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A Quick Guide to Successful Breastfeeding

There’s a big global push in from experts to have mothers of newborns breastfeed exclusively for at least six months.


And many new moms want to. But only about 60 percent who start off breastfeeding keep it up for six moths or more, according to the Centers for Disease Control and Prevention.

Here’s a quick guide to advice from lactation consultants, pediatricians and researchers who had tips for women on how to reach their breastfeeding goals.

To-wen TsengA Quick Guide to Successful Breastfeeding
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Breastfeeding: It Takes a Whole Village

When my first child was born, I did not have a breastfeeding plan. Then my pediatrician advised me about the American Academy of Pediatrics guidelines: exclusive breastfeeding for the baby’s first six months. Then, as foods are introduced, continuing breastfeeding until at least baby’s first birthday.

A friend gave me an electric breast pump. Another friend gave me a cooler and some ice packs. I got serious.

I breastfed my child, relied on pre-pumped breastmilk to get through day care days. I faced breastfeeding discrimination situation at work by six months. I had four business trips by one year. But I insisted.

I insisted not because I am a true believer in the benefits of breastfeeding, though I myself was bottle-fed, along with many in my cohort. But my insistence was mostly because of the support I had.

To-wen TsengBreastfeeding: It Takes a Whole Village
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Things To Know About Storing Breast Milk For A Flight

A horror story about a mom being forced to dump her breast milk in an airport is circulating on Internet. It reminds me about the two years when I was breastfeeding. I travel frequently for work and flew a few times with my breast pumps during that two years. My impression is that traveling as a breastfeeding mom can be challenging, but not impossible. Most agents do understand breast milk security procedures, and mothers should be good if they know the TSA guidelines in regards to breast milk storage.

Here are several things to keep in mind when carrying breast milk on a flight.

To-wen TsengThings To Know About Storing Breast Milk For A Flight
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Baby-Friendly Hospital Initiative Practices: Challenges and Strategies, by To-wen Tseng

Baby-Friendly Hospital Initiative Practices: Challenges and Strategies

There has been lots of discussion about Baby-Friendly Hospital Initiative, a global initiative of WHO and UNICEF. How mommy-friendly is the Baby-Friendly Hospital Initiative? Is the breastmilk-only mandate putting babies in danger?

SDCBC’s recent Spring Mini-Seminar focused on this hot topic. Dr. Nancy Wight (MD, FAAP, FABM, IBCLC), Rose de Vigne-Jackiewicz (RN, MPH, IBCLC), Ruth Fletcher (BSN, RN, IBCLC) and Nancy White (BSN, RN, IBCLC) talked about the challenges and strategies practicing Baby-Friendly Hospital Initiative.

To-wen TsengBaby-Friendly Hospital Initiative Practices: Challenges and Strategies, by To-wen Tseng
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Highlights of California Breastfeeding Summit 2017: Culture, Trauma, and Marijuana, by To-Wen Tseng

Themed “California Dreamin,” this year’s California Breastfeeding Summit took place at Anaheim, CA in January. At a recent San Diego County Breastfeeding Coalition’s general meeting, the coalition’s Kim Speckhahn (BS, IBCLC), Kimberly Elkins (EdM, IBCLC) and Dr. James Murphy (MD, IBCLC, FABM, FAAP) shared what they took home from the Summit.

Heidi Burke-PevneyHighlights of California Breastfeeding Summit 2017: Culture, Trauma, and Marijuana, by To-Wen Tseng
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Breastfeeding in flu season, by To-wen Tseng

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As San Diego flu cases reach new high this season, many mothers are asking, “Can sick moms breastfeed?”

From my personal experience, sick moms can totally breastfeed—I once breastfed in an emergency room when down with stomach flu. And my husband was attacked the second day. Our breastfed son, then eight month old, turned out to be the only one of the family who didn’t get sick. Our pediatrician said the antibodies in breast milk protected our child.

Of course, I’m not a medical personal and may not be persuasive enough. Here is what experts have to say.

Heidi Burke-PevneyBreastfeeding in flu season, by To-wen Tseng
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Partners in Narrowing Breastfeeding Support Gaps in Communities, by To-wen Tseng

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Once again, it’s a new year with new hope and new challenge. While many of lactation consultants in San Diego County are continue to support breastfeeding families, it is very helpful to learn about the “RBLs”—Regional Breastfeeding Liaisons—at WIC.

Having that in mind, San Diego County Breastfeeding Coalition invited four local RBLs to talk about the program at a recent coalition general meeting. They are Kimberley Elkins (EdM, IBCLC, RBL) and Jennifer Nolan (RD, IBCLC, RBL) from American Red Cross WIC, and Laurel Hiroshige (RD, CLE, RBL) and Kim Speckhahn (BS, IBCLC) from North County Health Services WIC.

Heidi Burke-PevneyPartners in Narrowing Breastfeeding Support Gaps in Communities, by To-wen Tseng
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Breastfeeding is a Human Right, by To-wen Tseng

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Breastfeeding is a human right, don’t tell me “formula is as good”

December 10 is Human Rights Day. And right before the Human Rights Day this year, I received an e-mail from a mother, crying about how her employer doesn’t support breastfeeding and how her supervisor telling her “Not only breastfeeding moms are good moms, formula is as good.”

I was saddened. I am sad because I feel her. When I asked for breastfeeding accommodation from my previous employer, someone form the company told me, “You can just use formula. It’s as good. My son was formula-fed and he went to Harvard.”

Heidi Burke-PevneyBreastfeeding is a Human Right, by To-wen Tseng
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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

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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