How Breastfeeding Enhances Mother-Child Bonding

Photo by Dao Hodac

Scientists have long known that the mother's brain is flooded with oxytocin when breastfeeding. But until recently, they had been puzzled as to how enough oxytocin was produced to alter the mother's moods. Now they know.

A study published on July 18, 2008 at the Public Library of Science Computational Biology found that breastfeeding mobilizes more than the usual brain cells that secrete oxytocin. Breastfeeding puts dendrites to work as well to secrete oxytocin.

Oxytocin, which is also secreted during labor and sexual intercourse, is also known as the "love hormone". It increases feelings of trust, relaxation and love. It has a sedative effect. No wonder many women report feeling drowsy while breastfeeding.

Breastfeeding also fosters closeness between mother and child in other ways. It enables Mommy and baby to have more physical and skin-to-skin contact. Mothers and babies gaze into each other's eyes for extended periods of time while breastfeeding. Mothers also tend to interact in other ways with their babies when breastfeeding.

In contrast, bottle-fed babies can easily be passed on to other people to be fed -- making it easier for Mom to be separated from baby - and worse be fed without any human contact at all, through a bottle prop.

While breastfeeding has been shown in several studies to help immensely with mother-child bonding, it is not a necessary condition for bonding to occur. However, those who bottle feed can and should take the following lessons from breastfeeding to foster a stronger bond with their children:

• be attentive to your child's cues and respond to them promptly
• seek ways to be physically close and affectionate to your child in appropriate ways
  
• make plenty of eye contact with your child
• spend time with your child
• relax and trust in your ability to be a good mother to your child

Resources:

PLOS Computation Biology, July 2008

The Benefits of Extended Breastfeeding

Photo by Alexander Tundakov

Now that my nursling is almost 2 years old, I raise many eyebrows whenever I raise my blouse to breastfeed. Family and friends have begun to say, "Oh, you're still breastfeeding him?" implying that I should stop already.

This just shows that lay people do not know the benefits of breastfeeding into toddlerhood, also known as "extended breastfeeding".

My own reasons for continuing to breastfeed are quite unscientific. I like being able to comfort Anton easily when he's hurt, cranky or ill. I also think it's great that I can put him to sleep without having to carry him; in fact, I can lie down and doze off myself.

On the other hand, scientific research reveals many benefits of breastfeeding a toddler, such as:

• Protection From Diseases

Breastmilk continues to provide antibodies against the diseases that the mother has been or is exposed to. As a result, toddlers who are still breastfeeding get sick less often and for shorter periods than their non-nursing peers.

(Goldman AS et al. Immunologic components in human milk during weaning. Acta Paediatr Scand. 1983 Jan;72(1):133-4; Goldman AS, Goldblum RM, Garza C. Immunologic components in human milk during the second year of lactation. Acta Paediatr Scand. 1983 May;72(3):461-2; Gulick EE. The effects of breastfeeding on toddler health. Pediatr Nurs. 1986 Jan-Feb;12(1):51-4)

• Increased Protection Against Allergies

Children who were breastfed longer had lower incidence of respiratory allergy than children who were breastfed for a shorter duration or not at all.

(Saarinen UM, Kajosarri M. Breastfeeding as a Prophylactic Against Atopic Disease: Prospective follow-up Study until 17 years old, Lancet 346:1065-1069, 1995.)

• Higher Intelligence

Studies have shown that children and adults who were breastfed perform better than those who were not breastfed. However, even among those who were breastfed, those who were breastfed for longer durations outperformed those who were breastfed for a shorter period.

(Mortenson EL, MIchaelsen KF, Sanders SA, Reeinisch JM. The association between duration of breastfeeding and adult intelligence. Journal of the American Medical Association 2002;287:2365-2371; and Daniels M C, Adair L S. Breast-feeding influences cognitive development of Filipino children. J Nutr. 135: 2589-2595, 2005)

• Nature

Anthropologist Katherine Detttwyler notes that the normal duration of breastfeeding among primates ranges from 2.5 to 7 years.

(Dettwyler, Katherine PhD. A time to wean. Breastfeeding Abstracts. 14,1: 3-4. 1994)


Clearly, when it comes to breastfeeding, longer is better! So why do health caregivers and breastfeeding advocates have a difficult time getting mothers to adhere to the minimum recommendation of breastfeeding for one year?

In contrast, milk companies have convinced the public that children need to be drinking formula even after they've started school. Even though the science fully backs extended breastfeeding, it is the milk companies that are touting outrageous unsubstantiated benefits for their follow-on formulas and growing-up milks.

What can we learn from milk companies so that more children will enjoy the benefits of extended breastfeeding?

Parents Sue Bottle Companies Over BPA

Photo by Hey Paul

Parents Begin Taking Action Over BPA in Feeding Bottles

When news that the chemical bisphenol A (BPA) could harm children broke out, we knew it was only a matter of time before parents would take action. Four Ohio parents have sued five baby bottle companies for using BPA even though the companies were aware of its possible danger to children.

In late 2007, a US panel of experts concluded that BPA could pose some risks to developing fetuses and children. The risks include birth defects and developmental problems. The chemical is used in making feeding bottles and sippy cups.

Unfortunately, this issue is little known in developing countries like the Philippines, where a growing number of children are bottle-fed. Formula-feeders as well as those who give expressed breastmilk in bottles should be concerned about their children's exposure to BPA. (Since BPA is also used in DVDs, food cans and other products, all of us are exposed)

The Filipino mothers who are knowledgeable about the issue are upper-middle income women who get information from the Internet and foreign sources. They have told me that the issue of BPA has not figured in Philippine media at all.

Because of their concern, some mothers are switching to glass bottles, which are more expensive. One mother said her family doctor has advised that, when the child is 1 year or older, the feeding bottles no longer have to be sterilized (thanks to formula companies marketing milk for older children, many families in the Philippines continue giving formula to their children well into their school-age years). Not sterilizing is supposed to lessen the exposure to BPA since the chemical apparently leeches at high temperatures.

This is like exchanging one danger for another. Microorganisms multiply rapidly in baby bottles and artificial nipples, even when these have been sterilized.

Unfortunately, in the Philippines (and possibly other countries as well), even health professionals are ill-informed to give the best advice to parents of infants. And the lack of correct information and inadequate support for breastfeeding are causing well-intentioned parents to unwittingly expose their children to danger.

Related article:

BPA: Yet Another Concern for Formula Feeders
Baby Bottle Makers Sued Over Bisphenol A Use

Letter to the Editor of Inquirer

I sent this letter to the Inquirer on June 1, 2008 after seeing a photo of a bottle-feeding child on the paper's online gallery. For copyright reasons, I am hesitant to post the picture and caption here.


Dear Editor,

I was shocked and dismayed by the photo you chose to accompany a piece on "Walk the World" campaign (Walk the World, photo by AFP/Jay Directo).

After all, the Inquirer supported the stricter implementation of the National Code on the Marketing of Breastmilk Substitutes and is a Hall of Fame Awardee for Child-Friendly Newspaper given by the Philippine Press Institute and Asian Institute of Journalism. And yet you didn't see the irony in showing a bottle feeding child beside an article about world hunger.

How anybody could consider infant formula as adequate nutrition for children is mind-boggling. Infant formula has nutrients with dubious bio-availability, is devoid of antibodies, increases children's risks for diseases until adulthood, and prevents children from attaining their full cognitive potential -- all the while burning big holes in the pockets of the masses.

Indeed, children receiving infant formula are experiencing a form of hunger. They will never be the healthiest, strongest and smartest persons that they could possibly be.


Yours truly,
Alexis Rodrigo
(former UNICEF staff)
Windsor, Ontario

New labeling guidelines give milk companies an "escape clause"

Photo by tigerpuppala_2

The Philippines Department of Health has issued new guidelines for the labeling of infant formula and other breastmilk substitutes. This, following the approval by the Supreme Court of the revised implementing rules and regulations of EO 51, or the Milk Code.

It would be refreshing to look at cans of powdered infant formula and no longer see health and nutrition claims, which the guidelines now prohibit.

However, it is mind-boggling that the Health Department allowed an alternative message regarding the existence of disease-causing microorganisms in powdered formula. Thus, milk companies must put either this message:

"This product may contain pathogenic microorganisms and must be prepared and used appropriately."

or this message:

"There is likelihood that pathogenic microorganisms will be in this product when it is prepared and used inappropriately."

Which message do you think the milk companies will use?

The first version warns about the possible presence of pathogenic microorganisms regardless of how the product is prepared. The second version attributes the presence of pathogenic microorganisms to wrong preparation and use of the product. Therefore, if pathogenic microorganisms should be found in infant formula, then it is the customer's fault for not following directions.

Disease-causing germs have been found in powdered infant formula because it is impossible to completely sterilize powdered formula. So it can have pathogenic microorganisms even before the can is even opened by the consumer. This is a crucial message that all potential and existing buyers of powdered formula should be aware of.

DOH should remove the alternate message and require milk companies to clearly state that their products are not sterile and could contain bacteria and other microorganisms - substances that could lead to babies' sickness or even death.

Breastfeeding ensures survival in a disaster

The breastfeeding world is abuzz with news of a police officer in China who is wet-nursing eight babies, five of them orphaned by the recent earthquake.

Read the story here or here.

Once again, breastfeeding has been proven to save the lives of infants in the aftermath of a disaster.

It bothers me that both news accounts say that the babies were left in an institution that did not have powdered milk, as if that were the more ideal situation. In fact, the use of powdered milk -- in ordinary life but even moreso in a disaster situation -- could be deadly to infants. Imagine the risks involved in feeding powdered milk to babies when clean water is scarce, hygiene is poor and diseases abound! It would be next to impossible to sterilize feeding bottles, artificial nipples and water.

This is why UNICEF and WHO have released a statement stating, "there should be no donations of breast milk substitutes (BMS), such as infant formula, other milk products, bottle-fed complementary foods represented for use in children up to 2 years of age, complementary foods, juices, teas represented for use in infants under six months; and bottles and teats."

The most ideal situation is for infants to be breastfed either by their own mothers or other mothers, such as what Jiang Xiaojuan is doing in China. Unfortunately, the practice of wet-nursing has all but disappeared in many cultures, including rural Philippines. Most people find it weirder for a child to suckle from another woman than from a plastic bottle!

Breastfeeding women who have been traumatized by disaster should receive counseling so that they can resume breastfeeding. But I wonder, how many health and social workers are trained to provide such counseling?

Even if the breastfeeding mother is malnourished and dehydrated, she can still breastfeed. In that case, the mother needs to receive adequate food; it is not necessary to give artificial milk to her baby to make up for the mother's inadequate nutrition.

If artificial feeding is necessary, UNICEF and WHO say that liquid ready-to-use infant formula is the most appropriate, and should be given with a cup and spoon, not bottles and nipples.

Download the official UNICEF and WHO statement here.

Another study shows breastfeeding and IQ link

Image by flikr

A study published this month in the Archives of General Psychiatry once again shows the link between breastfeeding and higher IQ.

Hailed as the largest ever randomized trial conducted on lactation, the Promotion of Breastfeeding Intervention Trial (PROBIT) Study found that exclusive and prolonged breastfeeding were associated with higher IQ and teachers' ratings in children 6.5 years old. The study was conducted among 17,046 healthy breast-feeding infants in 31 Belarussian maternity hospitals and their affiliated polyclinics.

The experimental group was subjected to a breastfeeding promotion programme modeled on the Baby-friendly Hospital Initiative of WHO and UNICEF, while the control group was subjected to usual hospital/clinic practices. Those in the experimental group were nearly seven times more likely than the control group to still be exclusively breastfeeding at 3 months (43.3% for the experimental group vs. 6.4% for the control group), and were more likety to be breastfeeding at any age up to 12 months.

When followed up 6.5 years later, the experimental group had higher "means on all of the Wechsler Abbreviated Scales of Intelligence measures for verbal IQ, performance IQ, and full-scale IQ. Teachers' academic ratings were significantly higher in the experimental group for both reading and writing.

The authors concluded that, "These results ... provide strong evidence that prolonged and exclusive breastfeeding improves children's cognitive development."

Click here to read the abstract of the study.

For more on the superiority of breastfeeding vs. formula feeding:

Long-term effects of breastfeeding
A neonatologist tells why to breastfeed
Breastfeed/be breastfed to prevent cancer

BPA: Yet another concern for formula feeders

Is this baby getting harmed too?
Photo by Orin Optiglot

Walking along the aisles of my local pharmacy in Windsor, Ontario, a sign caught my eye. It said that all baby bottles containing bisphenol A (BPA) had been voluntarily removed from store shelves. I got so excited that I just had to drag my husband over to see the sign. I couldn't believe it: BPA containing baby bottles had been voluntarily removed from Canadian shelves when, in the Philippines, concerns over BPA have been ignored.

Breastfeeding advocates in the Philippines have been raising the alarm on BPA for the past few years, not months. And yet the Filipino public remains largely ignorant of BPA's dangers and retailers, no everybody else, just haven't shown any care at all.

BPA is a chemical found in hard plastic. It's not just in feeding bottles and sippy cups, but in many household items such as water bottles, CDs, DVDs and even dental sealants. According to an article in The Milwaukee Journal Sentinel, 93% of Americans tested had BPA in their urine.

Studies have linked BPA to breast cancer, testicular cancer, diabetes and hyperactivity in laboratory animals. However, the US Food and Drug Administration approved its use in manufacturing. Because of an investigation by Michigan congressmen, it was found that the FDA relied on only two studies to determine the safety of BPA -- both of which were funded by the Society of the Plastics Industry. One study had never been published; the other was criticized for being flawed.

Fortunately for residents of Canada, the Canadian government is poised to pronounce BPA as a toxic chemical and to ban it from the manufacture of baby feeding bottles and infant formula cans. In the meantime, the stores have begun removing the questionable products from their shelves.

However, even in Canada, the whole discussion about BPA has been disconnected from the issue of breastfeeding. BPA is not only a health problem or an environment problem. It demonstrates the increased risk of exposure to contaminants for babies who are formula-fed. Breastfed babies who receive expressed breastmilk in plastic feeding bottles are at an increased risk, too. The photo of Canadian Health Minister John Baird giving out BPA-free feeding bottles shows how the dangers of bottle-feeding seems to have been forgotten in this discourse.

Having never used feeding bottles for my third child, my husband and I breathed a sigh of relief. However, we do use sippy cups. Because I just recently bought them in Canada, I can be confident that the ones we're using don't have BPA. But now I'm starting to get suspicious of plastics in general, so I have ordered stainless steel water bottles for all my children, including the two who are already in school.

7 ways fathers can support breastfeeding

Photo by *clairity*

Arugaan, one of the leading NGO advocates for breastfeeding in the Philippines, recently organised a father's support summit. This inspired me to reflect on my own husband's role in supporting me to breastfeed our three children.

Here are the seven ways my husband supports breastfeeding:

1. He supported my natural childbirths. I decided early on to have drug-free, natural childbirths -- which means that I needed DH (darling husband) to be my labor coach and advocate. While he turned pale the first time he watched a childbirth video, he was a real trooper when it came to the real thing. He breathed with me, gave me massages, walked hospital halls with me, discussed options with me, held my hand when I pushed, and supported my weight when I squatted.

Having a natural birth meant that both my baby and I were fully conscious and alert right after birth, and I was able to bring baby to the breast right away.

2. He allowed me to room in with our babies. When I first gave birth 13 years ago, rooming in was almost unheard of and the resident pediatrician was hesitant to allow us. There was a hint of threat when she said that we would need to sign a waiver that the hospital was no longer responsible for whatever happened to the baby if we insisted on rooming in. It didn't help that we were completely unprepared for the birth and our newborn didn't have any clothes yet (everybody said primie's arrive late!). I almost gave in. DH looked me in the eye and said, "What will happen if our baby goes to the nursery?" "They might give her a bottle," I replied. Without further ado, DH told the doctor that we were rooming in.

Rooming in helps mother and baby get a good start in breastfeeding by allowing unlimited opportunities to breastfeed. Babies in nurseries can only be breastfed at set times, which often do not coincide with a baby's hunger. The end result is that many babies receive a bottles of formula and/or glucose water in the nursery and get soothed with a pacifier.

3. He took over caring for our older children. When you have two or more children, there's always somebody else demanding your attention away from the newborn baby. DH helped by taking over some of the child care tasks, such as reading bedtime stories and tucking older children into bed. He made sure our naps were undisturbed. I could focus on the new baby for at least a few weeks.

A mother and baby need time to settle into a good breastfeeding routine. Each baby is different, so even if a mother has breastfed in the past, she'll still need time to adjust to a new baby. It helps if the mother is allowed to rest, recover from the birth, and have plenty of time alone with the new baby.

4. He woke up in the middle of the night to take care of the baby. Breastfed babies rarely need any attention at night, except to latch onto the breast. Because of this, I got pretty spoiled and didn't want to get up from bed at all. Therefore, DH had to change the baby's diaper at night and -- if the baby happened to be in a playful rather than sleepy mood at 2 am -- take over baby duties and bring baby back into bed to me when asleep. Some women feel sorry for their spouses who are at work during the daytime. However, mother, father and baby all benefit from father's night time involvement.

Mothers need plenty of rest especially right after childbirth. Lack of sleep can interfere with a good breastmilk supply. By getting up with the baby, DH allowed me to catch as much sleep as I could. It was also a wonderful opportunity for him to bond with the baby. Besides, a Mom is also at work during the daytime even if she stays home!

5. He is proud when I breastfed in public. I am more embarrassed than DH about breastfeeding in public. He believes I should do it more often to encourage more women to breastfeed. I am always willing to breastfeed my child (now 17 months old) whenever and wherever he wants to nurse, but of course, I would never want to expose myself. DH also comes in handy when I need something to shield me from curious eyes for a few seconds.

Women need support to breastfeed in public. Some women give a bottle when outside just to avoid this! Others give up breastfeeding altogether because they cannot overcome the embarrassment. If DH is not embarrassed, and is even proud, that his wife is breastfeeding, then the woman will have the confidence to breastfeed in public.

6. He never questioned my purchase of breastfeeding supplies and gadgets. Breastfeeding is supposed to be free, and it is, except for the cost of food for the mother and the value of her time. But if you're like me, you'll also want the best breast pumps, both manual and electric, a battery pack for the electric breastpump, fashionable breastfeeding clothes, five kinds of slings, breastfeeding pillows, breastfeeding books, malunggay pills, and other breastfeeding gadgets and tools. DH never once complained about my obsession and its cost.

These breastfeeding-related products are not essential to a successful breastfeeding relationship, but they do help. They make breastfeeding easier, more pleasant and more convenient. Anything that will keep a woman breastfeeding is well worth its price.

7. He promotes breastfeeding to everyone he knows. DH can sometimes be more militant than I am about breastfeeding. He tells every woman he knows who is pregnant or has recently given birth that they should breastfeed. And if they've stopped, he tells them to relactate. He tells other fathers to encourage their wives to breastfeed, too.

People need to know that fathers also care about breastfeeding. Breastfeeding is not just something that hormone-crazed mothers go around telling other women to do. Fathers also benefit when mothers and children breastfeed successfully. They have a happier and healthier family, and the economic benefits are significant to any breadwinner (unless he happens to be married to me).

Kudos to all the men out there, fathers or not, who support and protect breastfeeding!

DHA and ARA in infant formula may be unsafe

Photo: Ancient Chemistry Set by Vortistic

A recent report from the Cornucopia Institute questioned the safety of DHA and ARA in infant formula. According to the report, infant formula with these additives have been linked to side effects including diarrhea, flatulence, jaundice and apnea.

DHA and ARA are fatty acids that are naturally present in human breastmilk. They are essential for the normal growth and development of infants.

The problem is, the form of DHA and ARA added in infant formula are not identical to what's in human breastmilk.

According to the report, the DHA and ARA additives are extracted from fermented algae and fungus with the use of hexane, a neurotoxic chemical. Furthermore, the laboratory-produced oils are only 40-50 per cent DHA and ARA. The rest of the oils is made up of sunflower oil, diglycerides, and nonsaponifiable materials -- some of these are not present in human breastmilk and are not meant to be consumed by human infants!

Ironically, milk companies are marketing DHA- and ARA-supplemented formula as "designer" infant formulas and many mothers, even doctors, are falling for it!

It is just another marketing gimmick from milk companies.

You can read the full report here:

http://cornucopia.org/index.php/replacing-mother-infant-formula-report/

Despite Wyeth's claims, addition of lutein is questionable

Photo: "Through a child's eye" by DownTown Pictures

Beginning around the time that the Supreme Court released its ruling on the Revised Implementing Rules and Regulations of the Philippines Milk Code, Wyeth launched a massive campaign to promote its milk supplement with lutein. Wyeth's advertising and other promotional and marketing materials have emphasized the addition of a substance called "lutein" and claim that this enhances the visual development of children -- a claim that is in violation of the Supreme Court's ruling.

Perhaps many parents are falling for these claims. What they do not know is that the New Zealand Food Safety Authority (NZFSA) has concluded that the addition of lutein in infant formula and follow-on formula is not justified.

In a document entitled, "Application A594 - Addition of Lutein as a Nutritive Substance to Infant Formula and Follow-on Formula - Draft Assessment Report" dated 13 November 2007, NZFSA made the following points:

The evidence is not sufficient that milk companies should be allowed to add lutein for eye health.

The data presented is insufficient and presents a high level of uncertainty. Moreover, most of the data presented were from research conducted by the milk company itself and have neither been published nor subjected to peer review.

The proposed levels (amount) of lutein to be added does not have any sound basis in science.

The proposed maximum levels of 250ug/L in infant formula and 500ug/L in follow-on formula do not have any sound basis in science. These levels are much higher than what is present in human breastmilk. Manufacturers did not consider bioavailability and the instability of lutein, which would lead to reductions in lutein content due to storage and time. NZFSA is concerned that this might lead to overdosing to make up for the losses.

The addition of lutein cannot be claimed anywhere on the label.

The NZFSA recommends that the only reference to the addition of lutein is in the ingredient list and the nutrition information panel." Like the Philippines, New Zealand law prohibits nutrition, health and related claims in infant formula products.

The analysis that the NZFSA made to assess the addition of lutein shows the kind of scientific rigour that the Department of Health needs to exercise to properly implement the Milk Code.

Based on their actions, milk companies are not concerned with clear eyesight. They are, rather, clouding our vision.

Presidential pronouncements on breastfeeding

Here's a report from Alex Iellamo of WHO Western Pacific Regional Office, from a recent conference on Infant and Young Child Feeding:

We are glad to inform you that on December 17 almost 300 Chiefs and Hospital Directors have gather in Manila Hotel to express their support to the Infant and Young Child Feeding Program of the Government.

The event was graced by the Secretary of Health, but the highlight of the day was the presence, and the strong message of support of the President of the Philippines, her Excellency Gloria Macapagal Arroyo.

The President, in her keynote message, highlighted the following:
A) Breastfeeding as a fundamental strategy, to eliminate hunger and reduce child mortality in the Country;
B) That there is no "Substitute" for Mother's Milk…(In reiteration of what the Supreme Court of The Philippines, had also affirmed last October 9, in the final resolution of the Milk Code Case)
C) That with the Supreme Court upholding 56 out of 59 of the new provisions of the RIRR of the Milk Code, its time for all hospitals to support and contribute to the improvement of the Infant and Young Child Feeding Program of the Country…upholding the Milk Code of the Philippines and the Mother Baby Friendly Initiative of the Government

The President repeatedly stated in her message, that this Program should be tagged as the "Healthy Start Program…"

During the event, our Regional Director, Dr. Soe, presented the latest available scientific evidence in support of Breastfeeding, and the presentation was highly appreciated, in fact most of the participants as well as the other resource speakers requested for immedicate copies.

The year 2007 is ending with another important milestone for the IYCF Program, and for Child Survival in The Philippines. This is just a week after the Launching of the Philippines Child Survival Strategy, and now we have the President of the Republic, that reaffirms the importance of Breastfeeding, for the filipino children and the future of whole Country…

With this note, I wish to all of you a wonderful Christmas Season and a happy New Year

Alex

Photo @UNICEF/PHI/2007/J Bondoc