Reducing the Risk for Formula‐Fed Infants: Examining the Guidelines

ABSTRACT: Early in this century, outbreaks of Enterobacter sakazakii among infants fed on powdered infant formula in Western Europe and the United States forced a rethinking of the cherished belief that artificial feeding is a very safe choice for infants in the developed world. Alarmed by these reports, the World Health Organization and the Food and Agriculture Organization convened an Expert Meeting in 2004 to determine the causes and again in 2006 to develop guidelines for reducing the risk to infants from intrinsic bacterial contamination in powdered infant formula. Reducing the frequency of contamination at the manufacturing level would eliminate about 80 percent of the problem. Reconstituting the formula with water boiled and cooled to no less than 70° C is critical to destroy remaining bacteria. Arguments from the infant formula industry, some segments of the medical community, and some Western countries against this “lethal step” trivialize the scope and severity of the problem and ignore clear scientific evidence. (BIRTH 37:1 March 2010)     

A Study of Breast Feeding Rates at a Large Australian Obstetric Hospital

Summary: A prospective breast feeding survey in a large obstetric hospital was carried out from 1988 to 1991. For each year, a sample of women were interviewed following delivery and data was collected which included the method of feeding, patient status (public or private patients), age, parity, (including previous breast feeding experience), marital status, country of birth and the number of babies. The mother's feeding method after delivery and on discharge from hospital were recorded. Women who were breast feeding on discharge were interviewed at 3 months. When putting the figures for the 4 years together, the breast feeding commencement rate was 88%, the breast feeding rate on discharge was 80% and the breast feeding rate at 3 months was between 51% and 57%. Factors found to be affecting die breast feeding rate at 3 months included patient status, age and parity. Problems experienced by the motiiers after discharge from hospital included nipple pain, nipple trauma and mastitis. Private patients reported a significantly higher rate of mastitis than public patients.     

Organizing and Documenting Lactation Support of NICU Families

A documentation tool designed for use by lactation consultants in the neonatal intensive-care unit provides an efficient and complete method for recording the progress of the mother and infant. It incorporates the research base into interventions that begin during the early postpartum period and continue through the preterm infant's hospital stay. The system for using this tool helps consultants in giving comprehensive and timely lactation support.     

Hyperlactation: How Left-brained ‘Rules’ for Breastfeeding Can Wreak Havoc With a Natural Process

A variety of arbitrary and often unphysiological rules for breastfeeding are frequently suggested to breastfeeding mothers. Many of these rules duplicate strategies commonly used to increase milk supply, and thus, when undertaken by the many women who already have a generous milk supply, can lead to overproduction. Oversupply, or hyperlactation, is a frequent yet often unrecognized problem that can present with a variety of distressing symptoms for the breastfeeding mother and her infant. Infants may present with symptoms suggesting colic, milk protein allergies, or gastroesophageal reflux, or may present with unusually rapid or slow growth. Mothers may present with tender leaking breasts, sore infected nipples, plugged ducts or mastitis, or even the perception of insufficient milk supply. With an understanding of the pathophysiology of these symptoms, proper diagnosis and breastfeeding management can allow milk production to return to homeostatic levels and provide dramatic symptom relief.