Alicia: What Breastfeeding Means to Me

I gave birth to my daughter Hailee in February 2009, one month before my 22nd birthday. I was a very young mom and very insecure with that even though my husband and I had already been in a very happy and loving relationship for over 6 years and married for 2 of them. We were young, crazy, and madly in love with each other. We made a choice to start our family early, and it was absolutely the best choice for us.

With that said, I was still left feeling very judged and inadequate as a mother at times because of my age. Comments like, "Wow. You are getting started young," from strangers really wore my confidence down. My older sister was the only person in either of our families' that I had known to breastfeed. My sister nursed her sweet son for close to 2 years though, and I saw how that bonded them together.

Breastfeeding was not something I had to decide if I wanted to do or not. For me, it was my only choice. It was also the beginning of me making choices for my child that were solely based on what was best for us, and had nothing to do with other's opinions. Of course it was healthy for me and my baby, but it was so much more for me. Breastfeeding gave me confidence in myself as a mother that I was doing what was best for my child. My husband's opinions were suddenly the only ones that mattered to me when it came to our daughter, and he was more supportive of breastfeeding than I could have ever imagined he would be.

I hope anyone out there struggling with confidence in your parenting choices can be inspired to try to just make choices based on what is best for you and your family despite your age or family dynamic. I love hearing what works for other families, but in the end I feel very strongly that something different works for every family. Whether it is breastfeeding, discipline, or the kinds of foods you eat; we all do things differently so let's be strong in those decisions. And a final word: let's support those other mamas out there who make choices different than our own, because it's what is best for their family.

-Alicia

Ali: What Breastfeeding Means to Me

When I was pregnant with my daughter, the decision to breastfeed wasn’t an easy one for me. I have had Crohn’s Disease for 10 years and was on the fence about nursing due to the medication I was on at the time. I went back and forth and was very torn. I had always supported breastfeeding, but I didn’t know if it was going to be what was best for us. Needless to say, I ultimately decided to give it a try.

Today is my daughter’s 11 month birthday and we are still exclusively breastfeeding. Has it been easy? Not at all. Crohn’s Disease weakens my immune system and I have battled with thrush since she was 5 weeks old. I have also had mastitis a few times and currently she is going through a horrible biting phase. Despite all the tears and the hard times, I wouldn’t change it at all.

What does breastfeeding mean to me? It means that we have been able to overcome obstacles together. It means I have put so much of myself into nursing to do the best that I can for my daughter. It means that this little person, my baby, is so incredibly important to me that I would do anything possible to give her what I can.

It means that everyday I get to stop whatever I am doing to enjoy and snuggle with my baby. I get to rub her face, calm her, and feed her. I cherish this even more now that she is walking and active. No matter where we are, whether it be in a busy place or sitting on the couch, we get to stop what we are doing, I get to stare into my little one’s eyes and remember why I love her so much.

It means that I can soothe her every need. When she hits her head and signs “milk” I know she wants her mommy to take away her pain.

It means that we both are healthy. She is getting the best nutrition possible and I have been in remission for the first time in 10 years. We both have needed each other. She needs me, and I need her.

It means that someday I will look back at our nursing relationship and miss it. I will miss the snuggles, the certain milk cry, her being close to me, and us being one.

- Ali

Lactation Lounge on Fox

:)

Study Examines Effects of Domperidone on Composition of Breastmilk

A study published in the January edition of the journal Pediatrics examines the effect of domperidone on the nutrient composition of breast milk. Domperidone is a drug that is often prescribed to improve breast milk volume, but there is a lack of evidence on its effects on milk composition. The study authors examined a group of mothers who had experienced lactation failure and who had delivered infants at less than 31 weeks gestation. Mothers were randomly assigned to receive domperidone or a placebo for 14 days. Protein, energy, fat, carbohydrate, sodium, calcium and phosphate levels were measured, in addition to serum prolactin levels and total milk volume. Domperidone did not substantially alter the nutrient composition of the breast milk, while it did increase the volume of milk in the mothers studied.

To access the study online, go to http://pediatrics.aappublications.org/cgi/content/abstract/125/1/e107

Action Needed

Visit the WIC website to learn how you can voice your opinion regarding Governor Schwarzenegger's veto of AB 513 and SB 257. You will find a sample letter, as well as the email addresses of several major newspaper editors.

And in the news this evening...

We were so excited to have Catherine Garcia from NBC 7/39 in San Diego come by the store and do a segment on the financial benefits of cloth diapering and breastfeeding.

California Vetoed: AB 513 & SB 257

Two breastfeeding bills have been on the governor's desk. Both were vetoed this week. :(
Veto Messages:

AB 513 (DE LEON):
To the Members of the California State Assembly:
I am returning Assembly Bill 513 without my signature.
I share the author's interest in promoting safer, healthier outcomes for mothers and their children. My Administration has several programs dedicated to promoting and encouraging mothers to breastfeed their infants for the multitude of health benefits it provides.
However, the addition of a new mandate, no matter how small, will only serve to increase theoverall cost of health care. This, like other mandates, only increases cost in an environment inwhich health coverage is increasingly expensive.
California has over 40 mandates on its health care service plans and health insurance policies.
While these mandates are well-intentioned, the costs associated with the cumulative effect of these mandates mean that these costs are passed through to the purchaser and consumer.
I continue to have serious concerns about the rising costs of healthcare and must weigh the potential benefits of a mandate with the comprehensive costs to the entire delivery system - and for that reason, I cannot support this bill.

Sincerely,
Arnold Schwarzenegger

SB 257 (Pavley)

To the Members of the California State Senate:
I am returning Senate Bill 257 without my signature.
This bill would require every state agency and department, including local offices, when notified by a female employee that she is nearing maternity leave, to notify the employee of information regarding lactation accommodation on the Internet Web site of theDepartment of Public Health.
While I appreciate the author's intent, I believe that this bill is unnecessary. Current law already requires that accommodation be made for lactating employees. I do not believe it has been adequately demonstrated that employees are unaware of their options.
For these reasons, I am unable to sign this bill.

Sincerely,
Arnold Schwarzenegger

If Breast Is Best, Why Are 70% of U.S. Hospitals Pushing Formula?

WASHINGTON (July 13, 2009)—The majority of U.S. hospitals are providing formula packets upon discharge to breastfeeding mothers while nearly one-fifth of hospitals give something other than breast milk as a first feeding to healthy babies, a report by the Centers for Disease Control found. This practice contradicts the best medical evidence available and breastfeeding recommendations supported by many organizations working to improve maternal and child health nationwide, including Lamaze International.

Breast milk, the natural first food for babies, provides a potent dose of antibodies and essential nutrients. Research indicates that breastfeeding benefits continue throughout a child’s life, including decreased risk of diabetes, obesity, juvenile leukemia, heart disease, asthma and ear infections. Breastfed children also have been found to have better jaw and eye development than those who are not breastfed.

Breastfeeding benefits moms, too. Directly after childbirth, breastfeeding helps a uterus return to its normal size. It may help a new mother lose pregnancy weight, and studies show that it reduces the risk of breast and ovarian cancer. The act of breastfeeding has been shown to increase bonding between mother and baby.

Lamaze International has used recommendations from the World Health Organization to develop six healthy practices that increase the opportunity for women to have safe and healthy birth experiences. One of these practices is to Keep Mother and Baby Together—It’s Best for Mother, Baby and Breastfeeding. When a mother and her baby are skin-to-skin, rooming-in together, there are unlimited breastfeeding opportunities. Researchers have found mothers were more likely to continue breastfeeding if their baby was brought to them for feeding when rooming-in was not possible.

Lamaze International, an organization that bases its education on the latest scientific research, encourages expecting women to tell their care providers they want to keep their babies with them during their hospital stay. By making her preferences known, a woman can ensure unlimited breastfeeding opportunities, which in turn will help give her baby the best start possible.

For more information, download information about the Lamaze Healthy Birth Practices, view videos online, or visit www.lamaze.org.

PRESS CONTACT: Kara Dress, 202-367-2434, marketing@lamaze.org
ALL OTHER INQUIRIES: 800-368-4404; info@lamaze.org

Breastfeeding and Heart Disease

Women who breastfeed are at lower risk for heart disease later in life. Data from nearly 140,000 postmenopausal women (median age 63 years) were studied, as reported in the May 2009 edition of the journal “Obstetrics and Gynecology.” The study authors found that postmenopausal women with a single live birth who breastfed for 7-12 months were significantly less likely to develop cardiovascular disease than women who never breastfed. Among the women, increased duration of lactation was also associated with lower rates of hypertension, diabetes and hyperlipidemia. Access the study online at http://journals.lww.com/greenjournal/Abstract/2009/05000/Duration_of_Lactation_and_Risk_Factors_for.5.aspx.

Strong Evidence Base for Benefits of Breastfeeding

New Rochelle, NY, March 19, 2009—Breastfeeding offers irrefutable and long-lasting health benefits for both mother and baby, which are supported by a comprehensive body of scientific research, including original articles and reviews such as those in Breastfeeding Medicine, the peer-reviewed journal of the Academy of Breastfeeding Medicine. The Academy is a global organization of physicians dedicated to the promotion, protection, and support of breastfeeding through education, research, and advocacy ( www.bfmed.org).

According to leaders of the Academy, despite a sound scientific basis for the advantages of breastfeeding, dissenting opinions that aim to discredit breastfeeding, and question its relevance for women, receive exposure in the mass media such as the recent article in The Atlantic. Critics of breastfeeding do a disservice to new mothers around the world who seek the facts about the proven health benefits of breastfeeding as they often misrepresent the scientific findings and wrongly base global recommendations on the experiences and views of select groups of women.

Clinical and basic science research supports the role of breastfeeding in the development of a baby’s immune system and the presence of maternal antibodies protect infants against infection. Artificial feeding is also associated with increased risk of common disorders of early childhood such as ear infections, asthma, skin disorders, digestive problems, and respiratory tract infections. Studies have also linked artificial feeding to increased risk for obesity, type 1 and 2 diabetes, childhood leukemia, sudden infant death syndrome (SIDS), and necrotizing enterocolitis. Mothers benefit as well, and a history of breastfeeding has been associated with a reduced risk of type 2 diabetes and of breast and ovarian cancer.

With this growing body of evidence, and increasing support among health and medical professionals, breastfeeding rates in the U.S. are in fact on the rise. “But we are reminded as articles like this arise that misinformation abounds. Our goal is to continue to educate healthcare professionals to support mothers who understand the singular importance of breastfeeding and choose to do so,” remarks Caroline J. Chantry, MD, President of the Academy.

“The Academy of Breastfeeding Medicine encourages all women to make an informed choice when faced with the question of how to feed their infants based on strong, well-referenced scientific information. The data are compelling, scientific, and reinforced constantly. Breastfeeding for the new mother may not always be easy, but it is important and rewarding for both mother and infant,” says Ruth A. Lawrence, MD, Editor-in-Chief of Breastfeeding Medicine, from the Department of Pediatrics, University of Rochester School of Medicine and Dentistry.

The Academy promotes the development and dissemination of clinical practice guidelines, and offers clinical protocols for the care of breastfeeding mothers and infants which are available on the Agency for Healthcare Research and Quality’s (AHRQ) National Guideline Clearinghouse website. The education of physicians and other healthcare professionals is the continuing goal of its Annual International Meeting; the 2009 Meeting will be held November 5-8 in Williamsburg, VA.

Breastfeeding Medicine is an authoritative, peer-reviewed, multidisciplinary journal published quarterly. The journal publishes original scientific articles, reviews, and case studies on a broad spectrum of topics in lactation medicine. It presents evidence-based research advances and explores the immediate and long-term outcomes of breastfeeding, including the epidemiologic, physiologic, and psychological benefits of breastfeeding. The Academy's complete position statement appears on the Academy website ( www.bfmed.org).

New Breastfeeding Campaign Turns Heads

http://www.nbcbayarea.com/around_town/the_scene/Lactating-Women-Getting-Second-Looks-in-Marin.html

Best Practices in Maternity Care Not Widely Used in the United States

WASHINGTON (January 7, 2009)—Despite best evidence, health care providers continue to perform routine procedures during labor and birth that often are unnecessary and can have harmful results for mothers and babies. The Centers for Disease Control’s (CDC) most recent release of birth statistics reveals that the rate of cesarean surgery, for example, is on the rise to 31.1% of all births—50% greater than data from 1996. This information comes on the heels of The Milbank Report’s Evidence-Based Maternity Care, which confirms that beneficial, evidence-based maternity care practices are underused in the U.S. health care system.

Research indicates that routinely used procedures, such as continuous electronic fetal monitoring, labor induction for low-risk women and cesarean surgery, have not improved health outcomes for women and, in fact, can cause harm. In contrast, care practices that support a healthy labor and birth are unavailable to or underused with the majority of women in the United States.

Beneficial care practices outlined by Evidence-Based Maternity Care, a report produced by a collaboration of Childbirth Connection, the Reforming States Group and the Milbank Memorial Fund, could have a positive impact on the quality of maternity care if widely implemented throughout the United States. Suggested practices include to:

• Let labor begin on its own.
• Walk, move around, and change positions throughout labor.
• Bring a loved one, friend, or doula to support you
• Avoid interventions that are not medically necessary
• Choose the most comfortable position to give birth and follow your body’s urges to push
• Keep your baby with you – it's best for you, your baby and breastfeeding.

“Lamaze is alarmed by the current rate of cesarean surgery, and furthermore, by the overall poor adherence to the beneficial practices outlined above in much of the maternity care systems in the United States,” says Lamaze International President Pam Spry, PhD, CNM, FACNM, LCCE. “We are continuing to work to provide women and care providers with evidence-based information to improve the quality of care.”

Lamaze International has developed six care practice papers that are supported by research studies and represent “gold-standard” maternity care. When adopted, these care practices have a profound effect—instilling confidence in the mother, and facilitating a natural process that results in an active, healthy baby. Each one of the Lamaze care practices is cited in the Evidence-Based Maternity Care report as being underused in the U.S. maternity care system.

Debra Bingham, MS, RN, DrPH(c), Chair of the Lamaze International Institute for Normal Birth says, “As with any drug, we need to be sure that women and their babies receive the right dose of medical interventions. In the United States we are giving too high a dose of cesarean sections and other medical interventions which are causing harm to women and their babies. Yet there are many countries where life saving medical interventions are under dosed which can also cause harm. Every woman and her baby needs and deserves the right dose of medical interventions during childbirth.”

The research is clear, when medically necessary, interventions, such as cesarean surgery, can be lifesaving procedures for both mother and baby, and worth the risks involved. However, in recent years, the rate of cesarean surgeries cause more risks than benefits for mothers and babies. Cesarean surgery is a major abdominal surgery, and carries both short-term risks, such as blood loss, clotting, infection and severe pain, and poses future risks, such as infertility and complications during future pregnancies such as percreta and accreta, which can lead to excessive bleeding, bladder injury, a hysterectomy, and maternal death. Cesarean surgery also increases harm to babies including women giving birth prior to full brain development, breathing problems, surgical injury and difficulties with breastfeeding.

For more information on the Six Care Practices that Support Normal Birth, finding a health care provider and how to give birth with confidence, visit www.lamaze.org.

Breastfed Baby May Mean Better Behaved Child

By Serena Gordon
HealthDay Reporter
Wednesday, October 29, 2008; 12:00 AM

WEDNESDAY, Oct. 29 (HealthDay News) -- Add yet another potential benefit to breast-feeding: Fewer behavioral problems in young children.
Parents of youngsters who were breast-fed as infants were less likely to report that their child had a behavior problem or psychiatric illness during the first five years of life, a new study found.

And the likelihood of mental health issues decreased in proportion to the duration of breast-feeding, meaning that a child who had been breast-fed for a year was less likely to have behavior problems than a child who had been breast-fed for just two months.

"This is an early finding, but it suggests that breast-feeding during infancy could have an effect on behavior during childhood," said the study's lead author, Dr. Katherine Hobbs Knutson, a resident in the department of psychiatry at Massachusetts General Hospital in Boston.
She was to present the findings Wednesday at the American Public Health Association's annual meeting, in San Diego.

Previous research has shown that breast milk offers numerous benefits for babies and that breast-feeding can benefit both mother and infant. Babies who are breast-fed are less likely to suffer from ear infections, diarrhea, pneumonia, wheezing, and bacterial and viral illnesses, according to the American Academy of Pediatrics (AAP). Research has also linked breast-feeding with a reduced risk of obesity, diabetes, sudden infant death syndrome (SIDS) and certain cancers, according to the AAP.

For mothers, breast-feeding helps the uterus quickly return to its pre-pregnancy shape and helps burn additional calories, which can help get rid of extra pregnancy weight, the AAP reports. Additionally, breast-feeding is believed to help nurture the mother-child bond.
The new study reviewed more than 100,000 interviews of parents and guardians of children between the ages of 10 months and 18 years who participated in the National Survey of Children's Health. Parents were asked about breast-feeding and about their child's behavior and mental health.

Examples of questions included: Are you currently concerned a lot, a little or not at all about how your child behaves? How he/she is learning pre-school or school skills? Has a doctor or health professional ever told you that your child has behavioral or conduct problems?

Parents of children who were breast-fed were 15 percent less likely to be concerned about their child's behavior, compared to formula-fed infants. And the breast-fed children were 37 percent less likely to have a medically diagnosed behavioral or conduct problem, according to the study.
And, Knutson said, the effect of breast-feeding appeared to be cumulative, with those who were breast-fed for a longer duration even less likely to have behavior problems.

She also said the study found "a correlation between breast-feeding and cognitive development." "These findings are certainly intriguing," said Dr. Debra Bogen, a pediatrician in the division of general academic pediatrics at the Children's Hospital of Pittsburgh. The study adds to the "overwhelming evidence that women should, if they can, offer breast milk to their babies," she added.

Both Bogen and Knutson said the nutritional composition of breast milk might have an effect on the way a baby's brain develops, and that better nutrition could explain the behavioral differences. But both experts felt it was too soon to know for sure the exact cause of the potentially protective effect.

More information
For more on the benefits of breast-feeding, visit the National Women's Health Information Center.

SOURCES: Katherine Hobbs Knutson, M.D., resident, department of psychiatry, Massachusetts General Hospital, Boston; Debra Bogen, M.D., pediatrician, division of general academic pediatrics, Children's Hospital of Pittsburgh; Oct. 29, 2008, presentation, American Public Health Association annual meeting, San Diego

Breastfeeding Report Card from the CDC

The Centers for Disease Control and Prevention has released its Breastfeeding Report Card with information on how breastfeeding is being protected, promoted and supported in each state. The publication reports information state-by-state information on five “outcome” and nine “process” indicators. These indicators can be used to: tell the story of breastfeeding practices in each state; monitor progress and celebrate state successes; identify opportunities for growth and improvement in breastfeeding protection, promotion, and support within each state. For more information, go to http://www.cdc.gov/breastfeeding/data/report_card.htm

World Breastfeeding Week

August 1-7, 2008 will be World Breastfeeding Week, and the World Alliance for Breastfeeding Action (WABA) is calling for increased support for mothers “striving to achieve the gold standard of infant feeding: To breastfeed their babies exclusively for the first six months, and continue breastfeeding, together with feeding other appropriate complementary foods, for up to two years and beyond.” For informational resources, free downloads and details on breastfeeding-promoting activities, go to http://www.worldbreastfeedingweek.org. Tying in to the 2008 Summer Olympics, also taking place in August, WABA is also sharing the breastfeeding message with its own “virtual torch run.” To learn more, go to http://www.worldbreastfeedingweek.org/worldwide.htm

CA Labor Commissioner Cites Company For Not Providing Lactation Accommodation to Employee

Santa Clara-June 20, 2008-California Labor Commissioner Angela Bradstreet today announced the issuance of a citation to a Santa Clara-based International Security Services, Inc. for failing to provide private accommodations for an employee to express breast milk for her newborn. The citation is the first of its kind since the law took effect in 2002. A fine of $4,000 has been assessed.

"Under the law, employers are obligated to accommodate employees who wish to provide breast milk for their infant children," Bradstreet said. "This employer failed to provide a reasonable amount of break time and a private room for an employee to express milk for her baby as required."

The labor commissioner received a complaint -- the first lodged as a result of the 2002 legislation -- from the employee on March 7, which prompted an investigation. The investigation revealed that the employee was not provided an appropriate, designated room. Initially the room that was provided was computer server room with security cameras. This offered an inadequate level of privacy needed to perform the milk expressing process.

Labor Code sections 1030-1033 became law in 2001 and mandates every employer, regardless of size, to provide a reasonable amount of time to accommodate expressing of breast milk and to make reasonable efforts to provide the employee with the use of a room or other location, other than a bathroom, in close proximity to the employees work area to express milk in private.

Bradstreet urged women who are not being provided appropriate accommodations for milk expressing to contact her office and file a complaint.

"This is not the type of law that we can address with enforcement sweeps and filing a complaint is important so that we can correct the violation and educate the employer," added Bradstreet.

The DLSE adjudicates wage claims, investigates discrimination and public works complaints, and enforces state labor law and Industrial Welfare Commission wage orders. To learn more about the functions of the California Labor Commissioner, visit our web site at www.dir.ca..gov/dlse.

No Added Sugar in Breast Milk, Unlike Formula

In a country where childhood obesity is an epidemic, parents must be cautious of what they feed their children, starting in infancy. A recent article in The New York Times reports that all formulas contain added sugar, and that Similac Organic formula is sweetened with cane sugar (sucrose), a much sweeter sugar. Breast milk, on the other hand, provides the perfect nutrition for babies while reducing the risk of, infections, chronic diseases and childhood obesity. Read more in a recent press release distributed by Lamaze.

Breastfeeding-Related Maternity Practices at Hospitals and Birth Centers

Breastfeeding provides optimal nutrition for infants and is associated with decreased risk for infant and maternal morbidity and mortality (1); however, only four states (Alaska, Montana, Oregon, and Washington) have met all five (2) Healthy People 2010 targets for breastfeeding (3).* Maternity practices in hospitals and birth centers throughout the intrapartum period, such as ensuring mother-newborn skin-to-skin contact, keeping mother and newborn together, and not giving supplemental feedings to breastfed newborns unless medically indicated, can influence breastfeeding behaviors during a period critical to successful establishment of lactation (4--9). In 2007, to characterize maternity practices related to breastfeeding, CDC conducted the first national Maternity Practices in Infant Nutrition and Care (mPINC) Survey. This report summarizes results of that survey, which indicated that 1) a substantial proportion of facilities used maternity practices that are not evidence-based and are known to interfere with breastfeeding and 2) states in the southern United States generally had lower mPINC scores, including certain states previously determined to have the lowest 6-month breastfeeding rates.† These results highlight the need for U.S. hospitals and birth centers to implement changes in maternity practices that support breastfeeding.

Read more from the CDC (including statistics for each state) here