The Secret to Pain Free Breastfeeding

Breastfeeding Help And Baby Care For New Parents

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

Breastfeeding Help And Baby Care For New Parents Summary

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Author: Kate Hale
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This is one of the best ebooks I have read on this field. The writing style was simple and engaging. Content included was worth reading spending my precious time.

Purchasing this e-book was one of the best decisions I have made, since it is worth every penny I invested on it. I highly recommend this to everyone out there.

Evidence About Breastfeeding Practices

How do we know what we know about the prevalence of breastfeeding (The word prevalence is used here to mean the combined effect of breastfeeding initiation rates and breastfeeding continuance rates.) Before attempting to trace trends in infant feeding practices, let us consider the nature of the evidence. National surveys that produce the kind of representative data that allow statistical evaluation have been available only since 1955. These surveys consist primarily of national fertility or natality surveys and of marketing surveys conducted by manufacturers of artificial baby milk. For most, exclusive breastfeeding is not a separate statistic. However, the percentage of exclusive breastmilk feedings at hospital discharge can be found in state birth certificate databases (Feldman-Winter et al., 2002). A brief description of national surveys conducted in the United States follows (Grummer-Strawn & Li, 2000) National Health Interview Survey A personal interview is conducted in 43,000...

The Prevalence of Breastfeeding

The net result of these shifts in technology and attitudes has been a rapid decline in the prevalence of breastfeeding in Western nations since the 1940s. In the United States, the proportion of newborns receiving any breastmilk at 1 week postpartum declined steadily to a low of 25 percent in 1970 (Martinez & Krieger, 1985). The proportion of newborns exclusively breastfed at hospital discharge was even lower it declined from 38 percent in 1946 (Bain, 1948) to 21 percent in 1956 and only 18 percent by 1966 (Meyer, 1968). The period of most dramatic decline of breastfeeding coincided with economic factors in the United States that encouraged major migrations from rural to urban areas. For example, between 1945 and 1970 approximately five million African-Americans moved from the rural South to the urban North. The association between internal migration from rural to urban areas and a decline in breastfeeding also has been noted in developing countries. Breastfeeding...

Breastfeeding and Infancy

The breast is much more than a passive reservoir of milk. The mammary glands in the breast extract water, amino acids, fats, vitamins, minerals, and other substances from the maternal blood. They package these substrates, synthesize many new nutrients, and secrete a unique fluid specifically tailored to the needs of the infant. The glands balance milk production with infant demand, so that the volume of milk produced during lactation is determined by infant need. Milk production in the first 6 months averages about 750 ml day,1 but breastfeeding mothers have the potential to produce far more milk. Mothers who breastfeed twins can produce over 2000 ml day.

Nutritional Needs during Breastfeeding

Eating a healthy diet while breastfeeding is important. A healthy infant doubles its weight in the first 4 to 6 months after birth, and, for a mother who is exclusively breastfeeding, breastmilk must provide all the energy, pro tein, and micronutrients to support this rapid growth. Moreover, the diet also needs to support maternal health - allowing the breastfeeding mother to lose weight gained during pregnancy, replenishing nutrient stores depleted by the demands of pregnancy, and maintaining nutrient stores to support milk production. Breastfeeding women need significantly more energy, protein, and micronutrients during lactation to support milk formation. For women exclusively breastfeeding, synthesis and secretion of breast milk requires an additional 750 kcal day and an extra 15-20 g of high-quality protein.1 Requirements for most vitamins and minerals are 50-100 higher, compared with before pregnancy. Figure 4.6 compares the nutritional needs of lactating versus nonlactating...

The Promotion of Breastfeeding

The many ways of encouraging mothers to breastfeed their own infants breastfeeding promotion may be considered to lie on a continuum. At one end, in societies where breastfeeding is the cultural norm, promotion consists of assuming that mother and infant will breastfeed. This assumption is combined with social arrangements, such as special foods for the mother or lightened duties, espe cially within the first few weeks after birth, to ensure that breastfeeding becomes well established. At the other end, in societies in which artificial feeding is the norm, promotion often consists of encouragement to breastfeed, sometimes offered by government officials and often by healthcare professionals or members of elite population groups, without at the same time removing cultural barriers to breastfeeding. Breastfeeding Promotion in the United States Healthy People Statements. In 1978, the US Public Health Service defined national health objectives with a report, Healthy People (USDHHS, 1979)....

Ten Steps to Successful Breastfeeding

Have a written breastfeeding policy that is routinely communicated to all health-care staff. 3. Inform all pregnant women about the benefits and management of breastfeeding. 4. Help mothers initiate breastfeeding within 30 minutes after birth. 5. Show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants. 8. Encourage breastfeeding on demand. 9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants. 10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic. have achieved the Innocenti goals for example, in Italy, the country that hosted the Innocenti conference, the government has made little progress toward fulfilling its goals as a signatory of the declaration (Chapin, 2001). The World Alliance for Breastfeeding Action (WABA) is a multinational coalition of individuals and private organizations involved in research...

Randomized Controlled Trials on the Effect of Lactation Consultant and Health Provider Intervention on Breastfeeding

Booklet instruction for breastfeeding given during first pediatric visit 33-page breastfeeding booklet sent home shortly after discharge N 150 state (Louisiana) has a listing of registered LCs who are certified by the International Board of Certified Lactation Consultants. Employers and regulators can thus confirm that an individual is currently certified. The National Certification Corporation for Neonatal and Obstetric Nurses also offers a subspecialty exam in breastfeeding for RNs. It is considered a first step to becoming certified by IBLCE. For more information on lactation consultant certification, go to the International Board of Lactation Consultant Examiners Web site at www.iblce.org.

The Unique Characteristics of Counseling Breastfeeding Women

There are unique aspects of working with breastfeeding women that differ from other aspects of health care. Breastfeeding is an emotion-laden subject that may be viewed as an integral part of human sexuality, not just an infant feeding method. It touches deep-seated feelings that people have about themselves and their bodies that reach back to childhood. This emotional content makes breastfeeding counseling, like sex counseling or childbirth education, unusually sensitive. Health-care workers assisting breastfeeding families must be especially intuitive, caring listeners and advisors. Working with new mothers and babies is a popular and thus, competitive, activity. Not only are newborns adorable, but the mothers and fathers are (generally) healthy and happy. By working on the hospital maternity unit or in a birth center, the nurse gets to play a paid, starring, ongoing role in the usually joyous family dramas of birthing and early breastfeeding. As a result, nurses compete to work...

Organizations And Events That Promote Breastfeeding

1995 World Alliance for Breastfeeding Action 1998 United States Breastfeeding Committee of breastfeeding. Guidelines and Recommendations for Breastfeeding US National Breastfeeding Policy Conference United States Breastfeeding Committee, 2001 The Right to Breastfeed Act passed to ensure a woman's right to breastfeed on federal property Expert Panel on Breastfeeding Breastfeeding Blueprint century or so, as breastfeeding became associated with more restrictive aspects of women's lives, as breastmilk was thought by some to be inferior to increasingly available manufactured infant milks, and as use of manufactured milks became a hallmark of privileged segments of society, large portions of both lay and health-care populations came to be lieve that there was little reason to persist in traditional breastfeeding practices. Since the early 1990s, however, it has become increasingly clear that breastfeeding confers health and psychological advantages on the breastfeeding infant and also...

The Replacement of Maternal Breastfeeding

Wet-nursing may not have been the earliest alternative to maternal breastfeeding, but it was the only one likely to enable the infant to survive. Wet-nursing is common, although not universal, in traditional societies of today and (by inference) among ancient human societies. An already-lactating woman may have been the most obvious choice for a wet nurse, but women who stimulate lactation without a recent pregnancy have been described in many traditional societies (Slome, 1976 Wiesch-hoff, 1940). Prelacteal Feeds. Many of the world's infants, even those who later will be fully breastfed, receive other foods as newborns. Of 120 traditional societies (and, by inference, in many ancient preliterate societies) whose neonatal feeding practices have been described, 50 delay the initial breastfeeding more than two days, and some 50 more delay it one to two days. The stated reason is to avoid the feeding of colostrum, which is described as being dirty, contaminated, bad, bitter,...

Breastfeeding Rates Percentages and US Healthy People 2010 Breastfeeding Objectives for the Nation

Initiate breastfeeding within the early postpartum period 64 68 75 Breastfeeding at 6 months after birth 29 31 50 Breastfeeding at 12 months of age 16 18 25 In the late 1980s, the promotion of breastfeeding became an important goal within WIC. The Child Nutrition and WIC Reauthorization Act of 1989 required that a certain proportion of its budget was to be spent on the promotion and support of breastfeeding and that each state health department would establish a breastfeeding promotion coordinator. Today breastfeeding women have a higher priority for enrollment in WIC programs than do nonbreastfeeding mothers they are provided more, and increasingly varied, foods, and their benefits persist longer one year, as opposed to 6 months for nonbreastfeeders. Despite these efforts, the increases in breastfeeding rates of WIC enrollees have been minimal. WIC infants initiate breastfeeding at a much lower rate than non-WIC infants (56 percent vs. 77 percent) and continue breastfeeding at 6...

The Costs of Not Breastfeeding Reported by Various Researchers

Costs of Not Breastfeeding Health care costs for infants (if exclusive breastfeeding increased from 60 to 80 percent) Food vouchers for breastfeeding mothers vs. medical costs for gastroenteritis and otitis media in formula-fed infants Office visits, drug prescriptions, hos-pitalizations of breastfed vs. nonbreastfed infants Office visits, drug prescriptions, hos-pitalizations of breastfed vs. nonbreastfed infants health care system is in the billions of dollars (see Table 1-1). Weimer (2001) calculated that a minimum of 3.6 billion would be saved if breastfeeding were increased from current levels to those recommended by the US Surgeon General (75 percent initiation and 50 percent continuation at 6 months). This figure is likely an underestimation of the total The United States Breastfeeding Committee (2002) estimated the nonmedical costs of artificial feeding as follows Every 10 percent increase in breastfeeding rates among WIC recipients would save WIC 750,000 per year. Because...

Tides in Breastfeeding Practice

Throughout the world today, an infant is apt to receive less breastmilk than at any time in the past. Until the 1940s, the prevalence of breastfeeding was high in nearly all societies. Although the feeding of manufactured milks and baby milks had begun before the turn of the century in parts of Europe and North America, the practice spread slowly during the next decades. It was still generally limited to segments of population elites, and it involved only a small percentage of the world's people. During the post-World War II era, however, the way in which most mothers in industrialized regions fed their infants began to change, and the export of these new practices to developing nations was underway.

Historical and Work Perspectives

Just as the breastfeeding course flows and ebbs in a woman's life, so breastfeeding has experienced flows and ebbs through the centuries. It takes a village to return to breastfeeding, and community-based programs that promote breastfeeding are successfully and steadily increasing the rate of breastfeeding around the world. As more mothers choose to breastfeed, the need for specialized help increases also. The visibility and acceptance of lactation consulting as an allied health profession offers opportunities for practice in hospitals, the community, and in private practice. Randomized clinical trials consistently demonstrate that lactation consultant services lengthen a mother's breastfeeding course and save money through healthier mothers and babies.

The Biological Norm in Infant Feeding

The class Mammalia is characterized principally by the presence of breasts (mammae), which secrete and release a fluid that for a time is the sole nourishment of the young. This manner of sustaining newborns is extremely ancient it dates back to the late Mesozoic era, some 100 million years ago. (See Figure 1-1.) Hominid precursors first appeared about 4 million years ago the genus Homo has existed for about 2 million years. The currently dominant human species, Homo sapiens sapiens, has existed for perhaps 40,000 years. Information about breastfeeding practices among our earliest ancestors is uncertain, although other information about Paleolithic societies that existed 10,000 or more years ago sheds light on this subject. Early Breastfeeding Practices

Do Lactation Consultants Make a Difference

In this day of cost containment in health care, administrators want to know if lactation consultants are effective. Do interventions by LCs and other health-care providers make a difference in outcomes of breastfeeding Table 2-1 presents randomized controlled trials, the highest level and most rigorous type of research study, of breastfeeding interventions worldwide. Most of the studies show that the interventions have a positive effect on breastfeeding. Note from the table that even if the results do not reach significance, any intervention (even a booklet given to the mother) results in higher rates of breastfeeding than no intervention. These results hold constant regardless of where the studies were done. If the data from the randomized controlled trials in the table were translated to health-care costs saved by breastfeeding, it would show that LC services save the health care system enormous

Getting a Job as a Lactation Consultant

Most lactation consultants are health professionals, usually nurses, who start their career in a job where they work with breastfeeding dyads. They learn about breastfeeding on the job and by personal experience rather than as part of their formal education. Others begin by affiliation with La Leche League and take the necessary courses and gain

Hospital Based Lactation Programs and Services

Every breastfeeding mother seen by LC without referral or breastfeeding mothers seen only with referral Telephone hotline or warmline postdischarge telephone calls Prenatal classes on breastfeeding Home postpartum visits and assistance with breastfeeding Pump rental and sales Postpartum breastfeeding consults for Continuing education for staff, area seminars, preceptorships, and breastfeeding classes Research on lactation and breastfeeding issues (most often at a tertiary-care medical center) Whatever system is used, it is wise to estimate the anticipated workload prior to the start of the lactation service. Most hospital-based programs have been in existence six or seven years and employ two to four LCs who mostly work part-time. Thus one must measure full-time equivalent hours (FTEs) in order to determine the completeness of coverage. For example, in some hospitals, three part-time LCs share seven days per week coverage. The actual number of work...

Sample Time Expended to Provide LC Services in a Hospital

X 10 breastfeeding mothers in the mother-baby unit Although lactation services will generate minimal revenue compared to high-tech medical equipment, they are an effective marketing tool for the hospital. Women make most of the decisions about health-care services for family members. Health strategists claim that if the mother uses a certain hospital for her baby's birth and she liked the service she received there, she will probably use that same hospital again for the family's future healthcare needs. In the United States and many other developed countries, the women most likely to breastfeed are educated and in middle-to-higher income brackets thus, a lactation service increases the hospital's visibility and credibility with young, Just as the lack of physicians' support can prevent a program from being added to the array of services already offered, physician support can pave the way for the addition of a lactation program. Such support is most likely to be obtained if the key...

Correcting Negative Female Workplace Behaviors

Although there are no studies on the time allocation of various role components, LCs report that the majority of their time is spent in direct care of clients. The role of the LC closely parallels that of the clinical nurse specialist insofar as it requires in-depth clinical knowledge and expertise in a particular area. Gibbins et al. (2000) describe a model of the Nurse Practitioner (NP) or Clinical Nurse Specialist (CNS) in the role as a lactation consultant in a breastfeeding clinic. This advanced practice role encompasses the dimensions of the advanced practice model research, leadership, education, and clinical practice. Like the clinical specialist, the LC does the following Giving breastfeeding mothers consistent breastfeeding information is vital. The patient takes for granted that the person to whom she spoke knows exactly what should be done. If confusion or controversy is found among the staff, we cannot expect the patient to become knowledgeable and comfortable with...

HCPCS Codes For Breast Pumps

From payer to payer, and new codes may not be recognized by all payers (International Lactation Consultant Association, 2002). The Reimbursement Tool Kit available from ILCA at www.ilca.org is a valuable source of information. The Healthcare Insurance Guide for Breastfeeding Families can be downloaded free at the Medela Web site (www.medela.com).

Autocrine Versus Endocrine

It is at this point that lactation shifts from endocrine control (hormone-driven) to autocrine control (milk removal-driven) (Prentice et al., 1989). It follows, then, that the amount of colostrum secreted by nonbreastfeeding women during the first few days postpartum is similar to that of breastfeeding women however, this reverses abruptly after the first few days. Thus breastfeeding is not a major factor for the initiation of lactation but it is essential for the continuation of lactation (Kulski & Hartmann, 1981). From a clinical standpoint the onset of

Frequency of Feedings

How often does the exclusively breastfed infant feed Hornell et al. (1999) recorded the daily number of feedings of 506 Swedish infants for the first 6 months. These mothers live in a country where breastfeeding is the norm. Each had previously breastfed at least one infant for at least 4 months and considered that they breastfed on demand. The neonate's ability to suckle effectively at the breast takes time and practice. For the first few feedings, even in full-term infants, suckling is usually disorganized. Drugs given to the mother during childbirth can also inhibit early suckling. Usually, after several attempts, the infant latches onto the breast and begins to suckle vigorously and effectively. These first feedings are critical because they imprint a suckling pattern that tends to be repeated in subsequent feedings. A healthy infant unaffected by labor or birth analgesia or anesthesia should be allowed to demonstrate hunger before being offered the breast. Practicing lactation...

Antiinfective Properties

Wherever infant morbidity and mortality are high, breastfeeding conclusively helps to prevent infantile diarrhea and gastrointestinal infections (Almroth & Latham, 1982 Brown et al., 1989 Clavano, 1982 Duffy, 1986 Espinoza, 1997 Granthan- McGregor & Back, 1972 Habicht, DaVanso, & Butz, 1988 Jason, Niebury, & Marks, 1984 Koop-man et al., 1985 Kovar et al., 1984 Mitra & Rabbani, 1995 Perera et al., 1999 Ravelomanana et al., 1995 Ruuska, 1992). Breastfeeding minimizes diarrhea both by providing protective factors and by reducing exposure to other foods or water that may contain enteropathogens (Van Derslice, Pop-kin, & Briscoe, 1994). As antibiotic resistance becomes a global problem, discoveries about the protective effect of breastfeeding become even more important (Hakansson et al., 2000). Protection is dose-dependent. In a review of field studies conducted to identify the effect of breastfeeding on childhood diarrhea in Bangladesh, children partially breastfed had a greater risk of...

Superbill Lactation Visit Receipt

Medicare applies to individuals over age 65 and is not applicable for breastfeeding except that insurance companies usually follow Medicare rules for payment. Medicaid is a federal program administered by the states, and state regulations apply to mothers and children who qualify on the basis of poverty. The regulations in various states may differ in billing rules and regulations. About one third of US births are paid for under Medicaid. Medicaid reimbursement for health care is further complicated by the fact that some Medicaid recipients are also enrolled in managed care plans. The plans' policies on reimbursement differ from the state and federal rules governing reimbursement when the patient is not enrolled in managed care. As an example of a successful private medical practice, Pediatrician Tina Smillie set up her breastfeeding practice right after passing the IBLCE exam. She began by writing a series of two- or three-page letters to the HMOs in her area stating benefits of...

Clinical Implications Mother

Breast Pinch

Size, symmetry, and shape of the breasts proper have minimal effect on lactation. The assessment provides the opportunity to reassure the woman with small breasts that she will be able to breastfeed and have a sufficient supply of milk. Asymmetry of breast size is usually normal, but marked asymmetry may be an indication of inadequate glandular tissue in a small minority of women (see Color Plate 27). Hypoplasia (lack of breast tissue) accompanied by a wide space between breasts (intramammary space) is another anatomical red flag associated with insufficient lactation (Huggins, Petok, & Mireles, 2000). When mothers with possible hypoplasia (underdeveloped breasts) are identified, their newborn baby should be monitored closely for adequate milk intake. Inadequate glandular tissue might prevent the mother from exclusively breastfeeding her baby however, she can continue to enjoy the breastfeeding relationship if she provides the baby with additional nutrition while feeding...

Application of Physiological Principles

The greater the degree of emptying at a breastfeed, the greater the rate of milk synthesis after that feed. Women with smaller breasts can produce as much milk as women with larger breasts but they must breastfeed more often. Daly et al., (1993) were able to determine the rate of synthesis of human milk. Figure 4-3 (A) shows the volume of milk produced by a small-breasted woman who had a storage capacity of 111 ml for her right breast and a capacity of 81 ml for her left breast. Thus the maximum amount of milk that this woman appeared to be able to store was about 20 percent of her infant's 24-hour milk intake. From her breast volume changes over time, it appears that her infant met its demand for milk by breastfeeding frequently. Conversely, Figure 4-3(B) displays a larger-breasted woman who produced similar volumes of milk but with larger storage capacities for her breasts (right breast, 600 ml left breast, 180 ml), allowing her to store nearly 90 percent of her infant's 24-hour...

Average Wage and Consult Time of Lactation Consultants

A health-care professional who needs clinical hours to qualify as an applicant to take the LC certification examination should seek out a job where she will work with breastfeeding mothers to accumulate clinical hours. Working on a mother-baby unit is an example. The individual who is still in a school to become a health-care professional can investigate the possibility of taking a supervised clinical practicum as a part of a degree. For each hour spent in a clinical practicum, a student can reduce the number of hours needed to take the exam by 5 to 1, up to 500 hours. For example, a 40-hour practicum counts as 200 hours toward the number of hours of breastfeeding experience needed. Opportunities for clinical experience working with breastfeeding dyads is an issue when the individual who wishes to become an LC does not have access to clinical learning. Not everyone who desires to work as a lactation consultant wishes to become a nurse or other type of health professional. There are...

Problem Oriented Medical Records

An assessment of physical and psychosocial factors based upon subjective and objective data what you think is going on. Examples Infant poorly positioned on the breast breastfeeding at margin of nipple ineffective breastfeeding Latch score 3 (1 low 10 high). P Plan. Organized plan for care. Based upon the assessment, what you plan to do about the problem to help the breastfeeding mother and baby. Exam

Required Competencies for Lactation Practice

Breastfeeding education and advocacy 2. Clinical management of breastfeeding vices on breastfeeding increase the likelihood that the staff will provide consistent information. Although providing in-service education is an important, perhaps even essential, role of the lactation consultant, one can (like the proverbial horse brought to a watering hole) offer but not impel other health-care workers to drink from the pool of knowledge. Other nursing staff may have fallen into the habit of expecting the LC to take care of all breastfeeding issues. If an LC is not available on all shifts or all days, this person cannot possibly always take care of things. Rather than expecting the LC to do it all, it is more effective for her to teach the staff, so that all health-care workers are operating from the same frame of reference in how they assist breastfeeding mothers and when they will intervene to resolve a difficulty (Shrago, 1995). Because of the heightened awareness of the importance of...

An Example of a Narrative Note

On breast and suckled effectively until asleep. Breastfeeding assessment score 9 10. 05-22-03 1500 Discussed basic breastfeeding information including normal infant elimination patterns to watch for after discharge. Mother given written materials on sore nipples, engorgement, use of breast pump, and breastmilk storage.

Technological Innovations in Infant Feeding

1915 the newly created United States Children's Bureau sponsored several studies of infant mortality in major cities. Each study showed that babies fed artificial milks (i.e., anything other than mother's milk) were three to five times as likely to die as those who were breastfed. The studies also documented that both the rate of breastfeeding and the rate of infant mortality were linked each increased steadily as family income decreased. In summarizing these results Williamson (1915) commented that the disadvantages of a low income were sufficient to offset the greater prevalence of breast feeding among the babies of the poorer families. During this same period, a similar observation was made in England, where high infant mortality prevailed among poor, working-class mothers, 80 percent of whom breastfed their infants (Levenstein, 1983). As women's aspirations for community service and commercial involvement were rising, Victorian beliefs about modesty discouraged breastfeeding in...

Composition of Term and Preterm Milk During the First Month of Lactation

Human milk is a good source of vitamin A (200 IU dl), which is present mainly as retinol (40-53 ng dl). Required for vision and maintenance of epithelial structures, vitamin A is at highest levels in the first week after birth and then gradually declines. Deficiency of vitamin A is a serious health problem for young children in many developing countries, leading to blindness through damage to the corneal epithelium (xe-rophthalmia) and to increased morbidity from infectious diseases. The prolongation of even partial breastfeeding provides an important source of vitamin A to children in developing countries (Bates & Prentice, 1994). Unlike other micronutrients, folate (which is bound to a folate-binding protein) remains at the same level throughout all stages of lactation. Folate supplementation of a breastfeeding mother with megaloblastic anemia results in an increase in milk folate levels even though her plasma values remain the same. Maternal stores of folate diminish...

Acknowledgements

Christina M Smillie MD, FAAP, IBCLC, Breastfeeding Resources, Stratford, Connecticut I am especially grateful to La Leche League International for providing the foundation for my breastfeeding education and to those institutions which encouraged and supported me in writing the book the School of Nursing, Wichita State University, and Via Christi Regional Medical Center, both of Wichita, Kansas.

History

In a cultural setting in which nearly all mothers breastfed, help with breastfeeding was available through the shared knowledge of other family members, neighbors, and friends. As childbirth came to be managed by health professionals in hospital settings, however, knowledge of lactation, which a mother formerly shared with her daughters or a sister with her younger siblings, was set aside. Thus, during the 1960s (at the nadir of breastfeeding) in the United States and shortly thereafter in other countries (such as Australia and Scandinavia), volunteer breastfeeding support groups became a major source of assistance and information about how to breastfeed (Phillips, 1990). As the numbers of breastfeeding mothers increased, health-care providers at first denounced these groups later they came to appreciate them for the important role they played in helping mothers and in forcing the medical profession to consider As these volunteers relearned the art of breastfeeding, they also sought...

Certification

Scott and Smith assembled a small group of breastfeeding experts who had come to the field of lactation through voluntary service, mostly through La Leche League. In 1984, these individuals gathered and concluded that legitimacy of the field would be heightened if minimal standards of knowledge and skills were recognized through a certification examination. Subsequently, they developed the IBLCE Examination based on a three-dimensional content outline or test blueprint and derived from practice analysis.

Lactation Programs

A New York state law mandated in 1984 that any institution providing care for new mothers and babies had to have at least one person on staff who was designated to serve as a resource for other staff members and to provide breastfeeding assistance to patients. This landmark event helped launch the subsequent growth of the lactation consultant as a clinical specialty. The 1990s could be characterized as the decade for the emergence of breastfeeding programs and clinics. Only a small number of hospitals in the United States had a lactation program in the early 1990s. But within the past decade lactation programs have proliferated rapidly and most hospitals and birth centers now have lactation services staffed by certified LCs, who have thus grown in numbers and visibility. Although lactation expertise has long been integrated into midwifery practice in countries where midwives predominate, LCs are becoming more common, especially in Australia, Canada, and Europe (Figure 2-1).

Reimbursement

If postpartum home visits are part of a maternity insurance package, breastfeeding assistance is given as a part of a routine postpartum visit to the mother's home. Nurses providing these home visits are usually salaried by the home health company that employs them. Services above and beyond the packaged LC services are paid for either by a separate insurance claim or by the family themselves.

Private Practice

Rising rates of breastfeeding and short hospital stays have resulted in lactation services as a private practice. Some physicians are successful in building a practice that is limited to breastfeeding families. Both professional health workers and those without a health-care background are finding they can enjoy the work they love, assisting women with breastfeeding, and still survive. Some LCs started by opening a breast pump rental depot. Others set up a private practice after receiving numerous calls from mothers who requested their help with breastfeeding. Several had been (or still were) hospital nurses who wanted to do more to help breastfeeding mothers than could be accomplished in the hospital. Still others found that a private practice in lactation consulting was an extension of their previous work as volunteer LLL leaders. One of the hardest lessons for an LC to learn is that a private practice is a business if she has no business experience, she must learn about it...

Variations

Lack of full protraction of the nipple on the common pinch test (see Figure 3-11, later in this chapter) is fairly common in primigravid women. Poor nipple protractibility in women during their first pregnancy has been reported to range from 10 to 35 percent (Alexander et al., 1992 Blaikeley et al., 1953 Hytten & Baird, 1958 Waller, 1946). Protractility of the nipple gradually improves during pregnancy and, by puerperium, most women have good nipple protraction. Generally, nipple protraction continues to improve with each subsequent pregnancy and lactation experience. The relationship between protractility and subsequent breastfeeding difficulty is minimal. Because the infant makes a teat not from the nipple alone but from the surrounding breast tissue, the actual shape of the nipple may be a secondary consideration. Nipple inversion is found in about 3 percent of women and is usually bilateral (87 percent) (Park, Yoon, & Kim, 1999). Of the total number of inverted nipples, 96 percent...

Milk Production

With closure of tight junctions in the cells of the alveoli (Figure 3-7) and through the mediation of the hypothalamus, the alveolar cells respond with milk secretion at the base of the alveolar cell, where small droplets form and migrate through the cell membrane and into the alveolar ducts for storage (see again Figure 3-6). The rate of milk synthesis after each breastfeeding episode varies, ranging from 17 ml hr to 33 ml hr in one study (Arthur et al., 1989). Milk synthesis is related to the degree of breast fullness. For example, a woman who did not breastfeed her baby for 6 hours will have a lower rate of milk synthesis than if she had breastfed every 90 minutes (Cregan & Hartmann, 1999).

Galactopoiesis

This phenomenon, the supply-demand response, is a feedback control that regulates the production of milk to match the intake of the infant. A common adage that expresses this response is The more the mother breastfeeds, the more milk there will be (La Leche League International, 1997). Because lactation is an energy-intensive process, it makes teleo-logical sense that there should be safeguards against wasteful overproduction as well as mechanisms for a prompt response to the infant's need. A case of a new mother who became pregnant three months after having a pituitary resection supports the concept of autocrine control (de Coop-man, 1993). After delivering a healthy infant, this mother had sufficient milk to completely sustain her baby by breastfeeding without supplementation. This unusual situation was attributable to the pituitary abscess that caused milk production to continue through her pregnancy after she weaned her first child thus her milk yield postpartum was based on milk...

Nutritional Values

Around the world, breastmilk is remarkably stable, varying only within a relatively narrow range. Constituents of colostrum and breastmilk and their amounts are shown in Appendix 4-A of this chapter. A profile of lactose protein and lipid concentrations in human milk for the first 30 days of lactation is seen in Figure 4-4. Yet, because breastfeeding is an interactive process, the infant helps to determine composition of the feed. During weaning (involution phase), for example, the concentrations of sodium and protein in breastmilk progressively increase and the milk is saltier in contrast, concentrations of potassium, glucose, and lactose gradually decrease (Prosser, Saint, & Hartmann, 1984).

Suckling

The precise way in which infants use their oral and facial muscles to efficiently take in nourishment from their mothers' breasts is vital information for health professionals, because some breastfeeding infants have initial difficulty getting on the breast, and a few continue to have suckling dysfunction. In a study of spontaneous feeding behavior, infants placed in a prone position between their mothers' breasts after an un-medicated delivery began licking, suckling, and rooting movements after about 15 minutes, began hand-to-mouth movements after about 34 minutes, and spontaneously began to suckle after 55 minutes. Licking movements both preceded and followed the rooting reflex in alert infants (Widstrom et al., 1987). Does the infant suckle or suck at the breast Now that we have discovered that the mechanism by which babies extract milk from the breast differs considerably from the method that they use on a bottle teat, we urge that separate words are needed to differentiate the...

Figure

Healthy infants, even preterm infants, who consume enough breastmilk to satisfy their energy needs receive enough fluid to satisfy their requirements even in hot and dry environments (Almroth & Bidinger, 1990 Brown et al., 1986b Cohen et al., 2000). Exclusive and prolonged breastfeeding in healthy infants enhances infant growth during the first three months of life and growth and does not affect the normal growth pattern during the first year (Kramer et al., 2002). The volume of milk must provide sufficient caloric energy to permit normal growth and development. Small amounts of colostrum averaging about 37 ml (range, 7-123) are yielded in the first 24 hours postpartum (Hartmann, 1987 Hartmann & Prosser, 1984) the infant ingests approximately 7 to 14 ml at each feeding (Houston, Howie, & McNeilly, 1983). This milk yield gradually increases for the first 36 hours, followed by a dramatic increase during the next 49 to 96 hours. By day 5, volume is about 500 ml day it increases more...

Signs and Symptoms of Deficiency

Unrecognized thiamin deficiency can produce ill-defined symptoms, such as irritability, depression, fatigue, and insomnia, particularly in people with increased thiamin requirements (e.g., pregnant and breastfeeding women, women taking oral contraception, adolescents, diabetics, heavy alcohol users, the chronically ill).

Clinical Approach

Amenorrhea can ensue for 2 to 3 months after a term delivery breast-feeding may inhibit hypothalamic function and lead to a greater duration of amenorrhea. However, in a nonlactating woman in whom menses does not resume by 12 weeks after delivery, then pathology must be suspected. Overall, the most common cause of amenorrhea in the reproductive years is pregnancy. Hence, a pregnancy test is the appropriate initial test. If the patient does not have a history of postpartum hemorrhage, pursuit of hypothalamic causes, such as hypothyroidism or hyperprolactinemia, often is fruitful. If the patient is somewhat obese or has a history of irregular cycles, then a diagnosis of polycystic ovarian syndrome (PCOS) would be entertained. Findings consistent with PCOS include a positive progestin withdrawal bleed (vaginal bleeding after ingestion of a progestin, such as medroxyprogesterone acetate or Provera). PCOS is characterized by estrogen excess without progesterone, obesity, hirsutism, and...

Pregnancy And Epilepsy

Breast feeding Antiepilepsy drugs pass into breast milk (see p. 116), phenobarbital, primidone and ethosuximide in significant quantities, phenytoin and sodium valproate less so. There is a risk that the baby will become sedated or suckle poorly but, provided a watch is maintained for these effects, the balance of advantage favours breast feeding whilst taking antiepilepsy drugs.

Epidemiology and Prevalence

The incidence of mother-to-baby transmission has been estimated at 15 in Europe and approx 45 in Africa. The transmission rates among African women are believed to be much higher owing to a combination of more women with end-stage disease with a higher viral load and concomitant placental infection, which renders it more permeable to the virus (24,25). The use of antiretroviral therapy during pregnancy, together with the advice to avoid breastfeeding, has proven efficacious in reducing both vertical and horizontal transmission among HIV-positive women in the western world. For those in third-world countries, the reality is stark. Access to treatment is limited, and there is no realistic substitute for breast milk, which provides a valuable source of antibodies to other life-threatening infections. Patients receiving blood transfusions, organs, or blood products where screening is not routinely carried out must also be included.

Extra Nipple On Areola

Areola Nipple

Both the nipple and the areola are well supplied with smooth muscle that contracts to express milk from the ductal system during breast-feeding. Rich sensory innervation, especially in the nipple, triggers milk letdown following neurohormonal stimulation from infant sucking. Tactile stimulation of the area, including the breast examination, makes the nipple smaller, firmer, and more erect, while the areola puckers and wrinkles. These normal smooth muscle reflexes should not be mistaken for signs of breast disease.

Pregnancy and Lactation

The effect of pregnancy and lactation on bone density was studied by Karlsson et al. (83). DXA measurements of the PA lumbar spine, total body, and proximal femur were performed using a Lunar DPX-L. Seventy-three women who were 5 or fewer days postpartum were compared to 55 age-matched controls. Lumbar spine BMD was 7.6 lower and total body BMD was 3.9 lower in the postpartum women than in the controls. Of the postpartum women, 65 were followed to determine the effects of lactation on BMD. Those women who did not breastfeed showed no changed in bone density. Femoral neck bone density decreased by an average of 2 in the first 5 months after delivery in those women who breastfed for 1 to 6 months with no additional bone loss being seen between months 5 and 12 postdelivery. Women who breastfed for more than 6 months had an 8.5 decline in BMD at Ward's area and a 4.1 decline in BMD at the lumbar spine at 5 months postpartum. No additional loss was seen at 12 months postpartum. Femoral...

Answers To Case 49 Breast Abscess and Mastitis

Summary A 20-year-old breast-feeding woman who is 3 weeks postpartum complains of right breast pain and fever of 2 days' duration. She notes progressive pain, induration, and redness in the right breast. Her temperature is 102 F. There is also significant fluctuance noted in the right breast.

Maternal Neonatal Transmission of HBV and HCV

Other than identification of the HBV-infected mother and immunization of her newborn infant, realistic methods for reducing the risk of maternal-neonatal transmission of the bloodborne hepatitis viruses are unknown. Breastfeeding has not been definitively implicated in transmission of HBV or HCV to the infant, even in HIV-positive women with high hepatitis virus titers (5). For the nonpregnant HBV- or HCV-infected woman considering beginning a family or enlarging an established one, effective preconception antiviral treatment, leading to clearance of the responsible virus, would seem likely to eliminate or reduce the risk of transmission to the infant.

Progestogenonly Contraception

Medroxyprogesterone acetate and its metabolites are excreted in breast milk, so women who breastfeed should wait until 6 weeks post partum before starting Depo-Provera, when the infant's enzyme system should be more mature. Norethisterone enantate 200 mg (Noristerat) is shorter acting than Depo-Provera, 8 weeks, and is used to provide contraception after administration of the rubella vaccine, and until a partner's vasectomy has taken effect. It can also be used in the longer-term but only on a 'named patient' basis.

Congenital And Neonatal Infections

The most common pathogens of congenital and neonatal infections are viruses and the protozoa Toxoplasma gondii. Bacteria and the spirochete Treponema pallidum are less common. (See Chapter 6 on infectious diseases.) Fetuses are infected transplacentally, and neo-nates are infected during delivery through an infected birth canal or by breast feeding with infected milk. The maternal infection may be acutely acquired or more often results from reactivation of a clinically latent infection. Infections during the first trimester produce the most widespread injuries, notably inflammatory destructive lesions in the brain, sensory organs, and viscera, and malformations (Table 14.4). Among the major malformations are hydranencephaly, polymicro-gyria, hydrocephalus, and microcephaly. The neurologic sequelae of infections acquired later in gestation are mental retardation visual, auditory, and motor deficits and seizures. Maternal infections are diagnosed by sero-logic tests, and fetal...

Bilateral Visual Field Obliteration

A 28-year-old housewife presents to your office for a 6-week-postpartum checkup. She complains of fatigue greater than expected and palpitations. Her hair is falling out as well. She denies sadness or depression symptoms. Before this, she had not had any medical problems. She is breast-feeding her child and is not on any birth control. She had her first period since giving birth last week. A pregnancy test done in the office is negative. What is your most likely diagnosis

Dietary Hazards Caffeine and Alcohol

About 1 of a maternal dose of caffeine (whether from coffee, tea, soft drinks, chocolate, or medicines) is transported into the breastmilk. Infants metabolize caffeine more slowly than adults, and caffeine in breast milk may cause irritability and wakefulness. High intake of alcohol can inhibit milk production. Moreover, infant exposure to alcohol during breast-feeding may have serious adverse effects on development. Ethanol itself readily passes into the milk at concentrations approaching those in maternal blood and can produce lethargy and drowsiness in the breast-feeding infant. Heavy alcohol consumption (more than 4-5 drinks day) by nursing mothers may impair psychomotor development in their infants.10 The effects of occasional light drinking are unknown.

Intrauterine Adhesions Ashermans Syndrome

Intrauterine scarring leading to an unresponsive endometrium is most commonly due to injury to the pregnant or recently pregnant uterus. However, any mechanical, infectious, or radiation factor can produce endometrial sclerosis and adhesion formation. The sine qua non for development of IUA is endometrial trauma, especially to the basalis layer. The adhesions usually are strands of avascular fibrous tissue, but they also may consist of inactive endometrium or myometrium. Myometrial adhesions usually are dense and vascular, carrying a poor prognosis. Women with atrophic and sclerotic endometrium without adhesions carry the worst prognosis. This condition usually is found after radiation or tuberculous endometritis and is not amenable to any therapy. Postpartum curettage performed between the second and fourth weeks after delivery, along with hypoestrogenic states such as breast-feeding or hypogo-nadotropic hypogonadism, is associated with extensive intrauterine scar formation. Uterine...

Some Tips For Examining Young Children 14yearolds

Aroused Feeding Milk

If possible, do the physical examination in front of the parents so that they can interact with you and ask questions. Often parents have specific questions about their baby's physical appearance, so stating normal findings as you go can be quite reassuring. This is also an excellent time to observe parental bonding with the newborn, and to observe how well the breastfeeding baby latches and sucks. To detect problems early, try to observe breast-feeding firsthand. Breast-feeding is physiologically and psychologically optimal, but many mothers will need help and support. Early detection of difficulties and anticipatory guidance can promote and sustain healthy breast-feeding. Newborns are most responsive 1 to 2 hours after a feeding, when they are neither too satiated (becoming less responsive) nor too hungry (and often agitated). It is helpful to start with the newborn swaddled and comfortable. Then undress the newborn as the examination proceeds, for gradual stimulation and arousal....

Association Of Agentic Extraversion And Affiliation With Two Neurobehavioral Systems

When close proximity to a rewarding goal is achieved, the incentive-motivational approach gives way to a consummatory phase of goal acquisition (Herbert, 1993). In this phase, specific interoceptive and proximal exteroceptive stimuli related to critical primary biological aims elicit behavioral patterns that are relatively specific to those conditions (e.g., sexual, social, or food-related) (Hilliard et al., 1998 MacLean, 1986 Timberlake & Silva, 1995). Performance of these behavioral patterns is inherently rewarding (Berridge, 1999). In the case of potential mate acquisition, examples of affiliative behavioral patterns are courtship, gentle stroking and grooming, actual mating, and certain maternal patterns such as breastfeeding, all of which may include facial, caressive tactile, gestural, and certain vocal behaviors (Polan & Hofer, 1998). Tactile stimulation may be particularly effective in activating affiliative reward processes in animals and

Epidemiologic Risk Factors

In addition to age over 50 and Caucasian race, an increased number of ovulatory cycles appears to increase risk for ovarian cancer, reflected in an association with early menarche, late menopause, and nulliparity (Berek and Bast 2006). Conversely, factors that decrease the number of ovulatory cycles, including repeated pregnancies, prolonged breast feeding and use of oral contraceptives, decrease the risk of ovarian cancer. A protective effect from tubal ligation suggests that exogenous carcinogens might gain access to the ovary from the uterus through the fallopian tube. However, evidence for viral or strong chemical carcinogens has not been obtained, with the possible exceptions of the use of talc products in all histotypes and of cigarette smoking in mucinous cancers, but not in the more common serous histotype (Berek and Bast 2006). Approximately 10 of ovarian cancers are familial and are associated with mutations in BRCA1, BRCA2 or, less frequently, with the mismatch repair...

Organochlorine Compounds Polycyclic Aromatic Hydrocarbons and Breast Cancer

Finally, it is worth noting that a careful analysis of all risk factors for breast cancer must be done before one can conclude that a cluster of breast cancer cases is related to some local environmental factor. For example, a study done in the San Francisco Bay area, involving both Caucasian and African-American women, found that the elevated breast cancer incidence in the Bay area could be completely accounted for by regional differences in known risk factors, e.g., parity, age at first pregnancy, months of breast feeding, and ages at menarche and menopause.180

Risk Factors

Prior surgery when there was risk for transfusion Prior dental procedures Surrogates Use of cocaine Use of marijuana Divorced or separated Income below poverty level 12 yr or fewer education Not a Risk Factor Infant breastfeeding from infected mother Race or ethnicity Hepatitis C may be transmitted from mother to infant at time of delivery. The risk in otherwise healthy mother-infant pairs is approx 6 , but risk increases dramatically, to approx 20 , if mothers are co-infected with HIV (9). A recent Italian study examined vertical transmission in 15,250 pregnant women (10). Three-hundred-seventy women were seropositive to hepatitis C virus antibody, and 72 of these were positive for HCV RNA. The risk of development of CHC in the offspring of viremic mothers was 5.1 . Pregnancy did not affect level of viremia, but tended to ameliorate ongoing liver injury in the mothers 56.4 of mothers had elevated alanine aminotransferase (ALT) in the first month of pregnancy, but only 7.4 had...

Box 372

Usually, there is a risk that the drug can enter breast milk and he transferred to the nursing infant, in whom exposure could have adverse effects (see Fables 37-4 and 37-5). Unfortunately, there is little conclusive information about drug dosage and effects via breast milk however, retrospective clinical studies and empiric observations coupled with known pharmacologic pathways allow recommendations to be made.1 The amount of drug excreted in breast milk is usually not more than 1 to 2 of the maternal dose therefore it is highly unlikely that most drugs have any pharmacologic significance for the infant.KS'M I he mother should take prescribed drugs cist after breastfeeding and then avoid nursing for 4 hours or more, if possible,1 ss to markedly decrease the drug concentration in breast milk.

Ovarian Cancer

Ninety percent of ovarian cancers are of epithelial origin. The malignant cells probably have a clonal origin (6), and are thought to arise either directly from the surface epithelium of the ovary or from inclusion cysts (7). Ovulation appears to be a major risk factor for ovarian cancer, since pregnancy (8), the contraceptive pill (9), and breast feeding (10) are all associated with a decreased relative risk of developing the disease, although there is evidence that ovarian hyperstimulation may increase the risk (11). A great deal needs to be learned about the natural history of the various forms of this

William Buchan

Thanks to the influence of John Locke, children's health and medicine (paediatrics) had become a strong clinical speciality in Britain. William Cadogan's famous Essay upon Nursing, and the Management of Children, which urged natural breastfeeding and was against unnatural swaddling, was published in 1748, some fourteen years before Rousseau while William Buchan's

Arms At Sides

Occasionally, the shape of the nipple in inverted, or depressed below the areolar surface. It may be enveloped by folds of areolar skin, as illustrated. Long-standing inversion is usually a normal variant of no clinical consequence, except for possible difficulty when breast-feeding.

HIV infection

Treatment regimens include polytherapy to decrease resistance, and compliance is a must. Patients should have regular monitoring of liver function tests and blood counts to detect toxicity. Combination retroviral therapy decreases the risk of perinatal transmission to less than 2 . Evidence shows that route of delivery can further decrease vertical transmission. Scheduled cesarean delivery (prior to labor or rupture of membranes) should be discussed for HIV positive women. HIV-infected women who choose to deliver vaginally should receive intravenous ZDV during labor. Breast-feeding should be discouraged. The neonate generally also receives oral ZDV syrup.

Transmission

Sharing needles by IV drug users is the second most common source of transmission of HIV. Vertical transmission from an infected woman to her baby has been found to occur during pregnancy, during the process of delivery of a baby, and from breast-feeding. Blood and blood-product transfusions have been linked to infection, although the routine screening of donor blood for HIV now makes this an extremely rare event.

Radioiodine 131i

131I is the preferred initial treatment for hyperthyroidism caused by Graves' disease in North America. It is contraindicated in children and pregnant or breast-feeding women, and can induce or worsen ophthalmopathy. It is used in combination with surgery in some cases of thyroid carcinoma, especially those in which metastases are sufficiently differentiated to take up iodide selectively.

Considerations

Principle 131i Treat Hyperthyroidism

Radioactive iodine is the treatment of choice for Graves disease in adult patients who are not pregnant. It should not be used in children or breastfeeding mothers. Antithyroid drugs are also well tolerated and successful at blocking the production and release of thyroid hormone in patients with Graves disease. Some examples of these drugs include propylthiouracil (PTU). methimazole. and carbimazole. These drugs work by inhibiting the organification of iodine, although PTU also prevents the peripheral conversion of thyroxine (T4) to triiodothyronine (T,), its more active form. The most serious potential side effect of these drugs is agranulocytosis, which occurs in 3 per 10.000 treated patients per year. All of these drugs are relatively safe during pregnancy, although PTU is the preferred agent. Antithyroid drugs are especially useful in treating adolescents, in whom Graves disease may go into spontaneous remission after 6-18 months of therapy. Surgery is reserved

Normal Changes

Immediately following delivery, the uterus begins the process of involution, the return to its nonpregnant size. Contraction of the uterine musculature promotes hemostasis by compressing the uterine blood vessels. An IV infusion of oxytocin (Pitocin) given during or immediately after the third stage of labor will aid in producing increased uterine tone. Early breast-feeding also leads to uterine contraction, further promoting involution. In most cases, the uterus has returned to normal size by the time of the 6-week follow-up visit. Vaginal bleeding is usually heaviest in the hours following delivery, then decreases significantly. Brown or blood-tinged lochia occurs for about the next week. This is followed by white or yellow lochia, which continues for approximately 3-6 more weeks. In women who are not breast-feeding, menstruation usually restarts by the third postpartum month. In women who are breast-feeding, ovulation and menstruation can be suppressed for much longer. Anovulation...

Hepatitis B

The HBsAg carrier rate in pregnant women varies widely, from 0.15 in white U.S. women, to 8.9 in Asian women born outside the United States (9). The AT levels may be normal or only slightly elevated in many HBsAg-positive individuals. For epidemiologic purposes, persons with detectable HBsAg should be considered infectious. Mothers who are HBsAg-positive should not be discouraged from breastfeeding, as long as the infant has received prophylactic treatment. Mast et al. (28) found that mode of delivery and breastfeeding were not associated with HCV transmission. They also found that the overall risk of transmission was 4 for PCR-positive mothers, compared to 0 for PCR-negative mothers. Factors associated with an increased risk for transmission were prolonged duration of membrane rupture, use of internal fetal monitoring devices, and meconium-stained amniotic fluid. Obstetricians may be able to alter two of these factors to decrease the risk of perinatal transmission. Current data...

New Mothers Guide to Breast Feeding

New Mothers Guide to Breast Feeding

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

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