Birth Matters Virginia

Is Formula-Feeding Risky?

Two new studies say that there are risks for babies whose mothers choose to formula-feed. 

The first study put forth in the Journal of Perinatology was published in July of 2009. 

"Infant feeding decisions affect maternal and child health outcomes, worldwide. Even in settings with clean water and good sanitation, infants who are not breast-fed face an increased risk of infectious, as well as non-infectious morbidity and mortality. The decision not to breast-feed can also adversely affect mothers' health by increasing the risk of pre-menopausal breast cancer, ovarian cancer, type II diabetes, hypertension, hyperlipidemia and cardiovascular disease. Clinicians who counsel mothers about the health impact of infant feeding and provide evidence-based care to maximize successful breast-feeding, can improve the short and long-term health of both mothers and infants."

To read the full study, including how breastfeeding affects breast and ovarian cancers, click here.

The second study, from Wiley InterScience's Birth Issues in Perinatal Care came about in August 2009.

"When exclusive breastfeeding is set as the normative standard, the re-calculated odds ratios communicate the risks of any formula use. For example, any formula use in the first  6 months is significantly associated with increased incidence of otitis media (OR: 1.78, 95% CI: 1.19, 2.70 and OR: 4.55, 95% CI: 1.64, 12.50 in the available studies; pooled OR for any formula in the first 3 mo: 2.00, 95% CI: 1.40, 2.78). Only shorter durations of exclusive breastfeeding are available to use as standards for calculating the effect of "any formula use" for type 1 diabetes, asthma, atopic dermatitis, and hospitalization secondary to lower respiratory tract infections.

Conclusions: Exclusive breastfeeding is an optimal practice, compared with which other infant feeding practices carry risks. Further studies on the influence of presenting exclusive breastfeeding as the standard in research studies and counseling messages are recommended."

To see the full study, including their findings pertaining to asthma, Type I and II Diabetes, and atopic dermatitis, click here. 

 

 

Gestational Diabetes Linked to Weight Gain in First Trimester

If you're pregnant and concerned about developing or being diagnosed with Gestational Diabetes, a new study shows an increased risk with excessive weight gain in the first trimester.  Women who gain more than the recommended 3 to 6 pounds, have a higher risk of developing gestational diabetes than women who stay within the recommendations.  Black, hispanic, and asian women have a higher risk than white women, and women who are obese are also at greater risk.  For more information, click here.  For more information about gestational diabetes, check out the American Diabetes Association.

2010 More Than... LATCH Conference

    If you didn't get a chance to attend this year's Annual East Coast More Than... LATCH Conference*, you missed a lot of good information!  The full conference was 3 days of amazing presentations, skill labs, and great company.  The first day was comprised of skill labs.  Among the topics presented were how to properly fit a bra, how to identify a posterior tongue tie, and tandem nursing.  The day ended with an inspiring chat with Pat Farrell.  She reminded us all that we do what we do because it's our gift and the best way to use our gift is in the service of others.

  Days two and three were chock full of information presented by experts in various fields.  They covered topics such as breast surgery and its impact on breastfeeding, innovative ways to increase milk supply, and the anatomy of the nipple.  Every presentation was informative, engaging, and highly educational.  There was not a dull moment!

    If you've thought about going in years past, it is definitely worth it!  What an amazing 3 days!

*This is not a Birth Matters Virginia event.

Before You Ask to be Induced...

You're 36 weeks pregnant and starting to get antsy.  Emotionally, you are ready to meet your baby.  Physically, you are uncomfortable and anxious to be able to do things like sleep on your belly.  You're seeing your doctor this week and thinking about asking him or her to induce your labor 10 days before your due date.  What are the risks?  What does induction entail?  Before you talk to your doctor, check out the Agency for Healthcare Research and Quality's Guide written for pregnant women considering elective induction. 

Important News for VBAC!

If you've had a cesarean, chances are, you have heard that future births will also be cesareans.  Chances are, you have also heard of the term "VBAC," or vaginal birth after cesarean.  What you may not have heard are the risks and benefits to attempting to a VBAC, or whether or not your care provider supports such efforts.  If you're interested in a vaginal birth, but are worried about the risks, a new study may help put your mind at ease. 

"New research to be published in BJOG: An International Journal of Obstetrics and Gynaecology has found that women with three or more prior caesareans who attempt vaginal birth have similar rates of success and risk for maternal morbidity as those with one prior caesarean, and similar overall morbidity (adding vaginal births and emergency caesareans together) as those delivered by elective repeat caesarean.

[...]

The findings indicate that women with three or more prior caesarean deliveries did not experience a difference in morbidity based on whether they attempted VBAC or elected for a repeat caesarean. The 89 women with three or more prior caesareans who attempted VBAC were as likely to be successful as women with one or two prior caesareans, 79.8% compared to 75.5% and 74.6% respectively. In addition, none of them experienced significant maternal morbidity such as uterine rupture, uterine artery laceration, and bladder or bowel injury."

To see the complete article from the Royal College of Obstetricians and Gynaecologists, click here.

UNICEF UK Baby Friendly Initiative Statement on New Breastfeeding Research

Previously, we posted the findings of a new study that amounted to formula being equal to breastmilk.  The article, appearing in many, many places brought varied responses from readers, but left just about all of the readers wanting more information about the "study."  Thanks to UNICEF's Baby Friendly Initiative, those results are becoming more clear. 

"A number of newspaper articles have today reported on a Norwegian study which has found an association between higher levels of male hormones in pregnancy and the ability to breastfeed after birth. The authors are reported to have extrapolated from their findings that mothers’ ability to breastfeed is entirely down to these hormone levels. They are also reported to have claimed that exposure to high levels of testosterone before birth account for the differences in health outcomes between breast and bottle fed babies. The findings of this small study are of interest and may warrant further investigation. However, the claims made in relation to these findings do not account for the large differences in breastfeeding rates between countries, with some having 99% of mothers successfully breastfeeding. They are also contradicted by the large body of evidence which shows that levels of successful breastfeeding can be increased by a range of improved support interventions.

The claims made relating to the health outcomes of breastfeeding do not account for the dose response found in many studies, which show that babies breastfed exclusively or for longer periods have the best overall outcomes.

The study does not account for or tally with the known mechanisms for how breastmilk protects against illness. For example, breastmilk contains a range of anti-infective properties including immunoglobulins, white cells, anti-inflammatory components, enzymes and non-antibody factors such as lactoferrin and the bifidus factor."

To read the complete statement from UNICEF, including other resources citing research-supported benefits to breastfeeding, click here. 

United States Maternity Care Facts and Figures

Childbirth Connection has just released it's report for 2007's birth data.  Over 4 million births are included, which is the largest number ever recorded in the United States.  Childbearing women and newborns comprised 25% of the patients being discharged from hospitals, making birth and pregnancy the number one reason for hospitalization in America.  Six of the ten most common hospital procedures were maternity-related, and cesareans were the most common operating room procedure in 2007.  To read the entire report, click here.

Dangers of Unnecessary Cesareans

Recently on MedWire, a report confirmed what most women and doctors already know*: that cesareans should only be performed when truly medically necessary. 

Cesarean section linked to increased risk for maternal death, serious complications

By Ingrid Grasmo

25 January 2010

Lancet 2010; Advance online publication

 

[...]

"Women undergoing operative vaginal delivery had a 2.1-fold increased risk for maternal mortality and morbidity index (at least one of: maternal mortality, admission to intensive care unit [ICU], blood transfusion, hysterectomy, or internal iliac artery ligation) compared with women delivering spontaneously."

[...]

The researchers conclude: “Cesarean section should be done only when there is a medical indication to improve the outcome for the mother or the baby.”

 

To read the full article, click here. 

 

*The World Health Organization recommends a c-section rate of 11 to 15%.  Acdoring to Virginia Health Information, the current average across Virginia is 22.36% with some hospitals over 30%.