Booster Shots

Oddities, musings and news from the health world

Category: breastfeeding

Add breast-feeding to the protect-a-newborn checklist. (One Kardashian has)

June 22, 2010 | 10:18 am

InfantNewborns need adults to protect them not just from obvious risks such as car accidents, falls and well-meaning toddlers who want to carry the baby, but also less obvious risks, such as infections. That amounts to more than simply a washing of hands. Everyone might not know this, but Kourtney Kardashian? Well, she might. (More on that later.)

A study published Monday in the journal Pediatrics parses the data on more than 4,000 infants and their risk of infections.

The researchers, based in the Netherlands, write in their conclusion:

"Exclusive breastfeeding until the age of 4 months followed by partial breastfeeding was associated with a significant reduction of respiratory and gastrointestinal infectious diseases in infants. Exclusive breastfeeding until the age of 6 months tended to be more protective than exclusive breastfeeding until the age of 4 months and partially thereafter."

That is, the researchers couldn't say for sure that 6 months is better, but they're pretty sure it is. The results aren't especially surprising but rather more of an effort to gain data on the benefits of breast-feeding. And you know how we love data ...

The researchers recommend policies that encourage exclusive breast-feeding for at least four months. They're pretty sure six months would be better. 

Here's the breast-feeding study; a guide to breast-feeding, courtesy of the U.S. Department of Health and Human Services; and an explanation of the Kardashian sister reference.

Apparently, the sisters are famous, and thus people pay attention to them: The Kardashian phenomenon. So, having a baby? Note Kourtney's position; Kim's stance is still a little unclear.

— Tami Dennis

Photo: A mother lends some extra protection. Credit: Ricardo DeAratanha

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Breastfeeding saves a lot of money, study says

April 4, 2010 |  9:01 pm

If all U.S. women followed medical recommendations to breastfeed their infants exclusively for six months, the nation could save $13 billion a year in medical costs and prevent 911 deaths, according to an analysis published in the new issue of the journal Pediatrics.

Bottle The study authors compared the costs of 10 childhood diseases at current breastfeeding rates and the projected costs of those diseases if 90% of U.S. women complied with the recommendations. The costs included medical care and as well as indirect costs, such as missed time from work. The majority of the deaths linked to failure to breastfeed involve Sudden Infant Death Syndrome, the authors said, as well as complications among premature babies.

About three-quarters of U.S. women breastfeed, but only 32% are still nursing exclusively after three months. Just 12% of infants are exclusively breastfed for six months.

Several medical associations, including the American Academy of Pediatrics, recently urged Congress to appropriate $15 million per year to support breastfeeding in the United States. More support is needed in hospitals and at work places to encourage breastfeeding, the authors state.

"People shouldn't blame mothers because they are often not supported well, even from the moment their babies are born," said Dr. Melissa Bartick, the lead author of the study and an instructor at Harvard Medical School, in a news release.

-- Shari Roan

Rodent of the Week: Another advantage to nursing the baby

March 5, 2010 |  1:02 pm

Rodent Newborn mice who receive their mother's milk experience a biological process that boosts their metabolism, possibly lowering the risk of obesity and diabetes in adulthood, according to a new study.

Breast-feeding confers several protective benefits in human babies. Some research suggests, for example, that breast-fed babies have a lower risk of obesity and diabetes later in life. The new study sheds light on a little-known process that takes place just after birth in mice. Researchers in Spain found that suckling the mother's milk prompts the newborn's liver to produce a molecule that then turns on heat-generating brown fat. That process helps the baby's body adapt to a lower environmental temperature than it experienced inside the mother's womb.

The protein that is released in response to suckling, called FGF21, also appears to be important in regulating metabolism. In the study, researchers injected the protein into fasting newborn mice and found that the treatment prompted heat generation within brown fat and boosted body temperature. These brown fat cells burned more energy and glucose. Recent studies in humans have found that greater activity in brown fat appears to protect against obesity.

"There are many evidences that alterations of dietary, genetic, environmental, or other origin in the metabolic performance during the fetal and early neonatal life can make an individual prone to develop diabetes and obesity in adulthood," the lead author of the study, Francesc Villarroya, of the University of Barcelona, said in a news release. "It will be important to know whether any disturbance in this naturally occurring event [the burst of FGF21] may have negative consequences in adulthood."

Researchers still don't know yet if this process observed in mice is similar in human newborns. The study is published in the journal Cell Metabolism.

— Shari Roan

Photo credit: Advanced Cell Technology Inc.

Infant victims of Haiti's earthquake need breast milk*

January 28, 2010 |  6:55 am

OK, you've opened your hearts to the hundreds of thousands of bereft and destitute victims of the Haitian earthquake. Hopefully, you've opened your wallets and maybe even scoured your closets for things to send.

But -- and here, I address myself to lactating moms -- have you opened your shirt yet?

Several groups promoting breast milk and breastfeeding are putting out an "urgent call" for human milk donations, saying the infrastructure is "now in place" for aid groups to receive and distribute breast milk to premature and orphaned infants affected by the earthquake in Haiti.

In fact, human milk donations right now can only be delivered safely aboard the U.S. Navy ship Comfort, which has a Neonatal Intensive Care Unit and is caring for some Haitian babies born prematurely. But Gina Ciagne, a certified lactation counselor* and director of breastfeeding and consumer relations at Lansinoh Labs, said it's important for women willing to pump their milk for donation to identify themselves to the closest chapter of the Human Milk Banking Assn. of North America. They'll need to get their blood tested and certify that they don't take most medications or herbal supplements, don't smoke or take illegal drugs, and are willing to donate at least 100 ounces of milk.

The Human Milk Banking Assn. of North America is one of the groups making the appeal for donations. Joining the group are: LaLeche League International, the U.S. and International Lactation Consultants Associations and the United States Breastfeeding Committee.

Milk donations must be processed and pasteurized in a human milk bank before shipping and then kept in a steady state of refrigeration until they reach recipients -- a tall order in the ruined country, where electricity is virtually nonexistent and relief deliveries remain spotty in many places. Late last week, UNICEF put out a statement saying "conditions are not currently met in Haiti" for human milk donations.

At the same time, UNICEF underscored the importance of nourishing and protecting babies in disaster sitiations by encouraging the continuation -- and resumption, where possible -- of breastfeeding. The U.N. office called exclusive breastfeeding of babies under 6 months old "a lifeline" in this emergency situation, where water treatment infrastructure is damaged or nonexistent and communicable diseases are on the rise.

UNICEF also repeated "internationally accepted guidelines" that strongly discourage the donation of breast-milk substitutes such as infant formula or powdered milk or milk products. Because those may require the use of water that is not sufficiently clean and because milk replacements can prompt some traumatized nursing mothers to cease or reduce their breastfeeding, denying their babies some of breastmilk's protective benefits.

That was a problem after the Asian tsunami of 2004. According to the Emergency Nutrition Network, some 72% of families with infants received donated baby formula. The result was a dramatic decline in breastfeeding and a tripling of diarrheal diseases among babies, the British group concluded. "People are really well-meaning, and it's a very difficult concept for people to grasp," said lactation consultant Gina Ciagne. "But breastfeeding is going to be so much better."

-- Melissa Healy

*This blog clarifies Ciagne's title.

Obesity may factor into choosing bottle over breast

January 20, 2010 |  2:47 pm

The health benefits of breastfeeding for mothers and babies are widely known -- studies have shown it may improve cognitive development among children and could reduce a woman's risk of getting breast cancer or cardiovascular disease. But new research suggests that very obese woman may not breast feed as much or for as long as their normal-weight counterparts.

Dmfrwmgw The study, released in the January issue of the journal Obesity, looked at information about 3,517 white women and 2,846 black women who were part of the Pregnancy Risk Assessment Monitoring System from 2000 to 2005.

Among the participants, 7.1% of the white women and 5.3% of the black women were underweight; 53.8% of the white women and 39.5% of the black women were normal weight; 20.9% of the white women and 28.3% of the black women were overweight; 10.5% of the white women and 15.6% of the black women were obese; and 7.7% of the white women and 11.3% of the black women were very obese.

Overall, a greater number of white women (67.2%) than black women (41.2%) initiated breastfeeding, and white women breastfed for longer periods compared to black women. Among white women, breastfeeding was highest among those who were normal weight and went down as their pre-pregnancy body mass indexes rose, with very obese white women having lower odds of beginning breastfeeding than normal-weight white women. Among black women BMI was not a factor in beginning to breastfeed.

BMI was also relevant in breastfeeding duration. Very obese white women had on average the shortest period of breastfeeding while normal-weight white women had the longest. Among white women the odds of breastfeeding at 10 weeks decreased as their BMIs increased.

The authors point to other studies that show overweight and obese women may have a harder time breastfeeding than women of normal weight and they urge that overweight and obese women as well as black women may need more guidance to start breastfeeding.

-- Jeannine Stein

Photo credit: Ricardo DeAratanha / Los Angeles Times

Lengthy pacifier use can lead to speech problems

October 21, 2009 |  6:00 am

Pacifiers Questions on whether a baby should be given a pacifier or allowed to thumb-suck have existed for generations. The concerns center on whether sucking habits will impact tooth alignment and speech development. The latest evidence, published today, suggests that long-term pacifier use, thumb-sucking and even early bottle use increases the risk of speech disorders in children.

The study looked at the association between sucking behaviors and speech disorders in 128 children, ages three to five, in Chile. Delaying bottle use until at least 9 months old reduced the risk of developing a speech disorder, researchers found. But children who sucked their thumb, fingers or used a pacifier for more than three years were three times as likely to develop speech impediments. Breastfeeding did not have a detrimental effect on speech development.

The authors of the study noted that other research suggests that use of a pacifier or thumb-sucking for less than three years also increases the risk of a speech problem. The sucking motion may change the normal shape of the dental arch and bite. Breastfeeding, however, seems to promote positive oral development.

"The development of coordinated breathing, chewing, swallowing and speech articulation has been shown to be associated with breastfeeding. It is believed that breastfeeding promotes mobility, strength and posture of the speech organs," the authors wrote.

The study is published in the open access journal BMC Pediatrics.

- Shari Roan

Photo credit: Los Angeles Times

Breastfeeding moms: Want lovely bones? Do some exercise

October 13, 2009 |  2:50 pm

Breastfeeding mothers do a lot for their babies, but the process of breastfeeding can shortchange moms when it comes to bone mineral density.

Js8ehjncDuring pregnancy and lactation a woman's body can show bone mineral loss even greater than what the average woman experiences after menopause. While bone mineral density usually returns to normal levels when lactation stops, it doesn't return to pre-pregnancy levels in all women.

But exercise, according to a new study, may help shore up that bone loss. Researchers from the University of North Carolina at Greensboro recruited 20 breastfeeding women, randomly assigning half to an exercise intervention group, and half to a control group that did no exercise. Neither group changed their diet.

The 16-week exercise program consisted of aerobic activity three days a week (brisk walking) and resistance training three days a week that emphasized increasing core strength. Individual exercises included squats, bench presses, push-ups, abdominal planks and dead lifts and were done at home with handheld weights and a stability ball. Since all study participants were sedentary at the beginning of the study, time and intensity of the exercises increased gradually.

All that exercise paid off--the workout group showed significantly less bone mineral density losses in the lumbar spine compared with the control group. The intervention group also showed greater muscular strength and improved endurance over the control group. That group also lost substantially less lean body mass than the control.

The study concluded: "Additional research is needed to determine whether these beneficial effects of exercise continue after weaning, resulting in higher [bone mineral density] and decreasing the risk of osteoporosis in later life."

The study appears in the October issue of the journal Medicine & Science in Sports & Exercise.

-- Jeannine Stein

Photo credit: Barbara Peacock/CORBIS

WIC program gets its first overhaul -- to include fresh produce

September 30, 2009 |  2:19 pm


There is rejoicing today at agencies that work with recipients of food vouchers through the Women, Infants and Children program.

"We're in seventh heaven," said Laurie True, executive director of the Cal WIC Assn., based in Sacramento.

Starting Thursday, WIC recipients -- more than 8 million of them -- will be able to use vouchers to buy fresh fruit and vegetables, under a program revision that has been years in the making.

"We're extremely excited," said Pina Hernandez, outreach manager for the Public Health Foundation Enterprises WIC Program, which provides WIC services to 316,000 people in Los Angeles and Orange counties.

"It's a much-needed change," said Elizabeth Pivonka, president of the Produce for Better Health Foundation, a nonprofit behind a national public health initiative to get people to eat more fruit and vegetables.

"That's the one food group consumers are eating so little of," she said.

When WIC was devised more than 30 years ago, hunger and vitamin deficencies were problems, and the WIC foods reflected that -- eggs, cheese, protein, milk, juice. Today, of course, obesity is the top food-related health problem.

WIC also provides education to recipients, and Pivonka said the emphasis on the reasons people need fruit and vegetables might help families develop good eating habits. And for families who might have felt that fresh produce was too expensive, the targeted funds will "give them permission to eat fruits and vegetables," she said.

The provision is $6 a month for children, $8 for pregnant women and mothers of children 5 and under, or $10 for mothers who are exclusively breast-feeding.

"Is it sufficient? No, but it's just a supplemental program," Pivonka said.

-- Mary MacVean

Breastfeeding may benefit women with a family history of breast cancer

August 10, 2009 |  1:35 pm

Women who have watched a mother, sibling or child battle breast cancer can become understandably preoccupied, if not obsessed, with trying to reduce their own risk of the disease. One possible way to do that? Breastfeed.

In a study published online today in the Archives of Internal Medicine, researchers at Brigham and Women's Hospital and Harvard Medical School analyzed information on 60,075 women who had given birth and who had provided information about, among many other things, their breastfeeding practices.

Earlier studies had hinted that breastfeeding might lower a woman's chance of developing the disease, but those results were far from conclusive.


This study seems somewhat clearer. It found that women who had a so-called first-degree relative with breast cancer were less likely to develop pre-menopausal breast cancer if they had ever breastfed. Duration of breastfeeding didn't affect risk, the study said, nor did whether the women supplemented with formula, nor did whether the women experienced a cessation of menstruation. Just the act of breastfeeding.

No such connection was found in women who didn't have a family history of breast cancer.
Here's a synopsis of the study; more on the risk factors for breast cancer, from the American Cancer Society; and a roundup of information on breastfeeding, from the National Institutes of Health's Medline Plus.

(As for the women in this study, if you hadn't guessed already, they were participants in the Nurses' Health Study. Some years ago, thousands upon thousands of nurses answered detailed questions about seemingly every health factor imaginable. Researchers have been mining their answers ever since, and the possible connections between health and lifestyle gleaned from those participants just keep coming.)

In this study, the researchers conclude: "The observed 59% reduction in risk compares favorably
with hormonal treatments such as tamoxifen for women at high risk for breast cancer. Moreover, breastfeeding is associated with multiple other health benefits for both mother and child. These data suggest that women with a family history of breast cancer should be strongly encouraged to breastfeed."

-- Tami Dennis

Photo: Los Angeles Times

A nipple, a cellphone camera -- and a diagnosis

July 24, 2009 | 12:05 am

Cellphone cameras are so handy, aren't they? In a bizarre little article in the British Medical Journal, doctors describe how a woman, by taking quick snapshots of her nipple, was able to provide clear evidence of the symptoms she was experiencing -- and as a result, a diagnosis was made.

The article, "Lesson of the Week: An underdiagnosed cause of nipple pain presented on a camera phone," described a 25-year-old breast-feeding woman who was experiencing extreme transient pain in the nipples. The nipples, in addition, changed color:

--First white, with tingling,
--Then blue, with a burning pain,
--Then red, with the pain fading away.

(We kid you not.)

The patient carefully took photographs of her nipples in each of these states, presented them to her doctor, and a diagnosis of "Raynaud's phenomenon of the nipple" was made. What happens is this:

WHITE -- blood vessels constrict (cut-off in blood supply leads to whiteness)
BLUE -- remaining blood in the nipples turns blue because it becomes deoxygenated, and that's the color blood turns when the oxygen in it is used up
RED -- the vessels dilate, and fresh, oxygenated blood re-enters the nipple.

This occurs when the temperature drops below a certain key level, one that depends upon the patient in question.

As the paper explains, the patient should: Avoid exposure to cold. Breast-feed in warm environments. And wear warm clothes.

--Rosie Mestel


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