Baby's Health Archives

Tongue Tied Babies

July 13, 2008

We've all had one of the those moments where we stutter, stammer, or are at a loss for words. "I'm tongue tied," we might joke. But for some babies, being tongue tied is actually a serious problem. Tongue tie, or Ankyloglossia, is a condition that restricts the tongue's movement. The frenulum, the piece of skin that attaches the tongue to the floor of the mouth, is shorter than normal. This can make it difficult for the baby to latch on properly. Some tongue tied babies don't gain enough weight, and breastfeeding can be painful for the mom. Long term, tongue tie sometimes causes speech problems.

A new study, just published in Pediatrics, found that a freunulotomy, a minor surgical procedure to cut the frenulum, can improve breastfeeding. Here's the study abstract:

OBJECTIVE. There is evidence that infants with ankyloglossia can experience breastfeeding difficulties including poor attachment to the breast, suboptimal weight gain, and maternal nipple pain, which may lead to early weaning of the infant. No studies have investigated the cause of these breastfeeding difficulties. The objective of this study was to determine the effectiveness of frenulotomy in infants experiencing persistent breastfeeding difficulties despite professional assistance by measuring changes in milk transfer and tongue movement during breastfeeding before and after frenulotomy.

PATIENTS AND METHODS. Twenty-four mother-infant dyads (infant age: 33 ± 28 days) that were experiencing persistent breastfeeding difficulties despite receiving professional advice were recruited. Submental ultrasound scans (Acuson XP10) of the oral cavity were performed both before and ≥7 days after frenulotomy. Milk transfer, pain, and LATCH (latch, audible swallowing, type of nipple, comfort, and hold) scores were recorded before and after frenulotomy. Infant milk intake was measured by using the test-weigh method.

RESULTS. For all of the infants, milk intake, milk-transfer rate, LATCH score, and maternal pain scores improved significantly postfrenulotomy. Two groups of infants were identified on ultrasound. One group compressed the tip of the nipple, and the other compressed the base of the nipple with the tongue. These features either resolved or lessened in all except 1 infant after frenulotomy.

CONCLUSIONS. Infants with ankyloglossia experiencing persistent breastfeeding difficulties showed less compression of the nipple by the tongue postfrenulotomy, which was associated with improved breastfeeding defined as better attachment, increased milk transfer, and less maternal pain. In the assessment of breastfeeding difficulties, ankyloglossia should be considered as a potential cause.

For more informtaion, Kellymom.com has a series of articles on this topic. And here's an excellent article that can help you figure out if your baby is tongue tied. Surgery is not the only option. (Read this too). But bottom line, talk to your pediatrician and a lactation consultant to figure out if your baby is tongue tied, and what is the best treatment option.

Updated: The Winners of the method Baby Products

June 11, 2008

UPDATED: Here are the winners:

"The most surprising part about becoming a parent: how much my view of the world has changed, including how I both gained additional understanding for my parents and yet also felt additional confusion. " Posted by: Ewokmama

"The most surprising thing for me, throughout pregnancy and now while nursing my twins, is how different men and women really are. Physically, my husband can't do as much for the boys as I do (nursing) and emotionally we respond to them in different, but both loving, ways." Posted by: Sally

If you won, please email me your mailing address.

AND HERE'S THE ORIGINAL POST:

I've had allergies all spring. Either that, or a cold. Or maybe both. Who knows.

I do know I sometimes get exczema, so I'm always on the lookout for "green" personal care and cleaning products. And here's my latest find...method. Actually, to be clear, method found me. Earlier this spring, the method folks emailed me asking me to host a party at their temporary store in New York City. After doing a bit of due diligence, I decided I liked the company's dedication to non-toxic products. And so, I said, sign me up. (To learn more about this, go to the bottom of the method site, click on either FAQ or Company Info.)

The party wasn't your typical "tupperware" fest. In fact, there was little talk of cleaning. Instead, a "mixologist" taught us how to make organic drinks. The Liquid Muse...aka Natalie...made the best mojito I have EVER had. Ever. And fortunately, I'm not pregnant or breastfeeding, so I didn't have to consider anything other than my low tolerance.

Here's the recipe for that mojito.
Method Mojito
(Recipe created by The Liquid Muse, and inspired by Method Home)
1 heaping tablespoon of peeled, seeded and diced organic cucumber
1 heaping tablespoon of diced organic lime
1 teaspoon raw brown sugar
3-5 torn mint leaves
1 1/2 ounces organic vodka (Square One has a new cucumber-infused one!)
organic sparkling lemonade
Muddle cucumber, sugar and mint leaves in tall glass. Pour in vodka. Fill with ice. Top with sparkling lemonade. Garnish with a sprig of mint or lime wheel.

Now for the exciting part...I have a giveaway of method's new line of baby and kids' products. You can read about them here on the method blog. The kind folks at method have put together a collection of theses items.

To win, please leave a comment answering this question: What has been the most surprising part of being pregnant or a new parent? The deadline to enter this contest is June 25th. I'll be away until then, so you may not see your comment posted until I get back.

Health Benefits of Breastfeeding

May 20, 2008

There are always new stories about the health benefits of breastfeeding. Here are some recent ones:

Breastfeeding can reduce the mother's risk of getting rheumatoid arthritis.. Here's another article on this from the NYT.

A new study suggests that a mother's seizure medication taken to control epilepsy is not harmful to her breastfed infant. The findings are preliminary, and not considered definitive.

Finally, a new study found that breastfeeding can reduce the mother's risk of getting metabolic syndrome, a combination of factors that puts you at risk for heart disease and diabetes. Here's a definition of metabolic syndrome. (Via Motherwear blog).

Smoking and Breastfeeding

September 04, 2007

I had my high school experimentation with cigaretttes. (Sorry, mom). Fortunately I was never a smoker. I know it's a habit that can be very hard to kick. But if you are smoking and breastfeeding, here's yet another reason to quit... a new study has found that babies sleep less if their mother smokes. The nicotine in breast milk seems to shorten babies naps by one third.

The study was done by the Monell Chemical Senses Center. Here's their website, and here's the link to the press release.

Now some quotes from the press release:

“Infants spent less time sleeping overall and woke up from naps sooner when their mothers smoked prior to breastfeeding,” says lead author Julie A. Mennella, PhD, a psychobiologist at Monell.

The findings, published in the journal Pediatrics, raise new questions regarding whether nicotine exposure through breast milk affects infant development....

Total sleep time over the 3-1/2 hours declined from an average of 84 minutes when mothers refrained from smoking to 53 minutes on the day they did smoke, a 37% reduction in infant sleep time. This was due to a shortening of the longest sleep bout, or nap, and to reductions in the amount of time spent in both active and quiet sleep.

The level of sleep disruption was directly related to the dose of nicotine infants received from their mothers’ milk, consistent with a role for nicotine in causing the sleep disruptions....

An earlier study from Mennella’s lab demonstrated that breast milk nicotine levels peak 30 - 60 minutes after smoking one or two cigarettes and clear by three hours after the smoking episode. Emphasizing the many benefits of breastfeeding on infant health and development, Mennella notes that lactating mothers who smoke occasionally can time their smoking episodes to minimize nicotine exposure to their child...

For more on this story go to The Washington Post.

And one final thought...if you can't quit smoking, it's still best to continue breastfeeding. The American Academy of Pediatrics has said smoking is not a contraindication to breastfeeding-- translation, you can smoke and breastfeed, but you should quit. Here's some information from Kellymom on smoking and breastfeeding.

FDA's Codeine Warning For Breastfeeding Moms

August 19, 2007

After our first son was born I remember getting some sort of narcotic for pain. I can't remember which one it was, but I do know that it made me feel sick, so I stopped taking it. And maybe that was a good thing. The FDA has just issued a warning to breastfeeding moms who may take codeine to treat pain.

Here are portions of the story on WebMD:

The FDA today warned breastfeeding mothers who take codeine for after-birth pain to carefully watch their babies for signs of life-threatening drug side effects.

At risk are infants breastfed by women who are "ultra-rapid metabolizers" of codeine. Such women have a genetic makeup that allows their bodies to process codeine with extreme speed.

Normally, the body slowly turns codeine into morphine, a pain-relieving narcotic. But ultra-fast metabolizers "get a real jolt" of morphine -- and so do their breastfed babies, warns Janet Woodcock, MD, the FDA's deputy commissioner and chief medical officer.

"Infants of nursing mothers taking codeine may have increased risk of morphine overdoes if their mothers are ultra-rapid metabolizers of codeine," says Sandra Kweder, MD, deputy director of the FDA's office of new drugs....

Codeine, Kweder says, is very commonly used to relieve the pain of birth procedures such as episiotomy or C-section. The drug has been used safely for decades....

Ultra-fast codeine metabolism occurs in people who have a mutation in the gene coding for a liver enzyme called CYP2D6. The mutation is uncommon, but not rare. Kweder says it occurs in 1% to 10% of Caucasians, about 3% of African-Americans, about 1% of Hispanics and Asians, and -- surprisingly -- in some 28% of North Africans, Ethiopians, and Saudi Arabians....

The FDA does NOT advise women to stop breastfeeding if they need codeine.

"This announcement today does not mean women who need pain medicine should not breastfeed," Woodcock said. "The benefits of breastfeeding are well documented."

The FDA urges all breastfeeding women taking codeine to watch their infants -- and themselves -- for signs of side effects.

The FDA recommends that if you are a nursing mother taking codeine, you should call a doctor immediately if you become extremely sleepy to the point you are having trouble caring for your baby.

Usually newborns nurse every two or three hours and should not sleep for more than four hours at a time. If you are a nursing mother taking codeine, you should call the doctor immediately if your newborn:

* Sleeps more than usual
* Has difficulty breastfeeding
* Has difficulty breathing
* Becomes limp

In Botswana, Using Infant Formula Instead of Breastmilk Proved Deadly

August 05, 2007

This is a truly tragic story. More than 500 children in Botswana died during a diarrhea epidemic, most likely because they did not breastfeed. Their moms were using formula because of a government health campaign aimed at stopping the spread of HIV. Here's part of a Boston Globe story.

Doctors noticed two troubling things about the limp, sunken-eyed children who flooded pediatric wards across Botswana during the rainy season in early 2006: They were dying from diarrhea, a malady that is rarely fatal in Nkange. And few of their mothers were breast-feeding, a practice once all but universal.

After the outbreak was over and at least 532 children had died -- 20 times the usual toll for diarrhea -- a team of US investigators solved the riddle.

A decadelong, global push to provide infant formula to mothers with the AIDS virus had backfired in Botswana, leaving children more vulnerable to other, more immediately lethal diseases, the US team found after investigating the outbreak at the request of Botswana's government.

The findings joined a growing body of research suggesting that supplying formula to mothers with HIV -- an effort led by global health groups such as UNICEF -- has cost at least as many lives as it has saved. The nutrition and antibodies that breast milk provide are so crucial to young children that they outweigh the small risk of transmitting HIV, which researchers calculate at about 1 percent per month of breast-feeding....

Botswana, with an extensive public water system, good roads, and a legacy of competent governance, joined the UNICEF-led effort and agreed to pay for the program as a standard service to new mothers.

There were skeptics. Some international public health specialists, including Coovadia, cautioned that few Africans had the means to prepare formula in a sanitary manner -- a process that requires access to clean water, utensils, formula powder, and heat for sterilization.

And even for those who could make formula safely, some specialists warned, breast-feeding's other health benefits could not easily be replaced.
...

Some Baby Bottles Leach Bisphenol A, a Dangerous Chemical

June 04, 2007

As if you don't have enough to think (ie. worry) about, here's one to give you pause. Your baby's plastic bottle... whether it contains formula or breast milk...could be dangerous to his health. A study by Environment California found that dangerous levels of a chemical called Bisphenol A (BPA) leaches out of bottles made by Avent, Dr. Brown’s, Evenflo, Gerber and Playtex.

Of course there's a debate about the safety of BPA. The plastic industry, as expected, says it's perfectly safe. But others say BPA disrupts hormones and is especially harmful to fetuses and young children.

Here's a good summary from The Green Guide, a site owned by National Geographic.

Depending on whom you talk to, BPA is either perfectly safe or a dangerous health risk. The plastics industry says it is harmless, but a growing number of scientists are concluding, from some animal tests, that exposure to BPA in the womb raises the risk of certain cancers, hampers fertility and could contribute to childhood behavioral problems such as hyperactivity.

According to its critics, BPA mimics naturally occurring estrogen, a hormone that is part of the endocrine system, the body's finely tuned messaging service. "These hormones control the development of the brain, the reproductive system and many other systems in the developing fetus," says Frederick vom Saal, Ph.D., a developmental biologist at the University of Missouri. Endocrine-disrupting chemicals can duplicate, block or exaggerate hormonal responses. "The most harm is to the unborn or newborn child," vom Saal says.

Plastic water and baby bottles, food and beverage can linings and dental sealants are the most commonly encountered uses of this chemical. Unfortunately, it doesn't stay put. BPA has been found to leach from bottles into babies' milk or formula; it migrates from can liners into foods and soda and from epoxy resin-lined vats into wine; and it is found in the mouths of people who've recently had their teeth sealed. Ninety-five percent of Americans were found to have the chemical in their urine in a 2004 biomonitoring study by the Centers for Disease Control and Prevention (CDC).

So what can you do to keep your family safe? For your baby, consider using glass bottles. Evenflo makes some. The Green Guide (see the sidebar) also has this advice: "Use glass baby bottles or plastic bag inserts, which are made of polyethyelene, or switch to polypropylene bottles that are labeled #5 and come in colors or are milky rather than clear."

Here are some other safety guidelines from Environment California and from The Green Guide (see the sidebar).

Milk Shortage at Colorado Milk Bank

March 16, 2007

I first saw this story over at the Motherwear Breastfeeding blog...

The Mothers' Milk Bank in Colorado desparately needs donations. Their supplies are running low. That poses a serious risk for babies like 6 month old Julia Lam, who is getting donated breast milk while she undergoes chemotherapy.

To see Julia's story, you can watch this video from a Denver TV station.

To make a donation, go to the milk bank website or call (303)869-1888 or toll free (877)458-5503. You don't have to live in Colorado to help out.

ABC's SuperNanny's Negative Take on Breast Feeding

March 12, 2007

Supernanny needs a "time out" of her own. In Monday's season finale she sets out to fix the Walker family. One of the alleged chief problems, a 14 month old who, god forbid, is still breast feeding.

The Supernanny says to the mom: "So it really is in your court because I can help you either way. But the decision has to be yours."

As it turns out, mom wants to wean. She says, "I want to do it. I want to go ahead and try it...I'm ready to wean Alyssa (spelled?). I've been wanting to do it for months. I just don't know how to do. I don't know how to do it on my own."

Once the mom says that, the Supernanny's true feelings come through: "I'm glad that you've come to that decision because it show me that you're ready for personal growth which is good and there will be much benefit for you and Alyssa."

I could deconstruct this episode for the rest of the night-- the negative portrayals of extended breastfeeding, co-sleeping and sling-wearing. But bottom line, I think it's a shame that the show's producers depict breastfeeding as something to be avoided. The American Academy of Pediatrics recommends breastfeeding for at least one year, and as long after that as the mom wants. The World Health Organization recommends breastfeeding for two years. Even the Centers for Disease Control and Prevention has set a goal that by 2010, 25% of all moms still breastfeed when their baby is one year old. (Healthy People 2010). As for the babies themselves, some anthropologists think children would self-wean somewhere around 3 and 4 years old.

Beyond this, the show completely ignores the health benefits that come from breastfeeding. Instead, Supernanny turns breastfeeding into something that is simply about the mother-child bond. She asks the mom, "Is the reason you're still breastfeeding her an emotional one?" The mom answers, "It's just the feeling of, you know, we love each other, you know."

Yes, weaning is emotional. I was weepy when I weaned our first son at 11 months and I get teary just thinking about weaning our second son. But come on, Supernanny, you could have at least tipped your hat to the mom for keeping at it for 14 months. It's no small feat.

Of course whether or not to breastfeed is a matter of personal choice. Breastfeeding works for some women, and not for others. But it's too bad that Supernanny and ABC didn't celebrate this mom's choice, and instead presented it as an obstacle to family harmony.

Go to your "naughty mat," Supernanny. Good riddance until next season.

And moms if you want some real advice on weaning, try Kellymom. There's good information about the benefits of extended breastfeeding too.

Earth's Best Recall- Apple Peach Barley

February 20, 2007

Lunch time here, and as usual, The Bear was all set to get a jar of Earth's Best baby food. He's been eating this stuff since he was six months old. Of course he's still getting breast milk, and now real finger foods, but when I resort to a prepared jar of mush, it's always Earth's Best.

Now here's a news alert from the FDA to give me pause...Earth's Best is recalling jars of Wholesome Breakfast Apple Peach Barley 2nd Foods. There's a possibility that there could be botulism in the jars. No one has gotten sick, and they haven't actually found contamination (only incorrect pH levels), but the company isn't taking any chances. If you have a jar, throw it away. Click here to read the company press release for more details.

I'm not going to abandon Earth's Best just yet. But I will make sure I don't have any jars of this particular flavor. And, as I always tell the kids, let's make sure the jar makes a "pop" noise before we eat anything.

New York City Mayor Promotes Breast Feeding

February 12, 2007

Go Mayor Mike! I always knew I sort of liked you, even though you are a Republican. But now I think you've won me over.

The New York Post is reporting that New York City Mayor Michael Bloomberg is spending more than $2 million to get city run hospitals to promote breastfeeding.

"We don't yet have any hospitals in New York City that meet national 'baby-friendly' standards," Bloomberg's health commissioner, Dr. Thomas Frieden, said at a parenting conference last week.

"That means getting formula out of the nursery. It means putting the baby on the breast immediately after birth. It means that every person who interacts with that mother and child is supportive and encouraging of breast-feeding."

According to the Post, Deborah Kaplan, chief of the Health Department's Bureau of Maternal, Infant and Reproductive Health, says the days of hospital goody bags filled with formula freebies are over. Hospitals will now give new moms ice packs to keep pumped breast milk fresh.

The Gothamist covered this one as well.

The man who doesn't want you to smoke in City bars or clog your coronaries with sweet, sweet trans fats now wants to do something healthy for the tiniest and newest New Yorkers...City health commissioner, Thomas Frieden, wants babies to dine on nothing but their mothers' breast milk for the first six months of life. Right now, about 75% of New York mommies breast feed their babies but nearly 40% stop before the six month mark.

It's nice to see a politician promote breastfeeding.
Oh, and by the way, it seems fitting that we can say Happy Birthday to you too, Mayor Mike.

Consumer Reports Recalls Its Own Report On Infant Car Seats

January 18, 2007

Consumer Reports has always been my Bible. I would never buy a car or a children's product without first checking what CR has to say.

Well today, my faith in CR is shot. They've withdrawn the scathing story they published earlier this month about infant car seats. It seems there was a big mistake in the report. The report claimed CR tested the car seats at a certain speed, 38 m.p.h, when in fact it was closer to 70 m.p.h according to the National Highway Traffic Safety Administration (NHTSA).

CR is backpedaling furiously. If you try to find that original story on its site, it is gone. Gone. Completely gone. I wrote a post about the original report. And now, when I click on the links in that post that are supposed to take me to the study, I'm directed instead to today's press release.

Here's a quote from that orginal study:

Cars and car seats can’t be sold unless they can withstand a 30-mph frontal crash. But most cars are also tested in a 35-mph frontal crash and in a 38-mph side crash. Car seats aren’t.

Nine infant seats provided poor protection in some or all of our tests, even though they meet the federal safety standard. One seat, the Evenflo Discovery, didn’t even meet that standard. We urge federal officials to order a recall of that seat.

Here's what CR is saying today:

Consumer Reports is withdrawing its recent report on infant car seats pending further tests of the performance of those seats in side-impact collisions.

A new report will be published with any necessary revisions as soon as possible after the new tests are complete.

We withdrew the report immediately upon discovering a substantive issue that may have affected the original test results. The issue came to light based on new information received Tuesday night and Wednesday morning from the National Highway Traffic Safety Administration (NHTSA) concerning the speed at which our side-impact tests were conducted.

For a minute now, let's put aside the colossal error CR seems to have made and look at the bigger picture. If these seats were actually tested at 70 m.p.h, and they "failed disastrously," then maybe the seats really are dangerous. Honestly, don't most of us drive on highways from time to time? If so, we're not going 38 m.p.h., that's for sure.

In which case, maybe it's NHTSA which should come under a bit of scrutiny here. According to the New York Times, NHTSA only requires car seats to pass a test at 30 m.p.h.

The federal government requires that the seats protect babies in front impacts of 30 m.p.h. The highway traffic safety agency said it was trying to develop a side-impact standard. It rates cars under a New Car Assessment Program, which it uses to award “stars” to each model, and those are done at 38 m.p.h. for side impact.

So, while I'm disappointed in Consumer Reports, I do think there may just be a kernel worth hanging on to in their report. Moms and dads, check out their original study, it's worth considering.

Infant Car Seat Ratings

January 09, 2007

This is not a story about breast feeding. But it is a story that every parent of an infant should read. It's about car seat safety.

Consumer Reports just released a new study of infant car seats. The tests subjected the seats to the same collision tests required for cars, and the results were downright frightening. (If you want a real scare, watch the video on the Consumer Reports site).

For ratings of all the seats tested, click here. Now here's a quote from the story.

Cars and car seats can’t be sold unless they can withstand a 30-mph frontal crash. But most cars are also tested in a 35-mph frontal crash and in a 38-mph side crash. Car seats aren’t.

When we crash-tested infant car seats at the higher speeds vehicles routinely withstand, most failed disastrously. The car seats twisted violently or flew off their bases, in one case hurling a test dummy 30 feet across the lab. Here are the details:

Of 12 infant seats we tested, only 2 performed well: the Baby Trend Flex-Loc and the Graco SnugRide with EPS.

Nine infant seats provided poor protection in some or all of our tests, even though they meet the federal safety standard. One seat, the Evenflo Discovery, didn’t even meet that standard. We urge federal officials to order a recall of that seat.

Infant car seats sold in Europe undergo more rigorous testing than do models sold in the U.S. Indeed, when we crash-tested an infant seat we bought in England, it was the best in our tests. An infant seat sold in the U.S. by the same manufacturer failed. (See European models.)

Our findings offer added evidence of problems with LATCH, the federally mandated attachment system for child car seats. Most car seats performed worse with LATCH than with vehicle safety belts. And LATCH attachments aren’t always easy to use.

So here's what Consumer Reports recommends you do:
Consumers Union, the nonprofit publisher of Consumer Reports, strongly believes that NHTSA should strengthen safety testing for car seats so that it is comparable with the tests conducted on new cars. That means including a side-crash test. If the New Car Assessment Program is any indication, crash performance improves when results are publicized.

The agency also needs to revisit the LATCH standard. Automakers should make anchors and tethers easy to access. And LATCH anchors should be required in center-rear seats.

For now, here’s how to keep your baby as safe as possible while traveling:
If you’re shopping for an infant car seat, buy one of the two we recommend. (See the Ratings.)

If you already own a Chicco KeyFit, Compass I410, Evenflo Embrace, or Peg Perego Primo Viaggio SIP, use it with vehicle safety belts, which passed our tests, not with LATCH, which didn’t. If you can’t get a tight fit with the safety belt, buy one of the two seats we recommend.

If you own a different infant seat, consider replacing it with the Baby Trend Flex-Loc or the Graco SnugRide with EPS.

Secure your child in the center-rear seat if the car seat can be tightly fastened there. Go to www.nhtsa.gov to find a free car-seat inspection station near you.

Send in the registration card that comes with new car seats, so that the manufacturer can contact you if the seat is recalled.

Remember that any child car seat is better than no seat at all.

Now, for the responses to this story: The National Highway Traffic Safety Administration had already admitted that the LATCH system was confusing to parents. Interestingly, The Juvenile Products Manufacturers Association has questioned the results of the Consumer Reports study.

As for us, we have the Britax Companion infant car seat that didn't rate so well. Very disappointing. I've always been a huge Britax fan. To me, their products are the Volvos of car seats. A little clunky in design, but super safe. In fact, The Britax was previously Consumer Reports' top-rated seat based on the federal standards. And in terms of personal experience, when The Bortski was about 5 months old I got rear-ended at a stop sign. He was totally fine, thanks to his Britax infant seat.

As for The Bear, given his age and size I think we'll move him out of his infant seat and into one for an older kid. For now, I'm most likely sticking with Britax. But I'll keep my eyes out for any further reports.

Drinking Alcohol and Breast Feeding

December 27, 2006

We actually have a babysitter for New Year's Eve. Yes, believe it or not, we have found the holy grail of sitters. Someone who actually wants to work on New Year's Eve. Now, truth be told, we don't have any plans. But we do have a few days to scare something up. And at a minimum, we have a bottle of champagne in the refrigerator we could take with us on a walk in Central Park.

If that's what it comes to, we'll probably have trouble finishing the bottle. You see, I have zero tolerance for alcohol. One glass of red wine and I get sleepy. One beer makes me full. A good mojito and I'm giddy. Two Tanqueray and Tonics and I'm apt to spill State secrets. Anything more and it's lights out.

So for me, I've never worried too much about whether it was ok to drink while I was breast feeding. I knew I would never drink so much that it would be an issue.

Nevertheless, I have been wondering about the official take on alcohol and breast feeding. So after a bit of research, I've found that as with anything mommy related, there are differing, and sometimes conflicting, opinions.

But from numerous reputable sources, it seems that bottom line, alcohol in small amounts is ok. One to two drinks per week is fine. You might want to feed your baby before you have a drink, and then wait 2 to 3 hours after drinking before feeding again. Also, there's no need to "pump and dump." As the alcohol leaves your bloodstream, it also leaves your breast milk. So sober up, and your boobs will be set to go. If it makes you feel better, give your baby a bottle of expressed milk in the meantime.

Here's a bit of information from Kellymom.com:

In general, if you are sober enough to drive, you are sober enough to breastfeed. Less than 2% of the alcohol consumed by the mother reaches her blood and milk. Alcohol peaks in mom's blood and milk approximately 1/2-1 hour after drinking (but there is considerable variation from person to person, depending upon how much food was eaten in the same time period, mom's body weight and percentage of body fat, etc.). Alcohol does not accumulate in breastmilk, but leaves the milk as it leaves the blood; so when your blood alcohol levels are back down, so are your milk alcohol levels.

Always keep in mind the baby's age when considering the effect of alcohol. A newborn has a very immature liver, so minute amounts of alcohol would be more of a burden. Up until around 3 months of age, infants detoxify alcohol at around half the rate of an adult. An older baby or toddler can metabolize the alcohol more quickly.

La Leche League also says that the occasional drink is ok, but excessive drinking is not.

Alcohol abuse (excessive drinking) by the mother can result in slow weight gain or failure to thrive in her baby. The let-down of a mother who abuses alcohol may be affected by her alcohol consumption, and she may not breastfeed enough. The baby may sleep through breastfeedings, or may not suck effectively leading to decreased milk intake. The baby may even suffer from delayed motor development. If you are concerned that you or someone you know is drinking alcohol excessively, call your doctor.

At least one organization, the March of Dimes says you should avoid alcohol while breast feeding.

Small amounts of alcohol do get into breast milk and are passed on to the baby. One study found that the breastfed babies of women who had one or more drinks a day were a little slower in acquiring motor skills (such as crawling and walking) than babies who had not been exposed to alcohol. Large amounts of alcohol may also interfere with ejection of milk from the breast. For these reasons, the March of Dimes recommends that women abstain from alcohol while they are nursing.

So, what's a mom to do? Use caution if you plan to get your party on this New Year's Eve. If you want a drink or two, it seems you can go for it. You deserve to celebrate your parenting successes of the past year. Just remember, you may still have to get up in the middle of the night to feed your baby. So make sure you'll be sober enough to safely care for her. And don't forget, if you have an early bird, she's not going to give you the day off from work.

Come to think of it, maybe I should book that sitter for January 1st. Cheers!!!

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FDA Warns Nestle Over Baby Formula

December 18, 2006

If you've been using Nestle's Good Start Infant Formula with Iron to feed your baby, you may want to think twice.

The U.S. Food and Drug Administration issued Nestle a warning letter on November 27th after a sample failed to meet proper nutrient levels. It seems the sample, collected in May, did not meet minimum requirements for calcium and phosphorus.

Nestle has said that its tests found that its product is fine. Here is a quote from a Reuters news story:

"We are working with FDA to better understand how issues relating to analytical testing methods might explain the differences noted in these two nutrients," the company said.

The Dairy Reporter.com reported that Nestle stands by its product.

“We have had two independent tests done by absolutely top quality laboratories and we have not been able to confirm the findings of the FDA,” said a Nestlé spokesperson. “There is no question of a recall. We are in contact with the FDA and discussions are in progress.”

Nestle has had problems with its formula in the past. It was first accused, in the 1970's, of unethically pushing formula on women in developing countries and thus discouraging them from breast feeding. Check out Breastfeeding.com for background on the boycott. This will lead you to Baby Milk Action, a group devoted to boycotting Nestle.

Nestle has 15 working days from receipt of the letter to respond. So that brings us to some time this week. Let's see what happens. I have calls in to both the FDA and Nestle to see what's happening. I'll keep you posted.

And PS...thanks to Micky at Mocha Milk for first pointing out this story.

Epidurals and Breast Feeding

December 11, 2006

I wrote thank you notes to the anesthesiologists who gave me my epidurals. Seriously. After both kids were born, I sent the doctors birth announcements and thanked them profusely for making my labor more comfortable. I'm a wimp, and there was no way I was going to "just say no" to drugs. I am the total opposite of my friend who had three babies at home, on the sofa and in an inflatable swimming pool.

So, I took particular interest in the results of a new study which says that women who have epidurals have more trouble breast feeding. Here's a section from the study's Abstract published in The International Breastfeeding Journal:

Background
Anecdotal reports suggest that the addition of fentanyl (an opioid) to epidural analgesia for women during childbirth results in difficulty establishing breastfeeding. The aim of this paper is to determine any association between epidural analgesia and 1) breastfeeding in the first week postpartum and 2) breastfeeding cessation during the first 24 weeks postpartum.
...
Conclusions
Women in this cohort who had epidurals were less likely to fully breastfeed their infant in the few days after birth and more likely to stop breastfeeding in the first 24 weeks. Although this relationship may not be causal, it is important that women at higher risk of breastfeeding cessation are provided with adequate breastfeeding assistance and support.

Note the use of the word "opioid" above. The researchers were basically investigating whether the epidural made the babies so sleepy that they had trouble eating. (This is something I had heard about anecdotally before I had our kids). The researchers conclude that this is a possibility. But that it's also likely that there could be a link between the choices women make about pain management and breast feeding.

As for me, I had epidurals and I breast fed. I was fortunate that both of my kids picked up on the boob thing pretty quickly. I breast fed The Bortski for eleven months, and The Bear and I are now going strong on our eighth month of boob milk.

Why was I able to succeed and some people have trouble? Quite honestly I have no idea. Maybe it's just been just good luck. Or maybe it was my obsessive nature, which made me religiously feed the babies every two hours for a couple of weeks after birth. I remember doing everything within my power to wake The Bear when he was sleepy. I stripped him down to his diaper. I tickled his nose and lips. I pinched-- or more accurately-- dug my fingernail into the heel of his foot. I remember feeling like I had reached a milestone when he ate for more than 5 minutes without falling back asleep.

Perhaps these researchers are onto something that OB's and anesthesiologists need to investigate further. Quite honestly, I don't know anything about the medical aspects of epidurals. All I know is that without one, I might have bit my husband's head off (oh, actually I did that when he was chewing nuts while I was having a contraction). I also threw up all over him before I got my epidural.

So, I really hope this study doesn't deter women who plan to breast feed from getting pain relief if they really want it. There's no medal for being a tough guy during labor. If you need help, get it. And as I tell all my friends who are about to have a baby, if you want an epidural, ask for it "early and often." There's no telling how long it will take for the doctor to show up once you request the epidural. So repeat after me..."early and often."

And for goodness sake, if you have to have pitocin to get your labor going, get the epidural before the pitocin. With The Bortski, I had the pitocin first, epidural second. The pitocin made the contractions so unbearable I had a hard time staying still when they were trying to insert the epidural needle. With The Bear, I got the epidural first, pitocin second. Now that, was sheer bliss. And if you're wondering about-- or maybe passing judgment on-- my decisions, please note that I had preeclampsia so my doctors had to induce me both times.

One more thing... send a Holiday card to your doctors...they'd probably be happy to hear from you.

Plus, to hear what other bloggers have to say about this study, check out The Lactivist and Breastfeeding123.

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Teething and Breast Feeding

November 29, 2006

The Bear has teeth!
No, duh, you say. All bears have teeth. So true. But for those of you who are new here, "The Bear" is our baby. He's now eight months old, and among other milestones (sitting up, clapping his hands and pushing himself backwards to slide on the floor) he now has two little buds poking out of his bottom gum. Very cute. But man, they hurt! He clamped down nice and hard today. I let out an involuntary yelp and pulled my boob out of his mouth. I don't think he saw the memo yet about not biting the boob that feeds you.

Another side benefit of these two new teeth is a little extra crankiness. Of course, it seems to be rearing its head in the middle of the night. Someone recommended we rub Whiskey on his gums. We tried a little Johnnie Walker a couple of times, and it worked! But I'm afraid to keep doing that in the middle of the night, for fear of creating a new dependency in addition to his 3:00 a.m. nursing addiction. The pediatrician recommended giving him a little Tylenol or letting him suck on something cold.

Has your babe ever nipped your nip? If so, how did you react? Did it happen multiple times? How did you get the kiddo to cut it out? And how do you handle teething? Inquiring minds want to know.

By the way, for those of us with a few more teeth, we celebrated The Bear's eight month milestone with cupcakes of course!

Donating Breast Milk

November 05, 2006

There are a lot of things you simply don't know about your breasts before you have kids. I, for one, didn't know that boobs can leak or grow exponentially. And I certainly didn't know that you can donate your breast milk. It simply never occured to me that you can donate breast milk in the same way that you can donate blood.

Welcome to the wild wild west of parenting. Lots to know. Lots to know.

Here's the scoop. Milk banks have been around since the turn of the century. The first one opened in 1909 in Vienna, Austria. In 1919, milk banks opened in Boston and Germany. Today, the Human Milk Banking Association of North America (HMBANA) is a non-profit that is sets the standards and guidelines for milk banks in Canada, Mexico and the U.S. It was founded in 1985. There are currently 11 milk banks that distribute the milk to hospitals, and babies who are home and need breast milk. Sometimes they are even able to help babies who have been adopted.

The milk banks screen donors and carefully process and pasteurize the milk. If you're interested in becoming a donor, contact the milk bank closest to you.

In addition to the milk banks that are affiliated with the HMBANA, there is now also a company called Prolacta. This for profit operation is also collecting breast milk and selling it to hospitals.

Prolacta recently announced a deal with the University of Minnesota Medical Center to collect milk. Like the milk banks of HMBANA, Prolacta then sells the milk back to hospitals. Only it charges a lot more. This recently caught the attention of some of my fellow breast feeding bloggers. To read The Lactivist's take on Prolacta, click here.

Prolacta is also a sponsor of an organization called The International Breast Milk Project that collects milk and sends it to children in Africa who are orphans because their parents had HIV. Here's a news story about donations to children in South Africa.

Whatever your take on Prolacta, I think the main thing to focus on here is that there are moms out there whose generosity is helping improve the lives of babies who need help. Think about how tiring it is to feed and care for your own children. Now consider that these donors are also taking the time to pump milk to help babies that they'll never meet.

Breast milk donors, we applaud you!

Breast feeding and Thyroid Problems

October 25, 2006

Have you ever tried to take a baby with you to one of your doctor's appointments? It might seem practical. You don't need a sitter. You don't have to worry that the baby will get hungry while you're away...especially if he won't take a bottle. So I do it all the time. Maybe not one of my smartest moves.

Invariably, there are the steps to drag the stroller up, a narrow examining room and the challenge of keeping the baby from trying to grab the stirrups in the Ob's office. Lovely. As always, there's the perfectly timed crying. Just as the doctor prepares to examine you, the screaming starts. And let's not forget the last time I took The Bear (our now 7 month old) to the doctor with me-- a plane crashed into a building a few blocks away. The appointment was cancelled.

So I had pretty low expectations when I went back to the doctor to try the appointment again. I was seeing an endocrinologist because it turns out my thyroid has decided to go haywire after this pregnancy. I have something called Hashimoto's. Basically it's an auto-immune condition where the immune system attacks the thyroid. This creates hypothyroidism, or an under-active thyroid. So now I'm taking thyroid replacement medicine.

Of course my questions were: (1) is the thyroid imbalance bad for the baby if I'm breastfeeding? (2) is it ok to take the medication, Synthroid, if I'm breastfeeding? As any good former reporter (or anal mom) would do, I checked multiple sources. I found this link about breastfeeding and thyroid conditions. And per the pediatrician, my general practitioner, my endocrinologist and my gynecologist (oh and a second endocrinologist I saw after The Bortskerini was born), Synthroid is just fine if I'm breastfeeding. In fact, it should make me feel better.

Now to be fair, I didn't really feel all that bad. Just VERY tired. But then again I have two kids, and a baby who doesn't sleep through the night. So we'll see if the thyroid medication will help. (Exhaustion and depression are hypothyroid symptoms).

In the meantime, maybe The Bear will start to take pity on us and stop waking up at 4 in the morning...a mere two hours before his big brother, The Bortskerini decides to yell, at the top of his lungs, "HELP!!!"

If you're concerned about any medication you may be taking while breastfeeding, check here.

Breast feeding Videos

October 23, 2006

Welcome to my new weekly feature...The Boob Tube...or You Boob.

We've all been hearing a lot about YouTube lately, you know the company that Google bought for $1.65 billion.

To see what all the fuss was about, I checked out YouTube, and did a test. I did a search for "breast feeding" videos and found 72 clips. They range from home movies to television commercials. Some are funny, some are serious. And so, starting today, I'll do a YouTube breastfeeding video of the week.

To kick things off, I'll salute my inner francophile and show you a clip of a breastfeeding commercial from the 1970's. Click here to see the clip.

Now my French is not so great, but here's a rough translation:
Gesture of love, Promise of health, Give them your milk, To feed better is to live better.

Wouldn't it be a different world if we had commercials like this on the TV in the U.S?!?! And by all means, if your French comprehension is better than mine, please let me know!

Baby Einsteins?

October 04, 2006

Have you ever tried to actually read an article printed in a medical journal? I've had to do it more than a few times...while working as a reporter, and now, while researching my book, "Mama Knows Breast." Personally, I find that reading the results of a scientific study is an exercise in skimming and extreme concentration. I'm not a doctor. I don't play one on TV, and the last science class I took was aptly nicknamed "Physics for Poets." Science is not my forte. Just give me the bottom line.

Anyway, I just read the latest study that examined the possibility of a link between breastfeeding and intelligence. And here's the study's conclusion: "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."

The study was published today in the British Medical Journal, BMJ. Here's a link. The study notes that since 1929, other researchers have found that children who were breastfed had higher IQ's. But this new study says some of the earlier research is flawed because it did not consider the mother's IQ as a factor. Basically, the study published today says that kids inherit their IQ; they don't get it from breastfeeding.

The authors write, "Children who were breast fed had mothers with higher IQ and with more education and who were older, less likely to be in poverty or to smoke, and more likely to provide a stimulating and supportive home environment." In other words, the kids were smart because their moms were smart, not because they were breastfed.

As the headline from a Medpage story put it, "Children Inhert IQ From Mom's Brains; Not Her Milk." For more news stories on this research, you can go to WebMd, MSNBC, or the CBC.

So why don't I groove on reading scientific articles? Is it because my mom breastfed me for six months and not longer? I doubt it. I simply didn't get the math or science gene in the family. It went to my brother, the neurologist. And he got less breastmilk than I did.

Yom Kippur, Fasting and Breastfeeding

October 01, 2006

I am not good at fasting. I can barely go three hours without eating or drinking something. If I don't eat, I get cranky and tired. So Yom Kippur, or the Jewish Day of Atonement, is always a challenge. One year, in fact, I actually got sick from not eating.

Last year I was pregnant and I didn't feel well so I didn't fast. Jewish law actually says you do not need to fast if you are ill. So what is the answer for breastfeeding moms? Are you required by Jewish law to fast?

I should state that I'm Reform; in other words, I'm flexible about my religious life. If I was Orthodox, or Conservative, I would probably know the answer to this question about fasting and breastfeeding right up front. Or I would have asked a Rabbi, family member or friend. In my case, I've turned to the internet. Bottom line, it seems that Jewish law says that both pregnant and breastfeeding women should fast unless their health, or the baby's health, would be at risk.

Here is a good site with an explanation as well as guidelines on how to fast while breastfeeding. Nishmat: The Jerusalem Center for Advanced Jewish Study for Women.
Another source of information is Kellymom. www.Kellymom.com.

As always, make an informed decision. And if you do refrain from eating, have an easy fast.

Happy Meal

September 29, 2006

There are certain meals you'll always remember. Both good and bad. Good-- lobsters from a Maine clamshack; steak frites from a fancy New York restaurant. Bad-- salmon croquettes and something I ate that landed me in the ER. So how about the kids? We all know they develop refined food preferences pretty quickly.

As for the Titty Bear, he just had his very first meal that was OTB, or "off the boob." He reached the six month milestone and so it was time for some rice cereal. The Bortski (our two year old) actually had his first rice cereal at four months. But since then, the pediatrician's recommendations for first solids have changed. The American Academy of Pediatrics now recommends exclusive breastfeeding (ie. NOTHING, but breastmilk) for the first six months. So, that's what we did this time around.

The Titty Bear turned six months a couple of weeks ago, but it took me a little while to get the stars aligned for his big culinary adventure. First we had to get the thumbs up from the pediatrician, then I wanted to give him a couple of days to get over his shots, then we were traveling to visit relatives. Once things settled down, it was time to set him up in the high chair.

Day 1, Attempt 1: After a very sleep deprived night (but that's another story altogether), stumble into kitchen blinking in bright lights. Bortski is already seated "like a growm-up" at the table with DaDa having oatmeal. Wrangle the Titty Bear into the high chair. Bortski immediately wants back into the high chair. Go figure. Pour rice cereal into bowl. Add water. Notice an odd looking brown clump. Dump the mixture in the sink. Start to pour another bowl. Think twice. Dump the whole box of cereal in the trash.

Day 1, Attempt 2: Now we're cooking. Bortski is fine about ceding his throne to the Titty Bear. In fact, he is wearing a paper crown he got at an arts and crafts class at a book store. "I'm a Prince," he says, from his seat at the table. Titty Bear starts to suck on the high chair tray. Make the rice mixture. Put spoon to his mouth. Titty Bear looks shocked. Offended even. He starts to shake. Is something seriously wrong? Determine he is fine. Continue feeding. "I ate the whole thing!"

Day 2: The Titty Bear loves it. Cereal is all over his face. His hands. He tries to pick up the bowl. Afterwards, flat out refuses to breastfeed. Do we have a problem here?

Day 3: Not so interested.

Day 4. I think this thing is working. Titty Bear eats his cereal. Breastfeeds to wash it down. And promptly takes a nap. Still sleeping 2+ hours later. Go check that he's still breathing.

So will the Titty Bear remember these very first meals? If he's anything like the Bortski, some day he'll look at the rice cereal and say "blech." But just in case, I have pictures to show him how much he loved it. Now, if I could just get this crusty mess out of my hair.

Letters to The New York Times

September 07, 2006

You may recall the recent New York Times story about how hard it is for working moms to breastfeed, especially moms who don't have "white collar" jobs. As the article pointed out, white collar workers have an easier time pumping because they often have privates offices or even designated lactation rooms. "Blue collar" workers often find their jobs incompatible with breastfeeding, and their employers unsupportive. ( I wrote about this story on September 4).

These Letters to the Editor reaffirm the primary point of the article. They emphasize the need for employers, and even the government, to foster an environment that makes it easier to pump, or even breastfeed, at work.

Breastfeeding Linked to Reduced Bedwetting

July 11, 2006

Ok, so just when you thought that they couldn't come up with another study showing the benefits of breastfeeding, here's one for you. Breastfeed kids are less likely to wet their beds. That's the news according to a study done by researchers at Robert Wood Johnson University Hospital’s children’s hospital and UMDNJ-Robert Wood Johnson Medical School. Here's the story.

Comments on the NYT Breastfeeding Article

June 26, 2006

A couple of weeks ago the NYT ran a big article about the benefits of breastfeeding. The article focused on a government public health campaign to promote breastfeeding. Conversations about the article and the campaign now continue on the internet. "Breast-feed or Else" was the article's title. Now NYT blogger Judith Warner has written an entry "Why Vilify Mothers Who Bottle-Feed?" Check out the more than one hundred comments to her blog entry.

Another Breastfeeding Benefit--Preventing Obesity

June 19, 2006

Breatfed babies are less likely to put on extra weight. That's the latest from the Centers for Disease Control and Prevention. Here's The New York Times story.

Government Ad Campaign Encourages Breastfeeding

June 14, 2006

The government is encouraging mothers to breastfeed with an aggressive advertising campaign. The Department of Health and Human Services' ads suggest that not breastfeeding is actually dangerous to your baby's health. One of the television ads shows a pregnant woman clutching her stomach while riding a mechanical bull in a bar. The suggestion...its risky to ride a bull, and risky to give your baby formula. The slogan of the campaign...Babies Were Born to Be Breastfed.

Senator Tom Harkin of Iowa is going one step further. He has proposed putting warning labels on cans of infant formula. Here's an article about this from The New York Times, as well as a Today Show segment that has clips from the television commercials.

World Health Organization Releases New Standards for Kids' Growth

April 27, 2006

The World Health Organization has released a new study that gives guidance on how every child in the world should grow. These new standards, which are based on kids who were breastfed, show that growth is influenced more by nutrition and healthcare than by genetics or ethnicity. Here's the press release from the WHO.

Study Finds That Breastfeeding Prevents Obesity in Kids

A study in the May issue of the medical journal "Diabetes Care" found that moms who had gestational diabetes (diabetes diagnosed during pregnancy) can cut the risk that their children will be overweight if they breastfeed longer than three months. The study was done in Germany. Here's a link to the press release about the study.