Keeping the cord intact a little longer....

We Can Be Much Kinder - Birth Matters Video Contest

H1N1 INFLUENZA & breastfeeding (Japan)

Due to the recent cases of H1N1 (swine) influenza in Japan, LLL Japan has issued a press release in Japanese :
http://llljapan.org/binfo/flu.html
and also the Japanese Association of Lactation Consultants:
http://www.jalc-net.jp/FAQ_ans/influ2009.html
These may be useful to share with your doctor in case you have flu symptoms and are breastfeeding.

For information on the H1N1 influenza in English see:
http://www.cdc.gov/h1n1flu/breastfeeding.htm (breastfeeding)
http://www.cdc.gov/h1n1flu/guidance/pregnant.htm (pregnant mothers)

Breastfeeding / H1N1 (Swine) Flu Recommendations for Physicians

Breastfeeding / Swine Flu Recommendations for Physicians from the Academy of Breastfeeding Medicine
New Rochelle, NY, May 12, 2009—Breastfeeding can limit the severity of respiratory infections in infants and is particularly important for minimizing the risk and effects of infection during an influenza outbreak, such as the current H1N1 influenza virus (also known as the “swine flu”) outbreak, according to recommendations released by the Academy of Breastfeeding Medicine (ABM). The Academy’s complete recommendations are available online at www.bfmed.org
The new guidelines presented by ABM urge physicians to support continued breastfeeding even if the mother is suspected of having the H1N1 influenza virus, since the infant would likely have been exposed to the virus before the mother’s symptoms appeared. Continued breastfeeding may help limit the severity of respiratory symptoms in infants that become infected.
Other key recommendations encourage continued breastfeeding even if the mother is taking either of the two antiviral medications prescribed to treat or prevent influenza infection (oseltamivir or zanamivir). Breastfeeding should also continue if an infant becomes ill with suspected H1N1 flu. Furthermore, if breast milk is only part of an infant’s diet, it would be wise to increase the amount of breast milk the infant receives during an influenza outbreak, perhaps supplementing breastfeeding with expressed or pumped milk.
Good hygiene, including regular hand washing around the baby, can help minimize exposure to respiratory droplets that may carry the flu virus. Limiting close contact by non-caretakers, use of a mask if a caretaker has flu-like or other respiratory symptoms, and avoiding crowds are other recommended actions to reduce risk of infant exposure. According to ABM President, Caroline J. Chantry, MD, "It is timely for physicians to be reminded that breast milk contains a myriad of antiviral and immune boosting components beyond specific antibodies that will help protect the infant even when a mother does not have preexisting immunity to a particular illness."

WHO's Infant and young child feeding model chapter for textbooks

Infant and young child feeding: Model Chapter for textbooks for medical students and allied health professionals

The Model Chapter on Infant and Young Child Feeding is intended for use in basic training of health professionals. It describes essential knowledge and basic skills that every health professional who works with mothers and young children should master. The Model Chapter can be used by teachers and students as a complement to textbooks or as a concise reference manual.

http://www.who.int/nutrition/publications/infantfeeding/9789241597494.pdf

Isn't it interesting that OB/GYNs have to be encouraged to encourage their patients to breastfeed.

Iron for babies

Expectant parents might like to know there is a study published in The Lancet in 2006 that shows that waiting 2 minutes before clamping the umbilical cord provided the infants with more body iron at 6 months of age without causing any harm at birth.
Delayed cord clamping increases infants' iron stores.

To supplement or not?

Some doctors are not as supportive of breastfeeding as you would wish. If you are having problems, and the doctor advises supplementing with formula without really investigating how and why breastfeeding is not going as well as it should, you may like to check out the information from the Academy of Breastfeeding Medicine. These are protocols written by doctors for doctors on important topics like supplementation (in English and Japanese) based on protecting the breastfeeding relationship. You might even consider sharing the information with your doctor.

Of course your doctor wants to see your baby growing and thriving, but in Japan the supplements are too often a quick-fix solution. Somewhat surprisingly, supplements are routinely offered at many hospitals if a mother complains she is too tired and wants to sleep after the birth. This is just bad practice. Everyone is tired after having a baby...but you learn to breastfeed by breastfeeding, not by having someone else take care of your baby and feed supplements. Then the mothers complain they don't have enough milk, but your breasts don't continue to produce milk if you don't use it! This is known as the "use it or lose it" principle.

Supplementation with formula changes the gut flora in the baby, and can seriously affect your baby's health both now and in the future (allergies, diabetes, ear infections...the list is very long) so it is not something that should be approached lightly. Supplementing with the mother's own milk is always a better first choice, and if supplementation is indicated, mothers need good advice and support on how to express and use their own milk. "Just one bottle won't hurt "...or will it?

To increase your baby's breastmilk intake, also see Dr. Jack Newman's recommendations and contact a local Lactation Consultant or your local La Leche League Leader.

getting started

Choosing a doctor, hospital, clinic or midwife who is supportive of breastfeeding is important. As Dr Jack Newman points out, they all say they are supportive, but his article tells you what to look out for. The challenge for mothers like you in Japan is to find somewhere that truly values breastfeeding, does not separate mothers and babies after birth, and does not suggest bottles of glucose water or infant formula as a quick fix at the first sign of a breastfeeding problem. Discuss breastfeeding and hospital policies with your caregiver during pregnancy, and find out if they are willing to be flexible, and perhaps "bend the rules" for you. Asking the tricky questions now might save a lot of heartache later.

This list of 10 questions for all pregnant mothers is very useful, so you have some idea about the right questions to ask about your birth and breastfeeding!