Cold Remedies and Breastfeeding

Quite often, nursing mothers will wonder if it is safe to take cold medicine while breastfeeding. Generally speaking, there is little risk to your baby from taking over-the-counter remedies for a brief period of time. However, some drugs are safer than others; and a few can have a negative impact on milk production. The InfantRisk Center of Texas Tech University Health Sciences Center at Amarillo has a helpful analysis of common cough and cold remedies.

On a personal note, although I try to avoid all drugs while pregnant or nursing, if I am really miserable with a cold I will take Ibuprofen (Motrin, Advil). Not only does it relieve the pain of a headache, sore throat, etc., but its anti-inflammatory property will reduce swelling in mucous membranes such as your nose and sinuses, making it easier to breathe. And, according to InfantRisk, Ibuprofen is "the preferred analgesic in breastfeeding mothers as only small amounts get into milk".

Breastfeeding Facts for Fathers

Check out Molly Remer's book review of Breastfeeding Facts for Fathers at the Citizens for Midwifery blog.

The Case of the Virgin Gut

This is so important for parents to know... Even the Occasional Bottle of Formula Has Its Risks.

The "Swine Flu" and Pregnant/Breastfeeding Women

The CDC yesterday issued some guidance for healthcare providers in treating pregnant and breastfeeding women who have or may have the swine influenza A (H1N1) virus. The CDC notes that the flu can be more severe in pregnant women, with a higher risk of complications for the baby, especially if the mom develops pneumonia.

On the subject of breastfeeding, the CDC's advice - which is applicable for pretty much any illness, not just the flu - is as follows:

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

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

It is important to note that by the time a woman shows symptoms of an illness, her baby has already been exposed, so she should never stop breastfeeding or be separated from the baby when sick. There are only a couple notable exceptions to this rule - tuberculosis and HIV come to mind. But for almost all diseases, a sick mother should breastfeed more, not less.

Shopping for Breast Pumps

Shopping for a breast pump? The US Food & Drug Administration has a whole website devoted to choosing a pump. This might be a good place to start, but the FDA does not make any recommendations as to specific brands. For even more information, check out Kellymom's list of
milk expression tips & pump information.

Melamine found in US formula

FDA defends safety of U.S. infant formula:

FDA tests found "very low levels" of the industrial chemical melamine in Nestle's Good Start Supreme with Iron formula, said Stephen Sundlof, director of the FDA's Center for Food Safety and Applied Nutrition.

It also found low levels of cyanuric acid in Mead Johnson's Enfamil Lipil with Iron, Sundlof said. Mead Johnson is a unit of Bristol-Myers Squibb.

Those findings "do not raise public health concerns," Sundlof told a conference call. "The domestic supply of infant formula is safe."

Representatives for Nestle and Bristol-Myers could not immediately be reached for comment.

The FDA earlier this week said it had found one brand of formula containing melamine, a chemical used widely in the production of plastics and fertilizer, but declined to name the company to Reuters.

The article goes on to say that the FDA is not yet finished testing samples.

It's not rocket science

I've had this bookmarked for the longest time (3 1/2 years, to be exact), but since it's NaBloPoMo and I'm looking for things to blog about quickly, thought I'd share. It's an excellent post from katiekind about mothers, babies, and attachment:

You could take it as an insult, but God does not credit us with being rocket scientists when it comes to taking care of the next generation. Instead he pre-programs caregiving behavior on the part of mothers AND he pre-programs babies to elicit caregiving from their mothers. An obvious example is how a nursing mother's breasts gush milk in response to hungry-baby sounds. Just in case she can't figure it out from the way her baby is frantically mouthing anything that gets near...her breasts start to tingle and next thing she knows, the front of her shirt is milky. It is not the most subtle of hints. But considering how tiny and vulnerable babies are, it's a hint to heed. This milk-ejection reflex subsides after the first few months of nursing. By that time a nursing mother and her baby have sync'ed up well and the mother knows her baby's subtlest signs of need for nursing.

But it doesn't stop there.

Read more.

News Items

A couple items in the news caught my eye, regarding recent research studies:

Contaminants in human milk - not breastfeeding an infant typically poses more of a threat to the baby's health than does exposure to any of the chemicals which can be detected in breastmilk.

Depressed pregnant women have twice the risk of preterm delivery - A recent study found that pregnant women with symptoms of depression have an increased risk of preterm delivery, and that the risk grows with the severity of the depressive symptoms. Most of the women in the study were not taking medication for depression.

Caffeine intake during pregnancy - Any amount of caffeine intake by pregnant women increases the risk of low birth weight in their babies:

In light of this evidence, the UK Government's Food Standards Agency are altering their guidance on the recommended daily limit of caffeine consumption and reducing it from 300mg to 200mg.

In the News

Some interesting items in the news this week about pregnancy, breastfeeding, and child care:

The rates of pregnant women with diabetes is soaring.

While the news that More Mothers Breast-Feed, in First Months at Least is exciting (especially the increase among African-American moms), the number of babies still breastfed at six months remain unchanged. And there are other questions about the collection of data:

The most recent C.D.C. survey did not report breast-feeding rates at 6 months because of a lack of data.

and further:

Dr. Barbara L. Philipp, associate professor of pediatrics at Boston University, said the C.D.C. survey had not asked mothers whether they breast-fed exclusively. “One sip was positive, so they set the bar very low,” Dr. Philipp said.

and hospitals have still not banned the bags:

Dr. Philipp said that while doctors and nurses were doing a better job of emphasizing the benefits of breast-feeding to patients, most continue to offer new mothers free diaper bags containing infant formula when mothers go home with their newborns.

“That’s a problem because at least five studies have shown that when a doctor or nurse hands the family that bag, even if they take the formula out, that mother will have less success with breast-feeding,” Dr. Philipp said.

Breast cancer risk cut by breast feeding (not if you live in Tanzania, though) although a Brittish poll found that 75% of moms are not aware of that benefit.

And while it isn't exactly "news", more studies confirm that Breastfeeding will improve children's IQ scores.

Just in case you needed something else to worry about, extra iron for infants who don't need it might delay development, arsenic in baby rice puts children at risk, children are more vulnerable to harmful effects of lead at age 6 than as toddlers, and nearly one-third of U.S. parents don't know what to expect of infants.

Breast milk contains stem cells

What's the deal with Perth? First H.Pylori, then Heath Ledger, now this:

Breast milk contains stem cells.

Made for Birthing

Take a look at these neat hospital gowns made for birthing. Not only do they allow coverage for modesty while still providing access for medical procedures and breastfeeding, they also help support baby's immune system:

The risk of germs is one of the biggest risks in hospital birth. Hospitals and medical caregivers supposedly provide a "sterile field" but you and your baby are still exposed to a multitude of germs that your body has not built immunity to. Roll your gown around on your bed, couch, and hold the dog and cat before you bring it to the hospital. You'll be bringing YOUR "sterile field" from home for your baby to be born into and to be touched by first and covered by. Not harsh, potentially risky hospital towels and sheets.

Breast Pump Comparisons

Need to buy a breast pump? Compare brands and styles at Breast Pump Comparisons.

Hospitals May Overfeed Newborns

It seems that as breastfeeding continues to make its comback, we continually have to redefine "normal"; since for years "normal" was based on what was normal in babies fed artificial milk - everything from how fast babies grow, to how often they eat, how long they sleep, how often they poop, and even how much weight they loose after being born:

Physiologically appropriate infant weight loss is less for babies fed formula in the hospital than for those who are breastfed, suggesting that hospitals feed too much, researchers here said.

Formula feeding in the first few days of life may lead to later overweight and obesity by way of metabolic imprinting, Patricia J. Martens, Ph.D., and Linda Romphf, of the University of Manitoba, reported online in the Journal of Human Lactation.

Link

Gibbon learns parenting, breastfeeding from humans

Look, learn works for Sue the gibbon:

Since the birth of Intan, a baby siamang gibbon, staff at the Christchurch wildlife centre are taking a unique approach to teaching new mother Sue how to care for her gibbon.

The use of video technology, cue cards, and even real life demonstrations of how to breastfeed are being used to teach Sue correct parenting.

Breast-feeding patrons visiting the reserve have also been enlisted to help give Sue the right idea.

She was fascinated by it, said Monique Van Der Linden, head of Willowbank's zoo section.

Monkeys were able to "learn from people", she said.

Breastfeeding Briefs

New this week:

Breastfeeding reduces the risk of cardiovascular disease later in life:

Having been breastfed in infancy is associated with a lower average body mass index (BMI) and a higher average HDL (high-density lipoprotein or “good” cholesterol) level in adulthood, even after accounting for personal and maternal demographic and CVD risk factors that could influence the results,” said Nisha I. Parikh, M.D., M.P.H., author of the study and a cardiovascular fellow at the Beth Israel Deaconess Medical Center in Boston, Mass.

A lower BMI and high HDL both protect against CVD.

(link)

Breastfeeding & IQ are genetically linked - This study shows that breastfeeding increases I.Q. for most children. For around 10% of children, however, breastfeeding has no effect on I.Q. due to a lack of a particular gene variant:

This study looked at how long-chain polyunsaturated fatty acids (LC-PUFAS), which are present in human milk but not in cow's milk or most infant formulas, are metabolized. LC-PUFAS in breast milk, the authors said, is believed to enhance cognitive development because the fatty acids are required for efficient neurotransmission and are involved in neuronal growth and regeneration.

(link)

Breastfeeding Briefs

I'm hoping to make this a weekly feature. In the news:

Research confirms what breastfeeding and childbirth professionals have been saying for years, Breastfeeding Does Not Create Sagging Breasts:

However, there are some factors that increase the chance of sagging breasts. A higher BMI and larger bra size before pregnancy increased the chance that the breast would sag. Also, smoking history, the number of pregnancies, and age also affected the risk factors of getting sagging breasts.

Factors that did not affect whether or not the women had sagging breasts were the number of children that were breastfed and the amount of time spent breastfeeding each child. Also, the amount of weight gained during pregnancy apparently had no affect on long term breast shape.

Breast milk helps lungs but not if mom has asthma - "Breast-feeding seems to protect children from asthma later in life, but only when the mother does not have the respiratory disorder herself."

News of the weird - Breastfeeding smell linked to higher sex drive.

The USDA announced this week a new MyPyramid for Pregnant and Nursing Moms. The website feature allows you to put in some information about you and your baby or pregnancy, and get recommendations on what you should be eating. Unfortunately, the website does not allow you to input dates for babies older than one year of age, nor does it account for women who are tandem nursing, or who are pregnant while nursing. Furthermore, it does so in a rather rude way, by stating that the date you have entered is "invalid". A better approach would be to refer mothers of older babies to the regular MyPyramid feature. If this irritates you as much as it does me, feel free to let the USDA know.

Here is the UNICEF Policy on Infant feeding and HIV:

UNICEF and other UN agencies recommend exclusive breastfeeding for HIV-infected women for the first six months of life unless replacement feeding is acceptable, feasible, affordable, sustainable and safe before that time. Such conditions are rare in much of the developing world. However, if they do exist, it is recommended that HIV-infected women avoid breastfeeding. [emphasis added]

The risk of a baby contracting HIV through breastfeeding from an infected, untreated mother is between 5-20%. However, the death rate of formula-fed babies in the developing world is approximately 33%. While formula feeding merely doubles the risk of death, compared with breastfeeding, for babies born in the US, babies in developing countries are ten times more likely to die within the first year. Given these numbers, a baby is better off getting milk from an HIV-infected mother unless the five UNICEF criteria can be met.

UNICEF also recommends exclusive breastfeeding of a baby already known to be HIV+.

The Nursing Room Locator

Thanks to My Baby & More, check out The Nursing Room Locator. As the author states:

I firmly believe that every mother has the right to nurse her child wherever she sees fit, be it a bench in the mall or at the coffee shop down the street. That said, sometimes you just want a quiet place to feed your baby.

So she's compiling a list.

Breastfeeding and HIV-Positive Moms

Exclusive breastfeeding halves HIV infection risk for baby:

After three months, the HIV infection rate among the exclusively breastfed group was 4.04 percent.

Among the mixed group, babies who received formula milk in addition to breast milk were twice as likely to acquire HIV infection. And those who had solid food -- typically porridge -- ran 11 times the risk of infection compared with the breastfeeding-only group.

In addition, the death rate at three months among the exclusively breastfed babies was 6.1 percent; among children given replacement feeds, it was 15.1 percent.

Traveling with Breastmilk

Mothering Magazine has a nice piece on Traveling With Breastmilk, including some creative tips on packing it and technical advice on how long it stays good:

When our country goes to orange alert at the airports, mothers who travel without their babies are not allowed to take their pumped breastmilk in the cabin of the plane with them. Women have traditionally been encouraged to keep pumped breastmilk on ice, so they often took it in their purse or carry-on bag. Now, however, toting breastmilk in your carry-on bag without a baby has become officially forbidden and deemed "suspicious." Of course, if you had the baby with you, you wouldn't need to pump and carry precious breastmilk. What is a mother to do? Get clever.

New research in the journal Breastfeeding Medicine has come to the rescue. The researchers took frozen breastmilk and thawed it, refroze it, refrigerated it and left it out at room temperature. Essentially, they beat it up. What did they find? Breastmilk is fairly robust and does not grow bacteria easily nor lose vitamins A and C or free fatty acids (FFA) to any degree that would harm a full term baby. Breastmilk fresh from the breast or thawed in a clean container can be left at room temperature for less than 8 hours. This means on a day trip, you can safely pack expressed breastmilk in your checked bag and take it home just as it is.

Breastfeeding Benefits

According to recent studies, being breastfeed may increase one's social mobility and protect mothers from heart attacks:

[Study leader Alison Steube of the Harvard Medical School] said: "Pregnancy is associated with a number of things that you normally wouldn't want to happen to your body, including storing more fat and having higher than normal levels of fatty acids circulating in the blood.

"By breastfeeding, mothers can convert those energy reserves into nutrition for their infants. Breastfeeding isn't just good for babies, it's good for mothers, too."