Breastfeeding, 2005; International Lactation Consultant Association, 1999; UNICEF/WHO, 2004; WHO, 1998). Interrupting, delaying, or limiting the time that a mother and her baby spend together may have a harmful effect on their relationship and on breastfeeding success (Enkin et al., 2000). Keeping Mothers and Babies Together Babies stay warm and cry less, and breastfeeding gets off to a good start when mothers and their baby have frequent time together, beginning at birth. Mothers learn to recognize their baby’s needs, responding tenderly and lovingly. A connection that lasts a lifetime begins to form.  The Moment of Birth Nature prepares you and your baby to need and seek each other from the moment of birth. Oxytocin, the hormone that causes your uterus to contract, will stimulate “mothering” feelings after birth as you touch, gaze at, and breastfeed your baby (Uvnäs-Moberg, 1998; Winberg, 2005). More oxytocin will be released as you hold your baby skin-to-skin. Your brain will release endorphins, narcotic-like hormones that enhance these mothering feelings. These hormones help you feel calm and responsive and cause the temperature of your breasts to rise, keeping your baby warm (Uvnäs-Moberg, 1998). Because of the normal “adrenaline rush” babies experience right after birth, your baby will be bright, alert, and ready to nurse soon after birth (Porter, 2004; Righard & Alade, 1990). During the hours and days following birth, you will learn to understand your baby’s cues and unique way of communicating with you. Healthy newborns placed skin-to-skin on their mother adjust easily to life outside the womb. They stay warm, cry less, have lower levels of stress hormones, are more likely to breastfeed, and breastfeed sooner than newborns who are separated from their mother ( Bystrova, Widstrom, et al., 2007; Bystrova et al., 2003; Carfoot, Williamson, & Dickson, 2005; Christensson, Bhat, Amadi, Eriksson, & Hojer, 1998; Christensson et al., 1992; Lindenberg, Cabrera Artola, & Jimenez, 1990; Mikiel-Kostyra, Mazur, & Boltruszko, 2002; Uvnäs-Moberg, 1998 ). The benefits of skin-to-skin contact continue beyond the first hour after birth. The longer and more often mothers and babies are skin-to-skin in the hours and days after the birth, the greater the benefit (Moore & Anderson, 2007; Syfrett, Anderson, Neu, & Hilliard, 1996). Babies who are cold, including premature babies, return to a normal temperature more quickly when held skin-to-skin by their mother (Charpak et al., 2005 ). When a mother and her baby are skin-to-skin, her baby is exposed to the normal bacteria on her skin, which may protect her baby from becoming sick due to harmful germs (WHO, 1998). Research suggests that women who hold their baby skin-to-skin following birth care for their baby with more confidence, and they recognize and respond to their baby’s needs sooner than mothers who are separated from their baby ( Widström et al., 1990). And mothers often prefer holding their baby skin-to-skin rather than swaddled in a blanket! Other benefits to babies from skin-to-skin contact include easier breathing, higher and more stable blood sugar levels, and a natural progression to breastfeeding (K. Christensson, Cabrera, E. Christensson, Uvnäs-Moberg, & Winberg, 1995; Christensson et al., 1992; Johanson, Spencer, Rolfe, Jones, & Malla, 1992; Walters, Boggs, Ludington-Hoe, Price, & Morrison, 2007 ). Babies placed skin-to-skin with their mother immediately after birth have a natural instinct to attach to the breast and begin breastfeeding, usually within one hour ( Righard & Alade, 1990; Walters et al., 2007; Widström et al., 1990). Mothers who hold their baby skin-to-skin after birth are more likely to make greater amounts of breastmilk, breastfeed longer, and breastfeed without offering formula (Bystrova, Matthiesen, et al., 2007; DiGirolamo, Grummer-Strawn, & Fein, 2001; Mikiel-Kostyra et al., 2002; Moore et al., 2007; Vaidya, Sharma, & Dhungel, 2005). It is also important to note that experts recommend exclusive breastfeeding—no other liquids or foods—during the first six months of life (AAP Expert Workgroup on Breastfeeding, 2005).
Rooming-In With Your Baby
Keeping your baby with you continuously during the day and at night (called
“rooming-in”) has many benefits. Rooming-in with your baby makes breastfeeding
easier. Studies done throughout the world suggest that mothers who room-in with
their baby make more milk, make more milk sooner, breastfeed longer, and are
more likely to breastfeed exclusively compared with mothers who have limited
contact with their baby or whose baby is in the nursery at night (Bystrova,
Matthiesen, et al., 2007; Daglas et al., 2005; Declercq, Sakala, Corry, &
Applebaum, 2006; Fairbank et al., 2000; Flores-Huerta & Cisneros-Silva,
1997; Lindenberg et al., 1990; Pérez-Escamilla, Pollitt, Lönnerdal, & Dewey,
1994; Syafruddin, Djauhariah, & Dasril, 1988; Yamauchi & Yamanouchi,
1990).In the days following birth—whether in a hospital, at a birth center, or at home—mothers’ and babies’ physical and emotional need for each other continue. It makes sense that the more time two people spend together, the sooner they get to know each other. Mothers who are with their baby for longer periods of time, including during the night, have higher scores on tests that measure the strength of a mother’s attachment to her baby (Klaus et al., 1972; Norr, Roberts, & Freese, 1989; Prodromidis et al., 1995). While together, mothers quickly learn their baby’s needs and how best to care for, soothe, and comfort their newborn. Rooming-in is better for babies. While babies are with their mother, they cry less, soothe more quickly, and spend more time in quiet sleep (Keefe, 1987). Babies who room with their mother are more likely to take in more breastmilk (Bystrova, Matthiesen, et al., 2007), gain more weight per day ( Yamauchi & Yamanouchi, 1990), breastfeed exclusively (Mikiel-Kostyra, Mazur, & Wojdan-Godek, 2005), and are less likely to develop jaundice, a yellowing of the skin that sometimes requires treatment (S yafruddin et al., 1988). Normal newborn care in the hospital (e.g., exams, vital signs, and baths) can be done while rooming-in. You can be close to your baby and even help with some of the care if you wish. Babies bathed by their mother and held skin-to-skin stay just as warm as babies bathed in the nursery and placed in warmers (Medves & O’Brien, 2004). Well-meaning friends and family may advise you to let your baby stay in the nursery at night so that you can get more sleep. However, studies show that mothers whose baby is cared for in the nursery do not get more sleep than mothers who room-in with their baby at night (Keefe, 1987, 1988; Waldenström & Swenson, 1991). Many mothers sleep more peacefully knowing that their baby is with them. Rooming-in may have other long-term benefits for mothers and babies. Research suggests that rates of child abuse, neglect, and abandonment are lower for mothers who have frequent and extended contact with their newborn during the early postpartum period (N. Lvoff, V. Lvoff, & Klaus, 2000; O’Connor, Vietze, Sherrod, Sandler, & Altemeier, 1980). Unlimited Opportunities for Breastfeeding When you and your baby are together, skin-to-skin, and rooming-in, you’ll have unlimited opportunities for breastfeeding “practice.” Make those times happen! If you have lots of visitors, tell them it’s time for breastfeeding. If you’re holding your baby skin-to-skin, your baby’s special ways of communicating will tell them he’s hungry. If your baby is unable to be in your room, ask for your baby to be brought to you for breastfeeding. Researchers found that mothers are more likely to continue breastfeeding if their baby is brought to them for feeding when rooming-in isn’t possible (DiGirolamo, Grummer-Strawn, & Fein, 2008). Recommendations from Experts The benefits of keeping moms and babies together are so impressive that many professional organizations have made recommendations promoting skin-to-skin contact and rooming-in and opposing routine separation of mothers and babies after birth. These organizations include the Academy of Breastfeeding Medicine (ABM Protocol Committee, 2007); American Academy of Pediatrics (AAP Expert Workgroup on Breastfeeding, 2005); the American College of Obstetricians and Gynecologists (ACOG Committee on Health Care for Underserved Women & Committee on Obstetric Practice, 2007); the Association of Women’s Health, Obstetric and Neonatal Nurses (2000); the World Health Organization (1998); and the International Lactation Consultant Association (1999). Recommendations from Lamaze International You wait nine months to meet your baby. You dream about your baby and look forward to the moment of birth with excitement. After birth, you and your baby will want and need to be together. Studies show that being together is best for both of you. Lamaze International, which bases its education on the latest scientific research, joins the many organizations that recommend keeping moms and babies together after birth. Lamaze International encourages you to give birth in a place where you and your baby can be together without unnecessary interruptions. If you’re having your baby in a hospital, tell your caregiver that you plan to hold your baby skin-to-skin after birth and keep your baby with you throughout your stay. And reassure your friends and family that the best place for your baby is with you! To learn more about safe, healthy birth, read The Official Lamaze Guide: Giving Birth with Confidence (Lothian & DeVries, 2005), visit the Lamaze Web site (www.lamaze.org), and sign up to receive the Lamaze…Building Confidence Week by Week e-mails. Most recent update: July 2009 References Academy of Breastfeeding Medicine [ABM] Protocol Committee. (2007). ABM Clinical Protocol #7: Model breastfeeding policy. Breastfeeding Medicine, 2(1), 50–55. American Academy of Family Physicians. (2007). Family physicians supporting breastfeeding (position paper). Retrieved April 15, 2009, from http://www.aafp.org/online/en/home/policy/policies/b/breastfeedingpositionpaper.html American Academy of Pediatrics Expert Workgroup on Breastfeeding. (2005). Breastfeeding and the use of human milk. Pediatrics, 115(2), 496–506. American College of Obstetricians and Gynecologists [ACOG] Committee on Health Care for Underserved Women & Committee on Obstetric Practice. (2007). ACOG Committee Opinion No. 361: Breastfeeding: Maternal and infant aspects. Obstetrics and Gynecology 109(2, Pt. 1), 479–480. Association of Women’s Health, Obstetric and Neonatal Nurses. (2000). Evidence-basedclinical practice guideline: Breastfeedingsupport: Prenatal care through the first year. Washington, DC: Author. Bergman, N. J., Linley, L. L., & Fawcus, S. R. (2004). Randomized controlled trial of skin-to-skin contact from birth versus conventional incubator for physiological stabilization in 1200- to 2199- gram newborns. Acta Paediatrica, 93, 779–785. Bystrova, K., Matthiesen, A.-S., Widstrom, A.-M., Ransjo-Arvidson, A.-B., Welles-Nyström, B., Vorontsov, I., et al. (2007). The effect of Russian maternity home routines on breastfeeding and neonatal weight loss with special reference to swaddling. Early Human Development, 83(1), 29–39. Bystrova, K., Widstrom, A.-M., Matthiesen, A.-S., Ransjo-Arvidson, A.-B, Welles-Nyström, B., Vorontsov, I., et al. (2007). Early lactation performance in primiparous and multiparous women in relation to different maternity home practices: A randomized trial in St. Petersburg. International Breastfeeding Journal, 2, 9. Bystrova, K., Widstrom, A.-M., Matthiesen, A.-S., Ransjo-Arvidson, A.-B., Welles-Nyström, B., Wassberg, C., et al. (2003). Skin-to-skin contact may reduce negative consequences of “the stress of being born”: A study on temperature in newborn infants subjected to different ward routines in St. Petersburg. Acta Paediatrica, 92(3), 320–326. Carfoot, S., Williamson, P., & Dickson, R. (2005). A randomized controlled trial in the north of England examining the effects of skin-to-skin care on breast feeding. Midwifery, 21 (1), 71–79. Charpak, N., Ruiz, J. G., Zupan, J., Cattaneo, A., Figueroa, Z., Tessier, R., et al. (2005). Kangaroo mother care: 25 years after. Acta Paediatrica, 94, 514–522. Christensson, K., Bhat, G. J., Amadi, B. C., Eriksson, B., & Hojer, B. (1998). Randomised study of skin-to-skin versus incubator care for rewarming low-risk hypothermic neonates. Lancet, 352(9134), 1115. Christensson, K., Cabrera, T., Christensson, E., Uvnäs-Moberg, K., & Winberg, J. (1995). Separation distress call in the human neonate in the absence of maternal body contact. Acta Paediatrica, 84(5), 468–473. Christensson, K., Siles, C., Moreno, L., Belaustequi, A., De La Fuente, P., Lagercrantz, H., et al. (1992). Temperature, metabolic adaptation and crying in healthy full-term newborns cared for skin-to-skin or in a cot. Acta Paediatrica, 81(6–7), 488–493. Daglas, M., Antoniou, E., Pitselis, G., Iatrakis, G., Kourounis, G., & Creatsas, G. (2005). Factors influencing the initiation and progress of breastfeeding in Greece. Clinical and Experimental Obstetrics & Gynecology, 32(3), 189–192. Declercq, E. R., Sakala, C., Corry, M. P., & Applebaum, S. (2006). Listening to mothers II: Report of the second national U.S. survey of women’s childbearing experiences. New York: Childbirth Connection. DiGirolamo, A. M., Grummer-Strawn, L. M., & Fein, S. (2001). Maternity care practices: Implications for breastfeeding. Birth, 28(2), 94–100. DiGirolamo, A. M., Grummer-Strawn, L. M., & Fein, S. (2008). Effect of maternity-care practices on breastfeeding. Maternity care practices: Implications for breastfeeding. Pediatrics, 122(Suppl. 4), S43–S49. Enkin, M., Keirse, M. J. N. C., Neilson, J. Crowther, C., Duley, L., Hodnett, E., et al. (2000). A guide to effective care in pregnancy and childbirth. New York: Oxford University Press. Fairbank, L., O’Meara, S., Renfrew, M., Woolridge, M., Sowden, A., & Lister-Sharp, D. (2000). A systematic review to evaluate effectiveness of interventions to promote the initiation of breastfeeding. Health Technology Assessment, 4(25), 1–71. Flores-Huerta, S., & Cisneros-Silva, I. (1997). Mother-infant rooming-in and exclusive breast feeding. Salud Pública de México, 39(2), 110–116. International Lactation Consultant Association. (1999). Evidence-based guidelines for breastfeeding management during the first 14 days [Booklet]. Raleigh, NC: Author. Johanson, R. B., Spencer, S. A., Rolfe, P., Jones, P., & Malla, D. S. (1992). Effect of post-delivery care on neonatal body temperature. Acta Paediatrica,81(11), 859–863. Keefe, M. R. (1987). Comparison of neonatal nighttime sleep-wake patterns in nursery versus rooming-in environments. Nursing Research, 36(3), 140–144. Keefe, M. R. (1988). The impact of infant rooming-in on maternal sleep at night. Journal of Obstetric,Gynecologic, and Neonatal Nursing, 17(2), 122– 126. Klaus, M. H., Jerauld, R., Kreger, N. C., McAlpine, W., Steffa, M., Kennel, J. H., et al. (1972). Maternal attachment: Importance of the first postpartum days. The New England Journal ofMedicine, 286(9), 460–463. Lindenberg, C. S., Cabrera Artola, R., & Jimenez, V. (1990). The effect of early post-partum mother-infant contact and breast-feeding promotion on the incidence and continuation of breast-feeding. International Journal of Nursing Studies, 27(3), 179–186. Lvoff, N. M., Lvoff, V., & Klauss, M. H. (2000). Effect of the baby-friendly initiative on infant abandonment in a Russian hospital. Archives of Pediatrics & Adolescent Medicine, 154(5), 474–477. Medves, J., & O’Brien, B. (2004). The effect of bather and location of first bath on maintaining thermal stability in newborns. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 33(2), 175–182. Mikiel-Kostyra, K., Mazur, J., & Boltruszko, I. (2002). Effect of skin-to-skin contact after delivery on duration of breastfeeding: A prospective cohort study. Acta Paediatrica, 91(12), 1301–1306. Mikiel-Kostyra, K., Mazur, J., & Wojdan-Godek, E. (2005). Factors affecting exclusive breastfeeding in Poland: Cross-sectional survey of population-based samples. Sozial- und Präventivmedizin/Social and Preventive Medicine,50(1), 52–59. Moore, E. R., & Anderson, G. C. (2007). Randomized controlled trial of very early mother-infant skin-to-skin contact and breastfeeding status. Journal of Midwifery & Women’s Health, 52(2), 116–125. Moore, E. R., Anderson, G. C., & Bergman, N. (2007). Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews , Issue 3, Art. No.: CD003519. Norr, K. F., Roberts, J. E., & Freese, U. (1989). Early postpartum rooming-in and maternal attachment behaviors in a group of medically indigent primiparas. Journal of Nurse-Midwifery, 34(2), 85–91. O’Connor, S., Vietze, P. M., Sherrod K., Sandler, H. M., & Altemeier. W. A. (1980). Reduced incidence of parenting inadequacy following rooming-in. Pediatrics, 66(2), 176–182. Pérez-Escamilla, R., Pollitt, E., Lönnerdal, B., & Dewey, K. G. (1994). Infant feeding policies in maternity wards and their effect on breast-feeding success: An analytical overview. American Journal of Public Health, 84(1), 89–97. Porter, R. H. (2004). The biological significance of skin-to-skin contact and maternal orders. Acta Paediatrica, 93, 1560–1562. Prodromidis, M., Field, T., Arendt, R., Singer, L., Yando, R., & Bendell, D. (1995). Mothers touching newborns: A comparison of rooming-in versus minimal contact. Birth, 22(4), 196–200. Righard, L., & Alade, M. O. (1990). Effect of delivery room routines on success of first breast-feed. Lancet, 336(8723), 1105–1107. Syafruddin, M., Djauhariah, A. M., & Dasril, D. (1988). A study comparing rooming-in with separate nursing. Paediatrica Indonesiana, 28(5–6), 116–123. Syfrett, E. B., Anderson, G. C., Neu, J., & Hilliard, M. E. (1996, October). Very early kangaroo care beginning at birth for preterm infants and mothers who choose to breastfeed: Effect on outcome. Abstract presented at the first Workshop on the Kangaroo-Mother Method for Low Birth Weight Infants (sponsored by the World Health Organization, Maternal-Child Health Collaborating Center), Trieste, Italy. UNICEF/WHO. (2004). Baby-Friendly Hospital Initiative in the U.S.—The ten steps to successful breastfeeding. Retrieved April 15, 2009, from http://www.babyfriendlyusa.org/eng/10steps.html Uvnäs-Moberg, K. (1998). Oxytocin may mediate the benefits of positive social interactions and emotions. Psychoneuroendocrinology, 23(8), 819–838. Vaidya, K., Sharma, A., & Dhungel, S. (2005). Effect of early mother-baby close contact over the duration of exclusive breastfeeding. Nepal Medical College Journal, 7(2), 138–140. Waldenström, U., & Swenson, A. (1991). Rooming-in at night in the postpartum ward. Midwifery, 7(2), 82–89. Walters, M. W., Boggs, K. M., Ludington-Hoe, S., Price, K. M., & Morrison, B. (2007). Kangaroo care at birth for full term infants: A pilot study. MCN: The American Journal of Maternal/Child Nursing, 32(6), 375–381. Widström, A. M., Wahlberg, V., Matthiesen, A. S., Eneroth, P., Uvnäs-Moberg, K., & Werner, S., et al. (1990). Short-term effects of early suckling and touch of the nipple on maternal behavior. EarlyHuman Development, 21(3), 153–163. Winberg, J. (2005). Mother and newborn baby: Mutual regulation of physiology and behavior—A selective review. Developmental Psychobiology, 47(3), 217–229. World Health Organization [WHO]. (1998). Evidence for the ten steps to successful breastfeeding (rev. ed., WHO/CHD/98.9). Geneva, Switzerland: Author. Yamauchi, Y., & Yamanouchi, I. (1990). The relationship between rooming-in/not rooming-in and breast-feeding variables. Acta PaediatricaScandinavica, 79(11), 1017–1022. Acknowledgements This healthy birth practice paper was revised and updated by Jeannette Crenshaw, RN, MSN, NEA-BC, IBCLC, LCCE, FACCE. The six healthy birth practice papers were originally written in 2003 by Lamaze International as the 6 Care Practice Papers. | ||
Friday, May 11, 2012
Time magazine's breastfeeding cover
I am a Lactation Consultant and breastfeeding advocate; so I am supportive of almost anything that promotes breastfeeding. The TIME magazine cover was the brainchild of their advertising dept., meant soley to increase their mag...azine's sales...at any cost. The breastfeeding mother should be supported by her family, friends and our society. TIME magazine has exploited this issue, and caused more harm by polarizing people on the issue of breastfeeding. The US's breastfeeding rates are lower than most other countries. Breastfeeding is recommended by the AAP, CDC, and WHO. Breastfeeding is not just a lifestyle choice, but because of the short and long term health benefits to both mother and child; it becomes a national health issue. www.babyfirstlactation.comSee More
Thursday, May 3, 2012
Wednesday, May 2, 2012
pacifiers vs. breastfeeding?
No more nipple confusion: Study says pacifiers may help breast-feeding
Getty Images stock
Don't ban the binky! New research finds that pacifiers may encourage breast-feeding.
Now, a few pediatricians are questioning the commonly held belief that pacis meddle with a newborn’s breast-feeding. And in a complete about-face, the latest research suggests that pacifiers may encourage breast-feeding.
In December 2010, Oregon Health & Science University Doernbecher Children’s Hospital locked up pacifiers in the newborn nursery to improve their breast-feeding record even more. To everyone’s surprise, they saw breast-feeding rates drop as soon as the pacifiers were no longer readily available.
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Did, or does, your child use a pacifier?
Beginning in December 2010, nurses were instructed to give pacifiers only to babies who needed soothing for procedures such as circumcisions. Each time a nurse retrieved a pacifier from the supply closet, she had to enter a code and the patient’s name.
“When we removed pacifiers from routine distribution, we weren’t seeing the improvements we had expected,” says Phillipi. She and Laura Kair, a resident in pediatrics, studied data collected on the feeding behavior of 2,249 babies born in the hospital between June 2010 and August 2011.
Prior to the pacifier lock-down, about 80 percent of babies born in the hospital were exclusively breastfed. After, the number dropped to about 70 percent.
Phillipi and Kair’s research results didn’t surprise John McDonald, a neonatologist and medical director of the regional women and children's program for Providence Health & Services, Oregon, who was not involved in the study. “When you look at all of the medical literature on the relationship between pacifiers and breast-feeding, the level of scientific evidence doesn’t really support an adverse effect on pacifier use and exclusive breast-feeding.”
Although hiding pacifiers in a supply closet sounds dramatic, many hospitals follow this tactic, as it is one of the “Ten Steps to Successful Breastfeeding” recommended by the World Health Organization and United Nations Children’s Fund. To achieve the coveted WHO Baby-Friendly Hospital status, a hospital must follow all ten steps.
“As our hospital is trying to get Baby-Friendly status, we anticipated that removing pacifiers would improve exclusive breast-feeding,” says Kair. “Pacifiers were a low hanging fruit, removing them was an easy thing to do.”
"The primary reason for WHO's policy on pacifiers is the potential for interference with suckling and establishing lactation," says Dr. Chessa Lutter, a senior advisor in food and nutrition for the Pan American Health Organization/World Health Organization.
"There is some evidence to suggest that giving pacifiers or bottle nipples can interfere with suckling and getting a good latch on. It's very important that the baby be able to properly latch on, which evolves over baby’s first week of life. Establishing a good suck is extremely important for the mother as well, so her own nipple isn’t irritated or damaged," Lutter says.
There’s a wealth of widely accepted research to back up the WHO’s support of exclusive breast-feeding. Moms who breastfeed have an easier time shedding pregnancy pounds, and it reduces their risk for some cancers. Breastfed babies have fewer ear infections and bouts of diarrhea, while also having reduced risk of certain cancers, obesity, and asthma.
Lutter says the WHO's policy "is an old one, put out in 1991. At that point the evidence showed pacifier use lowered breastfeeding. Since then, better randomized studies have been done and the evidence is very mixed. But I think really the concern is establishing a good suck at the get go and discouraging pacifier use to establish lactation."
So whether pacifiers interfere with this healthy habit is still up for debate.
“As we try to support more breast-feeding and we adopt some of these recommended standards like the Baby-Friendly Hospital status, it puts health systems, physicians and parents in this challenging place to say, ‘Is limiting pacifiers truly a proven practice that will help enhance breastfeeding?’” McDonald says.
Unfortunately, no one yet can answer why babies sucking on pacifiers has any impact at all on breastfeeding.
Pacifiers at Doernbecher Children’s Hospital remain behind closed doors. The researchers are not recommending that any hospital or individual parent change their pacifier practice just yet. More research needs to be done, they say, pointing out that this was not a controlled trial, only an observational study.
One limitation of the observational study, Kair admits, is that parents could have brought pacifiers from home and those pacifiers would not have been documented in the study. But that was also the case before the study was conducted.
Kair and Phillipi are presenting their results at the Pediatric Academic Societies annual meeting in Boston on Monday.
“As pediatricians and as moms ourselves, we want to promote breast-feeding because we know it’s best for moms and babies,” Phillipi says. “But we also want to know the best evidence, so that we can help moms be successful with that endeavor.”
Did, or does, your child use a pacifier? Tell us about it on our Facebook page.
Tuesday, May 1, 2012
Pitocin's possible effects on breastfeeding
Synthetic Oxytocin and Depressed Newborn Feeding Behaviors; Could There be a Link?
Written by Jennie Bever Babendure, PhD, IBCLC
The ever increasing rates of labor induction and augmentation have caused many to begin to ask if the use of synthetic oxytocin to start or augment labor may impact mothers and babies after birth. In an Acta Paediatrica article published online ahead of print, Ibone Fernandez and her colleagues asked this question by looking at neonatal feeding reflexes in relation to oxytocin dosage during labor1. In this small pilot study, researchers documented the total dose of oxytocin given during labor to induce or augment contractions in 20 first time mothers. On day 2 of life, and at least 1 hour after breastfeeding, they placed babies skin to skin with their mothers in biological nurturing positions to elicit Primitive Neonatal Reflexes, including those involved in breastfeeding. When 3 observers blind to the oxytocin dose coded videotapes of these 20 minute sessions, they found a significant correlation between higher doses of synthetic oxytocin during labor and the absence of sucking behavior in infants. In fact, many of the newborns whose mothers received higher doses of oxytocin spent a large part of the 20 minutes skin to skin crying.
When the authors later followed up with the mothers about breastfeeding status at 3 months, they found another surprising correlation: mothers who were exclusively breastfeeding at 3 months had received a lower average dose of oxytocin during labor than mothers who were not breastfeeding exclusively.
Findings of this study are limited in that this was a very small pilot of only 20 women, and all received oxytocin either to augment or induce labor, thus the study lacks an important control group of mothers who did not receive oxytocin. As such, the authors are careful to point out that the results should be interpreted with caution. The relationship found between oxytocin dose and infant suck in this study is a correlation only, and provides no evidence that higher doses of oxytocin caused the depression in sucking behavior. (Click this link for a great discussion of why we can’t say a correlation indicates cause.)
In addition, all study mothers received epidural anesthesia, thus the depressed sucking behavior could be related to maternal dose of anesthesia (which was not recorded), precipitating increased need for labor augmentation. However, as studies in rodents have shown reduced food intake in response to oxytocin injection, and previous clinical research has demonstrated an association between intrapartum oxytocin administration and risk of artificial feeding independent of epidural anesthesia, the idea that synthetic oxytocin might have an impact on breastfeeding behavior is an intriguing hypothesis that deserves further study2-8.
I joke that the picture below shows me ‘under the influence’ of oxytocin. If you look closely, I look just the tiniest bit love-crazed. Could oxytocin, a hormone that can inspire such intense bonding actually have a negative effect at high doses? I’ll keep a close watch as further research unfolds!
The ever increasing rates of labor induction and augmentation have caused many to begin to ask if the use of synthetic oxytocin to start or augment labor may impact mothers and babies after birth. In an Acta Paediatrica article published online ahead of print, Ibone Fernandez and her colleagues asked this question by looking at neonatal feeding reflexes in relation to oxytocin dosage during labor1. In this small pilot study, researchers documented the total dose of oxytocin given during labor to induce or augment contractions in 20 first time mothers. On day 2 of life, and at least 1 hour after breastfeeding, they placed babies skin to skin with their mothers in biological nurturing positions to elicit Primitive Neonatal Reflexes, including those involved in breastfeeding. When 3 observers blind to the oxytocin dose coded videotapes of these 20 minute sessions, they found a significant correlation between higher doses of synthetic oxytocin during labor and the absence of sucking behavior in infants. In fact, many of the newborns whose mothers received higher doses of oxytocin spent a large part of the 20 minutes skin to skin crying.
When the authors later followed up with the mothers about breastfeeding status at 3 months, they found another surprising correlation: mothers who were exclusively breastfeeding at 3 months had received a lower average dose of oxytocin during labor than mothers who were not breastfeeding exclusively.
Findings of this study are limited in that this was a very small pilot of only 20 women, and all received oxytocin either to augment or induce labor, thus the study lacks an important control group of mothers who did not receive oxytocin. As such, the authors are careful to point out that the results should be interpreted with caution. The relationship found between oxytocin dose and infant suck in this study is a correlation only, and provides no evidence that higher doses of oxytocin caused the depression in sucking behavior. (Click this link for a great discussion of why we can’t say a correlation indicates cause.)
In addition, all study mothers received epidural anesthesia, thus the depressed sucking behavior could be related to maternal dose of anesthesia (which was not recorded), precipitating increased need for labor augmentation. However, as studies in rodents have shown reduced food intake in response to oxytocin injection, and previous clinical research has demonstrated an association between intrapartum oxytocin administration and risk of artificial feeding independent of epidural anesthesia, the idea that synthetic oxytocin might have an impact on breastfeeding behavior is an intriguing hypothesis that deserves further study2-8.
I joke that the picture below shows me ‘under the influence’ of oxytocin. If you look closely, I look just the tiniest bit love-crazed. Could oxytocin, a hormone that can inspire such intense bonding actually have a negative effect at high doses? I’ll keep a close watch as further research unfolds!
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