The Benefits of Respecting the 'Golden Hour'

I recently had the privilege of assisting a mother breastfeed her baby shortly after birth. When I came into the mom's hospital room, her baby was already placed on her chest skin-skin and looking ready to breastfeed. We used the baby-led latching technique and after about 20 minutes of attempting, got the baby latched on and the breastfeeding journey had begun. This made me think that we as health care providers really need to examine the way we respect the mother-baby dyad within the 'Golden Hour' after birth. Hence my latest blog!!!

 The way your baby is cared for and nurtured immediately after birth significantly impacts their transition from the womb to life outside. In a culture that commonly separates mothers and babies for routine procedures such as cleaning, weighing and measuring, most babies are missing that critical time of being skin to skin with their mothers, which has short and long term consequences for all. As these procedures are not necessary to maintain or enhance the well being of either mother or baby, there is no reason why they cannot be delayed beyond the first critical hour.

The first hour should be focused on baby’s first breastfeed and mother-baby and family bonding. Unless mother or baby is in need of medical assistance, hospital protocols should support this time of new beginnings for both vaginal and caesarean births.

What Is An Undisturbed First Hour or sometimes referred to as the 'GOLDEN HOUR'? Babies are born and immediately placed tummy down on their mother’s stomach. A warm blanket should be placed over both mother and baby, to keep mother warm. This slows the production of adrenaline hormone in her so as to not interfere with oxytocin and prolactin hormones being produced (essential for bonding and breastfeeding). - At this time, the mother’s needs are simple: warmth and a quiet, calm environment. It is important to remember that she is still in labour – the placenta and membranes are still to be birthed, and her uterus needs to contract down.

Here are 7 important reasons why the first hour after birth should be undisturbed:

#1: Baby-Led Initiation of Breastfeeding It is quite common these days for hospital staff to want baby to begin breastfeeding within the first hour. In addition to the importance of early feeding for mother-baby attachment and bonding, it also helps to expel the placenta more quickly and easily, reducing the risk of postpartum hemorrhage. Read more about the benefits of a natural third stage here. It’s common for caregivers to assist baby to latch onto the nipple, which is unnecessary in most cases. When babies who have not been exposed to medications are placed skin to skin with their mothers and left undisturbed, they will instinctually crawl to their mother’s breast and attach themselves to the nipple. This is now known as the ‘breast crawl’ and was first observed by Swedish researchers in the 1980s. Further observation discovered that babies are born with innate instincts that assist them in finding their mother’s nipple, like all newborn mammals.

#2: Body System Regulation Babies who are left skin to skin with their mothers for the first hours immediately after birth are better able to regulate their temperature and respiration. Newborns aren’t able to adjust their body temperature as well as older children and adults as they don’t have the same insulating fat levels. They have spent nine months in an environment that is perfectly temperature controlled. If babies lose too much heat, they have to use more energy and oxygen than they can spare to try and keep their temperature stable. An undisturbed first hour with skin to skin also reduces the risk of hypoglycemia (low blood sugar levels). Newborn babies can produce glucose from their body stores of energy until they are breastfeeding well and are more likely to do so when they remain skin to skin with their mothers.

#3: Promotes Delayed Cord Clamping Leaving the umbilical cord intact while it is still pulsating allows babies to receive oxygen still via the placenta, while adjusting to breathing through their lungs. Being skin to skin with their mothers helps babies to stabilize respiration, meaning that their cord will remain intact for longer and giving them more chance to receive vital red blood cells and reduce the risk of iron deficiency anemia. Even if you have a c-section, delayed cord clamping is possible, but not in all cases. Ultimately it depends on the willingness of your chosen care provider and your unique situation. Speak to your care provider to see if he or she supports delayed clamping during straight forward c-sections. It’s an important question to ask when interviewing your care provider.

#4: Promotes Mother-Baby Attachment Prolonged skin to skin after birth allows mother and baby to get to know each other. Mothers who have skin to skin contact after birth are more likely to feel confident and comfortable in meeting their babies’ needs than those who had none. Attachment is critical to newborn survival and mothers are hard wired to look after their young. Oxytocin receptors in a woman’s brain increase during pregnancy, so when her baby is born, she is more responsive to this hormone that promotes maternal behaviour. Oxytocin is produced in large amounts when breastfeeding and holding babies close skin to skin. Mothers who had early skin to skin with their babies are more likely to demonstrate bonding behaviours later in their child’s life, such as kissing, holding, positive speaking and so on. 

#5: Improves Breastfeeding Success Rates Breastfeeding initiation and duration is likely to be more successful with babies who have early skin to skin contact. This is particularly important in countries where breastfeeding rates significantly drop a few months after birth, such as Australia, America and the UK. The World Health Organization recommends exclusive breastfeeding for babies in the first six months to achieve optimal growth, development and health. Creating the right conditions for the initiation of breastfeeding would help promote longer durations of breastfeeding for many women. Babies who are left to self attach usually have a better chance of proper tongue positioning when latching. This can increase long term breastfeeding as mothers experience more ease and fewer problems when latching is not an issue.

#6: Protects Against The Effects of Separation Babies are born ready to interact with their mothers – a newborn baby who has not been exposed to excessive medication will be very alert and gaze intently into their mother’s face, recognizing her smell, sound of her voice and the touch of her skin. Remaining with their mother is key to a baby’s survival and separation is life threatening. Babies are born with a mammal’s primal instinct to stay within the safe habitat of mother, where there is warmth, safety and nourishment. When babies are separated from their mother they will protest loudly, drawing their mother’s attention to their distress. Babies undergo what is literally a cold turkey withdrawal from the sensory stimulation of their mother’s body. If they are not reunited with their mother despite their protests, they will go into a despair state – essentially giving up and becoming quiet and still. This is partly a survival instinct to avoid attracting predators, and their body systems slow down to preserve energy and heat.

#7: Boost Your Baby’s Immunity Naturally When babies are born, they emerge from a near-sterile environment in the uterus and are seeded by their mother’s bacteria. This essentially trains the baby’s cells to understand what is ‘good’ and ‘bad’ bacteria. This kicks tarts their immune system to fight off infections and protects from disease in the future. Research indicates that if babies aren’t given this opportunity to be exposed to their mother’s bacteria, either because they are not born vaginally, held skin to skin or breastfed, then the baby’s immune system may not reach its full potential and can increase the child’s risk of disease in the future. Skin to skin contact and early breastfeeding is an excellent way to help increase your baby’s exposure to bacteria if you need a cesarean section for medical reasons. Find out more ways to boost your baby’s immune system here.

Tips For Planning An Undisturbed Hour After Birth A better understanding of how an undisturbed hour after birth impacts breastfeeding, mother well being and newborn development, helps make it possible for us to make informed choices about this critical period: Choose your birth carer and setting to increase your chances for an undisturbed natural birth and first hour. Caregivers should support you having an undisturbed first hour and leave routine baby checks until you are ready. Create an optimal environment for birth (warm, dim lighting, quiet, private, supported). This boosts the right hormones for natural birth, which reduces the need for interventions that could cause separation from your baby. Ensure your caregivers understand the important of leaving the umbilical cord intact until it has stopped pulsating, so baby cannot be separated from you. To promote production of oxytocin and prolactin, make sure your environment after birth remains warm and calm.

I hope you enjoyed this latest Nourish Blog. As always, please feel free to post any comments or questions. 

Happy Breastfeeding!!!

Credit to Sam McCulloch

 

 

Posted on May 1, 2016 .

When Does Breast Milk Come In? 7 Important Facts

Did you know that your breasts actually start making milk before your baby is born?

From around four months pregnant, your breasts start making colostrum.

Colostrum is the first milk your baby gets after being born, and is a concentrated source of anti-infective factors, protein and minerals.

However, your milk ‘coming in’ refers to when your breasts start making large volumes of breastmilk, and the composition changes (e.g. higher lactose and lower sodium concentration).

When Does Breast Milk Come In?

Here are 7 important facts about your milk coming in:

#1: Your Breast Milk Will Come In Regardless Of Whether Your Baby Breastfeeds Or Not

Your milk coming in is driven by hormones, which means it will happen whether your baby breastfeeds or not.

During pregnancy, you have high levels of prolactin (your milk making hormone). But you don’t make lots of milk during pregnancy due to high levels of the hormone progesterone. High levels of progesterone prevent prolactin from doing its job fully.

After your placenta has come away (third stage of labour), this makes your progesterone levels plummet. In turn, this means prolactin levels (which continue to be high) can now kick into action, and start the process of making lots of milk.

#2: Your Breast Milk Will Most Likely Come In Around Day 3

For most mothers, their breast milk comes in between days 2 and 5.

Many first time mothers notice their breast milk comes in around day 3 or 4.

With subsequent babies, many mothers notice their milk comes in sooner – around day 2 or 3.

It’s important to remember that your baby gets colostrum from the very start, so you don’t need to be concerned that he is not getting anything to eat.

#3: Frequent Feeding In The Early Days Helps Build A Good Milk Supply

Ideally, your baby will have skin-to-skin time with you straight after birth, and during this time, he will receive his first breastfeed.

Thereafter, ideally you and your baby will be kept together (rooming-in) and you will continue to spend as much time as possible in skin-to-skin contact with your baby, feeding him whenever he needs to be fed. Learning hunger cues can be very helpful.

For more information about how to get breastfeeding off to the best start possible, read our article about what you need to know before the first breastfeed.

Getting breastfeeding off to the best start possible is important, because early frequent and effective milk removal increases prolactin activity in the breast, which helps you to set up an abundant and robust milk supply.

#4: Your Breasts May Feel Full, Warm And Hard

Milk production usually starts to increase between 30 – 40 hours after your placenta is delivered, but it may take a little while longer for you to notice the increased volume your breasts are making.

Different mothers feel different things in their breasts when their milk comes in. Most women experience their milk coming in as a gradual change, rather than something that happens all of a sudden.

Most commonly, mothers notice their milk coming in when their breasts feel fuller, warmer and harder. However, the degree to which different mothers feel this varies a lot. For some mothers, this feeling may be subtle (especially for women with large breasts) while for other mothers it may be very obvious and even painful.

If you happen to be expressing or leaking milk, you may notice that the milk changes from the thicker, yellow colour of colostrum to a thinner, whiter colour when your milk comes in.

If you don’t notice your milk coming in but you notice your baby’s poos changing to a lighter colour (e.g. yellow mustardy colour) by day 5, this is a good sign that your milk has come in.

#5: You May Notice Your Let-Down Reflex

The let-down reflex is where the hormone oxytocin allows the milk stored in the breasts to be released from the glandular (milk-making) tissue into the milk ducts and out of the nipple.

A baby suckling at the breast stimulates tiny nerve endings on the nipple and areola which signal for the release of the hormone oxytocin from the pituitary gland in the brain.

Some mothers don’t ever feel their let-down reflex while others feel it very strongly, especially when their milk comes in.

If you are a mother who feels your let-down reflex, you may notice a tingling sensation, a slight pain or sudden fullness in your breasts. You may notice milk leaking from the breast your baby isn’t feeding from (as the let-down reflex occurs in both breasts simultaneously). You may notice your baby’s sucking changing from a quick shallow suck to a deeper more rhythmical sucking when your let-down occurs.

#6: There Are Some Things That May Delay Your Milk Coming In

If your milk comes in later than day 3, it is said that there is a delay in your milk coming in.

Here are some possible reasons that could mean there is a delay in your milk coming in:

Birth Factors

Mother’s Health

Issues that affect a mother’s hormones may cause a delay in her milk coming in. For example diabetes,polycystic ovary syndrome, hypothyroidism, obesity.

Other Factors

Anything that impacts how well and how often milk is removed from a mother’s breasts may delay her milk coming in.

For example, if a mother is separated from her baby (e.g. baby is in special care nursery) or if her baby isn’t feeding well (e.g. due to a tongue-tie), milk may not be removed as often or as well and hence can cause a delay in her milk coming in.

#7: Don’t Lose Heart If There Is A Delay In Your Milk Coming In

If there is a delay in your milk coming in, remember that many mothers have been able to bring in a full milk supply even after a week or two (and sometimes even longer).

If it is recommended that you begin to supplement your baby with extra milk, you may find the Academy of Breastfeeding Medicine supplementation protocol very helpful.

Here are some things that can help to make your milk come in:

  • Discussing with medical or nursing staff, or a lactation consultant about what the possible cause of the delay for your milk coming in is. There may be things that can be done to help rectify the situation (e.g. if retained placental fragments are the issue, the milk usually comes in normally once the fragments are removed).
  • See a lactation consultant. A lactation consultant can undertake a thorough assessment to work out an individualised plan to get breastfeeding working well for you and your baby.
  • Ensure your breasts are frequently and effectively drained – at least 8 times every 24 hours. Ideally, this would be achieved by feeding your baby, but if your baby happens to not be feeding well, then expressing may need to occur. Before your milk comes in, hand expressing is the mainstay of expressing. Once your milk has come in, using a hospital grade electric pump (and finishing up with hand expressing) is ideal.
  • Frequent skin-to-skin contact with baby can also help with milk production.

Breastfeeding is our biological norm and thus our bodies are designed to make milk in a way that is suitable for newborns. Their tiny bellies are around the size of a marble on their first day of life, so it makes perfect sense that our mature milk doesn’t come in for a bit of time. Remember that though the milk doesn’t ‘come in’ immediately following birth, you are likely to make the perfect amount of colostrum.

Renee Kam IBCLC in Breastfeeding. Last updated on August 11, 2015

Posted on April 24, 2016 .

How We Make Breastmilk

How does milk production work?

By Kelly Bonyata, BS, IBCLC

To understand how to effectively increase (or decrease) milk supply, we need to look at how milk production works…

For the most part, milk production is a “use it or lose it” process.  The more often and effectively your baby nurses, the more milk you will make.

In the Beginning…

Endocrine (Hormonal) Control of Milk Synthesis — Lactogenesis I & II

Milk production doesn’t start out as a supply and demand process. During pregnancy and the first few days postpartum, milk supply is hormonally driven – this is called the endocrine control system. Essentially, as long as the proper hormones are in place, mom will start making colostrum about halfway through pregnancy (Lactogenesis I) and her milk will increase in volume (Lactogenesis II) around 30-40 hours after birth.

During the latter part of pregnancy, the breasts are making colostrum, but high levels of progesterone inhibit milk secretion and keep the volume “turned down”. At birth, the delivery of the placenta results in a sudden drop in progesterone/estrogen/HPL levels. This abrupt withdrawal of progesterone in the presence of high prolactin levels cues Lactogenesis II (copious milk production). Other hormones (insulin, thyroxine, cortisol) are also involved, but their roles are not yet well understood. Although biochemical markers indicate that Lactogenesis II commences approximately 30-40 hours after birth, mothers do not typically begin feeling increased breast fullness (the sensation of milk “coming in”) until 50-73 hours (2-3 days) after birth.

These first two stages of lactation are hormonally driven – they occur whether or not a mother is breastfeeding her baby.

Established Lactation…

Autocrine (Local) Control of Milk Synthesis — Lactogenesis III

After Lactogenesis II, there is a switch to the autocrine (or local) control system. This maintenance stage of milk production is also called Lactogenesis III. In the maintenance stage, milk synthesis is controlled at the breast — milk removal is the primary control mechanism for supply. Milk removal is driven by baby’s appetite. Although hormonal problems can still interfere with milk supply, hormonal levels play a much lesser role in established lactation. Under normal circumstances, the breasts will continue to make milk indefinitely as long as milk removal continues.

By understanding how local/autocrine control of milk synthesis works, we can gain an understanding of how to effectively increase (or decrease) milk supply.

What does current research tell us about milk production?

Current research suggests that there are two factors that control milk synthesis:

Milk contains a small whey protein called Feedback Inhibitor of Lactation (FIL) – the role of FIL appears to be to slow milk synthesis when the breast is full. Thus milk production slows when milk accumulates in the breast (and more FIL is present), and speeds up when the breast is emptier (and less FIL is present).

The hormone prolactin must be present for milk synthesis to occur. On the walls of the lactocytes (milk-producing cells of the alveoli) are prolactin receptor sites that allow the prolactin in the blood stream to move into the lactocytes and stimulate the synthesis of breastmilk components. When the alveolus is full of milk, the walls expand/stretch and alter the shape of prolactin receptors so that prolactin cannot enter via those receptor sites – thus rate of milk synthesis decreases. As milk empties from the alveolus, increasing numbers of prolactin receptors return to their normal shape and allow prolactin to pass through – thus rate of milk synthesis increases. The prolactin receptor theory suggests that frequent milk removal in the early weeks will increase the number of receptor sites. More receptor sites means that more prolactin can pass into the lactocytes and thus milk production capability would be increased.

Both of the above factors support research findings that tell us:

FULL
Breast=SLOWER
Milk
Production

EMPTY
Breast=FASTER
Milk
Production

Research indicates that fat content of the milk is also determined by how empty the breast is (emptier breast = higher fat milk), rather than by the time of day or stage of the feed.

How does milk supply vary throughout the day?

Earlier researchers observed that milk volume is typically greater in the morning hours (a good time to pump if you need to store milk), and falls gradually as the day progresses. Fat content tends to increase as the day progresses (Hurgoiu V, 1985). These observations are consistent with current research if we assume the researchers were observing babies with a fairly typical nursing pattern, where baby has a longer sleep period at night and gradually decreases the amount of time between nursing as the day progresses.

Storage capacity: Another factor that affects milk production and breastfeeding management is mom’s milk storage capacity. Storage capacity is the amount of milk that the breast can store between feedings. This can vary widely from mom to mom and also between breasts for the same mom. Storage capacity is not determined by breast size, although breast size can certainly limit the amount of milk that can be stored. Moms with large or small storage capacities can produce plenty of milk for baby. A mother with a larger milk storage capacity may be able to go longer between feedings without impacting milk supply and baby’s growth. A mother with a smaller storage capacity, however, will need to nurse baby more often to satisfy baby’s appetite and maintain milk supply since her breasts will become full (slowing production) more quickly.

 Think of storage capacity as a cup – you can easily drink a large amount of water throughout the day using any size of cup – small, medium or large – but if you use a smaller cup it will be refilled more often.

What does the research tell us about increasing milk supply?

Milk is being produced at all times, with speed of production depending upon how empty the breast is. Milk collects in mom’s breasts between feedings, so the amount of milk stored in the breast between feedings is greater when more time has passed since the last feed. The more milk in the breast, the slower the speed of milk production.

To speed milk synthesis and increase daily milk production, the key is to remove more milk from the breast and to do this quickly and frequently, so that less milk accumulates in the breast between feedings:

EMPTY
Breast=FASTER
Milk
Production

In practice, this means that a mother who wishes to increase milk supply should aim to keep the breasts as empty as possible throughout the day.

To accomplish this goal and increase milk production:

  1. Empty the breasts more frequently (by nursing more often and/or adding pumping sessions between nursing sessions)
  2. Empty the breasts as thoroughly as possible at each nursing/pumping session.

To better empty the breasts:

  • Make sure baby is nursing efficiently.
  • Use breast massage and compression.
  • Offer both sides at each nursing; wait until baby is finished with the first side before offering the second. Switch nursing may be helpful if baby is not draining the breast well.
  • Pump after nursing if baby does not adequately soften both breasts. If baby empties the breasts well, then pumping is more useful if done between nursing sessions (in light of our goal to keep the breasts as empty as possible).

Are you having problems with oversupply?

Mothers who are working to remedy oversupply usually need to decrease supply without decreasing overall nursing frequency or weaning baby. One way to accomplish this is by “block nursing” – mom nurses baby as frequently as usual but restricts baby to one breast for a set period of time (often 3-4 hours but sometimes longer) before switching sides. In this way, more milk accumulates in the breast before mom switches sides (thus slowing milk production) but baby’s nursing frequency is not limited.

Posted on April 17, 2016 .

Why spiced-up breast milk is good for your baby’s food acceptance

I  recently attended a conference at the Alberta Children's Hospital called 'Nourishing the Neonate". The study in this article was mentioned during one of the speakers sessions. I find what foods to eat or avoid while breastfeeding is still one of the most common questions I get asked about, so I thought I would share this very interesting and informative article. Enjoy!!!

It was When I had my children, I felt that there was a tendency by experts, including those in my own pediatric profession, to push certain principles that took all the fun out of life. This played out for me, in particular, after I gave birth to my first child, and was told as part of my breast-feeding “support” that I should avoid all spicy foods, because they would upset the baby. Like any good Cambridge, Mass., mother, I turned this into an argument about multiculturalism (“What about the mothers in Sichuan?”), but what I really thought was that it harked back to some old ideas about spices heating up the blood, and generally making life too interesting for the nursing mother.

Why are women told to avoid strong flavours when breast-feeding?

Twenty-five years ago, researchers asked a group of nursing mothers to load up on garlic. In the study, Maternal Diet Alters the Sensory Qualities of Human Milk and the Nursling’s Behavior, which ran in 1991 in the journal Pediatrics, nursing mothers who ate garlic produced breast milk with a stronger smell, as evaluated by researchers who didn’t know which sample was which. What was most interesting was how the milk tasted to the babies, those poetically named “nurslings.” When the garlic effect was there, the babies stayed longer on the breast and nursed more vigorously.

Dr. Julie Mennella, a biopsychologist at the Monell Chemical Senses Center in Philadelphia, was the lead author on the 1991 study; she has continued to study the effect of early exposures on the development of taste. “Amniotic fluid and mother’s milk have a lot of sensory information,” she said. “The baby gets the information when they feed on the milk.”

Another study, published in 2001, showed that babies who had been exposed to a flavour in utero or while nursing were more likely to like that flavour when they were weaned.

What goes into your stomach goes into your bloodstream, broken down into molecules of protein, carbohydrate, fat. The flavours cross as well, including potent molecules called volatiles, which carry scent, which in turn heavily influences taste, as you know if you have ever tried to eat something delicious when you have a bad head cold.

The variety of flavours that you eat during pregnancy go into your blood and then into the amniotic fluid, which the baby is constantly drinking, in utero, and the flavours that you eat while nursing cross from the blood vessels that supply the mammary glands into the breast milk. So instead of restricting the maternal diet, there is now good evidence that by eating a wide variety of healthy and tasty foods during these periods, we are actually doing our babies a major favour.

“Breast-fed babies are generally easier to feed later because they’ve had this kind of variety experience of different flavours from their very first stages of life, whereas a formula-fed baby has a uniform experience,” said Dr. Lucy Cooke, a psychologist specializing in children’s nutrition, who is a senior research associate at University College London. “The absolute key thing is repeated exposure to a variety of different flavours as soon as you can possibly manage; that is a great thing for food acceptance.”

Her own research has included working with children at the age of weaning to increase the acceptance of vegetables by offering repeated exposures to them.

“Babies are tremendously adaptable and very accepting of all sorts of strange flavours,” Cooke said.

What about the idea that some foods in the mother’s diet can make a baby fussy or gassy or colicky? By definition, the foods that cause gas in the mother do so because they are not absorbed, and sit in her intestine, making trouble. On the other hand, a number of studies suggest that some colicky babies do better if their mothers stay away from cow’s milk, so doctors may advise nursing mothers to cut that out for a 10- to 14-day trial, while making sure they still get plenty of calcium.

Caffeine is sometimes also a culprit, pointed out Dr. Pamela High, a professor of pediatrics at Brown University and medical director of the infant behavior, cry and sleep program at Women & Infants Hospital of Rhode Island. But mothers of colicky babies often restrict their diets further and further, and many ultimately give up nursing, High said in an e-mail, even though this usually doesn’t help.

So yes, the flavours we eat when we’re pregnant or when we’re nursing, go to the baby, aromatics and all. But this should be a positive message rather than a list of thou-shalt-nots, since it means that we are providing something beyond protein and calories; we’re actually letting our babies, unborn and born, into some of the joys of our human omnivory.

“A diet of the healthy foods she enjoys is modelling at its best,” Mennella said. “The baby only learns if the mother eats the foods.”

When, as a nursing mother, I ate the spicy foods that I love so well, I’ll have you know that I was actually modelling. My children, after all, were going to grow up in a family in which spicy food was part of every possible family occasion.

And if the flavours of the foods you love can make the experience of childbearing and child rearing a little tastier, or spicier, for mothers, that’s all to the good as well, and very much in line with what we hope our children are drinking in mother’s milk.

“Food gives pleasure,” Mennella said. “There’s a lot of biology underlying the pleasure of eating.”

PERRI KLASS The New York Times News Service Published Thursday, Mar. 31, 2016 3:07PM EDT

Posted on April 9, 2016 .

Breast Milk vs Formula.....The Ingredients Speak For Themselves

What’s In Breast Milk and What’s In Formula?

By Kelly Winder in Baby. Last updated on February 15, 2016

Ever been curious as to what’s found in breast milk and what ingredients can be found in formula?

Developed by the Douglas College for the Breastfeeding Course for Health Care Providers, this eye opening comparison of breast milk ingredients and formula ingredients is astounding.

Please understand that this article has not been published so formula feeding mothers can feel guilty.

Nor has it been posted for anyone to feel superior.

BellyBelly often acknowledges that there are plenty of valid reasons why parents formula feed their babies and we support them.

We also understand that some things can be hard to hear when we’ve not come to peace with them.

This article contains important information that we need to know — it’s science, biology and healthcare all in one. It’s even more important to hear for those who have a choice and are researching what to feed their baby.

With information comes education, and with both of those things, it gives you power and options. BellyBelly is dubbed “The Thinking Woman’s Website” because it’s written especially for parents who want to know more than marketing hype when making choices and decisions — just as I did as a young mother. So if you feel you may be offended, please do not read any further.

 

Formula Ingredients

Water

Carbohydrates

  • Lactose
  • Corn maltodextrin

Protein

  • Partially hydrolyzed reduced minerals whey protein concentrate (from cow’s milk)

Fats

  • Palm olein
  • Soybean oil
  • Coconut oil
  • High oleic safflower oil (or sunflower oil)
  • M. alpina oil (Fungal DHA)
  • C.cohnii oil (Algal ARA)

Minerals

  • Potassium citrate
  • Potassium phosphate
  • Calcium chloride
  • Tricalcium phosphate
  • Sodium citrate
  • Magnesium chloride
  • Ferrous sulphate
  • Zinc sulphate
  • Sodium chloride
  • Copper sulphate
  • Potassium iodide
  • Manganese sulphate
  • Sodium selenate

Vitamins

  • Sodium ascorbate
  • Inositol
  • Choline bitartrate
  • Alpha-Tocopheryl acetate
  • Niacinamide
  • Calcium pantothenate
  • Riboflavin
  • Vitamin A acetate
  • Pyridoxine hydrochloride
  • Thiamine mononitrate
  • Folic acid
  • Phylloquinone
  • Biotin
  • Vitamin D3
  • Vitamin B12

Enzyme

  • Trypsin

Amino acid

  • Taurine
  • L-Carnitine (a combination of two different amino acids)

Nucleotides

  • Cytidine 5-monophosphate
  • Disodium uridine 5-monophosphate
  • Adenosine 5-monophosphate
  • Disodium guanosine 5-monophosphate

Soy Lecithin (an emulsifier)

When choosing formula for your baby, make sure you read the labels and choose a lower protein formula. A recent study has found that many formulas are being made on the higher acceptable limits of protein, which may be an explanation of the link between formula and childhood obesity.

 

What’s In Breast Milk?

Here is a summary of what ingredients can be found in breast milk.

 

Breast Milk Ingredients

Water

Carbohydrates (energy source)

  • Lactose
  • Oligosaccharides (see below)

Carboxylic acid

  • Alpha hydroxy acid
  • Lactic acid

Proteins (building muscles and bones)

  • Whey protein
  • Alpha-lactalbumin
  • HAMLET (Human Alpha-lactalbumin Made Lethal to Tumour cells): AMAZING!!!
  • Lactoferrin: AMAZING!!!!
  • Many antimicrobial factors (see below)
  • Casein
  • Serum albumin

Non-protein nitrogens

  • Creatine
  • Creatinine
  • Urea
  • Uric acid
  • Peptides (see below)

Amino Acids (the building blocks of proteins)

  • Alanine
  • Arginine
  • Aspartate
  • Clycine
  • Cystine
  • Glutamate
  • Histidine
  • Isoleucine
  • Leucine
  • Lycine
  • Methionine
  • Phenylalanine
  • Proline
  • Serine
  • Taurine
  • Theronine
  • Tryptophan
  • Tyrosine
  • Valine
  • Carnitine (amino acid compound necessary to make use of fatty acids as an energy source)

Nucleotides (chemical compounds that are the structural units of RNA and DNA)

  • 5’-Adenosine monophosphate (5”-AMP)
  • 3’:5’-Cyclic adenosine monophosphate (3’:5’-cyclic AMP)
  • 5’-Cytidine monophosphate (5’-CMP)
  • Cytidine diphosphate choline (CDP choline)
  • Guanosine diphosphate (UDP)
  • Guanosine diphosphate – mannose
  • 3’- Uridine monophosphate (3’-UMP)
  • 5’-Uridine monophosphate (5’-UMP)
  • Uridine diphosphate (UDP)
  • Uridine diphosphate hexose (UDPH)
  • Uridine diphosphate-N-acetyl-hexosamine (UDPAH)
  • Uridine diphosphoglucuronic acid (UDPGA)
  • Several more novel nucleotides of the UDP type

Fats

  • Triglycerides
  • Long-chain polyunsaturated fatty acids
  • Docosahexaenoic acid (DHA) (important for brain development)
  • Arachidonic acid (AHA) (important for brain development)
  • Linoleic acid
  • Alpha-linolenic acid (ALA)
  • Eicosapentaenoic acid (EPA)
  • Conjugated linoleic acid (Rumenic acid)

Free Fatty Acids

Monounsaturated fatty acids

  • Oleic acid
  • Palmitoleic acid
  • Heptadecenoic acid

Saturated fatty acids

  • Stearic
  • Palmitic acid
  • Lauric acid
  • Myristic acid

Phospholipids

  • Phosphatidylcholine
  • Phosphatidylethanolamine
  • Phosphatidylinositol
  • Lysophosphatidylcholine
  • Lysophosphatidylethanolamine
  • Plasmalogens

Sphingolipids

  • Sphingomyelin
  • Gangliosides
  • GM1
  • GM2
  • GM3
  • Glucosylceramide
  • Glycosphingolipids
  • Galactosylceramide
  • Lactosylceramide
  • Globotriaosylceramide (GB3)
  • Globoside (GB4)

Sterols

  • Squalene
  • Lanosterol
  • Dimethylsterol
  • Methosterol
  • Lathosterol
  • Desmosterol
  • Triacylglycerol
  • Cholesterol
  • 7-dehydrocholesterol
  • Stigma-and campesterol
  • 7-ketocholesterol
  • Sitosterol
  • β-lathosterol
  • Vitamin D metabolites
  • Steroid hormones

Vitamins

  • Vitamin A
  • Beta carotene
  • Vitamin B6
  • Vitamin B8 (Inositol)
  • Vitamin B12
  • Vitamin C
  • Vitamin D
  • Vitamin E
  • a-Tocopherol
  • Vitamin K
  • Thiamine
  • Riboflavin
  • Niacin
  • Folic acid
  • Pantothenic acid
  • Biotin
  • Minerals
  • Calcium
  • Sodium
  • Potassium
  • Iron
  • Zinc
  • Chloride
  • Phosphorus
  • Magnesium
  • Copper
  • Manganese
  • Iodine
  • Selenium
  • Choline
  • Sulpher
  • Chromium
  • Cobalt
  • Fluorine
  • Nickel

Metal

  • Molybdenum (essential element in many enzymes)

Growth Factors (aid in the maturation of the intestinal lining)

Cytokines

  • interleukin-1β (IL-1β)
  • IL-2
  • IL-4
  • IL-6
  • IL-8
  • IL-10
  • Granulocyte-colony stimulating factor (G-CSF)
  • Macrophage-colony stimulating factor (M-CSF)
  • Platelet derived growth factors (PDGF)
  • Vascular endothelial growth factor (VEGF)
  • Hepatocyte growth factor -α (HGF-α)
  • HGF-β
  • Tumor necrosis factor-α
  • Interferon-γ
  • Epithelial growth factor (EGF)
  • Transforming growth factor-α (TGF-α)
  • TGF β1
  • TGF-β2
  • Insulin-like growth factor-I (IGF-I) (also known as somatomedin C)
  • Insulin-like growth factor- II
  • Nerve growth factor (NGF)
  • Erythropoietin

Peptides (combinations of amino acids)

  • HMGF I (Human growth factor)
  • HMGF II
  • HMGF III
  • Cholecystokinin (CCK)
  • β-endorphins
  • Parathyroid hormone (PTH)
  • Parathyroid hormone-related peptide (PTHrP)
  • β-defensin-1
  • Calcitonin
  • Gastrin
  • Motilin
  • Bombesin (gastric releasing peptide, also known as neuromedin B)
  • Neurotensin
  • Somatostatin

Hormones (chemical messengers that carry signals from one cell, or group of cells, to another via the blood)

  • Cortisol
  • Triiodothyronine (T3)
  • Thyroxine (T4)
  • Thyroid stimulating hormone (TSH) (also known as thyrotropin)
  • Thyroid releasing hormone (TRH)
  • Prolactin
  • Oxytocin
  • Insulin
  • Corticosterone
  • Thrombopoietin
  • Gonadotropin-releasing hormone (GnRH)
  • GRH
  • Leptin (aids in regulation of food intake)
  • Ghrelin (aids in regulation of food intake)
  • Adiponectin
  • Feedback inhibitor of lactation (FIL)
  • Eicosanoids
  • Prostaglandins (enzymatically derived from fatty acids)
  • PG-E1
  • PG-E2
  • PG-F2
  • Leukotrienes
  • Thromboxanes
  • Prostacyclins

Enzymes (catalysts that support chemical reactions in the body)

  • Amylase
  • Arysulfatase
  • Catalase
  • Histaminase
  • Lipase
  • Lysozyme
  • PAF-acetylhydrolase
  • Phosphatase
  • Xanthine oxidase

Antiproteases (thought to bind themselves to macromolecules such as enzymes and as a result prevent allergic and anaphylactic reactions)

  • a-1-antitrypsin
  • a-1-antichymotrypsin

Antimicrobial factors (used by the immune system to identify and neutralize foreign objects, such as bacteria and viruses)

  • Leukocytes (white blood cells)
  • Phagocytes
  • Basophils
  • Neutrophils
  • Eoisinophils
  • Macrophages
  • Lymphocytes
  • B lymphocytes (also known as B cells)
  • T lymphocytes (also known as C cells)
  • sIgA (Secretory immunoglobulin A) (the most important antiinfective factor)
  • IgA2
  • IgG
  • IgD
  • IgM
  • IgE
  • Complement C1
  • Complement C2
  • Complement C3
  • Complement C4
  • Complement C5
  • Complement C6
  • Complement C7
  • Complement C8
  • Complement C9
  • Glycoproteins
  • Mucins (attaches to bacteria and viruses to prevent them from clinging to mucousal tissues)
  • Lactadherin
  • Alpha-lactoglobulin
  • Alpha-2 macroglobulin
  • Lewis antigens
  • Ribonuclease
  • Haemagglutinin inhibitors
  • Bifidus Factor (increases growth of Lactobacillus bifidus – which is a good bacteria)
  • Lactoferrin (binds to iron which prevents harmful bacteria from using the iron to grow)
  • Lactoperoxidase
  • B12 binding protein (deprives microorganisms of vitamin B12)
  • Fibronectin (makes phagocytes more aggressive, minimizes inflammation, and repairs damage caused by inflammation)
  • Oligosaccharides (more than 200 different kinds!)

 

Summing It All Up

That’s quite a lot to digest — pardon the pun! So to make sense of it all, I asked BellyBelly’s International Board Certified Lactation Consultant (IBCLC), Renee Kam, what she believes to be the most important ingredients in breast milk. We all know that breast milk is known for it’s protective and immune supporting properties — Renee reinforced this with her response. She says:

“Breastmilk contains the right balance of probiotics and prebiotics that human babies need to colonise their bowels with a healthy bacteria. Perhaps the most important anti-infective factor in breastmilk is an antibody called secretory IgA (sIgA). SIgA helps protect a baby from pathogens he is most likely to come across in the environment he lives in (we called this ‘targeted protection’). Breastfed babies may have asymptomatic infections (that don’t show any signs of inflammation) because of the anti-inflammatory factors in breastmilk, which can turn acute-inflammatory cells (e.g. neutrophils) off.”

The fats in breast milk are very important too.

“Of the fats in breastmilk, 88% are made from long-chain fatty acids. It’s these long-chain fatty acids (e.g. omega 3 fatty acids, especially DHA) that are constituents of brain and nerve tissue, and are needed in early life for mental and visual development.”

Finally, the self adjusting properties of breast milk are important too — a mother’s breast milk is custom made for her baby, based on the baby’s age and needs at the time. Renee says:

“The breastmilk a mother makes for her baby is different on day one, to day seven, to day 30, and so on. For example, the breastmilk made by a mother of a premature baby has different concentrations of various substances to suit her baby’s special needs. And, when weaning, a mother’s breastmilk increases the concentration of immune protective factors to give her baby a final dose of immune protection before weaning is complete.”

 



 

 

Posted on April 3, 2016 .