News Moms Need

A new study from the CDC released in today’s journal Pediatrics revealed that 40% of mothers surveyed gave solid food to their baby before the age of four months. While the American Academy of Pediatrics, the American College of Obstetrics and Gynecology, and the American Academy of Family Physicians all recommend breastfeeding or formula feeding exclusively to the age of six months, many of the 1134 mothers involved in the study introduced cereal and fruit long before then, some as early as four weeks.

This early introduction of solid food occurred more than twice as often in women feeding with formula over breastfeeding women. The main reasons women gave for starting solids so early were “My baby was old enough,” “My baby seemed hungry a lot of the time,” “My baby wanted the food I ate,” “A doctor or other health professional said my baby should begin eating solid food,” or “It would help my baby sleep longer at night.”

This low adherence to infant feeding recommendations is of concern because, developmentally, younger infants are not prepared for solid food. Researchers have suggested that “early introduction of solids may increase the risk of some chronic diseases, such as diabetes, obesity, eczema, and celiac disease.” The health benefits of breastmilk (lower risk of ear and respiratory infections, diarrhea, diabetes, obesity, and sudden infant death syndrome) are significantly impacted when women cut back on breastfeeding as they introduce solids.

When beginning solid foods in your baby’s diet, it’s important to know that solid foods are meant to complement your baby’s overall nutrition, not replace breastmilk or formula. During this transition, your baby’s primary source of nutrition should still be breastmilk or, if he is bottle-fed, formula.

Speak with your baby’s health care provider before introducing solid foods into his diet. Remember these things when you do start:
    • Although you’re starting your baby on solid foods, you don’t need to wean him from breastmilk right away. Some babies may no longer have an interest in breastfeeding after 1 year of age. But breastfeeding can continue beyond the first year of life if mother and child wish.
    • Don’t feed your baby solid or pureed foods through his bottle. This takes away from your baby’s overall learning about how to hold and eat foods. It can also put him at risk for eating too much and becoming overweight. It’s best to use a teaspoon to feed your baby solid foods. Also, feeding baby with a spoon plays an important role in your baby’s language development.
    • Do not give your baby cow’s milk until he is at least 1 year old. At age 1, cow’s milk can become a major source of essential nutrients for your baby. Babies should be given whole milk until age 2.
    • Do not give food or sweets to your baby as a reward for good behavior. Instead reward him with praise, kisses, love and attention.
    • Practice good oral hygiene for your baby right away. As soon as he has teeth, start cleaning them with a small wet washcloth.

We’ve all heard that “breast is best” for babies, but not every woman can breastfeed.  Some moms have had surgery or take medications that transfer to breast milk and are unsafe for the baby, or just don’t produce enough milk to sustain a baby.  Some babies have severe allergies or a failure to thrive.  Whatever the problem, moms might still be able to provide breast milk – just someone else’s.

Generations ago, women might bring in a wet nurse to help feed the baby.  Not so much today.  A donor milk bank is a service established for the purpose of collecting, screening, processing and distributing donated human milk to meet the specific medical needs of individuals for whom it is prescribed.

The Human Milk Banking Association of North America says donor milk banks receive milk from lactating mothers who have been carefully screened for health behaviors and communicable diseases, similarly to the way blood banks screen donors.  Milk is transported to the milk bank frozen. It is heat-treated to kill any bacteria or viruses, processed and then refrozen. It is only dispensed after a sample is cultured and shows no bacteria growth. Milk is shipped frozen by overnight express to hospitals and to individual recipients at home. 

The milk is dispensed by physician prescription or by hospital purchase order only. There is a processing fee charged to cover the expense of collecting, pasteurizing and dispensing the milk.

The mission of the National Milk Bank is to provide premature and critically-ill babies with the best possible nutrition for survival and healthy development. If you are interested in donating or wish to learn more, click on the links above.

As every breastfeeding mom will tell you, breastmilk is precious and you want to keep it around as long as it’s safe to do so. You can keep pumped breastmilk in the refrigerator or freezer in either bottles or bags made just for storing breastmilk. It doesn’t last forever, so be sure to write the date on the container before you store it. So, how long will it last?

• In the refrigerator (temperature must be 32-39 degrees F), breastmilk can be kept for 5-8 days.
• If stored in the freezer inside your refrigerator, it will keep for two weeks.
• If your refrigerator has a freezer with a separate door (top, bottom or side-by-side), it will keep 3-6 months.
• If you have a separate, stand-alone freezer, breastmilk will keep for 6-12 months.

When you’re ready to use it, thaw and warm the milk. Don’t put it in the microwave because it can get too hot in there. Instead, put a bag or bottle of frozen milk under cold running water. To warm milk, put the bottle or bag under hot running water or in a bowl of warm water. Shake the bottle or bag to even out the temperature throughout the container. Be sure to put a drop or two of milk on the inside of your wrist to test the temperature before giving it to your baby.

Since, unlike with a bottle, you can’t see what a breastfeeding baby is taking in, lots of new moms wonder if their baby is getting enough milk. Your body is pretty amazing. As you breastfeed, your body learns when your newborn needs more milk and, for most women, will make the exact amount your baby needs.

Feed your baby when she is hungry. For most newborns, this is about eight to 12 times over a 24 hour period, which averages out to about every two to three hours. But keep in mind that every baby is different and yours may want to feed more or less often than that. And as your baby grows, her feeding patterns may change, and she may wait longer between feedings.

Most babies feed for 15 to 30 minutes at a time at one breast. It’s OK if your baby takes more or less time. When she is finished with one breast, burp her and then switch to feed her from the other breast. It’s OK if she really isn’t hungry for more from the other breast – let her be the judge. Just be sure to start her on that other breast at the next feeding.

But what if you’re still not sure that she’s getting enough? She is getting enough if:

• She is gaining weight
• She is making six to eight wet diapers a day by the time she is five to seven days old.

If you’re still worried, here are some signs of infant dehydration:

• Not having a wet diaper for at least five or six hours.
• Urine that is darker in color and has a strong odor
• Dryness of the mouth and tongue.
• Crying without tears.
• Acting unusually cranky or sleepy
• A sunken appearance to the eyes, cheeks or fontanels.

If you think there is a possibility that your baby might be dehydrated, call her health care provider right away. He may want to see her to make sure all is well.

Mothers who are returning to work or school usually need a breast pump. How often you’ll need to pump milk depends on whether you’re feeding your baby only breastmilk or if you’re switching between breastmilk and formula.

There are a variety of pumps available. Women who pump infrequently often prefer manual pumps, while working women commonly like electric double pumps because they shorten the time it takes to use them. There are “open system” and “closed system” pump designs. In both designs, breastmilk flows through the breast shields and tubing and is deposited into containers. In an “open” system, it is possible for some milk to come in contact with parts of the machine.  In a “closed” system, none of the breastmilk can enter the machine, so it is safe for several women to use it by simply changing the shields, tubing and containers. A lactation consultant can help you evaluate your needs and choose wisely.

Shop around until you find the pump that works best for you. Prices for breast pumps vary depending on their features. Be sure to compare costs. Some health insurance companies help pay for a breast pump. Find out if your insurance covers the purchase of a breast pump. Many women will add a breast pump to their baby shower registry so that a few friends can pitch in together. But don’t forget that you will also need to purchase bags or bottles to store the pumped breastmilk.

You may also want to think about renting a breast pump. For many families, this is a cost-effective solution. If you choose to go this route, make sure you rent a “closed” system pump. Talk to your health provider or hospital staff for more information about where to rent a pump. Reusing a friend’s pump is safe, too, as long as you buy new accessories (tubing, storage bags, bottles, nipples). Talk to your health care provider if you’re interested in this option.

The March of Dimes is pro-breastfeeding, no two ways about it. Breast milk is the best food for most babies. We do recognize, however, that there are women who cannot or choose not to breastfeed and they should never be thought of as less than good mothers because of this. But we have been pleased to see the growing numbers of women who choose to breastfeed, even when they return to work. 

That being said, there’s a lot of debate about something I saw on the news the other night. There is a new doll coming to the American market called The Breast Milk Baby which is aimed at teaching little girls how to breastfeed. The doll is made in Spain by Berujan Toys. It comes with a special halter top that has two flowers where nipples would be. When a little girl puts on the top and holds the baby doll up near the flowers, it makes suckling sounds. The company says it’s a great way for girls to play and learn, it’s fun and educational. We give little girls baby bottles with their dolls, why not this?

The March of Dimes does not endorse or recommend products. I’m writing about this simply to generate a discussion. While this doll appears to be very popular in Europe, it’s running into some controversy here. What do you think?

A new study just published in the journal Pediatrics reports that breastfeeding your baby is protective against SIDS, sudden infant death syndrome. The study states that breastfeeding’s protective benefits apply regardless of the extent and length of time a baby is breastfed, although the longer the time the greater the benefit.

SIDS is the sudden, unexplained death of an infant younger than 1 year old. It is particularly worrying because it can occur without warning in a baby who seems healthy. While most SIDS cases happen in babies between 2 and 4 months old, it is the leading cause of death in infants between 1 month and 1 year old.

Dr. Fern Hauck and her colleagues from the University of VA School of Medicine reviewed over 280 studies of breastfeeding and SIDS that had been conducted over a 43 year period of time.  They focused on 18 studies that met their specific criteria. Their analysis showed that breastfeeding is protective against SIDS, and this effect is stronger when babies are exclusively breastfed.  Infants who had received any breastmilk for any amount of time had their risk factor reduced by 60 percent. If the infants had been breastfed up to the age of two months or older, their risk was 62% lower. In infants who had been exclusively fed breastmilk, the researchers saw the greatest reduction - their risk was 73% lower.

The American Academy of Pediatrics recommends that infants be fed only breast milk (no water, formula, other liquids or solids) for about the first 6 months of life. Women should continue to breastfeed their babies for the next six months while solid foods are introduced. They can continue breastfeeding after 12 months as long as mother and baby desire.

You can read more about reducing the risk of SIDS at this link.

The Food and Drug Administration (FDA) is urging parents not to give premature babies (babies born before 37 weeks of pregnancy) the thickening product called SimplyThick. The product may cause a life-threatening health problem called necrotizing enterocolitis (NEC). With NEC, tissue in the intestines gets inflamed and dies.

Some premature babies have trouble swallowing. SimplyThick is a product that’s added to breastmilk or formula to make it thicker. Health providers recommended SimplyThick because it helped premature babies swallow their food and keep it down, without spitting it up. SimplyThick was available from distributors and local pharmacies.

The FDA learned that some babies got sick with NEC after they were sent home on an eating plan that included SimplyThick. Sadly, some of these babies died. NEC most often happens early in a premature baby’s life while she is still in the hospital, not after she’s sent home. NEC is very dangerous to a baby’s health.

At this time, the FDA isn’t sure what about SimplyThick is making babies sick. The organization is actively looking into the link between SimplyThick and these illnesses and deaths.
 
In the meantime, the FDA urges parents to stop using the product immediately, even if their babies don’t appear to be sick.

Call your baby’s health care provider if she shows any of these signs:
• bloated stomach
• greenish-tinged vomiting
• bloody stools

For more information on SimplyThick and the risk to premature babies, visit the FDA website.

We have all heard the importance of drinking enough water everyday. We hear it on the news, see it in health magazines, and hear it from our doctors. However, when it comes to newborn babies, we hear the opposite. Most health experts say that newborn babies should not be given water – at all! Why?

The American Academy of Pediatrics says “Until your baby starts eating solid foods, he’ll get all the water he needs from breastmilk or formula.” If a baby is given water in addition to breastmilk or formula, he may not have the appetite he needs to feed when he should. The water may temporarily make him feel like he is full, so he won’t eat as well at the next feeding. This would mean that he would be missing out on vital nutrients. It is very important that he get all the calories and nutrients he needs in order to grow and be healthy.

it is not necessary to supplement your newborn’s diet with water since breastmilk and formula already contain water. So, your baby is already getting all the water his little body needs. In fact, giving a baby too much water can even lead to certain health problems.

So, when is the right time to give your baby water?

Once your baby is eating solid food (at around 6 months of age), it’s a good idea to give him some water in between feedings. In fact, giving water instead of juice at that point is helpful so that your baby learns to adapt to the plain taste of water (instead of the surgery taste of juice). For more information on how and when to give your baby water or juice, read this article from the American Academy of Pediatrics.

As always, if you have questions, we suggest you speak with your baby’s health care provider.

Many premature or sick babies cannot feed from the breast right away.  They’re  not strong enough or mature enough to grasp the suck, swallow, breathe process. However, the benefits of breast milk, including protection from many diseases, may be especially crucial for these babies. A recent study found that very premature babies who received breastmilk soon after birth had higher mental development scores at 30 months and were less likely to be rehospitalized than premature babies who did not receive breastmilk. Breastmilk, however, may need to be supplemented to meet the nutritional needs of small premature babies.

For babies unable to suckle for the first week or two, moms can use a breast pump to express their milk so that the milk can be fed to their babies through a tube or with a dropper. By pumping her breasts, a mother keeps up her milk supply so that her baby can breastfeed when he is stronger.

Don’t be discouraged if it’s time to go back to work and you still want to breastfeed.  You can pump at the office and continue to provide your little one the best food possible.