Pediatrics
- Breastfeeding
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Child Health and Learning
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Selected child topics from InfoMedSearch InfoMedLinks and a new topic: Health-Environment and Learning.
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Breastfeeding
NIH – Breastfeeding (Medical Encyclopedia) “Recommendations: Choosing how and what to feed your baby is a personal decision that deserves careful and thorough consideration. Breast milk is the natural nutritional source for infants less than one year of age. Most health care professionals (including the American Academy of Pediatricians and the National Association of Pediatric Nurse Associates and Practitioners) recommend breastfeeding for your baby's first year. Breast milk is the best source of nutrition for the first 6 months of life. It contains appropriate amounts of carbohydrate, protein, and fat, and provides digestive enzymes, minerals, vitamins, and hormones that infants require. Breast milk also contains antibodies from the mother that can help the baby resist infections. Experts agree that breastfeeding your baby for any length of time, regardless of how short, is of benefit to you and your baby. You can provide your baby with breast milk directly by breastfeeding or by feeding your baby breast milk from a bottle. ... ADVANTAGES OF BREASTFEEDING Research shows that breastfed babies may have less frequent: • Ear infections • Stomach or intestinal infections • Low iron levels in the blood (iron-deficiency anemia) • Skin diseases (infantile eczema) • Infant allergies Breastfed babies may have less risk of developing: • Digestive problems such as constipation or diarrhea • Obesity or becoming overweight • High blood pressure • Diabetes • Tooth decay”
NIH – Breastfeeding “What are the benefits of breastfeeding? Breastfeeding offers many benefits to the baby: Breast milk provides the right balance of nutrients to help an infant grow into a strong and healthy toddler. Breastfed infants, and those who are fed expressed breast milk, have fewer deaths during the first year and experience fewer illnesses than babies fed formula. Some of the nutrients in breast milk also help protect an infant against some common childhood illnesses and infections, such as diarrhea, middle ear infections, and certain lung infections. Some recent NICHD-supported research also suggests that breast milk contains important fatty acids (building blocks) that help an infant's brain develop. Two specific fatty acids, known as DHA and AA, may help increase infants’ cognitive skills. Many types of infant formulas available in the United States are fortified with DHA and AA, and all formula available for preterm infants is fortified with these fatty acids.”
Highlighted Articles
Breastfeeding and Child Cognitive Development (Arch Gen Psychiatry. 2008) “Conclusion These results, based on the largest randomized trial ever conducted in the area of human lactation, provide strong evidence that prolonged and exclusive breastfeeding improves children's cognitive development.”
Advances in our understanding of the biology of human milk and its effects on the offspring. (J Nutr. 2007) "The most important short-term immunological benefit of breast-feeding is the protection against infectious diseases. There is also some evidence of lower prevalence of inflammatory bowel diseases, childhood cancers, and type I diabetes in breast-fed infants, suggesting that breast-feeding influences the development of the infant's own immune system. One of the most consistent findings of breast-feeding is a positive effect on later intelligence tests with a few test points advantage for breast-fed infants."
Optimal duration of exclusive breastfeeding: what is the evidence to support current recommendations? (Am J Clin Nutr. 2007) "That review concluded that infants exclusively breastfed for 6 mo experienced less morbidity from gastrointestinal infection and showed no deficits in growth but that large randomized trials are required to rule out small adverse effects on growth and the development of iron deficiency in susceptible infants. Others have raised concerns that the evidence is insufficient to confidently recommend exclusive breastfeeding for 6 mo for infants in developed countries, that breast milk may not meet the full energy requirements of the average infant at 6 mo of age, and that estimates of the proportion of exclusively breastfed infants at risk of specific nutritional deficiencies are not available. Additionally, virtually no data are available to form evidence-based recommendations for the introduction of solids in formula-fed infants. Given increasing evidence that early nutrition and growth have effects on both short- and longer-term health, it is vital that this issue be investigated in high-quality randomized studies."
Immunization
NIH - Immunizations - general overview (Medical Encyclopedia) “IMMUNIZING CHILDREN: Babies get so many shots these days! Many parents are concerned that the sheer number of vaccines might overwhelm, weaken, or use up a baby's immature immune system. But a baby's immune system is built to make antibodies to as many as 10,000 foreign proteins. If a baby were to receive all 11 available vaccines at once, this would engage only a tiny fraction of the immune system. … IMMUNIZATION SCHEDULE The recommended immunization schedule is updated at least every 12 months by organizations such as the American Academy of Pediatrics. Consult your primary care provider about specific immunizations for you or your child. The current recommendations are available on the Centers for Disease Control and Prevention (CDC) website at www.cdc.gov/vaccines. At every doctor visit, ask about the next recommended immunizations.”
NIH - Childhood Immunization “Vaccines help make you immune to serious diseases without getting sick first. Without a vaccine, you must actually get a disease in order to become immune to the germ that causes it. Vaccines work best when they are given at certain ages. For example, children don't receive measles vaccine until they are at least one year old. If it is given earlier it might not work as well.”
CDC - Recommended Immunization Schedules for Persons Aged 0--18 Years --- United States, 2008
CDC - Immunization Schedules (USA)
Childhood Vaccines: What They Are and Why Your Child Needs Them “Are there any reasons my child should not be vaccinated? In some special situations, children shouldn't be vaccinated. For example, some vaccines shouldn't be given to children who have certain types of cancer or certain diseases, or who are taking drugs that lower the body's ability to resist infection. The MMR vaccine shouldn't be given to children who have a serious allergy to eggs. If your child has had a serious reaction to the first shot in a series of shots, your family doctor will probably talk with you about the pros and cons of giving him or her the rest of the shots in the series. Talk to your doctor if you have any questions about whether your child should receive a vaccine.”
CDC - Common Questions Parents Ask about Infant Immunizations
NHS – Childhood immunisations (UK) “Childhood immunisation prevents a large variety of diseases. These include: Tetanus. An infection found in the soil that causes severe muscle contractions and breathing difficulties. Polio (short for poliomyelitis). A virus that first attacks the gut (bowel) but then travels to the nervous system. Polio can cause paralysis (when you can't move your limbs) in one or more parts of your body. Pneumococcal infections. These can affect anyone, but young children are at an increased risk of developing serious complications such as meningitis. Diphtheria. A highly contagious disease caused by a bacterium called Corynebacterium diphtheriae. It causes a serious throat and chest infection. Meningitis C. Caused by the meningococcus group c bacterium. In rare cases it can lead to blood poisoning and serious types of meningitis. Hib (full name is haemophilus influenzae type b). A bacterium that can cause pneumonia and meningitis. Whooping cough (pertussis) - causes prolonged coughing that can be very distressing. In children, complications can include brain damage. Measles. Caused by the measles virus and can result in a serious fever and rash. In severe cases, measles can be fatal. Mumps. Caused by the mumps virus. Mumps usually leads to inflammation and swelling of the salivary glands (the glands located just below the ears). In severe cases this can cause deafness. Rubella (also know as German measles). Caused by the rubella virus and can lead to a mild illness and rash. In later life rubella can be serious to an unborn child as it can potentially lead to several birth defects. Other immunisations Some children may require additional immunisations that are not part of the childhood immunisation programme. Your GP will be able to advise you if your child requires any further immunisations. These may include immunisations if your child has a chronic condition.”
Highlighted Article
Thimerosal exposure in infants and neurodevelopmental disorders: An assessment of computerized medical records in the Vaccine Safety Datalink. (J Neurol Sci. 2008) “Routine childhood vaccination should be continued to help reduce the morbidity and mortality associated with infectious diseases, but efforts should be undertaken to remove Hg from vaccines.”
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Pediatrics
Breastfeeding
NEWS:
Basics And Benefits Of Breast-Feeding
Behavioral Link Between Breastfeeding And Lower Risk Of Childhood Obesity “Breastfeeding has a number of positive health benefits for baby: it can prevent ear infections and allergies, and lowers the risk of developing respiratory problems. It can also help prevent against obesity later in life, but the reason for this still isn't known.”
Benefits Of Breastfeeding Outweigh Risk Of Infant Exposure To Environmental Chemicals In Breastmilk
Breast milk 'may be allergy key'
Breastfeeding and antidepressants (Infant Behavior and Development 2008)
Breastfeeding Associated With Increased Intelligence, Study Suggests
Breastfeeding cuts asthma risk “They found that children who had been breastfed for six months or more had a significantly reduced risk of developing asthma. This was particularly the case among young boys.”
Breastfeeding may boost post-baby weight loss “New moms may be better able to return to their pre-pregnancy weight by exclusively breastfeeding their infants, according to new research. "The practice of exclusive breastfeeding helps mothers lose the weight accumulated during pregnancy and do that faster compared to those who don't practice exclusive breastfeeding," Dr. Alex Kojo Anderson, of the University of Georgia in Athens, told Reuters Health.“
Breastfeeding may help explain weight disparities “Lower rates of breastfeeding may help explain why minority and disadvantaged U.S. children are at greater risk of becoming overweight, a new study suggests. Researchers found that among 739 10- to 19-year-olds, those who had been breastfed for more than four months had a lower average body mass index (BMI), and lower odds of being overweight. This was true regardless of race or parents' education levels, the researchers report in the journal Pediatrics. However, the study found, there were disparities when it came to rates of breastfeeding; 40 percent of white adolescents but only 11 percent of black children had been breastfed for at least four months. “
Breastfeeding Now Safer For Infants Of HIV-infected Mothers
Breastfeeding, Other Factors May Affect Risk Of Breast Cancer Type
Breast-Fed Baby May Mean Better Behaved Child “Parents of youngsters who were breast-fed as infants were less likely to report that their child had a behavior problem or psychiatric illness during the first five years of life, a new study found. And the likelihood of mental health issues decreased in proportion to the duration of breast-feeding, meaning that a child who had been breast-fed for a year was less likely to have behavior problems than a child who had been breast-fed for just two months. “
Breast-Feeding Seems to Protect Against Some Allergies “Atopic disease -- which includes eczema, asthma and food allergies -- may be delayed or even prevented in high-risk infants if they are exclusively breast-fed for at least four months or fed infant formula without cow milk protein. That's the conclusion of a new clinical report from the American Academy of Pediatrics (AAP) that's published in the January issue of Pediatrics. The report replaces an earlier policy statement from the AAP. "Basically, it probably does not matter what pregnant or lactating women eat," said Dr. Frank Greer, an author of the report, professor of pediatrics at the University of Wisconsin and chairman of the AAP Committee on Nutrition. "The best prevention for atopic [allergic] disease is exclusive breast-feeding for four months," he added. "And if your infant comes from a family with significant atopic disease, then weaning from breast milk to a partially or extensively hydrolyzed [hypoallergenic] formula [without cow milk protein] may delay or prevent the onset of atopic disease, especially atopic dermatitis [eczema]." Greer added that this recommendation would also apply to formula-fed infants who are at risk for atopic disease. “
[Breast-feeding, frequency and problems - results of the bavarian breast-feeding study] (Gesundheitswesen. 2008) “CONCLUSIONS: Breast-feeding problems that lead to termination of nursing are often due to a lack of milk or, respectively, a mother's concern about giving too little milk. Prospective, quality-assured counselling should focus on increasing the frequency of breast-feeding and on an improvement of suckling techniques in the first weeks of life. The medical necessity to supplementary feeding should be critically assessed and clearly explained to the mother in order to avoid giving her the feeling that she is unable to adequately feed her own child.”
Diet 'can flavour mother's milk'
Fatty Acid Supplementation of Human Milk Improves Cognition of Preterm Infants “During pregnancy, these fatty acids are transferred to the fetus by placental proteins and incorporated into cell membranes, Dr. Christian Andre Drevon and colleagues explain. However, premature infants are relatively deprived of DHA and AA because human milk supplies less than the fetus receives in utero.”
Feed the Baby, Starve Mom? “The truth probably lies somewhere in the middle. Breastfeeding does have a metabolic effect that encourages the body to return to its natural shape. But nursing alone, especially if mother leads a sedentary life and hits the freezer for ice cream — just won't burn off the pounds. “
Foods High In Conjugated Linoleic Acids Can Enrich Breast Milk
Health Tip: Soothing Engorged Breasts
More Mothers Breast-Feed, in First Months at Least “About 77 percent of new mothers breast-feed their infants at least briefly, the highest rate seen in the United States in more than a decade, according to a government survey released on Wednesday.”
New Insights Into Role Of Breastfeeding In Preventing Infant Death, HIV Infection
No Added Sugar In Breast Milk, Unlike Formula “Added sugar in infant formula, specifically sucrose, is linked with several health risks, including damage to tooth enamel, a preference for more sweet foods and the inclination to overeat. Research shows that babies and children prefer sweeter foods and tend to eat more of it than foods that are less sweet. Babies who overeat and have rapid weight gain in the first year are more likely to become obese during childhood. Breast milk, which contains no hidden ingredients, provides superior nutrients that cannot be duplicated in infant formulas. Breastfeeding provides nutritional, immunological and developmental benefits to children. Breastfed children have fewer incidences of respiratory infections and ear infections, and are leaner at one year than formula-fed children. Exclusive breastfeeding for a minimum of four months also decreases the risk of type 1 diabetes as well as the incidence of asthma and eczema.”
Prolonged Breast-Feeding May Improve Subsequent Lung Function “Infants who received prolonged breast-feeding have improved lung function at age 10 years vs those who are not breast-fed, according to the results of a prospective birth cohort study reported in the November 10 Online First issue of Thorax.”
Short breastfeeds 'best for baby' “Giving regular, short breastfeeds is more beneficial than the "baby-led" method, a British study suggests. Allowing a baby to choose when it feeds, and for how long, is often recommended to new mothers. A study of 63 mothers in Bradford found regular feeds of up to 10 minutes on each breast led to increased weight gain and a higher breastfeeding rate. However, midwives said the method suggested in Archives of Disease in Childhood would not apply to everyone. The World Health Organization recommends that babies are exclusively breastfed until they are six months old, but only around one in four UK mothers follows that advice. “
Study Shows How Breastfeeding Transfers Immunity To Babies
Suspected Carcinogenic Chemicals Used To Make Teflon, Scotchgard, Found In Human Milk
Taking Codeine While Breast-Feeding May Harm Infant “Breast-feeding moms who take medicines containing codeine may be unwittingly risking the health of their infant, new Canadian research suggests. The study indicates that a relatively rare genetic predisposition causes some women to metabolize codeine-laced drugs into morphine far faster than normal -- possibly harming the infant's central nervous system in the process. In such cases, the threat of a morphine overdose appears to be reversible if the woman stops taking the medication. However, for mothers with the genetic vulnerability, the unabated ingestion of codeine and gradual build-up of morphine in a baby's system can prompt extreme sleepiness, abnormal breathing, and even death, the researchers warned.“
Vitamin D Deficiency May Lurk in Babies “Physicians have known for more than a century that exclusive breast-feeding may be associated with vitamin D deficiency and rickets, and that the condition is easily prevented and treated with inexpensive vitamin drops or cod liver oil. But doctors are reluctant to say anything that might discourage breast-feeding. Now some researchers are also linking vitamin D deficiency with other chronic diseases like diabetes, autoimmune disorders and even cancer, and there have been calls to include blood tests of vitamin D levels in routine checkups. “I completely support breast-feeding, and I think breast milk is the perfect food, and the healthiest way to nourish an infant,” said Dr. Catherine M. Gordon, director of the bone health program at Children’s Hospital Boston and an author of several studies on vitamin D deficiency, including Aleanie’s case. “However,” Dr. Gordon continued, “we’re finding so many mothers are vitamin D deficient themselves that the milk is therefore deficient, so many babies can’t keep their levels up. They may start their lives vitamin D deficient, and then all they’re getting is vitamin D deficient breast milk.” “
ARTICLES:
Breastfeeding and Formula Feeding
Breast-Feeding, Antiretroviral Prophylaxis, and HIV.
Breast-feeding vs. formula: What's right for your baby?
Medications: Information for Pregnant and Breastfeeding Women
JOURNAL ARTICLES:
Associations of maternal fish intake during pregnancy and breastfeeding duration with attainment of developmental milestones in early childhood: a study from the Danish National Birth Cohort (American Journal of Clinical Nutrition 2008) “Conclusions: Maternal fish intake during pregnancy and the duration of breastfeeding are independently associated with better early child development.”
Breastfeeding and Child Cognitive Development (Arch Gen Psychiatry. 2008) “Conclusion These results, based on the largest randomized trial ever conducted in the area of human lactation, provide strong evidence that prolonged and exclusive breastfeeding improves children's cognitive development.”
Breastfeeding reduces postpartum weight retention (Am J Clin Nutr 2008) “Conclusion: Breastfeeding was associated with lower PPWR in all categories of prepregnancy BMI. These results suggest that, when combined with GWG values of 12 kg, breastfeeding as recommended could eliminate weight retention by 6 mo postpartum in many women.”
Breastfeeding-Related Maternity Practices at Hospitals and Birth Centers --- United States, 2007 (MMWR 2008)
Breast-feeding Protects against Arsenic Exposure in Bangladeshi Infants. (Environ Health Perspect. 2008)
Does initial breastfeeding lead to lower blood cholesterol in adult life? A quantitative review of the evidence (American Journal of Clinical Nutrition 2008) “Conclusions: Initial breastfeeding (particularly when exclusive) may be associated with lower blood cholesterol concentrations in later life. Moves to reduce the cholesterol content of formula feeds below those of breast milk should be treated with caution.”
Early mixed feeding and breastfeeding beyond 6 months increase the risk of postnatal HIV transmission: ANRS 1201/1202 Ditrame Plus, Abidjan, Côte d'Ivoire (Preventive Medicine 2008)
Maternal dietary intake of polyunsaturated fatty acids modifies the relationship between lead levels in bone and breast milk. (J Nutr. 2008) “In conclusion, higher maternal dietary intake of PUFA may limit the transfer of lead from bone to breast milk.”
Maternal employment and breastfeeding: results from the longitudinal study of Australian children. (Acta Paediatr. 2008)
Mercury in breast milk - A health hazard for infants in gold mining areas? (Int J Hyg Environ Health. 2008)
Nicotine in breast milk influences heart rate variability in the infant. (Acta Paediatr. 2008)
Short- and long-term decrease of blood pressure in women during breastfeeding. (Breastfeed Med. 2008) “CONCLUSIONS: In conclusion, both systolic and diastolic blood pressures fall during a breastfeeding session, and pre-breastfeeding blood pressure decreases during at least the first 6 months of a breastfeeding period in a homelike environment. This study lends further support to the health-promoting effects of breastfeeding.”
Vitamin D deficiency in exclusively breast-fed infants. (Indian J Med Res. 2008)
Vitamin D status among immigrant mothers from Pakistan, Turkey and Somalia and their infants attending child health clinics in Norway. (Br J Nutr. 2008) “In conclusion, there is widespread vitamin D deficiency in immigrant mothers and their infants living in Norway. Exclusively breast-fed infants who did not receive vitamin D supplements had particularly severe vitamin D deficiency.”
Why mothers stop breastfeeding: mothers' self-reported reasons for stopping during the first year. (Pediatrics. 2008)
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