Mama Knows Breast




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Earth’s Best Recall- Apple Peach Barley

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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

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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

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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.
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.

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

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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

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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

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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

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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

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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

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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

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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.