New Emojis to Include Breastfeeding, by To-wen Tseng

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The emoji lexicon is one that continues to grow month after month, year after year. Once little more than a collection of smiley faces and a few symbols, now the emojipedia is set to grow bigger and more inclusive, and the emoji-powers-that-be at Unicode seem to have their finger on the pulse of the world’s zeitgeist with the latest additions.

Many symbols of social progress were approved to be added to the official line up during the 149th meeting of Unicode Consortium, the international group that regulates emojis. The consortium signed off on 56 new symbols as part of an effort to make emojis more representative of a wide and diverse base.

The list will take the total number of the cartoon images, which are increasingly being used to replace words in text messages, to 1,724. In the digital times, the adding of new emoji has kind of become like adding a new word to our language. The new adding of “words” are based on proposals submitted to the consortium over the past year and one big standout emoji was “Woman Breastfeeding Baby.”

Also included in the new list, Unicode 10, are emojis featuring a woman wearing a hijab and a person practicing yoga.

The mix will be added to the collection in 2017. The inclusion of breastfeeding emoji was welcomed on Twitter as a triumph of normalizing breastfeeding. Considering the problems Facebook users have experienced when it comes to posting pictures of breastfeeding, it is good to see the emoji being received in the wider world.

Bustle: The New Breastfeeding Emoji Will Help Stamp Out Any Stigma That’s Left
— USBC (@USbreastfeeding) November 22, 2016

There’s now a breastfeeding woman emoji. 💪 💪
— Glamour (@glamourmag) November 23, 2016

A #breastfeeding emoji is finally on its way!
— To-Wen Tseng (@twtseng) November 23, 2016

Rachel W. Lee, a registered nurse and medial equipment trainer at University of College of London Hospital, submitted the breastfeeding emoji for approval.

“The lack of a breastfeeding emoji represents a gap in the Unicode Standard given the prevalence of breastfeeding in cultures around the world, and through history,” she wrote. Her proposal for the breastfeeding emoji pointed out that “three million mothers participate in the activity of breastfeeding in the United States at any given time,” and that the baby bottle ranks in the top 50% of emojis used on emojitracker.com.

Earlier this year, Google revealed a series of new emojis in an effort to better represent gender equality. It’s a comfort that a breastfeeding emoji comes out at a time when the President-elect of the United States calls breastfeeding “disgusting.” “In dark times, we can always use more emoji,” the Ringer reported.

Among the Unicode Consortium members who get to vote on emoji standards are Apple, Google, Microsofr, Huawei, Facebook and Adobe. The Government of India is also a voting member.

Despite their approval, emoji take some time to roll out to smartphones. Android N was the first OS to support Unicode 9; all of the latest emoji from Unicode 9 was found in Android 7.0 this May. Those using iOS just saw Unicode 9 this month in the iOS 10.2 Public Beta. New emoji are typically released on phones with a new version of the phone’s operating system, often quite some time from when they’re initially approved. But as it says: baby steps!

leonardbrunoNew Emojis to Include Breastfeeding, by To-wen Tseng
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Allergic Proctocolitis in the Exclusively Breastfed Infant

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Can food protein induced allergy happens to exclusively breastfed infants? The answer is yes, according to Dr. Eyla Boies (MD, FABM, FAAP), a clinical professor of pediatrics at UCSD. Many confuse allergy with Tolerance. There is a difference. A true food allergy causes an immune system reaction that affects numerous organs in the body. It can cause a range of symptoms. In some cases, an allergic reaction to food can be severe and even life-threatening. In contrast, food intolerance symptoms are generally less serious and often limited to digestive problems. The most common foods implicated in food allergies in breastfed infants include cow’s milk, egg, soy, wheat, peanuts, tree nuts, fish, shellfish, sesame seeds, and corn. Other common foods include pork, tomatoes, onions, cabbage and berries. Cow’s Milk Protein (CMP) is the most common food allergens in young children, with 2% of children under four years old allergic to CMP. The severity of a food reaction is generally related to the degree of baby’s sensitivity. Meanwhile, cow’s milk allergy is uncommon in adults; less than 0.5% of adults are allergic to CMP. Food protein can induce Enterocolits, Protocolitis and Enteropathy. When Food Protein Induced Enterocolitis and Enteropathy happen, there will be an acute vomiting pallor one to four hours after food ingestion, and a chronic moderate to severe bloody stools with chronic diarrhea. Both diseases are rare in breastfed infant: currently there are only 14 cases in the literature. Breastfeeding is likely to protect babies from them. Food Protein Induced Prctocolitis is considered a milder form of the spectrum of food induced allergy. It seen to be more often in breastfed infants (less than 60%) whose mothers are consuming cow’s milk, sometimes soy or egg, compared to formal fed infants. Food protein may also plays a role in Gastroesophageal reflux disease (GERD), colic and eczema. Colic may be a result of an allergy to make protein in formula-fed babies. Much more rarely, colic may be a reaction to specific foods in mom’s diet in breastfed babies. An 1983 study found that cow’s milk proteins can cause infantile colic in breastfed infants. Another 2005 study found that exclusion of allergic foods from the maternal diet was associated with a reduction in distressed behavior among breastfed infants with colic presenting in the first 6 weeks of life. Management plans for food protein allergies in the exclusively breastfed infant can be formulated. Dr. Boies recommends a careful history and exam including mother’s diet and medications and then elimination diet for the mother as with food protein induced proctocolitis. Dr. Boies al recommends counseling about nature course of colic and GERD, such as positioning including prone for period while awake, and less reliance on medications for GERD. The most important thing when treating GERD and colic is ensuring proper growth. While food protein induced allergy can happen to exclusively breastfed infants, breastfeeding plays an important role in the prevention of allergic diseases (AD). Overall, breastfeeding less than three months is not protect against the development of AD. A 2004 study found that exclusive breastfeeding for at least four month can lower incidence of CMP allergy until 18 months. But a more general long term impact of breastfeeding on food allergies remains to be determined. Kellymom provides a useful resource for mothers on dairy and other food sensitivities in breastfeeding babies, including how closely mother needs to watch what her eats, recognize possible signs of food allergy from normal baby fussiness, and find out what foods are most likely to be the problem. TO-WEN TSENG 曾多聞

Heidi Burke-PevneyAllergic Proctocolitis in the Exclusively Breastfed Infant
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Breastfeeding in public is a civil right—in California, and anywhere in America

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Recently in Georgia, a mom claimed deputy threatened to arrest her for being “offensive” by breastfeeding in a grocery store.

On Sunday, Savvy Shukla took to Facebook after a trip to Piggly Wiggly, a local grocery store in Muskogee County, Georgia, where the deputy told her she needed to cover up because someone might find her breastfeeding offensive.

Savvy said she told the deputy that Georgia law allows public breastfeeding, but the deputy said he could see her areola and that if someone else saw it, he would arrest her.

While most of us (the readers of SDCBC’s blog posts and myself) assume that everybody knows that breastfeeding in public is legal in our great country, apparently some people don’t. Breastfeeding-in-public harassment situations repeatedly hit moms everywhere in America, including here in San Diego.

A couple of years ago, Rebecca Garcia was harassed for breastfeeding her 8-month-old son in one of the courtrooms at the Chula Vista Courthouse. When her son started to fuss, the bailiff, Deputy Chong, approached to Rebecca and asked what she was doing. When Rebecca said she was breastfeeding, Deputy stated loudly in front of the entire courtroom, “You should be ashamed of yourself, it’s inappropriate, you need to leave and go outside, do that somewhere else private, it is illegal to breastfeed in court!”

Rebecca reported that, “I felt embarrassed and ashamed because of the way that the Deputy was staring me down.”

Fortunately, after contacting San Diego County Breastfeeding Coalition and filed a complaint to San Diego County Courts, Rebecca receives a formal, written apology for the action of Deputy Chong. And after the Georgian deputy reportedly threatens to arrest Savvy over breastfeeding at Piggly Wiggly, Muscogee County Sheriff defends the nursing mom and confirmed that public breastfeeding is legal in Georgia.

So what does the law actually say?

According to the Federal Public Breastfeeding Law, “Notwithstanding any other provision of law, a woman may breastfeed her child at any location in a Federal building or on Federal property, if the woman and her child are otherwise authorized to be present at the location.”

According to California Civil Code, section 43.3, “Notwithstanding any other provision of law, a mother may breastfeed her child in any location, public or private, except the private home or residence of another, where the mother and the child are otherwise authorized to be present.”

That says, a mother may breastfeed her child in any public space.

Yet mothers sill harassed for nursing in public. So what we can do?

There are several things you can do to make a difference.

  • Next time when you see a mother breastfeeding in public, please smile at her and show your support.
  • Learn about the laws in your state that protect the rights of mothers breastfeeding in public: United States Breastfeeding Laws at Nursing Freedom
  • When someone asks you to cover up in a store or restaurant, stay calm and breathe deeply. If the person is an employee of the establishment, you may ask, “Are you refusing to serve me because I am breastfeeding?” If the person respect your right, thank them and breastfeed on. IF they harass you, contact us here at San Diego County Breastfeeding Coalition. We are here to help. If you are not in San Diego county, call the Best for Babes NIP Harassment Hotline to report the incident: 1-855-NIP-FREE

Other resources:

California Breastfeeding Law Cards

Badass Breastfeeders Group

This is an original post for San Diego County Breastfeeding Coalition by To-wen Tseng. Photo credit to Tribune Media Wire.

Heidi Burke-PevneyBreastfeeding in public is a civil right—in California, and anywhere in America
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Doulas Supporting Breastfeeding

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A doula is a new mom’s BFF—breastfeeding friend. Why and how? Breastfeeding consultant and doula Leilani Wilde shared her insights at a recent San Diego County Breastfeeding Coalition general meeting.

A doula is a woman experienced in birth and/or postpartum care who provides emotional, physical, and informational support to the mother before, during, and after the birth.

A birth doula can play an important role in supporting mothers during labor, delivery, and initial breastfeeding at hospital, birth centers, or at home births. When a brand-new baby is placed on a new mom’s breast shortly after the birth, it’s often hard for the mom to believe that she really has anything to feed the baby. The baby often doesn’t latch on right away, either. Having a doula there can be a wonderful reassurance that there was nothing strange about mom and baby both being unsure how to get started.

“As a birth doula, my job is to reduce moms’ pain and offer comforting measures and support to them,” said Wilde. A doula has a lot to do at birth: eliminating stress and keeping moms relaxed; reducing the likelihood of interventions; supporting dads; helping new parents understand what the postpartum journey is like.

Wilde shard one technique that she often uses when providing one-on-one support throughout labor: acupressure points. “When assisting moms through labor, acupressure points can be used to help facilitate labor and help avoid interventions.”

Once the baby arrives,  a doula promotes on demand breastfeeding by assisting and observing mom and baby. First help mom recognize baby’s feeding cues, and then encourage frequent skin-to-skin that regulate body temperature and help baby seek out the nipple.

“Doulas never leave their side until the baby gets feed,” said Wilde. When a breastfeeding attempt failed, doula assures mom, supports her, and comforts her.

When breastfeeding finally happens—“The first latch is always magical!” said Wilde. Now the doula’s job is to teach mom how to recognize a good latch. Wilde pointed out that while doulas are not educated to the level as lactation consultants, they are trained and know the breastfeeding basics. They should also be able to recognize red flags indicating further evaluation, intervention, and possible referral.

Families may benefit from referral to a postpartum doula, this is especially true for new parents. Day one after giving birth is often a chaos—nurses are telling the mom things, doctors are telling the mom things, family members are telling the mom things—the mother may heard a lot information about breastfeeding but not absorbing them. In this case a postpartum doula can answer all the questions that families may have.

Imagine a young couple looking down on their precious newborn. Baby is here! Now what?

Now the doula steps in, teaches parents the opportunities to feed, the needs of the baby, and supports the family with encouragements, gives them the current information.

New moms don’t always have their moms or their in-laws nearby to help them. Doulas can “mother” the new mother by helping with the chores so the new moms can rest, or by empowering them so they can succeed and lean to trust their own natural instincts.

Even when new moms do have their moms or in-laws nearby, there is still a role for the doula. The grandmas may aren’t as current as the new parents would like them to be when it comes to taking care of the new baby. The new mother may getting a lot of education but not enough support from her in-laws. “Just listen,” said Wilde. “Moms always need someone to that is non-judgmental talk to.”

This is an original post for San Diego County Breastfeeding Coalition by To-wen Tseng

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Where California Ranks in Breastfeeding Rates

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When my son was born, I knew I wanted to at least try to nurse him. Although my mom did not breastfeed me—I was born in the era of “formula is best”—, it had been drilled into my head repeatedly throughout my pregnancy that “breast is best.”

That is the message apparently being resonating with many new mothers across the nation, as indicated in the latest edition of the U.S. Centers for Disease Control(CDC)’s annual Breastfeeding Report Card.

More than four out of five American mothers tried to nurse their babies at least once in 2013, the latest year of which data is available. But too many gave up breastfeeding too soon, according to the study recently released by the CDC. A number of factors drive the decision including a lack of resources and support, according to the study.

“High breastfeeding initiation rates show that most mothers in the U.S. want to breastfeed and are trying to do so. These rates suggest that mothers, in part, may not be getting the support they need, such as from healthcare providers, family members, and employers,” stated the CDC study. “The early postpartum period is a critical time for establishing and supporting breastfeeding.”

Breastfeeding supports a child’s growth and development, according to the guidelines by the American Academy of Pediatrics (AAP). And the U.S. Surgeon General’s Office notes the practice can prevent illness and reduce future health issues, including asthma and the risk of sudden infant death syndrome.

The CDC’s 2016 survey of breastfeeding rates in each state was released during National Breastfeeding Month in August.

The U.S. average is 81.1 percent of mothers breastfeeding at least once. The states with the highest breastfeeding initiation rates are Utah at 94.4 percent, Idaho at 92.9 percent and Oregan at 92.5 percent. California average is 90.2 percent.

The survey shows progress across the country. But, at six months, nearly half of all mothers surveyed had stopped breastfeeding altogether. And only 22.3 percent were exclusively breastfeeding at six months, as recommended by AAP.

In California, though, women tend to breastfeed longer than the average American mom.

Of mothers surveyed in California:
• 90.2 percent are breastfeeding at least once.
• 51.1 percent are breastfeeding exclusively at three months.
• 58.5 percent are breastfeeding at six months.
• 24.8 percent are breastfeeding exclusively at six months.
• 34.3 percent are breastfeeding at 12 months.
Those numbers are up compared to California’s results in the 2007 survey. At that time, 52.9 percent of mothers in the state were breastfeeding at six months and only 17.4 percent were breastfeeding exclusively. A total number of 83.8 percent of mothers had tried to nurse at least once, as compared to 2013’s 90.2 percent. Still, it didn’t meet the U.S. Department of Health and Human Service’s Healthy People 2020 goal of having 60.96 percent mothers continue breastfeeding at six months. Only 12 states in 2013 met the goal. The Healthy People 2020 plan is a 10-year national objective plan initiated in 2010 for improving the nation’s health.

The CDC hopes the state-by-state Breastfeeding Report Card will encourage all involved in the child’s first year to encourage mothers to breastfeed. The report goes beyond breastfeeding rates and looked at barriers to continued nursing. Sometimes it’s a lack of information and support provided to the moms at the hospital, sometimes it’s a lack of accommodations for moms to properly pump at work.

I overcame the odds and nursed past the 12-month benchmark. Breastfeeding was the right choice of nourishment for us, my child has only been sick for one time before turning two years old. Breastfeeding also brought us incredible bond of love, it always comforted my baby whenever he got hurt or scared. It’s the hope that moms can better achieve their breastfeeding goals with a more active support.

This is an original post for San Diego County Breastfeeding Coalition by To-wen Tseng.

Heidi Burke-PevneyWhere California Ranks in Breastfeeding Rates
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Breastfeeding and co-sleeping: A Biologic Imperative

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“Sleep like a baby” is a common expression, but what does it really mean?

According to Dr. James McKenna, an anthropology professor at University of Notre Dame and a world-recognized behavioral sleep expert, it means baby sleeps near the mother with frequent breastmilk delivery.

Then why parents in today’s industrialized world often believe that that solitary infant sleep is the norm?

At a recent World Breastfeeding Week MIni-Seminar sponsored by UCSD Medicine School and SDCBC, Dr. MeKenna discussed the historical and cultural circumstances that led to the assumption.

Until recent historic periods in the western world, no human ancestral or modern infant was ever separated from its caregiver. In the 1700s, Catholic Church in Europe banned bedsharing to help prevent infanticide among poor, starving mothers who confessed to “overlaying their babies” due to lack of birth control and the means to support a family.

Then In 1901, Marianna Wheeler, a superintendent of the Babies’ Hospital in New York, published a book “The Baby” and wrote, “The constant handling of an infant is not good for him. The less he is lifted, held and passed from one pair of hands to another, the better… The newborn infant should spend the greater portion of his life on the bed.”

American psychologist John Watson believed that no child could get too little affection, his psychological school of behaviorism had a huge influence on models of child development in the 1920s. He once said, “never hug or kiss your children…Never let them sit on your lap. If you must, kiss them once on the forehead when they say goodnight. Shake hands with them in the morning.”

“The Motherhood Book” published in 1935 claimed “babies should be trained from their earliest days to sleep regularly and should never be woken in the night for feeding,” “baby should be given his own bedroom from the very beginning. He should never be brought into the living room at night.”

And year later, Dr. Spock, the American pediatrician authority of the 1940s, promoted the same view.

In the 1980s, America sleep research began when only 9% of American were being breastfed and formula feeding was the craze. AAP guidelines stated “never let a baby fall asleep at the breast.”

More recently, Dr. Richard Ferber, the inventor of famous Ferber Method, published “Solve Your Child’s Sleep Problems” and wrote “sleeping in your bed can make an infant confused and anxious rather than relaxed and reassured. Even a toddler may find this repeated experience overly stimulating…if you find that you actually prefer to sleep with your baby, you should consider your own feelings very carefully.”

Dr. McKenna called this a “damaging statement.” In a matter of fact, Dr. Ferber changed his mind later and rewrote his famous “Solve Your Child’s Sleep Problems” in 2006. This time, he wrote, “Whatever yo want to do, whatever you feel comfortable doing, is the right thing to do, as long as it works…most problem can be solved regardless of the philosophical approach chosen.”

But even after that, the American authorities still warned mothers about co-sleeping. Just in 2008, Deanne Tilton Durfee, director of the LA County Inter-Agency Council on Child Abuse and Neglect, issued a warning, “We know that value of holding your child, cuddling your child, loving your child But if you take the baby to bed with you and fall asleep, you are committing a potentially lethal act.”

The truth is, co-sleeping doesn’t increase the chance of SUDI, sudden unexpected death in infancy. In most of the SUDI cases, babies were already in an unsafe sleeping environment,  they could die by sleeping all alone, it doesn’t matter if she’s sleeping with the parents. In many cases, the parent roll over the baby when high on drug.

Fortunately, the erroneous assumption is changing. “The whole fuzz is caused by 10 people,” said Dr. McKenna, “and I’, sure they can be easily replaced by another 10 people. Two decades from now, co-sleeping will be the norm.”

Many new researches show that co-sleeping benefits mother and infant in many ways. Dr. McKenna’s recent research stated that co-sleeping and breastfeeding is a mutual re-enforcing system; he called it “breastsleeping.” An 2007 research found that co-sleepers are more secure being left alone.

So what makes co-sleep safe? Dr. McKenna provided the following factors:

  • Supine sleep position.
  • Exclusive breastfeeding.
  • No maternal smoking.
  • No children co-sleeping with infant.
  • Adhere to routine practice.
  • Avoid co-sleeping on couches, armchairs, reclines, or waterbeds.
  • Avoid bed-sharing if the baby is bottle feeding or the parent is a smoker, place crib or bassinet next to bed instead.

This is an original post for San Diego County Breastfeeding Coalition by To-wen Tseng.

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Deciphering the Lactation Curve

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What can a lactation consultant learn from the dairy industry?

According to Lisa Marasco, MA, IBCLC, FILCA, the dairy industry can provide a different prospect of milk production and help healthcare professionals decipher the lactation curve.

The concept of a lactation curve is well known in the dairy industry, but not in the human lactation world. When we look at milk production in the paradigm of this curve, we begin to understand the underlying drivers of milk production and why some women’s production seems more resilient than others.

At a recent SDCBC general meeting, Marasco explored the factors involved in the curve, the concept of persistency, and the importance of what happens in the beginning to long-term calibration.

Marasco made an analogy between the lactation trajectory and the rocket forces: the trajectory is a path followed by a projectile flying or an object moving under the action of a given force. And our goal is long term maintenance of sufficient milk production.

Marasco introduced her famous milk supply equation inspired by the dairy industry to explain the key factors which make an ideal “trajectory” and allow moms to make enough milk:

Sufficient lactation tissue

+ Intact nerve pathways and ducts

+Adequate hormones and hormone receptors

+Adequately frequent, effective milk removal and simulation

=Good milk production

Marasco further explained what each piece of the equation means, so that her fellow lactation consultants can use it to solve milk supply mystery for the moms they work with.

Sufficient lactation tissue: This is the question whether the mother has “the right size of the rocket to do the job,” using Marasco’s own wording. Some women have less glandular tissue than others, and as a result produce less milk. However this is not a question of breast size, but of the amount of milk making structures inside the breast.

Intact nerve pathways and ducts: If the mom had a breast injury or a breast surgery, she may have sustained damage to her milk ducts and/or nerves. Both are key to milk production.

Adequate hormones and hormones receptors: An often overlooked source of milk supply problems, adequate hormones are another part of the milk supply equation. Conditions such as PCOS, anemia, thyroid problems and postpartum hemorrhage can affect mom’s hormone levels and may cause problems with milk supply.

Adequately frequent, effective milk removal and stimulation: This part of the equation is at the heart of many breastfeeding problems.

  • Adequately frequent: Frequently empty of mom’s breasts signals her body to maintain a good level of milk production. In dairy industry is regular pump. In human lactation world it’s effective baby suck. “Mom may owns the equipment, but babies drive the supply!” said Marasco. What does adequately frequent mean? Generally it means 8 to 12 feedings in 24 hours, but some babies who don’t remove much milk at feedings require even more feedings. Pacifiers can mask feeding cues, so consistent use of them can reduce feeding frequency and lower milk supply.
  • Effective milk removal: Removing a significant amount of milk at each feeding also signals mom’s body to maintain good milk production. But a baby who has a poor latch, is sleepy, s refusing the breast, has an anatomical barrier (such as tongue tie or eldest palate) to effective milk removal, or is otherwise unable to remove enough milk, will make it difficult to establish and maintain and adequate milk supply. Milk removal also occurs with a breast pump, so pumping problems can also results in lower milk supply.

Fortunately, there are steps lactation consultants can take to remedy many of the causes of low milk supply. For measures to take to increase milk supply, Marasco recommend the Morton Maximizing Production video.

This is an original post for San Diego County Breastfeeding Coalition by To-wen Tseng.

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Benefits of Skin-to-Skin Contact (It’s for Dad, too!)

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Benefits of Skin-to-Skin Contact (It’s for Dads, Too!)

The other night before bedtime story, my three-year-old pulled up his pajamas, put his stuffed piggy on his chest, claiming, “I’m breastfeeding Piggy!”

“Oh that’s sweet!” I said, “But I’m not sure if you can do that—boys don’t have milk.’

“I’m a big MAN!” He corrected me. He likes to call himself a big man these days.

“Okay, big man. Still, men don’t have milk, either.”

He paused, then announced, “I’m skin-to-skin Piggy!”

I laughed. That was cute. I snapped a shot with my cellphone. I have no idea where he learned about the term “skin-to-skin.” But he was right—while skin-to-skin (baby naked, not wrapped in a blanket) contact between mom and baby helps breastfeeding, skin-to-skin contact between dad and baby can be beneficial, too. It is the easiest way to form a secure attachment and does a lot more than promote bonding.

It helps baby adapt

Thermal regulation is a very common problem with infants, especially preterm babies. When the baby was in the womb, he didn’t need to regulate his own temperature. Since parents’ skin is the same temperature as the womb, baby will find it easier to adapt to his post-birth environment.

It boosts baby’s mental and brain development

Skin-to-skin contact is a multi-sensory experience. Holding baby on parent’s skin increases the development of essential neural pathways, which accelerates brain maturation. According to a Canadian study, preemies who received skin-to-skin contact had better brain functioning at 15 years old—comparable to that of adolescents born full term—than those who had been placed in incubators. The research shows skin-to-skin contacted babies spend more time in quiet sleep, which stabilizes their heart rate, enhances organizational patterns in the brain and helps the brain develop better.

It promotes healthy weight

One Cochrane Library review concluded that skin-to-skin contact dramatically increases newborn weight gain. When babies are warm, they don’t need to use their energy to regulate their body temperature. They can use that energy to grow instead. Plus, skin-to-skin touched babies enjoy increased breastfeeding rates, which can’t hurt healthy weight gain.

It reduces baby’s stress and pain

Just 10 minutes of skin-to-skin contact reduces babies’ level of the stress hormone cortisol, and increases levels of the “cuddle hormone” oxytocin, which stimulates the parasympathetic nervous system to make babies feel calm and safe, according a research published in AACN Clinical Issues. “When preterm infants are held chest-to-chest, they react less to heel sticks, a minimally invasive way to draw blood, and a common source of pain among preemies,” said Dr. Susan M. Ludington, the lead author of the research.

It helps baby sleep

Less stress equals to better sleep. Preemies who were cradled skin-to-skin slept more deeply and woke up less often than those who slept in incubators, reported the journal Pediatrics.

There are now a multitude of studies that show that mothers and babies should be together, skin-to-skin immediately after birth. After that, continued skin-to-skin can still be beneficial, either between mom and baby or dad and baby. The baby is happier, the baby’s temperature is more stable, the baby’s heart and breathing rates are more normal, and the baby’s blood sugar is more elevated.

From their time in the womb, babies recognize their fathers’ voice. Babies find skin-to-skin contact with dad calming, and it helps dad and baby bond. So get snuggling. Happy, happy Father’s Day!




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Handling criticism about extended breastfeeding

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When my son was two months old and I was breastfeeding, everybody told me, “that’s great. Breast is the best.” When my son turned two years old and I was still breastfeeding, everybody told me, “your child is too old to be breastfed.”

Breastfeed a baby beyond age one is known as extended breastfeeding. The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months after birth, and breastfeeding in combination with solid foods until at least age one. Extended breastfeeding is actually recommended as long as the mother and her baby wish to continue, but, still, mothers decide to nurse their babies beyond age one often face unwelcome opinions and judging looks. Here are some questions extended nursing moms often hear and how one can response.

  1. Aren’t you tired of watching your diet for such a long time?

“In fact, you don’t need to have the perfect diet to breastfeed. Of course, we need to take a bit more precaution when nursing, and we can’t be completely reckless with our bodies. But no breastfeeding mom should feel bad about eating the occasional doughnut or burger or drinking the once-a-while cup of coffee or tea.”

  1. How long are you going to breastfeed?

“A lot of the time, women don’t know how long they’re going to breastfeed. Maybe a few years, maybe a few days. A lot of the time, extended breastfeeding is not planned, it just happened because both the mom and her baby enjoy the relationship.”

  1. You’re still breastfeeding? Why?

“Yes, I’m still breastfeeding. I’m doing this because my baby and I wish to continue the relationship, also because of the many health and emotional benefits of extended breastfeeding.”

  1. Once you give your baby solid food, you should stop nursing. Breast milk over 6 month is not nutritious.

“This is a common myth. The truth is, breast milk is the gold standard for infant nutrition. As your baby gets older, the composition of your breast milk will continue to change to meet his or her nutritional needs.”

  1. Aren’t you afraid your boobs are going to get stretched out?

“I’m not thinking about what my boobs are going to look like in the future. I’m thinking about feeding my baby. My breasts are for babies, not a sexual organ or an object of fetishes.”

  1. I never breastfed my kids, and they turned out fine.

When I asked for lactation accommodation upon my return to work after giving birth, a supervisor told me “Just give him formula. We feed our kid formula and he went to Harvard.” I told him I think it’s great that his son went to Harvard, “But your kid is your kid, mine is mine. And breastfeeding is a human right.”

  1. Your child is too old to be breastfed.

“The World Health Organization recommends breastfeeding exclusively until my baby is six months old and then to continue breastfeed until they are two years of age or older. That’s two years of age OR OLDER.”

Breastfeeding a toddler is a controversial topic, as any mom who’s done so publicly can attest. When my son turned 18 months old and was still being breastfed, I stopped nursing in public. When he turned two years old and was still being breastfed, I let both my mom and mother-in-law believe that I had already weaned him. By so doing saved me some arguments. But in an ideal world, every mother chose to continue breastfeed her baby beyond age one should be able to proudly nurse her toddler!-




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Maternal Nutrition and Perinatal Outcomes

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Maternal diet in pregnancy is super important—it can affect three generations: the mother, the baby, and the reproductive cells in the fetus. To help her colleagues better understand maternal nutrition and perinatal outcomes, Dr. Mary Barger (MPH, CNM), associate professor at University of San Diego, talked about healthy eating in pregnancy at a recent SDCBC general meeting.

Omega-3-fatty acids

One thing that is important for pregnant mother is Eicosanoids. “Good” Eicosanoids inhibit platelet aggregation, promote vasodilation, and inhibit cellular proliferation, while “bad” Eicosanoids promote platelet aggregation and vasoconstriction. Anti-inflammatory eicosanoids, which Dr. Barger referred to as the “good” ones, come from eating a diet rich in long-chain omega-3-fatty acids that can be find in fish oil.

“We should eat fish!” Dr. Barger said that Americans no longer eat enough fish, because the EPA oversold the risk of fish. For mercury concerns, Dr. Barger gave a guideline, “don’t eat shark, swordfish, king mackerel, tilefish, and limit other fish intake to 12 oz per week.”

Breastfeeding mothers should eat a Omega-3s rich diet, too.


Not only is maternal diet during pregnancy important, it is important even before pregnancy. Studies found that healthy eating, which means more protein and less carbs, decreased risk of infertility by 70%.

Folic Acid

Dr. Barger also described evidence of how the intrauterine environment affects gene expression. “A pregnant mother’s diet may turn the genes around,” she said.

With the help of some fat yellow mice, scientists have discovered exactly how a mother’s diet can permanently alter the functioning of genes in her offspring without changing the genes themselves.

The unusual strain of mouse carries a kind of trigger near the gene that determines not only the color of its coat but also its predisposition to obesity, diabetes, and cancer. When pregnant mice were fed extra vitamins and supplements, the supplements interacted with the trigger in the fetal mice and shut down the gene. As a result, obese yellow mothers gave birth to standard brown baby mice that grew up lean and healthy.

What are the “supplements”? “It’s folate,” said Dr. Barger. She recommended pregnant women eat food containing folic acid.

Mediterranean Diet

Dr. Barger said, “the single most important thing that a pregnant woman puts in her body is food.” Studies found that the “mediterranean diet” can lower the risk of preterm birth. The Mediterranean diet, also known as low-glycemic diet, is associated with less gestational weight and less glucose intolerance. The goal is to eat nutrient-rich, low glycemic foods or minimum five fruits and vegetables a day.


Only a small increase of vitamin A is needed in pregnancy. American women have low vitamin D levels and a daily supplement of 20 ng/ml during pregnancy is recommended; larger amounts are required during breastfeeding for infant vitamin D sufficiency. Vitamin B12 supplement is recommended for RNA/DNA synthesis, such as brain and spinal column and RBC formation.


Iodine supplement is recommended for thyroid functioning and prevention of congenital mental retardation. Recommended intake of Calcium during pregnancy is 1300mg per day.

A normal pregnancy is not a “fragile” event. Mothers should still enjoy their favorite foods, just make a little changes, eat a little bit healthier for their babies. In general, Dr. Barger recommended pregnant mothers:

  • Have three meals and two snacks a day, because infrequent eating or fasting is associated with preterm birth.
  • Drink plenty of water as primary source of liquid and avoid alcool.
  • To avoid food borne illnesses that can cause maternal or fetal disease by eating, eat only well-cooked meat.



leonardbrunoMaternal Nutrition and Perinatal Outcomes
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