Sunday, March 28, 2010 Preterm Infants-- Breastfeeding Versus Bottle-Feeding

Preterm Infants-- Breastfeeding Versus Bottle-Feeding

A few references that talk about the differences between breastfeeding & bottle-feeding preterm babies...
Chapman DJ. Building the Evidence Base: Preterm Infants' Energy Expenditure After Breastfeeding Versus Bottle-Feeding. J Hum Lact. 2010 Mar 19. [Epub ahead of print]
Berger I, Weintraub V, Dollberg S, Kopolovitz R, Mandel D. Energy expenditure for breastfeeding and bottle-feeding preterm infants. Pediatrics. 2009 Dec;124(6):e1149-52. Epub 2009 Nov 23.
Lubetzky R, Vaisman N, Mimouni FB, Dollberg S. Energy expenditure in human milk- versus formula-fed preterm infants. J Pediatr. 2003 Dec;143(6):750-3.
Chen CH, Wang TM, Chang HM, Chi CS. The effect of breast- and bottle-feeding on oxygen saturation and body temperature in preterm infants. J Hum Lact. 2000 Feb;16(1):21-7.
Blaymore Bier JA, Ferguson AE, Morales Y, Liebling JA, Oh W, Vohr BR. Breastfeeding infants who were extremely low birth weight. Pediatrics. 1997 Dec;100(6):E3.

If you have favorite references on this subject that aren't mentioned above, please add them in the comments.

Very crafty

Wednesday, March 24, 2010

Cosy Baby, Happy Mommy

Visit for great slings, wraps and mei tais!

More than 1 million baby slings recalled

By JENNIFER C. KERR, Associated Press Writer Jennifer C. Kerr, Associated Press Writer – Wed Mar 24, 4:30 pm ET
WASHINGTON – More than 1 million baby slings made by Infantino were recalled Wednesday after claims linking them to three infant deaths.

The Consumer Product Safety Commission said babies could suffocate in the soft fabric slings. The agency urged parents to immediately stop using the slings for babies under 4 months.

The recall involves 1 million Infantino "SlingRider" and "Wendy Bellissimo" slings in the United States and 15,000 in Canada.

Infantino President Jack Vresics said the company has been working closely with the commission on its sling concerns.

"Our top priority is the safety of infants whose parents and caregivers use our products," Vresics said in a statement. He said the company would offer a free replacement baby carrier, activity gym or shopping cart cover to any affected consumer.

The slings wrap around the chest so on-the-go parents can carry their babies or just stay close as they bond with their infants.

Earlier this month, CPSC issued a broad warning about sling-style baby carriers, saying they pose a potential suffocation risk to infants, especially babies under 4 months. Babies who had a low birth weight, were born prematurely or had breathing problems such as colds were also at risk.

At the time, the commission did not single out a specific type of sling or manufacturer. It said it had identified or was investigating at least 14 deaths in the last 20 years associated with baby slings.

In Wednesday's announcement, CPSC said three of the deaths occurred last year and were linked to Infantino slings. It did not say exactly how the babies died.

In its general sling warning earlier this month, CPSC said infants can suffocate in two different ways:

_A sling's fabric can press against a baby's nose and mouth, blocking the baby's breathing and suffocating a baby within a minute or two.

_The other scenario involves slings where the baby is cradled in a curved or "C-like" position, nestling the baby below the mother's chest or near her belly. That curved position can cause a baby who doesn't have strong neck control to flop its head forward, chin-to-chest, restricting the infant's ability to breathe. "The baby will not be able to cry for help and can slowly suffocate," warned the commission.

Slings have been promoted by baby experts as a way to calm fussy babies or for nursing moms who can breast-feed their little ones in the sling.

Consumer Reports raised concerns about slings back in 2008, and had called on CPSC to issue a recall of the Infantino SlingRider. Safety advocates criticized the curved position that the baby can fall into while inside the sling.

Baby experts and breast-feeding advocates insist that not all slings are dangerous. They say carriers that keep a newborn baby solidly against the mother's body, in an upright position, are safe.

The Infantino slings being recalled were sold from 2003 through 2010 at several retailers, including Target, Babies R Us and Burlington Coat Factory. Consumers can call Infantino at 866-860-1361 to receive a free replacement product.

There are no federal safety rules for baby slings.

Infantino says it's working with CPSC and ASTM International, an organization that sets voluntary safety standards, to develop a standard for slings.

The CPSC specializes in product safety, and often negotiates agreements with manufacturers for recalls, when necessary.


On the Net:

Consumer Product Safety Commission:


All Babywearing is NOT the same

Too many moms can't find help needed to breastfeed

By Catherine Porter
Happy pink and yellow Easter eggs dot the walls of the Toronto East General Hospital's breastfeeding clinic, along with pictures of babies sucking peacefully on breasts.

If only it was that easy.

Anxious mothers crowd the space, holding, bouncing, rocking their babies.

They look tired and raw.

"I just can't get him to latch on my left breast," says one, who has driven all the way from Ajax.

"He was crying all night non-stop. He didn't want to suck my breast and he wasn't pooing or peeing," says another, her 4-day-old son finally quiet in her arms. "I was here for two hours yesterday learning how to do it."

You can't be prepared for how hard breastfeeding is. You assume it will happen easily, like popping a cork back into a bottle. It's a skill that can take days to learn, and the consequences of getting it wrong are nipples with bruises and open sores.

I speak from experience.

I think of the two weeks after giving birth to both my kids as my personal version of Guantanamo Bay's frequent flyer program: Never sleeping for more than two hours; awoken by a screaming alarm; forced to drag my swollen bleeding body back into the torture chamber of my child's mouth.

It wasn't any easier the second time, despite having a year of practice.

And I didn't have to face tube-feeding or mastitis – an infected milk duct. Senay Jurkiewicz awoke 10 days after giving birth to 7-month-old Burton with chills and a fever. Her fever went, but the blocked duct never did – it grew to the size of a kiwi.

She called one breastfeeding clinic and got an appointment – in two weeks. Two weeks?

"There's definitely not enough resources," says Jurkiewicz, who found antibiotics, but no breastfeeding help from a family doctor.

This brings me to the point. Toronto Public Health put out a damning report about breastfeeding this week.

It surveyed 1,500 first-time mothers and found 39 per cent left the hospital with free infant formula – despite the World Health Organization, Health Canada, the Canadian Paediatric Society all promoting exclusive breastfeeding to ensure both mama and baby's long-term health. It's like the nurses you sometimes see wheeling patients out to the hospital courtyards for a cigarette break.

While the report lambastes hospitals for not having baby-friendly practices in place for the mother while she is there, there's little discussion of our failures once she goes home. Remember: most moms are only in hospital for a day, maybe two. Then, back at home, the milk comes in and she's left to her own devices.

Hands-on support for breastfeeding has been shrinking for years in Toronto.

First, the North York Hospital shut its breastfeeding clinic. (Dr. Jack Newman set up a private breastfeeding clinic down the road, but he charges $50 a visit to cover his costs.) Then, Scarborough Hospital shut its general campus clinic.

Most of the clinics left open are by appointment, and only serve mothers who delivered there.

The only drop-in clinic in the whole city new moms can rush to, regardless of where they gave birth or live, is here, at Toronto East General. But even it has cut its hours, citing budget constraints and a caseload burdened with patients from as far as Pickering.

"We as health-care professionals are failing mothers because we're not giving them proper help," says Janet Zablocki, the clinic's warm-faced nurse and lactation consultant, rushing between babies.

She lists the medical benefits of breastfeeding a baby: more robust immune system, less chance of asthma, gastrointestinal and ear infections. They're less prone to childhood diabetes and sudden infant death syndrome.

In light of this, the clinic's annual $145,000 budget seems a puny down payment for a long-term windfall.

Why aren't there more of them? Despite all its talk about the importance of breastfeeding, our government has not made it a priority. Unlike Quebec, we don't have a provincial policy. We should.

The mothers who can't find help feel like they've failed the biggest test of parenting – protecting their child's health.

"I spent days feeling so guilty and ashamed," 30-year-old Michi Methven emails me. The mental health administrator switched to formula after two weeks of infected nipples.

"I refused to leave the house for fear someone would see me bottle-feeding and yell at me from the street."

Tuesday, March 23, 2010

Public breastfeeding shouldn't be taboo

By Justin Prochaska

Published March 23, 2010

Zach Callaway/Graphic Designer
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Last Friday, The Maneater ran a letter to the editor about an incident that occurred at the Student Recreation Complex regarding a woman and her young child.

Apparently, this woman was breastfeeding her child by the pool when an employee told her she was not allowed to breastfeed there and asked the woman to move.

I read this and couldn't believe it. Last time I checked, this was still America.

It is ridiculous mothers are not able to feed their children wherever they go.

I understand some people are prudes and find offense by exposed "private parts" in public, but the world doesn't revolve around them. I can see why people wouldn't want to walk around and see bare breasts all around, but this should be a non-issue.

I know I can't tell people what should offend them, but the fact is breastfeeding is a natural and healthy way to feed a newborn child. There is no reason mothers shouldn't be able to feed their kids in public. It isn't fair to exile new mothers who want to keep their children healthy.

It's not like breastfeeding is pornography. How much can you actually see anyway? I'm not a mother, obviously, but I would expect most women would probably make an effort to cover themselves to a certain degree.

The mother should be able to feed her child without any type of hassle. A woman and her baby have the right to breastfeed wherever they please.

If the baby doesn't eat, he or she probably won't be too happy. I would much rather let a woman feed her child than listen to a crying baby for hours on end, and I'm fairly positive in thinking most of you out there would agree with me.

Unlike smoking, a breastfeeding mother doesn't harm innocent passers-by. Public breastfeeding isn't dangerous or hazardous to anybody. All mothers should be able to feed their children, and all kids should have the right to eat in peace.

In the past, people have said public breastfeeding is obscene and should be done in the privacy of the home. Well, here's an idea: If public breastfeeding is insulting and offensive to you, don't look at it. Nobody is forcing you to watch it. Just turn your head and move on with your life.

It's funny, though. We live in such a double standard society. In this country, it is frowned upon to publicly breastfeed, because bare breasts are vulgar and crude. Yet, it is perfectly fine for men to walk around wearing oversized pants down to their waists with their cracks hanging out. Please.

We also don't bat an eye when a well-endowed woman gets on TV, shows her cleavage and persuades us to buy beer, adopt a puppy or join a cult. Of course, the moment a woman pulls out her breast to nurture a young child, everyone freaks out.

The woman who wrote the letter to the editor should not have been asked to move. It isn't illegal to breastfeed. It isn't illegal for the child to eat. In fact, as the writer referenced, Missouri law allows public breastfeeding.

The woman said she would not be "marginalized into silence by any ignorant staff person again." Good for her. She has every right to be upset.

This is the 21st century. Our society is way too conservative. We need to stop being appalled by any sight of breasts in public. Just because you don't like it doesn't mean the world should stop and cater to you.

America prides itself on its freedoms, but if a woman can't feed her own child in public without causing commotion, what freedoms do we really have?

Untitled Photographs

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Thursday, March 18, 2010

Breastfeeding Twins

Nursing M and J

Nichole's story:

Before I had the boys everyone thought I was nuts that I did want to nurse. My aunt who is a nurse told me it was too hard with one I wouldn't really be able to do it. The boys were born @ 36 weeks bc I was in a lot of pain with my upper baby turning breech. When they took me in for the c section I told people I didn't want them to have a bottle at all. Well, their sugar was really really low and I was throwing up so they tried a bottle but neither of them really sucked so that was the end of that. In the hospital I would feel what was like a blur because I was so tired from having them in the room and getting no sleep since they had put me on bedrest 2 months before. But every time I fed the babies I would pump. Literally everytime. My milk came in 2 days later probably from all the feeding and pumping.
So the boys started losing a little weight but nothing too bad but you know, the pediatricians freak you out so I started getting scared, and their jaundice wasn't going away and my one guy hurt so bad! But his tongue was on the roof of his mouth. So we got that fixed but I was still paranoid so they told me to get fenugreek. By now I'm obsessed with breastfeeding.
There was one day where I apparently wasn't eating or drinking well or just drying up? My boys just sucked and sucked for hours. Screaming! Well, my grandma started screaming @ me because the boys didn't know how to take a bottle. I didn't handle that well. So I went out and got goats rue and it helped a lot! Now I'm still taking it and refuse to go off of it. So, things have been great. I stopped attempting to tandem feed because they were like 3 months old and they started fighting. Every once in a while I will try. Its a little awkward.
I will have to say at first because I was so tired being away from my fiance I would wake up in the middle of the night and catch myself nursing my pillows!
I have learned from Janet that sometimes its just easier to let them sleep with you. So I kicked my fiance out of bed and they now sleep with me. They are awesome little men and are very much mommas boys but that's ok because I like it that way!

Free Formula Spoils Breastfeeding

stock image photo

Free formula spoils breastfeeding
March 16, 2010

Laurie Monsebraaten

Noor Javed

New mothers given formula upon discharge ranged from 22 per cent to 78.5 per cent, depending on the hospital where she delivered: Toronto public health report

Almost 40 per cent of new mothers leave the hospital with free infant formula, a recipe for spoiled breastfeeding according to a new Toronto Public Health report.

Women who didn’t receive the free samples were 3.5 times more likely to be breastfeeding exclusively after 2 weeks, said Breastfeeding in Toronto, Promoting Supportive Environments, released Tuesday.

The study, conducted in 2007 and 2008, found that of 1,500 first-time mothers surveyed, 39 per cent were given formula at hospital discharge. As a result, many of these women stopped breastfeeding sooner than those women who weren’t given formula.

“A substantial proportion of hospitals are still doing this,” said Dr. David McKeown, Toronto’s Medical Officer of Health. “There are some incentives for hospitals to do this (promote formula)...and that is really not in the interest of infants and mothers.”

McKeown said hospitals should have a “comprehensive breastfeeding policy, help for mothers to initiate breastfeeding within a half-hour of birth, and ensure newborns are not given food or drink other than breast milk unless medically indicated.”

The World Health Organization (WHO), Health Canada, the Ontario Ministry of Health and Long-Term Care, and Toronto Public Health support exclusive breastfeeding to six months of age as the best nutritional choice for babies. At six months, they recommend solid food and continued breastfeeding until age two and beyond.

The Breastfeeding Committee for Canada, which promotes breastfeeding, notes that aggressive formula marketing has plagued hospitals since the 1940s.

“The provision of free formula in hospital, free educational materials for new parents and educational donations for staff has been taken for granted as a convenient way to provide patient and staff education,” the committee says on its website. “Strains on health care budgets have led health care facilities to depend on formula company donations as though there are no alternatives.”

There has always been controversy about hospitals receiving free formula. It is why Toronto East General Hospital – the only Baby Friendly hospital in the city and among about two dozen in the country – cancelled its contract in 2005, said Linda Young, director of maternal newborn and child health.

To become Baby-Friendly, hospitals and other facilities have to comply with the WHO’s International Code of Marketing Breastmilk Substitutes. This code stipulates that there should be no free or low cost supplies of breast-milk substitutes to maternity wards and hospitals.

“When the formula companies put together a contract, they list all the things that they give – the formula, the nipples, and the bottles, and it comes up to a big number,” Young said, adding there is sometimes a signing bonus of anywhere between $130,000 and $150,000 which hospitals can use for other programs and services.

The only other GTA hospital that Young knows of that is buying formula instead of getting it free is Lakeridge in Oshawa. “Any kind of money is hard to give up for a hospital,” she said.

The impact of promoting formula as they leave the hospital gives off mixed messages to new mothers, adds Young.

“They give it to the women ‘just in case’,” she said. “But the real message is that you will probably fail... and one bottle leads to another.”

The International Formula Council, representing infant formula makers and marketers, has long argued that free samples have no bearing on a women’s decision whether to breastfeed or formula-feed their baby and that mothers want to be informed of their choices.

Ann Holden, patient care manager for the family birthing centre at St. Joseph’s Health Centre, said the hospital receives free formula from manufacturers and is currently renegotiating its contract with Abbott Canada, makers of Similac.

But the hospital has never given out infant formula in the five years she has held the post, she said. “We have never given formula samples or any infant-feeding supplies.”

However, the hospital will provide free samples when mothers request formula for feeding, she said in an interview.

Dr. Jack Newman of the Newman Breastfeeding Clinic, said no birthing hospital in Southern Ontario hands out formula in gift packages anymore. Instead, most new mothers get infant formula from nurses when they leave the hospital.

“The nurses will say ‘I’m not supposed to hand this stuff out, but here are a couple of bottles if you are having trouble,’ ” he said in an interview Tuesday night.

“The nurses think they are helping,” Newman said. “But in fact they are not.”