Newborn Care: Newborn Feeding
By Loraine Stern, MD

By now you have heard "breast is best" enough times to convince you to initiate newborn nursing. If it is a new skill for you, you may need some help getting started. Depending on the facilities at your hospital, how busy the women's unit is, how long you stay and whether there are lactation specialists to help you, you may leave the hospital well on your way. The critical factor is for you and your newborn to be together, preferably skin to skin, for as much of the time as possible.

If you need extra help with newborn feeding, and many women do, lactation consultants and educators are available in most communities - unless you live in Antarctica.

Resist the temptation to use formula in the first couple of weeks if your newborn seems to want to nurse every hour for a while. It is nature's way of stimulating your milk supply and using formula will interfere with this process.

The reasons a woman cannot nurse her newborn are very few - for example, anti-thyroid medications may prohibit breastfeeding. Some prior breast surgery may interfere. Most antibiotics and most routine medications are fine. Check with your pediatrician if you are not sure. A web site called LactMed has information about 700 medicines during breastfeeding by both trade names and generic.

Formula is wholesome and safe for newborns so if you have to or choose to formula feed do not feel guilty. Choosing a formula depends on several factors such as price, availability and family history. If, for example, there is a strong family history of milk sensitivity or allergy, you might be advised to either choose an alternate formula or watch for signs your baby is not tolerating a standard formula. Spitting up is not a problem but vomiting, diarrhea, blood in the stools may be signs of a serious reaction. Newborn gas is normal in the first few weeks and not necessarily from a formula intolerance. The newborn care video will discuss newborn feeding in more detail.

Newborn Care: Food Allergies
The rate of reported food allergies in children is increasing. As reported in Pediatrics, the number of doctor visits and hospitalizations because of food allergies has increased. This might represent an increase in awareness by doctors and parents rather than more allergic disease.

Can we help prevent food allergies in children?
Approximately 90% of allergic reactions to food are caused by 8 different food types: milk, eggs, peanuts, tree nuts, soy, wheat, shellfish and fish. Overall, studies have not shown that women who excluded eggs, peanuts, milk and fish while pregnant have children with fewer allergies than those without a restricted diet. Also, there is a lack of evidence to support that giving these foods to babies will cause, promote or worsen allergies.

There is, however, evidence that exclusive breast feeding for the first 3-4 months of life as well as continued breast feeding while introducing these allergenic foods might help with decreasing the amount of allergic problems in your child. Therefore, breast feed your newborn as long as you can. The American Academy of Pediatrics recommends at least a year and longer if possible.

More about Breastfeeding
The scientific data continues to be published regarding the benefits of newborn breastfeeding. A new study from the Netherlands shows that exclusive breastfeeding for four months reduces the risk of both respiratory and gastrointestinal infections by 45. The protection is even greater for the newborn if exclusively breastfed for six months, lowering the infection rate to 65% compared to formula fed babies. These results support the American Academy of Pediatrics and the World Health Organization's recommendations that all newborns and babies be exclusively breastfed for six months. In my practice, a lot of women return to work when the newborn is around four months old and find it hard to continue exclusive breastfeeding. This data shows that that all their hard work in nursing their babies has a fantastic health benefit even if they cannot make it to six months.

Another study recently published calculated the benefit to society if more newborns and babies were exclusively breastfed. The researchers looked at the illnesses that are decreased by breastfeeding in both babies and moms. They found that if 90% of American families exclusively breastfed for six months, the savings could amount to $13 billion a year and over 900 lives-with 95% of those being infants. We have a long way to go in this country. In 2005, approximately 12% of U.S. families exclusively breastfed their children for six months. The goal in 2010 is 17%. If met, this would save over $2 billion and 140 lives.

These numbers are overwhelming. These studies reinforce some of the health benefits of breastfeeding.

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