A Parent’s Guide to Respiratory Virus EV-D68

EV-D68

Lately, there has been a lot of media coverage about a respiratory virus outbreak that has now spread to 22 states: EV-D68. On Twitter, I’ve been seeing a lot of extreme comments to CNN Breaking News‘ post about the virus, such as “the world is coming to an end,” “zombie apocalypse,” and a lot of unnecessary blaming of President Obama. Despite stirring up a lot of panic, according to the CDC the respiratory virus is actually “not commonly severe.” 

As a parent and nurse, I figured I should post an entry about the virus, how it affects your family, and what you can expect if you find that your child(ren) come down with symptoms that may alert you to this infection. So here’s the scoop:

What is EV-D68?

EV-D68 is a non-polio enterovirus, which is a very common class of virus that causes dozens of other illnesses, which generally are not severe. D68 is a virus that mostly affects infants, children, and teens, due to a more vulnerable immune system.  It usually manifests as a mild infection, like the common cold. However, the more severe cases of EV-D68 infections are in infants, children, teens, and immune compromised people who have a history of asthma or wheezing.

Why am I hearing about EV-D68 just now?

Most cases of EV-D68 weren’t found in the US. It originally was discovered in California in the 60s, but is rarely reported here until recently. The Centers for Disease Control and Prevention (CDC) doesn’t generally gather information about this virus if children are becoming sick from it, because it often presents like a cold/flu and is treated similarly. However, on August 19, 2014, the CDC was alerted to a sudden increase in severe respiratory illnesses in infants, children, and teens, along with pediatric intensive care unit hospitalizations. What is alarming about it is the increased number of children requiring hospitalization.

With the school season back in full swing, rates of sickness are also increasing as expected. Additionally, rates of those with asthma have increased over the years. What makes EV-D68 bad for some kids over others, is the combination of a history of a respiratory condition (wheezing, asthma) and catching the virus. And hospitals are seeing more and more children hospitalized for respiratory illnesses, both with and without prior respiratory histories, moreso than in previous years. 

How many kids have been affected by this?

As of September 19, 2014, 160 confirmed cases have been reported to the CDC (an up-to-date count of cases in the link below). The CDC requests that hospitals send samples (throat and nose cultures) from suspected cases to be sent to them for confirmation. In the grand scheme of things this is not an alarming number. For instance, for the same class of viruses, enteroviruses are responsible for 10 to 15 million infections per year. However, the fact that a significant number of children hospitalized do not even have a history of respiratory illness and are requiring aggressive critical care is causing greater concern. 

The CDC reports that people are more likely to become infected by this type of enterovirus in the summer and fall seasons, and they expect EV-D68 to follow a similar pattern.

How is the virus spread?

Much like the common cold and flu, EV-D68 is spread from person to person. Close contact with an infected person, touching objects or surfaces that an infected person has made contact with then touching the eyes, mouth, or nose will spread it.  The key, like many viruses, is to wash hands in warm water for 20 seconds while scrubbing vigorously and disinfect surfaces with which your children have frequent contact. Avoid kissing, hugging, and sharing of eating utensils with sick people.  Wash hands after diaper changes, since the virus is shed through stool, too (CDC, APHA). 

With infants, keep them away from sick people, and make sure you are washing your own hands after contact with surfaces and people who are infected. Check with your child’s daycare to see what they are doing in response to this infection: how often are they disinfecting toys and other surfaces, are they enforcing rules to prevent sick children from coming to daycare, are they educating families about the importance of keeping sick children at home to prevent further spread of illness, are they staying alert to symptoms, etc. Hopefully they are hypervigilant all the time, but sometimes it takes a big scare like this to establish or enforce measures. 

People who are infected are contagious for 1-3 weeks through coughing, sneezing, and saliva, and the virus is still contagious through stool for “several weeks or longer,” after the person feels better. The term “entero” means it exists in the GI tract.

If my child gets sick from EV-D68, what symptoms should I expect? 

Symptoms are much like the common cold or flu, so it’s hard to tell if they are sick from EV-D68: fever, runny nose, sneezing, cough, muscle aches. If it is serious, your child may experience wheezing or difficulty breathing.  If your child has a history of wheezing or asthma, they are more susceptible to getting sick from this virus and their symptoms (like their ability to breathe) are likely to be more severe. The CDC recommends bringing your child to the ER if they are having any signs of trouble breathing (their breathing rate seems abnormally fast, they appear they are using a lot of effort to breathe).

The CDC recommends that those with less severe symptoms should be managed with over-the-counter pain and fever medications. (Remember, NO Aspirin for children!) Ask your child’s pediatrician what fever to treat, what dosage is appropriate, and at what fever to report to them or the Emergency Room.

Generally, call the doctor if your child’s rectal temperature is 100.4 F or higher. Ask them to teach you how to take a rectal temperature if you don’t know how, or check an armpit temperature. The temperature under the armpit is lower than rectal by about 1 degree F, so if you see an armpit temp of 99 F, call the doctor. 

What treatments are available if my child gets infected?

Treatments for EV-D68 are supportive measures – fluids, oxygen, etc. There is no vaccine and there are no specific antiviral medications for treating it. Read the section below for more information on what to expect when you bring your child to the hospital.

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Since I am not a Pediatric Nurse, I asked Sarah Hickle, a nurse with almost 10 years of Emergency Room experience,  who most recently worked in the Emergency Room at Rady Children’s Hospital in San Diego about the impact of EV-D68 and advice for concerned parents. Emergency Room nurses, after all, are the first ones to assess and treat your child. Here’s what she had to say:

As an ER RN at a Children’s Hospital, what have you been seeing re: EV-D68?

For probably the past month or so, we’ve definitely seen an huge increase in what we originally thought was just asthma, mostly children 12 and under. What was also interesting was we were getting a lot of kids that really had no huge respiratory problems. In our ER, we aren’t diagnosing the virus specifically because it’s really not going to change how we treat the illness. We started applying isolation precautions [wearing disposable gowns and protective masks] since information emerged about the virus.

What can parents expect if they bring their baby or child into the ER with a possible infection with EV-D68?

We typically would start off with [asthma therapy] nebulizer treatments: albuterol or duo-neb. Some kids would improve with 3 back-to-back treatments and starting steroid therapy. However, some needed more advanced care [like needing a breathing mask that pushes air into the lungs with two different levels of pressure to improve breathing, or a breathing tube if other methods are ineffective]. Along with the above mentioned, [they may need] IV steroids vs oral [for difficulty breathing due to inflammation in the lungs], continuous albuterol respiratory treatments, additional oxygen, magnesium infusions. Some required the use of helix [a breathing gas of helium and oxygen to help breathing].

Labs [bloodwork] that are being done are CBC, BMP, VBG, and blood culture if fever, possible influenza or RSV [tests] to rule those out as root causes. Chest X-rays are [also] done. (look below for description of these tests)

What advice would you give to scared parents bringing their kids into the ER?

To parents, I want them to be aware but don’t panic. Give [your children their] prescribed breathing treatments if they have a prior history and follow up with their [Primary Care Physician]. Come to the emergency room if they have labored breathing. Have your child lift up their shirt and look at their chest. If you see them using their abdominal muscles, sucking in between the ribs, or sucking in the throat, they need to be seen in the emergency room. If they are running a fever, Tylenol and Motrin are always appropriate except children under 6 months of age can only receive Tylenol. Don’t worry that we won’t believe you that they had a fever [if you treated it with motrin or Tylenol], it is always appropriate to treat. But, remember that fever is just a number. High fever doesn’t necessarily mean they are sicker. Look at how well your child is taking oral fluids, playing, and responding medications.

Explanation of Tests: 

A CBC is a Complete Blood Count which checks a white blood cell count for infection, hemoglobin and hematocrit to check for if your baby/child is experiencing anemia or if their blood volume and oxygen in the blood is low.

A BMP is a Basic Metabolic Panel that checks for electrolytes.

VBG is a Venous Blood Gas to check to see if your baby/child is breathing well enough (if not breathing well, it will show an imbalance of carbon dioxide and oxygen).

A blood culture means a sample of blood is taken and put on a slide and in a lab container to see what kind of kind of bug grows. This also is done to help decide which kind of antibiotic or antiviral will treat the infection.

A chest x-ray is a picture that’s taken to see how clear the lungs are. The doctors will be able to see if the airways are very tight, if the lungs are well-inflated, and if there is “junk” in your baby’s lungs.

Knowledge is power, so I hope you feel comforted in knowing a little more about this. It’s still always super scary when your little one gets sick, and when it involves their breathing it is even scarier. However, it’s good to know what to expect and not buy into some of the hype out there. The world isn’t over because of EV-D68, but hopefully this virus will be, soon!

Sources:

Non-Polio Enterovirus Infection – About: http://www.cdc.gov/non-polio-enterovirus/about/index.html

Transmission of EV-D68: http://www.cdc.gov/non-polio-enterovirus/about/transmission.html

Entervirus D68 CDC: http://www.cdc.gov/non-polio-enterovirus/about/EV-D68.html?s_cid=cdc_homepage_whatsnew_001

Trends in Asthma Prevalence: http://www.cdc.gov/nchs/data/databriefs/db94.pdf

Up-to-date prevalence: http://www.cdc.gov/non-polio-enterovirus/about/EV-D68-states.html

Symptoms of Non-Polio Enterovirus Infections from the CDC: http://www.cdc.gov/non-polio-enterovirus/about/symptoms.html

CNN – Enterovirus D68 in 19 States, Canada: http://www.cnn.com/2014/09/17/health/enterovirus-outbreak/index.html

American Academy of Pediatrics: Advice on Managing Fevers in Children: http://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Issues-Advice-on-Managing-Fevers-in-Children.aspx

American Public Health Association’s Get Ready Blog on EV-D68: http://getreadyforflu.blogspot.com/2014/09/ev-d68-whats-that-what-you-need-to-know.html

Infant CPR & Choking

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I figured after a few weeks of fun posts like diaper bags and baby goodies, I would publish one on a more serious note.

Recently, one of my friends from nursing school posted on Facebook about how she just performed the Heimlich maneuver on her choking toddler, who accidentally swallowed a screw. Now, Heather is a really attentive and caring mom (who is also an ICU nurse) so I figured well if this can happen to her, it can happen to anyone!

I myself am not sure I would be able to witness my baby choking or cardiac arrest without completely losing it, so I figured I would brush up on my infant CPR and guidelines in response to choking and share them on Little Sproutings. After all, my Basic Life Support (BLS) certification online training has expired, so I need to review it for work anyway. Plus, if anything, readers can familiarize themselves with an overview so they can try on their own if they are ever put in this scary position, instead of freak out and call 911, resulting in delayed treatment. 

So here goes… (the below information is what I have learned from onlineAHA.org through my own BLS certification)

Basic Infant (up to 12 months old) Life Support

CPR: Cardio-Pulmonary Resuscitation

Pulse Check for Baby: You check for a brachial pulse, above the elbow on the inside of their upper arm, with 2 fingers:

CPR Brachial Pulse

Sequence of Life Support: Compressions, Airway, Breathing

Chest Compressions: For infants, each compression should be 1.5 inches deep, to approximately the 2nd knuckle on your index finger. For every 15 compressions, give baby 2 breaths if you’re alone, 30 compressions then 2 breaths if you have someone to help. Compressions should continue for 2 minutes (at least 100 compressions per minute) or 5 cycles before checking for baby’s pulse. Your fingers (for compressions) should be at the center of the baby’s chest, just below the nipple line on the lower half of the breastbone. Compress to a steady beat, like in the chorus of the song “Stayin’ Alive,”  by the BeeGees,  which is not too fast or slow. 

Single Rescuer Compression TechniqueCPR Compressions

2-Rescuer Compression Technique: (one person at baby’s head keeping airway open, one person with thumbs encircling rib cage):

CPR 2 rescuer


Rescue Breaths: Tilt the baby’s chin up using one hand to lift the baby’s jaw so baby’s head is in the “sniffing” position (be sure not to hyperextend baby’s neck, because this can close off the airway) and the other fingers to tilt the chin up.  Place your mouth over baby’s nose and mouth to make a tight seal and give 2  breaths  lasting 1 second (not too fast or long) that make the chest rise. Do not give a big breath and do not over extend the baby’s neck. (Jia wasn’t a fan of demonstrating rescue breaths)

CPR Head Tilt Mouth to MouthIMG_2591

 

********* WHAT TO DO IF YOUR BABY BECOMES UNRESPONSIVE************

Do a quick check to see if baby is responsive and breathing. Tap their foot quickly to elicit a response. Check to see if baby is breathing. If not breathing and unresponsive, check for a pulse for ONLY 10 SECONDS. If s/he does not have a pulse or you can’t feel a pulse:

  • If you witnessed baby go unresponsive: Have someone call 911.  Start chest compressions. If you are alone, call 911 immediately then return to baby to start compressions.
  • If you did NOT witness baby go unresponsive and you are alone, begin compressions right away (for every 30 compressions give 2 breaths). Repeat for 2 minutes, then call 911. If someone was with you, have them call 911 while you start compressions.
  • Begin CPR right away for 2 minutes. Every 15 compressions, give 2 breaths if someone is with you. If you are alone, give 30 compressions and then give 2 breaths.  Do this for 2 minutes (5 rounds of compressions and breaths) before re-checking for a pulse.
  • Repeat this until you feel a pulse. Once you feel a pulse (yay!!) check to see if it’s more than 60 beats per minute. If not, continue chest compressions to make sure baby is getting enough blood flow.
  • Hopefully you have 911 on the phone so the operator can help walk you through this, too!

Relief of Choking in Infants:

Choking occurs when there is an object closing the airway. If there’s a mild obstruction (you can see something in their mouth) that you can’t get out and the baby is able to cough and breathe but can’t cough forcefully enough to remove, call 911. If baby is severely choking – the baby can’t breathe or make sounds, is turning blue, unable to cry – you need to perform back slaps and chest thrusts. NEVER PERFORM THE HEIMLICH MANEUVER ON AN INFANT! They are too little and performing it can be fatal. 

  1. Kneel or sit down in a chair
  2. Hold baby face down with head slightly lower than her chest (like pictured below) with baby’s body resting on your forearm.
  3. Support baby’s head and jaw with the same hand making sure you are not wrapping your fingers or resting your hand on their throat. Rest your arm on your thigh.
  4. Deliver 5 back slaps between the baby’s shoulder blades with the heel part of your hand. CPR Backslaps
  5. Next, place your free forearm on the baby’s back and cradle her head with your hand. The baby will be held between both forearms. Rotate baby as a unit, so that she is on her back but her head is still supported with the other hand.
  6. Perform 5 firm downward chest thrusts as pictured below, with your fingers on the lower half of the baby’s breastbone just below the nipple line (like chest compressions).Chest Thrust CPR
  7. If this does not relieve choking, repeat the sequence of 5 back slaps and 5 more chest thrusts until relieved or baby is unresponsive (then place infant on flat surface, start CPR without checking for a pulse, and rescue breath sequence checking the mouth for the object for 2 minutes, then call 911 if you are alone. If someone is with you, have them call 911 immediately and then start CPR). You start CPR without a pulse check because you know choking was the reason for baby becoming unresponsive, not because of a heart problem.

Good luck and I hope you NEVER have to put these skills to practice!!!

Sources:

http://circ.ahajournals.org/content/122/18_suppl_3/S640.full

BLS for Healthcare Providers @ onlineaha.org 

To find a CPR class near you, to become certified, visit: www.onlineAHA.org

Disclaimer: The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. It is not intended on being used as a certification in Basic Life Support. All content, including text, graphics, images and information, contained on or available through littlesproutings.com is for general information purposes only. Little Sproutings makes no representation and assumes no responsibility for the accuracy of information contained on or available through this website, and such information is subject to change without notice. You are encouraged to confirm any information obtained from or through this website with the American Heart Association or the American Red Cross. This information is current at the time this post was published. LITTLE SPROUTINGS (AS WELL AS ITS AUTHOR) IS NOT RESPONSIBLE NOR LIABLE FOR ANY ADVICE, COURSE OF TREATMENT, DIAGNOSIS OR ANY OTHER INFORMATION THAT YOU OBTAIN THROUGH THIS WEBSITE. As a Registered Nurse and mom, I feel it is my duty to post information that can potentially save a little one’s life. My hope is that this information will help save babies’ lives when there is no healthcare personnel present. 

No infants were harmed in the making of this or any post on Little Sproutings :) 

Next Week’s Topic: EV-D68 – The Respiratory Virus that is Causing a Stir

A Sprout By Any Other Name…

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Recently, as our little family has been out in public, I’ve received many compliments and questions from moms about my iPhone case. It’s covered from edge to edge with Jia pictures from her first month and I love it!

Personalization is so fun and makes a gift or trinket special. Before I had Jia, I liked things that were monogramed, though I never had anything of my own personalized except my push present purse that Jeff bought for me. But, after Jia’s arrival, I have a better appreciation for personalized keepsakes. So many of my friends’ babies were born with such neat names, they may need a little personalization, too! (this is for you, Kannon, Madison, Kipton, Gage, Colbie, Tiana, Hayden, Lorelei, Liam, Liana, Lena, Kadence, Caden, and so many more cuties!)

We put a lot of thought into naming Jia, and with so many adorable pictures we’ve taken of her, we are so happy to have things with her name (and face) on them.

Here are a few personalized items that Jia has, that I adore:

Names in Knit, LLCNames in Knit is a company started by retired dietitian and stay-at-home mom, Paula Ceresnie. She makes personalized gifts like dolls, doll blankets, storybooks, coloring books, sweaters, hoodies, baby and stroller blankets, pillows, cuddle bears, and more! We were lucky enough to have been gifted Jia’s soft baby blanket (photographed above) by a family member and the quality is just incredible. Her blanket is double-sided, we got to choose yarn color, and Jia does a great job modeling it as you can see! I am positive it will be one of her favorite keepsakes for years and years to come. Even after washing, the blanket is super soft. (Thanks Ching and Janice!)

From Paula: “The world needs another baby gift company like Names In Knit to help make babies and parents feel special about the gifts they give and receive. Parents spend many hours and days thinking and picking out a name to fit their new baby.  Should the name honor a Grandparent or show tribute to someone?  Should the name be traditional or popular?  A baby’s name is special, it’s something to be proud of.  Every baby has its own name and identity and should have their own Names In Knit personalized knit baby blanket.  Gift givers and parents love giving and receiving blankets and personalized knits from Names In Knit because it is a gift that lasts.  A favorite comment we receive is “I am going to college and taking my blanket with me; it has always been on my bed.  It’s my favorite”   Everyone wants to give a gift that is special, but we still need help getting the word out to more and more people.  We want to share the joy and love a personalized knit blanket brings.”

IMG_2492Snapfish iPhone Case – I just love Snapfish.com. I’ve been a loyal member since 2003 and they always have great quality products, prints, gifts, etc. After Jia was born and I upgraded my phone from a 4S to a 5S, I was plagued with the question of what case to buy for it, but I also wanted my sweet girl on it. If you were like me, any excuse to talk about your baby to strangers filled you with pride, and you felt more important to the world knowing you were a mom. Anyway, for $34.99, you can plaster your loved one’s face all over your case! You can also customize photo mugs, desk photo panels, canvases, photo albums, posters, fleece blankets, keychains, Christmas ornaments, baby announcements, calendars, and more. Snapfish almost always has a coupon floating around, so make sure to search for one. I got $12.60 off my phone case order. Their customer service is fantastic, if you’re unsatisfied with any order they will make sure it gets done right. Photographed is my phone case along with a mug I got free (they send so many special e-mail offers) and the month-by-month books I make for her. I try to wait until there’s a “buy one book, get two free!” type offer in my e-mail. They come pretty frequently, so just sign up! 

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Land’s End Personalized Hooded Bath Towel - We received a sweet plush personalized hooded towel for Jia, light pink with a darker pink bow on the hood with “Jia” embroidered beneath. It’s my favorite hooded towel, since it’s the softest and thickest – even moreso than our organic one from TL Care. Though our towel is no longer available, they still have others! Lots of other companies make personalized hooded bath towels, too. (Thanks Rebekah and Ellis!)

Pottery Barn Kids Personalized Stroller Blanket - Another gift we received that I love is our stroller blanket from Pottery Barn Kids. Jeff’s company sent us a gift after Jia was born, personalized with her birthday and name. It’s adorable and just about the softest plush velvety fabric you could imagine! You can choose font styles, thread color, appliqués, monograms, and style. Our Stroller Blanket is a great quality thick chamois blanket that will certainly keep her warm in the winter months, strolling around outdoors. We also feature it in all of her monthly birthday photos. (See our Stroller Blanket in previous post here.) PB Kids has a cute personalization section. (Thanks MicroStrategy!)

6K3A6244Homemade - Homemade is always an option for personalization, of course. Pinterest houses millions of arts and crafts ideas that can spark the interest of anyone with any skill level. Jia’s godmother, Megan, made Jia this beautiful burlap wreath. It hangs above her crib and really completes her nursery. When we lived in a 1 bedroom condo, we hung this above her crib in her section of the living room which helped make her space “hers.” The wreath really came in handy for her newborn photoshoot, since who doesn’t love putting a tiny baby in awkwardly adorable poses? (photo by leeliuphoto.com

Other websites, like PersonalizedPacifiers.com or Makaboo.com or places like Etsy are always available for specially customized handmade gifts.

Do you have any really neat personalized baby items? Where are yours from?

Next Week’s Topic: Infant CPR

The Diaper Bag: Your Season’s Fashion Must

Blog Diaper Bag Photo 3

A parent’s diaper bag is a vital accessory once baby arrives. When Jia was pretty new to us, I would get a little bit anxious leaving the house because I really didn’t know what I needed to stuff inside of it and if there was enough of it all. Sometimes I’d go out and realize I left my nursing cover at home, or I would have an abundance of burp cloths but forgot to replenish the stock of bibs in the diaper bag. While preparing to leave the house by changing a diaper, feeding, or getting Jia strapped into her carseat, I needed my husband to make sure the diaper bag was ready.

We cloth diaper at home with Cloth-eez pre fold diapers with Thirsties Duo Wraps (with snaps) or Bummis Simply Lite diaper covers, and use The Honest Company‘s eco-friendly/baby-friendly disposables when we’re “on-the-go” for an extended period of time or for overnight. But, if we are going on a short afternoon trip, we tend to keep Jia in cloth. That being said, our diaper bag is usually pretty stuffed to the brim.

Here’s what we always have in our bag:

  • At least 4 Honest disposable diapers
  • Honest Company travel wipes
  • Honest Soothing Bottom Wash and disposable wash cloths
  • Nasal aspirator
  • 1 change of clothes
  • 1 pair of socks
  • Baby leggings
  • 2 Cloth-eez prefolds
  • Nursing cover
  • Planet Wise Wet Bag – Medium (waterproof, so much that it can be filled with water and won’t leak, used for spitty clothes/bibs/soiled cloth diapers)
  • Aden & Anais swaddle blanket (for shielding the sun if Jia’s in the stroller or as a nursing drape)
  • Umbrella
  • Miniature Manicure set (Earth Therapeutics, from TJ Maxx, has teeny tiny nail clippers, scissors, tweezers, and larger nail clippers)
  • Sun hat
  • Baby Shades
  • California Baby Super Sensitive Broad Spectrum sunscreen
  • JJ Cole Agility Wrap baby carrier (it’s easy to fold/shove into a bag)
  • Extra Avent Soothie Pacifier
  • Extra bibs (Jia is a spitter, so I keep at least 3 on hand)
  • Extra burp cloths (at least 2), we use the cloth-eez prefolds that Jia has outgrown since they are super absorbent
  • Package of Unscented Boogie Wipes

(wow I’m realizing how much stuff that is, and wondering how in the world I am able to put it all into one bag!)

A few things about what’s inside:

Honest Diapers – When Jia was a newborn, her bottom was protected with Huggies Pure & Natural, which we actually needed since Jia was so tiny. She was full-term, but I felt the Honest Newborn diapers were just too wide for her (I had her nursery stocked with newborn Honest Diapers way before she was born). But, after 1.5 weeks in Huggies, she had so many poop blowouts that I had to switch her to the Honest diapers – luckily by then she was able to fit them. I was tired of doing so much poo laundry, especially when she was so young! I was sleep-deprived and trying to survive as a first-time mom with a newborn for goodness sakes! The last thing I wanted to do was spend time with what little energy I had, to do laundry. The performance of the Honest Diapers has been unbelievable. With Huggies Pure & Natural, I was dealing with at least three poo-exploded onesies each day… Once I switched to Honest diapers, I only did the laundry because we were running out of outfits! I had MAYBE one soiled onesie after 3 or 4 weeks. I really love what the company stands for and between cloth diapering and Honest products, I don’t ever have to worry about chemicals next to her tushie.

Cloth-eez Prefold Diapers – These are 100% cotton pre fold diapers that you fold yourself and secure with pins or a Snappi and use a diaper cover on top. You re-use the cover as long as it’s not soiled, just wiping polyurethane lining if it gets a little wet and secure a fresh with a new cloth-eez pre fold inside. We tried the microfiber/bamboo inserts from Alva Baby (wrapped with a Thirsties Duo Wrap), but not more than 2 diaper changes would go by where we didn’t end up with a soiled diaper cover, too. Cloth diapering support groups recommended me doubling up on inserts, and that only helped half of the time. A friend of mine from nursing school raved about Cloth-eez and since we made the switch, we’ve been very happy!

Blog Diaper Bag PhotoAvent Soothie Pacifiers – I held off for 2.5 months before giving Jia a pacifier for fear of nipple confusion. After working at WIC and promoting practices that supported breastfeeding, I was hard-wired to avoid the pacifier (recommended until baby’s latch is adequate and breastfeeding is well-established) and so I avoided them altogether. As a result, Jia did not take well to pacifiers initially. Once she got old enough, I wanted to find a way to quickly soothe her if I couldn’t swaddle and rock/hold her (like in the car seat or falling asleep in the crib), so I tried The First Years Gumdrop pacifiers that we got free from the hospital. She did OK with them, but of course, they kept falling out and really wasn’t interested in them. Then, a friend with a newborn recommended Wubbanubbs and they have been LIFESAVERS! They are Avent Soothie Pacifiers with a tiny baby-safe stuffed animal sewn to it. It helps prevent pacifiers from falling off baby’s face/chest and can be placed in a swaddle to stay close to baby. These pacifiers have worked wonders and are the best texture and fits comfortably around her lips. Jia has a cow, giraffe, and froggie (A nearly 3 month old Jia photographed on day 1 with her Wubbanubb).

Overall, I have found that the sunhat, nursing cover, and blanket have been so important to have in the diaper bag. Jia doesn’t like her baby sunglasses much, but she is happy in her sunhat. The blanket is useful for chilly legs, shading from the sun, a modesty drape for nursing, or a swaddle. 

What must-have items do you have in your diaper bag?

Boobie-nomics: Nature’s Supply & Demand

Boobienomics

I was just recently asked to write a post about building a milk supply, not because of difficulties in latch or getting the milk let-down going, but how to amplify a breastmilk stockpile and what to do to make sure your supply is maintained. So here goes:

So my passion for breastfeeding first started back in my days spent as a summer intern at The Special Supplemental Nutrition Program for Women, Infants, & Children (WIC) in Lafayette, Indiana. In the weeks leading up to our World Breastfeeding Week Celebrations August 1-7 (World Breastfeeding Week), the other interns and I worked tirelessly to artfully craft displays, flyers, educational games for kids to learn about breastfeeding, and other materials to promote breastfeeding. During the celebrations, we  sat in breastfeeding workshops to help mothers learn about baby latching and baby holding techniques, helped educate WIC clients, and played games to create a positive atmosphere surrounding “Breast is Best.” I remember that even at the young age of 20 I was really looking forward to breastfeeding my future baby.  My most impassioned presentations in my undergraduate studies, particularly in my Nutrition Communications class (F&N 424 taught by Barbara Mayfield), surrounded the physiological/immunological benefits of breastmilk to the infant. I even flirted with the possibility of becoming IBCLC Certified to be a Lactation Consultant (I decided not to because it would be way too expensive and take way too long to complete while working full time as an ICU nurse). 

Fast forward nearly a decade and here I am exclusively breastfeeding my 6 month old. Let me just start off by saying that there was no question on whether or not I would breastfeed Jia. My husband knew how determined I was to exclusively breastfeed her in order to give her the best chance at a strong immune system and high IQ, almost to the point where I was a little afraid I’d jinxed myself and would encounter difficulties once Jia arrived. 

So, after Jia was born, I continued steadfast with this same degree of determination. (See the above picture, that was my stockpile that I donated to a Children’s Hospital Milk Bank)

My husband’s close friend Justin’s wife Armita has been such an invaluable resource. Once Jia was born, I didn’t have a friend who lived nearby who’d semi-recently had a baby to the point where she was past the “what am I doing?” stages but still had all her experiences still fresh in her mind. She had her baby Axel in March the previous year and guided me through figuring out when to pump to maximize my supply.  Thanks Armita!!!

The Pump:

Baby is the best at getting milk. As they should be, right? Second best – the pump. 

I have a Medela Pump In Style Advanced Double Electric Breastpump and I love it. It’s effective, comfortable to use, and it’s very straightforward. My health insurance covered the cost of my pump (I searched Medela’s website for medical suppliers that take insurance and called each one to see if they took my insurance. I was determined to use a Medela, since it’s the best out on the market). I paid something like $25 extra to get the tote bag, and the tote bag didn’t even have the peekaboo spot for the pump, so I’m not sure what the point was… 

Some of my friends have other pumps, and quite frankly, most have had problems with theirs. The suction is too weak, the parts are confusing, the suction isn’t comfortable, the list goes on. When I was pregnant, I asked women what pump they used. The ones that had Medelas were very satisfied. 

Your pump shouldn’t feel uncomfortable. If yours works and is comfortable, then that’s all you need!

Whether you are pumping to amp up your milk supply and/or you’re stockpiling for your return to work, below are some pearls of wisdom from my experience.

What I Learned and Did

  • Get to know your breastpump. They are intimidating at first. There are so many tubes, flanges, tiny little plastic parts, little membrane circles, it’s all a bit daunting. Just read the picture manual and try it when you have a good 15 minutes to relax and let it sink in. I felt overwhelmed, but Armita told me – “Just sit down and try it. It’s really not bad.”
  • Having trouble pumping? Try a few things: Check to make sure the breast shield fits you (picture on right from medelabreastfeedingus.com). If the pressure is painful, try to start at a lighter intensity of suction by turning down the knob. Readjust the breast shield so that it is centered on your nipple. Sometimes the pump cPrintan feel so mechanical and foreign that it’s hard to relax to get your milk to let-down. A warm compress can help your milk ducts release. Lightly massaging the breast tissue can help this too. Sometimes looking at pictures or videos of your baby can help stimulate the milk let-down. If you’re stressed out or anxious, this can DEFINITELY affect your let-down. Try to turn on some relaxing music or put on a TV show that you like. My let-down takes a long time when Jeff watches Sons of Anarchy… 
  • Start pumping when your baby is about 1 month old. That way you get a feel for how much your baby will be eating and how often.
  • Know this – The breast is an “organ of active production,” as Marie Davis, RN IBCLC says on her website, lactation consultant.info. This means that when the breast is stimulated to produce, it will produce. When the demand for more milk is sensed, the breast will produce more in response – Boobie-nomics! 
  • If your baby eats from one breast, make sure that breast is completely empty by pumping it after baby is done eating, then pump the other breast. Empty breasts re-fill faster. Partially empty breasts are slower to re-fill. (Obviously if I was out in public I wouldn’t do this, but when I was at home, this is what I did) Do this in the daytime and at nighttime, once you put your baby back down to sleep or hand her over to your partner so you can pump. 
  • When your baby goes to sleep for the night, pump 3 hours after the last time you fed your baby (Jia fed at 7:15 PM before bed, so I made sure to pump at around 10:30 PM, since she would wake up at about midnight for a feeding when she was still eating at night). This will stimulate your body that there is still a demand for milk, so it’ll maintain and increase your supply!
  • Don’t skip night feedings and let someone else do the feeding [if you're not pumping instead]. You don’t want your body to think it doesn’t need to make milk.
  • When you wake up in the middle of the night because your breasts feel full, go and pump them. If you’re worried your baby may wake up for a feeding soon, do what I did: I pumped one entire breast and partially drained the other. That way I still had some for when she was hungry, but the pressure from one was relieved (whew! It can be painful!) and one breast is empty (and ready to fill). After Jia was weaned off of night feedings (the last time I pumped in the middle of the night), my body slowly learned that we don’t feed the baby at night. So I wake up really full and pump, getting 10-11 ounces, putting 7 ounces in a bottle for Jeff to feed Jia for breakfast and the rest gets reserved for later freezing. 
  • When you’re still establishing your supply, do not pump a bottle to later let your partner feed the baby without pumping while they are feeding the baby! You don’t want your body to think the baby didn’t need to be fed in the absence of feeding. Example:  If you pumped at night, so your partner could feed the baby the next evening while you slept, your body isn’t getting the trigger to produce milk. Instead, your body thinks the baby didn’t need to eat during that time. If Jeff fed a bottle to Jia before bed so I could go to the gym, I pumped immediately after I came back from the gym. This did two things: I replenished the stockpile, and I told my body to still keep making milk! 
  • Eat lots of carbs, don’t go on a diet, and drink tons of water. Water intake means milk output. Carbs (bread, pasta, muffins, cookies, etc.) help stimulate milk ducts, mostly because of the yeast in them. I’ve learned that oats, flax, and yeast help stimulate milk production. If you’ve heard about lactation cookies (to increase/maintain milk supply), read below for the recipe I used, it includes all 3 of these ingredients. 
  • If you’re leaking, use a Milkies Milk-Saver. (TMI – Before I knew of this genius invention, I hovered over 2 empty Avent bottles to collect whatever was dripping before and after a shower, and even when I was nursing on one side, I let the other side drip into a bottle) Milkies is an awesome invention that lets you slip this soft silicone pod into your nursing bra/top of the side that you’re not using to nurse, so your let-down reflex milk doesn’t go to waste. It collects in the pod. I saved about 2 ounces every time. Add that up and with a baby 0-3 months, you’ll have a full feeding after two uses without even trying! Milkies is responsible for a good bulk of my early freezer stockpile. I got mine on Amazon.com. After a while, you stop leaking so much and a little disposable nursing pad keeps you from leaking. I use Lansinoh Disposable Nursing Pads. (They’re not eco-friendly, but the organic reusable nursing pads I bought got soaked through in an instant and even 6 months out, I still leak if there’s cotton next to me). I’ve found they are cheaper at Target than Amazon. 
  • Save bags in volumes that your baby eats. This is so there is minimal waste. Time, date, and write down the volume on the bag, then freeze. or refrigerate. When Jia was 0-2.5 months, she ate 3-4 ounces per feeding (one side). After 3 months, she started needing more, so she ate 5-6 ounces per feeding. We found this out because Jeff would try and feed her before bed when he came home from work in time, and when she started needing more, she would give him an ear full! She’s 6 months old and eats about 5-7 ounces per feeding, 4 feedings per day and solids once a day. The Lansinoh bags are my favorite. They have a writeable space on the tab, the volume increments are accurate, they stand upright on a flat surface after filling, and they have a double zipper that clicks as you seal them. I got mine on Amazon.com 
  • Limit alcohol consumption (til you know how it affects you, or you have a good supply). For some people, alcohol dries up their supply, due to dehydration. If you have more than one drink, you may not want to keep that milk for your little one. Our pediatrician told us that one drink is fine as long as you don’t consume alcohol immediately before you feed the baby. She said no need to “pump and dump” with one drink, if a couple hours before the next feeding.

Doing what I’ve listed above, I was able to donate over 564 ounces of milk to the King’s Daughters Milk Bank! I donated because I had about 5% of freezer space left for food. And, because Jia had an intolerance to soy and dairy the milk I’d saved wasn’t safe for her. Even now after donating, we have an entire shelf in a second freezer in the basement that is getting full! 

3 main ingredients to help boost one’s milk supply are: oats, flax seed, and brewer’s yeast. Nutritional yeast or baking yeast will not work, it must be brewer’s yeast. You can find it on amazon for about $5, or in Whole Foods for about $15 for a large canister. I read on Baby Belly’s website that raw cookies (like my recipe) are more effective than baked cookies. Or, you can always toss some flax seed, oats, and brewer’s yeast into one of your cookie recipes, too!

Lactation Cookies: 

  • 1/2 c coconut oil (or 1 stick of butter if you can have dairy)
  • 1/2 c milk (I use almond milk)
  • 4 Tbsp cocoa powder (I use organic unsweetened cacao)
  • 1/3 c agave or honey (I use organic agave from Trader Joe’s)
  • 1 c peanut butter (I use Trader Joe’s Organic Unsalted Creamy)
  • 1 Tbsp vanilla extract
  • 1/3 c  ground flax seed (I got mine from Trader Joe’s,  theirs is ground with blueberries but beware if your’e avoiding soy, it has soy lecithin)
  • 1/4 c brewers yeast (I bought a canister of un-bittered yeast from whole foods)
  • 3 c rolled oats (I use Trader Joe’s organic old-fashioned whole grain oats)

Mix first 4 ingredients over medium high heat in a large pan/wok and boil for 1 minute. Lower heat to medium. Add peanut butter and vanilla. Once mixed together, add the flax and yeast, then gradually add the oats. Turn off heat once well mixed, then wait til the mixture isn’t hot. Roll into little ball/cookie shapes onto wax or parchment paper. Refrigerate and done! I ate about 3-4 a day, mostly because I craved sweet and salty. It’s like a chunky Reese’s ball. I’ve shared this recipe with many friends and they love them. Tell your partner they will lactate if they eats them (haha, they won’t) because they are so good you’ll want them all for you!

Lactation Smoothie: (I got this from Pinterest from here, it has the power of half a batch of Lactation Cookies): 

  • Whole banana
  • 2 Tbsp almond or peanut butter
  • 1 Tbsp brewer’s yeast
  • 2 Tbsp ground flax
  • 1/3 C oats
  • 2-3 Tbsp cocoa powder
  • Agave/Maple syrup to taste

Put all ingredients in a blender. Top with almond milk and ice cubes, blend!

Other ingredients known to help milk supply: fenugreek (often in Mother’s Milk tea, you can’t donate milk if you take this) and fennel tea.

Happy Milking!

Disclaimer: If you are having trouble with latching or if you’re unsure if your baby is getting enough milk, speak with your pediatrician or lactation consultant. Try to consult with these professionals to ensure you are not missing anything! Breast is best and there are so many health benefits of receiving breast milk! Some moms have insurmountable difficulties with breastfeeding which makes them ultimately unable to feed their babies. It’s OK if this is you, your baby will thrive and will still be happy, healthy, and above all, loved! 

Sources for increased lactation with supplementation:

BabyBelly.com.au Lactation Cookies Recipes

Effect of yeast culture (Saccharomyces cerevisiae) on adaptation of cows to postpartum diets and on lactational performance. Garrett JE, Robinson PH. J Anim Sci. April 1999 77(4): 988-999. 

The effects of supplementing diets fed to pregnant and lactating ewes with saccharomyces cerevisiae dried yeast. Zabek K., Milewski S., Wojcik R., Siwicki AK. Turk J Vet Anim Sci. 2014. 38 (2): 200-206. 

Introducing my Sprout to Solids

Blog Post Solids Photo

As a dietetics major in undergrad, we were well-versed in maternal and infant nutrition since this was one of our core requirements come our senior year in the program. We learned about theories behind maternal nutrition throughout pregnancy and postpartum, as well as what baby needs to thrive. What was always hammered into our Maternal and Infant Nutrition course was that baby should know how to support her own head, have an interest in the food of those around her, and be 6 months old.

Six months, six  months, six months!

Baby’s iron stores are only good enough to last 6 months out of the womb (as well as zinc, protein, vitamins B and D), so by the time baby reaches 6 months of age, iron-fortified cereal has long been the recommendation as a first food for baby for as long as I can remember. Breastmilk alone is nutritionally complete for the first 6 months of life. I also learned early exposure to solid foods can have a negative impact on baby, mostly because baby’s gut hasn’t fully matured enough to handle solid foods without possible inflammation, allergies, constipation, and/or diarrhea. However, before I even had Jia, I noticed on my Facebook newsfeed that a lot of my friends were starting their babies on solid foods right around the 4 month mark. Despite all of the adorable pictures of babies with food all over their faces, in my head I questioned this since it went against what I learned all those years back in college.

Reasons I’d encountered were:

  • an older family member or parent thought the baby would sleep better at night
  • the cereal given in bottles would alleviate reflux/colic, as directed by pediatrician
  • parent thought the baby seemed hungry after feedings
  • parent just felt like their baby was old enough

Then, I had Jia. At her 4  month appointment, we went in for a follow-up for her soy/dairy intolerance. At the end of our appointment, our pediatrician said, “Normally I would be starting her on solid foods right now, but because of her soy and dairy allergies I want to hold off.” I actually breathed a gigantic sigh of relief – I wasn’t at all comfortable starting her so early. But I thought to myself, Why were the rules changing? 

So, I went to where I knew to look: the American Academy of Pediatrics.

The American Academy of Pediatrics (AAP) recommends waiting to introduce solid foods until infants are between 4 and 6 months old. – aap.org

The rules hadn’t changed drastically, but they did change.

Continuing my search, a 2010 article from the Maternal and Child Health Journal titled, “Introduction of Solid Food to Young Infants” states that exclusively breastfed babies should not start solid foods until they are 6 months old, while formula-fed babies should be started between 4 and 6 months.

We introduced Jia to solids at 5 months & 1 week old. She’d been experiencing teething symptoms, no longer sleeping through the night, often crying and screaming until she nursed at night. Jeff and I’d been going back and forth between Tylenol doses and Hyland’s Teething Tablets still unsure what would settle her. I went ahead and tried solids because of the AAP’s recommendation and that of our pediatrician to allay her discomfort and trouble sleeping. After two nights, she was back to sleeping. Not sure if it was because she was really ready to eat solids to keep her full at night (the pediatrician said she was requiring nighttime feedings due to increased calorie requirements) or if her gums just coincidentally started feeling some relief. 

which food first?

Yet another change is to the traditional solid-food sequence! Back in the day in dietetics, we learned introduction of solids should go in this order: iron-fortified cereal, vegetables, fruits, meats. Veggies were always before fruits, for fear of baby developing a sweet-tooth (or sweet-gum, ha). Nowadays, it’s a free-for-all. Though they say that single-grain cereals are usually started first, the AAP states “there is no medical evidence that introducing solid foods in any particular order has an advantage for your baby,” and that “babies are born with a preference for sweets…the order of introducing foods does not change this.” Even though, I’m more comfortable starting a few vegetables before I introduce fruits to Jia.

what we did: (keep in mind, each food should be tried individually for a couple days to watch for allergic reaction before the next)

  1. Happy Bellies Organic Baby Oatmeal (1 Tbsp day 1, 1.5 Tbsp day 2, 2 Tbsp day 3)
  2. Freshly mashed avocado
  3. Frozen peas that were microwaved in water, water drained, peas mashed then mixed with a little breastmilk (the skin of the peas bothered me, the milk helped with consistency)
  4. Fresh peeled organic carrots (carrots are on the Dirty Dozen list of foods you should eat organically, due to pesticide content. See source below) steamed in our rice cooker then mashed. Jia – not a fan on day 1, and day 2 she kept having problems keeping carrots down. We’ll revisit carrots.
  5. Mashed banana with a tad of breastmilk
  6. Beets, peeled and steamed (vacuum-sealed from the grocery store), mixed with oatmeal
  7. Blueberries – mashed by hand
  8. Pears – pureed with a food processor

Once Jia was OK (two poops that were OK, about 2 days) with the fruit/veggie, I would mix. Example: once she was ok with banana, I mixed banana and avocado, beets and blueberries, etc. 

To mash, so far for the majority of Jia’s venture into solid foods, I have been using Nuk’s Mash & Serve Bowl that we got from our Amazon.com Baby Registry. I was looking for something simple and would “upgrade” to a more intricate baby food making contraption if this one didn’t work. So far it is getting the job done, it washes out easily, and using Munchkin’s White Hot Safety Spoons, the food was easy to scrape out of the grooves of the bowl.  My MIL lent us her Cuisinart Food Processor which worked really well with the pears, so I’ll probably keep using that for my homemade foods. My favorite bib for solid food feeding has been Modern-Twist’s Baby Bucket Bib. It’s made of food-grade silicone so it is buttery soft and is SUCH a breeze to rinse and clean mashed up food, and can be rolled up and thrown into a diaper bag for food on the go. Jia loves to grab it and suck food off of it when she’s done. I LOVE it. Sometimes I put the Bibbitec Ultimate Baby Bib on her for extra mess protection – it’s like a smock for eating. I also got the Baby Bjorn Soft Bib, which is much more rigid, definitely not even close as soft. It has a cute little “pearl” necklace detail, but if given the choice, I’ll grab for the Modern Twist bib. To serve Jia’s little portions and to keep them portioned in the fridge or if on the go, I love the Wean Green Wean Cubes. They’re made of glass, so no harmful PVCs, phthalates or BPA, the lids snap on very securely with a reassuring *click* and they’re the perfect size.  I also have the Oxo Tot Baby Food Freezer Trays for our mixes. I haven’t poked them out of their freezer pods yet but they’re nicely sized 3/4 oz. cubes and the trays are BPA/phthalate free! The lid slides on (so it always fits onto the tray) and has a little lip at the top and bottom if you want to take out just one cube and leave the remaining cubes intact. 

Happy Eating!

Sources:

American Academy of Pediatrics (http://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/Starting-Solids-Too-Early-May-Increase-Obesity-Risk.aspx)

HealthyChildren.org (http://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Switching-To-Solid-Foods.aspx)

Maternal and Child Health Journal (http://link.springer.com/article/10.1007/s10995-010-0669-5/fulltext.html)

Dirty Dozen – Organic.org (http://www.organic.org/articles/showarticle/article-214)

Tooth Decay and Long-Duration Breastfeeding?! Not Even Close.

Blog Post 8.8.14

I apologize for the length of my first real entry on Little Sproutings. I am very passionate about this topic so I felt it was my job to address it very thoroughly!

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I recently came across an article on Parenting.com titled, “Breastfeeding Longer than 2 Years Associated with Tooth Decay,” where they cited a research study that claimed there was an association with long-term breastfeeding – that of which lasts longer than 24 months of age – with tooth decay. As a happily breastfeeding mom and a huge champion of moms being able to breastfeed as long as they are capable, I was deeply disturbed by this claim.

Not only was this statement irresponsible and dangerous, but I was also disappointed to have this article pop up from another one of their tweets during World Breastfeeding Week (August 1-7). 

First of all, breastfeeding is the best choice a mother can make for her infant/toddler (if she is not experiencing any physical problems with the ability to breastfeed). It provides the best immune system antibodies, great bonding opportunities, and helps reduce the risk of SIDS by developing a strong airway by utilizing a stronger sucking mechanism, among many other benefits that I will address in a later post. So, any attempt to find any negative association with breastfeeding leads me to criticize the source. Second, throwing a claim out there to the public – in a parenting forum – is likely going to make many families question the great decision that they have been making: breastfeeding as long as the baby will do so. 

As with any alarming or suspicious conclusions or conversely, anything that seems “too good to be true,” make sure you look into what research article they are referencing.

Here’s what to do when you find this sort of article:

Do a little digging by doing a quick google search to find the actual research article title. I found the Reuters Health article that cited one of the researcher’s names, Benjamin Chaffee. Then I went over to my trusted scholar.google.com – it was our go-to for finding research articles when I was studying for my Master’s Degrees and it shows you the actual research publication. Use the search terms that are used in the article.  I typed the headline from Parenting.com into scholar.google.com followed by the name “Chaffee” and clicked “Since 2014,” since it was cited as “recent research.” 

I found the original research article (source below) and looked into its methods and findings. Here are some of the MANY pitfalls that I have found: 

  1. This study was conducted among LOW-INCOME families in Porto Alegre, Brazil. I researched how prevalent dental care was in Brazil as a whole, and found a cross-sectional study (one that grabs an equal portion of participants from each qualifying category to get a representative sample of the entire population) and it showed that 31% of children aged 0-14 years old had NEVER had a dental visit. (Source below)
  2. The study’s methods stated that they accounted for confounding variables (things that would interfere and thus result in a bias) for “feeding habits and child growth” BUT…
  3. One of the key pieces of data used by these researchers was the intake of all fluids after 6 months of age, including breastmilk, formula, AND JUICE. **The American Academy of Pediatrics even states that children under 1 year of age should NOT BE GIVEN JUICE at all, and for those aged 1-6 years old, to limit juice consumption.** Further, those 12 months and older (since the study is for children who breastfeed after 2 years of age) provided data on junk food intake. 
  4. The study used confidence intervals to analyze their data; however, multivariate analyses (other ways to study interaction of variables) should be conducted to identify causative factors here. 

The researchers draw a very general conclusion about tooth decay and breastfeeding from a non-representative sample that has recently been used in United States media sources. This claim is not only dangerous, but it is also unfair to blame breastfeeding as the culprit rather than pointing the finger at the actual negative habits of those in this study. Feeding juice to infants and allowing children 12 months and older access to the list of junk food cited in the article, such as cookies, candy, chips, chocolate milk, soft drinks, sweet biscuits, and honey is the real problem! Babies that have just reached their twelfth month should NOT be eating these foods anyway! There is plenty of valid research showing the contribution of these junk foods to tooth decay.

I also found problems with the article on Parenting.com and Reuters Health. Sneaky writers will throw in legitimate sources, like those seen here. By citing a quote from the American Academy of Pediatrics, The American Academy of Pediatric Dentistry, or the World Health Organization (WHO), makes trusting readers and consumers believe that these great organizations agree with what is stated elsewhere in the article.

Reuters Health cited the WHO’s recommendation for mothers to breastfeed as long as possible and also referenced the American Academy of Pediatric Dentistry stating its recommendation of a first dental visit once the first tooth appears or the child is one year old. The National Center for Chronic Disease and Prevention and Health Promotion is also cited in Parenting.com’s article. By publishing statistics about tooth decay prevalence in children above two years of age, along with the statement, “Forty-eight percent of children over the age of 2 have tooth decay,” in the same paragraph implies that this is due to breastfeeding.  Parenting.com’s research source? The Daily Mail. Not the original research article. Did these respected organizations (WHO, AAP, etc.) contribute anything about how breastfeeding is associated with tooth decay? The answer is: No. 

“Exclusive breastfeeding is recommended up to 6 months of age, with continued breastfeeding along with appropriate complementary foods up to two years of age or beyond.” – The World Health Organization

Chaffee is quoted in the Reuters article saying that “Our study does not suggest that breastfeeding causes caries (cavities),”  but this quote did not make its way on to the Parenting.com article. Excessive sugar intake is most definitely a huge factor along with limited to no access to dental care. 

The Australian Breastfeeding Association does a wonderful job at addressing this all-too-frequent attack on breastfeeding and dissects the contributing factors to tooth decay. La Leche League International also addresses parents’ and dentists’ concerns about night nursing and cavities to which they put it quite nicely: “some kids get dental cavities in spite of nursing, not because of it.”

Breastfeeding does not seem to be the problem here. Not even close. I hope the writers at Parenting.com, Daily Mail, and other similarly influential outlets to parents do a much more thorough job at their research in the future before publishing such a claim. These are not pitfalls of breastfeeding; rather, these are pitfalls of poor oral hygiene. 

Sources: 

Association of Long-Duration Breastfeeding and Dental Caries Estimated with Marginal Structural Models. Chaffee B., Feldens C., Vitolo M. Annals of Epidemiology. 2014, 24 (6):448-454.

Inequalities in dental services utilization in Brazilian low-income children: the role of individual determinants. Baldani MH., Mendes YB, Lawder JA, de Lara AP, Rodrigues MM, Antunes JL. J Public Health Dent. 2011 Winter 71 (1): 46-53.

American Academy of Pediatrics: Where We Stand: Fruit Juice. http://www.healthychildren.org/English/healthy-living/nutrition/Pages/Where-We-Stand-Fruit-Juice.aspx

World Health Organization: Breastfeeding. http://www.who.int/topics/breastfeeding/en/

Parenting.com: http://www.parenting.com/toddler/health/breastfeeding-longer-2-years-linked-to-child-tooth-decay

Why “Little Sproutings” was Planted

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One Friday this past July my husband Jeff, our nearly 5 month old daughter Jia, and I were driving to Brooklyn, NY to attend a friend’s wedding. We started talking about my friend who has two little girls, one the same age as Jia and the other almost two years old. She and I would message back and forth on Facebook, taking turns between asking for advice and answering the other one’s questions about babies and being a mom. Most recently,  she’d asked how I weaned Jia off of nighttime feedings, how often Jia nurses in the daytime/at what intervals, and how I structure her nap times. She lightheartedly referred to me as “mommy extraordinaire” and was slightly embarrassed at sounding like a first-time mommy.  Mommy Extraordinaire? I felt flattered but couldn’t help but laughed to myself. I told her that I am far from extraordinary; however, I give lots of credit to my many mamma friends for the great advice that has helped me through my formative months as a new mom.

As Jeff and I continued up the never-ending NJ Turnpike, we talked about how I should start a blog – a discussion area – as a resource to other moms with similar concerns that I have had as a new mom (for example, key foods that I have had in the cupboard throughout Jia’s intolerance to soy and dairy, how Jia sleep trained, my quest for the least poo-accident-prone cloth diapering system, baby items that I couldn’t live without, or items that I wish I’d had when Jia was a newborn that would have made my life much easier!), tying in my knowledge as a healthcare provider (we all know you should vaccinate your kids, so what’s the deal with the resurgence of whooping cough and measles?). 

Jeff thought my perspective would be unique. My experiences working in public health and as a nurse would allow me to reach an audience at more of an educational level, while at the same time I am a new and (at times) struggling mom who is also learning. Every baby is both special and unique, and parenting styles vary from family to family.

I am in no way a pediatric expert or even a near-perfect mom. I just hope that my experiences, both good and bad, along with the legwork I have put in to researching various topics and products, will be helpful to someone one way or another. If my readers are able to learn from my mistakes or benefit from my input, then I’ll be paying it forward!

A big big hug to my husband who gave me the encouragement and support to get this thing going, and to Brooker for helping me get started! Many huge thanks to my Mom, Mother-in-Law Joyce, Armita C., Berry T., Crystal A., Cynthia T., Debbie H., Desiree C., Erin C., Erin M., Heather W., Kelly D., Lee G., Mary M., Megan K., Megan W., Patty F., Sam K., and all the other mommies out there who have helped me along the way! 

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