Mama Knows Breast




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How Long Did You Breastfeed?

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Every mom has a different story about what worked best for her and her baby.  Some moms exclusively breastfeed.  Some exclusively formula feed. Some do a mixture of the two.  And as for introducing solids, there’s a range here as well.  Some pediatricians recommend starting solids at 4 months. Some say later.  The American Academy of Pediatrics recommends exclusive breastfeeding for 6 months.  And then continuing breastfeeding until at least 12 months.

Well, there’s a new editorial by some researchers in the UK who say exclusive breastfeeding for 6 months has some problems.  Here’s the story from ABC.com Watch this video.  And an important point that comes up at the end of the video, the researchers received funding at some point in the three years prior to the editorial from baby formula and food companies.

Federal Breastfeeding Policy

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From The Washington Post, a story about how new rules are helping federal workers who are breastfeeding and pumping:

Federal workers who need to breast-feed on the job should be given a reasonable amount of time, must be provided access to a clean, private room and might not be paid while doing so, according to new government personnel rules.

Administration officials quietly released changes to the government’s breast-feeding policy shortly before Christmas, soon after President Obama ordered updates to how federal agencies and departments accommodate breast-feeding mothers.

The changes, outlined in a memo issued by the Office of Personnel Management, apply to all breast-feeding employees of the executive branch and were among several provisions related to workplace health and safety in last year’s health-care law.

“As the nation’s largest employer, the federal government strives to be a leader in the promotion of wellness programs and progressive workforce policies,” OPM Director John Berry said in his memo to agency personnel chiefs.

According to the memo, agencies and departments must provide employees with “a reasonable break time to express breast milk” up to one year after the birth of a child. Breast-feeding employees must be given access to a private area other than a restroom that is shielded from public view and intrusion by coworkers.

Federal personnel rules do not require compensation for workers who take breaks to breast-feed or express milk, but several agencies provide compensated breaks of 15 minutes each in the morning and afternoon that employees could use for breast-feeding, the OPM said.

Breastfeeding Benefits

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A piece in The Huffington Post written by a doctor outlines the benefits of breastfeeding.  Here’s an excerpt:

While formula may be able to mimic the nutritional value, it can’t match breast milk in protecting babies from illness, nor is it as easily digestible by the newborn’s immature digestive tract. Epidemiological studies have shown that breastfed babies have fewer bouts with ear infection, respiratory infection, meningitis, diarrhea, and constipation. They also have lower risk of allergies, asthma, obesity, diabetes, childhood leukemia and sudden infant death.

The benefits to mothers are similarly impressive, with studies linking breastfeeding to lower risk for type 2 diabetes, breast cancer, ovarian cancer, hypertension, cardiovascular disease, and postpartum depression. The skin-to-skin contact with their babies causes the mother’s pituitary to release oxytocin, a hormone that helps milk flow, while at the same time helping the uterus to shrink after delivery.

From a purely practical standpoint, breast milk is always available, does not have to be warmed before feeding the infant and does not require lugging around a bunch of supplies. Also, breast milk is free and breastfeeding saves the cost of formula and supplies, which can tally up to more than $1,500 a year. Breastfed babies have been shown to be sick less often, resulting in lower health care costs and fewer missed days of work for parents. The government estimates the U.S. could save $13 billion a year in medical care costs if 90 percent of new mothers breastfed exclusively for six months.

Lactation Rooms on Capitol Hill

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The New York Times has a cool story today about the lactation rooms for people who work in Congress.

There are four lactation suites throughout the Hill — two in House office buildings, one that is undergoing renovation in a Senate office building and one in the Capitol itself — along with several health stations. All are clean, private areas where mothers can nurse their babies and pump their milk. They are also one of the few truly bipartisan spaces left on the Hill, neutral zones amid partisan warfare.

“I definitely got to know Republicans who I wouldn’t have otherwise known,” Ms. Walsh said. “Especially with all of the limitations on travel and trips and everything like that these days, there’s not a lot of camaraderie up there, there’s not a lot of room to meet people on the other side of the aisle.

“You all have something very significant in your life in common,” she said, “and you can all relate to each other and sympathize” about the difficulties of motherhood.

The first suite specifically for lactating mothers on the Hill was opened in the fall of 2006, by Congress’s Office of the Attending Physician. But after taking up the gavel in 2007, Nancy Pelosi, the first female House speaker, was instrumental in making that chamber what she called “family-friendly for new mothers.” She opened the first nursing-only rooms on the House side, and others soon sprang up.

“It is good for our country — more young moms in Congress, pretty soon more women leaders in Congress,” Ms. Pelosi said at a news conference in 2009. “And, who knows, maybe one of these new young moms will be the president of the United States.”

The rooms, which can be entered only through doors with electronic locks, are similar to those in many large corporations, with hospital-grade breast pumps, comfortable chairs and couches, a sink and a mini-refrigerator. There are also a smattering of magazines, telephones and a television often used for watching floor votes — this is Congress, after all.

Besides bottles filled with mothers’ milk, they have also yielded unexpected job opportunities, moments of quiet reflection amid the bustle of Congress and some unlikely friendships.

Finding Breast Milk on the Internet

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This CNN story is the latest in a burst of press about the growing movement to buy breast milk on the Internet. More and more, it seems mothers are using technology to find a modern day equivalent of a “wet nurse.”  There’s the Facebook group called Eats on Feets and there is also Only The Breast.com

But this option is not without controversy.  Tanya of the Motherwear Breastfeeding Blog outlines some of the issues. And recently, The FDA  issued this statement:

Consider the possible safety risks

If you are considering feeding a baby with human milk from a source other than the baby’s mother, you should know that there are possible health and safety risks for the baby.  Risks for the baby include exposure to infectious diseases, including HIV, to chemical contaminants, such as some illegal drugs, and to a limited number of prescription drugs that might be in the human milk, if the donor has not been adequately screened.  In addition, if human milk is not handled and stored properly, it could, like any type of milk, become contaminated and unsafe to drink.

FDA recommends against feeding your baby breast milk acquired directly from individuals or through the Internet

When human milk is obtained directly from individuals or through the Internet, the donor is unlikely to have been adequately screened for infectious disease or contamination risk.  In addition, it is not likely that the human milk has been collected, processed, tested or stored in a way that reduces possible safety risks to the baby.

FDA recommends that if, after consultation with a healthcare provider, you decide to feed a baby with human milk from a source other than the baby’s mother, you should only use milk from a source that has screened its milk donors and taken other precautions to ensure the safety of its milk.

There are human milk banks that take voluntary steps to screen milk donors, and safely collect, process, handle, test, and store the milk.  In a few states, there are required safety standards for such milk banks.  FDA has not been involved in establishing these voluntary guidelines or state standards.

You can contact your state’s department of health to find out if it has information on human milk banks in your area.  Another source of information is the Human Milk Banking Association of North America (HMBANA), a voluntary professional association for human milk banks (http://www.hmbana.org/. disclaimer icon).  HMBANA issues voluntary safety guidelines for member banks on screening donors, and collecting, processing, handling, testing and storing milk.

Why We Won’t Get a Dog as a Chanukah Gift

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Update on December 6th: We are now the proud caretakers of Joey and Rocky, two gold fish.

The people who live next door to us have a dog.  So do the people across the street.  The same goes for several families down the hill, and up the hill as well. You can imagine the chorus when one neighborhood canine starts barking.

There are simply dogs everywhere in our new suburb.  In fact, the week we moved in, a polar bear sized white beast (I’m not exaggerating), escaped (again) from his house.  It took six kids to corral him, attach a leash and walk him home.

Hence, you can understand why the boys want a dog for Chanukah.   Much to their regret, it’s just not going to happen.

I didn’t have a dog growing up, and while I resented my parents’ decision, I am apparently inflicting the same fate on my kids.  Fortunately, my husband, who grew up with cats, agrees.

We recognize the myriad benefits of having a dog.  It would be a companion for the kids; a way for them to learn responsibility.  But you all know the reality… I would be the one walking, feeding and caring for the dog.  I would be the one going to the vet.  I would be the one wielding endless rolls of tape to get the dog hair off the couch.

Plus, I now have this to back up my argument: having a pet costs money.  A recent story in the New York Times exhorted readers to think about the costs of owning a pet before making a holiday gift purchase.

Yet the reality is that pets cost far more than many people expect. And right now, as the economy continues to stumble, those costs have become a burden to many people, like the cat lover who cannot afford medical care or the horse owner struggling with boarding fees.

The problem is that the general information out there is not realistic. The American Society for the Prevention of Cruelty to Animals estimates the cost for a large dog at $875 a year for food, medical expenses, toys and a few related expenses, and $560 for first-year setup costs. The estimate for a cat is $670 a year, with first-year expenses of $365, for a total of $1,035.

The Times goes on to talk about how those numbers can really run much higher.  But that’s not what this story is about.  Pure and simple, I am not bowing to the neighborhood pet pressure.

Besides, I think I’ve come up with some other Chanukah presents that might take their mind off the dog thing.  This year, I’m leaning towards the type of gifts that take time, make a mess, and require a dash of creativity.  So far I’ve stashed away some paint, glue, wax, felt, Popsicle sticks and Legos.  And if I end up with a Popsicle stick puppy or a floppy-eared wax figurine, well, I’ll deal with the guilt then.

In the meantime, our youngest will just have to stick with his favorite stuffed animal named “Bow Wow.”  And maybe a goldfish or two.

Study Finds It’s Too Easy For Parents To Give Kids The Wrong Medicine Doses

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Recently, in the middle of the night, I found myself squinting at the markings on the side of a medicine dispenser.  One teaspoon?  Where was the half-teaspoon marking?  The thing was virtually illegible.

It turns out many parents face similar challenges when trying to give their kids the correct dosage of a medicine, and it has dangerous consequences.

In 2009, the US Food and Drug Administration responded to reports of unintentional drug overdoses among children who took over-the-counter medicines.  The FDA issued guidelines that recommended greater consistency and clarity in OTC medication directions and measuring devices.

Now, a new study just published by the Journal of the American Medical Association has confirmed that this is sorely needed.  Researchers found that 98 percent of the top selling OTC children’s medications sold in 2009 had confusing and inconsistent dosing directions and markings on the dispensers.  From The Wall Street Journal:

[The study] looked at 200 OTC pediatric liquid medications and found that 74% came with a measuring device such as a cup or syringe, almost all of which contained at least one inconsistency, such as extra markings on the measurement device that weren’t relevant to the dosing instructions. (A full 81% of products studied had superfluous markings.)

And from WBUR and National Public Radio:

The industry group that represents makers of over-the-counter kids’ medications, the Consumer Healthcare Products Association, says they’ve already made some progress in improving dosing instructions for parents.

They’re moving closer to adopting consistent units of measurement, so that the directions on the bottle match the markings on the dosing device.

“It will take between now and next year to fully implement the guidelines,” says CHPA’s Barbara Kochanowski.

In the meantime, what’s a parent to do?  First of all, I never use a teaspoon or kitchen spoon. Those are notoriously innacurate.  Mainly, my approach is to make sure I ask the pediatrician what dosage to give.  I find that sometimes the doctor’s order is actually different than the recommendation on the packaging.  And from now on, I’m going to make sure I look at the dispenser in the light of day, when my eyes can focus better.  And when I’m really in doubt, well that’s what waking up a spouse is intended for.

Breastfeeding and Mom’s Sleep

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Babies don’t sleep through the night.  They just don’t.  Parents never get any sleep.  And that is never going to change.

I’ve often heard people claim that breastfeeding moms get the least amount of sleep because they have to wake up to breastfeed.  But that just didn’t ring true with my experience.  If I had been bottle feeding, I would have had to get up anyway.  I would have had to get out of bed, make the formula, stumble back to the bedroom… all with a screaming child.  Yes, my husband could have done some feedings, but there was little chance I was going to sleep through that.

So I wasn’t surprised to see the results of a new study which found that moms who breastfeed are not losing any more sleep than moms who formula feed.  Here’s a link to the study in the journal Pediatrics. And from Reuters:

Contradicting the suspicion that breastfeeding moms get less sleep, the results represent “good information to be able to tell women, (that) ‘not breastfeeding is not going to help you get better sleep,’” study author Dr. Hawley Montgomery-Downs of West Virginia University told Reuters Health. “And the benefits (of breastfeeding) for both mom and baby are tremendous.”…

There has been an “urban myth” that women who breastfeed get less sleep, Montgomery-Downs noted, which may cause some to hesitate to do so. Caring for a newborn is challenging enough, without being sleep-deprived, and some research has even suggested poor sleep after childbirth may increase the risk of postpartum depression…

When Montgomery-Downs and her colleagues asked 80 new mothers to report how often they woke up and how rested they felt, and to wear sensors that measured how long and efficiently they slept, they found no significant differences between those who relied on breastfeeding, formula, or both. They report their findings in the journal Pediatrics…This suggests that “there may be some kind of compensation” for breastfeeding mothers, Montgomery-Downs said in an interview.

For instance, babies who breastfeed may wake up more (and wake up their parents more), but those nighttime feedings may have less of an impact than if they were drinking formula, she suggested. In order to prepare a bottle, women often have to get up, turn on the lights, and move around quite a bit, all of which may make it harder for them to go back to sleep.

Alternatively, when breastfeeding, women may be awake for shorter intervals, and be less active, which makes it easier for them to go back to sleep. Women who breastfeed also have higher levels of the hormone prolactin, which facilitates sleep, Montgomery-Downs noted. And if the babies are sleeping next to the mothers, they may feed while the mother is sleeping, she added.


Breastfeeding and Vitamin D

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MSNBC has a story that’s a reminder that Vitamin D is especially important for young children and infants. From the story:

…(B)reast milk — considered the best source of nutrition for babies — is low in vitamin D. The American Academy of Pediatrics (AAP) recommends all children, including infants, get 400 international units (IU) of vitamin D per day, an amount that is not possible to get from breast milk alone, experts say. And while people can also get vitamin D from sunlight, the AAP advises that infants younger than six months avoid exposure to direct sunlight due to skin cancer risk.

So what’s a mom to do?

The AAP recommends vitamin D supplements, in the form of drops, be given to breast-fed babies shortly after birth…Only about 5 percent to 13 percent of breast-fed babies received vitamin D supplements between 2005 and 2007, according to a study published in April in the journal Pediatrics. These low numbers might stem from the misperception that breast milk contains everything the baby needs, experts say.

So why is Vitamin D important? From the Mayo Clinic’s website:

The major biologic function of vitamin D is to maintain normal blood levels of calcium and phosphorus. Vitamin D aids in the absorption of calcium, helping to form and maintain strong bones. Recently, research also suggests vitamin D may provide protection from osteoporosis, hypertension (high blood pressure), cancer, and several autoimmune diseases.

Rickets and osteomalacia are classic vitamin D deficiency diseases. In children, vitamin D deficiency causes rickets, which results in skeletal deformities. In adults, vitamin D deficiency can lead to osteomalacia, which results in muscular weakness in addition to weak bones. Populations who may be at a high risk for vitamin D deficiencies include the elderly, obese individuals, exclusively breastfed infants, and those who have limited sun exposure. Also, individuals who have fat malabsorption syndromes (e.g., cystic fibrosis) or inflammatory bowel disease (e.g., Crohn’s disease) are at risk.

Here’s a link to the AAP recommendations.  As always, before you make any decision about a vitamin supplement, check with your pediatrician.

Working on a New Book About Toilet Training

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We did our civic duty today and took the kids to vote with us. They were very excited to put the ballot into the slot and were fascinated by the camera crews. But now…on to a mess of a different sort… toilet training.

We’re still dealing with nighttime bed wetting with one of the kids, so that has been an inspiration of sorts for my next book. I’ve put together a book proposal for a toilet training book, and the working title is “Parents Know Poop: 100 Toilet Training Tips.”

I’m really excited about this one, and tomorrow night I get to pitch my idea at a MediaBistro event. I’m a finalist in a book pitch contest. So tomorrow night, in front of a distinguished panel of publishing execs, I’ll get to use some of the very words I’m trying to erase from the kids’ vocabulary.

Wish me luck! Oh, and leave a comment here with your best toilet training tips, tricks and tribulations. If you’ve got a really good one, I’ll add it to my proposal.