Mama Knows Breast

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Tongue Tied Babies

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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, 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

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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.

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

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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).

Leave A Comment and Enter to Win Weleda Baby Lotion and Soap

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When our kids were newborns, I hated bath time. I was scared. In my eyes, water plus baby equaled danger. I wouldn’t bathe them unless another adult was around. As a result, the kids sometimes went more than a week without a bath. But it didn’t really matter. They weren’t all that dirty. And besides, “baths dry out the skin,” I rationalized.
Once we hit the sandbox years all that changed. Apple sauce and yogurt made baths a necessity. So I figured out various tricks to make things feel less precarious. My all time best move– using a towel under their armpits to lift them out of the bath. It worked wonders.
And these days, there are definitely high points in the bath routine. The boys now ask to take a “brothers’ bath.” Together, they bathe their ducks and “wash” the tub walls. There are even comedic moments. The Bear (2 years old) once announced, “Mommy, a nugget.” (That’s his word for a little poop). And sure enough, I found a marble-sized green ball in the water.
Even so, I sometimes avoid bath time for a different reason– pure exhaustion. With a 2 year old and a 3 year old, baths involve an incredible amount of wrangling– into the bathroom, clothes off, into the tub, spash splash plash, out of the tub, moisturize, diaper on before there’s a pee on the floor, pajamas on. It’s like herding recalcitrant cattle.
But maybe I don’t need to dread all of this so much. Weleda, the makers of organic personal care and medicinal products recently contacted me to tell me about their items for babies. So far, I’ve tried the Calendula Lotion and Calendula Cream Bath. Both have a lovely scent that reminds me of a spa. I can’t tell you what the kids think of these products– we’re away and I’m not about to try anything new on them while we’re not home. I did, however, test the products on my own skin, which is extremely sensitive and prone to exczema. And so far so good. (But before you try any new products on a child with rash prone skin or allergies, check with your pediatrician).
Weleda has offered to give away five sets of the lotion and cream bath. So I’m holding a little contest. Leave a comment with your favorite bath time story. I’ll then pick five winners at random. The contest deadline is March 30th.

Smoking and Breastfeeding

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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

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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

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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

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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

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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

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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.