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In The News:

Q: I've heard on tv that there can be risks to not giving solids earlier than 6 months. Is this true?

A: This was a report of a look at just a few older studies, and was never meant to be spun in the media the way it was. You can read the disclaimer from the authors here: http://www.gosh.nhs.uk/pressoffice/pressrelease_00899.

Looking at ALL the research and especially newer studies, breastfeeding exclusively (ONLY breastfeeding or expressed breastmilk) for the first 6 months of life is strongly supported. Adding formula or solid foods to baby's diet only has disadvantages before this.

A baby is truly ready for other foods when they can sit, pick up the food, and get it to their own mouth. When starting solids, babies should breastfeed first, because human milk is still their most important food until at least a year of age. After one year, babies can breastfeed at some feedings and have solid foods and a cup of water at other meals.

Here's the response from the World Health Organization:

"WHO's global public health recommendation is for infants to be exclusively breastfed for the first 6 months of life to achieve optimal growth, development and health. Thereafter, infants should be given nutritious complementary foods and continue breastfeeding up to the age of 2 years or beyond.

WHO closely follows new research findings in this area and has a process for periodically re-examining recommendations. Systematic reviews accompanied by an assessment of the quality of evidence are used to review guidelines in a process that is designed to ensure that the recommendations are based on the best available evidence and free from conflicts of interest.

The paper in this week's BMJ is not the result of a systematic review. The latest systematic review on this issue available in the Cochrane Library was published in 2009 ("Optimal duration of exclusive breastfeeding (Review)", Kramer MS, Kakuma R. The Cochrane Library 2009, Issue 4). It included studies in developed and developing countries and its findings are supportive of the current WHO recommendations. It found that the results of two controlled trials and 18 other studies suggest that exclusive breastfeeding (which means that the infant should have only breast milk, and no other foods or liquids) for 6 months has several advantages over exclusive breastfeeding for 3-4 months followed by mixed breastfeeding. These advantages include a lower risk of gastrointestinal infection for the baby, more rapid maternal weight loss after birth, and delayed return of menstrual periods. No reduced risks of other infections or of allergic diseases have been demonstrated. No adverse effects on growth have been documented with exclusive breastfeeding for 6 months, but a reduced level of iron has been observed in developing-country settings.

Randa Saadeh "


For Mothers:

Q: "Why does my newborn nurse so often?"

A: The first weeks of breastfeeding are the "market research phase". The more milk your baby drinks, the bigger the milk factory your body builds. Feedings should last less than forty-five minutes. If feedings are longer, and your baby seems unhappy, see a lactation consultant. Short, frequent feedings are perfectly normal.


Q: "Can my baby breastfeed when I am sick?"

A: It's important to keep breastfeeding during an illness, with very few exceptions. It takes several days to weeks to get sick once you get a germ. The baby has already been exposed to the germ by the time you get symptoms. Your milk will have antibodies to the germ. If you have one of the rare illnesses that require your baby to be separated from you, you can usually keep providing your milk.


Q: "What if I need to take medicine?"

A: Many medicines are very low risk for breastfeeding babies. Lactation consultants have access to scientific information about the safety of medicines during breastfeeding (see: Other Resources) The Physician's Desk Reference (PDR) is not a good source of information about the safety of drugs for breastfed babies.


Q: "I was told to feed my baby every 3 (or 4) hours. Is this true?"

A: New research shows that the more often a baby breastfeeds in the first few days and weeks after birth, the more milk the mother makes. Some mothers can make enough milk when they feed on a schedule, but many cannot. A baby's stomach is the size of his fist, so he needs to eat often to grow well.


Q: "I was told that breastfeeding for too long causes sore nipples. Is this true?"

A: If the baby latches and sucks right, breastfeeding is comfortable. If breastfeeding hurts, get help right away.


Q: "If I'm having trouble breastfeeding, can I just pump?"

A: Of course this is an option if your baby cannot breastfeed. Human milk is very important for babies, and the process of making milk is good for mothers, helping protect them from cancers and weak bones later in life. Direct breastfeeding is worth working for, though. Breastfeeding helps mothers to bond with their babies and to be calmer under stress. Babies who are only bottle fed have more chance of speech problems, lower lung capacity, and more need for braces than those who feed at the breast. New research shows that baby's saliva enters the breast and helps the mother meet the baby's needs for immune protection. If you are exclusively pumping, letting your baby lick or mouth your nipple every day may help this communication happen.


Q: "I don't really need a lactation consultant, just a little support. Where can I go?"

A: La Leche League is the most well known mother to mother support group. Queens County, NYC has several meetings each month. Pregnant moms and breastfeeding moms are welcome - it can be found here. Queens mothers also have access to an email group to communicate about mothering and breastfeeding - it can be found here.Queens mother can also access their facebook group here.


For Fathers:

Q: "How can I be involved?"

A: Fathers are very important in a baby's life. Babies who have fathers who care for them daily (holding, bathing, carrying, playing, changing) are more likely to do well in school, have happier relationships, and more satisfying work lives. You might feel a little sad at first that you don't make milk. Thatís okay. You teach your baby that love doesn't have to come with food. Dads usually play with baby in a more exciting way than others do, wooing their baby into a special relationship. It's best for children if their parents work as a team to give the baby the best mothering and fathering possible.


Q: Iím worried that our baby isn't getting enough milk. How do I tell?

A: Babies who are getting enough milk have lots of wet and dirty diapers. They are happy and relaxed after feeding, and they wake up often to breastfeed.


Q: How much will my baby sleep?"

A: At first, one 3-6 hour stretch of sleep is normal. Many babies and toddlers wake up several times a night to breastfeed. Despite this, research shows that mothers who only breastfeed get more sleep than those who bottle feed. Encourage her to rest during baby's naps.


Q: What if I smoke?

A: Exposure to second hand smoke triples your baby's chance of getting lung cancer in his life. It can also cause asthma, pneumonia, and sudden infant death syndrome (SIDS). If you smoke, smoke outside the house, change your clothes and wash your face and hands when you return. The baby should not sleep in the same bed or room as a parent who smokes. Having a parent who smokes is the greatest risk factor for SIDS.


For Grandparents:

Q: They're going to spoil that baby!

A: Previous generations were told that babies should not be held or fed often. New research shows that "babying" the baby now helps the baby grow up to be more confident and independent later.


Q: Won't frequent feeding make the baby fat?

A: Breastfed babies usually grow very fast in the first few months, and then slow down. Scientists have learned that mothers who breastfeed on demand, and let the baby control when and how much to eat, raise children who are less likely to be overweight. Parents should control what is offered to the baby. For the first 6 months, babies only need mom's milk. After that, they can be offered small bits of fruits, vegetables, beans, meats, and grains. After one year potentially allergenic foods like eggs, fish and animal milks (cheese, yogurt) can be offered. Breastfed toddlers should get most of their "dairy" foods from mom.



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