Nursing Your Kids

In the comments of my post about pumping exclusively Katharine wrote, Exclusive pumping because you don’t want to sit still and breastfeed sounds mechanical and icky to me.

Caro followed up by writing, Katharine, I bet that one woman’s relaxing is another woman’s icky.

These are both excellent points. When I first read about exclusive pumping (note: for some reason I can’t help but write pumpkin instead of pumping-and yes I just corrected that- every single freaking time I write it) I assumed women did it because they had to. It never occurred to me that someone who didn’t want to physically nurse their baby would actually go to all of the trouble of pumping. And pumpking (see!!!) is trouble. There’s equipment to wash, there’s milk to store, parts to assemble and disassemble, and then there’s the actual part where you have to hope the letdown reflex will kick in and hope you’re pumping enough. When you’re pumpking (ugh, I can’t make it stop- I may have to switch to the verb expressing) exclusively every ounce counts much more than if you’re just expressing occasionally.

It seems strange to me that someone (once all latch problems are under control) would rather hook up to a machine than hook up to a baby, especially for those middle of the night feedings. But strange to me isn’t necessarily strange to someone else. Like caro said, one woman’s relaxing is another woman’s icky.

A recent article in Babble about expressing exclusively brought some interesting points.

“I don’t think there’s any question” breast milk is superior to formula, said Dr. Ruth Lawrence, a professor of pediatrics and expert on breastfeeding at the University of Rochester. “I would opt for breast milk in a bottle rather than no breast milk at all.”

Still, she said, drinking pumped breast milk from a bottle differs considerably from nursing. “Babies who suckle at the breast — that’s the physiological way to feed. The baby doesn’t get the same kind of activity — tongue, mouth, swallow — when it is feeding from the bottle.” And, she added, “it’s been shown that the die is cast for obesity in the first year of life, and we tend to overfeed babies when we bottle feed them.”

For the two months I was expressing for Sam I remember that everyone who tried to bottle feed him, especially his grandmothers, tried to insist that he finish what was in the bottle whether he wanted it or not. I’m sure that this would have been the case whether it was formula or breastmilk, but that desire to see a baby finish a bottle is completely different than letting a baby nurse until he or she is finished. I’m sure that bottle fed babies are over fed, which is why they created a growth chart for breastfed babies. Even so, I don’t know that this is the best point for a breastfeeding advocate to make. So many women are turned off by experiences with pushy and rude lactation consultants that this point, that you’re basically setting your kid up for obesity by bottle feeding them isn’t going to make them feel any better about their decision to breastfeed, no matter what form the breastfeeding takes.

The balance of foremilk and hindmilk that helps nursing babies first satisfy their hunger, then feel full is missing when pumped milk mixes in a bottle. And psychologically there can be more pressure to finish a bottle when expressed breast milk represents so much work for the mother.

Yes! They call it liquid gold. It’s painful to see it go to waste.

Dr. Lawrence worries that most women aren’t getting the proper support when they set out to nurse their babies, and that some women find the idea so distasteful they don’t try. “Some women do it because they can’t envision the baby suckling at their breast. I suspect it has to do with our whole modern attitude about the breast. It’s become such a sex object.”

Wanting to physically separate yourself from your baby because you view your breasts as sex objects, not a temporary source of nourishment, is something that I find icky. Yes, breasts are sexual, but the inability to put that aside for the brief time period that a child needs them for food just seems cold to me.

All the women I spoke with would agree on one thing: mothers who wish to breastfeed would benefit from better support and information. Inconsistent, inconsiderate nurses and lactation consultants, doctors who either push formula or ignore mothers’ requests for help with nursing, and rigid hospital policies regarding babies’ weight need to change. As Dr. Lawrence points out, babies have been losing weight in the days after birth since the beginning of the human race: it’s a feature, not a bug. By fetishing weights and measures, the modern healthcare establishment borrows from the formula industry while paying lip service to breastfeeding — a recipe of mixed messages that sets mothers up to fail.

It’s hard to feel confident in your decision to breastfeed when your baby just keeps losing weight. At his first appointment with his pro-breastfeeding pediatrician, when Sam had lost more than 10% of his birth weight and my milk had yet to come in, he was weighed both before and after I nursed him. He actually LOST weight in between. I felt like a failure. When his pediatrician recommended supplementing with formula with a dropper until my milk came in I felt like more of a failure. But I’d read enough to know that it was normal and I continued to nurse him every two hours whether he seemed interested or not. A meeting with a good lactation consultant, a kind lactation consultant who was patient and thorough and sweet to me and my baby helped ease my mind two days later. And by then my milk had come in, only I didn’t really know it because Sam was nursing so often I didn’t really become engorged. I could have been set up to fail just as easily as thousands of other women who give up nursing in the first few days. But I wasn’t. I was well-informed and had a good support system including a pediatrician who reminded me for the entire first year of his life that breastfed babies just don’t weigh as much as formula fed babies and that I shouldn’t put too much stock into the percentile charts as long as Sam was healthy and growing.

Whatever the reason for expressing milk instead of nursing, I still think it’s a worthwhile pursuit. And while I don’t necessarily understand the women who prefer expressing for sexual reasons, or just don’t feel like sitting down with a baby who nurses on and off all day long, I still think they’ve made a good choice. Breastmilk is best.

A while back I wrote about the episode of Family Guy where Lois weans Stewie. I couldn’t find a clip (copyright laws be damned!) but Tanya at the Motherwear blog just posted one today!

Watch and enjoy.

On my baby message board a number of women have written about exclusively pumping for their babies. The majority of these women had to pump instead of give milk “from the tap” because their babies were unable to latch correctly. Some of the babies couldn’t latch for medical reasons, either they were premature or they had cleft palate. Other mothers just had bad experiences with lactation consultants who were unwilling to listen and unable to help. A few women on the board who are first time mothers-to-be have expressed interest in pumping exclusively for their children because they don’t want to breastfeed, yet can’t deny the health benefits. One woman just said she doesn’t have the personality to breastfeed- her baby was a lazy eater who would consistently fall asleep at the breast. She couldn’t handle just sitting there and pumped to avoid the stress relaxing brought on.

I have mixed feelings about exclusively pumping. The idea of it makes me incredibly jealous. Women who pump can go out and leave their babies in the care of their husbands, family, friends, or other caretakers for more than an hour or two. They can have a break when they feel overwhelmed, and trust that their babies will eat. At the same time, these women have to get up in the middle of the night and attach themselves to a machine. They can’t just drag their babies along when they have a day’s worth of errands to run, they have to schedule time to pump or run the risk of their supply dropping.

When I weigh the advantages and disadvantages to both I can’t help but think that mothers who pump exclusively are making the bigger sacrifice. Pumping, which is something I admittedly did on a very limited basis, seems like so much more work to me. It’s time consuming, yes, but there’s something so luxuriously lazy about just sitting down to nurse for hours every day.

I don’t really have any answers or profound thoughts on the matter. It’s just something I’ve been mulling over.

I saw this article about an office that’s so breastfeeding friendly that nursing mothers are allowed to bring their child to work. Sure, it’s a WIC office, so employees are setting a good example for their clients at the same time, but even so, I’m impressed. Very impressed. I hope that more workplaces take notice and make their policies more flexible.

Blest be the sling that binds
Moms bond with their babies as they wear them, even to the job

She dreads the day when the sling will eventually have to be retired.

The Mother’s Milk Bank of New England, which I posted about last week, is a finalist in a contest to win $10,000 for startup funds through Ideablob.

The Mothers’ Milk Bank of New England is a newly formed non-profit milk bank serving babies, hospitals, and families throughout New England. The Milk Bank will provide screened and pasteurized breastmilk to premature and critically ill babies, primarily in neonatal intensive care units. This milk will be donated by volunteer mothers in our region. For sick and premature babies, breastmilk can mean the difference between life and death, and a short or long hospital stay. Studies have shown that premature babies who receive banked milk are far less likely to suffer life-threatening complications and have much faster recovery rates.

Please go to the site and vote for this worthwhile cause. It requires registration, but it’s quick and painless and mother’s milk can save lives.

I haven’t gotten a single comment on this site since December. I didn’t really think too much of it at first, but I was starting to feel kind of down about it. I mean, I know that breastfeeding is sort of a niche market, and I’m not a huge commenter on other sites which doesn’t really encourage comments here. But a month without comments? Not even one?

Anyway, I checked my spam filter and sure enough every legitimate comment was stuck with comments from “people” named Halo and Neo encouraging me to pierce delicate parts of my anatomy. My eyes began to bleed after the third page of spam comments so I gave up trying to rescue comments from the abyss and just deleted everything. So if you’ve commented recently and it hasn’t shown up I apologize. I’ll try and do better!

It’s not just me. Comments are funky all over 451 press.

According to various reports, Salma Hayek, executive producer Ugly Betty has become a milk machine since the birth of her daughter Valentina in September. Rumor has it she’s pumping around the clock to help lose some of the baby weight.

A friend of the actress said: “Salma has been pumping and freezing endless amounts of breast milk. When she’s not feeding Valentina, she’s hooked up to an industrial-size breast pump.”

“The best way of losing weight is to work toward a gradual weight loss, eat when you’re hungry, and make sure you get enough fluids. It’s the best way of losing weight easily and safely!”

I hope this is just rumor. I’m all for breastfeeding, but I’ve got to agree with the lactation consultant. Breastfeeding isn’t just for weight loss and it’s important for mom to stay healthy too. The weight will come off when your body is ready to let it go. Rushing it will just make you feel run down.

In the comments of Bryan’s post that described zinc deficiencies as something that the “breast is best” people are trying to hide, Sarah wrote:

Zinc isn’t the only thing; I saw on GMA that Vitamin D is also not included in breastmilk and supplementing is encouraged. That’s also why, if a child has jaundice at home, they recommend supplementing with formula and then returning to the breast.

This isn’t entirely accurate. From Kellymom:

The American Academy of Pediatrics and the Canadian Paediatric Society recommend vitamin D supplementation for all infants and children to ensure that the small percentage of infants/children who need additional vitamin D do not become deficient.

World Health Organization information [Butte 2002, p. 29 states,
"...although there is abundant evidence suggesting that breastfed infants often receive less vitamin D than is required, most studies fail to find rickets in breastfed infants less than 6 months of age... infants who are exclusively or predominantly breastfed for 6 months or longer can be at an increased risk of rickets if their mothers are at risk of vitamin D deficiency, and the infants receive limited sun exposure and no vitamin D supplements."

In addition, gastrointestinal supplements are not the most easily absorbed form of Vitamin D. Per "Infant feeding: the physiological basis" [WHO, 1991] by James Akre,
“…it is now understood that the optimal route for vitamin D ingestion in humans is not the gastrointestinal tract, which may permit toxic amounts to be absorbed. Rather, the skin is the human organ designed, in the presence of sunlight, both to manufacture vitamin D in potentially vast quantities and to prevent the absorption of more than the body can safely use and store.”

As for jaundice, it’s a condition that occurs in more than half of all newborns. It’s caused by elevated bilirubin levels and in most cases it’s nothing to worry about.

From the AAP:
Q: Does breastfeeding affect jaundice?
A: Jaundice is more common in babies who are breastfed than babies who are formula-fed, but this occurs mainly in infants who are not nursing well. If you are breastfeeding, you should nurse your baby at least 8 to 12 times a day for the first few days. This will help you produce enough milk and will help to keep the baby’s bilirubin level down. If you are having trouble breastfeeding, ask your baby’s doctor or nurse or a lactation specialist for help. Breast milk is the ideal food for your baby.

And from Kellymom: I won’t quote the whole thing since you can go to the site and read it yourself, but I will quote the parts that stress that breastfeeding does not usually need to be discontinued because of jaundice and that formula feeding is far from being the first approach if baby isn’t feeding well.

Breastmilk jaundice is normal. Rarely, if ever, does breastfeeding need to be discontinued even for a short time. Only very occasionally is any treatment, such as phototherapy, necessary. There is not one bit of evidence that this jaundice causes any problem at all for the baby. Breastfeeding should not be discontinued “in order to make a diagnosis”. If the baby is truly doing well on breast only, there is no reason, none, to stop breastfeeding or supplement with a lactation aid, for that matter.

…the first approach to not-enough-breastmilk jaundice is not to take the baby off the breast or to give bottles . If the baby is nursing well, more frequent feedings may be enough to bring the bilirubin down more quickly, though, in fact, nothing needs be done. If the baby is nursing poorly, helping the baby latch on better may allow him to nurse more effectively and thus receive more milk.

Again, there are cases when jaundice is a problem and can be serious. But these cases are out of the ordinary and most breastfeeding mothers just need to nurse often and regularly to treat it.

Breastfeeding is not harmful. I think it’s dangerous to suggest that breastfeeding somehow deprives babies of essential vitamins and minerals. It doesn’t. Breastmilk is the perfect food. Formula is a substitute that is chemically engineered to mimic breastmilk. Formula companies add things to their formulas so it will be more like breast milk. Don’t let headlines and partial information dissuade you from feeding your baby the best food possible.

Last week Bryan posted the following:

Also, I have read a few article [sic] that state some essential minerals can not be passed through the breast. They suggest supplements for both mom and baby. Zinc is the big one I have found. Now, why don’t the “Breast is best” sites ever mention the need to supplement?

I wonder what else they are hiding…

While the information in Bryan’s post is correct, what he’s taken from it doesn’t seem to be. Based on his statement that the “breast is best” people are hiding things, it seems he believes breastfed babies are often deprived of zinc. This just isn’t true. Though it’s true that maternal zinc deficiency can be a problem, zinc deficiencies are extremely rare. There’s usually no need for additional supplementation after solids are started.

Most breastfed babies begin eating solid foods after six to eight months of age. Some breastfed babies begin solid foods sooner. The website he quotes states that human milk doesn’t provide the recommended amounts of zinc for older infants between the ages of 7 months and 12 months so breast-fed infants of this age should also consume age-appropriate foods…

In other words, breast milk provides enough zinc for up to 7 months of age. Kellymom, the breastfeeding authority on the web states that

Healthy full-term breastfed babies do not need additional zinc past what they get from breastmilk and (after 6-8 months) from complementary foods. Good sources of zinc include meat (especially red meat) and yogurt. Signs of a mild zinc deficiency include: lessened appetite, lowered immune function, limited activity, growth faltering. Low birth weight, small for gestational age and premature infants are at risk for zinc deficiency.

It doesn’t appear from either source that the majority of infants are suffering from a lack of zinc so I’m not entirely sure what he thinks the breastfeeding community is hiding. Doctors recommend that nursing mothers continue to take a prenatal vitamin for additional supplementation. But according the research on Kellymom:

If you eat a reasonably-well balanced diet, vitamin supplements are not considered necessary for breastfeeding mothers.

* Mothers who smoke cigarettes may benefit from additional iodine.

So if your diet is reasonably healthy and you have no known vitamin or mineral deficiencies, rest easy. Your breastfed baby should be fine.

Stonyfield yogurt, makers of the popular Yo Baby line, is releasing a new kind of yogurt for pregnant and breastfeeding mommies called, you guessed it, Yo Mommy. Their baby yogurt, in all of its full fat, sugary, organic glory is delicious. One can only hope that their new “mommy” yogurt is just as good.

Here’s their press release:

(PRLog.Org) – Jan 18, 2008 – Londonderry, NH – Stonyfield Farm, the world’s leading organic yogurt-maker, announces YoMommy, the first yogurt created to address the specific nutritional needs of pregnant, nursing and new moms, and their growing babies.

YoMommy comes in 4-ounce four-packs at a suggested retail price of $2.99. Flavors include Strawberry and Peach, and Blueberry and Raspberry. YoMommy is now available nationwide in natural food stores and in select grocery stores.

While I don’t necessarily agree that, “Enjoying Stonyfield Farm’s YoMommy, a healthy and delicious yogurt from a brand name that you trust, is the simplest way to nourish yourself, which will go a long way to taking care of your baby as well.” really is the “simplest” way to eat well, I know that a few extra vitamins, minerals, DHA and probriotic cultures won’t hurt, especially if you, like me, spent the first trimester eating mostly crackers and french fries.

I was reading an article about how anxious mothers tend to stop breastfeeding before their less anxious counterparts. Anxiety and depressive thoughts lead women to wonder if their babies are eating enough. These mothers are more likely to supplement with formula, add cereal to breast milk earlier than recommended, or stop breastfeeding entirely.

Before Sam was born I suffered from depression and anxiety and took medication for both disorders. Once he was born my hormones kicked into overdrive, and though I wouldn’t exactly call myself cheerful or perky, aside from some severe low points caused primarily by sleep deprivation I haven’t really been overly depressed or anxious since his birth. I truly believe that the hormones released from breastfeeding helped me.

I’d read enough before his birth to know that my milk may not come in immediately and that supplementing is not only unnecessary, it’s not recommended. I’d also read enough to know that breastfeeding isn’t easy. I knew that it takes work and practice and that despite all assumptions to the contrary breastfeeding really isn’t natural. Not any more. Not in this society, where the majority of our mothers (and in many cases their mothers ) didn’t breastfeed.

My milk didn’t come in for five days, and Sam was losing weight and hungry and awake all night and my nipples were raw and blistered from him sucking and sucking even though nothing was coming out. It was awful and I don’t think Bob and I will ever forget the sounds of his cries echoing in our hallways at four in the morning. But I knew that the rough patch would pass. I trusted my milk would come in eventually and it did. I was huge and engorged and it hurt, but I felt confident that I was able to feed my son.

Without support from women with experience, without the expectation that it’s going to be tough, many women give up. Depression and anxiety compound the difficulties and the natural sleep deprivation that comes with parenting a newborn make it easy to decide that breastfeeding just isn’t working.

Anyway, I just feel lucky that after Sam’s birth I was in an emotional state where I was able to continue nursing despite the difficulties. It wasn’t easy. It didn’t feel natural. I had mastitis several times and clogged ducts and overproduction issues. But I suffered through and it got better. Then it got good and it felt natural. And even though I was a clueless first time mother, as my teeny little baby started packing on the pounds I knew I was doing at least one thing right. Like Kelli said back in April, Breast is best.

The Lactivist posted about an online contest going on at Ideablob that allows anyone to post a business or non-profit idea and compete for $10,000, given away each month. The Motherwear Breastfeeding Blog is also encouraging people to vote.

One of the contestants is The Mothers’ Milk Bank of New England, a newly formed non-profit milk bank serving babies, hospitals, and families throughout New England.

The Milk Bank will provide screened and pasteurized breastmilk to premature and critically ill babies, primarily in neonatal intensive care units. This milk will be donated by volunteer mothers in our region. For sick and premature babies, breastmilk can mean the difference between life and death, and a short or long hospital stay. Studies have shown that premature babies who receive banked milk are far less likely to suffer life-threatening complications and have much faster recovery rates.

The Milk Bank needs money for:

1) Processing and storage equipment. $5,000 for the purchase of equipment; freezers, pasteurizers, refrigerator, etc.

2) Milk Money Fund. Insurance doesn’t always cover the cost of donor milk. $3,000 would be for our Milk Money Fund, to provide donor milk to families who cannot afford the processing and shipping fees.

3) Start-up marketing costs. $2,000 for publicizing the Milk Bank in our region, particularly to recruit potential milk donors i.e. radio public service announcements, web and print materials to educate the parents and medical providers about milk donation and use.

So, here’s our chance to make a big difference today. Here’s what to do:

·Go to the Milk Bank page on IdeaBlob, and vote for this project! You have to register first and confirm by email, which doesn’t take long.

·Blog or post about this wherever you can to help bring in more votes.

Thank you for your time today! And cross your fingers…

BPA is also present in many different brands of bottles and sippy cups. After reading numerous reports I ditched almost all of our sippy cup stash and replaced it with a few BPA free plastic sippy cups and two expensive, but awesome aluminum sippy cups.

Z Recommends has a series of posts on BPA and the companies that produce baby bottles and sippy cups. Here’s their shortlist of BPA-free baby products.

ZRecs BPA-Free Shortlist:
Bottles: Adiri | Born Free | MAM | Medela | Mother’s Milkmate
Sippys: Born Free | Klean Kanteen | Sassy | SIGG | Thermos
Pacifiers: Playtex | Gerber/NUK | First Years
Pumps and Supplies: Medela | Mother’s Milkmate

As for the unsafe, here’s their quick take:

If you are here to check on information about bottles or sippy cups you already have, we can say with some confidence that you should be most concerned if you are using bottles by Avent, Dr. Brown’s, Evenflo, the First Years, Munchkin, Nuby, Playskool, or Second Nature, or sippy cups or breast pumps by many of these brands. You are also likely, but less certain, to be using products containing Bisphenol-A if you are using bottles by Gerber, Playtex, or Tommee Tippee. We have included BFree in our “Brands to avoid” section for reasons of its own, which you can read at the link.

Read more about BPA levels in infant formula at Z Recommends.

I’m glad that more options for BPA-free products are coming into stores in time for my second child. Dr. Brown’s has already released a glass version of their popular bottle, Evenflo has glass bottles, and stores like Whole Foods stock other, less widely available brands like Born Free. It’s also a relief to know that one of my breast pumps is a Medela, as all of Medela products are made without BPA.

Of course breast is best, but if you feed your baby formula you may want to consider the risks of Bisphenol-A which has been found in mosts brands of baby formula. In December CNN reported that

The Environmental Working Group is a nonprofit research organization focused on public health and the environment. It does not take money from special interest groups. The group previously raised concerns about the presence of BPA in plastic baby bottles and is pushing for regulation of the compound.

“BPA is a chemical that is harmful at very low doses,” says Jane Houlihan, the organization’s vice president for research. “We’re talking about millions of babies exposed every year to this toxic chemical that’s found in infant formula.”

The Environmental Working Group surveyed the top five manufacturers of baby formula to determine whether they used BPA in their packaging. Here’s a summary of their findings:

* The makers of Nestlé, Similac, Enfamil and PBM (who make store-brand formulas sold at WalMart, Target, Kroger and dozens of other retailers) all said that they use BPA in the linings of metal cans holding liquid formula.

* Powdered formulas are a better choice. Our calculations indicate that babies fed reconstituted powdered formula likely receive 8 to 20 times less BPA than those fed liquid formula from a metal can.

To avoid exposing your child, breastfeeding is the best choice. Powdered formula is the next safest choice, especially Similac and Enfamil whose packaging only contains BPA on the tops and bottoms, not the cardboard sides. If you must feed your baby liquid formula, concentrated formulas in plastic containers are a better choice than ready to serve formula since the concentrate requires dilution.

Motherhood has turned me into a hippie. I breastfed my son for 22 months, started composting and gardening, began buying almost exclusively organic and local foods, I bring my own bags when I shop, I buy and use exclusively reusable water bottles, I’ve eliminated all toxic cleaning products from my house, and now I’m cloth diapering.

One of the benefits of turning into a hippie is that I’m not exposing my son to a variety of chemicals he’d otherwise be exposed to. Pesticides, weird food colorings, leaching plastics, and numerous hormones and antibiotics don’t have much opportunity to hang out in my house these days. Now that I’m pregnant with number two, I have yet another reason to be grateful I’m able to breastfeed: the absence of BPA in my future child’s system.

For those of you who aren’t aware of the current debates, Bisphenol-A, or BPA, is a controversial chemical that can leach out of can linings and plastics into your foods and beverages. Though it’s still legal to use in food grade cans and plastics, scientific studies have linked BPA to cancers, fertility problems, and behavioral problems. The Green Guide’s article on BPA says:

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).

The FDA says that BPA is perfectly safe and the effects of the plastics are only problematic in doses much larger than humans will consume. The fact that it can be problematic at all is what makes me pause. If there’s a possibility of harm, and newborns are especially susceptible, why is BPA present in baby formula and baby bottles?