marți, 21 decembrie 2010

“Just One Bottle Won’t Hurt” -- or Will It?

“Just One Bottle Won’t
Hurt” -- or Will It?
Supplementation of the Breastfed Baby
an article by
Marsha Walker
From Health e-Learning
This and many more articles available at of the Breastfed Baby
“Just One Bottle Won’t Hurt”---or Will It?
Marsha Walker, RN, IBCLC (
· The gastrointestinal (GI) tract of a normal fetus is sterile
· the type of delivery has an effect on the development of the intestinal microbiota
o vaginally born infants are colonized with their mother’s bacteria
o cesarean born infants’ initial exposure is more likely to environmental
microbes from the air, other infants, and the nursing staff which serves as
vectors for transfer
· babies at highest risk of colonization by undesirable microbes or when transfer
from maternal sources cannot occur are cesarean-delivered babies, preterm
infants, full term infants requiring intensive care, or infants separated from their
· breastfed and formula-fed infants have different gut flora
o breastfed babies have a lower gut pH (acidic environment) of
approximately 5.1-5.4 throughout the first six weeks that is dominated by
bifidobacteria with reduced pathogenic (disease-causing) microbes such as
E coli, bacteroides, clostridia, and streptococci
o babies fed formula have a high gut pH of approximately 5.9-7.3 with a
variety of putrefactive bacterial species
o in infants fed breast milk and formula supplements the mean pH is
approximately 5.7-6.0 during the first four weeks, falling to 5.45 by the
sixth week
o when formula supplements are given to breastfed babies during the first
seven days of life, the production of a strongly acidic environment is
delayed and its full potential may never be reached
o breastfed infants who receive supplements develop gut flora and behavior
like formula-fed infants
· The neonatal GI tract undergoes rapid growth and maturational change following
o Infants have a functionally immature and immunonaive gut at birth
o Tight junctions of the GI mucosa take many weeks to mature and close the
gut to whole proteins and pathogens
o Open junctions and immaturity play a role in the acquisition of NEC,
diarrheal disease, and allergy
o sIgA from colostrum and breast milk coats the gut, passively providing
immunity during the time of reduced neonatal gut immune function
o mothers’ sIgA is antigen specific. The antibodies are targeted against
pathogens in the baby’s immediate surroundings
o the mother synthesizes antibodies when she ingests, inhales, or otherwise
comes in contact with a disease-causing microbe
o these antibodies ignore useful bacteria normally found in the gut and ward
off disease without causing inflammation
· infant formula should not be given to a breastfed baby before gut closure occurs
o once dietary supplementation begins, the bacterial profile of breastfed
infants resembles that of formula-fed infants in which bifidobacteria are no longer dominant and the development of obligate anaerobic bacterial
populations occurs (Mackie, Sghir, Gaskins, 1999)
o relatively small amounts of formula supplementation of breastfed infants
(one supplement per 24 hours) will result in shifts from a breastfed to a
formula-fed gut flora pattern (Bullen, Tearle, Stewart, 1977)
o the introduction of solid food to the breastfed infant causes a major
perturbation in the gut ecosystem, with a rapid rise in the number of
enterobacteria and enterococci, followed by a progressive colonization by
bacteroides, clostridia, and anaerobic streptococci (Stark & Lee, 1982)
o with the introduction of supplementary formula, the gut flora in a
breastfed baby becomes almost indistinguishable from normal adult flora
within 24 hours (Gerstley, Howell, Nagel, 1932)
o if breast milk were again given exclusively, it would take 2-4 weeks for
the intestinal environment to return again to a state favoring the grampositive flora (Brown & Bosworth, 1922; Gerstley, Howell, Nagel, 1932)
· in susceptible families, breastfed babies can be sensitized to cow’s milk protein
by the giving of just one bottle, (inadvertent supplementation, unnecessary
supplementation, or planned supplements), in the newborn nursery during the first
three days of life (Host, Husby, Osterballe, 1988; Host, 1991)
o infants at high risk of developing atopic disease has been calculated at
37% if one parent has atopic disease, 62-85% if both parents are affected
and dependant on whether the parents have similar or dissimilar clinical
disease, and those infants showing elevated levels of IgE in cord blood
irrespective of family history (Chandra, 2000)
o in breastfed infants at risk, hypoallergenic formulas can be used to
supplement breastfeeding; solid foods should not be introduced until 6
months of age, dairy products delayed until 1 year of age, and the mother
should consider eliminating peanuts, tree nuts, cow’s milk, eggs, and fish
from her diet (AAP, 2000)
· in susceptible families, early exposure to cow’s milk proteins can increase the risk
of the infant or child developing insulin dependent diabetes mellitus (IDDM)
(Mayer et al, 1988; Karjalainen, et al, 1992)
o the avoidance of cow’s milk protein for the first several months of life
may reduce the later development of IDDM or delay its onset in
susceptible individuals (AAP, 1994)
o sensitization and development of immune memory to cow’s milk protein
is the initial step in the etiology of IDDM (Kostraba, et al, 1993)
ß sensitization can occur with very early exposure to cow’s milk
before gut cellular tight junction closure
ß sensitization can occur with exposure to cow’s milk during an
infection-caused gastrointestinal alteration when the mucosal
barrier is compromised allowing antigens to cross and initiate
immune reactions
ß sensitization can occur if the presence of cow’s milk protein in the
gut damages the mucosal barrier, inflames the gut, destroys
binding components of cellular junctions, or other early insult with
cow’s milk protein leads to sensitization (Savilahti, et al, 1993)References
American Academy of Pediatrics, Work Group on Cow’s Milk Protein and Diabetes Mellitus.
Infant feeding practices and their possible relationship to the etiology of diabetes mellitus.
Pediatrics 1994; 94:752-754
American Academy of Pediatrics, Committee on Nutrition. Hypoallergenic infant formulas.
Pediatrics 2000; 106:346-349
Brown EW, Bosworth AW. Studies of infant feeding VI. A bacteriological study of the feces and
the food of normal babies receiving breast milk. Am J Dis Child 1922; 23:243
Bullen CL, Tearle PV, Stewart MG. The effect of humanized milks and supplemented breast
feeding on the faecal flora of infants. J Med Microbiol 1977; 10:403-413
Chandra RK. Food allergy and nutrition in early life: implications for later health. Proc Nutr Soc
2000; 59:273-277
Gerstley JR, Howell KM, Nagel BR. Some factors influencing the fecal flora of infants. Am J Dis
Child 1932; 43:555
Host A, Husby S, Osterballe O. A prospective study of cow’s milk allergy in exclusively
breastfed infants. Acta Paediatr Scand 1988; 77:663-670
Host A. Importance of the first meal on the development of cow’s milk allergy and intolerance.
Allergy Proc 1991; 10:227-232
Karjalainen J, Martin JM, Knip M, et al. A bovine albumin peptide as a possible trigger of
insulin-dependent diabetes mellitus. N Engl J Med 1992; 327:302-307
Kostraba JN, Cruickshanks KJ, Lawler-Heavner J, et al. Early exposure to cow’s milk and solid
foods in infancy, genetic predisposition, and risk of IDDM. Diabetes 1993; 42:288-295
Mackie RI, Sghir A, Gaskins HR. Developmental microbial ecology of the neonatal
gastrointestinal tract. Am J Clin Nutr 1999; 69(Suppl):1035S-1045S
Mayer EJ, Hamman RF, Gay EC, et al. Reduced risk of IDDM among breastfed children. The
Colorado IDDM Registry. Diabetes 1988; 37:1625-1632
Savilahti E, Tuomilehto J, Saukkonen TT, et al. Increased levels of cow’s milk and blactoglobulin antibodies in young children with newly diagnosed IDDM. Diabetes Care 1993;
Stark PL, Lee A. The microbial ecology of the large bowel of breastfed and formula-fed infants
during the first year of life. J Med Microbiol 1982; 15:189-203

marți, 2 noiembrie 2010

Părinţii greşesc, şi bebe suferă

Sunteţi cei mai fericiţi părinţi din lume pentru că, in sfărşit, vă puteţi lua "minunea" acasă de la maternitate. Dar sunteţi pregătiţi să aveţi grijă de bebeluş aşa cum trebuie, fără să ii puneţi in nici un fel in pericol sănătatea?

Sunteţi cei mai fericiţi părinţi din lume pentru că, in sfărşit, vă puteţi lua "minunea" acasă de la maternitate. Dar sunteţi pregătiţi să aveţi grijă de bebeluş aşa cum trebuie, fără să ii puneţi in nici un fel in pericol sănătatea? Medicii pediatri sunt de părere că părinţii, din dorinţa de a face orice pentru copilul lor incă din primele zile de viaţă, consultă orice sursă de informaţii: cărţile despre ingrijirea copiilor, revistele, internetul. Insă nu toate recomandările găsite astfel sunt benefice pentru cel mic. Despre cele mai frecvente greşeli ale proaspeţilor părinţi ne vorbeşte dr Rodica Nanu, secretar ştiinţific in cadrul Institutului pentru Ocrotirea Mamei şi Copilului "Alfred Rusescu".

Una dintre cele mai obişnuite greşeli făcute de mămici este alternarea laptelui matern cu ceai sau apă incă din primele săptămăni de viaţă a bebeluşului. "Cel puţin in primele şase luni de viaţă, alăptarea trebuie să fie exclusivă. Bebeluşul nu are nevoie nici de apă, nici de ceai, laptele matern asigurăndu-i copilului hidratarea şi substanţele nutritive necesare dezvoltării. Chiar şi pe timp de caniculă, dacă mama bea cel puţin doi litri de lichide zilnic, alăptarea ii este suficientă micuţului", precizează dr Rodica Nanu.


Specialistul nostru le atrage atenţia părinţilor că programul de alăptare trebuie realizat impreună cu bebeluşul. Astfel, dacă micuţului ii este foame la o oră după ultima alăptare, nu trebuie să ii interzicem să sugă doar pentru că programul stabilit de noi presupune să hrănim copilul doar din patru in patru ore. "Noaptea, bebeluşii se pot trezi şi din oră in oră plăngănd pentru că vor lapte. Sub nici o formă nu trebuie să ii interzicem micuţului să sugă noaptea. Alăptările nocturne sunt chiar mai benefice pentru mamă decăt cele din timpul zilei, deoarece stimulează producerea de prolactină şi oxitocină, cei doi hormoni care favorizează producerea de lapte", atrage atenţia dr Rodica Nanu. Pe de altă parte, dacă programul alăptării impune ca micuţul să sugă la cel puţin trei-patru ore, este absurd să il trezim ca să mănănce. Este absolut normal ca un bebeluş de o săptămănă să doarmă 5-6 ore pe noapte, iar după ce a implinit o lună - 7 ore. Dacă micuţul doarme mai mult este indicat ca părinţii să il ducă la pediatru, deoarece este posibil să existe o problemă. Ieşirile in locuri aglomerate trebuie făcute cu precauţie, deoarece bebeluşii sunt sensibili şi pot contracta foarte uşor virusuri. Dar asta nu inseamnă că micuţilor le sunt interzise ieşirile in aer liber.

PLĂNS. Mulţi părinţi se sperie că bebeluşul plănge prea mult. Ei pun plănsul pe seama colicilor şi-i dau copilului să bea ceai. Insă de foarte puţine ori pe micuţ il doare cu adevărat burtica. Plănsul este de fapt manifestarea unui copil nemulţumit de mediul din jur: fie este prea cald sau prea frig in casă, fie aerul este prea uscat. Plănsul copilului poate fi şi un semn de protest pentru că nu ii place gustul laptelui după ce mama a măncat anumite alimente. Sau prin plăns el poate protesta contra mirosului puternic şi persistent al deodorantului folosit de mamă.

luni, 1 noiembrie 2010

Old ways best in childrearing - think Neolithic.

Want to raise a compassionate, moral child? Get Neolithic say researchers at the University of Notre Dame

The child rearing practices in hunter-gatherer societies result in children with better mental health, greater empathy and conscience development, and higher intelligence in children, says psychology professor Darcia Narvaez, who specializes in the moral and character development of children.

It would make sense that the way humans grew up for 99% of our history might have an impact on human development.

The researchers did three studies of children including the practices of parents of three-year-olds, a longitudinal study of how certain child rearing practices relate to child outcomes in a national child abuse prevention project, and a comparison study of parenting practices between mothers in the U.S. and China.

The results will be presented at a conference at Notre Dame in October titled "Human Nature and Early Experience: Addressing the Environment of Evolutionary Adaptedness."

The six characteristics that were common to our distant ancestors are:

  • Lots of positive touch – as in no spanking – but nearly constant carrying, cuddling and holding;
  • Prompt response to baby's fusses and cries. You can't "spoil" a baby. This means meeting a child's needs before they get upset and the brain is flooded with toxic chemicals. "Warm, responsive caregiving like this keeps the infant's brain calm in the years it is forming its personality and response to the world," Narvaez says.
  • Breastfeeding, ideally 2 to 5 years. A child's immune system isn't fully formed until age 6 and breast milk provides its building blocks.
  • Multiple adult caregivers – people beyond mom and dad who also love the child.
  • Free play with multi-age playmates. Studies show that kids who don't play enough are more likely to have ADHD and other mental health issues.
  • Natural childbirth, which provides mothers with the hormone boosts that give the energy to care for a newborn.

Americans don't raise their kids that way so much any more, Narvaez says in a release from Notre Dame.

Instead of being held, infants spend much more time in carriers, car seats and strollers than they did in the past. Only about 15 percent of mothers are breastfeeding at all by 12 months, extended families are broken up, and free play allowed by parents has decreased dramatically since 1970. Ill advised practices and beliefs have become commonplace, such as the use of infant formula, the isolation of infants in their own rooms, or the belief that responding too quickly to a fussing baby will 'spoil' it.

By Elizabeth Weise

vineri, 15 octombrie 2010

Children 'should sleep with parents until they're five'

Margot Sunderland, director of education at the Centre for Child Mental Health in London, says the practice, known as “co-sleeping”, makes children more likely to grow up as calm, healthy adults.

Sunderland, author of 20 books, outlines her advice in The Science of Parenting, to be published later this month.

She is so sure of the findings in the new book, based on 800 scientific studies, that she is calling for health visitors to be issued with fact sheets to educate parents about co-sleeping.

“These studies should be widely disseminated to parents,” said Sunderland. “I am sympathetic to parenting gurus — why should they know the science? Ninety per cent of it is so new they bloody well need to know it now. There is absolutely no study saying it is good to let your child cry.”

She argues that the practice common in Britain of training children to sleep alone from a few weeks old is harmful because any separation from parents increases the flow of stress hormones such as cortisol.

Her findings are based on advances in scientific understanding over the past 20 years of how children’s brains develop, and on studies using scans to analyse how they react in particular circumstances.

For example, a neurological study three years ago showed that a child separated from a parent experienced similar brain activity to one in physical pain.

Sunderland also believes current practice is based on social attitudes that should be abandoned. “There is a taboo in this country about children sleeping with their parents,” she said.

“What I have done in this book is present the science. Studies from around the world show that co-sleeping until the age of five is an investment for the child. They can have separation anxiety up to the age of five and beyond, which can affect them in later life. This is calmed by co-sleeping.”

Symptoms can also be physical. Sunderland quotes one study that found some 70% of women who had not been comforted when they cried as children developed digestive difficulties as adults.

Sunderland’s book puts her at odds with widely read parenting gurus such as Gina Ford, whose advice is followed by thousands.

Ford advocates establishing sleep routines for babies from a very early age in cots “away from the rest of the house” and teaching babies to sleep “without the assistance of adults”.

In her book The Complete Sleep Guide for Contented Babies and Toddlers she writes that parents need time by themselves: “Bed sharing . . . more often than not ends up with parents sleeping in separate rooms” and exhausted mothers, a situation that “puts enormous pressure on the family as a whole”.

Annette Mountford, chief executive of the parenting organisation Family Links, confirmed that the norm for children in Britain was to be encouraged to sleep in cots and beds, often in separate bedrooms, from an early age. “Parents need their space,” she said. “There are definite benefits from encouraging children into their own sleep routine in their own space.”

Sunderland says moving children to their own beds from a few weeks old, even if they cry in the night, has been shown to increase the flow of cortisol.

Studies of children under five have shown that for more than 90%, cortisol rises when they go to nursery. For 75%, it falls whenever they go home.

Professor Jaak Panksepp, a neuroscientist at Washington State University, who has written a foreword to the book, said Sunderland’s arguments were “a coherent story that is consistent with neuroscience. A wise society will take it to heart”.

Sunderland argues that putting children to sleep alone is a peculiarly western phenomenon that may increase the chance of cot death, also known as sudden infant death syndrome (Sids). This may be because the child misses the calming effect on breathing and heart function of lying next to its mother.

“In the UK, 500 children a year die of Sids,” Sunderland writes. “In China, where it [co-sleeping] is taken for granted, Sids is so rare it does not have a name.”

luni, 11 octombrie 2010

Sugarul persistent

Sugarul persistent

În ultima suta de ani specia noastra s-a schimbat. În emisfera nordica agricultura, asa cum a existat în secolele anterioare, s-a sfarsit. Populatiile s-au acumulat în orase. Bolile infectioase au fost partial controlate. Mortalitatea infantila a scazut si longevitatea a crescut. Noua demografie a tarilor dezvoltate este în prezent formata din familii în care exista doar un singur copil, sub rata de înlocuire. Moartea a disparut din viata de zi cu zi, aruncata in spitale. Nu mai e naturala. Exista întotdeauna cineva pe care sa se dea vina - de obicei un medic incompetent sau serviciile de sanatate. Se cheltuiesc milioane pe medicamente inutile. Intr-o lume de nerecunoscut, condusa de oficiali gri, urmasi ambitiosi ai clasei medii ridicati la rang de sefi de gasca, au disparut semnele originilor noastre "de jos". Este uimitor modul în care copiii sunt înca alaptati. Dupa o nastere chirurgicala într-un mediu steril, bebelusii umani sunt alaptati la san. E adevarat, o fac la sani rusinosi si ascunsi, nu pe terase. Dar sug, nefericitii, în scurtul lor stadiul pre-cultural, aproape la fel ca stramosii lor din Pleistocen. Sug sani provizorii, sani in drumul spre viitoarea cupa D. Sug nevinovati în întunericul unei camere. Daca ar suge in public, mamele ar fi amendate. În public numai lapte praf, biberon, suzeta. Biberon cu tetina anatomica – asa cum fabricantii isi imagineaza mamelonul supt.
Alaptarea este tolerata, atata timp cat copilul este nevinovat. Apoi, acesta devine indecent. Un copil care pune mâna in decolteul mamei este un tigan. Sugarul persistent nu este marinarul racitor cântat de Caetano. Este un animal care isi tareste mama în noroiul biologiei. O fiinta neolitica. Resturi de taran. O versiune prescurtata a profesorului José Rodrigues dos Santos, tratandu-si mama drept suedeza. Iar femeia lactanta întârziata nu poate fi decat o neo-hippie intarziata, cu fuste lungi colorate, scutece de panza si lipsa de deodorant.
Pentru fiecare copil, un trusou de haine de designer, un patut pe masura, o scoica de transport model A, un carut, un sac de nécessaire, un balansoar, o cadita, o gama completa de cosmetice pentru copii, buletin, carte de sanatate, carte de vaccinuri. Ca nu mai vezi copilul? Cui îi pasa. Ceea ce conteaza este ideea de copil. Sentimentul de pace si liniste pe care ideea de copil o declanseaza, accesoriile sale, chiar daca ascunde copilul real. Copilul real este colici, tortura sanului, lipsa de somn, inchisoare domiciliara. Din fericire e rar si traim bine si fara el.

Traducerea e evident ca nu imi apartine :)

MI-a placut la nebunie!!! Este de pastrat! :)

duminică, 10 octombrie 2010

Parlamentul EU

Mi-au placut la nebunie aceste fotografii... M-au induiosat profund.

joi, 13 mai 2010

E un blestem ca ne-am nascut in Romania?

M-am nascut acum 32 de ani in Romania. Am crescut in Romania comunista, mi-am trait tineretea in Romania in tranzitie si acum imi cresc copilul intr-un fel de Romanie, pe care nu stiu cum sa o denumesc.

Inainte de a deveni mama nu aveam nici un stres. Ma multumeam cu ce aveam , nu ceream prea mult. Invatasem sa supravietuiesc in Romania, ma consolasem cu ideea ca asa suntem noi si asa trebuie sa traim.
Acum dupa 32 de ani de Romania sunt mama si am pretentii!

Am pretentii pentru copilul meu! Am pretentii sa schimbam ceva.


Vreau doctori pregatiti si care sa ma respecte!
VReau conditii normale in spitale!
Vreau sa nu mai vad peste tot animale fara stapan, care ling, mananca, urineaza in nisipul in care ar trebui sa se joace copilul meu.
Vreau sa nu ma mai uit mereu pe unde calc, doar pentru ca concetatenii mei nu stiu ce e ala un cos de gunoi.
Vreau sa nu mai traiesc in nesiguranta!
Vreau sa nu mai aud replica: "Aici trebuie sa traim! Nu avem ce face!"
Vreau ca noi toti sa avem pretentii, sa nu mai plecam capul la primarie, la doctor, etc.