1. Breastfeeding problems are challenges that can be solved rather than reasons to wean.

2. The most effective latch is the “asymmetric” latch — where baby is covering more of the areola with her lower lip than with her upper lip and where her chin, but not her nose, is touching the breast.

3. You can assess the latch by observing the change in baby’s sucking when she’s swallowing milk.

4. Newman’s all-purpose nipple ointment, which can be mixed by a pharmacist from instructions at breastfeedingonline.com, combines an antibiotic ointment, an antifungal powder and a topical corticosteroid.

5. Breast compression — gentle squeezing — can help babies get more milk and more high-fat milk.

6. Raynaud’s syndrome, a painful but treatable blanching, usually of extremeties such as fingers and toes, can sometimes affect a nursing mother’s nipples.

7. Milk oversupply can be decreased in some cases by nursing on one breast only, for several feeds.

8. Domperidone (a drug for nausea and vomiting) and herbs, such as fenugreek and blessed thistle, can be used to increase milk production.

9. Adoptive mothers who want to breastfeed can induce milk production more effectively using Newman’s protocol.

10. Tube-feeding on the nipple or a finger is a good alternative to bottle-feeding for babies who won’t latch on, or who need supplementation, because it helps train them to take the breast.

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An Infant Feeding Summit hosted by the Centre for Food and Allergy Research was held in May 2016. A consensus agreement, supported by published evidence, was accepted at this Summit and the following recommendations were:

NOTE CHANGE TO ALLERGIES AND WEANING

When your infant is ready, at around 6 months, but not before 4 months, start to introduce a variety of solid foods, starting with iron rich foods, while continuing breastfeeding.
All infants should be given allergenic solid foods including peanut butter, cooked egg and dairy and wheat products in the first year of life. This includes infants at high risk of allergy. Hydrolysed (partially and extensively) infant formula is not recommended for prevention of allergic disease.

Guidelines with ages can only ever be approximate as babies develop at different rates.
When your baby is ready for solids, he will show signs of readiness, which is a better guide for an individual baby – he will show a great interest in what you are eating, perhaps try to grab your food; he will have lost the tongue-thrust reflex that pushes food back out of the mouth; and he will be able to sit upright. These tend to occur at around 6 months of age, with some a little earlier and others a little later.

It is now recommended that once solids are introduced, a variety of foods should be given and the type and order do not matter. Research suggests that introducing the most allergenic foods (as mentioned above) by about 10–12 months of age is associated with a reduced risk of allergy developing. A gap of 2–3 days between each new food should be enough, in case there is some reaction.

Regardless of the age your baby starts solids, it is recommended that breastfeeding continue during the process of introducing new foods.

Breastmilk is the normal food for all babies and is even more important for a baby with symptoms of reflux. It is easy to digest and contains everything he needs for his normal development. It helps protect him. Although babies usually ‘grow out’ of reflux, it can be a very difficult and tiring time for parents.

REFLUX AND SOME ADVICE FOR BABIES LESS THAN 5 MONTHS Gastro-oesophageal Reflux and the Breastfed Baby (A.B.A)
First published 2000 Revised 2004, 2006, 2008, 2011
Breastfeeding: and reflux

Sometimes Milk Thickeners are added to milk because it is believed that the feed becomes heavier and will tend to stay in the stomach and not rise into the oesophagus. However, they do not ‘cure’ reflux and may cause other problems. There is no evidence that thickeners are helpful for breastmilk-fed babies.

Thickeners don’t change the number of times a baby’s stomach contents rise into the oesophagus, but they can reduce the number of times the baby vomits.
When babies are healthy and growing well, in spite of vomiting, thickeners are not recommended. These products are mainly used for babies being fed formula, which can be thickened more easily. They are used when babies are vomiting so much they are not gaining weight.

You cannot thicken breastmilk that your baby drinks straight from the breast. It is also hard to thicken expressed breastmilk, as live enzymes in the milk quickly break down the starches that make up many thickeners. Mothers have tried different ways to thicken their expressed breastmilk or have given a small amount of thickener mixed with water to the baby before breastfeeding.

Thickeners include commercial milk thickeners, rice cereal, ‘cornflour’ (which can be made from wheat or corn) and bean gum. The thickened milk can be given by cup, spoon or bottle. With a bottle, a larger hole in the teat is needed to allow for the thicker milk. Adding solids to the baby’s diet to increase the thickness of stomach contents has also been tried. All these things carry risks and should not be tried except under the care of a health professional.

AFTER 5 MONTHS…

Solids If your baby is having solid foods, try not to over-feed him. Avoid spicy and acidic foods or any food that seems to worsen the reflux. Begin one food at a time and wait a few days or more before starting something different. This may help you find out if any food makes the reflux worse.

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The 3rd most plentiful ingredient in human milk after lactose and fats, is Human milk oligosaccharides known as H.M.O. Research has found that babies cannot digest them, despite their structure being a rich source of energy. So then came the question by the chemist, Bruce German (famous for studying the components of human milk) …

Why would a mother use so much of her energy making these complicated chemicals if they were useless to her baby?

What else these could H.M.O’s could be used for?

He found that the H.M.O.’s pass through an infant’s stomach and small intestine undamaged and land in the large intestine, where most of our bacteria live. So, he hypothesised what if nature did not intend these H.M.O to be used as food for the baby, instead as food for the microbes that live in the large intestine.

Alongside this research, paediatricians were studying the stools of breast fed infants compared with formula fed infants and what they had found were microbes called Bifidobacterium (BIFS). These were more common in the stools of BF infants and they argued that human milk must contain some substance that nourished the bacteria. They called this the BIFIDUS FACTOR.

They assumed that the H.M.O.’s and the bifidus factor were one and the same and they nourished the gut microbes in the breast fed baby. It is now the 1990’s and we now know that there is more than a hundred H.M.O.’s in human milk, but only a few had been characterized. German was not satisfied with not knowing what each specific H.M.O.’s looked like. It was assumed that all the H.M. O’s nourished all the species of bacteria (BIF’s) equally. But… German thought otherwise. He wanted to know which Human Milk Oligosaccharide was feeding which Bifidobacterium.

SO…Together with a team of chemists, microbiologists, and food scientists, German identified all the H.M.O’s, and pulled them out of the human milk and fed them to all the bacteria, but to their surprise nothing grew. They concluded that H.M.O’s are not an all- purpose food for the BIF’s and in 2006, the team found that the sugars (HMO) selectively nourish one subspecies, BIFIDOBACTERIM LONGUM INFANTIS.

If you provide this specific B.Infantis with H.M.O’s it will outcompete any other gut bacteria. B.Infantis uses thirty genes to devour every scrap of H.M.O’s and no other bacterium has this genetic makeup, so nature has intended human milk to nourish this microbe.

What does this mean?? Well as it digests the H.M.O’s it releases short chain fatty acids, which feed an infant’s gut cells.

These gut cells are fed so that they can make adhesive proteins which keep microbes out of the blood stream and out of the ant inflammatory molecules that regulate the immune system. These changes only happen when B. Infantis feed on H.M.O’s.

The second thing that happens is the release of sialic acid, and we know that the human brain depends on sialic acid for growth. Our brain is very large for a primate, and the growth in the first year of life is extremely fast. Another researcher ( David Mills) has hypothesised that the reason why human breast milk contains 5 x as many HMO’s as cow’s milk is to fuel this growth.

So, by keeping the bacterium well fed we can raise brainier babies. Our evolution from ape to man. Food for thought! As there is only these H.M.O’s in breast milk, the microbe’s full potential is only unlocked when it feeds on breastmilk. So, these Nourishing, inflammatory and anti-infective process that happen when Bacterium infantis consumes H.M.O.’s  are setting up the foundations of our immune systems  and brain development.

I know it all sounds very technical and it has taken me some time to sift through all my lecture notes on this topic to try and simplify it as much as I can without losing the main objective. I love a good scientific rationale for explaining something that has been intuitively know for some time!

Hamlet

So, the second thing that research is trying to explain, is how breast fed infants and mothers are less likely to develop some types of cancers. Again, it is a very complex hypothesis and the research articles are a bit to in depth for our purposes. It can be researched further by doing a literature search on HAMLET as it is quite fascinating. Breastmilk contains a compound called HAMLET (Human Alpha- lactalbumin Made Lethal to Tumour cells). HAMLET is formed when the protein: alphalactalbumin, is mixed with a fatty acid called oleic acid at a low PH. It can attack cancer cells by reducing the strength of the cancer cells outer defence mechanism, or by targeting the cancer cells mitochondria (power house) and effectively deleting the information contained in its nucleus. This causes the cancer cell to lose energy and memory and it dies in a process called apoptosis. The scientists have been busy working on mice to discover that this HAMLET can kill or limit the development of brain, colon and bladder in genetically susceptible mice and can kill over 40 different types of cancer. The other amazing thing they have discovered is that only targets and kills cancer cells, leaving the healthy cells unharmed, unlike chemotherapy. As they are finding out more and more about HAMLET, the newest hypothesis is once again it is the infants gut that promotes the formation of HAMLET due to the perfect PH balance of a breastfed gut, the environment is perfect to produce HAMLET and they now wonder if that is why childhood cancers such as leukaemia and lymphomas are less prevalent in a breast-fed child.

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