Nurture for the Future

The Problem with Breastfeeding Advice

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Breast milk – it’s nature’s brain food and the best start to life you can give to your baby.  If you want to raise a smart kid, then breastfeeding is one of the things you can do to give your child a headstart.  So why aren’t more mothers offering it to their babies?  Whenever the topic comes up for discussion, I often hear other mothers telling me how they really wanted to breastfeed their babies but they didn’t have enough milk.

Although there are medical cases where mothers really do not have enough milk, it is a rare occurrence.  If the problem of not having enough breast milk to meet a baby’s needs is such a common problem, what did mothers in the past feed their babies back in the days before formula became an option?  I believe that the reason why so many women have trouble breastfeeding is because of lack of appropriate information.

There is information everywhere.  Just google “breastfeeding” and you will find millions of links to information about it.  The question is, how reliable is that information?

I read a lot about breastfeeding while I was pregnant with Gavin.  I thought I knew everything there was to know.  But when Gavin was born, I found myself stumbling.  My nipples were sore, I couldn’t get him to latch on properly, I didn’t have any milk, etc.  It was so bad at times that I wanted to cry.

We know breastfeeding is a good thing to do.  The problem is that most of us don’t know how to breastfeed a baby.  No amount of reading can prepare you for that – especially when the information is not particularly reliable.  Tumbling Boobs and PhD in Parenting highlight some of the reasons why this information is unreliable – it’s because it comes from infant formula companies.

Tumbling Boobs puts it very well: “The absurdity of a formula company creating a breastfeeding advice line is in the same league as a bacon company sponsoring a kosher food festival.”

PhD in Parenting asks: “If you wanted to eat a healthy lunch, but had a craving to scarf down two Mars bars instead, would you call the Mars company for advice on how to curb your cravings? If you were trying to get in shape and exercise, but didn’t feel like going for your morning run, would you call your couch potato friend who always tries to convince you to skip your workouts and join her on the couch? If you were struggling to remain faithful to your spouse, would you call the hot guy who is always flirting with you at work for advice? If you were struggling with breastfeeding, but really wanted to continue, would you call an infant formula manufacturer for advice?”

Unfortunately, the formula companies are often the ones aggressively pushing information.  If they aren’t pushing the information, they are sponsoring it, for example, WebMD’s guide to breastfeeding is sponsored by Gerber.

While some information presented is useful, others can be misleading and completely unhelpful. For example, one thing I read about breastfeeding before I had Gavin was that you should breastfeed for 10-20 minutes on each side, every two to four hours.  When I tried that, the nurses were constantly sending him back to me because he was still hungry.  Even after Gavin, I still assumed that information was correct.  I thought it didn’t work for me because Gavin was a big baby (4kgs at birth) with a larger stomach, therefore, needing more time on the breast to fulfill his feeding needs.

When I had Gareth, I didn’t make the same mistake.  I just let him suckle until I was sure he was really done.  On one occasion, he was on the breast for two hours straight.  After that, he went back to the nursery to sleep under the UV lights (for jaundice) and didn’t come back to me until six hours later!  Then again, Gareth was even bigger than Gavin – 4.5kgs at birth.

It wasn’t until I read the comments from other mothers on KellyMom’s Facebook page that I realised it was the information that was flawed rather than my babies being “the exceptions to the rule”.  If you need information about breastfeeding, make sure you get it from reliable websites, like KellyMom.  If you’re going to take advice about breastfeeding from someone, make sure she’s a mother who has successfully breastfed her child(ren) before, otherwise, it’s just hearsay.

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Why Breastfed Babies are Smarter – Part 2

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We took Gareth to see the paediatrician for his vaccinations yesterday.  While waiting, I saw a free publication of a parenting magazine called “Positive Parenting” lying on the table.  I was intrigued because the magazine focuses on child development and the optimisation of a child’s potential – two areas I’m intensely interested in.  In that particular publication they had available, there was an article entitled “Brighter Brains with Breastfeeding”.

You may recall an earlier post I wrote about why breastfed babies are smarter which discusses the theory that it may not necessarily be the constituents of breast milk that promote brain development.  It was theorised that it was the way in which breast-fed babies were handled compared to how bottled-fed babies were handled that made the difference in IQ points between breast-fed babies and bottle-fed babies.

The article in Positive Parenting, however, begs to differ.  They talk about the vital nutrients in breast milk that are essential for brain development:

  • breast milk contains greater levels of essential polyunsaturated fatty acids – DHA (docosahexaenoic acid) and AA (arachidonic acid) – which have a significant role in brain development.  They are important for synaptogenesis (forming of connections between brain cells), membrane function (the function of brain cell walls) and myelination (a process that speeds up communication between brain cells).
  • breast milk contains high concentrations of cholesterol which facilitates myelinisation of the central nervous system.
  • breast milk also contains high concentrations of taurine, an important amino acid that cannot be made by the baby’s body.  Taurine is required in the development of brain tissue.  It is vital for the synthesis and release of neurotransmitters in the brain.

Breastfeeding also indirectly promotes development by enabling better visual development which is important for visual activity, leading to reading and learning readiness.  Breastfeeding also protects babies from illnesses that can cause malnutrition, learning and hearing difficulties.

Though the jury might still be out on why breastfed babies are smarter, the main fact still remains: breastfed babies are smarter.  And until science is able to irrefutably conclude the true reasons as to why that is so, the best thing to do is to breastfeed our babies.

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Why Breastfed Babies are Smarter

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One of the benefits of breastfeeding commonly listed is that it makes babies smarter.  Although the research on this belief is somewhat controversial, the estimate is that babies who are breastfed grow up to be on average 7-10 points higher in IQ than their non-breastfed peers.  Breastfeeding has also been link to children with higher grades in school and the advantage gained is greater the longer you breastfeed your baby.

There were some counter-arguments that breastfeeding does not lead to smarter babies but that, on average, the mothers of breastfed babies generally had higher IQ, education level and socioeconomic status than mothers of non-breastfed babies which tended to skew the results.  A study released in 2008 – the largest to date – however concluded that there is a link between prolonged and exclusive breastfeeding and children with higher IQ.

The question now is why that is so – is it the components of breast milk or something in the way breastfeeding mothers handle their babies that affects intelligence?  Health News suggests the following reasons as to why breastfed infants are smarter:

  • Breast milk contains fatty acids and other nutrients that are necessary for the development of babies.
  • Physical and emotional aspects of breastfeeding may lead to permanent improvements in brain development.
  • Breastfeeding may increase verbal interaction between mother and child which could aid development.

Jill Stamm, author of Bright from the Start, however believes it has to do with the way breastfeeding mothers handle their babies compared to bottle-feeding mothers:

Look at the typical nursing session:

  • The baby is latched successfully onto the mother’s left breast and suckles for a few minutes of serious “work”. Then Mom and her baby lock eyes and mom begins to softly talk or whisper to the baby.  At this time, the baby gazes up and to his left.
  • Mom may even pick up her infant’s tiny left hand and massage it and play with it.  The baby’s hand may start to pat her breast, or his hand meets her free hand and they play together.  Notice that while latched to Mom’s left breast, the baby explores with his left hand and is being stroked and soothed on the left side of his body.
  • Now having finished nursing on the left breast, the baby is switched to the right breast.  The social interchange continues.  This time, however, the sensation received, and the exploration he is free to do, happen on his right side, and his eye gaze is up and to his right.

Unlike bottle nursing, there is little or no interaction with the baby during feeding because the baby is usually held on the carer’s preferred side (most people have a preferred side on which to carry the baby which influences the side of the baby that gets stimulated) – usually the non-dominant side – while the bottle is held in the dominant hand.  Physical interaction with the baby is limited because the carer has no “free” hand to stroke or play with the baby.

The significance of this is related to the corpus callosum – a band of fibers in the brain connecting the two hemispheres.  The better the formation of the corpus callosum, the better the integration between information processed in the left and right hemispheres.  Activities that encourage crossing of the midline of the body helps to build the corpus callosum.  For instance, in the breastfeeding example above:

  • the breastfed infant is switching eye gaze, at one breast crossing the midline of his body to have both eyes gaze left, and later crossing the midline of his body to have both eyes gaze right, and,
  • the breastfed infant might reach alternating arms and hands across his body when feeding on each side to tug on Mom’s necklace or pull of her glasses.

Although this is purely anecdotal, what is shown to be true is that breastfed mothers tended to talk more to their babies and this can lead to smarter babies.

However, a study cited by Rhonda Mahony on a group of preemies found that “tests given to 300 of the children when they were seven and a half to eight years old found that those who had been fed their mother’s breastmilk as newborns had a significantly higher IQ score than those who had gotten no breastmilk. The hospital staff fed all the preemies through a tube, so if there was an IQ effect, it was caused by the breastmilk itself, not the act of breastfeeding.”  However, this was a rather small study.

Moral of the story?

If you can breastfeed your baby, then do so.  If you can’t, try to express as much of your milk as possible for as long as possible.  If you can’t, bottle feed your baby as closely as possible to the way you would breastfeed a baby – talk to your baby and switch sides!

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Mastitis and Medications while Breastfeeding

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I came down with a bout of mastitis a couple of days back.  At least, I think it was mastitis.  The symptoms weren’t quite as clear cut as I remembered.  I’ve always thought it had to occur in both breasts for it to be mastitis.  In this case, I felt the pain on the right side of the right breast.  There was no accompanying lump to signify a blocked duct or engorgement.  It came out of the blue – I went to sleep feeling fine and woke up shivering with a mild body ache and feeling tenderness in my breast.  My breast wasn’t particularly painful but it felt sore upon palpation.  It was the letdown that gave it away.

Perhaps I had somehow mistakenly assumed I would be exempt from mastitis and blocked ducts this time around having an over eager and expert toddler to help keep the milk excess under control.  Then again, mastitis sometimes occurs for no other reason other than being run down.  Ironically, I have been resting more than usual – the boys have been kind to me allowing me to sleep relatively undisturbed through the night.  Neither had I been staying up late.  However, the days preceding I had been burning the midnight oil and receiving less than the minimum required hours of sleep so it seems like this was merely the latent effect of running on empty.

Do I recall correctly that it is often the case that many people get sick during the holidays because they no longer have the adrenaline to keep them going?  When the holidays arrive, they take the break that their bodies have been so desperate for, the adrenaline goes, and BAM!  They’re sick.  Doesn’t it go something like that?  It’s kind of like my Dad and his weekend migraine.  He used to only get migraines on the weekend.  After a multitude of tests, one doctor suggested it might be the weekend migraine which is cured by ensuring that he woke up at the same time on the weekend as he did during the weekdays instead of sleeping in.  True enough, his migraine was cured after that.

But I digress…  shivering, fever, muscular and joint aches right down to my fingers, and a painful right breast especially on letdown – it had to be mastitis or at the very least some funky kind of flu bug.  I suspect it was partly due to being run down and partly to the fact that both boys had been sick with stuffy noses which often makes it hard to suckle properly.  Plus, Gavin seems to have returned to sleeping through the night without waking to nurse except just before it is time to wake up for school.

What do they say when you have mastitis?  Get plenty of rest and take the baby to bed.  That I did – but the rest was limited because Gareth, still suffering from his stuffy nose, was going through periods of fussiness.  His highness had Mummy pacing up and down the room, carrying him in aching arms, to help him settle.  I decided then I needed to be medicated and double-checked the medications while breastfeeding.  Commonly used drugs for fever and mastitis are paracetamol and ibuprofen, and according to the NHS, both are fine so long as you have a full-term and healthy baby.

While we’re on the topic, since cough and colds are frequent ailments that also plague breastfeeding mothers, the NHS advises against taking cough and cold medications when breastfeeding.  You can click on the link to read specifically what was said about each specific medication usually taken for coughs and colds.  It was also interesting to note that cough suppressants are not recommended these days because it suppresses the coughing reflex which is important for helping the body expel excess mucous from the airways.  May I be so bold now as to extrapolate from this that we can forget about the old wives recommendations to avoid foods and drinks that aggravate the cough?  If coughing helps us clear unwanted, excess mucous, shouldn’t we be encouraging the coughing reflex?  Anyway, I’ll leave that one open for debate.

I only wanted to cover the general medications that a breastfeeding mother might need to take, but if you need more information on drugs and breastfeeding, Le Leche League adds the following questions for consideration:

  • Has the drug been given to infants? A drug commonly prescribed for infants is usually a good choice for a breastfeeding mother.
  • Has the drug been given to other breastfeeding mothers? A drug that has a history of use by breastfeeding mothers is a better choice than a new, possibly untested drug.
  • What is the duration of the drug therapy? The duration of the drug therapy can affect its compatibility with breastfeeding. A drug considered compatible with breastfeeding when taken for a few days might not be compatible when taken over a long period of time.
  • Is the drug short-acting? A short-acting form of the drug may be a better choice for a breastfeeding mother than a longer-acting form that stays in the mother’s system for a longer period.
  • How is the medication being given? A drug given by injection or by mouth is less concentrated than one given intravenously. However, a drug may be given intravenously because it is inactivated or not absorbed by the digestive system, so the baby’s digestive system would also inactivate or not absorb the drug.
  • How well can the baby excrete the drug? Some drugs accumulate in a baby’s system and can potentially build to toxic levels. A drug that is quickly eliminated by the baby is more compatible with breastfeeding.
  • Does the drug interfere with lactation? Some drugs should be avoided by breastfeeding mothers because they affect breastfeeding itself (the let-down or milk supply).

Further information can be found at:

Can I Breastfeed My Baby If I Am Sick? Another FAQ article.

Maternal Medications and Breastfeeding, NEW BEGINNINGS article by Gwen Gotsch.

Medication and Breastfeeding, LEAVEN article by Pat Sturges.

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Tandem Nursing – Reasons for Not Weaning the Toddler

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Although there was a lot of protest when I said I was going to tandem breastfeed my two boys, it was pretty much accepted and I went on to nurse Gavin even after Gareth was born.  However, with Gavin’s declining behaviour in recent times, the discussion for me to wean Gavin has been revisited.

Here are some of the arguments why I should have weaned him:

  • If I had weaned him, he wouldn’t be so “sticky” to me right now
  • If I had weaned him, he wouldn’t be behaving so badly right now

Here are my thoughts on the matter:

Who’s to say that had I weaned him he wouldn’t be “sticky” to me right now?  And who’s to say that weaning him would have had any effect on his current behaviour.  For all we know, he could be even worse than he is right now.  And if I had weaned him, he may have felt even more jealous of his brother’s nursing time.  My friend who did not breastfeed her daughter also found her daughter to become more demanding and more “sticky” after she had her second child.  Her daughter also displayed all the classical signs of sibling rivalry.

The fact is, our toddler’s world has turned upside-down when his baby brother was born.  How can we not expect him to react to it?

Now here are the reasons why I am glad I am still nursing Gavin:

  • At night, when both boys stir in their sleep, all I have to do is nurse them simultaneously and the three of us can all go back to sleep.  If Gavin had been weaned, I really don’t know how I would be able to nurse Gareth, carry Gavin, and sleep all at the same time.  I noticed that in the days prior to the pregnancy, sometimes the only way to get Gavin back to sleep without breastfeeding was to carry him and walk.
  • Breast milk is a laxative and helps Gavin overcome some of the problems with constipation that has been plaguing him.  We spoke to the doctor about Gavin’s constipation and she explained that it was a common problem for many toddlers because they are often too impatient to poop when they are supposed to and that causes the poop to get impacted in the bowels.  Additionally, the longer the poop remains in the bowels, the more water gets reabsorped and the harder the poop becomes.  Hard poop hurts and that causes toddlers to avoid the toilet even more which only serves to compound the problem.  No wonder toddlers are constipated.
  • Breast milk is my ultimate reward that Gavin can never say “no” to.  Okay, so this is probably not the sort of thing I should be doing, but hey, it’s effective.  Whenever Gavin misbehaves, all I have to do is threatened to take away his nursing time and he immediately falls back into line.  No other reward has the same effect as the promise of breastfeeding – not even chocolate, not even ice cream, not even the toy shop, although potentially the bookshop but we aren’t about to reward him with a trip to the bookshop in the middle of the night.  Given how difficult Gavin can be right now, this is probably one of the easiest methods for getting his cooperation.

So please tell me again why I should wean him?

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The Pureen Manual Breast Pump – Update

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I take it back.  There is a serious flaw in the design of the Pureen Manual Breast Pump and I can’t figure out what it is.  Although I have managed to use the pump successfully (relatively successfully), I’ve still encountered problems with it that I cannot resolve.  Twice I’ve had a big letdown while expressing milk and twice the pump has over flowed for reasons unknown.  I thought I had it figured, but clearly, I don’t.

Another problem I’ve discovered is that if you have a big let down and the milk doesn’t drain quickly enough, some of it gets sucked into the handle.  If enough milk gets sucked into the handle, it can spill out.

Something else I should have added in the review (which was so kindly pointed out by MieVee) is that the Pureen Manual Breast Pump is made of polycarbonate – that non-BPA-free material – which leaches BPA during sterilisation and is part of the reason why I decided to get a new pump in the first place.

I’ve come to the conclusion that the unexplained leakage that occurred while I was expressing milk is due to a design flaw of the Pureen breast pump.  The Pureen breast pump looks similar to the Avent pump, however, it is more compact in size and comes with less separate components.  Since I’ve never had any problems with leakage as far as the Avent pump was concerned, I’m assuming it is these differences in design that lead to the problems I experienced with the pump.  I guess that’s why it is RM35 and not RM200+.

So now we’re back to the First Years Manual Breast Pump (which is available at Toys ‘R’ Us, Jusco and Parkson)…  “Penny wise, pound foolish”.  At least Parkson had a sale when we bought it this time.

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