From Dr. Brian Symon: Words of Advice on Early Supplemented Breastfeeding Until Full Milk Production

Given new scientific data that exclusively breastfed newborns are in fact at significant risk for brain-threatening hypoglycemia, jaundice and dehydration, mothers are asking how they can supplement in the first days of life without compromising their long-term breastfeeding success. What they don’t realize is that supplemented breastfeeding in the first days of life transitioning into full breastfeeding or combination feeding was in fact the norm before the WHO/UNICEF Baby-Friendly exclusive breastfeeding guidelines. In fact, the historical evidence shows that all native breastfeeding countries, before the Baby-Friendly guidelines, supplemented their newborns with the milk of wet nurses, sugar water, also called “pre-lacteal feeds,” almost universally until a mother’s milk came in. The reasons for supplementation were to prevent newborn hunger, starvation, jaundice, dehydration and hypoglycemia.  Despite widespread mother-led supplementation of newborns in places like Bangladesh, mothers successfully breastfed the vast majority of their babies up to one (98%) to two years (89%) of age.  We used common sense to feed our babies and that is how we protected them in the first days of life and beyond.  Sadly, since the publication of the exclusive breastfeeding guidelines, hospitalizations for jaundice and dehydration have steadily increased and are now the leading causes of newborn hospitalization worldwide.

Here is Dr. Brian Symon talking about supplemented breastfeeding in the early days and how to transition over to full or combination breastfeeding.

By Dr. Brian Symon, General (family) Practitioner, Adelaide, South Australia

My heart goes out to the mothers writing about their struggle to breast feed and in some cases, babies ‘failing to thrive‘.  Landon Johnson’s story is a tragedy.

As a Family Physician my work is largely focused on the care of pregnant women and newborn babies.

My stance is very simple.

1. The ONLY logical reason for having a child is ‘the joy of parenting’.

We don’t do it because it’s easy.

We don’t do it for the “life style”.

We don’t do it for the “money”.

We do it for the deep joy of raising a child and seeing that baby thrive and develop.

If it’s not being joyful for the mothers whom I care for I want to change things so that the pleasure and joy returns. Continue reading

给医生和家长们的一封信 ——关于母乳喂养不足的危害 (Chinese Translation)

亲爱的医生同僚以及家长们:

我叫Christie del Castillo-Hegyi,是一名美国急救医师,之前是NIH研究院的科学家,在布朗大学时我曾做过关于新生儿脑损伤的研究。同时,我也是一位6岁孩子的母亲,我的孩子患有神经功能疾病。写这封信是因为我的孩子在刚出生不久就因为母乳喂养不足而成为新生儿黄疸、低血糖和严重脱水的受害者。之前作为一名准妈妈,我学习了所有关于母乳喂养的指导知识去迎接我的第一个孩子。不幸的是,遵循了这些指导以及儿科医师的意见,却导致我的孩子经受了为期4天无奶水摄取的ICU监护。随后,他被诊断为多重神经发育障碍。作为一名医师和科学家,我找到了一些同行评议期刊来解释为何会出现这样的情况。我发现有充分的证据可以显示新生儿黄疸、脱水、低血糖和发育障碍之间的联系。我希望告诉你们我是多么相信这些适用于我的儿子和你们所照顾的许多其他孩子们。经过健康怀孕和正常阴道分娩,我的儿子以8磅11盎司的重量出生。然后就被直接放在我的胸口立即哺乳。每3个小时需要哺乳20-30分钟。我们在医院待着的每一天都会接受儿科医师和哺乳顾问的检查,哺乳顾问注意到他长了一个头锁。他所用的尿布数量也在预期范围内。孩子出生的第二天,就被查出患有黄疸病,经皮胆红素值为8.9。我们出院48小时后做了定期复查,发现孩子的体重减少了5%。出院前,哺乳顾问告诉我们孩子可能会饿,这时候只需要对他进行母乳喂养。到家后,孩子开始变得烦躁,我给他喂奶的时间就越来越长,一直到晚上。 甚至在喂完奶,锁消退后他还是哭。 他没有睡觉。 第二天早上,他停止了哭闹,也安静了下来。 我们的儿科医师陪护了大约68个小时(直到出生后第3天结束)。尽管尿湿的尿布数量在预期范围内,但他的体重却少了1磅5盎司,大约是他出生时体重的15%。 那时。我们并没有意识到也未被告知体重减少的百分比,并且依旧整晚努力去哺乳一个饥饿的婴儿,当我们弄明白这样的体重减少是不正常的时,我们已经筋疲力尽了。他得了黄疸病,但却没测胆红素。儿科医师告诉我们可以选择用配方奶喂养或者等到第4天或第5天有母乳时再进行喂养。 因为太想用母乳喂养了,我们就对他又进行了一天不成功的母乳喂养,第二天我们去看了哺乳顾问,他称了一下乳量发现他正在完全将母乳消耗完。当我哺乳并查阅哺乳手册的时候,我才意识到我已经没有奶水了。我设想了一下这4天他所受的折磨以及母乳喂养手册鼓励的这2天持续的母乳喂养,可能这就是奶水不足的迹象吧。随后,我们就用了配方奶,最后他终于睡着了。三个小时之后,我们发现他反应有点迟钝。我就强行往他嘴里喂奶,这让他更加警觉了,但随后他就开始乱抓。我们赶快把他送到了急诊室。经过检查,他的葡萄糖值不正常(50 mg/dL),严重脱水,也叫高钠血症(157 mEq/L),重度黄疸(胆红素24 mg/dL)。我们再次被告知孩子并无大碍,但是由于我一直在做新生儿脑损伤研究,知道脑细胞会因为低血糖和严重脱水而在极短的时间内死亡,所以我并不相信医院关于孩子一切正常的检查结论,尽管我也非常希望孩子没事儿。

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The Rest of My Breastfeeding Story

Written by Fed is Best Foundation Co-Founder Christie del Castillo-Hegyi, M.D. 

Not many people know the rest of my breastfeeding story, the part that happened after my son’s hospitalization. People assume that because I spend most of my time advocating for safe infant feeding practices by educating moms on how to breastfeed safely, that I am against breastfeeding or want mothers to feel like exclusive breastfeeding is unsafe. That couldn’t be further from the truth.

Clearly if a mother has enough breast milk, exclusive breastfeeding is a wonderful way to feed her child, if that’s how she chooses to feed them. But I had to learn the hard way that being a good mother is not defined by exclusive breastfeeding.

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Q&A: One Nurse’s View on Strict Breastfeeding Policies

Jody Segrave-Daly, our co-founder and the pro-mom advocate known as “The Momivist” regularly interviews nurses about their view and experiences, working with strict breastfeeding-only policies. Here is an excellently informative interview with a nurse we’ll call Sarah, as she’s asked we keep her name and hospital anonymous. 

Jody Segrave-Daly, AKA The Momivist: What are the most common encounters that you see with breastfed babies in the first 48 hours of life,  in your hospital, which has strict breastfeeding policies?

Sarah, RN at Hospital with Strict Breastfeeding Policies: I’ll start with the positive. One thing I really like about hospitals that have these policies, such as the Baby Friendly Hospital Initiative, is the emphasis on skin-to-skin after delivery. Instead of baby immediately being taken to a warmer, baby is placed on mom’s chest. Mothers seem to really enjoy this immediate contact with their babies, babies’ vital signs tend to stabilize better, and breastfeeding is encouraged in the first hour after birth (if baby shows interest). Continue reading