Supporting Breastfeeding

La Leche League Canada

Radiologic Procedures While Breastfeeding

Mothers often ask if they must wean before having a medical diagnostic scan or x-ray. In most situations, weaning is not necessary.

The first step is to gather information about the type of testing that is being recommended. Useful information to collect is the name of the test and the name of the radio-contrast compound or radio-opaque contrast media (i.e. the drug taken or injected to make parts of the body show up when x-rayed or scanned) being used.

 

MRI Scan (magnetic resonance imaging)

  • Best for looking at soft tissue (brain, muscle, cancers, blood vessels, etc.), and can be used for looking at bone.
  • Does not use radioactive material, but does use radio-contrast medium that under magnetic field shows up body parts.
  • Contrast is not always used but does enhance the image. Contrast substance used most commonly is gadopentetate and it is not radioactive
  • Less than 0.04% of the dose of gadopentetate will appear in a mother’s milk and only 0.8% of that is absorbed by the baby.
  • Those with claustrophobia are given conscious sedation.

 

CT Scan (computerized axial tomography) or CAT scan.

  • Gold standard for looking at bleeding (clots), tumours, inflammation, bone or tissue injury, guiding passage of a needle etc.
  • Person takes a compound that contains iodine. Multiple x-rays are taken encircling the body, and the iodine reveals bones or tissues.
  • Contrast medium used is not radioactive. Contrast is not always used. Like for MRIs it is used to enhance imaging.
  • The iodine in the contrast material is bound to a molecule forming the compound.  The compound does not enter the milk in any noticeable amount. The compound does not release enough iodine to alter the infant’s thyroid function.

 

IVP (intravenous pyleogram), or lymphangiogram

  • Uses contrast media similar to MRI (see above)
  • Contrast medium is delivered by intravenous to show under x-ray the kidney, lymph nodes or blood vessels.

 

Radioactive Scans

  • A radioactive form of gallium (Ga), technetium (Tc), or iodine (I) is sometimes given to a mother before a test or used as a treatment.
  • In order to protect the baby from ingestion of the radioactive compound in breastmilk, weaning for a period of time is recommended.
  • Appropriate times for being off the breast are listed in Hale
  • Mother will need to express her milk during this time to maintain her supply.

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Consider Other Options

If a mother has been told to wean her baby for one of the first three scans, she may be able to consider other options. Printed information can be shared with the doctor, such as pages from Medications and Mother’s Milk, Breastfeeding Answers Made Simple, or other references.
Has she asked her doctor if the test can be postponed or if another less invasive procedure is possible?  Has the doctor shown her evidence indicating that the baby must be weaned? Has she discussed with her doctor the risks of temporary weaning?

 

Support For Temporary Weaning

In the case where weaning is unavoidable, because the scan requires a radioactive contrast medium (the fourth scan above) which is not compatible with breastfeeding, a mother will require support as she decides how to cope with the situation. She may wish to prepare ahead by pumping and freezing breastmilk for use during the hours or days it takes the radioactive substance to leave her body. “Decay time” is the total time needed for the medium to leave her body. The term “half-life” refers to both the length of time it takes for ½ of the contrast medium to leave the body and the time it takes for the level of radioactivity to decrease by 50%. Decay time is usually 5-10 half-lives. You can prepare for pumping during the decay time and discarding breast milk safely should that be necessary.

In some cases, a mother may have to arrange for a caregiver for the baby during the “decay time”. Decay times and half-lives of many radioactive contrast agents are available from Hale or from the x-ray laboratory where the test is being done.

 
Note: This article was published in 2010. Updated resources may be available. For more detailed information and references, please refer to the article.

http://www.lllc.ca/sites/lllc.ca/files/Keeping-in-the-LLLoop-Fall-10.pdf

 

 

 
If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader. In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/.

If you have found this article helpful, La Leche League Canada would appreciate your support. Your donation is essential and very much appreciated to help LLLC cover the cost of producing breastfeeding resources: https://www.lllc.ca/donate or become a LLLC Friend http://www.lllc.ca/join-lllc-friends

 

 

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Storing Human Milk

Human milk is a fresh, living substance – not just a ready-to-use food.  When you make the effort to provide expressed milk for your baby, if he or she cannot nurse directly, you are ensuring that your baby continues to receive ideal nourishment and protection against many diseases.

Before you begin to express your milk, wash your hands with hot, soapy water and have your storage containers ready.   How you store your milk will affect how well its nutritional and anti-infective qualities are preserved.

Human milk’s anti-bacterial properties actually help it stay fresh.  The live cells and antibodies in the milk that discourage the growth of bad bacteria in your baby’s intestines also guard against bacterial growth when the milk is stored in a container.  The interpretation of research on human milk storage varies widely.  The following guidelines are adapted from La Leche League International’s pamphlet, which was created with the assistance of members of the LLLI Health Advisory Council and Anne Eglash, MD, FAAFP, FABM.  They provide evidence-based ranges for the storage of milk for full-term, healthy babies.

How Long to Store Human Milk

Whenever possible, babies separated from their mothers should get milk that has been refrigerated, not frozen.  Some of the anti-infective properties are lost when milk is frozen—though frozen milk still helps protect babies from many diseases and is much better for your baby than commercial infant formula.  How long you can store milk depends on the temperature.  A mother’s expressed milk can be safely stored at room temperature for 4-6 hours, in a refrigerator for 3-8 days, and for 6-12 months in a standard home freezer (See “Milk Storage Guidelines” below for details)

If cold milk is warmed but untouched, it can be returned to the fridge for a later feeding. It is not clear how long it is safe to keep milk after the baby drinks from the container.  Some mothers keep the leftover milk at room temperature to use within an hour if the baby appears hungry after a short sleep.  Others refrigerate and reheat the milk left from a previous feeding.  However, there is no research on the safety of either of these practices. Avoid wasting precious milk by offering small amounts at a feeding.

Frozen milk which has been thawed can be kept in the refrigerator for up to 24 hours.  While there is some evidence that milk thawed for a few hours may be refrozen, this results in further breakdown of milk components and loss of antimicrobial activity.  It is best not to refreeze thawed milk.  Remember that refrigerated milk will stay fresher than milk that was once frozen.

Expressed human milk can be kept in a common refrigerator at a workplace or day care center.  Check that the refrigerator temperature is 4°C or less.  Health authorities agree that human milk is not among the body fluids that require special handling or storage in a separate refrigerator.  To keep expressed milk cool when a refrigerator is not available, place it in an insulated container with an ice pack.  This also helps when transporting milk home from the workplace or to the babysitter, especially on warm days.

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Containers for Storage

The best options for storing human milk are glass or hard-sided plastic containers with well-fitting tops.  Be sure they do not contain the controversial chemical bisphenol A (BPA). Containers should be washed in hot, soapy water, rinsed well, and allowed to air-dry before use.   Containers may also be washed and dried in a dishwasher.  If you are using these containers for freezing your milk, do not fill them up to the top – leave an inch of space to allow the milk to expand as it freezes.

If you plan to store your milk in bags, choose thick plastic bags that are designed for storing human milk rather than bottle liners.  Care must be used to avoid contamination during handling and storage of bags as they are less durable than glass containers.  Double-bagging can help prevent leakage accidents.  Squeeze out the air at the top before sealing and allow about an inch for the milk to expand if it is to be frozen.  Stand the bags in a rigid container at the back of the refrigerator shelf or in the back of the freezer, where the temperature consistently remains the coldest.

Put only 60 to 120 ml (two to four ounces) of milk in the container – the amount your baby is likely to eat in a single feeding.  This avoids waste.  Small quantities are also easier to thaw.

If a mother expresses a small amount of milk in one session, it is fine to add fresh milk to chilled milk.  The newly expressed milk should be cooled in the refrigerator for 30 to 60 minutes before being added to the stored milk.   This method can be used for frozen milk, although this practice is questioned by some researchers.  The volume of fresh milk should be less than what is already in the frozen container.

Be sure to label every container of milk with the date it was expressed; if milk expressed on different days is combined, then the earlier date should be used.  If the milk will be given to your baby in a day care setting, also put your baby’s name on the label.

 

Using Stored Milk

Human milk may separate into a milk layer and a cream layer when it is stored.  This is normal.  Swirl it gently to redistribute the cream before giving it to the baby.

The milk only needs to be lukewarm, not hot.  Some babies accept milk right from the refrigerator.

Do not use a microwave oven to heat human milk.  Because microwaves do not heat liquids evenly, there may be hot spots in the container of milk, and this can be dangerous for infants.

High temperatures can affect many of the beneficial properties of milk.  Warm milk gradually and with care.

If milk is frozen, containers should be thawed in the refrigerator overnight or under cool running water.

Cold milk can be gently warmed under warm running water for several minutes.   Or immerse the container in a pan of water that was warmed on the stove.  Do not heat the milk in a pan directly on the stove.

If thrush or yeast infections are affecting you or your baby, continue to breastfeed during the outbreak and treatment.  While being treated, you can continue to express your milk and give it to your baby.  It is unknown if milk expressed and stored during a fungal infection could cause a recurrence.  If you are concerned, after treatment is finished, already stored milk could be boiled and cooled to kill any yeast before use.

Occasionally, breastmilk that has been frozen and thawed may smell or taste soapy; sometimes it may even smell rancid (‘off ’).  This is due to the breakdown of milk fats.   The milk is safe and most babies will still drink it.  In the future, you may want to scald your expressed milk by heating it just until bubbles form at the edges.  This deactivates the lipase enzyme, which breaks down milk fats.  The scalded milk should then be quickly cooled and frozen normally.  Scalded milk is still a healthier choice than commercial infant formula.

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Milk Storage Guidelines

                 Where            Temperature                      Time
At room temperature

(fresh milk)

             19° to 26°C 4 hours (ideal); up to

6 hours (acceptable)*

(some sources use 8 hours)

In a refrigerator                      <4°C 72 hours (ideal); up to

8 days (acceptable)**

In a freezer

(standard home freezer)

           -18° to -20°C 6 months (ideal); up to

12 months (acceptable)

 

*The preference is to refrigerate or chill milk right after it is expressed.

**Eight days is acceptable if collected in a very clean, careful way.

 

Making It Work for You and Your Baby

This information can help you decide how to store your milk to best meet your needs. Breastmilk is remarkably resilient and stores well because of its antibacterial properties. However, it is always preferable to store milk for as short a time as possible. This will minimize the loss of antibodies and nutrients, and keep bacterial growth to a minimum. The fresher your milk, the better.

 

http://www.lllc.ca/Information-sheets

 

 

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader. In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/.

If you have found this article helpful, La Leche League Canada would appreciate your support. Your donation is essential and very much appreciated to help LLLC cover the cost of producing breastfeeding resources: https://www.lllc.ca/donate or become a LLLC Friend http://www.lllc.ca/join-lllc-friends

 

 

 

 

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Breastfeeding and Cigarette Smoking

La Leche League Leaders are often asked whether smoking cigarettes impact a mother’s ability to breastfeed. It is not the role of La Leche League to judge a parent’s decision to smoke. We are here to provide fact based information which allows parents to make their own decisions. So what does some of the research say?

What people believe about smoking and breastfeeding: a study that looked at the factors which contribute to intention to breastfeed and breastfeeding outcomes examined how smoking status affected the decision making. The conclusion of the researchers was “Women perceived that a strong risk of harming the baby was posed by smoking while breastfeeding and received little encouragement to continue breastfeeding despite an inability to stop smoking. The perceptions of the toxic, addictive, and harmful effects of smoking on breastmilk constitution and quantity factored into reasons why women weaned their infants from breastfeeding much earlier than the recommended 6 months.”

Breastfeeding duration: a 2006 study followed mothers who had smoked during pregnancy and mapped how long they continued to breastfed. The results showed a lower rate of initiating breastfeeding and a shorter duration (average of 11 weeks vs 28 weeks) when compared with the non-smoking mother control group. The statistical difference persisted even after adjusting for mother’s age, education, income, father’s smoking status, mother’s country of birth, mother’s intention to breastfeed for more than 6 months and baby’s birth weight.

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Does breastfeeding change smoking behavior? A 2012 study done in Italy showed that women who had stopped smoking during pregnancy were less likely to resume smoking after giving birth if they were breastfeeding. Women who had continued to smoke during pregnancy and breastfeeding smoked less at the interview check points than the mothers who were not breastfeeding. A similar study concluded that early prenatal care and breastfeeding is associated with postpartum smoking abstinence.

Infant sleep: a 2007 study looked at sleep duration in a group of infants on two separate occasions: after their mothers had smoked and when their mothers had refrained from smoking. They found the babies spent less time over all and the longest sleep session was shorter.

Lower respiratory tract infections: Lower respiratory tract infections (LRTIs) considered in this study were pneumonia, bronchitis and bronchiolitis. This study looked back at a large group of children born over a two year period in Oslo Norway and tracked health information from physicians. Their data showed that the babies of non-smoking breastfeeding mothers who breastfed for more than six months had the lowest risk of having a LRTI in the first year of life. Babies of mothers who smoked and breastfed for more than six months had an increased risk of an LRTI in the first six months of life. The risk decreased in the second six months although not to a level as low as that of the non-smoking group. Short term breastfeeding (less than six months) and smoking had an increased risk of LRTIs compared with short term breastfeeding without smoking. The results suggest that breastfeeding has a protective effect for babies who are going to be exposed to environmental tobacco smoke. A 2008 study on a similar topic looked at breastfeeding, maternal smoking, recurrent LRTIs and asthma in children.

http://www.lllc.ca/thursdays-tip-breastfeeding-and-cigarette-smoking

 

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader. In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/.

If you have found this article helpful, La Leche League Canada would appreciate your support. Your donation is essential and very much appreciated to help LLLC cover the cost of producing breastfeeding resources:  https://www.lllc.ca/donate or become a LLLC Friend http://www.lllc.ca/join-lllc-friends

 

 

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Breastfeeding, Inflammation & Infection

We have long known that babies who are breastfed have a lower risk of getting an infection and that their immune systems develop differently. The biological mechanisms behind these differences are still under investigation by scientists.

 
A recently published study by Arnardottir, Dalli and Sehan into a class of molecules called “specialized pro-resolving mediators” (SPMs) found that these inflammation resolving molecules are found in high numbers in human milk. This group of molecules is involved in clearing infections, reducing inflammation, combating pain and healing wounds.

 
The highest levels of these SPMs were found in the breastmilk of healthy mothers. Mothers who had an active case of mastitis (a breast infection) had much lower levels in their milk samples. When their milk was tested it did not have the same ability to resolve inflammation and infection. Cow’s milk and artificial infant formula showed no detectable level of SPMs.

 

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Further study will be needed to see how these SPMs have a role in the protection of the infant from infection and the development of the babies’ immune system. For now it would appear that they play a role in the mother in protecting against or resolving mastitis.

 
For more information about avoiding or resolving mastitis check out:

⦁ La Leche League Canada’s FAQs

⦁ La Leche League International’s Breastfeeding Today

⦁ Talking things over in-person with a La Leche League Leader is always the best way to get support and information that is right for your situation.

 
http://www.lllc.ca/thursdays-tip-breastfeeding-inflammation-infection

 

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader. In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/.

 

If you have found this article helpful, La Leche League Canada would appreciate your support. Your donation is essential and very much appreciated to help LLLC cover the cost of producing breastfeeding resources: https://www.lllc.ca/donate or become a LLLC Friend http://www.lllc.ca/join-lllc-friends .

 

 

 

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Creating Your Nursing Nest

In the early days of breastfeeding, you are going to spend a lot of time sitting and nursing. It is helpful to create yourself a nursing nest spot (or two) so that everything you might want is within arm’s reach once you get baby latched on. Here are some tips from other mothers of the things they think found important to have at hand:

1) Something to drink: Keep a full unspillable water bottle or cup by your nursing nest. It is amazing how thirsty you can feel when your milk lets down. If you forget to put a drink close by, you will feel like you are in the desert watching for a waterhole and never getting there. The kitchen tap will seem like a mirage and you will be sure the nursing session will never end!

2) Something to eat: You are producing 500- 700 calories of milk a day for your baby; feeling hungry is justifiable. You may be sitting in your nursing nest for a while so be prepared with healthy snacks. Nuts, granola bars and fruit can all sit at room temperature which means they are ready to eat when you need them. Some mothers make a sandwich or cut up cheese to keep in a container in the fridge. This gives them a snack that can be grabbed with one hand on the way to the nursing nest.

1 Nursing NestWM

 

3) Something to entertain your mind:  Mothers figure out how to breastfeed while reading books, working on their computers or using a smart phone. Television can be a distraction option and older children are guaranteed to keep your mind occupied. Gazing in awe at the most beautiful baby in the world is one of the best parts of breastfeeding so don’t forget to put aside the gadgets for a while. Whatever stage your nursing child is at won’t last long and this time together in your nursing nest will quickly become a memory.

4) A towel, receiving blanket or burp cloth: in the early days you may be leaking and baby may be overflowing at both ends. Having something at hand that is intended for mopping up soggy spots will come in handy.

5) A really good breastfeeding resource book:  You are sitting in your nursing nest and breastfeeding; as the milk flows the questions start to flow through your mind. You could poke around the internet for answers but how do you evaluate the quality and applicability of the advice and information you will find there?  The Womanly Art of Breastfeeding  is a book you can read from front to back or you can dip in and find information about almost anything to do with breastfeeding. Having it at hand is like having a breastfeeding buddy in the room with you.

6) Your La Leche League Leader’s phone number or e-mail address: If you have your smart phone in your hand and you have a question now is a good time to contact LLL.  A conversation with a Leader is better than searching the internet for answers to your questions because she can help you figure out what information is relevant to your specific situation and what is not. If you have the number at hand you won’t need to search for it on the day you decide you really want it. There are no foolish questions and Leaders don’t mind if you are crying when you call.

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Because breastfeeding isn’t always easy, we’re here to help.

 

http://www.lllc.ca/thursdays-tipcreating-your-nursing-nest

 

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader. In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/.

If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/join-lllc-friends so we can continue to help others breastfeed. Thank you!

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Toxic Chemicals in Breastmilk

There is no reason to discourage breastfeeding.

The internet is buzzing with articles about toxic chemicals in breastmilk following the release of research [1] done by the Harvard T H Chan School of Public Health which looked at the levels of perfluorinated alkylate substances (PFAS) in breastmilk.
Perfluorinated alkylated substances (PFAS) make up a large group of chemicals which have been used in industrial and consumer products since the 1950s. The substances are mainly used in firefighting foams, protective coatings in food wrappers and containers, stain resistant textiles, floor wax, polish and in the electronic industries. These substances have a high likelihood of ending up in waste dumps, sewage water and the general environment.

The chemicals of the PFAS group are virtually indestructible and were until recently thought to be completely biologically inert and not available for uptake in living organisms. It now appears that they bond with proteins and fats in food sources. Since the late 1990s, increasing numbers scientific studies have brought PFAS chemicals in the focus of international environmental concern. PFAS are shown to be globally distributed and some of them are bioaccumulative which has implications for human exposure.

 

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The Harvard research, which was done in the Faroe Islands in conjunction with the Norwegian Government, showed that PFASs are transferred through breastmilk and that blood samples levels increased the longer that babies were breastfed. After the babies were weaned their accumulated PFAS levels decreased. Babies who were exclusively breastfeed had higher levels than partially breastfeed babies. This information is important not as a reason to discourage breastfeeding but because it is a look at PFAS exposure and accumulation levels in both women and children in that community. The tested babies only showed levels of PFASs in their blood samples because their mothers had built up an accumulation of PFASs over their lifetimes which they could pass on.

Presumably every other adult in that community has similar levels of accumulated PFASs.
Choosing to formula feed doesn’t necessarily protect an infant from exposure to these chemicals for two reasons. Firstly the baby has already been exposed in utero. Studies have shown that PFASs cross the placental barrier and high maternal levels can be linked to miscarriages. Secondly, community water supplies can carry high levels of PFASs. Drinking water prepared by treatment which does not include GAC filtration or reverse osmosis will generally contain higher PFAS levels. The potential for exposure to PFASs in formula fed babies through water supply applies both to the water used in the manufacturing of the formula and the water used to prepare it at home.
Philippe Grandjean, adjunct professor of environmental health at Harvard Chan School and spokesperson for the research team said “There is no reason to discourage breastfeeding, but we are concerned that these pollutants are transferred to the next generation at a very vulnerable age. Unfortunately, the current U.S. legislation does not require any testing of chemical substances like PFASs for their transfer to babies and any related adverse effects.”

 
More information about PFASs can be found at the following links:

 
Community Drinking Water [2]

Immunization response and PFAS exposure [3]

European Commission Community Research and Development information Service (CORDIS) Final Report summary – PERROOD (Perfluorinated organics in our diet) [4]

 

Do you have questions or concerns about breastfeeding or are you searching for a supportive community of other breastfeeding mothers? Check out a LLLC group near you.

 

1 http://www.ehjournal.net/content/14/1/47
2 http://www.ewg.org/enviroblog/2015/08/your-drinking-water-safe
3 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4488050/
4 http://cordis.europa.eu/result/rcn/55843_en.html

 

 

http://www.lllc.ca/thursdays-tip-toxic-chemicals-breastmilk

 

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader. In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/.

If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/join-lllc-friends so we can continue to help others breastfeed. Thank you!

 

 

 

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Should You Mix Human Milk With Formula?

The Canadian and American Pediatric Associations recommend exclusive breastfeeding for the first six months of life and then the slow introduction of complementary foods while continuing to breastfeed for a year or longer. Exclusive breastfeeding means nothing but breastmilk: no water, no juice and no formula. Many mothers are happy to know that their breastmilk is all baby needs in the first six months but other mothers may consider supplementing with formula for a variety of reasons. Those mothers may have questions about whether it is okay to mix formula into their breastmilk.

Dad and Babe

 

Here are some science based answers to this question:

It’s best not to mix breastmilk and formula in the same bottle because the storage guidelines for the two substances are very different. If you mix your milk with formula, and the baby doesn’t finish the bottle, then some of your milk goes down the drain. Formula has to be discarded after the feeding (Alberta Health) [1] whereas human milk left in the bottle can be refrigerated for another feed (LLLI Safe Handling and Storage of your milk [2]).

Mixing formula into the breastmilk will affect some of the protective components of human milk. The following quotes are from the Human Milk Banking Association of North America (HMBANA), [3] in their 2005 publication “Best Practice for Expressing, Storing and Handling Human Milk in Hospitals, Homes and Child Care Settings”: “Feed human milk, with or without fortifiers, separate from formula to maximize the benefits of human milk. If the mother is not producing sufficient milk for each feeding, collect as many pumpings as necessary to make one exclusive human milk feeding and use formula at the other feedings.”  The rationale: Quan et al [4] found that when bovine milk based formula is mixed with human milk prior to feeding, there is a significant (41-74%) decrease in lysozyme activity. Additionally, there is significant increase in the growth of E coli, resulting from the decrease in anti-infective properties in the milk. “Adding human milk fortifier causes a 19% decrease in lysozyme but no corresponding effect on the anti-infective properties or increased growth of E coli.”

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It makes sense that human milk, which is alive, would not be in its ideal state by adding a dead substance, possibly containing agents that might bind up some of the live constituents in the human milk, making them hard to absorb by the baby, or maybe not available at all.

The aim for most mothers is to exclusively human milk feed their babies. Therefore, if formula is used because the mother has not enough milk, but might in the future, it is best to treat the formula like a medicine, used temporarily and separately, to ‘top up’ her milk until such time as she has enough of her own.

Mothers with adequate milk supplies who may choose to use formula for some feedings rather than expressed breastmilk, will also want to ensure that their babies get the full benefits of the breastmilk by using the formula separately rather than mixing it with breastmilk.

If you have questions about how to increase your milk supply or any other
breastfeeding questions please contact a LLL Leader.
http://www.lllc.ca/thursdays-tip-should-you-mix-human-milk-formula

 

Links:

1 https://myhealth.alberta.ca/health/Pages/conditions.aspx?hwid=hw97537&

2 http://www.llli.org/faq/milkstorage.html

3 https://www.hmbana.org/

4 http://www.ncbi.nlm.nih.gov/pubmed/8200164

 
If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader. In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/.

If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/join-lllc-friends so we can continue to help others breastfeed. Thank you!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

LLLC Spring Appeal Campaign [5] for the support of breastfed babies: Help LLLC Grow – If you, or someone you know, has benefitted from the support of LLLC, a donation is one way you can “pay it forward”.
Donate Today!
Over 385,000 babies are born in Canada each year and we want to ensure every mother has access to La Leche League Canada support whenever she needs it. We are working hard to grow and we need your support. Every donation helps us provide more support to more families!
Thanks to past donations, we have been working hard to grow our services:
Our volunteer Leaders are the cornerstone of LLLC and the support we provide. We have increased our Leaders by 10% in the past year and Leader Applicants by 40% over the past 2 years!
More than 13,000 mothers attend LLLC meetings and another 20,000 receive one-to-one phone support from Leaders.
We have doubled our community and health professional outreach in just one year!
5 new Information Sheets in various languages were made available free of charge to mothers and health professionals
A new Communication Skills program was developed to strengthen health professional and breastfeeding peer support skills and our Best for Babies pre-natal program continues to grow.
Our Leaders are a vital part of LLLC’s breastfeeding foundation. They freely devote their time to help other parents give their children the optimal start in life. You, the donor, make up the other part of the foundation on which the LLLC breastfeeding services rest. Your gifts mean that our Leaders can carry out the valuable help families need. Frankly, we would be unable to deliver services to families without you or our Leaders so please take a moment to consider how valuable your support is and make a donation, either online or by using our pledge form. If a one-time donation is not suitable for you, perhaps spreading your gift over a year would make sense. Our pledge form has the monthly donation option for your convenience.
We are proud of our growth – but we want to do so much more! We need your support to help us serve even more mothers. Please donate today so we can grow to serve the mothers and babies of tomorrow.
Thank you for taking the time to consider supporting La Leche League Canada and our continued efforts to support all breastfeeding families who need us.

5 http://www.lllc.ca/fundraising-campaign

 

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Flying With Your Breastfeeding Baby

As the summer holidays approach, many families will be flying with a breastfeeding child. This week we share some tips and tricks from experienced travelers that can help things go more smoothly for you and baby. We also have an update on the regulations that apply to breastmilk and baby food in your carry-on luggage.

Travelling with your Baby

Flying with your baby 

  • Use a sling or your favourite soft baby carrier in the airport. Without having to wait for the baggage attendants to dig out your stroller and bring it to the door of the plane, you’ll walk right off the flight. You can send the stroller through as luggage if you want to have it at your destination. Airline regulations require that you take baby out of the soft carrier or sling during take-off and landing.
  • Carry as little as possible into the cabin. Stuff your coat into your suitcase just before it goes on the conveyor belt. Another trick is to stuff coats into baby’s car seat and hold them tight with the seatbelt straps before wrapping the car seat in plastic to go on with the luggage.
  • Don’t get on when they are pre-boarding people travelling with small children. You’re going to be sitting on the plane for hours as it is. Keep walking around and moving for as long as possible.
  • Nursing during take- off and landing can help baby’s ears adjust to the pressure changes. Your seat neighbours will appreciate you nursing your baby and helping her stay comfortable and calm.
  • Surprisingly, there can be privacy in the tight seating arrangements. Often the person in the next seat thought my baby was sleeping when she was actually nursing. A shawl or jacket draped around your shoulders can create a visual barrier and help your baby to be less distracted by the activity in the cabin.
  • To stay hydrated, ask for more than one drink at a time when the flight attendants come around. If you have a wiggly baby you may feel safer bringing a water bottle with a secure lid that can be refilled after passing through the security check. If it falls nobody will get wet.
  • On flights shorter than four hours, you will only be offered a small snack. Bring some easy to eat foods that aren’t too crumbly or sticky. This suggestion applies to both mothers and young children who are eating solids. Everyone will be happier if they aren’t hungry.
  • If you have to change planes, go for a good walk in the airport during the layover instead of sitting around the departure lounge.
  • Especially when travelling with children who are a bit older, bring a couple of new small quiet toys. My daughter fondly remembers wondering what new things I would have for the plane ride.
  • Be prepared to miss the movie. Feel lucky if you get to read at all.
  • You might be able to stand at the back of the plane after the food service is completed to give baby a change of position. This suggestion requires a smooth flight. Be prepared to return to your seat if the seatbelt sign comes on.

Canadian Air Transport Security Authority (CATSA) regulations regarding breastmilk and baby food/drink:

“Exceptions for Liquids, Food and Personal Items:

Some items are exempted from the 100 ml or 100 g (3.4 oz.) limit and do not have to be placed in a plastic bag. However, you must declare these items to the screening officer for inspection.

The exceptions are:

• Baby food/drink: If you are travelling with an infant younger than two years of age (0-24 months), baby food, milk, formula, water and juice are allowed.

• Breast milk: Passengers flying with or without their child can bring breast milk in quantities greater than 100 ml

• Gel and ice packs are allowed, if they are needed to treat an injury, to refrigerate baby food, milk, breast milk, formula, water and juice for infants younger than two years of age (0-24 months), or to preserve medically necessary items or medication.”

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If you are travelling outside of Canada, be sure to check the security regulations in the country where you will be embarking on your return flight or the next leg of your trip.

Because onboard refrigeration may not be available on an aircraft, the cabin crew is unable to look after breastmilk and baby food during the trip. Airlines ask that you bring these items in a small cooler (following the CATSA regulations) to keep them at the desired temperature. Check with your airlines to be sure that you know their specific rules and regulations regarding carry-on items.

Breastfeeding questions don’t just come up when you are at home. Find the contact information for a La Leche League Leader in the community you are visiting before you leave home or while you are away.
http://www.lllc.ca/thursdays-tip-flying-breastfeeding-baby

 

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader. In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/.

If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/join-lllc-friends so we can continue to help others breastfeed. Thank you!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

LLLC Spring Appeal Campaign for the support of breastfed babies:  Help LLLC Grow – If you, or someone you know, has benefitted from the support of LLLC, a donation is one way you can “pay it forward”.
Donate Today!
Over 385,000 babies are born in Canada each year and we want to ensure every mother has access to La Leche League Canada support whenever she needs it. We are working hard to grow and we need your support. Every donation helps us provide more support to more families!
Thanks to past donations, we have been working hard to grow our services:
Our volunteer Leaders are the cornerstone of LLLC and the support we provide. We have increased our Leaders by 10% in the past year and Leader Applicants by 40% over the past 2 years!
More than 13,000 mothers attend LLLC meetings and another 20,000 receive one-to-one phone support from Leaders.
We have doubled our community and health professional outreach in just one year!
5 new Information Sheets in various languages were made available free of charge to mothers and health professionals
A new Communication Skills program was developed to strengthen health professional and breastfeeding peer support skills and our Best for Babies pre-natal program continues to grow.
Our Leaders are a vital part of LLLC’s breastfeeding foundation. They freely devote their time to help other parents give their children the optimal start in life. You, the donor, make up the other part of the foundation on which the LLLC breastfeeding services rest. Your gifts mean that our Leaders can carry out the valuable help families need. Frankly, we would be unable to deliver services to families without you or our Leaders so please take a moment to consider how valuable your support is and make a donation, either online or by using our pledge form. If a one-time donation is not suitable for you, perhaps spreading your gift over a year would make sense. Our pledge form has the monthly donation option for your convenience.
We are proud of our growth – but we want to do so much more! We need your support to help us serve even more mothers. Please donate today so we can grow to serve the mothers and babies of tomorrow.
Thank you for taking the time to consider supporting La Leche League Canada and our continued efforts to support all breastfeeding families who need us.

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Top-up Bottles Undermine Breastfeeding

When new mothers are finding breastfeeding challenging there are often people around them who will suggest “topping up” with a bottle as the solution to any and all breastfeeding issues.  When baby is crying and mum is crying and everyone is hungry and nobody has slept well for a few days, giving a top up bottle after breastfeeding might feel like a reasonable plan.  Understanding how giving a top up bottle can undermine breastfeeding and having some alternative strategies to try can get you through that dark moment.

A top-up bottle changes the developing breastfeeding relationship in a number of ways:

  • A bottle nipple (regardless of the brand) is not the same as a breast in the way it is molded by baby’s mouth and the way baby’s tongue is used to empty it.  When baby uses the tongue action that works on the bottle nipple on mum’s breast, it pushes the breast out of the mouth and leaves baby sucking on mum’s nipple.  This leads to sore nipples and poor milk transfer from breast to baby.  Newborns who are still trying to figure out breastfeeding may have difficulty maintaining two kinds of sucking patterns if they are asked to move back and forth between breast and bottle.

 

  • The milk in a bottle nipple flows faster and with less effort required by baby.  This fast flow disrupts the natural suck, suck, swallow, breath pattern of a baby who is feeding comfortably at the breast.  Baby has no control over the rate of flow with a bottle and can’t stop to take a breather when he wants to.  Because milk flows easily from a bottle, and baby has no choice but to swallow what is in her mouth, even a baby with a full tummy will take some milk given with a bottle.  The fact that baby will take milk from a bottle is not a good indicator that he is still hungry.
  • When a baby is “topped up” with a feeding from a bottle rather than suckling at the breast, mum’s body does not get the hormonal signals to make more milk. Breastmilk is created on a demand and supply system; the more the baby nurses the more milk will be made.

 

  • Top-up bottles undermine a mother’s faith in her own body’s ability to produce enough milk for her baby.  The more bottles given, the more her confidence is undermined.  In combination with the lack of hormonal cues for her body to keep making milk, the situation can quickly become a self-fulling prophecy.

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If breastfeeding is feeling challenging and someone is suggesting a top-up bottle here are some things to try first:

  • Nurse more often. If you are following a schedule or feeling like baby should only nurse every (fill in the blank) hours put your ideas aside and watch your baby for hunger cues.  You can find more information on newborn nursing frequency in the La Leche League Canada FAQs and HERE.

 

  • Switch sides more often.  Babies who have become accustom to the quick flow of a bottle may get fussy at the breast when your initial let down slows down.  When the milk lets down on the side you are feeding on, it also lets down on the other side at the same time.  If baby has fed on one side and then starts to fuss try burping her and then offering the other side.  The quicker milk flow may encourage her to feed contentedly.  Switching sides also helps the baby who has long suckling sessions at the breast but isn’t nursing actively much of the time to get more milk.  You may need to switch back and forth a number of times during one feeding session.  Aside from the immediate benefit of baby getting more milk at this feeding, the switching induces more let downs which send hormonal messages to the brain to make more milk.  The body takes 24-48 hours to increase the milk supply.  A couple of days of switch nursing at every feeding can boost your milk production significantly.  There is more information on establishing your milk supply and knowing if your baby is getting enough milk on the LLLC website.

 

  • Call a La Leche League Leader or go to an LLL meeting.  Talking with someone who understands the normal course of breastfeeding and life with a newborn can make a huge difference both to your perception of what is going on and to the reality of your breastfeeding relationship.  Ensuring that baby is latched on well and nursing effectively will likely change the situation that had you considering a top up bottle as a viable option.

 

  • Don’t beat yourself up if you decide that a top-up bottle is the only solution to deal with whatever is happening at this very moment.  When you and baby have calmed down, you get to re-evaluate.  You can make that call to LLL in the morning or try nursing more often and/or switching sides starting with the next feeding.

 

  • If you have been giving top-up bottles for a few days or weeks you still have the opportunity to work your way back to exclusive breastfeeding.  You will likely want to talk to an LLL Leader or lactation professional to ensure that your baby is getting enough calories during the process of working away from the top up bottles and rebuilding your milk production.

 

  • Remember, most breastfeeding challenges have worked themselves out by the time baby has reached six weeks.  This doesn’t mean you should just wait six weeks and everything will get better on its own.  It might but you also may be able to turn things around in a few days with the right information.  There is no shame in asking for support and information.  If the first person you talk to doesn’t seem helpful keep going until you find someone who is a good fit for you and your baby.

 

http://www.lllc.ca/thursdays-tip-how-topping-bottle-can-undermine-breastfeeding-what-do-instead-0

 

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader. In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/.

 

If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation so we can continue to help others breastfeed. Thank you!

 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

LLLC Spring Appeal Campaign for the support of breastfed babies: Help LLLC Grow – If you, or someone you know, has benefitted from the support of LLLC, a donation is one way you can “pay it forward”.

Donate Today

Over 385,000 babies are born in Canada each year and we want to ensure every mother has access to La Leche League Canada support whenever she needs it. We are working hard to grow and we need your support. Every donation helps us provide more support to more families!

Thanks to past donations, we have been working hard to grow our services:

Our volunteer Leaders are the cornerstone of LLLC and the support we provide. We have increased our Leaders by 10% in the past year and Leader Applicants by 40% over the past 2 years!

More than 13,000 mothers attend LLLC meetings and another 20,000 receive one-to-one phone support from Leaders.

We have doubled our community and health professional outreach in just one year!

5 new Information Sheets in various languages were made available free of charge to mothers and health professionals

A new Communication Skills program was developed to strengthen health professional and breastfeeding peer support skills and our Best for Babies pre-natal program continues to grow.

Our Leaders are a vital part of LLLC’s breastfeeding foundation. They freely devote their time to help other parents give their children the optimal start in life. You, the donor, make up the other part of the foundation on which the LLLC breastfeeding services rest. Your gifts mean that our Leaders can carry out the valuable help families need. Frankly, we would be unable to deliver services to families without you or our Leaders so please take a moment to consider how valuable your support is and make a donation, either online or by using our pledge form. If a one-time donation is not suitable for you, perhaps spreading your gift over a year would make sense. Our pledge form has the monthly donation option for your convenience.

We are proud of our growth – but we want to do so much more! We need your support to help us serve even more mothers. Please donate today so we can grow to serve the mothers and babies of tomorrow.

Thank you for taking the time to consider supporting La Leche League Canada and our continued efforts to support all breastfeeding families who need us.

SeriesMeeting

La Leche League group meeting

 

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Breastmilk as Medicine?

If you have hung out with a group of breastfeeding mothers for any length of time, you will have heard someone suggest using breastmilk as a cure for rashes or eye infections or any number of other childhood maladies. Is this just crazy talk or is there science to back up using breastmilk as medicine?

The most common suggested “medicinal” use of breastmilk is to treat children’s eye infections. This is not a new idea as an 18th century quote, referring to human breast milk said: “It is an emollient and cool, and cureth Red Eye immediately.” Studies show that most conditions that cause gunky eyes in babies (blocked ducts and the common cold) will resolve on their own without any treatment. For bacteria caused pink eye, evidence shows that mother’s milk is unlikely to be effective against the bacteria that cause this infection. And certainly, in a newborn, genuine pink eyes need to be evaluated by a physician because there is the potential for long term irreversible eye damage.

1BabyCarrier

 

So what did the studies say?

Verd, in 2007, published an account of his clinic’s switch from treating infants with blocked tear ducts with antibiotic eye drops to mother’s milk drops. The study is retrospective and descriptive rather than quantitative, but it suggests that routinely using mother’s milk is probably safe. Blocked tear ducts, we know, get better without any therapy at all. But if you want to do something, instilling mother’s milk seems safe.

In 2012, Baynham and colleagues published a letter  in the British Journal of Ophthalmology, looking at the in vitro inhibitory effects of donated fresh breast milk against common ocular pathogens. (Translation: they squirted milk into petri dishes of eye germs to see what would happen.) They found that 100% of their donated milk samples contained bacteria (including, in some cases, bacteria that could cause human disease). Though there was some inhibition of bacterial growth against some bacteria, the inhibition wasn’t strong, and the authors concluded that “… human milk is unlikely to be effective against the most common causes of paediatric conjunctivitis.” There was one interesting finding: of all the bacteria tested, human milk was most effective against the bacteria that causes gonorrhea, which is the same bacteria that causes most serious neonatal eye infections, world-wide. Now, it wasn’t as good as an antibiotic, but for resource-poor communities in the developing world, human milk may be much better than nothing.

Ibhanesebhor, in 1996, also did an in vitro (in the lab) study  looking at the effects of human milk against bacteria. He found that while colostrum had some inhibitory effects, mature milk did not—presumably because colostrum has a much higher concentration of antibodies. In any case, even colostrum was effective against only some bacteria, and it wasn’t nearly as effective as an antibiotic.

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Another commonly suggested use of breastmilk is to treat ear infections. Most ear infections are middle ear infections, that is to say they are behind the ear drum. Breastmilk in the ear canal will not cross the barrier of the ear drum to reach the bacteria. Breastmilk in the ear canal may be effective against bacteria if the infection is in the outer ear canal such as a “swimmer’s ear” infection. Most inner ear infections clear up on their own. The American Academy of Pediatrics recommends waiting 48-72 hours after diagnosis before trying antibiotics. Warmth is soothing to an inflamed ear so mothers who have tried putting breastmilk in baby’s ear may have found that it gave some relief. Warm compresses or warmed oil drops or ear drops will also have the same effect.

Infant atopic eczema is a skin condition that affects about 50% of infants in the first years of their lives. Mothers often try breastmilk as a treatment. One study looked at the short-term efficacy of breastmilk versus hydrocortisone 1% ointment in infants with mild to moderate atopic dermatitis (AD). There were no significant differences between these two groups at days 0, 7, 14, and 21, and the interventions of both groups were found to have the same effects. As breastmilk and the hydrocortisone 1% ointment provided the same results in the healing of AD, the study’s authors support using breastmilk to treat infant atopic eczema because of low cost and accessibility.

Need help sorting out the myths from facts about breastfeeding? La Leche League Leaders are available by phone, e-mail and at group meetings.

http://www.lllc.ca/thursdays-tip-breastmilk-medicine

If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader. In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/.
If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/join-lllc-friends so we can continue to help others breastfeed. Thank you!

 

LLLC Spring Appeal Campaign for the support of breastfed babies: Help LLLC Grow – If you, or someone you know, has benefitted from the support of LLLC, a donation is one way you can “pay it forward”.

Donate Today

Over 385,000 babies are born in Canada each year and we want to ensure every mother has access to La Leche League Canada support whenever she needs it. We are working hard to grow and we need your support. Every donation helps us provide more support to more families!

Thanks to past donations, we have been working hard to grow our services:

Our volunteer Leaders are the cornerstone of LLLC and the support we provide. We have increased our Leaders by 10% in the past year and Leader Applicants by 40% over the past 2 years!

More than 13,000 mothers attend LLLC meetings and another 20,000 receive one-to-one phone support from Leaders.

We have doubled our community and health professional outreach in just one year!

5 new Information Sheets in various languages were made available free of charge to mothers and health professionals

A new Communication Skills program was developed to strengthen health professional and breastfeeding peer support skills and our Best for Babies pre-natal program continues to grow.

Our Leaders are a vital part of LLLC’s breastfeeding foundation. They freely devote their time to help other parents give their children the optimal start in life. You, the donor, make up the other part of the foundation on which the LLLC breastfeeding services rest. Your gifts mean that our Leaders can carry out the valuable help families need. Frankly, we would be unable to deliver services to families without you or our Leaders so please take a moment to consider how valuable your support is and make a donation, either online or by using our pledge form. If a one-time donation is not suitable for you, perhaps spreading your gift over a year would make sense. Our pledge form has the monthly donation option for your convenience.

We are proud of our growth – but we want to do so much more! We need your support to help us serve even more mothers. Please donate today so we can grow to serve the mothers and babies of tomorrow.

Thank you for taking the time to consider supporting La Leche League Canada and our continued efforts to support all breastfeeding families who need us.

 

 

 

 

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