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Existential Dilemmas in Birth and Feeding

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Mary is an IBCLC as well as a PhD student engaged in interdisciplinary studies of public policy and social change as they pertain to social justice as well as the birth and feeding of all our tiny humans and the adults they grow to become.

​This blog is a collection of things she'd thought you may like to read: informational tidbits, some of her academic work, and tried-and-true tips and tricks for parents!

Alcohol and breast/chest feeding

9/24/2013

1 Comment

 
Dr.Jack Newman - September 24, 2013 · The following is from a blog by a mother who tested her milk for alcohol. Not one of those useless kits that you can buy at various stores, but tested at a toxicology laboratory. I will copy from her blog the method she used and the results. I think this puts the lie to the notion that women should not drink while breastfeeding or need to "pump and dump" (an appalling term) after having even one drink. The following is an exact quote from her blog:

Method:
First I took a sample of my milk (about 1 mL) prior to drinking any alcoholic beverage. I expressed the milk mid-nursing session to ensure I had a goodly portion of fore & hind milk. After completing the nursing session, I mixed myself an alcoholic beverage consisting of 2 oz of 80 proof (40%) vodka in 10 oz of soda (Sprite). I proceeded to drink the entire 12 oz in about 30 minutes. About 30 minutes after finishing (1 hour after beginning to drink), I expressed some milk (about 1 mL) and labeled it 'immediate'. I then waited 1 hour and expressed more milk (about 1 mL) and labeled it '2 hours'. In the 2 hours (from the beginning), I did not drink any more alcoholic beverages, drink other beverages, or eat any other foods. Another day, 1/2 of a beer (4.3% alcohol) and 2-6 oz glasses of wine were consumed within 1.5 hours. About an hour from the beginning of the last drink, a milk sample (about 1 mL) was taken. This sample was labeled '1 hour - 3 drinks'. Another sample was taken about an hour after that (2 hours after the beginning of the last drink). This sample was labeled '2 hours - 3 drinks'.

The samples were stored in the refrigerator until processing. An Agilent headspace instrument was used to run the tests. Propanol and ethanol standards were also tested to ensure the instrument was within limits. The instrument is maintained by the KSP Lab Toxicology Section and used in forensic determinations of blood and urine alcohol content.

Results:
The sample labeled as 'immediate' registered as 0.1370 mg/mL which correlates to 0.01370% alcohol in the sample. The sample labeled '2 hours' registered as 0.0000 mg/ml which correlates to 0.0000%. The sample labeled '1 hour - 3 drinks' registered as 0.3749 mg/mL which correlates to 0.03749% alcohol in the sample. The sample labeled '2 hours - 3 drinks' registered as 0.0629 mg/mL which correlates to 0.00629% alcohol in the sample.

Conclusion:
The alcohol content in breast milk immediately after drinking is equivalent to a 0.0274 proof beverage. That's like mixing 1 oz of 80 proof vodka (one shot) with 2919 oz of mixer . By the way, 2919 oz is over 70 liters. Two hours after drinking one (strong) drink the alcohol has disappeared from the sample. Completely harmless to the nursing infant. Drinking about 3 drinks in 1.5 hours resulted in higher numbers, but still negligible amounts of alcohol would be transferred to the child. One hour after imbibing in 3 drinks, the milk was the equivalent of 0.07498 proof beverage. That would be like adding 1 oz of 80 proof vodka (one shot) to 1066 oz of mixer (1066 oz is over 26 liters). Two hours after imbibing in 3 drinks, the milk was 0.01258 proof. That would be like adding 1 oz of 80 proof vodka to 3179 oz of mixer (over almost 80 liters). So, even though an infant has much less body weight, any of these percentage of alcohol in breast milk is unlikely to adversely affect the baby. Bottoms up!

​
1 Comment

Bottle feeding technique

2/13/2012

0 Comments

 
From The Womanly Art of Breastfeeding, 8th Edition by La Leche League International (c) 2011

  • Feed the baby when he shows hunger cues, not on a schedule.
  • Hold the baby snugly. Keep him fairly upright to give him control.
  • Hold the bottle almost vertically against his lips at the start, as you would hold your finger to say "Shh."
  • When he reaches with his lips, tip the bottle horizontally into his opening mouth. Let him draw it in himself, so his lips close on the flat part of the bottle nipple, *not* just the skinny part.
  • Keep him fairly upright, so that the bottle is nearly horizontal when it's in his mouth. The milk won't pour into him automatically, and he'll have much more control.
  • You may hear him sucking some air, but it will just come out his nose.
  • If he gets tense or gulps, tilt baby and bottle slightly forward so the milk drains away. He will soon learn to pause on his own.
  • Let him pause and take breaks when he wants to.
  • When you think he is *nearly* full, twist and remove the bottle.
  • Immediately offer the bottle again to see if he wants more. If he takes it, offer another ten sucks or so, remove, and offer again.Finally he'll just keep his lips closed. This reduces the risk of overfeeding.
  • If he routinely doesn't finish the bottle, put less in it.
  • If there's milk left over, don't throw it out! It will keep just fine in the refrigerator until the next feeding.
  • If his mother is coming soon, try to distract him, or give him just a small amount. She'll be ready to nurse, and she'll want him to be ready too."

 The only thing I have to add to the above recommendations is to make the baby "work" for "letdown" while bottle feeding so that they have to suck that first stimulatory suck that they do when they latch onto the breast, which triggers the mother to let down. After a minute or so you can allow the nipple to get more milk to simulate letdown. After several minutes there, tilt the bottle backwards again so they have to "work" for another "letdown" and continue until the baby is finished (NOT necessarily until the bottle is empty).

For folks who need some rules to follow- general rules of thumb include no more than once ounce per hour, and it's a good idea to have 20-30 minutes be the goal to finish the bottle. If the baby is finishing the bottle in less time than that, their stomachs won't have enough time to communicate to their brains that they're full. Slow feeds more accurately replicate breastfeeding so they prevent both overfeeding and flow preference! It's generally much better to offer smaller amounts more frequently (i.e. 1.5-2 ounces every 1.5-2 hours) than larger amounts less often (i.e. 3-4 ounces every 3-4 hours).
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  • About Us
  • Services
    • WNY Orofacial >
      • Tethered Oral Tissues Defined
      • Treatment Philosophies
      • What to Expect
      • TOTs Challenges
      • TOTs Info
      • The Truth about TOTs
    • Breastfeeding Support Center
    • Virtual Parenting Support
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    • Request Your Initial Assessment
    • Schedule Your Follow-Up
  • Contact
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