Twitter Facebook RSS Feed Print
Your Baby

Breastfeeding May Improve Infant’s Dental Development.

2:00

Infants that breastfeed exclusively or predominately for their first three to six months of life are less likely to develop any kind of dental misalignment later on according to a new study.

The researchers, led by Karen Peres at the University of Adelaide in Australia, tracked just over 1,300 children for five years, including how much they breast-fed at 3 months, 1 year and 2 years old.

The children were also monitored for pacifier use.  About forty percent used a pacifier daily for four years.

When the children were 5, the researchers determined which of them had various types of misaligned teeth or jaw conditions, including open bite, cross bite, overbite or a moderate to severe misalignment.

The risk of overbite was one-third lower for those who exclusively breast-fed for three to six months compared to those who didn't, the findings showed. If they breast-fed at least six months or more, the risk of overbite dropped by 44 percent.

Similarly, children who exclusively breast-fed for three months to six months were 41 percent less likely to have moderate to severe misalignment of the teeth. Breast-feeding six months or longer reduced their risk by 72 percent.

The reason breastfeeding might offer protection from dental misalignments is the way it works an infant’s jaws. Breastfeeding involves coordinated tongue and jaw movements that support the normal development of teeth and facial muscles.

Dr. Danelle Fisher, vice chair of pediatrics at Providence Saint John's Health Center in Santa Monica, California, agrees that it’s the jaw movement.

"Breast-feeding requires the use of jaw muscles more so than bottle-feeding, so the mechanics of breast-feeding stimulate muscle tone in the jaw," Fisher said.

Open bite, overbite and moderate to severe misalignment were generally less common overall among the children who mostly or exclusively breast-fed. Children who mostly breast-fed but also used pacifiers, however, were slightly more likely to have one of these misalignment issues, the study found.

"Pacifiers are used for non-nutritive sucking but when overused, they can put pressure on the developing jaw and lead to more problems in older children with malocclusion [teeth/jaw misalignment]," Fisher said.

Parents oftentimes depend on the pacifier to help babies relax and self-soothe. The key is moderation of use.

The American Academy of Pediatrics recommends parents consider using a pacifier for an infant's first six months because pacifiers are associated with a reduced risk of sudden infant death syndrome (SIDS).

"Most infants need to suck for comfort or non-nutritive sucking," Fisher said. "Pacifiers can be helpful in the newborn period and even help reduce incidents of SIDS in infants who sleep with them."

Instead, parents should simply limit pacifier use, she said. In addition, pacifiers are not needed past the first six to 12 months, Fisher said, so parents can begin weaning after that time.

Like most studies, the results did not prove cause and effect, but an association.

The findings were published online in the journal Pediatrics.

Source: Tara Haelle, http://www.webmd.com/parenting/baby/news/20150615/breast-feeding-may-have-dental-benefits-study-suggests

Your Baby

Transitioning From Breastfeeding to Bottle-feeding

2:00

There are as many reasons as there are mothers for deciding to transition from breastfeeding to bottle-feeding. It doesn’t matter what the reason may be, making the change is a difficult choice for some mothers.

“Every mother experiences mixed emotions about weaning and usually feels some sadness about bringing nursing to an end,” says Kathleen Huggins, RN, author of The Nursing Mother's Companion.

Huggins offers several tips for mothers who have made the choice to switch.

At around 6 months (some parents start even earlier), babies are beginning to eat solid foods. Since these foods are more filling, many babies may want less breast milk. If you’re considering switching to the bottle, this is a good time to introduce bottle-feeding - a little at a time.

“Most moms consider weaning when there are natural transitions,” says Natasha L. Burgert, MD. She's a pediatrician in Kansas City, MO. “As baby's diet is changing and his immune protection from vaccines increases, many moms decide to cut back on their nursing.”

An important tip is to make sure you are ready for the commitment it takes to change yours and your baby’s routine. There isn’t a “normal” time to stop nursing your baby. There is only an average time. Some mothers continue to breastfeed up to a year or longer – that’s their choice. Don’t allow others to pressure you. If you try to switch and something doesn't feel right, trust your instincts.

“In my experience, moms are typically not disappointed if they are truly ready,” Burgert says. “If moms are emotionally torn about weaning, maybe it's not time.”

Breastfeeding is often a close bonding time between mothers and their infants. It doesn’t have to stop because you are switching to a bottle. It can also allow dads to experience the unique bond of feeding time.

Just because you begin using a bottle, nothing has to change in how you hold your baby. You can still hold he or she close and have skin-to-skin contact.

“Babies want to be close to you, hear your voice, be warm and snug, and get their tummies full,” Burgert says. “Both bottle and breast can equally do those things.”

If your baby expects you close at mealtimes, don't hand her a bottle, even if she's old enough to hold it.

“I suggest that she be held for all of these feedings,” Huggins says. “In this way, the baby and mother can continue to experience the close, loving bond that comes with nursing.”

Of course breastfeeding isn’t the only time for close bonding. Moms can still snuggle, cuddle and kiss their babies. None of that goes away with the introduction of a baby bottle.

Take your time when introducing the bottle. Make is a gradual transition by dropping one session every few days. Begin with a daytime feeding.

“Babies are busy playing and interacting with their environment,” Burgert says.

“Once solid feeding is going well, roll right into a bottle in the morning, rather than a nursing session.”

Once you start making the switch, ask for help from your husband or partner or other family members.

“It's best if someone else offers the bottles, so the baby associates breastfeeding with the mother,” says Laurie Beck, RN, of the U.S. Lactation Consultant Association.

It's often hardest for babies to give up bedtime nursing.

“To be successful, the routine has to change,” Beck says. You can “offer a drink from a bottle or cup and then try walking around to put the baby to sleep. Or let someone else put the baby to sleep so that they do not associate going to sleep with breastfeeding.”

While baby is adjusting to a new routine, mom’s body is also going through quite a few changes.  When you cut back on breastfeeding, your full breasts can be painful. Even when you are slowly changing over, breasts can feel very uncomfortable.

To relieve the pain try these methods:

Chill your breasts. “Ice packs help to constrict and feel good if the breasts are warm to the touch,” Beck says. You can get the same relief by putting chilled cabbage leaves in your bra. (Really!)

Remove some milk. Use a breast pump to take off some pressure. Don't pump for too long or your body will think that it should maintain its milk supply. “There's a difference between pumping 15 to 20 minutes to fully empty the breasts and removing just enough milk to make yourself comfortable,” Beck says.

Leave your breasts alone. Once you stop nursing, keep breasts off-limits to help your milk supply stop. “Avoid any breast stimulation, including forward-facing showers and sexual foreplay,” Huggins says.

There’s nothing unusual about switching from breastfeeding to bottle-feeding, millions of women have made the same choice. They key is to be ready and to take your time.

Source: Lisa Fields, Roy Benaroch, MD, http://www.webmd.com/parenting/baby/bottle-feeding-15/weaning-from-breast

 

 

 

Daily Dose

New Baby Questions!

1:30 to read

Lots of new baby questions this week in my office, so I that I thought I would cover a few of the most frequently asked by parents within days of bringing that precious newborn home from the hospital. So, here we go:

My baby has blue hands and feet…should I go to the ER?  The medical term for this is acrocyanosis.   It is not uncommon for a baby to have a bluish/purple discoloration to their hands and feet. This often occurs if the baby gets chilled or cold, whether that is after a bath or sometimes even after they are unswaddled to wake them up a bit to get them to eat.  If your baby has pink lips and tongue and seems otherwise fine this is the normal adjustment of a baby’s circulation and may last for a few weeks to months.  When parents are concerned about this and make a trip to the ER where they are discharged with the diagnosis of “worried well”.

What temperature do I need to have my thermostat set?  This question always makes me laugh a bit because some of it is truly dependent on the climate where you live. Many parents think they need to “crank up the heat” for a newborn, but actually a cooler room temperature has been shown to correlate with a reduction in sudden infant death (SIDS).  The “ideal” temperature that has been recommended is around 68 - 70 degrees, but for those of us who live in the south during the dead of summer, it is almost impossible to keep your house this cool and very expensive. At the same time, some parents are uncomfortable during the winter with the thermostat at 68 degrees…so I would recommend keeping your house comfortable and on the cooler side rather than too warm. You also do not need to bundle your baby when it is blazing hot outside, less is more if the house is hot.

What about a pacifier?  Mother’s come in and say, “I was told that I shouldn’t use a pacifier because it will cause “nipple confusion”.  While I am a huge proponent of breast feeding I think that a pacifier is also helpful for a breast feeding mother so that she does not use her own breast as a “human pacifier”. Many new moms come in to see me at the 2 week check up crying, exhausted and with bleeding nipples. They are putting their baby on the breast for hours at a time as “it seems the only way my baby is content”.  Although they were told that they could put their finger in their baby’s mouth as a way to help console their baby, that too does not provide much of a distance from the baby…even to go to the bathroom, take a shower or eat!! A baby has the reflex to suck which is termed, “non-nutritive sucking”.  This is one way that your baby will calm themselves.  So, once your baby is getting on the breast, I would buy a pacifier and “teach” your partner how to hold your baby in the position as if they were going to be fed,  but with a pacifier to suck on rather than the breast. Once situated you can try walking around, gentle bouncing or swaying while your baby is happily sucking on their pacifier. Mother gets a bit of a rest between feedings and infant is happy with a pacifier ( rather than a finger). We will discuss taking away a pacifier at another time! 

 

Daily Dose

Maternity Leave & Breastfeeding

1:15 to read

When Facebook’s Mark Zuckerberg and Priscilla, his pediatrician wife, had their baby last year he announced that he would be taking off 2 months to be at home with his wife and baby. For those fortunate enough to work for Facebook or Google or another company with a generous maternity/paternity leave policy they too may get anywhere from 2-6 months of paid leave after the birth of their baby. But for most workers, it is more the “norm” that a mother receives anywhere from 4-6 weeks of maternity leave, and in many cases it is not paid.   The first several months of being a new parent are often overwhelming, but knowing that you have 4-6 months of paid leave which allows you time to “become a family” certainly makes the adjustment to parent hood a bit easier.

Unfortunately, physicians (including pediatricians) are faced with returning to their practice often “as quickly as possible”.  I found that going back to work after 12 weeks (which I had to beg for) and trying to juggle a full load of patients, answering phone calls, taking night call and making hospital rounds really did impact my mood as well as my breastfeeding. Although I enjoyed breastfeeding,  I could not figure out how to find any time to pump between patients (talk about running late) to keep my milk supply up. So….I eventually made the decision that in order to keep working I would need to stop breast feeding, which was a bit traumatic for me…..in retrospect I was tougher on myself than I needed to be, but 30 years ago I didn’t realize the numerous other difficult parenting decisions that lay ahead.

Interestingly, a new study just published in Pediatrics is what made me ponder all of this.  Many studies have shown that mothers may have trouble continuing to breast feed after returning to work. This latest study from Australia actually found that the amount of time to return to employment was actually “far less significant than the number of hours a woman worked”.  The study found that working 19 hours or less per week was associated with a higher likelihood to continue breastfeeding.  Those women who returned to a work week of 19 hours or less “experienced no decline in the likelihood that they were breastfeeding regardless of when they returned to work and they were more likely to sustain breastfeeding as well”.  In other words longer breastfeeding, a win win for mother and child. 

As more and more women are employed during their child bearing years, the ongoing debate surrounding the appropriate length of time for maternity leave continues. While there have been many studies to show the importance of family leave after the birth of a baby ( better bonding, less post partum depression) this study is one of the first to show the benefit of a reduction of hours worked upon re-entry to the workplace.  It is my hope that this research may open the door for discussions examining the feasibility of reduced work hours for women who return to work after giving birth.  This new data may be pivotal in improving longer breastfeeding rates in the U.S.  

I am sure many women, although not included in the study,  who have juggled a career and breast feeding would agree.

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

DR SUE'S DAILY DOSE

Diagnosing a penicillin allergy.

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.