Premature Mothers Milk - Colostrum for Premature Babies

We have known for a very long time the importance of colostrum to all newborn infants.  However, studies published in the recent past suggest that colostrum produced by mothers of premature infants contains considerably HIGHER concentrations of immune-globulins and other protective elements than colostrum of mothers having delivered full-term infants.  In fact, they suggest that the earlier a baby is born prematurely, the greater the concentration of protective elements found in its mothers colostrum.   Not surprising.  It is yet another testament to how our bodies naturally protect our babies, regardless of gestational age!

More important than ever is the need to express colostrum for our prematurely born infants, even if we do not plan on breastfeeding!  While it is important to note that manual (hand) expression remains advisable, technology in mechanical expression (electric breast pumps) has risen to a new level of precision in facilitating the production and collection of colostral milk.  Here at Missouri Baptist, in accordance with the World Health Organization, we recommend that all babies receive their mother’s milk as soon as possible in the days following birth.  So much so, in fact, that we’ve just purchased 20 new State-of-the-Art, hospital-grade electric breast pumps (Medela Symphonies) to add to our already sizeable fleet!  Due to the newest technology, mothers of premature and full-term babies alike will have pumping regimes designed specifically to their pumping needs.  Our lactation consultants, post-partum and NICU staffs are pleased to be at your service.  Our goal is to help you and your baby get off to the best possible start!

When Breastfeeding Baby Refuses to Take Bottles

Planning for a return to work can be anxiety producing to say the least.  Fortunately, things often go better than expected, especially if you are able to plan carefully in advance.   However, on occasion, our sweet little friends decide to complicate the process by refusing to take a bottle!  Have no fear…eventually things work out if you hang in there.

Here is a list of some things to consider if you are being challenged:

 Bottle Giver – If your baby will not take a bottle from you (which is often the case), see if your partner or other caregiver has some success.  Baby may sense your presence in the room, so you might want to disappear for a while. 

Nipple Types – These days there are so many different choices!  Buy only one of two or three types of bottles with slow flowing nipples.  If your breastfeeding baby is introduced to a bottle with a fast flow nipple, he may choke and release the nipple quickly with overwhelm.  Conversely, if he is older or if you have a rapid and forceful milk ejection reflex, he may prefer a fast flow nipple.  So you might enlarge the nipple hole just a bit if he takes the bottle initially but seems frustrated with a slow flow.

Degree of Hunger – Try offering the bottle before your baby exhibits signs of hunger.  If that doesn’t work, try waiting until hunger signs are becoming evident (fussing and rooting).

Taste – I recommend teaching a breastfed infant how to take a bottle using fresh breast milk in the bottle.  If you are using previously frozen milk, and your baby is persistently refusing the bottle, I would suggest you perform a taste test: defrosted vs. freshly expressed milk.  In about 1 out of every 500 cases, previously frozen breast milk takes on a different (often soapy) flavor.  This has to do with changes in the lipid fraction of the milk during the freezing process (more on that later, but call the lactation office if you find this is in fact the case).

 Temperature - Is the nipple and milk warm (body temperature)?  While most babies enjoy their milk at room temperature or even cold, some have a “gourmet” palate that demands perfection.  A warm nipple is the expectation of your breastfed baby as milk is delivered directly from your soft and warm breast.  Something cold and firm may not be acceptable to your baby.

Sense of Smell – Babies are very sensitive and acutely aware of their own mothers scent.  Try rubbing the bottle nipple on the skin of your breast so that it smells more like you.  You might also have your caregiver place something that you have worn (yes, I mean your well worn, smelly tee shirt!) near baby’s face while the bottle is being offered.

Motion - Rocking, swaying, or riding in a car seat might mesmerize your baby enough to accept a bottle.

Trickery - Try slipping the bottle into baby’s mouth while she is sleeping in care giver’s arms (not flat on her back in bed).  She may awaken to discover that drinking her mama's warm, sweet milk from a different container isn’t so bad after all!

In any case, please don’t give up.  If all else fails, there are alternate ways to feed your baby (including by cup if necessary).  Some babies may opt for smaller indirect (bottle or cup) feedings during your work hours followed by frequent requests to feed directly from your breasts when you are at home.  As long as he gets an adequate 24 hour intake, he'll be fine.  You’ll see.  Things eventually work out and you will be proud of yourself for hanging in there!

FDA Recall of SimplyThick

Thickening of breast milk or formula is sometimes recommended in the treatment of gastroesophageal reflux in infancy.  Earlier this month, the FDA issued a recall of Simply Thick, a thickening agent manufactured by Thermo Pac, LLC.  They are investigating a possible link between the product and several cases of necrotizing enterocolitis (NEC), a life-threatening intestinal condition seen most often in premature infants.

The FDA is aware of 15 cases of NEC, including two deaths, involving the use of Simply Thick mixed in the breast milk or formula of premature infants.  Until the investigation is concluded, the agency is recommending that parents stop using the product in infants born at or before 37 weeks gestation.

Here’s a link to the FDA consumer update:  http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm256250.htm

The Milk Bar is….Open

Hi there!  My name is Molly and I’m filling in for Diana this week.  I am an Internationally Board Certified Lactation Consultant here at Missouri Baptist.  I work with moms and newborns on the postpartum floor, and I also facilitate our breastfeeding support group that meets on Thursday mornings at 10. 

One issue that came up this week in our meeting is how newborns need to nurse often, and at different intervals.  Imagine this:  You have just nursed your baby and he has fallen asleep at your breast.  You are congratulating yourself on a job well done, another feeding accomplished.  Now you’re looking forward to closing the “milk bar” and putting your breasts away for a couple of hours.  But wait!  Just 20 minutes later, your baby is stirring and seems like he wants to nurse AGAIN.  Could he really be hungry so soon after finishing his last session?  This scenario is a familiar one for many new moms, and it can be frustrating and confusing. 

Here is one explanation for what’s happening.  When your baby sucks, either at the breast or on a pacifier, his sucking activates his parasympathetic nervous system, which triggers his GI tract to release hormones.  The purpose of this is to aid in digestion.  One of these hormones is cholecystokinin, or CCK.  When CCK levels rise, they induce the baby to feel full and sleepy.  When CCK levels fall, your baby becomes alert and hungry.  So as your baby nurses, or sucks on a pacifier, his CCK rises and he starts to feel very drowsy…after 20 minutes or so, he succumbs and drifts into dreamland.  If he has been breastfeeding, he has had a nice little meal; but with a pacifier, he has missed out on any calories. 

At the breast, this whole process works magically by enabling your baby to nurse for a period of time, drink some milk, and digest it.  By putting him to sleep, it prevents your newborn baby from working too hard and too long.  Hey, sucking is a lot of work when you only weigh 7 pounds!  Afterward, your baby will take a cat nap, and while he isn’t sucking, his CCK starts to drop.  Like an alarm clock, it awakens him a short time later and he demands to nurse again.  It’s time for seconds!  This gives him a chance to top off his meal, in case he didn’t get enough the first time.  Also, it keeps the “milk bar” open and busy, which provides plenty of stimulation to build a generous milk supply.  However, beware of the pacifier, because in these instances, sucking on a pacifier may satisfy your baby, but without the benefit of the meal for him, and the stimulation for you. 

Hopefully understanding this system can help you, as a new mom, feel confident in offering the breast as many times as your newborn requests it.  The result will be a nice weight gain for your baby, and plenty of milk at the bar! 

MoBap Moms Breastfeeding Get-Together

Hello St. Louis Breastfeeding Moms,
We are starting a new MoBap Moms Breastfeeding Group.
This group of breastfeeding mothers and their babies meets in a comfortable and supportive environment while they discuss various aspects of breastfeeding.  Led by an International Board Certified Lactation Consultant, these get-togethers are designed to boost confidence, develop skills and lend support to mothers who are breastfeeding one or more babies. 

 Breastfeeding Get-Together Meetings are held weekly and at no charge!  So, jump in at any time!

When:    Every Thursday morning, 10:00-11:30 a.m.
Where:   3rd floor Childbirth Center Classroom (located on the mother-baby area).
Parking:  FREE Valet parking at the front door of the North Entry (Building D) or in the North Entry (Building D) parking garage.

For more information, please call: 314-996-5751 (Registration is not required)

Hope to see you there!

Maternal Benefits of Breastfeeding

Did you know that women who breastfeed their children for more than six months reap a variety of long-term benefits?   First of all, exclusive breastfeeding reduces the incidence of some forms of breast and ovarian cancers.  It is also known to improve bone density over time by decreasing then increasing with each successive breastfeeding cycle.  The hormones relaxin and oxytocin, known as the “mothering hormones”, are released during feedings.  These “mothering hormones” allow us an easier adaptation to the challenges of early post-partum infant care, thus reducing the chances of severe post-partum blues.  Finally, on a lighter note, the act of producing breast milk alone burns more than 500 calories per day!  You can’t beat that as a great method of losing our baby weight!

More on the Value of Skin-To-Skin

Now, more than ever, researchers are convinced that frequent and prolonged skin-to-skin contact results in better breastfeeding outcomes.  Studies are showing that skin-to-skin improves the rate of exclusive breastfeeding.  In one study, babies who spent more than one hour skin-to-skin with their mothers during the first 3 hours after birth were most likely to exclusively breastfeed during their first few days.  Furthermore, there seems to be a dose-response relationship between skin-to-skin and breastfeeding.   The longer mother and baby spend in skin-to-skin contact, the longer breastfeeding remains exclusive.  This, of course, translates to longer durations of breastfeeding (months and years), healthier outcomes, financial savings to the family, etc.  Known to be a “best practice” for both mom and baby, skin-to-skin begins at birth and can be continued for several weeks.