Duration of Early Feedings

In previous blogs, I have addressed recommendations regarding breastfeeding frequency in the early hours and days after birth. However, mothers may wonder how long feedings should last. So, here are a few words on early, in-hospital feeding duration.
During the first few days after delivery and before the transitional milk comes in, it is important that mothers allow their babies to feed at breast for as long as baby indicates a desire to do so. This is, of course, providing that mom is physically and emotionally comfortable. In the distant past, it was thought that limiting an infant’s feeding time at breast would prevent nipple soreness. This is NOT the case!!! As long as an infant is attached correctly and there is little or no discomfort for mom, unlimited feedings may take place without the risk of soreness.
Frequent, unlimited feeding at breast is advantageous to both mother and baby. For mother, frequent, unlimited feeding promotes milk production, rest and relaxation as she progresses through early post-partum. Unlimited feeding may also prevent painful breast engorgement as her transitional milk comes in. For baby, this allows plenty of practice in transferring milk BEFORE he has to handle the larger volumes. Furthermore, baby receives more colostrum (lots more swallowing), gains weight faster, stabilizes body temperature and blood sugar levels, expels more meconium, develops less jaundice, etc, etc.
In summary, if breastfeeding is comfortable for mom, and baby is swallowing at the breast, length of feedings need not be a concern.

Your Baby has a Fuel Gauge!

In a previous blog we talked about BABY watching VS CLOCK watching to determine baby’s readiness to feed.   A full-term newborn will exhibit hunger cues by flexing her arms, tightening her little hands into fists, turning her head and pulling her fists to her mouth.  Her whole body becomes tense and she produces sweet short vocal “yaps” to alert us to the fact that she is ready to feed.  These are early signs of hunger and would be the best time to put her to breast.  Late signs of hunger include a scowled forehead, facial tension and crying or screaming in “alarm” of the fact that she is hungry.

 So, how do we know when baby has had enough milk?  As baby continues to feed at the breast and her tummy begins to fill, her body should become increasingly more relaxed.  Arms lose their flexion and release to extension.  Fists open.  Scowled forehead disappears and baby’s face and mouth become more relaxed.  She may, in fact, “fall” off the breast.  Now, here’s the trick.  If, when you raise then release her arm, she tenses it and wiggles or roots, she probably needs to feed a little more.  However, if her arm flops down to her body (as if she were a rag doll), and this is repeated two or three times, chances are good that her tank is full!  Now it’s time to rest.  I’ll bet you didn’t know your baby came with a fuel gauge!

In the News...Again!

Monday, in the online addition of the journal Archives of Disease in Childhood, a team of researchers from the University of Crete in Heraklion, Greece,  reported finding significantly fewer incidences of infections and hospitalizations in children exclusively human milk-fed for the first 6 months of life.  Many other studies have had similar findings.  However, it is important for us to hear it again and again and again.

Certainly, Greek mothers need to hear it.  In 2000, while visiting Greece, I felt privileged to have been invited to attend a La Leche League meeting held in the suburbs of Athens.  The leaders of the group explained to me that breastfeeding rates were very low in Greece at the time and that it was a challenge to educate the public.  So, I am very glad to hear that this research has come out of a Greek university.

On the subject of the La Leche League meeting, it was really wonderful to see all those Greek mothers and babies gathered in support of what was best for their babies.  The meeting was conducted in Greek.  However, much to my surprise, I was able to understand most of what was being discussed!!  I guess breastfeeding is a universal “language”.  It certainly was not all Greek to me!!!  

Check out this link to WebMD for the story http://bit.ly/agRVmU

Protection Against Overweight and Obesity

Last week, Michelle Obama spoke about the importance of human milk feeding of infants in reducing the incidence of obesity. Several people have asked me exactly how breastfeeding confers this protective effect.

Researchers have found that there is a difference in intestinal flora (bacteria) and pH between breastfed and formula-fed infants. The breastfed infant gut has a lower pH with a higher level of healthy bacteria and fewer disease-causing organisms. The formula-fed infant gut has a higher pH which inhibits the growth of healthy bacteria and enables disease-causing bacteria to grow. Therefore, formula feeding predisposes the infant intestine to the development of long-term, low-grade inflammation, a condition associated with a number of health challenges including overweight and obesity. Because breast milk controls inflammation, it helps to protect infants and children from the development of childhood and adult obesity.

Breastfeeding in the News Again!

Everyone knows that breastfeeding is best for human babies. However, the fact that breastfeeding is best for human mother’s receives far less attention. A study published in the September 9th issue of The American Journal of Medicine finds that women who breastfed exclusively for at least one month were at a much lower risk of developing type II diabetes than those who gave birth but did not breastfeed. Type II diabetes is a major public health concern here in the US. If breastfeeding for at least one month could decrease the incidence of type II diabetes, then legislation and public health policy needs to reflect it. If you have a familial history of type II diabetes, this research will be particularly interesting to you. Here’s the link to information about this new study: http://www.reuters.com/article/idUSTRE6893Z320100910

Calling All Babies – Expressing the Need for Colostrum

As some of you know, I am a strong advocate of the veterinary model of healthcare management when it comes to birth and early infant feeding, regardless of one’s species! Anyone who breeds cows, horses or other mammals will tell you how important it is for a newborn to receive colostrum, a mother’s very first milk. Loaded with antibodies, colostrum protects an infant from harmful environmental bacteria and viruses. To this end, farmers who raise cattle will immediately coax a newborn calf to its mother, skin-to-skin with her udder. Knowing the serious health consequences of not receiving species-specific colostrum as soon as possible after birth, veterinarians and zoologists will take extraordinary measures (like milk expression and alternative feeding methods) to ensure that a newborn receives its mother’s first milk. In the animal world, it is well-recognized that health, and even survival, is greatly influenced by receipt of this amazing liquid. Although artificial baby milks may be formulated for some species, illness and healthcare costs are significantly higher for those that must be “hand raised” (formula fed).

Human infants are no different. Infants not having received colostrum are four times more likely to become ill and require hospitalization during the first year of life than their human-milk-fed counterparts. Often called baby’s “first immunization,” colostrum provides passive immunity to a newborn because it is so rich in antibodies. In addition to immune factors, colostrum has an amazing ability to stabilize blood sugar levels, far better than formula. This is extremely important to a newborn infant, especially those who may have had a stressful birth, been born prematurely or delivered by a diabetic mother.

Like farmers and veterinarians, We too can ensure that our babies receive colostrum as soon as possible after birth. In cases where baby can be placed directly at the breast, skin-to-skin after birth, we certainly should do so. If not, let’s hand express and spoon- or syringe-feed this liquid gold to our newborns (see blog on hand expression). Our babies deserve the very best, so let’s let advocate for them by behaving like a bunch of animals!

Skin-to-Skin Kangaroo Care – Yet Another Amazing Story!

You all HAVE to see this video clip featured on the TODAY show this morning. An amazing story you cannot miss! Here’s the link
Parenting on Today Show - Premature infant stirs to life after two hours of kangaroo care
It is yet another testament to the value of skin to skin contact for all babies!