Getting Good Fats Into Kids

Infants and children who are breastfed get their first source of good fats through human milk.  According to  Lawrence and Lawrence’s “Breastfeeding:  A Guide for the Medical Profession”, children who were breastfed show “more advanced development” at not only 1 year, but 8 to 10 years and at 18 years.  During the first year of life the brain more than doubles in weight with 85 percent of this growth in the cerebrum; 50 to 60 percent of this is lipids.

Much of this has been attributed to fatty acid and lipid components and has led to supplementation of formula with cholesterol (human milk is full of cholesterol and artificial baby milk typically has little to no cholesterol) and DHA.  Lawrence and Lawrence point out, “These compounds function in a milieu of arachidonic acid, lipases, and other enzymes, and no evidence indicates that they are effective in isolation or that more is better.”

We know cholesterol is important for cell membrane function and that infants who are breastfed have higher cholesterol levels than formula-fed infants.  Animal studies suggest this may protect against high cholesterol later in life.  We also know that in breastfeeding, the amount of fat delivered is not static and adjusts to the baby for a customized fat and calorie milk.

As children grow, we know that foods that contain essential fatty acids remain important – sources of these include fish, flax oil, seeds, nuts and nut butters, olive oil, avocado, hummus and wheat germ all provide good fats according to Dr. William Sears’ “The Family Nutrition Book.”  Obviously, eating too much fat regardless of the type of fat can cause obesity, but I find parents are mainly interested in replacing the “junk food” fats with “good fats”.

Some of my favorite good fats include coconut oil and avocado.  Coconut  butter/oil  got a very, very bad rap for year, but it is now known that the medium-chain fatty acids in coconut milk are an energy source and that coconut has powerful antibacterial and antiviral properties.  Coconut water, while not high in fatty acids per se, is high in Vitamin C, B vitamins, proteins and electrolytes.  Coconut milk is now being used in the United States to make coconut milk yogurt (very good in smoothies!), coconut milk that is sold in a carton just like bovine milk (great for folks with dairy allergies) and of course our friend the young Thai coconut (the white ones with the pointed tops) are more and more readily available.

Smoothies are a great way to get coconut water, meat or milk into your kids.  Coconut meat, water, lime juice, vanilla and a little sweetner can make an excellent smoothie for a snack.  My personal favorite involves coconut milk/yogurt mixed with frozen mango, some honey and banana.  Yum!

Avocado is another great source of fatty acids, and this can be made into a pudding by mixing it with cocoa powder,sweetner, vanilla, and coconut meat and water.

Happy eating,

Carrie

Breastfeeding, Pregnancy, Fish Oil Supplementation and Infant Allergies

(THE DISCLAIMERI am not telling anyone to take ANYTHING, any supplement, but looking at these studies has been interesting and may give you fuel to want to look on your own and speak to your health care provider regarding these studies.  There are many more studies coming out on this subject that you can search on the website PubMed, which has abstracts of medical journal studies). 

Here is something of interest I have been reading lately (yes, I love to read medical journal abstracts in my free time, don’t laugh).  Anyway, on the topic of human milk feeding, fish oil supplementation and infant allergies here is one study I just found:

This was published out of Sweden, I believe  in their pediatric journal June 1, 2009  (I found the abstract on PubMed):

Aim: To describe the effects of maternal omega-3 long-chain PUFA supplementation during pregnancy and lactation on the incidence of allergic disease in infancy. Methods: One hundred and forty-five pregnant women, affected by allergy themselves or having a husband or previous child with allergies, were included in a randomized placebo-controlled trial. Daily maternal supplementation with either 1.6 g eicosapentaenoic acid and 1.1 g docosahexaenoic acid or placebo was given from the 25(th) gestational week to average 3-4 months of breastfeeding. Skin prick tests, detection of circulating specific immunoglobulin E (IgE) antibodies and clinical examinations of the infants were performed. Results: The period prevalence of food allergy was lower in the omega-3 group (1/52, 2%) compared to the placebo group (10/65, 15%, p < 0.05) as well as the incidence of IgE-associated eczema (omega-3 group: 4/52, 8%; placebo group: 15/63, 24%, p < 0.05). Conclusion: Maternal omega-3 fatty acid supplementation may decrease the risk of food allergy and IgE-associated eczema during the first year of life in infants with a family history of allergic disease.

PMID: 19489765 [PubMed - as supplied by publisher]

This is not a huge study group (140 mothers), and this study is just one of the studies that are coming out on this topic.  You may consider doing your own PubMed search, and also talking to your health care providers regarding some of these studies.  I, of course, am not telling anyone to take or not take ANYTHING, I just thought these studies were interesting enough to share a bit.

I saw one study regarding how the introduction of eating fish itself seemed to be protective against atopic dermatitis (and again, I think this study came out of either Norway or Sweden).  Over here in the United States, fish is typically considered one of those foods mothers are advised to wait to start due to high allergic reaction and incidence.  Any of my Scandinavian readers, I would love to hear your thoughts regarding introduction of fish and allergy incidences in your country!

Carrie

Weaning A Child Who Is Over the Age of 4

This is another hard post to write as people feel so vehemently one way or the other about this subject. However, I am writing it because there is so little information available about this that applies to breastfeeding mothers nursing an “older child”  in an industrial society in our time, even though we know the “biological” age of weaning is two and a half to seven years of age.    Much of the work regarding nursing a child over the age of four looks at either non-Westernized societies (like I found a study on four-year-olds in Bangladesh who were nursing 8 to 9 times a day, many of whom  were assumed to be nursing due to being nutritionally stressed) or the work is more from an anthropological perspective, such as boys in royalty were nursed longer.

I am nursing my youngest, a  four and a half year old one to three or four  times a day right now.  My oldest child  nursed until she was a little over three years of age, weaned when I was on bed rest with  my second pregnancy, came back to the breast eight months later (and tried to remember how to nurse, LOL)  and attempted to nurse on and off until she was about four and three quarters.   Contrary to many people feeling uncomfortable about nursing a child over the age of 4, I don’t feel uncomfortable or badly about it.

I have many friends who have weaned children somewhere between the ages of 4 and 7.  People ask about child-led weaning; I have seen some children “wean  themselves” but the relationship there seemed to me to  always be a dance between mother and child with limits typically being set by the mother from an earlier age onward.  Many of the children who nurse frequently at the age of three or  three and a half seem to go on to nurse longer than those who are not nursing frequently at three and a half. 

I have one friend who wryly observes that her middle child, “was just sort of my experiment.  I set no limits on nursing at all, and he nursed until he was 7.”  (And this is a very structured, organized, limit-setting kind of woman!)    I have another friend who says that she feels most children after the age of 4 need some gentle assistance in weaning, and she feels there is no true “child-led” weaning unless you really do want to take that avid three and a half year old nursling and nurse them until they are 7 – and not everyone is comfortable with that.  There are older children over the age of three who do abruptly wean due to pregnancy or birth of a new sibling, but I have heard of these cases much less often than one would imagine.  However, these are not observations from a medical, scientific study – just what I have observed in my over ten years of working with breastfeeding mothers in lay groups and lactation settings.

Breastfeeding is a relationship between two people, and as such both parties deserve to have dignity and respect, especially the child.  The child may have high needs to be met, and some children have intense physiological sucking needs into the fourth year.  I am sure we can all remember children who sucked their thumbs until they were much older than four or five!  Some children have physiologic disease processes and truly need the antibodies that human milk provides.   The need for mother’s physical presence, for connection and the feeling of unconditional love and acceptance that comes from being at the breast is always there, always remains,  in these early years before adolescence.   The question becomes how comfortable one is using the breast to provide sucking, connection or closeness,  or  even antibodies,  as the child grows and matures. 

The question becomes how you feel in your heart.  Some mothers give a lot of “talk” to their child regarding weaning, “becoming a big boy or girl”, but truly feel conflicted in their heart.  They feel weaning is hard for the child, and they are not sure how to proceed without hurting the child or the child’s feelings, and they wonder how the relationship between themselves and the child will look once weaning is completed.  The mother and child have to find their relationship without that component of close connection, and this can feel challenging to both the mother and the child.

Instead of making this a time of conflict and ambivalence, I suggest several things:

1. Search your heart and see if you can see weaning as a process of opening the world to your child, of not “taking away” this precious relationship, but part of growing up, of expanding horizons.

2.  Do you love your child unconditionally at times other than when they are at the breast?  Does your love and warmth and respect for this child come forth?  If not, nursing may be how they are searching to fill this – that close and loving connection that occurs at the breast.  If you do want to wean, concentrate on your own positive thoughts toward your child and your relationship with that child first. 

3.  Search your heart and KNOW that your child (and you!) are going to be okay!  Find the positive ways your child can relax, go to sleep, handle the normal tensional outlets of each developmental stage and capitalize on that. 

4.  Work on discovering your child’s “love languages”.  If your child’s love language is “physical touch”, make sure you are filling their love tank with lots of physical touch at times other than nursing times.  If your child’s love tank is filled with “quality time”, do make sure you are providing lots of quality time to your child when you are not nursing.

5.  Have distractions ready for when the phone rings and that sort of thing.. ..I know many four-year-olds who still would like to nurse when mother is on the phone!

6. Look at your daily schedule and see how your child does with nursing when you are busy (some nurse less naturally then, but some nurse more because then they feel over-stimulated) versus when you are at home all the time (again, some children nurse less and some nurse more).

7.  If you are not comfortable nursing your child much past the age of 4 or 5, and your child is an avid nurser….  ….then it probably will be up to you to help your child cut down the number of nursings a day.  You have to be comfortable with this idea, and if you are not and want a truly child-led weaning, you may have to nurse until 5 or 6.    With some children the more you talk about weaning and cutting down number of nursings a day, the more anxious they become.  Many of the mothers I know had better success in just structuring their day so they were busy, daddy took over bedtimes in some cases, and other things that gradually and naturally  cut nursing down without a lot of explanation other than peacefully saying, “We can nurse at “X” time.  I am happy to (hold you now, get you a drink, get you something to eat, to play a game with you, to go to the pool, etc.) right now.”

8. Again, if you are ready to have the nursing relationship come down in intensity and you are helping your child grow, there may be some tears if the child is four and five and used to a certain rhythmical pattern of nursing to sleep or whathave you.  Again, this is where you must search your heart, see what you are comfortable with, feel okay that you truly are uplifting your child to the next level, that your child is growing up and it is going to be okay.  If you cannot believe this in your heart, then neither you nor your child is ready to wean. 

9. Some families do have a weaning party or provide a special weaning necklace or out to lunch to celebrate weaning.  Again, some children need help with moving on and need you to either decide it is okay to nurse until age 7 or they need you to be kind but not crumple. They may need you to  say after a weaning party or weaning lunch something to the effect of, “Nursing you was so special to me as well.  Today Daddy is going to take your little sister so you and I can do “X” together.”

10.  Work hard to examine how you feel about the joy of mothering.  If in your heart you feel enraptured with being home, with mothering, if you delight in your children, they are going to also feel joyful, happy, peaceful even without nursing and as nursing transitions and fades away.

If you continue to nurse your older child, be happy about it, be proud about it and know that when they are developmentally ready they will be done.  Whether or not “true” child-led weaning works for your family or not, whether you decide your child may need your help , cannot be decided by anyone but you and in your own observations of your child.  You can still respect your child and your child’s dignity whatever path you choose.  The path for the older child is not as clear as the path when nursing a small two or three year old, and that is okay, that is part of parenting.

Be comfortable with yourself and what your family needs from you, from the times when you do need to take the lead and the times when you need to surrender yourself.  That is the walk we walk in parenting a child that is a bit older.    But most of all, get clear in your own heart and decide.  That is what makes for a joyful family!

Love,

Carrie

A Breastfeeding Fact Every Parent Should Know

I am reviewing Hale and Hartmann’s “Textbook of Human Lactation” for an upcoming exam and LOOK at this:

“Lactation probably evolved initially to protect the young against infection and subsequently took on a nutritional role.  However, infant formula is focused on nutrition rather than protection.  Therefore, it is not surprising that the mortality rate of formula-fed infants in the USA today is at least 21% higher than breastfed babies.”

Wow, did you all know that?

Carrie

The Importance of Breastfeeding in the First Few Days

Okay, here is my second mini-rant of the day:  Colostrum and its benefits!

For those of you who are not as familiar with the early days of breastfeeding, this is what happens within the breasts:  Lactogenesis I occurs midway through pregnancy as estrogen causes the ductal system to grow and progesterone increases the size of lobes, lobules, and alveoli of the breast.  Most women have colostrum during pregnancy.  Lactogenesis II occurs with the sudden drop in progesterone after birth and the  mature human milk comes in within three to five days after giving birth.  There may be a mix of  colostrum/mature milk for up to two weeks post partum

Colostrum has many advantages.  At birth, the infant’s stomach is the size of a marble.  Colostrum is readily available in small amounts to match this.  Colostrum has a laxative effect and promotes the passage of meconium in the early days after birth.

Colostrum contains 60 components, 30 of which are exclusive to human milk.  Some of the most important components for the early days include:

  • Secretory IgA (sIgA), which paints the lining of the stomach and intestines.  This important immunoglobin protects the mucosal membranes in the body from germs, foreign proteins, and harmful invaders. Even as colostrum decreases and the volume of mature milk increases, there is still plenty of sIgA. A woman produces about 2.5 grams of IgA daily for her own use; a baby, who is less than 1/10th of the mother’s  size, receives .5 gram to one full gram while nursing.  Even past the first birthday, there are significant amounts of IgA in the milk and the concentrations of this immunoglobin increase during weaning. The presence of IgA stimulates the infant’s own gastrointestinal production of IgA.
  • High amounts of sodium, potassium, chloride and cholesterol
  • High in protein –three times higher than mature milk
  • Live cells in colostrum, which  survive in the baby’s GI tract and secrete growth factors, hormones and immune regulators.
  • White cells – there are as many live white cells in colostrum as there are in blood in the early weeks
  • Lactoferrin, the main protein in human milk.  Lactoferrin kills certain kinds of bacteria, viruses, fungi and tumor cells.
  • Oligosaccharides, which prevent bacteria from binding itself to surfaces in the respiratory tract.

Do keep in mind these benefits of exclusively breastfeeding your infant within the early days of life:

  • Helps mature milk come in earlier
  • Decreases severity of engorgement
  • Enhances milk supply
  • Helps uterus to involute
  • Bolsters mother’s confidence that she can be the sole provider for her infant
  • Gives mother plenty of practice
  • Prevents nipple confusion
  • Baby can practice at breast on small amounts of fluid before mature milk comes in
  • Colostrum’s supply of IgA coats the mucous membranes of the linings of the digestive tract, keeping harmful pathogens out and helping to activate the infant’s own immune system
  • Colostrum is high in protein, concentrated in volume,  and is easily digestible
  • Colostrum acts as a laxative and minimizes risk of jaundice
  • Assists with bonding and attachment

There are times when supplementation is necessary after birth but please do understand the risks of supplementing with artificial infant milk.  Even one bottle of artificial infant milk can sensitize a newborn to cow’s milk protein.  Formula changes the gut flora by breaking down the mucosal barrier colostrum provides and allows pathogens and allergens to enter. 

So, please have an open dialogue with your health care team if they are advocating supplementation for your healthy, full-term newborn.   Know what levels of bilirubin and blood glucose your baby has, and how breastfeeding can help.  Understand how to nurse your baby with a good latch, and how nursing your baby at least nine to 12  times within a 24- hour period is more likely to lead to breastfeeding success and satisfactory outcomes.  Talk to your pediatrician before you give birth as to what scenarios they would advocate supplementation for and why.  If you are giving birth in a hospital, know your hospital’s policies regarding supplementation of term infants.

Hope this will help some of you out there.

Just a few thoughts from my little corner of the world.

Extended Breastfeeding: Breastfeeding Beyond A Year

Okay, here is my mini-rant of the day!  I have had three separate mothers come and talk to me about their pediatricians telling them that human milk has no nutritive value after the first year of an infant’s life!  I cannot believe these pediatricians are in practice, I really can’t.  This is such misinformation to be spreading, and while these particular mothers were educated enough to know this isn’t true, what about the mothers who do not know the facts, hear this, and prematurely wean their child based on this information? 

So, let’s talk about the facts.  If you want to breastfeed your child beyond a year, here are some facts about the advantages of extended nursing.

First of all, many organizations around the world recommend nursing beyond a year:

  • The World Health Organization recommends nursing for a minimum of two years.
  • The United Nations Children’s Fund also recommends a minimum of two years.
  • The American Academy of Pediatrics recommends nursing for at least a year and for as long after that as is “mutually desirable”.
  • And the best organization, the organization of motherhood,  has this to say :  the estimated median age of weaning throughout the world is between three to five YEARS.

Why Breastfeed Beyond a Year?

  • At one year of age, a baby’s immune system is functioning only at 60 percent of the adult levels. A child’s immune system is not fully functioning at adult levels until six years of age. Nursing toddlers grow better and have better resistance to infection.
  • In particular, secretory IgA, an immunoglobin, appears to remain low for the first 18 months of a child’s life, so breastfeeding is an important source of this immunoglobin.  Breastmilk contains IgA, IgG and IgM to augment a child’s immune system until it is functioning at optimal levels.  Human milk still contains nutrients, growth hormone factors and immunoglobins after the infant is one year of age.
  • From the wonderful site www.kellymom.com:  “Human milk expressed by mothers who have been lactating for >1 year has significantly increased fat and energy contents, compared with milk expressed by women who have been lactating for shorter periods. During prolonged lactation, the fat energy contribution of breast milk to the infant diet might be significant.”
    — Mandel 2005
  • Also from www.kellymom.com:  “Breast milk continues to provide substantial amounts of key nutrients well beyond the first year of life, especially protein, fat, and most vitamins.”
    — Dewey 2001
  • In the second year (12-23 months), 448 mL of breastmilk provides:
    • 29% of energy requirements
    • 43% of protein requirements
    • 36% of calcium requirements
    • 75% of vitamin A requirements
    • 76% of folate requirements
    • 94% of vitamin B12 requirements
    • 60% of vitamin C requirements

    – Dewey 2001

  • Studies done in rural Bangladesh have shown that [human milk] continues to be an important source of vitamin A in the second and third year of life.
    — Persson 1998
  • Better skin.
  • There is no easier way to comfort a sick child.  A sick child will almost always nurse, even if they are not eating.
  • Nursing may help improve the dental arch
  • Comfort nursing can be a fundamental part and advantage of nursing a toddler.
  • Enjoyment of  the connection and closeness with your child!  Closeness and loving attachment are very important for all babies, children and teens, but the turbulent toddler years provide a special opportunity for love and reassurance that nursing can provide.
  • Norma Jean Bumgarner writes in the LLLI book “Mothering Your Nursing Toddler” :  “Some children are very shy and tend to withdraw from close interaction with people, even mother.  The shy child who is still nursing has a ready-made assertive behavior – asking to nurse-  that can help him learn how to get his other needs met, too.  Other children are so active that nursing is the only quiet, calm time in their busy waking hours.”

The Myths Surrounding Extended Nursing:

  • If a child can ask to nurse, there is something wrong with doing so.”

THE FACT:  If we biologically compare human mammals to other mammals, the natural weaning age would be somewhere between 2.5 years and 7 years.  Please see this article by Katherine Dettwyler here: http://www.kathydettwyler.org/detwean.html.  This article will clear up many of the biological comparisons for you regarding the physiological age of weaning.

  • Once a child no longer needs mother’s milk solely for nutritional purposes, there is no sense in breastfeeding.”   or “Your child should be drinking whole milk now instead of human milk.”

THE FACT:  While human milk does not provide all the nutrients a nursing child may need, see the truth regarding the child’s immune system in the above section and the benefits human milk provides. 

Norma Jean Bumgarner does write in her book, “If your child eats very little besides your milk and is anywhere past his first birthday, you should make a point of offering foods that are rich in minerals.  The little bit he eats should not be cheese or other dairy products that contribute nothing beyond what he is already getting from your milk.  His food should be mineral-rich and easy for people his age to eat, foods like tender meat, eggs, raisins, dried apricots, and foods made with wheat germ, including whole-grain breads……..Except for making iron-rich food attractive to your child his second or third year, it is usually best to trust your child’s preference for nursing or for eating.”

If you are concerned regarding Vitamin D and extended nursing in your toddler, please see this link from La Leche League International: http://www.llli.org/Release/vitamind.html  and here: http://www.llli.org/NB/NBJulAug04p124.html

  • Your child would eat more solid food if you would just wean him.”

THE FACT:  Norma Jean Bumgarner writes in “Mothering Your Nursing Toddler”:  “Children in the second and third years are notorious for eating nothing, or so it seems to mother….[Nursing] should be more a comfort than a worry that a child has a regular source of nutritious food through nursing.”

  • After a certain point, the nursing relationship is more for the mother than the child.” (This is especially said regarding 4, 5 year olds who still nurse)

THE FACT:  Uh, any mother who has nursed a child in this age range can tell you it is not for the mother….The child still wants to nurse, and the child is the other person within this relationship.  How would your child react if you tried to stop now?   As a parent you weigh your child’s need for nursing, connection and closeness to you with your own feelings and needs and come up with a plan that hopefully works for the both of you.  Look at your child and see what happy confidence is there from extended nursing, and go from there.

  • Extended nursing will spoil a child.”

THE FACT:  Just based upon historical accounts of nursing children all over the world, we know the most treasured, precious children were nursed the longest so they would not be afflicted with the diseases that sometimes accompanied weaning; so I guess in that sense extended nursing does spoil your child (because preventing illness and death is obviously spoiling, LOL).

ANOTHER THOUGHT:  Children come into this world without inhibitions about their bodies or other people’s bodies. Extended nursing gives them an opportunity as they grow to learn boundaries of when nursing is accepted and when it is not.  Nursing often provides the first opportunities to practice gentle discipline and set boundaries while guiding and teaching your child.

  • A toddler who is still nursing is too dependent on his or her mother.”

THE FACT:  See the comment above.  People who are critical of breastfeeding often say things such as that.  Above all, realize it is not other people’s  business and in fact, you do not have to mention your child is still nursing if you do not want to!  Talk to people who will support you and be encouraging!

A toddler or even early preschooler is still a very young child.  This child would be dependent upon you whether you were still nursing them or not!

  • If you weaned your child, your child would not be (insert behavior here)”

THE FACT:  It is interesting how whatever behavior comes up, this is due to and completely caused by  breastfeeding whereas bottle feeding is never mentioned as a cause of behavior.  Funny how the world works, ain’t it??

  • Comfort nursing encourages the toddler to turn to food for comfort

THE FACT:  The composition and quality of human milk (along with the quantity) changes throughout a twenty four hour period and within a feeding.  Many times toddlers nurse for comfort for only a few minutes and are off and running again; they are not sitting down to the eight-course nursing buffet the way a one-month-old does!

Handling Pressure to Wean

If a one year old is still not walking, chances are a pediatrician will reassure mother that the unfolding of this skill will happen in time and not to worry. Weaning is also a biological function and yet we think nothing of encouraging a child to wean. Weaning in the United States often does not have the same dangers as it does in other parts of the world, but it still deserves thought and respect as an important rite of passage in a child’s life.

Just a few thoughts from my little corner of the world.