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EVENTS
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World Breastfeeding Week
August 1 - 7, 2008
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For 15 years, World Breastfeeding Week (WBW) has been the greatest outreach vehicle for the breastfeeding movement, being celebrated in over 120 countries. Officially it is celebrated from August 1–7. Initiated by the World Aliance for Breastfeeding Action, this celebration has been an essential part of advocation and education for breastfeeding.
This year's theme is... In conjunction with the Olympics next August, WBW 2008 calls for greater support for mothers in achieving the gold standard of infant feeding: breastfeeding exclusively for six months, and providing appropriate complementary foods with continued breastfeeding for up to two years or beyond.
As every country sends its best athletes to compete at these global games, it is important to remind ourselves that, in a similar fashion, a healthy young athlete can only emerge from a healthy start on life. There is no question that optimal infant and young child feeding is essential for optimal growth and development.
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IN THE NEWS from Baby Friendly Initiative
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Assessing breastfeeding adequacy by monitoring urine output, stooling and timing of onset of lactation. Monitoring by mothers of their babies’ urine output and stooling, as a method of assessing their own breastfeeding adequacy, has been traditionally suggested, although the evidence base is limited. A study was carried out in an area of California with traditionally high exclusive breastfeeding rates to test this. The authors argued the need for a validated method for mothers to assess their own breastfeeding, given the increasing success of breastfeeding promotion campaigns and numbers of mothers leaving hospital breastfeeding exclusively.
All mothers (n=242) received a standard package of support from a lactation consultant with additional telephone support if needed. Mothers were interviewed and data collected on days 1, 4 (72-96 hours), 6, 8 and 14. Mothers were asked to report the frequency of wet and soiled nappies and to rate their level of breast fullness on a scale of 1- 5 (1 = no change, 5 = uncomfortably full). Onset of lactation (stage II lactogenesis) was defined as level 3, i.e. noticeably fuller. On average infants lost 5.5% of birth weight on day 4; however, 30 lost in excess of 10% and were classified as “breastfeeding inadequacy” (BI). Elimination was shown to increase steadily over the first week of life; however, there was a wide variation and difficulty was encountered in defining a frequency which was both sensitive (i.e. identified all cases of BI) and specific enough (i.e. did not identify cases of non-BI).
The most efficient predictor of breastfeeding inadequacy on day 4 was 3 or fewer soiled nappies. Sensitivity improved when used together with delayed onset of lactation (72 hours or longer), however low specificity is likely to result in false positive results. Urine output was less meaningful as mothers recall was less accurate. The authors conclude that fewer than 4 soiled nappies on day 4 and delay of lactogenesis stage II for 72 hours or longer is suggestive of difficulties in establishing breastfeeding. However, although it is useful for mothers to have a general idea of what newborn elimination patterns are, it is also important that they understand that there is a wide range of normal.
Impact of kangaroo care on breastfeeding for preterm babies. A randomised controlled trial was conducted to assess the impact of kangaroo care (KC) on a sample of mothers and preterm infants (n=66) of 32-36 weeks’ gestation who intended to breastfeed. In the KC group, unlimited KC was encouraged, whereas the control group received standard nursery care. The mean average time spent in KC was in 4.47 hours per day. Breastfeeding at hospital discharge and at 1.5, 3, 6, 12, and 18 months was recorded. The results demonstrated that KC dyads, compared with control dyads, breastfed for significantly longer (5.08 months vs 2.05 months). Breastfeeding was also significantly more likely to be exclusive at each data collection point.
Impact of frenulotomy on breastfeeding. A group of 24 mother-baby dyads with persistent breastfeeding difficulties despite receiving professional advice were assessed using ultrasound. The researchers were investigating whether frenulotomy was an effective method of treating ankyloglossia (tongue-tie) in babies where breastfeeding difficulties such as ineffective attachment, suboptimal weight gain and maternal nipple pain were experienced. The aim of the study was to measure changes in milk transfer and tongue movement during breastfeeding before and after frenulotomy. Assessment of breastfeeding, including ultrasound scans of the oral cavity, were performed before frenulotomy and again at around 7 days post-procedure. On ultrasound scan, two groups of infants were identified – one in which the infant’s tongue action compressed the tip of the nipple and the other in which the base of the nipple was compressed. In addition, milk transfer was assessed and milk intake measured using the test-weighing method. Maternal pain was recorded and an assessment made of the attachment (LATCH score - latch, audible swallowing, type of nipple, comfort, and hold). The researchers found that in all cases the above measures improved significantly. They recommend that an assessment for ankyloglossia should be made in all cases of breastfeeding difficulties.
Does breastfeeding impact on maternal blood pressure? It is suggested that breastfeeding has positive health benefits for mothers as well as for their infants and one area of interest is whether breastfeeding can reduce maternal blood pressure. A study in Sweden aimed to investigate this by measuring maternal blood pressure before, during and after a breastfeed, initially at 2 days postpartum and then during the following 25-week breastfeeding period. Sixty-six primiparae who had had a normal birth had their blood pressure measured 5 minutes before breastfeeding and 10, 30, and 60 minutes after a morning breastfeed. Thirty-three women continued to measure their blood pressure before and after breastfeeding for 25 weeks. The researchers found that blood pressure fell significantly in response to breastfeeding 2 days after birth. The fall in systolic and diastolic blood pressure amounted to an average of 8.8 mm Hg and 7.7 mm Hg respectively. During the 25-week follow-up period a significant fall in blood pressure was also observed with the overall fall in systolic and diastolic blood pressure amounting to a mean of 15 mm Hg and 10 mm Hg, respectively. Although the numbers were relatively small, the authors were able to conclude that, in a homelike environment, breastfeeding has a significant positive impact on both systolic and diastolic blood pressures of mothers.
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IN THE NEWS
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Florida Breastfeeding Coalition, Inc. is on the Governor's Council for Physical Fitness 2007-2008 list.
Centers for Disease Control
2008 Breastfeeding Report Cards
http://cdc.gov/breastfeeding/data/report_card2.htm
http://cdc.gov/breastfeeding/data/report_card3.htm
CDC SURVEY: 77 PERCENT OF NEW MOTHERS TRY BREASTFEEDING According to a CDC survey released last week, more than three-quarters of new mothers in the US breastfeed their infants for at least a brief period of time. The survey, part of the National Health and Nutrition Examination Survey, uses data from 434 infants. Indications are that the percentage of new mothers who try breastfeeding has steadily risen, from 60 percent in 1993-1994 to 77 percent in 2005 and 2006. The percentage of African American infants who were breastfed has increased from 36 to 65 percent during the same period, while the percentage of Hispanic breastfed infants increased from 67 to 80 percent. Rates are lowest among women who are low-income, rural, younger than age 20, unmarried and have a high school education or less. The survey did not report data on breastfeeding rates for infants six months of age and older. To access the report of this survey, go to http://www.cdc.gov/nchs/data/databriefs/db05.htm.
PUBLIC HEALTH & EDUCATION | CDC Report Finds Hospitals Do Not Do Enough To Promote Breastfeeding [June 13, 2008]
CDC on Thursday released its first-ever survey of breastfeeding practices at hospitals and birthing centers nationwide, which found that practices "unfriendly" to breastfeeding were common throughout the country, the AP/Google.com reports (Stobbe, AP/Google.com, 6/12). According to CQ HealthBeat, CDC endorses breastfeeding as a practice that provides optimal nutrition for infants and reduces the risk for infant and maternal morbidity and mortality. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5723a1.htm
Negative Impact of Formula Discharge Packs on Breastfeeding Research Update Hospital practices influence breastfeeding duration. Formula discharge packs given to mothers as they leave the hospital reduce exclusive breastfeeding at 10 weeks.
BREASTFEEDING AND CHILD COGNITIVE DEVELOPMENT
Context The evidence that breastfeeding improves cognitive development is based almost entirely on observational studies and is thus prone to confounding by subtle behavioral differences in the breastfeeding mother's behavior or her interaction with the infant.
Objective To assess whether prolonged and exclusive breastfeeding improves children's cognitive ability at age 6.5 years.
Design Cluster-randomized trial, with enrollment from June 17, 1996, to December 31, 1997, and follow-up from December 21, 2002, to April 27, 2005.
Participants A total of 17 046 healthy breastfeeding infants were enrolled, of whom 13 889 (81.5%) were followed up at age 6.5 years.
Main Outcome Measures Subtest and IQ scores on the Wechsler Abbreviated Scales of Intelligence, and teacher evaluations of academic performance in reading, writing, mathematics, and other subjects.
Results The experimental intervention led to a large increase in exclusive breastfeeding at age 3 months (43.3% for the experimental group vs 6.4% for the control group; P < .001) and a significantly higher prevalence of any breastfeeding at all ages up to and including 12 months. The experimental group had higher means on all of the Wechsler Abbreviated Scales of Intelligence measures, with cluster-adjusted mean differences (95% confidence intervals) of +7.5 (+0.8 to +14.3) for verbal IQ, +2.9 (?3.3 to +9.1) for performance IQ, and +5.9 (?1.0 to +12.8) for full-scale IQ. Teachers' academic ratings were significantly higher in the experimental group for both reading and writing.
Conclusion These results, based on the largest randomized trial ever conducted in the area of human lactation, provide strong evidence that prolonged and exclusive breastfeeding improves children's cognitive development. Arch Gen Psychiatry. 2008;65(5):578-584
Breastfeeding has been named as one of the Ten Recommendations to Prevent Cancer by the American Institute for Cancer Research (AICR) following analysis of a major new study. (November 2, 2007)
Impact of breastfeeding on cholesterol levels in adults Previous studies have indicated that breastfeeding may result in lower cholesterol concentrations in adults. This study aimed to elicit additional evidence to assess whether that argument was valid. The study consisted of a systematic review of published observational studies which compared initial feeding status and blood cholesterol concentrations in adults between those who were breastfed as babies and those who were artificially fed. 17 studies (17 498 subjects; 12 890 breastfed, 4608 formula-fed) were found and the data analysed. Results from these studies were pooled and adjusted for factors such as non-exclusive breastfeeding, age, socio-economic status, body mass index (BMI) and smoking. Mean total blood cholesterol was lower among those ever breastfed than among those fed formula milk (mean difference: -0.04 mmol/L). However, exclusive breastfeeding made a greater and more consistent impact (mean difference: -0.15 mmol/L). The authors conclude that breastfeeding, particularly when exclusive, may be associated with lower blood cholesterol concentrations in later life.
peer-reviewed and fully referenced database of drugs to which breastfeeding mothers may be exposed. Among the data included are maternal and infant levels of drugs, possible effects on breastfed infants and on lactation, and alternate drugs to consider.
May 30, 2008 - USA Today reports that the FDA is calling for new labels on prescription drugs prescribed to women that would include the possible health risks for pregnant and breastfeeding women taking the drug. Labels will be updated to provide information on the risks during pregnancy and breastfeeding, as well as the risks offailing to treat medical conditions. The FDA is accepting comments on this proposal.
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was posted on March 27th by the FDA’s Center for Devices and Radiological Health (CDRH).
This website is the product of an effort that was initiated with the U.S. Breastfeeding Committee.
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