NOT BREASTFEED---WHY???

You've heard all the reasons breastmilk is important and the optimal food for your baby (well, maybe not every single one of the reasons, but most of them at least), so would I suggest that some moms not breastfeed?

The main reason is when the baby's or mother's health might be compromised. And the main reason for that is that the mother needs a medicine that would cross her breastmilk and harm the baby. But fortunately, as you can see from the table, there's relatively few medicines that mean breast feeding should stop.

Stop breastfeeding if you are taking one of the these medicines

  • Anticancer drugs
  • Mysoline
  • Cyclosporine
  • Methotrexate
  • Lindane
  • Radioactive drugs
  • Parlodel
  • Narcotics and barbiturates

Source: Bailey Koch, RD, CSP

A mother might be tempted to stop the medicine in order to breastfeed, but stopping a needed medicine might cause her own problem to flare out of control. So it's usually a much better to stop or interrupt breastfeeding for a while and use formula. Also note that there's another group of medicines where you will need to talk to your doctor about the potential harm to the baby.  Sometimes, another medicine can be used.

Consult with your doctor prior to taking one of these:

  • Antidepressants
  • Isoniazid
  • Phenobarbital
  • Aspirin
  • Lithium
  • Prozac
  • Codeine
  • Metoclopramide
  • Valium
  • Demerol
  • Metronidazole
  • Zoloft
  • Ergots
  • Morphine
  • General anesthesia
  • Oral contraceptives
  • Indomethacin
  • Paxil

Source: Bailey Koch, RD, CSP

Also note that this list of medicines changes with new meds added and research clearing the way for some medicines so they can be used. So check with your doctor and online at www.womenshealth.gov.

But medicines alone aren't the only reasons not to breastfeed. Women with active tuberculosis, HIV, human lymphotrophic virus HTLV-1 or HTLV-2 (which are associated with certain cancers) or active herpes on their breast shouldn't breastfeed.

Rare genetic conditions can be a reason not to breastfeed. In one called galactosemia, babies can't process the sugar in breast milk, and brain damage can result.

Moms who have had complications after delivery, are malnourished or who are emotionally or physically fatigued should wait to breast feed until after those problems improve to breastfeed. To establish and keep their flow going, they may want to express their milk, but it may be not be enough for their baby until they are better.

There are some moms too who just don't want to breastfeed or feel they can't. If they are given some of the information about the benefits, they may change their minds. But they shouldn't be pressured to or pressured not to. Nor should they worry that their breasts or nipples aren't going to allow them to--that's rarely the case.

 

 

 

ARSENIC IN RICE / RICE PRODUCTS

The earth's minerals are commonly absorbed and incorporated into the fruits and vegetables we eat--in fact, that's one of the reasons they're recommended--so you can get your zinc and selenium and copper, for example. But some toxic metals are also absorbed.

Arsenic is one of those. We don't need or use it in our bodies, but it can accumulate and eventually contribute to tumor/cancer formation if it's in significant quantities. Of course, we don't know how much is too much--so that is being studied. We do know, however, that arsenic is particularly well taken up by rice, more so than by other foods. And if it's in rice, it's going to be in products made from it, like rice cereal and rice syrup. This then poses a specific problem for infants who are introduced to rice and often consume it daily as a source of protein and minerals, or to thicken their formula to lessen reflux.

So the FDA is obtaining over 1300 samples from the 30 food categories--and they will be announcing their findings. So stay tuned and if you're interested, link to their webpages describing their efforts and answering a variety of questions.

 http://www.fda.gov/food/foodborneillnesscontaminants/metals/ucm319870.htm

In the mean time, it might be best to limit your intake of rice and vary the cereals you feed your baby, since oat, wheat, barley and mixed grains are of equal nutritional value--though only oat should be used initially for infants where a sibling or parent has celiac disease--at least in the beginning. For more on this topic, see What to Feed Your Baby.

FIBER AND FITNESS

When I was growing up, my mother insisted I get plenty of roughage in my diet. That's what fiber was called in the past. And that's basically what it is. Roughage, the parts of plant food that we as humans don't have the enzymes to digest and absorb.

Why do we need it? My mother told me it was to bulk up the stools--and again she was right--for one of the reasons. Fiber holds onto water and fluids and softens the stools so they pass with less effort, which decreases constipation--which then decreases straining and all the diseases that are associated with that-hemorrhoids, diverticulitis, and somehow even heart disease--or that may be because the fiber can also bind to cholesterol and fats. Because fiber holds extra water, it can even help in some cases of long standing (chronic) diarrhea.

Because fiber is filling, it can also lessen total calorie intake, and potentially help with weight control. Fill up on carrots and celery, you may have as much room for that slice of chocolate cake you otherwise wouldn't have the will power to avoid. And certain fiber products, particularly the soluble fibers of oats are known for lessening cholesterol.

Types of Fiber

That  last paragraph said a lot. First that there are different types of fiber, based on whether they dissolve in water. Soluble fiber, the kind found in oats, fruits, beans and psylllum (which is used in lots of fiber pills and products), forms a gel (jello-like) with fluid. That gel slows stomach emptying, and in doing so, helps to regulate sugar and insulin levels as well as lower blood cholesterol levels. Insoluble fiber, in vegetables and other whole grains, pretty much remain the same passing through the intestine, providing much of the intestinal bulk.

The second point is that fruits and vegetables are excellent sources of fiber (see the table) but they are often ignored with all the focus on whole grains in various cereals, breads and pastas.

High-Fiber Foods

   

Fruits

 

Each serving has approximately 2 grams   of fiber. Older infants should have one or two each day. Avoid giving fruit   with pits to infants. Remember to remove skins and seeds.

     

Apple, 1 small             Cantaloupe, 1 cupa     Pear, 1/2 small

 

Apricot, 2 medium      Cherries, 10 large, pitted        Plum,   2 small

 

Banana, 1 small         Dried figs, 1.3 cup      Strawberries, 1/2 cup

 

Blackberries, 1/2 cup  Peach, 1 medium       Watermelon, 1–3 cupsa

     

Cooked   Vegetables

 

Each serving has about 2 grams of   fiber. Children should have two servings or more each day. Children 6 to 12   months should have one to two fistfuls per day; children one to three years, half   a cup of vegetable per day.

     

Avocado, fresh, 1/2 medium  Carrots, 1/3 cup          Potato, 2-inch diameter

 

Broccoli top, 1/3 cup  Green beans, 1/2 cup french fries, 20

 

Beans, 2 tbsp. Peas, 1/4 cup  Sweet   potato, 1/2 medium

     

Bread   and Cereal

 

Infants need iron from infant   cereal or meat, approximately 2 ounces per day. Each serving has about 2 grams   of fiber (but not needed for infants.

     

Cherrios, 2/3 cup        Animal crackers, 3 boxes (2 oz. each)

 

White bread, 3 slices   Whole-wheat bread, 1 slice    Graham crackers, 10 squares            Infant rice cereal and puffs have   minimal fiber       Infant oatmeal, 12 tbsp.  

 

a Estimates vary widely.

Source: Adapted from S. A. Cohen, Healthy Babies, Happy Kids (New York: Delilah Books, 1982), 168.

How Much is Enough?  How Much is too much?

Infants should be gradually introduced to fiber, usually as fruits and veggies, so that by a year of age they are  consuming 5 grams daily. After that, you can estimate how much a child needs by adding 5 grams to their age. Thus a 3 year old should receive about 8 grams and a 12 year old about 17 grams with adults needing 20-30 grams per day.

I do suggest that fruits and veggies make up a significant portion of that by including 5 or more servings per day. The best way to gauge the amount for each child is by asking them to eat a fistful of each. It's also to remember as "5 fistfuls a day." And sometimes I have them hold their fists together (figure) so I can show them, that's the size of an apple or peach--so that they can see they can easily accomplish the goal.

How Much is Too Much?

The one problem with fiber is that the intestine can digest some of the beans and vegetables and grains, producing gas. Beans, broccoli, cauliflower, cabbage and mushrooms are notorious as gas producers. And that gas can cause cramping and discomfort for some who are particularly sensitive. And for almost everyone, the gas will eventually come out, potentially causing embarrassing moments. A probiotic can sometimes help by providing healthy intestinal bacteria that actually feed off the fiber. But if it doesn't sometimes you can moderate the amount of fiber to lessen the gas while still having enough to benefit your gastrointestinal system.   

WHY BOTHER BREASTFEEDING? THE BABY'S BRAIN AND IMMUNE SYSTEM

theAs a mom-in-the-making, you may have thought about breastfeeding. But you're not really sure if you want to, especially after you talked to one of your friends who told you how she is still restricting her diet or how she is having to pump her breasts at her job to make sure she can keep her supply going and so the baby has enough while she's working. Or your own mother reminds you that you were bottle fed, and she thinks you turned out pretty well (whether you agree with her or not).

So why bother? That question might be best answered by another set. Why do the American Academy of Pediatrics, American Academy of Family Physicians,          (formerly known as the American Dietetic Association) and the World Health Organization and UNICEF not only recommend breastfeeding, but doing so exclusively for 6 months? And why would the US Department of Health and Human Services actually set goals for breastfeeding in their Healthy People campaigns?

IMMEDIATE IMPACT

A whole host of immune factors cross from moms to their breastfed babies, enhancing their ability to fight infection. The dense first milk, or colostrum, is loaded with antibodies, enzymes, and the mothers' own cells that boost the  babies' otherwise vulnerable immune system. The mothers' cells seem to be particularly important because they continue to form and provide these protective proteins.

Additionally probiotics pass to the babies. As you know, these favorable bacteria and yeasts populate the babies' intestinal tract and help to prevent infections. But you may not know the true importance of that those first colonies. They stay for the rest of the babies' lives. They are almost indestructible.

When an individual gets an infection later or when antibiotics are given for that infection, the intestinal  flora (the term for the bacterial and other species that inhabit the intestine) is temporarily changed, but gradually this population returns to what was introduced shortly after birth. How? Breastmilk also supplies the food for the flora, so that the flora becomes so strongly entrenched that it remains there forever.

THE RESULT

All of these protective factors work incredibly well together. They decrease the frequency of respiratory infections (including ear infections) and diarrheal diseases, lessening doctor's visits and parents' missed work. Importantly, the potential for more severe illnesses, like bacterial meningitis, is also decreased; and necrotizing enterocolitis, is also reduced in vulnerable premature infants.

Babies who are breastfed also have less Sudden Infant Death Syndrome (SIDS) and less gastroesophageal reflux as well. We're not sure the reasons, but the results are clear and obviously significant.

LONG-TERM BENEFITS

The amazing part, at least to me, is that breastfeeding for just a few months actually conveys ptoective benefits far beyond infancy (see the table). Those who were breastfed in infancy have less chance of becoming obese adults with less diabetes as well. Even before that they have fewer allergies, asthma, and childhood cancers; and later, they have less osteoporosis and vision defects.

And as I detail in What to Feed Your Baby, breastfeeding enhances brain and nerve development with breastfed infants having higher average IQs--not just in infancy but on into adulthood. And more recent research documented on other posting in this blog, show that the longer an infant is breastfed, the higher the IQ goes up (1 point for every month of breastfeeding).

Advantages of Breastfeeding for the Baby

   

Short-term/Immediate   Benefits

     

Long-term Benefits

     

Decreased incidence of   infections such as

     

Decreased risk of developing

 

-            diabetes

 

-            asthma

 

-            childhood cancers

 

-            rheumatoid arthritis

 

-            osteoporosis

 

-            vision defects

 

-            obesity

     

-            diarrheal disease

 

-            influenza

 

-            necrotizing enterocolitis (NEC)

 

-            herpes simplex

 

-            respiratory synctial virus (RSV)

 

-            ear infections

 

-            respiratory infections (i.e., bronchitis)

 

-            bacterial meningitis

       

Decreased incidence of illnesses   such as

       

Enhanced development and   intelligence:

     

sudden infant death syndrome   (SIDS)

 

gastroesophageal reflux (GER)

 

multiple sclerosis

     

higher IQ

 

cognitive and social development

       

Protection from allergies

       

Improved dental health

 

Source: Bailey Koch, RD, CSP, www.nutrition4kids.com.

BOTTOM LINE

in essence, breastmilk is very nutritious, very beneficial brain food. Optimizing a baby's growth, improving his or her immune function, with the benefits continuing into adulthood. No wonder it's the gold standard that all the milk-based formulas try to mimic.

BREASTFEEDING DOESN'T JUST BENEFIT THE BABY

Doctors and nurses and lactation consultants and public health workers always talk about how a mother improves a baby's health by breastfeeding, how the immune factors in breastmilk reduce the potential for infection, how the hormones that cross to the baby help it to grow, how certain fats improve brain function, and how each feature of breastmilk makes it the perfect food to nourish a baby.

But too often the benefits to the mother are ignored. That's unfortunate, because mothers truly do get some goodies for themselves (summarized in the table). Of course, there's this incredible mother-infant bonding that's enhanced by breastfeeding, but that bond activates in pregnancy and it would hard to believe that anything can increase that beautiful, nurturing relationship--or if it is increased, it may be the result of whatever makes a mother want to breastfeed in the first place.

Benefits of Breastfeeding for the Mother

   

Helps shrink uterus after childbirth

     

Promotes postpartum weight loss

     

Decreased insulin requirements in diabetic mothers

     

Increased sleep for mom

     

Protects mom against anemia

     

Improved emotional health

     

Stronger mother-child bond

     

Decreased risk of developing

 

breast cancer

 

uterine cancer

 

ovarian cancer

 

endometrial cancer

 

Source: Bailey Koch, RD, CSP

That's not lessening the impact of breastfeeding, it merely means that bond is also available to mothers who formula feed their infants. But some of the unique factors are that breastfeeding helps to shrink the mother's uterus after birth and breastfeeding decreases a diabetic mother's insulin requirements. Both of these benefits probably result from a hormone release within the mother's system.

Many breastfeeding mothers appreciate the increased metabolism that making and delivering breastmilk generates. The extra calories required often help mothers quickly lose the weight they gained during pregnancy, even while they are consuming more to stay healthy and provide the baby's nutrition. Other mothers find that the energy required also helps them sleep and feel emotionally satisfied with all they are doing for their baby.

But frankly, some of the most important benefits are long term, with breastfeeding mothers having a decreased risk of female cancers (ovarian, uterine, endometrial and breast) years after they finished breastfeeding. No one is quite sure of what those protective factors are, but research is ongoing to    understand why that occurs and whether prolonged breastfeeding will lessen the risk even more.