Riskfactors overweight

Weight of children and adults depents for a major part on what and they ate as infants and toddlers. People who enjoyed fruits and vegetables as young child will probably have healthier eating habits and are less at risk for overweight and companying diseases. According to research from Monell Chemical Senses Center children breastfed by breastfeeding mothers who eat a variety of fruits and vegetables (and mothers who breastfeed eat more fruits and vegetables then their formula feeding counterparts) tend to like fruits and vegetables better and are more willing to explore new tastes. Breastfeeding is a security measure in its own, as children fed formula tend to are more easily overfed and grow at an increased rate. Children fed on a protein hydrolysate formula are at less risk, because the pre-digested proteins are giving a stronger satiety signal then the cow’s milk proteins in regular formulas. Also children who are being bottle-fed by mothers who have trouble reading and interpreting the hunger and satiety cues of their infant are at increased risk of being overfed now and become overweight later in life.
Monell Chemical Senses Center (2007, December 4). Eat Fruits And Veggies While Breastfeeding And Baby Will Probably Like Them. ScienceDaily.
Julie A. Mennella, Alison K. Ventura, and Gary K. Beauchamp. Differential Growth Patterns Among Healthy Infants Fed Protein Hydrolysate or Cow-Milk Formulas. Pediatrics, 2010; DOI: 10.1542/peds.2010-1675
Worobey et al. Maternal Behavior and Infant Weight Gain in the First Year. Journal of Nutrition Education and Behavior, 2009; 41 (3): 169 DOI: 10.1016/j.jneb.2008.06.005

New mother - new baby

Getting used to your new role as mother: Am I doing it right, is my baby quite normal, Am I normal, ...? Checklist for new moms to get to know their child quickly and 'doing things right'.
Keep baby close to you in the first weeks, no more then a arm's lenth distance and as much as possible in close body contact. - By being close you get to know and love each other soon and learn each others language quickly.
Use instichts and reflexes that are innate for boh mothers and babies. - If baby is lying on his belly, supported all over, his nervous system will work at best and he can use all of his in-born instichts and reflexes to find his food and start dinner all by hinmself; if you are comfortably laid back, you can relax and enjoy working with him.
Baby stomachs are small and mom's milk digests easily. make sure baby can eat frequent small meals; that will make it easy to difest so he will grow well without colick and fuss and your milk supply will be firmly settled.
Uvnas Moberg K: De Oxytocine factor. Thoeris, 2007. ISBN-13: 9789072219213
Colson S: An Introduction to Biological Nurturing: New Angles on Breastfeeding. Hale Publishing, 2010. ISBN    0984503935, 9780984503933

Structured baby care

Becoming a parent is one major change in any adults’ life. The care and responsibility for another and vulnerable life carries a heavy eight. Fitting in another human being with different needs and without any intellectual means of communication into a structured way of living is a very hard chore for many a parent. In their drive to assist others some health care providers answer to these dilemma’s in developing programs and structures to aid parents to care for their child in structured way, fitting into their adult life style. They fancy that what fits adults, will fit infants. For easiness sake they forget that babies are by definition not miniature adults, but beings with completely different needs for growth and development. Ignoring those innate needs of an infant for near constant human contact and frequent small meals and naps can create severe negative consequences for both physical and psycho-emotional growth and development.
Aney M: ''Babywise' advice linked to dehydration, failure to thrive. AAP News 1998 14:21
van Veldhuizen-Staas CGA: Over het huilen van baby's (1998, 2005). http://eurolac.net/index.php?p=87
van Veldhuizen-Staas CGA: Inbakeren - wat en hoe; waarom wel of niet (2001, 2005, 2006) http://eurolac.net/index.php?p=88

Cheers!

During December holidays a glass to accompany dinner or to wish the best is a must. Often breastfeeding women are advised to absolutely not drink any alcohol at all or to pump and dump, but is that advise valid? Alcohol does transfer into milk in very small amounts. The concentration of alcohol in milk reflects the amount in mothers’ blood. If moms drinks one standard consumption with say 8% alcohol, her blood and her milk will contain 0.2 per mille. This is too little to affect her child. According to Hale (2010) moms alcohol in blood needs to be 3 per mille to negatively affect her baby. With these amounts driving a car is illegal (in The Netherlands) and one could wonder if a woman who is thought to be not able to drive a car is able to be responsible for the care of an infant. Chronic and heavy alcohol consumers are advised against breastfeeding, but an occasional glass at a festive dinner or to welcome  the New year can be enjoyed without fear. To be absolutely sure one can choose to delay breastfeeding to about 2 hours after consuming one glass of alcoholic beverage. Research has shown that children consume less milk at breast as long as mom has alcohol in her blood and her milk, but that they catch up in the hours following that. Merry and safe Holidays and a Happy and healthy 2011!
Hale T: Medications and Mothers’ Milk, Hale Publishing, Amarillo TX, 200813, p 382-384

Holidays

Eurolac Lactation Consulting wishes every one Christmas and other holidays like they have always wanted them to be, with lots of love, warmth and attention for all loved ones. For the breastfeeding moms: survical guides for feeds and feasts

Ecoparents: Borstvoeding en de feestdagen/Breastfeeding during the holidays. http://www.borstvoeding.ecoparents.com/feest.html / http://www.breastfeeding.ecoparents.com/holidays.html

Kenniscentrum Borstvoeding: Even rust. http://www.borstvoeding.com/columns/rust.html

About.com: Dealing with Breastfeeding During the Holiday Season. http://breastfeeding.about.com/od/resourcessupport/a/holidayseason.htm

Cupcake Mommies: Breastfeeding and the holidays. http://www.cupcakemommies.com/breastfeeding-and-the-holidays/

Best for Babes: Holiday Style Guide for Breastfeeding Babes. http://www.bestforbabes.org/2010/12/holiday-style-guide-for-breastfeeding-babes/

Early introduction of solid foods

Feeding practices in early childhood are known to have great impact at the evolution of weight in the rest of life. Early introduction of solid food is linked to a faster weight gain in infancy and therefor possibly with an increased overweight risk later on in life. Griffiths et al found a small, but on the scale of public health very significant difference in the growth of children with early or later introduction of solids. They conclude that mothers should explicitly be advised to hold on to the international standard to exclusively breastfeed for 6 months. Sloan c.s. related faster growth in children when they were weaned from the breast earlier. They linked this to a possible problem with overweight in preschoolers. Kim & Peterson detected a interesting link between place and method of child care, breastfeeding initiation and growth. Children who were for at home by their own parents tended to be more breastfed and introduced to solids alter then children taken care of in professional child care settings or by relatives or friends.
Kim J; Peterson KE: Association of Infant Child Care With Infant Feeding Practices and Weight Gain Among US Infants. Arch Pediatr Adolesc Med. 2008;162(7):627-633.
L J Griffiths LJ, L Smeeth L, S Sherburne Hawkins S, T J Cole TJ, C Dezateux C: Effects of infant feeding practice on weight gain from birth to 3 years.Arch Dis Child 2009;94:577-582.
Sloan S, Gildea A, Stewart M, Sneddon H, Iwaniec D: Early weaning is related to weight and rate of weight gain in infancy. Child: Care, Health and Development, 2008, 34(1):59-64.

Posture, health and safety

Lots has been said about the best for health and safest positions for babies to sleep. Since the world wide back to sleep campaigns the numbers of SIDS victims went down (although the fact that 2 things go on at the same or subsequent time do not prove any causal connection!), but other conditions, like funny misshaped heads with possible brain damage, increased. Sleeping on the back probably works as a SIDS prophylaxis because it makes it easier for the child to arouse and thus prevents him from sleeping so deeply that he forgets to breathe (which after checking off all confusing other factors is the essential definition of cot death). Besides, laying on the back is a very non-physiologic posture for a newborn, especially when he is alone. Among others it decreases his neurologic behavior and reflexes; laying on the tummy enhances neurologic beaviour and reflexes, thus stimulates breastfeeding. Good reflexes, being with another human being and breastfeeding all decrease SIDS risks and enhance each other when applied together.
Gettler LT, McKenna JJ: Never Sleep with Baby? Or Keep Me Close But Keep Me Safe: Eliminating Inappropriate Safe Infant Sleep Rhetoric in the United States. Current Pediatric Reviews, 2010,  6:71-77.
Colson SD, Meek JH, Hawdon JM: Optimal positions for the release of primitive neonatal reflexes stimulating breastfeeding. Early human development, 2008, 84(7):441-449.

Early influences on breastfeeding and health

Anzman c.s. explore their article the influence of early interventions and feeding habits on the incidence and prophylaxis of obesity and related illnesses later. Since parents have major influence in the early years and are the ones to decide exactly what their children eat and drinks, this is a good time for placing a health basis and implement healthy habits. What is to be considered healthy food and drinks is not not evident for all parents. Hampson et al found that mothers who scored high on Negative Affectivity during pregnancy were more likely to start solids at 3 months and offer sweet drinks from 6 months on. Health care providers who work with pregnant women might want to observe extra for signs of Negative Affectivity and take extra precautions in the form of prenatal information. Possibly a note in mothers’ charts may assure extra care in the well-baby clinic in order to ensure exclusive breastfeeding for 6 months and healthy beverage choices afterwards.
Hampson SE, Tonstad S, Irgens LM, Meltzer HM, Vollrath M: Mothers’ Negative Affectivity During Pregnancy and Food Choices for Their Infants. Int J Obes, 2010, 34(2):327.
Anzman S,  Rollins B, Birch L: Parental influence on children's early eating environments and obesity risk: implications for prevention. Int J Obes 2010, 34
(7):1116-1124

Breastfeeding and dental health (1)

It is often thought that breastfeeding will cause caries en mothers are advised to discontinue night feedings or all breastfeeding from the moment of eruption of the first teeth. According to research, amongst others performed by dr. Brian Palmer, DDS, this is an incorrect advise and instead breastfeeding and human milk will protect teeth and dental development. Calcium in milk (species specific) can stop and even partially undo demineralization of teeth, lactose is a less-available food source for caries inducing bacteria and human milk contains active, living components that fight especially the bacteria responsible for caries. Important research findings include the prehistiric  infant and toddler skulls with no signs of tooth decay, although it may be assumed that these children were breastfed very frequently and for extended periods.
www.brianpalmerdds.com

Breastfeeding in emergencies

Natural disasters as well as man-made emergencies are inevitable. Breastfeeding is a main precaution mothers can take in order to secure their childrens health and well-being in all circumstances. Artificial infant milks can be unavailable or it may be impossible to prepare or feed it safely. In the coming cold season it can easily happen to get struck in traffic for longer then planned. Make sure there's always a clean set of diapers and clothing in the car, as well as lots of drinking water and a blanket for each person. For infant and toddler food and drinks in the form of breastfeeding are ready available. Make sure to feed often to avoid dehydration and to ensure sufficient milk production. In the event of major natural disasters like earthquakes or floods, when it may take quite some time for help to arrive and the supply of fresh water and energy may be out of order for prolonged periods, breastfeeding is the best care for young children. Unlike the common beliefs stress will not dry milk up or prevent women to breastfeed and women who were not breastfeeding prior the the disaster can relactate. 
http://www.wellstart.org/Infant_feeding_emergency.pdf

Immunisation

Breastfeeding protects children against all kinds of diseases the mother has lived through and that the child himself colonizes his mother with. Research showed that maternal vaccination also protects her child. Eick et al found that the breastfed children of mothers who got a seasonal flu shot showed less influenza or influenzlike symptoms during the first half year of life. Vicor c.s. conducted a very interesting study that showed that preconceptional maternal immunisation can protect a child via breastfeeding to develop allergies. Maternal immunization with ovalbumin upregulates the inhibitory FcγRIIb expression on offspring B cells, avoiding skewed Th2 response and development of allergy. These findings contribute to the advancement of prophylactic strategies to prevent allergic diseases in early life. This might be a better prevention of allergies then the premature (between 4 and 6 months) introduction of solids.
Eick AA; Uyeki TM; Klimov A; Hall H; Reid R; Santosham M; O'Brien KL: Maternal Influenza Vaccination and Effect on Influenza Virus Infection in Young Infants. Arch Pediatr Adolesc Med. 2010;0(2010):archpediatrics.2010.192.
Victor JR, Muniz BP, Fusaro AE, de Brito CA, Taniguchi EF, Duarte AJS, Sato MN: Maternal immunization with ovalbumin prevents neonatal allergy development and up-regulates inhibitory receptor FcγRIIB expression on B cells. BMC Immunology 2010, 11:11

Education, ethnicity and breastfeeding

The Generation R Study is a population-based prospective cohort study from fetal life until young adulthood. The study focuses on 4 primary areas of research: growth and physical development; behavioural and cognitive development; diseases in childhood; and health and healthcare for pregnant women and children. In total almost 10,000 mothers with a delivery date from April 2002 until January 2006 were enrolled in the study. Sub-studies looked at breastfeeding. Exclusive breastfeeding until the age of 4 months and partially thereafter was associated with a significant reduction of respiratory and gastrointestinal morbidity in infants. These findings support health-policy strategies to promote exclusive breastfeeding for at least 4 months, but preferably 6 months, in industrialized countries. These goals however were not reached by the research subjects (mothers and children from all over Rotterdam from all backgrounds and classes). Especially the most vulnerable children, those with lowest-educated mothers, were less likely to start breastfeeding (73% compared to (95% for those with highest-educated mothers) and for shorter duration (15% breastfed up to 6 months, compared to almost 40% for highest educated mothers).  Also ethnicity is a determining factor for breastfeeding initiation and continuation. More non-native mothers started breastfeeding than native mothers, but relative fewer continued. In both native Dutch and non-native mothers breastfeeding continuation rates are low.
van Rossem L, Oenema A, Steegers EAP, Moll HA, Jaddoe VWV, Hofman A, Mackenbach JP, Raat H: Are Starting and Continuing Breastfeeding Related to Educational Background? The Generation R Study. Pediatrics 2009 123: e1017-e1027
Jaddoe VWV, Hofman A, Mackenbach JP, Raat H: Breastfeeding patterns among ethnic minorities: the Generation R Study. J Epidemiol Community Health jech.2009.Published Online First: 8 December 2009
Duijts L, Jaddoe VWV, Hofman A, Moll HA: Prolonged and Exclusive Breastfeeding Reduces the Risk of Infectious Diseases in Infancy. Pediatrics 2010 126: e18-e25

Breastfeeding and contraception.

Women who breastfeed are less likely to use hormonal contraceptives. Within 6 weeks after weaning to artificial infant food many women in the Van Wouwe et al study start oral contraceptives (OCP). The researchers advise to include more attention is given to this aspect that may decrease breastfeeding duration in the  BFHI (Baby Friendly Hospital Initiative) materials. According to the outcomes of the review of the literature Kapp c.s. conducted this fear for OCP may be unnecessary.  In multiple studies they found no evidence of possible negative effects of progestogen only OCP’s; the evidence for safety for the breastfed child was less strong, due to methodologically limited studies. Who none the less wants to avoid OCP’s modern fertility awareness-based methods (FABMs) of family planning are a valid option. Pallone & Bergus urge family physicians to get more expertise in counselling their patients is these methods.
Van Wouwe JP, Lanting CI, Van Dommelen P, Treffers PE, Van Buuren S: Breastfeeding duration related to practised contraception in the Netherlands. Acta Pædiatrica 2009, 98(1):86-90
Kapp N, Curtis K, Nanda K: Progestogen-only contraceptive use among breastfeeding women: a systematic review. Contraception 2010, 82(1):17-37.
Stephen R. Pallone SR and George R. Bergus GR: Fertility Awareness-Based Methods: Another Option for Family Planning. J Am Board Fam Med 2009; 22: 147-157

Herbs and breastfeeding

Breastfeeding not always comes easy and many mothers find they have to tackle bumps and sills and fight wolves and bears to get and keep breastfeeding going. There are, though, all kinds of devices and techniques they can use to aid them in their quest. Many people like to turn to herbal remedies to do so, while others say that won’t work. Fecka & Turek testd how much of the active substance gets into the fluid if you make tea of peppermint, melissa or sage. Thy actually found he amounts of it in the teas. While rsearching sage Gali-Muhtasib founds this not only to be a strong lactation inhibitor, but to have anti-inflammatory and antimicrobial properties as well as being a strong anticancer agent. Melli at al in their search for the use of peppermint in sore nipples found that women who applied peppermint gel rather than lanolin or a placebo gel showed less nipple damage after two weeks of preventive application. They urge to teach women proper techniques as well as prophylactic use of peppermint gel.
Fecka I,  Sebastian Turek S: Determination of Water-Soluble Polyphenolic Compounds in Commercial Herbal Teas from Lamiaceae: Peppermint, Melissa, and Sage. J. Agric. Food Chem., 2007, 55 (26), pp 10908–10917
Gali-Muhtasib H: Anticancer and medicinal properties of essential oil and extracts of East Mediterranean sage (salvia triloba). Advances in Phytomedicine 2006, 2:169-180
Melli MS, Rashidi MR, Nokhoodchi A, Tagavi S, Farzadi L, Sadaghat K, Tahmasebi Z, Sheshvan MK: A randomized trial of peppermint gel, lanolin ointment, and placebo gel to prevent nipple crack in primiparous breastfeeding women. Med Sci Monit. 2007 Sep;13(9):CR406-411.

A good start

The last decennia much has changed in the perinatal care and the routines have become  breastfeeding friendly. An important development was that children were not taken away from their mothers right away and that children could stay in mom’s room. More recently the importance of skin-to-skin contact is being recognised and most babies are allowed to spend some time undressed on their mothers’ tummies right after they are born. Research shows that skin contact good is for babies, for the initiation of mother-baby bonding and the initiation of breastfeeding. Moore & Cranston Anderson found a difference in the early days of breastfeeding, but not after a month. Olson et al found in their research that the decrease in breastfeeding after some weeks, despite intensive counselling and instruction, may very well be caused by the cessation of skin-to-skin position after the 1e hour postpartum and the first breastfeeding. She found that human infants ar not dorsal feeders (with pressure needed along the baby's back), but rather abdominal feeders and, like many other animals. In the prone position they show a diversity of reflex activity aimed at searching and finding the breast, latching on and maintaining milk flow. This way of breastfeeding (Biological Nurturing) prevents much of the ‘’fighting at the breast’’ behaviour many infants show at being put to breast and it enhances effective and do-it-yourself latching on.
Colson SD, Meek , Jane M. Hawdon JM: Optimal positions for the release of primitive neonatal reflexes stimulating breastfeeding. Early Human Development 2008, 84(7):441-449.
Moore ER, Cranston Anderson G: Randomized Controlled Trial of Very Early Mother–Infant Skin-to-Skin Contact and Breastfeeding Status. Journal of midwifery & women's health 1 March 2007 (volume 52 issue 2 Pages 116-125

Vintage

Vintage means giving old things a new meaning. Biological Nurturing is as old as (wo-)mankind en Suzanne Colson puts it forward as a new means of looking at breastfeeding. As superb as vintage styling. From the preface: ‘’ Most health professionals believe that mothers need to be taught how to breastfeed. An Introduction to Biological Nurturing describes new research evidence suggesting that mothers and babies innately know how to breastfeed, and introduces a new approach called biological nurturing. Biological nurturing is a collective term for optimal breastfeeding states and positions whose interaction release spontaneous behaviours helping mothers and babies get started with feeding. Biological nurturing is quick and easy to do. Most moms and babies automatically move into the correct positions if left on their own. The challenge for health professionals lies with understanding the releasing mechanisms and learning how to help mothers and babies do what comes naturally. This book restores confidence in nature's biological design and in mothers' innate capacity to breastfeed.’’
Colson S: An introduction to Biological Nurturing; new angles on breastfeeding. Hale Publishing, Amarillo TX, USA, 2010

Safe milk

Almost every child is best fed and nurtured when directly at breast. For all kinds of reasons for some children this is not possible for short or long time and they need expressed milk from their own  mother or a donor. Freshly expressed not manipulated milk is first choice, because it contains all vitamins and immunologic properties. When milk has to be stored there will be some loss of nutrients and immunologic properties, depending on time and temperature stored and material of storage container. Many institutions do not allow the use of raw milk for far of infection risks. Donor milk and sometimes even mom’s own milk, must be pasteurised. Common procedure is Holder pasteurization (63°C for 30 minutes). This will destroy all pathogens, but also a substantial part of immunologic factors. In studies in Europe, Africa and Northern America another pasteurisation method, Flash Heating or high-temperature short-time (HTST) pasteurization process (72°C for 16 seconds), proofed to be a safe way to destroy many pathogens, but safe most immunologic properties. In Flash Heating the glass milk container is put in a pan of cold water, which is brought to a boil and then removed from the heat source, rather then hated directly to  72°C and kept there for 16 seconds. This makes it a very safe and easy to use as an at home method of pasteurisation.
Akinbi H, Meinzen-Derr J, Auer C, Ma Y, Pullum D, Kusano R, Reszka KJ, Zimmerly K: Alterations in the Host Defense Properties of Human Milk Following Prolonged Storage or Pasteurization. Journal of Pediatric Gastroenterology & Nutrition 2010, 51(3):347–352
Terpstra FG, Rechtman DJ, Lee ML, Van Hoeij K, Berg H, Van Engelenberg FAC, Van't Wout AB: Antimicrobial and Antiviral Effect of High-Temperature Short-Time (HTST) Pasteurization Applied to Human Milk. Breastfeeding Medicine 2007, 2(1):27-33.
Chantry CJ, Israel-Ballard K, Moldoveanu Z, Peerson J, Coutsoudis A, Sibeko L, AbramsB: Effect of Flash-heat Treatment on Immunoglobulins in Breastmilk. J Acquir Immune Defic Syndr. 2009; 51(3):264–267.

More Mommy Milk

Throughout human history women have used all kinds of food products to support their milk supply. Scientific research has shown that accurate breastfeeding techniques, including frequent feeding and using adequate techniques to empty the breasts thoroughly are the basis for an ample milk supply. Foods, drinks and herbs can however give just that little extra, if only by boosting mom’s self-esteem and overall well-being. Many traditional galactogogues from all over the world can be categorized in one of these categories: ‘’increase overall immunity’’, ‘’increase gut function’’ and ‘’increase iron and calcium metabolism’’. All aimed at a better function of a mother’s body. Products that are somewhere around the world said to increase milk production include, but are not limited to aniseed, beer-yeast, hop, oats, mung beans, fenugreek, asparagus, apricots, leafy green vegetables (including dandelion greens), nuts like pecans, goat’s rue, milk thistle, blessed thistle, caraway, coriander, alfalfa.
Marasco, L. “Increasing Your Milk Supply With Galactogogues,” Journal of Human Lactation (24) 2008: 455‐56.
The Academy of Breastfeeding Protocol Committee: Protocol #9: Use of galactogogues in initiating or augmenting maternal milk supply. ABM 2004
http://www.drmomma.org/2010/08/lactation-cookies-recipe-increasing.html

Brain food

Brain development is enhanced during three developmental stages: foetal, infancy and adolescence. This intense development asks for optimal food. The wide-hl belief that the more positive intellectual development of breastfed children is mainly due to the fact that more intelligent woman breastfeed does not seem to be justifyable. A few generations back, in the ‘6o’s and ‘70’s off last century, highly educated women pertinently did not tend to breastfeed.  Fats are an elementary part of brain food, especially the fatty acids. Human milk contains the right fats and fatty acids for optimal brain development. Isaacs et al (including dr. Lucas from the early premature infants and human donor milk studies)  found that a minimum of 50% human milk in the diets of premature babies let to an improved verbal intelligence I all adolescents and to all forms of intelligence in male adolescents. . These data support the hypothesis that breast milk promotes brain development, particularly white matter growth. Mothers could even enhance the brain food quality of their milk by modelling their diets and possibly use supplements. Foods rich in omega 3 fatty acids can do this and provide for a more stable mental health for themselves. Helland at al found that maternal concentration of n-3 very-long-chain polyunsaturated fatty acids during pregnancy might be of importance for later cognitive function.
Isaacs EB, Fischl BR, Quinn BT, Chong WK, Gadian DG, Lucas A: Impact of Breast Milk on Intelligence Quotient, Brain Size, and White Matter Development. Pediatric Research 2010, 67(4):357-362.
Helland IB, Smith L, Blomen B, Saarem K, Saugstad OD, Drevon CA: Effect of Supplementing Pregnant and Lactating Mothers With n-3 Very-Long-Chain Fatty Acids on Children's IQ and Body Mass Index at 7 Years of Age. Pediatrics 2008 122: e472-e479

Breastfeeding without pregnancy

Breastfeeding is a natural and logical step in the sequence of conception, pregnancy and childbirth. However, a woman can breastfeed even without preceding pregnancy. (Szucs et al 2010, Biervliet et al 2001) This is named induced lactation. To induce lactation protocols are being used, where the use of hormonal medication plays an important part. The presupposition is that it is hardly, if at all, possible to create a full milk production, suitable to satisfy a child’s total nutritional needs. Gribble, however, found I her extensive review f the literature that in some cultures it seems to be no problem at all to relactate and subsequently fully breastfed for an extended period. Adoptive mothers in developing countries may have greater milk production than mothers in the west because they are more knowledgeable about breastfeeding, practice frequent breastfeeding, remain in close physical contact with their children and live in cultures that are supportive of breastfeeding. Adoptive mothers in the west should be encouraged to maximise their milk supply by emulating the mothering styles of women in developing countries and developing a strong support network for breastfeeding.
Gribble KD: The influence of context on the success of adoptive breastfeeding: developing countries and the west. Breastfeed Rev. 2004 Mar;12(1):5-13.
Szucs KA, Axline SE, Rosenman MA: Induced Lactation and Exclusive Breast Milk Feeding of Adopted Premature Twins. J Hum Lact August 2010 26: 309-313, first published on June 22, 2010
Biervliet FP, Maguiness SD, HayDM, Killick SR, Atkin SL: Induction of lactation in the intended mother of a surrogate pregnancy: Case report Hum. Reprod. (2001) 16(3): 581-583

Fortified milk

Human milk is the ideal food for human babies, with exactly the right amount of nutrients and energy for healthy growth and development. Often the value of mother’s milk is doubted and is thought to need fortifying. This is then often done by adding one or more scoops of powdered infant formula. This is a dangerous practice, because the still developing kidneys can’t yet process this mineral load, with disease as possible result. Children with restricted growth benefit more from optimisation of breastfeeding (more and better). For very small premature babies it may be true that they need more nutrients than the milk of their mothers can provide at that stage. Special mixtures of minerals and proteins (HMF: human milk fortifier) are used to supply with those, but it means they will get bovine milk based nutrition. This will increase their risk for health damage according to the research done by Chan and by Oval et al. Especially added iron prompted an increase of bacterial and fungal growth in the intestines. In another study Chan et al however found that HMF based on human milk did not lead to the negative consequences of bovine milk based HMF.
Chan GM: Effects of Powdered Human Milk Fortifiers on the Antibacterial Actions of Human Milk. Journal of Perinatology (2003) 23, 620–623
Oval F, Ciftci IH, Cetinkaya Z, Bukulmez A: Effects of human milk fortifier on the antimicrobial properties of human milk. Journal of Perinatology (2006) 26, 761–763.
Chan GM, Lee ML, Rechtman DJ: Effects of a Human Milk-Derived Human Milk Fortifier on the Antibacterial Actions of Human Milk. Breastfeeding Medicine. December 2007, 2(4): 205-208.

SIDS and sleep environment

Blair in his editorial defines SIDS as an exclusion diagnosis: a child died and after studying all factors involved we cannot demonstrate an adequate cause of death. In 1969 Beckwith put down this definition and after the following 40 years of intense research there is no prospective of finding a single plausible cause for cot death. There are, though, factors that increase the SIDS risk, including, but not limited to, breastfeeding or not and sleep arrangements. In different research groups Blair et al studied the correlations between sleep arrangements and SIDS and between bed sharing and breastfeeding. Thy found that sleeping place sharing children who died of SIDS always also had other risk factors involved, like prematurity, being ill of not well, parents who smoked or were under the influence of alcohol or drugs, the use of head-covering, pillows or sofa’s. Bed sharing in the first 15 months (or longer) proved positive in better breastfeeding outcomes. Health behaviour education for parents about sleep arrangements should always take into account these positive outcomes for breastfeeding. Good information about safe bed-sharing seem to have the best potential to secure breastfeeding and prevent SIDS as much as possible.
Blair PS, Fleming PJ: Recurrence risk of sudden infant death syndrome. Arch Dis Child 2008;93:269-270
Blair PS,  Sidebotham P, Evason-Coombe C, Edmonds M, Heckstall-Smith EMA, Fleming P: Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England. BMJ 2009; 339:b3666
Blair PS, Heron J, Fleming PJ: Relationship Between Bed Sharing and Breastfeeding: Longitudinal, Population-Based Analysis. Pediatrics 2010 126: e1119-e1126

Breastfeeding and depression

Purpose and necessity of breastfeeding for the health and well-being of mother and child are well documented. Although breastfeeding is for both mother and child an inborn capability, it is also a learned skills and therefore open to disruption. Maternal depression is known to be an inhibiting factor for initiation and duration of breastfeeding. Dennis et al found in their review of the literature that women with depressive symptomatology in the early postpartum period may be at increased risk for decreased breastfeeding duration and increased breastfeeding difficulties. There is also beginning evidence to suggest that depressed women may be less likely to initiate breastfeeding and do so exclusively. Bogen c.s. found a strong correlation between the use of antidepressants during pregnancy, but hardly any between being depressed and breastfeeding outcomes. Use of SRI’s during pregnancy led to a decreased intention to start breastfeeding.
Dennis CL, McQueen K: The relationship between infant-feeding outcomes and postpartum depression: a qualitative systematic review. Pediatrics. 2009 Apr;123(4):e736-51.
Bogen DL, Hanusa BH, Moses-Kolko E, Wisner KL: Are maternal depression or symptom severity associated with breastfeeding intention or outcomes? J Clin Psychiatry. 2010 Aug;71(8):1069-78. Epub 2010 Jun 15.

Artificial marketing

Pregnant women and mothers of infants are the target audience for advertisements of artificial breastfeeding replacements, also known as infant formula. Although infant formula #1 marketing is outlawed in the Netherlands, following the International WHO Code, marketing for #2 and #3 flourishes and they are more or less identical to #1 in lay-out and claims. Infant formula manufacturers claim all kinds of health profits for children that are fed their product. This kind of claiming health benefit through food is prohibited and may cause parents to make infant feeding choices based upon wrongful information. Infant formula being a health hazard rather then it offering health benefits would be a better kind of information for parents, that should be shared with them by their health care providers. Health care providers themselves, however, are still not all completely convinced that this is the matter. This may very well be caused by the fact that infant feeding research  often go from the hypothesis that infant formula is the norm, rather than formulate report titles and research-questions around the hazards of not-breastfeeding.

Stang J, Hoss K, Story M: Health Statements Made in Infant Formula Advertisements in Pregnancy and Early Parenting Magazines: A Content Analysis. ICAN 2010, 2:16-25.

Smith J, Dunstone M, Elliott-Rudder M: Health Professional Knowledge of Breastfeeding: Are the Health Risks of Infant Formula Feeding Accurately Conveyed by the Titles and Abstracts of Journal Articles? J Hum Lact August 2009 25: 350-358

Breastfeeding and diabetes

Both the initiation and maintenance of breastfeeding have been reported to be negatively affected by maternal diabetes. Breastfeeding, however, is for both mother and baby important in the prevention and treatment of diabetes. Type 1 diabetes is a chronic disease with a subclinical prodrome during which β cell autoimmunity becomes overt. According to research this may start as early as during the first year of life. Infant feeding practices play a significant role, complex proteins being a risk-adding factor, human milk a risk-lowering one. Mothers with type 2 diabetes should be advised to exclusively breastfeed each child for at least one month. According to Schwarz et al this would increase their carbohydrate metabolism. Sorkio c.s. showed in their study that is not the diabetes per se that decreases incidence and duration of breastfeeding, but the accompanying complications like a higher incidence of preterm labour and caesarean sections and the statistically lower age and education of mothers with diabetes.

Sorkio S, Cuthbertson D, Bärlund S, Reunanen A, Nucci AM, Berseth CL, Koski K, Ormisson A, Savilahti E, Uusitalo U, Ludvigsson J, Becker DJ, Dupré J, Krischer JP, Knip M, Åkerblom HK, Virtanen SM (2010): Breastfeeding patterns of mothers with type 1 diabetes: results from an infant feeding trial. Diabetes/Metabolism Research and Reviews, 26:206–211.

Knip M, Virtanen SM, Åkerblom HK: Infant feeding and the risk of type 1 diabetes Am J Clin Nutr 2010 91:1506S-1513S.

Schwarz EB, Brown JS, Creasman JM, Stuebe A, McClure CK, Van Den Eeden SK, Thom D: Lactation and Maternal Risk of Type 2 Diabetes: A Population-based Study. The American journal of medicine 2010, 123(9):863.e1-863.e6.

Breastfeeding and Multiple Sclerosis

Breastfeeding is good for babies and mothers as well. Mothers do their selves a favour by breastfeeding, and that is true for women with chronic diseases like MS as well. Langer-Gould et al (2009;2010) studied the combinations of Multiple Sclerosis and breastfeeding and vitamin D and with exclusivity of breastfeeding. They found that probably exclusive breastfeeding and concomitant suppression of menses significantly reduces the risk of postpartum relapses in MS.  In another study they found that although during pregnancy and exclusive breastfeeding in women with MS 25(OH)D levels are low, this was not associated with an increased risk of postpartum MS relapses. Earlier Haas & Homme (2007) found that breastfeeding had a positive effect on postpartum MS patients with intravenous immunoglobulin (IVIG) treatment in the 6 months postpartum.

Haas J, Hommes OR: A dose comparison study of IVIG in postpartum relapsing-remitting multiple sclerosis.  Multiple Sclerosis 2007; 13: 900-908.

Langer-Gould A, Huang SM, Gupta R; Leimpeter AD, Greenwood E; Albers KB, Van Den Eeden SP, Nelson LM: Exclusive Breastfeeding and the Risk of Postpartum Relapses in Women With Multiple Sclerosis. Arch Neurol. 2009;66(8):958-963.

Langer-Gould A, Huang S, Van Den Eeden SK, Gupta R, Leimpeter AD, Albers KB, Horst R, Hollis B, Steinman L, Nelson LM: Vitamin D, Pregnancy, Breastfeeding, and Postpartum Multiple Sclerosis Relapses.  Arch Neurol. Published online November 8, 2010.

Milksisters

Milksharing can, as with the sharing of blood, go through a structured system (milk bank analogue to blood bank), but there are also more informal ways. In The Netherlands the Mothers’ Milk Network is active since about 6 years. Basically this is database with donor and asking mothers. Donor mothers will have to do blood testing like blood donors do. The simplest way to share milk is when two women who know each other (neighbours, sisters, friends, …) nurse each other’s children or share their expressed milk. In the village the world turned into since the internet the pool in which to find a milksister is enlarged. On Facebook a grassroots movement (‘’Eats on feets’’ like ‘’Meals on Wheels’’) started en grew wide where donating and asking women can easily find each other. Shell, the woman who started the movement, advises mothers using other milk to be sure to check the source in order to prevent disease transmission.

Moedermelk Netwerk http://www.moedermelknetwerk.nl/donormelk.php

Sophia Moedermelkbank http://www.erasmusmc.nl/neonatologie/sophiamoedermelkbank/2475949/

Eats on Feets (NL) http://www.facebook.com/pages/Eats-on-Feets-Nederland/102427463158613

Donor milk

Giving and receiving blood is a well-respected custom. The donor freely gives what he has in abundance and saves a life. Safety precautions will keep risks as low as possible. Organ donations may be a bit more of a problem to some, but few will refuse a donated organ when absolutely necessary. When speaking about donor human milk more noses will be wrinkled and brows lifted, for this obviously has a higher ‘’Yucky-factor’’. But human milk can save lives as well. As food for an infant that can’t receive enough or none at all from his own mother, but also as medicine for children and adults. For premature babies a exclusively human milk based diet is safer than infant formula or human milk fortified with non-human-milk based products. The strong immunologic properties of human milk make it a powerful factor in the treatment of all kinds cancer.

Sandra Sullivan S, Richard J. Schanler RJ, et al: An Exclusively Human Milk-Based Diet Is Associated with a Lower Rate of Necrotizing Enterocolitis than a Diet of Human Milk and Bovine Milk-Based Products. The Journal of pediatrics 2010, 156(4):562-567.

Megan Doyle: Use of Human Milk as Cancer Therapy; Breast Milk Helps Reduce Cancer-Related Symptoms. Apr 27, 2009 http://www.suite101.com/content/use-of-human-milk-as-cancer-therapy-a113100

Another mom’s milk

Breastfeeding has been the preferred feeding for infants and toddlers since the dawn of mankind. The WHO stresses that each and every child should be exclusively breastfed during his first six months of life and continue to breastfeed complemented with suitable other foods till or passed his second birthday. Many people find this a hard to follow advice, because what if a mother can’t or isn’t allowed to breastfeed? The answer is simple: another mom’s milk is defined as exclusive breastfeeding as well. Throughout human history women fed ach others’ children for convenience and emergencies. In many cultures and times this even was a profession: women hired themselves, or rather their breasts, out to nurse other women’s’ children as a wet-nurse. Another woman’s milk always is better suited for a child than any animal milk be it processed or not, even if the wet-nurse’s child is of a different age than it’s milk-sibling. Breastmilk that is saf for a mom’s own child will be safe for another child as well. Mothers who cross-nurse (breastfeed each othr’s children) will additionally provide for tailor-made antibodies for both nurslings.

Thorley V. Sharing breastmilk: wet nursing, cross feeding, and milk donations. Breastfeed Rev. 2008 Mar;16(1):25-9.

Binns CW, Fraser ML, Lee AH, Scott J: Defining exclusive breastfeeding in Australia. Journal of Paediatrics and Child Health 2009, 45(4):174-180

Thorley V: Breasts for hire and shared breastfeeding: wet nursing and cross feeding in Australia, 1900-2000. Health History. 2008;10(1):88-109.

Thorley V: Mothers' experiences of sharig breastfeeding or breastmilk co-feeding in Australia 1978-2008. Breastfeed Rev. 2009 Mar;17(1):9-18.

Species specific milk

Each mammal receives milk form its own mother and that milk is species specific, tailor-made for the specific needs for growth and development for that species. In natural surroundings there is little chance to see a baby-animal consuming milk from the mother of another species. Humans don’t think something to be weird fast, so there are quite some orphaned animal babies who are happily drinking at another species mother’s teats. We even harvest tons of milk from cows to feed our own young. Milking human females to feed calves is a not so often viewed picture, although singer Pink doesn’t see that as an impossibility. Why is it then that so many people think it gross to feed a human child human milk from another mother?

http://www.youtube.com/watch?v=HcmfHZuJe0E&feature=fvst

http://www.growingyourbaby.com/2008/08/27/kate-garraway-raises-the-cross-breast-feeding-issue-again/

http://www.metro.co.uk/news/40405-pig-suckles-milk-from-cows-udders

http://eco-health.blogspot.com/2008/09/got-breast-milk-interspecies-suckling.html

http://www.stuff.co.nz/life-style/blogs/four-legs-good/3083733/When-mum-is-a-different-species

Milk production

Researchers have a growing understanding about how milk synthesis and output works and what the determinants or an adequate milk production are. Right after birth milk production is solely hormone driven. Whether or not a baby is drinking. After a day or 3 production will to convert into a demand-and-supply system where supply follows demand and frequent and functional breast stimulation is essential. This is a highly individual process, where rhythms and patterns need to be adapted to fit the possibilities and needs of mother and child as a pair. In breastfeeding counselling often a ‘’cooking book’’ technique is used, thinking breastfeeding is a one size fits all. On the one hand this may lead to an overload of milk produced, on the other hand to a significant deficit in milk volume, or, even more often, to a perceived low milk supply due to a misinterpretation to normal patterns and behaviour.

van Veldhuizen-Staas CGA: Overabundant milk supply: an alternative way to intervene by full drainage and block feeding. International Breastfeeding Journal 2007, 2:11

Christina M. Smillie CM, Suzanne Hetzel Campbel Sl, Susan Iwinski S: Hyperlactation: How Left-brained ‘Rules’ for Breastfeeding Can Wreak Havoc With a Natural Process.

Newborn and Infant Nursing Reviews 2005, 5(1):49-58

Dykes F: Western medicine and marketing: construction of an inadequate milk syndrome in lactating women. Health Care Women Int 2002; 23(5):492-502

Child’s teeth

Kay at al (2010) compared the incidence of caries in children with average or higher birth weights and lengths. They found that children who weight more and are longer at birth, but not at present, tended to show more caries at age 5. They do not explain this phenomena, but encourage further research. Breastfeeding is a well-researched factor in caries development in children. Kotlow c.s. studied breastfeed children with a tight maxillary frenum and found them to have more caries in the upper front teeth. In these children this kind of caries is thus probably not due to extended and/or night-time breastfeeding (as often suggested) but to the inability of these children to remove milk residues from between the upper lip and the mandible. Early detection and treatment of this anatomic variation is urged by the authors. Kobayashi et al assessed the incidence of cross-bite in children who did not breastfeed with those who breastfed short time (<6 months), medium long (6-12 months or extended (> 12 months). Children who never breastfed had a 15 fold chance of crossbite, as compared to children who breastfed past their first birthday. Short and medium term breastfeeders showed a 4 to 10 fold increase. In long time breastfeeders only 2 out of 100 showed crossbite, but never breastfed children had a 1 in 3 incidence.

Kay EJ, Northstone K, Ness A, Duncan K, Crean SJ. Is there a relationship between Birthweight and subsequent growth on the development of Dental Caries at 5 years of age? A cohort study. Community Dent Oral Epidemiol 2010; 38: 408–414

Kotlow LA: The Influence of the Maxillary Frenum on the Development and Pattern of Dental Caries on Anterior Teeth in Breastfeeding Infants: Prevention, Diagnosis, and Treatment. J Hum Lact August 2010 26: 304-308

Kobayashi H, Scavone H, Ferreira RI, Garib DG: Relationship between breastfeeding duration and prevalence of posterior crossbite in the deciduous dentition.

American journal of orthodontics and dentofacial 2010, 137(1):54-58