The Secret to Pain Free Breastfeeding

Breastfeeding Help And Baby Care For New Parents

The Breastfeeding Help Video Compilation By Australian International Board Certified Lactation Consultant Kate Hale is full of useful information about breastfeeding and how to manage low supply. It is very clear and concise in its content. It also has a lot handy tips for new mothers, including how to bath, massage and dress an infant. Learn how to care for a new-born, including how to deeply latch your baby and breastfeed without pain within minutes for a contented baby and an end to sore nipples. It is the only Dvd of which I am aware that is readily available to new mothers with an actual demonstration on how to correctly latch a baby on and off the breast using a couple of alternative feeding positions. Reading about breastfeeding in a book is nowhere near as useful as watching the Dvd. Continue reading...

Breastfeeding Help And Baby Care For New Parents Summary

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Author: Kate Hale
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It is pricier than all the other ebooks out there, but it is produced by a true expert and includes a bundle of useful tools.

Overall my first impression of this book is good. I think it was sincerely written and looks to be very helpful.

Potential Causes for the Protective Effects of Breastfeeding on Later Obesity

A number of hypotheses can be raised on the potential causes of a protective effect of breastfeeding. Even though the inverse relationship of both breastfeeding and breastfeeding duration with later obesity persists after adjustment for measurable confounding variables, residual confounding cannot be fully excluded. Since one cannot randomize healthy babies to either breast milk or formula feeding for ethical and practical reasons, undisputable proof for a protective effect of breastfeeding can hardly be obtained. However, the consistent results of many studies and the dose-response effect between the duration of breastfeeding and the later reduction of obesity risk observed in a number of studies make an effect of breastfeeding highly likely. Moreover, breastfeeding appears to enhance the emotional bonding of the mother to her child, mediated in part by the stimulation of maternal oxytocin release by infant suckling, and breastfeeding has been shown to lead to decreased...

Protective Effects of Breastfeeding against Later Obesity

It has long been known that populations of infants fed breast milk or formula differ in their growth kinetics, with formula-fed infants showing higher weight and length gains 26 . Based on a systematic review of 19 studies in affluent populations, Dewey 27 concluded that by the age of 12 months, the cumulative difference in body weight amounts to approximately 400 g in infants breast fed for 9 months and as much as 600-650 g in infants who are breast fed for 12 months. Given this very large effect of the mode of feeding on early weight gain, we attempted to study whether breastfeeding might also confer protection against later obesity risk. In a cross-sectional survey in Bavaria, Germany, we assessed the impact of breastfeeding on the risk of obesity and the risk of being overweight in children at the time of school entry 28 . Routine data were collected on the height and weight of 134,577 children participating in the obligatory health examination at the time of school entry in...

Breast Feeding

Besides providing milk that is more easily digested by vulnerable preterm infants, breastfeeding facilitates attachment by ensuring that the mother has a primary role in her baby's recovery (Kavanaugh et al., 1997 Meier, 2001). Preterm infants fed breast milk have lower risks of infection and NEC, learn to nipple feed better, have higher cognitive scores, and may have a lower risk of chronic gastrointestinal diseases and allergies (AAP, 2006 Mizuno et al., 2002 Mortensen et al., 2002). Women who breast-feed have less postpartum blood loss, enhanced bone mineralization, and a reduced risk of ovarian and breast cancer (AAP, 2006).

Breastfeeding

Breast-feeding Health workers can promote breast-feeding by advising mothers to start breast-feeding within an hour of birth breast-feed exclusively on demand for about 6 months. Exclusive breast-feeding means giving only breast-milk (and micronutrients and medicines if prescribed but no water) then breast-feed on demand and give complementary foods until at least 2 years of age. Health staff and traditional birth attendants should know how to help mothers start breastfeeding (and express milk or relactate if necessary) and deal with problems such as sore nipples, mastitis and worries about 'insufficient milk'. Many problems are avoided if the baby suckles in the correct position and is fed on demand. Maternity units should introduce the 'Baby Friendly Hospital Initiative' (Box 9.5). Data from Brazil and elsewhere shows that this is most successful when all steps, including those giving information and encouraging support groups, are implemented. In the Gambia, village support groups...

Childhood Obesity Project

In addition to prospective epidemiological and experimental studies, human intervention trials are needed to test this 'early protein hypothesis'. Therefore, we have set up the European Childhood Obesity Project (www. childhood-obesity.org) funded by the European Commission's 5th Framework Research Programme to test, in a randomized double-blind intervention trial, whether variation in protein intakes during the first year of life affects growth kinetics and later obesity risk. This trial is being conducted in 5 European countries which differ substantially in their prevalence of adult obesity and also in the nutritional characteristics of the habitual diet of infants and children, in particular in protein supply with complementary feeding, i.e. Germany (project and center coordinator Prof. Berthold Koletzko, Munich), Belgium (center coordinator Prof. Philippe Goyens, Brussels), Italy (center coordinator Prof. Marcello Giovannini, Milan), Poland (center coordinator Prof. Jerzy Socha,...

Human Immunodeficiency Virus HIV

HIV AIDS is the fifth leading cause of death among persons aged 25 to 44 in the United States (CDCP, 2003). Over the past decade, the widespread use of highly active antiretroviral therapy (HAART) has led to a marked decline in morbidity and mortality among HIV-infected patients (DHHS, 2006 BOJ Statistics, 2002). To prevent perinatal HIV transmission, a protocol of routine testing of pregnant women, antiretroviral therapy for those found to be infected, elective cesarean section in those with detectable HIV viral loads, antiretroviral therapy for newborns, and avoidance of breast-feeding among HIV-infected women has been adopted in this country. These measures have led to a marked decline in the number of HIV-infected newborns in the United States (CDCP, 2006a Cooper et al., 2002). Furthermore, effective prophylactic medications are available to prevent the development of opportunistic infections (OIs) such as Pneumocystis carinii pneumonia, toxoplasmosis, and disseminated...

Hormone Treatment of Health Problems

Ongoing research focuses on the importance of many hormones, especially on understanding their functions and how they might be used in the treatment of common disorders. Two hormones produced by the hypothalamus and released by the posterior pituitary (neurohypophysis) gland are vasopressin (antidiuretic hormone) and oxytocin. Vasopressin keeps the kidneys from losing too much water and helps maintain the body's fluid balance. Variants of vasopressin which decrease blood pressure, identified by Maurice Manning, may lead to a new class of drugs to control high blood pressure. Oxytocin induces labor by causing uterine contractions and also promotes the production of milk for breastfeeding. Manning and Walter Chan are working to develop oxytocin receptor antagonists that may be used to prevent premature births.

Reducing the risk of infection

Infected women of childbearing age should be counselled on avoidance of pregnancy through the use of contraceptives. There is a clear indication for using antiretroviral therapy, either the protocols based on triple therapy or the more affordable treatment based on nevirapine. One difficult issue is the feeding of the baby. Breast-feeding significantly increases the risk of mother to child transmission. Current recommendations are summarized in Box 5.2. Box 5.2 Recommendations about breastfeeding Exclusive breast-feeding should be protected, promoted and supported for 6 months. This applies to women who are known not to be infected with HIV and for women whose infection status is unknown. When replacement feeding is acceptable, feasible, affordable, sustainable and safe, avoidance of all breast-feeding by HIV-infected mothers is recommended otherwise, exclusive breast-feeding is recommended during the first months of life. To minimize HIV transmission risk, breastfeeding should be...

Oxytocin And Argininevasopressin

AVP has prominent roles in controlling fluid balance via its effects on the kidney and regulating blood pressure via its vasoconstrictive effects on blood vessels, and can directly promote the sensation of thirst. AVP also promotes the release of ACTH from the anterior pituitary in the presence of CRF, and is released following stressful stimuli 116 . In humans, oxytocin is predominantly involved in controlling smooth muscle contraction during both breast-feeding and parturition (myometrium). In rodents, oxytocin promotes a number of reproductive (grooming, arousal, lordosis, orgasm, nesting, birthing) and maternal behaviours. Although there are marked species differences in the effects of oxytocin, central infusion of this peptide in females of a monogamous prairie vole species promotes lifelong pair bonding in the absence of mating. Furthermore, pair bonding in this species, which normally accompanies mating, can be blocked by oxytocin antagonists, thus implying a key role for...

Why the Protein Energy Ratio

Pragmatic and physiological considerations justify expressing the protein requirements in relation to energy intake for situations as diverse as weaning diets, catch-up growth, and hypercatabolic states 4 . Infants and toddlers in developed countries usually show a high dietary PER during the complementary feeding period, averaging 2.5-3, because of the protein density of solid weaning foods and the low percentage of mothers still breastfeeding beyond the first 6 months of life 5 . In conditions of very high protein intakes, those in the higher classes of consumption seem to carry a major risk to become obese later on. On the other hand, in many developing countries the only available weaning foods are cereals, with a low PER value. When the protein concentration of weaning foods falls below the limits of human milk (with a PER of < 1, i.e., < 1g protein 100 kcal to lower levels), the infants' dietary requirements cannot usually be met 6 . Protein intakes and PER values show great...

Role of Quantity and Quality

Solutions for the high PER levels are in line, but opposed to those for malnourished children first of all, supporting breastfeeding at least up to 12 months in order to balance not just the excess protein but also balance the other macronutrients and micronutrients then using less protein-dense weaning foods (with a PER ideally ranging 2-3), and finally introducing an appropriate formula with 'adjusted' PERs when human milk is insufficient. Within this context, producers and regulatory bodies should consider the opportunity to further modulate the PER level of follow-on formulae, to counteract the apparently unavoidable trend to a high protein, high PER diet. According to recent reports, follow-on formulae with 1.3g l protein and 67kcal 100ml (with a PER close to 2) are adequate for diets in Swedish infants 30, 31 . The protein content and PER levels of follow-on formulae could be tailored further according to dietary habits differing in usual weaning foods 32 .

Infant Behavioral Development

Motor development was assessed in the two controlled trials in Honduras. In both studies, infants in the EBF group crawled at an earlier age than infants in the group given complementary foods (6.3 vs. 7.3 months in the first study 6.8 vs. 7.4 months in the second study) 13 . In the first study (but not in the second study), infants in the EBF group were also more likely to be walking by 12 months of age (60 vs. 39 , p 0.02). The mechanism by which exclusive breastfeeding during the 4- to 6-month age interval might affect motor development is unknown. Certain constituents of breast milk (e.g. docosahexaenoic acid) are known to be associated with infant mental development, but there is little evidence that they affect motor development. On the other hand, Vestergaard et al. 29 reported that achievement of two motor skills (crawling and pincer grip) was linked to the duration of breastfeeding in a large sample of Danish infants, even after adjustment for potentially confounding...

Infant Food Acceptance

Some parents and health care providers believe that there is a 'critical age' for infants to be introduced to complementary foods, and that waiting too long will interfere with the infant's acceptance of foods at a later age. This is linked to the notion of developmental 'readiness', an ill-defined concept that nonetheless has a strong influence on parental behavior. In an effort to address this concern, our first study in Honduras included an assessment of infant dietary intake at 9 and 12 months, as well as the mother's report of infant acceptance of 20 commonly consumed foods 8 . There were no significant differences between intervention groups in breastfeeding frequency, amount or number of foods consumed, percentage of food offered that was consumed, usual daily number of meals and snacks, number of food groups consumed, or overall food acceptance score. In our study of breast-fed infants in the US 14 , 4-day weighed intake records of all foods and fluids (including breast milk)...

Maternal Duration of Lactational Amenorrhea

In the systematic review conducted for WHO 4 , the authors concluded that exclusive breastfeeding through 6 months is associated with delayed resumption of menses, which can promote more optimal birth spacing in populations with relatively low rates of contraceptive use. Their conclusion was based on the results of the two Honduras trials. The difference in the percentage of mothers who were amenorrheic at 6 months postpartum was not statistically significant in the first trial (though in the expected direction), but was significant in the second trial (89 in the EBF group vs. 68 in the MBF group, p 0.02) 13 .

The Magnitude of the Problem

Fortunately, well-defined preventive and curative interventions exist for a large series of identified causes of death 18 . Those interventions can be delivered through the health sector with maternal education or birth control. In addition to immunization and specific treatments, nutritional interventions include appropriate use of breastfeeding and complementary feeding, and supplementation such as a pharmacological dosage of zinc and vitamin A. It is of note that other nutritional interventions are not considered in the analysis, and for this reason they will be discussed below. As a result of extensive analysis, 23 interventions were proven to be effective in a context of middle or low income countries identified. They were then put into an economic model where 18 contacts between the child or mother and a health care provider were incorporated into a delivery timetable from birth to 5 years of age 19 . The conclusion was that approximately USD 5 billion in new resources is...

Metabolic Advantage of Reduced Protein Formula

Potential renal solute load refers to solutes of dietary origin that would need to be excreted in the urine if not utilized by the body. It represents the sum of dietary nitrogen, sodium, potassium, chloride and phosphorus 18 and is a suitable parameter to measure the risk of dehydration illness. When ingested in excess, proteins constitute a considerable part of the solutes that must be excreted by the kidneys. Taking this into consideration, Ziegler and Fomon 18 recommended reducing the maximum protein content of infant formula from the level of 4.5g 100kcal, specified by the Food and Drug Administration, to 3.2g 100kcal. As an adaptive response to a high solute load, glomerular filtration rate and kidney size increase. While the adverse effects of a high protein intake in patients with kidney disease have been documented, there is to date no clear evidence of such detrimental effects in healthy individuals. The effect of formula- vs. breastfeeding on kidney growth was recently...

Organization and Quality of Perinatal and Neonatal Care

The organization of the health care delivery system has long been viewed as a key determinant of birth outcomes. In the 1970s, the March of Dimes developed practice guidelines advocating for the regionalization of perinatal care in the United States (Committee on Perinatal Health, 1976). These recommendations were the result of research during the previous decade linking the regionalization of neonatal care with improved neonatal survival and improved overall outcomes. As the program was initially envisioned, regionalized perinatal care involved the designation of three levels of care based on the clinical conditions of the patients, both the mother and the infant. Level I centers were able to provide basic or routine obstetric and newborn care. Level II centers had the capability to care for patients of moderate risk, and Level III centers were reserved for high-risk cases requiring the most specialized care. In addition to the designation of levels of care, regionalized perinatal...

Use of Date of Last Menstrual Period

To more than 25 days) can be due to variations in the timing of menstrual cycles, ovulation, and implantation of the blastocyst. Changes in age, levels of physical activity, body mass index (BMI), nutrition, breast-feeding, interpregnancy interval, smoking, alcohol consumption, and stressful life events can influence the length of an individual woman's menstrual cycle, and can therefore influence accuracy of LMP in estimating the duration of a pregnancy (Kato et al., 1999 Liu et al., 2004 Munster et al., 1992 Rowland et al., 2002).

Infant Iron and Zinc Status

There is very little information on the effects of the age at introduction of complementary foods on iron or zinc status of breast-fed infants. These two nutrients have been identified as the most likely limiting nutrients among EBF infants during the first 6 months of life 19 . Although the adequacy of certain vitamins during the period of exclusive breastfeeding may also be of concern, depending on maternal diet and nutritional status, these concerns can generally be addressed by assuring that the mother's intake is adequate (e.g. for vitamin A, B6, or B12). By contrast, the concentrations of iron and zinc in human milk are not altered by maternal supplementation. During the first 6 months, infant iron status is largely dependent on iron stores at birth, which are influenced by gestational age, birth weight, maternal prenatal iron status, and the timing of clamping of the umbilical cord. After birth, infant iron needs are influenced by the rate of growth and certain types of...

Children The Therapeutic Orphans

A few drugs were developed for children in such categories as antibiotics, antihistamines, and antiepileptics. But otherwise, few firms undertook studies to develop full pediatric label instructions or even pediatric formulations. Liquid formulations did exist for some drugs, but mainly for use in the elderly. In 1975, Wilson surveyed the 1973 Physician's Desk Reference for labeling instructions for pediatric patients and pregnant or breast-feeding women. He found that 78 of listed drugs either had no information for pediatric dosing or contained a disclaimer. A subsequent survey by Gilman (1992) showed that this situation had not improved qualitatively and had also risen to 81 . Eventually, the FDA issued the 1994 rule, which sought to strengthen the 1979 guideline on pediatric labeling requirements (Fed Reg 1994).

Discussion

Cong Khanh Nguyen What are the factors that lead to weight gain during the first week Are they related to maternal nutrition The second thing is you addressed the issue of nutrition before 2 years of age as being really critical, not only breastfeeding but also weaning food, the starting time and quality. Somehow it is dealing with protein and energy. So our topic is really interesting with regard to the protein and energy requirements for infancy and childhood. Again it is exactly what we are doing and understand about the requirements of protein. In early childhood protein plays a role in development, but we need to do something with protein in terms of controlling weight gain. It is really important for Viet Nam at the moment we have to do nutritional controls and also control weight because obesity occurs even in the malnourished population. Dr. Ziegler I would like to make two comments regarding the Stettler study. As Dr. Koletzko pointed out, the subjects were studied as...

Acute diarrhoea

Children with diarrhoea but no dehydration should receive extra fluids at home - as much as the child will take in small sips. If the child is being breast-fed, more frequent and longer breast-feeding is advocated supplemented with oral rehydration solution (ORS) or clean water. For non-exclusively breast-fed children give ORS, rice water, or clean water. If some dehydration is present - restlessness, instability, thirsty - take child to nearest clinic if possible.

Attachment

Regina Pally 27 recalls observations by Hofer 28, 29 on newborn and breast-feeding rat pups, on the topic of attachment. Contact with the mother stimulates physiological functions such as heart rate, temperature, and activity level. Separation from the mother causes separation anxiety, and the animals emit a distress cry, using the same laryngeal muscles as human babies use in similar situations. If the mother is absent

Hypoglycemia

Definitions of hypoglycemia have changed over the years and the acceptable level of blood sugar has risen in the last decade, driven in part by medico-legal concerns. The ''paper that launched a thousand law suits'' described changes in sensory-evoked brain stem potentials in neonates with blood sugars less than 2.6micromoll 1 (45mgdl1) (Koh et al., 1988). Because of this report most neonatalogists now treat any newborn that is shown to have a blood glucose level less than this. This leads, in many cases, to increased (and sometimes unnecessary) medical intervention in normal term breastfeeding newborns. In the case of an IUGR infant delivered from a pregnancy complicated by PIH (pre-eclampsia or superimposed pre-eclampsia) an aggressive approach is appropriate. Most neonatal units employ bedside capillary glucose monitors to screen for hypoglyce-mia. These are generally innacurate at the lower range of blood sugar recordings, which is the area of most interest to neonatologists and a...

The Impact of Birth

In the first half of the last century, Isakower 14 and Lewin 15 reported on hypnagogic hallucinations and dream screen phenomena. The observations were made from children in a state of just falling asleep, especially when somatically ill and with a fever, and from adult regressive patients with severe psychopathology. Isakower and Lewin concluded that the hypnagogic hallucinations and the dream screen phenomena sometimes discernible behind adult dream images both represent sensory memories stemming from infantile breastfeeding. These observations lent the first clinical support to the notion of Freud that the early experiences of care involve a principle of psychical projection, i.e. sensory memoryformation by body surface stimulation.

Child health

The past few decades have witnessed major improvements in the health of children throughout the world. The Child Survival programmes that UNICEF and WHO spearheaded have made significant contributions to the dramatic fall in child mortality rates in most developing countries (Fig. 12.3). The main interventions are usually summarized under the acronym, GOBI-FFF (growth monitoring, oral dehydration, breast-feeding, immunization, family planning, female education and supplementary feeding of pregnant women). Much remains to be done in reducing the avoidable mortality and morbidity in developed countries, the under five mortality rate has been reduced below 10 per 1000 live births but many developing countries still record rates that are over 100 per 1000. Many of the diseases that cause severe illness and death in children in developing countries can be prevented or treated by simple affordable measures provided through simple efficient child health services. In order to be most...

Bolivia 19962000

Health care costs in Bolivia were assumed to be a major impediment to the use of services, such as a skilled birth attendant and a hospital for birthing. To overcome this barrier and reduce the MMR of 390 per 100,000 live births (INE and MI 1994), a national health insurance plan has been phased in to cover the costs of services vital to the reduction of maternal and infant mortality. In July 1996 the Bolivian government implemented the National Maternal and Child Health Insurance (MCHI) Program, with the main objective, as the name implies, of increasing coverage of maternal and child care. For pregnant women and babies, the insurance covered prenatal, labor and delivery, and postpartum and newborn care, including cesarean sections and coverage for other obstetrical emergencies. On December 31, 1998, the government created the Basic Health Insurance (BHI) to augment the MCHI, with explicit coverage of complications of pregnancy, delivery, and postpartum, including postabortion care,...

Progestin Only Pills

Women using POPs experience many of the same noncontraceptive benefits of women using COCs, such as improvements in menstrual side effects and decreased risk of endometrial cancer. POPs confer no protection against ovarian and colon cancers. The progestin only pill can be safely used in many women for whom estrogen is contraindicated. These include women with a history of clots or VTE, hypertension , coronary artery disease or cerebrovascular disease women over 35 years who smoke and recently post-partum or breastfeeding women.

Breast abscess

E Lactational breast abscesses are common and tend to occur soon after starting breastfeeding and on weaning, when incomplete emptying of the breast results in stasis and engorgement. Nonlactational abscesses are more common in those aged 30-60 years and smokers. Surgical Lactational Daily needle aspiration with antibiotic cover may be successful, but in most cases, formal incision and drainage is carried out. Incision should allow full drainage and be cosmetically acceptable loculi are explored and broken down with a finger. The wound may be packed lightly with antiseptic soaked kaltostat and left open, with daily packing, or primary closure performed with antibiotic cover. Breastfeeding should continue from the non-affected breast and the affected side emptied either manually or with a breast pump. Advice on avoiding cracked nipples.

Kangaroo Care

Kangaroo care provides skin-to-skin care by placing the naked preterm infant in an upright position between the mother's breasts and allows unlimited breast-feeding. This concept of caring for preterm infants originated in Bogota, Columbia, as a low-cost way to assist preterm infants with temperature regulation, nutrition, and stimulation (Charpak et al., 1996). Kangaroo care is initiated after a routine period of stabilization after birth. A number of studies from developing countries, including a few randomized controlled trials, suggest that kangaroo care improves weight gain (an additional 3.6 grams per day), reduces the incidence of nosocomial (i.e., hospital-acquired), infections and reduces the incidences of severe illness and respiratory disease up to 6 months of age (Conde-Agudelo et al., 2003). Mothers who provided kangaroo care were more likely to continue to breast-feed and were more satisfied with the care that their infants received in the NICU.

Infection

Why breast milk is protective against infection is that it provides the nucleotides and immune cells needed for the modulation of the immune system in the gut. The initial bacteria to colonize the premature infant's gut have advantages compared to late arrivals. The normal gut flora of newborns initially consists of E. coli and Enterococcus, followed by Bifidobacterium, with heterogeneous bacterial flora becoming established by day 10. In breastfed newborns the benign bifidobacteria and lactobacilli predominate. In the neonatal intensive care unit a preterm baby will have delayed colonization with a limited bacterial species different to those described above. Coagulase-negative staphylococci, Enterobacter cloacae and Klebsiella predominate. There is a paucity of lactobacilli and bifidobacteria and increased candida colonization. Factors influencing this initial gut colonization are the (ab)use of broad-spectrum antibiotics, breast feeding versus use of formula, and the separation of...

New Mothers Guide to Breast Feeding

New Mothers Guide to Breast Feeding

For many years, scientists have been playing out the ingredients that make breast milk the perfect food for babies. They've discovered to day over 200 close compounds to fight infection, help the immune system mature, aid in digestion, and support brain growth - nature made properties that science simply cannot copy. The important long term benefits of breast feeding include reduced risk of asthma, allergies, obesity, and some forms of childhood cancer. The more that scientists continue to learn, the better breast milk looks.

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