Thank You to the Surgeon General

The Surgeon Generals Call to Action to Support Breastfeeding document was released last Thursday, January 20th. The Surgeon General begins the call to action with the following statement:

“For nearly all infants, breastfeeding is the best source of infant nutrition and immunologic protection, and it provides remarkable health benefits to mothers as well. Babies who are breastfed are less likely to become overweight and obese. Many mothers in the United States want to breastfeed, and most try. And yet within only three months after giving birth, more than two-thirds of breastfeeding mothers have already begun using formula. By six months postpartum, more than half of mothers have given up on breastfeeding, and mothers who breastfeed one-year olds or toddlers are a rarity in our society.”

The Call to Action asks for all members of the community to support breastfeeding mothers in their own way. The document outlines the importance of breastfeeding and includes information on the health, psychosocial, economic, and environmental benefits of breast milk. The surgeon general explains the barriers that breastfeeding mothers in the United States face, such as lack of knowledge and support, and what can be done about them.

The following objectives are including in the document, along with implementation strategies for achieving each one:

  1. Give mothers the support they need to breastfeed their babies.
  2. Develop programs to educate fathers and grandmothers about breastfeeding.
  3. Strengthen programs that provide mother-to-mother support and peer counseling.
  4. Use community-based organizations to promote and support breastfeeding.
  5. Create a national campaign to promote breastfeeding.
  6. Ensure that the marketing of infant formula is conducted in a way that minimizes its negative impacts on exclusive breastfeeding.
  7. Ensure that maternity care practices throughout the United States are fully supportive of breastfeeding.
  8. Develop systems to guarantee continuity of skilled support for lactation between hospitals and health care settings in the community.
  9. Provide education and training in breastfeeding for all health professionals who care for women and children.
  10. Include basic support for breastfeeding as a standard of care for midwives, obstetricians, family physicians, nurse practitioners, and pediatricians.
  11. Ensure access to services provided by International Board Certified Lactation Consultants.
  12. Identify and address obstacles to greater availability of safe banked donor milk for fragile infants.
  13. Work toward establishing paid maternity leave for all employed mothers.
  14. Ensure that employers establish and maintain comprehensive, high-quality lactation support programs for their employees.
  15. Expand the use of programs in the workplace that allow lactating mothers to have direct access to their babies.
  16. Ensure that all child care providers accommodate the needs of breastfeeding mothers and infants.
  17. Increase funding of high-quality research on breastfeeding.
  18. Strengthen existing capacity and develop future capacity for conducting research on breastfeeding.
  19. Develop a national monitoring system to improve the tracking of breastfeeding rates as well as the policies and environmental factors that affect breastfeeding.
  20. Improve national leadership on the promotion and support of breastfeeding.

If you are as excited as I am, you might like to read the entire thing for yourself:

http://www.surgeongeneral.gov/topics/breastfeeding/calltoactiontosupportbreastfeeding.pdf

Weaning

weaningWhen and how you decide to wean your breastfeeding child depends on whether you would like to follow a child-led weaning approach or a mother-led weaning approach. It is extremely rare that a child will self wean prior to the age of approximately 2.5 years old. Sometimes it can be difficult to tell the difference between weaning and a nursing strike. Know that real weaning is a gradual process and rarely happens abruptly.

Breastfeeding does not have to be an all or nothing thing. Consider the reasons you are wanting to wean. If you are going back to work, it is definitely possible for you to continue nursing during the times you are home. Breastfeeding is a powerful tool for reconnecting with your child after a long day of separation.

Weaning is a very personal decision. My only recommendation is that if you are going to follow a mother-led weaning approach, please do so gently and gradually. The following tips, meant for weaning children over 12 months of age, may help to make the transition a smooth one for you and your child:

  • Flexibility – Be prepared for weaning to be a gradual process and go into it knowing that you will need to be flexible while your child adapts.
  • Extra affection – Offer your child extra hugs, cuddles, and other forms of physical affection during the day and night. Your breastfeeding provides so much more to a developing child then just breast milk.
  • “Don’t offer – Don’t refuse” – Employ a “don’t offer don’t refuse” approach to weaning when you begin. If your child would like to nurse then by all means let him; but don’t offer when he is happily doing something else.
  • Drop one feeding – Start by dropping only one feeding at a time. Be prepared for nighttime and nap nursing sessions to be the last to go.
  • Avoid nursing spots – Avoid sitting in locations where your child is used to nursing, such as your favorite rocking chair.
  • Keep busy – Keeping your child distracted throughout the day will probably naturally limit nursing sessions.

Feeling Touched Out

There once was a time when I had complete control over my own body. Occasionally I would share this body with my loving husband, or a friend that needed a hug or a hand to hold. Shortly after the sharing, hugging, and holding was over, I was free to stretch out, go for a walk, or enjoy a nice long solitary shower.

The minute a woman becomes pregnant she truly learns what it means to share her body. The experiences shared between a mother and her unborn child are beautiful and life altering. Feeling those first kicks and hiccups are memories that will probably stick with someone forever. I have heard many new moms, in the last few weeks of pregnancy, exclaim that they “are ready to have their body back to themselves.” But hopefully the end of pregnancy marks the beginning of a breastfeeding relationship.

Although the baby is now on the outside, breastfeeding involves countless hours of putting another persons needs before your own. The benefits that come with breastfeeding your child are incredible, but it is completely normal to feel touched out, discouraged, and drained from time to time.

It is important to recognize these feelings so that they do not lead to resentment and a decision to wean that you might later come to regret. When I am feeling touched out, some of the following tips help to recharge my batteries so that I can once again enjoy and appreciate all of the positive aspects of breastfeeding my son:

  • Take breaks – Recognize the importance of taking breaks and make it a priority. Make sure you and your partner each have some time to yourselves each day, even if it is just 20 minutes. Sometimes it helps just knowing that there will be a window at the end of the day for you to soak in the tub or read a chapter of your book. I often find that after a short break I am recharged and can’t wait to cuddle up on the couch and nurse my son.
  • Free your hands – Sometimes just having your hands and arms free is a relief. Find a good arms free carrier such as the Ergo or a Moby Wrap. If you are having an especially hard day. Wear your baby on your back and go for a nice long walk, pretend you are alone!
  • Stretch – Take time to stretch your body out and feel the empty space around you. Stand up and stretch when your baby is on the floor for tummy time, or when your toddler is happily eating in their high chair.
  • Multitask – On days when it feels like all you are doing is breastfeeding, try to fit in other activities when you can. I used to often feel touched out when it took me a long time to nurse my son to sleep; now I bring a book with me and the second his eyes close I turn on a dim light and read. There are times when I stay in the room just to finish a chapter even after he is deeply asleep.

Breastfeeding Milestones

Like most breastfeeding moms, I always had a goal in the back of my mind for the length of time that I would like to nurse my son. This month, with my son at the ripe old age of 18 months, I met my initial goal of breastfeeding him for at least a year and a half! I will continue to breastfeed him until one of us is not enjoying it anymore; with my new goal being at least 2 years.

Among many new mothers, and some individuals who have yet to have children, it is a common belief that breastfeeding continues until the baby turns one year old – when they magically know how to self wean and suddenly become an independent toddler that is content with sippy cups and carrot sticks. It’s not that easy. Although one year is the goal touted by the American Academy of Pediatrics, several developmental milestones are taking place at the age of 12 months(such as learning to walk and talk). This can make it an emotionally difficult time for a child to give up breastfeeding.

Often parents set out with a goal of nursing their child until one year old. As that year approaches, it sometimes becomes obvious how much a 12 month old still needs the multiple benefits(nutritional and emotional) of breastfeeding. The World Health Organization recommends breastfeeding for up to two years of age or beyond

If you have met a breastfeeding milestone that you set for yourself and your child, whatever the milestone, you should be extremely proud!  Although incredibly rewarding and beneficial for all parties involved, breastfeeding is not an easy road to travel – especially in the beginning.

Zoloft And Breastfeeding

Postpartum depression is extremely common following child birth. This debilitating disease can make it nearly impossible for a new mother to tend to her baby. Many mothers opt for medical treatment in order to fulfill their new role as caregivers to their newborn child. However, there are certain risks associated with the use of antidepressants like Zoloft, also known as sertraline, while breastfeeding.

What Are the Risks Associated with taking Zoloft and Breastfeeding?

Any medication consumed by the mother may be passed on to her infant through breast milk. Several studies have shown varying results. In one, no Zoloft was found in the breast milk of mothers who were nursing while taking sertraline. However, two other studies showed detectable traces of Zoloft in breast milk and even traces of sertraline in the plasma of infants breastfed by mothers taking the prescription antidepressant.

The concern, of course, is that sertraline or its metabolite norsertraline, which has an antidepressant effect that is 10% that of Zoloft, may affect the emotional, physical, or mental development of the infant. In fact, a survey of published and unpublished studies indicated that mothers prescribed an average of 83 mg of Zoloft produced breast milk with an average of 45 mcg/L of sertraline. Considering the weight of the baby, these quantities would mean the infant ingested around 0.5% of the sertraline consumed by the mother.

Having established the Zoloft can, in fact, be passed from mother to infant through breastfeeding, it is important to consider the effects on babies receiving breast milk. In an Australian study, two infants showed possible negative side effects after receiving breast milk from mothers taking Zoloft. These included agitation and involuntary muscle twitching while sleeping. While both reactions were found to be benign and later resolved themselves, other studies have shown startling negative effects.

In one study, infants that consumed sertraline via their mothers’ breast milk did not react to pain as readily or quickly as expected for children their age. No control group was used, so it is impossible to rule out the effect of taking Zoloft and breastfeeding as the cause. Moreover, the results of a large study of over 900 mothers taking antidepressants while breastfeeding suggest that 10% of infants may show signs of withdrawal once they are weaned. Symptoms include disordered sleep, eating problems, irritability, and lower than normal body temperature.

What Can Be Done?

For those concerned about the effect taking Zoloft while breastfeeding may have had on their infant, there are a number of steps that can be taken. First and foremost, concerned mothers should consider consulting with a specialist in order to start any treatment that may be necessary. For those who have experienced problems associated with breastfeeding while taking Zoloft, a class action suit is currently underway. This is important for two reasons: 1) Compensation may be available for those affected, and 2) a class action suit also helps get the word out to others so that they can avoid the same problems.

Breastfeeding Foods To Avoid

Motherhood is the most wonderful as well as most blissful state in this world, which every woman goes through be it only for once in her lifetime. Sometimes women get dizzy on carrying their own baby in their arms for the first time along with breastfeeding them. But you need to ensure that the milk which is nourishing your child is healthy. This is the reason due to which nursing mothers are directed by their doctors to follow a diet that is well balanced in nature as well as nutrients.

Anything unhealthy you put in your body may adversely affect the child. The early signs of its body rejecting your breast milk can be too much spitting, fussiness, vomiting, rashes, colic as well as congestion. Therefore, there are some things a woman must avoid the intake of, while her breastfeeding period. During breastfeeding foods to avoid are the broccoli, chocolate, citrus fruits, coffee, garlic, spicy foods, alcohol, corn, peanuts, wheat, eggs, shellfish, soya, fish, parsley as well as the peppermint.

These foods have been asked to be limited or completely removed from the nursing mother’s diet by even grandmothers since a long time. But there are a few specific reasons for it. If we take the broccoli, it is said to increase the baby’s fussiness during nighttime. To see whether or not this super food is the culprit, avoid it totally. Once when the baby’s flatulence is fixed, start taking it again in your meals in small portions. The coffee and chocolates are asked to be avoided due to their high caffeine content.

They may also result in baby’s fussiness. In the case of citrus foods, the GI tract of a growing baby gets irritated by some of the compounds present in this food group. This results in harsh diaper rashes and increased spitting-up of the baby. In the case of garlic, you need to be careful, as this warm spice can change the taste of your milk. It is seen that garlic flavored milk many a times gets rejected by the babies. Spices in body in excess amounts will of course be leading to a greater fussiness in your child’s body and the peppermint is enough to reduce the quantity of milk produced by a woman who is nursing her baby.

All the dairy as well as poultry products are asked to be avoided because of the suspected allergies in the baby as well as the high levels of mercury found in the poultry products which may harm the infants. During breastfeeding foods to avoid should be kept in constant check.