October 15, 2005

• LLLI Responds to AAP Policy Statement on Sudden Infant Death Syndrome

Schaumburg, IL (October 2005) La Leche League International (LLLI) is concerned about the October 10, 2005 policy statement on Sudden Infant Death Syndrome (SIDS) issued by the American Academy of Pediatrics (AAP) Task Force on SIDS. The recommendations about pacifiers and cosleeping in the statement reflect a lack of basic understanding about breastfeeding management.

Pacifiers, which are recommended in this policy statement, are artificial substitutes for what the breast does naturally. Breastfed babies often nurse to sleep for naps and bedtime. The recommended pacifier usage could cause a reduction in milk supply due to reduced stimulation of the breasts and may affect breastfeeding duration.

LLLI recognizes that safe cosleeping facilitates breastfeeding. One important way cosleeping can help a mother’s milk supply is by encouraging regular and frequent feeding. Well-known research on safe cosleeping practices by Dr. James McKenna, Director of the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame was disregarded by the task force.

Also, the obvious omission of input by the AAP’s Section on Breastfeeding may account for the fact that breastfeeding management issues were not taken into consideration. Dr. Nancy Wight, President of the Academy of Breastfeeding Medicine, comments that this statement “represents a truly astounding triumph of ethnocentric assumptions over common sense and medical research.” Dr. Wight also states, “There are many physician members of the AAP who do not agree with these recommendations.”

Although the authors do state that breastfeeding is beneficial and should be promoted, their recommendations about pacifier use and cosleeping could have a negative impact on a mother’s efforts to breastfeed. The statement causes confusion for parents and falls seriously short of being a useful and comprehensive policy.

LLLI, a non-profit organization that helps mothers learn about breastfeeding, has an international Professional Advisory Board. The LLLI Center for Breastfeeding Information is one of the world’s largest libraries of information on breastfeeding, human lactation, and related topics. Monthly meetings are offered to pregnant women and nursing mothers and babies to learn about breastfeeding management. To find local groups call 800 LA LECHE or visit www.lalecheleague.org

February 1, 2005

• Recent Studies Point to Breastfeeding as a Benefit to Future Heart Health

Schaumburg, IL (February 2005) February is American Heart Month and recent studies show that human milk may provide a lifelong gift for future heart health. While the immunological benefits of human milk for the infant are well-known, there is also compelling evidence that there are lifelong benefits for the child related to weight control, blood pressure and blood lipids.

An article in Current Paediatrics [1] reviewed data that concluded breastfeeding has beneficial effects later on in life with regard to cardiovascular risk factors including blood pressure and plasma lipid profile (cholesterol), and that it reduced the risk of obesity during childhood.

Another study, which appeared in Circulation[2], states that children who had been breastfed as infants had lower blood pressure at age seven than those who had been formula fed. While the benefit resulted from even two months of breastfeeding, the effect was greater for those who had been breastfed for at least six months.

In addition, a study published in the British journal Lancet [3] concluded that preterm infants fed banked human milk had reduced C-reactive protein. The amount of this protein is a measure of the inflammatory process associated with atherosclerosis.

Breastfeeding offers the greatest protection from illness when babies are receiving human milk alone; this protection declines in proportion to the amount of supplements, such as formula, cow's milk, or solid foods they receive. Babies also receive more benefits the longer they are breastfed. Scientific studies call this effect a "dose response."

La Leche League International (LLLI), a nonprofit organization founded in 1956, is the world's largest resource for breastfeeding information. It has a presence in over sixty countries worldwide. For information on the short and long-term benefits of human milk, for breastfeeding help, or to find a group in your area, visit the LLLI Web site at www.lalecheleague.org or call (847) 519-7730.

[1] Current Paediatrics 04;14;97-103

[2] Circulation 04; 109 (10):1259-66

[3] Lancet 04-5-15:363 (9421):1571-78

October 6, 2003

• Contamination in breast milk

There has been a lot of publicity the last few days about a study by the Environmental Working Group that showed high levels of fire retardants in the breast milk of US women tested. Leaders and other breastfeeding mothers can be assured that breastfeeding is best, even in a polluted world.

A new LLLI press release on contaminants in human milk is available here:http://www.lalecheleague.org/Release/contaminants.html. This release also lists ten simple ways a woman can help reduce her body burden of this and other chemicals. Even though this release is about contaminants in general and does not specifically mention fire retardants, LLLI was aware of the study before the news release was prepared.

Studies to test for certain chemicals can only be done using human tissues that contain fat. Human milk is a specimen that is more easily available than, for example, a fat biopsy. The Environmental Working Group, who sponsored the study, affirms that breastfeeding is more important than ever.

Environmental Working Group spokesperson Lauren Sucher states: Despite the increased evidence of BPDE contamination, the researchers noted that "breast-feeding remains the single most important choice mothers can make for the health of their babies, offering innumerable benefits to mother and child."

Fetal exposure appears to be the biggest problem, and breast milk, while a good indicator of fetal exposure, may actually help overcome some of the harmful effects, the researchers said.

Mary Hurt
PRAssociate@llli.org

PS: You can also refer mothers to our latest FAQ on the LLLI site:
"Contaminants have been found in human milk. Should I wean my baby?"

July 27, 2003

• Drugs & medication
For questions relating to breastfeeding and medications, the UCSD/Dr. Phil Anderson Drug Breastfeeding Hotline has a new number as of January, 2003. The new number is: (900) 226-7536.

• Sunlight Deficiency, "Vitamin D," and Breastfeeding (press release) Schaumburg, IL (April 17, 2003)

Exclusively breastfed healthy, full-term infants from birth to six months who have adequate exposure to sunlight are not at risk for developing vitamin D deficiency or rickets. Rickets occurs because of a deficiency in sunlight exposure, not because of a deficiency in human milk.

"Vitamin D" is a steroid hormone (misclassified as a vitamin in 1922) that is produced in the body upon exposure of the skin to ultraviolet B (UVB) radiation in sunlight. Rickets is the bone-softening disease of childhood caused by inadequate exposure to UVB radiation.

Very few foods naturally contain significant amounts of vitamin D. The biologically normal and most common means of obtaining adequate levels of vitamin D for human beings, including infants, is through casual exposure of the skin to sunlight. Because the skin has a large capacity to produce vitamin D, adequate levels can be developed from partial exposure of the body to small amounts of sunlight well before sunburn occurs.

According to the World Health Organization and United Nations Children's Fund, small amounts of UVB radiation are beneficial for people and essential in the production of vitamin D. However, excessive sunlight exposure can cause sunburn and increase the risk of skin cancer.

Concerns about sunlight deficiency, vitamin D and breastfeeding have been raised by a new American Academy of Pediatrics (AAP) clinical report. The AAP now recommends that all infants have a minimum intake of 200 IU of vitamin D per day beginning during the first two months of life. Risk factors for developing vitamin D deficiency and rickets include low maternal levels of vitamin D, indoor confinement during the day, living at higher latitudes, living in urban areas with tall buildings and pollution that block sunlight, darker skin pigmentation, use of sunscreen, seasonal variations in UVB radiation, and covering much or all of the body when outside.

"No known risks of 'vitamin D' supplementation exist at the level recommended by the AAP. However, no research has actually investigated whether 'vitamin D' supplementation during the first six months has any negative consequences for infant health, such as vomiting and aspiration when supplementation is not tolerated, harmful alterations of the infant gut, or increased risk of infection," said Cynthia Good Mojab, MS, IBCLC, RLC, Research Associate in the Publications Department of La Leche League International. Therefore, parents may wish to talk with their healthcare providers about their infant's risk of vitamin D deficiency and decide whether or not supplementation with this hormone is warranted for their infant.