Techniques of Breast Feeding

Avoid Eggs, Peanuts, Milk While Breast Feeding: Exclusive breastfeeding and avoiding these and fish decrease allergies (Since fish adds valuable omega-3 fatty acids, and I advise continuing fish or fish oil or flax seeds—Ed .). Authors recommend hold off peanuts till 36 months of age. Am J Clin Nutr 8/97. Ed: Boiled peanuts probably OK since it is the high temperatures of roasting that forms the allergenic substance.

Education Programs Powerful Effect on Breast-Feeding: Thirty randomized and nonrandomized controlled trials and 5 systematic reviews of breastfeeding counseling from 1966-2001 were found and included. Educational programs had the greatest effect of any single intervention on both initiation (difference 0.23) and short-term duration (difference 0.39). Support programs conducted by telephone, in person, or both increased short-term (difference 0.11) and long-term duration (difference 0.08). In contrast, written materials such as pamphlets did not significantly increase breastfeeding. Data were insufficient to determine whether the combination of education with support was more effective than education alone. The effectiveness of primary care-based interventions to promote breastfeeding: systematic evidence review and meta-analysis for the US Preventive Services Task Force. Guise JM, Palda V, Westhoff C, Chan BK, Helfand M, Lieu TA; U.S. Preventive Services Task Force. Ann Fam Med. 2003 Jul-Aug;1(2):70-8

Exercise Doesn’t Lower Milk Consumption: Study of 24 women 1 hours after 30 min. moderate and even vigorous exercise found no decrease in milk consumption although small increase in lactic acid content of milk (0.09 to 0.21). No need avoid exercising. Pediatrics 2002 Apr;109(4):585-9

Mothers Put Baby on Own Breast Better: Only 46% of mothers in English study starting to breast feed still at it 6 weeks later. Women who put the baby to the breast the first time themselves were much more likely (71% vs 38%) to continue breast feeding than were women who had others, e.g. midwives, put the baby on their breast. Author recommends "hands-off" technique, apparently giving the women control of their own situations. BMJ 4/11/01

Nipple Candidiasis is Common: In a Canadian study of 105 women referred for breast feeding problems, 26% had a candida yeast infection. Nipple candidiasis was found to be associated with three factors: vaginal candidiasis (P = 0.001), previous antibiotic use (P = 0.036), and nipple trauma (P = 0.001). Physicians should be suspicious of nipple candidiasis; avoid antibiotics or use the shortest effective course; treat yeast vaginitis during the third trimester and after delivery aggressively; and treat mothers for nipple yeast if babies have oral or diaper candidiasis. Univ. Calgary. Nipple candidiasis among breastfeeding mothers. Case-control study of predisposing factors. Tanguay KE, McBean MR, Jain E. Can Fam Physician. 1994 Aug;40:1407-13. Ed: Eating yogurt every day is the best prevention.  Rubbing a little plain yogurt on the nipple if trauma or inflammation begins to occur can also help. Treat yeast vaginitis with direct instillation of plain yogurt.  

Pacifiers: Don’t Use 'Em: The use of a pacifier while still breastfeeding was found to decrease the amount of breastfed milk and increase the amount of infant formula that had to be added as a supplement. 68% of mothers in a study of 268 were already using a pacifier by the 6^th week. Pediatrics 3/99.

Pacifier & Thumb-Sucking Decrease Breast-Feeding: U Iowa study found at 6 wk, 3 mo, & 6 mo, only 46%, 36%, and 27% were doing any breast-feeding. Pacifier use already in 81%, 71%, and 59%. It and thumb sucking associated with early cessation of breast-feeding. 1387 infants from 8 hospitals around Iowa. Those not in child care but using pacified actually had highest rate of cessation. J Fam Pract 2002 May;51(5):465

Vitamin D Supplement Should be Given: New recommendations by the American Academy of Pediatrics for vitamin D supplementation for breast-fed infants have been published that underscore the importance of routine supplementation with 200 IU vitamin D per day. Nutrition for the pediatric office: update on vitamins, infant feeding and food allergies. Collier S, Fulhan J, Duggan C.  Harvard Medical School, Curr Opin Pediatr. 2004 Jun;16(3):314-320

Vitamin B-12 Deficiency in Strict Vegetarian Mom's Infant: A case of severe B-12 deficiency and illness in an infant reminds us of the importance of mothers taking vitamin supplements. Severe vitamin B12 deficiency in an infant associated with a maternal deficiency and a strict vegetarian diet. Weiss R, Fogelman Y, Bennett M. J Pediatr Hematol Oncol. 2004 Apr;26(4):270-1

Other

Older, Better Educated Moms Breast-Feed More; 36% Norwegians Breast-Feed Past 12 Months: Of 1932 12-month-old infants studied, at 12 months, 36% of the infants were being breast-fed. The odds of breast-feeding at this age were more than doubled both for mothers >/=35 years compared with mothers <25 years and for mothers in the highest educational group compared with mothers in the lowest. The odds of breast-feeding were 40% lower for mothers who smoked than for non-smokers. Breast-fed infants had a significantly lower daily intake of sweetened drinks than non-breast-fed infants and a 16% lower mean daily intake of added sugars (P<0.001). Furthermore, breast-fed infants had 30% higher odds of not receiving sweetened drinks daily, compared with non-breast-fed infants. Breast-feeding at 12 months of age and dietary habits among breast-fed and non-breast-fed infants. Lande B, Andersen LF, Veierod MB, Baerug A, Johansson L, Trygg KU, Bjorneboe GE., University of Oslo, Norway. Public Health Nutr. 2004 Jun;7(4):495-5

Physician Opinions Strongly Influence Continued Breast-Feeding: The American Academy of Pediatrics recommends exclusive breastfeeding for the first 6 months of life. Recent statistics indicate that initiation and maintenance of exclusive breastfeeding are low in the United States. In a prospective cohort study of low-risk mother-newborn pairs in a large, multispecialty group practice in which the mother was breastfeeding at 4 weeks, of the 288 mothers who were breastfeeding at 4 weeks and had a complete 12-week interview, only 152 (53%) were exclusively breastfeeding their infants at 12 weeks. Mothers who discontinued exclusive breastfeeding were more likely to have experienced problems with their infant latching on or sucking (odds ratio [OR]: 3.8) or report that a health care provider recommended formula supplementation (OR: 2.3). Clinicians reported limited time during preventive visits to address breastfeeding problems as a very important barrier to promoting breastfeeding. Obstetric providers were least confident in resolving problems with mothers not producing enough breast milk. Pediatric providers were least confident in resolving problems with breast pain or tenderness or cracked or painful nipples. In the final multivariate model, mothers whose pediatric providers recommended formula supplementation if an infant was not gaining enough weight (OR: 3.2) or who considered their advice to mothers on breastfeeding duration to be not very important (OR: 2.2) were more likely to have discontinued exclusive breastfeeding by 12 weeks postpartum. African-American mothers were significantly more likely to discontinue exclusive breastfeeding by 12 weeks. Opinions and practices of clinicians associated with continuation of exclusive breastfeeding. Taveras EM, Li R, Grummer-Strawn L, Richardson M, Marshall R, Rego VH, Miroshnik I, Lieu TA. Harvard Medical, Pediatrics. 2004 Apr;113(4):e283-90

Transfats High in Breast Milk and Come for Mother's Diet: Trans fatty acids content in human milk varied between countries from 0.35% in Africa to 7.2% of total fatty acids in Canada as a result of variation in dietary exposure. Since these are unhealthy for adults, they might be unhealthy for infants, too. Influence of trans fatty acids on infant and fetus development. Mojska H. Acta Microbiol Pol. 2003;52 Suppl:67-74

The reasons for ceasing breast-feeding observed in all subtypes were perceived shortage of milk volume and elder children's anger and jealousy. Pediatr Int. 2004 Feb;46(1):15-20