The Motherwear Breastfeeding Blog

No breastfeeding because of the rotavirus vaccine? President of the Academy of Breastfeeding Medicine responds.

You may have seen on other blogs or on Facebook that CDC scientists recently authored a study suggesting that mothers stop breastfeeding to make the rotavirus vaccine more effective (other people's characterization, not mine).  I overheard it being discussed at a mom's group last week. 

Fortunately, the president of the Academy of Breastfeeding Medicine, the organization representing physicians knowledgeable about breastfeeding, posted a response on the organization's blog. Thanks to Best for Babes for the tip!

It's a complicated issue and I'll leave it to the post to explain it all, but the bottom line is:  Don't panic, don't stop breastfeeding, don't storm the CDC headquarters in Atlanta.  In short, as this war-time parody poster says, Keep Calm and Nurse On.

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Poll: Where did you birth?

NPR reported last week that the rate of home birth has increased pretty dramatically in the last few years (up 25% between 2004 and 2009).  It's still a very small percentage of the total births, less than 1%, but the increase is still notable.

Why the increase?  NPR identified mothers' concerns about the record high c-section rate and liberal use of interventions as one driver of the increase.  One of my (hospital) midwives suggested that the lack of access to VBAC was driving more moms to birth at home.  And when I interviewed Jennifer Block, the author of Pushed, for a podcast on the Motherlove Blog she attributed part of the increase to the Ricki Lake movie, The Business of Being Born.

In any case, when I heard that piece it occurred to me that, while I've posted many polls, I've never asked you where you birthed.  So below is a poll asking just that.  You can vote more than once if you've had more thanone baby.  Me?  2 hospital births.

"Big Momma breastfeeds me, too"

What do you think of this PSA?

I think it should get points for originality and for acknowledging the influential role of grandmothers and dads, especially in the African American community.  I also like that the family is laughing at times.  The image of the grandmother feeding the baby by bottle at the end was momentarily confusing for me, but all in all I like it.

Tandem nursing too obscene for Funny or Die?

Funny or Die, a site known for sophomoric humor (including full frontal male nudity) apparently got a little light-headed from seeing a video of a mom tandem nursing her twins.

Funny or Die found the video by a comedienne and mother of twins Ahna Tessler, which (you are hereby warned), is laced with profanity, too risque and suspended the account of its creator.

The New York Times reported:

On the afternoon of Jan. 14 Ms. Tessler reached out to Funny or Die in a public area of the site, noting that the video had not been posted and that another video she had previously published was missing. That evening a site administrator replied, “Sorry, but your latest video got flagged as obscene, and we removed your account in response.”

When Ms. Tessler wrote back to say she “had no idea you couldn’t swear” on the site, the response was, “It was the breast-feeding video, not swearing.”

Funny or Die later reinstated the account and stated, “Funny or Die supports breast-feeding in all forms, especially among consenting adults.”  Which is kinda funny, I have to admit. 

Ahna Tessler told the New York Times that nursing twins is "the hardest thing I’ve ever done...I have to find the humor in this because it’s so insane right now, the amount of work and how exhausting it is.”

It's a strange world in which Funny or Die can't handle breastfeeding but the Catholic Church wants to see more of it.

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Study: Pumping method affects milk composition for preterm infants

Following on their study on milk volume and method of expression, which showed that a combination of pumping and hand expression (a technique termed "hands on pumping") yields more milk for preterm infants, a team at Stanford University School of Medicine has shown that pumping method also affects milk composition.

The study, led by Dr. Jane Morton, found:

The researchers’ findings confirmed that moms [of very preterm infants] who used hands-on pumping had higher fat content in their milk than women relying on electric pumps alone...

“People have suspected that mothers would be able to get more fat-rich milk with hands-on pumping but it’s never been demonstrated before,” said Jane Morton, MD, a community pediatrician who was the new paper’s first author. The suspicion arose because milk composition changes during a feeding, shifting from more-dilute milk at first to richer, higher-fat “hindmilk” at the end. Because of its high fat content, the hindmilk is more viscous, which may explain why it’s difficult to remove this milk with an electric pump alone. But extracting more high-fat hindmilk could give preemies an important calorie boost.

Dr. Morton says that her next research question is whether this higher-fat milk is sufficient to meet preemies' needs without the use of human milk fortifier.  This fortifier, with the exception of the human-milk product made by Prolacta Bioscience, is made from cow's milk.  Cow's milk products have been shown to increase the risk of the life-threatening condition necrotizing enterocolitis.

Another question many moms may have is whether the same applies for full term infants.  Here's a post I wrote on two different methods of hand expression, in case you'd like to conduct an experiment of your own!

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Guess what my baby ate?

My daughter (seen here by our chicken coop eating snow) goes to a wonderful home day care in our neighborhood twice a week. 

Each time she's there I get a report about what she ate and what she did. 

She is still an unenthusiastic eater at home, but here's what she ate on one day last week:

oatmeal with blueberries

pineapple

bread with hummus

brown rice spaghetti

brocolli

red lentils and quinoa

blueberries

nori sheets

more bread and hummus

and a smoothie with fruit, kale, flax meal, and hemp

First, am I lucky to have her there, or what?

And second, could this be the same baby who not long ago would spit everything out?

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A motorcycle courier for pumped milk

I thought that this idea was pretty original:  A business in Indonesia has begun to offer a courier service for pumped breastmilk.

The service was launched in 2010 by Fikri Nauval, owner of a cargo and document shipping business, who said he was inspired by his wife's using one of his motorcycle riders to send her breast milk home to their baby after she had to return to work.

He charges 30,000 to 40,000 rupiah ($3.30 to $4.40) a trip, keeping track of traffic conditions and the best routes for drivers to take using a GPS map on a computer.

Pretty expensive, especially for a developing country, but I guess for some babies only the best will do!

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Can you take pseudoephedrine for a cold while breastfeeding?

I had a yucky cold last week.  I was fine during the day using the usual home remedies, but one night I really wanted to be able to sleep well.  So I looked in our medicine cabinet to see what we had.

Yes, yes, I know that taking a cold medicine doesn't shorten the duration of a cold, but I don't think it's a crime to want some relief from the symptoms, especially when trying to take care of small chidren.

I've always cautioned moms against taking pseudoephedrine while nursing, but I wanted a refresher in the concern about it, and what I could take.  So I consulted Dr. Thomas Hale's Medications and Mothers' Milk, 2010.

(If you want the same information I have in this gem of a book - for free - you can call the Dr. Hale's Infant Risk Center!)

Here's what Dr. Hale says about pseudoephedrine's effect on milk supply: 

In a study of eight lactating women who received a single 60 mg dose of pseudoephedrine, the 24 hour milk production was reduced by 24%...While these results are preliminary, it is apparent that mothers in late-stage lactation may be more sensitive to pseudoephedrine and have greater loss in milk production.

Medications and Mothers' Milk has an appendix devoted to over-the-counter cold remedies, and for each of the many cold medicines which contain pseudoephedrine Dr. Hale has written "Probably safe, may suppress milk supply." 

I should note that nearly all of the cold medicines listed had mulitple ingredients, and there may be other concerns related to those medicines.  For example, for many products Dr. Hale has written "observe for sedation" (in the baby, that is).  In a handful of cases he lists medications as "unsafe."  The vast majority are listed as "probably safe," and two lonely products are listed as "safe." Again, if you have questions or concerns about a medication you want to take, call the Infant Risk Center.

Rumaging through our supplies, I found some cold medicine which had no pseudoephedrine but had phenylephrine (a decongestant).  I checked that, too, and read Dr Hale's assessment:  "Because of pseudoephedrine's effect on milk production, concerns that phenylephrine may supporss milk production [sic], have not been confirmed yet.  There is no evidence that this occurs at all."  He does not list "may suppress milk supply" in the Appendix for products containing this ingredient.

I generally ascribe to the precautionary principle when it comes to these things, but I was pretty desperate for a good night's sleep.  So, I decided to take an informed risk and use the product with phenylephrine, one time.  And it did help make it through the night.  I have a strong milk supply, and I didn't notice any dimunition.

I hope that you all make it through cold season in one piece, and that you take advantage of the Infant Risk Center for medication questions!

* This post is provided for educational purposes only.  Please consult your health care provider for care related to this topic.

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Why "normalizing" breastfeeding matters.

In a week when we're hearing a lot about breastfeding on Sesame Street, including statements of support by some top pediatricians, I wanted to share one of my favorite videos on the power of conformity.

The point is that if mothers perceive breastfeeding as normal (what everyone is doing) they're more likely to feel comfortable doing it.  And they're less likely to be harrassed at Target or get flack from their employers when they need to pump.  Getting breastfeeding back on Sesame Street would be one step in the direction of "normal."

I love this video and the point it makes about what happens when people perceive what's normal.  Please "like," share on Facebook, Tweet, share, forward, etc. if you do, too!

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This Martin Luther King Jr. Day, we recall some posts on race, ethnicity, and breastfeeding

I thought today might be a good day to compile a number of posts I've done which address issues of race and ethnicity and breastfeeding.

• First, I have a new post up at Best for Babes today entitled "Is there a 'soft bigotry of low expectations' when it comes to breastfeeding?" (link soon) which explores whether African American mothers receive lower quality care because providers expect them not to breastfeed.

• Here's a popular podcast on African American moms and breastfeeding was an interview I did with Kathi Barber, founder of the African American Breastfeeding Alliance

• Here are two posts I did on "Las Dos," the pattern of supplementation among Latina moms, and the campaign I worked on to reduce that practice:  "My husband, the breastfeeding slogan genius," and "Las Dos."

• Here's a plea I wrote for more diversity among lactation consultants.

• And here's an older post on race and other demographic factors and breastfeeding initiation data, called "Who breastfeeds?" and a more recent one describing an unwelcome result from the data, "Big gaps persist."

• While you offered a lot of different explanations for it, I suggested that race and ethnicity could answer the question: "Why do western moms breastfeed more?"

• Here's a recent post on breastfeeding and ethnicity for Best for Babes, specifically cultural practices related to breastfeeding and how hospitals respond.

• A post reporting on a segment on African American moms and breastfeeding on the NPR program "Tell Me More."

• Finally, here's a post about my book Spanish for Breastfeeding Support and a podcast of the audio portion of the first chapter.

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