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NCSA Newborn Updates

The articles enclosed are for your information only. We sugget that you do your own research and talk to your Pediatrian for further details. We will continue to present articles of value as they are presented to us. The NCSA does not support their validity but rather makes the information available to further your education and your baby's health.

1. Sleep - By Dr. Luis Rivera Diplomat of Philippine Pediatric Society

2. The Importance of Sleep Prof. Avi Sadeh

3. The Dangers of Soy (The following is taken from West A Price Foundation by Sally Fallon http://www.westonaprice.org/soy/infant.html)

4. Sour Smelling Breast Milk
http://www.kellymom.com/bf/pumping/lipase-expressedmilk.htm

5. Le Leache League Guidelines for Storing Breast Milk

6. "Did Mother's Kiss Kill Her Baby"?

 

1)Sleep By Dr. Luis Rivera Diplomat of Philippine Pediatric Society (back to top)

“Good sleep is essential to a baby’s growth and development. It is expected that on their first year of life, babies should sleep between 11 and 18 hours a day, and during this time have growth hormones actively working on their physiological and emotional development at three times the normal rate.
A baby who doesn't’t get enough good sleep will exhibit very real developmental problems that may include hyperactivity, aggression and learning difficulties. His physical and mental growth may also be impeded, and he may experience more behavioral problems and a reduced ability to pay attention and concentrate.
According to Dr. Luis Rivera, a Diplomat of the Philippine Pediatric Society, Fellow of the Philippine Society of Sleep Medicine and a Pediatric Consultant for Makati Medical Center and Asian Hospital, “Sleep for babies is not just rest for the body. It assists in brain development, proper learning and, to a certain extent, social adjustment. And since our growth hormones are released during sleep, the child is given developmental and growth values as well. Poor sleep can impact growth—they become stunted, or thinner, or smaller, crankier, and they develop slower.”
Dr. Rivera further explains, “What a baby really needs is good sleep, which is really nighttime sleep.”
Quality and duration of a baby’s nighttime sleep has a greater impact on overall growth and development than daytime sleep according to studies. At night, a baby’s brain development kicks in at full speed, as neurons grow and develop at an accelerated pace. This allows the child to develop cognitive and organized thoughts that allow him to learn and unlearn all the sensory input he encountered during his waking hours.
One of the best treatments for sleep problems in children is to adapt a regular bedtime routine that will signal the transition from wake to sleep for the child.
Bedtime routine
A good way to adopt a baby bedtime routine is to consistently practice it every day because, according to studies, babies as young as a few weeks respond well to bedtime routines.
The Baby Bedtime Routine is a simple three-step process. As per Dr. Rivera
1. Give the baby a relaxing five-minute warm bath.
2. Give the baby a two-minute oil massage applied with downward strokes for her limbs, clockwise circles on her tummy, outward sweeps on the chest, small circles on her head and face, and sweeping downward strokes on her back and feet. It would be best to perform the massage while talking to your baby in a soothing voice to further calm baby and get her ready for sleep.
3. Engage in quiet bonding time, talking to baby with a soothing voice in a dimly lit room. This will allow you both to wind down and welcome sleep. Some moms can use this time for breastfeeding, singing, or reading a story. It would be best to put your baby to bed as soon as she gets drowsy, but while still awake. This teaches her to be self-soothing and makes her more able to put herself back to sleep when she awakes during the night.
Dr. Rivera attests, “I actively recommended the bedtime routine to two or three of my patients recently and after three to four weeks, the babies were sleeping better. The bedtime routine is sleep-training for babies.”
According to studies, babies fall asleep 37 percent faster and experience 37 percent less night awakenings. The total duration of night awakenings decrease by as much as 49 percent, while at the same time increasing the length of babies’ longest continuous sleep by 23 percent. And more than just allowing babies to sleep longer and better, a well-rested baby also means a mom who is less tense, less tired and more energetic”.

2.The Importance of Sleep By Prof. Avi Sadeh (back to top)

Body Maturation
“Sleep is a basic physiological need required for physical recovery, reinvigoration, body growth, brain maturation, learning and memory. Chronic and sustained sleep deprivation can lead to exhaustion, physical damage to body tissues, dysfunction of the immune system, severe stress and even death.
The growth hormone, the one responsible for a baby’s physical growth, is secreted mostly during the deep stages of a baby’s sleep. A severe sleep disorder could, therefore, lead to insufficient secretion of this hormone and to compromised body maturation.

Brain Growth

When a baby suddenly becomes active during sleep -- her breathing becomes uneven, her eyes dart from side to side, and she smiles and grimaces – it means she is in a unique stage of sleep -- Rapid Eye Movement (REM) sleep. This stage is associated with dreaming. Babies spend as much as 50 percent of their sleep in REM sleep, which is very important for brain maturation, learning and development. A baby is born with about 30 percent of her full brain size, and during the first 3 years, the brain grows very rapidly -- to almost its full adult size. It is believed that REM sleep is an essential stage that facilitates brain growth, which is why babies spend so much time of their infancy in this unique sleep stage. We also know that during REM sleep, the brain “digests” and stores all the information that bombards a baby during the wakeful hours. Disruptions to their REM sleep could lead to the compromised learning of all the smart things we teach our babies when they are awake and alert.

Time to Sleep

When babies don’t get enough sleep, or if their sleep is disrupted, they tend to be very agitated, nervous, hyperactive, and difficult to manage or soothe. Most parents experience these situations when their baby reaches the time she needs to go to sleep. These signs present important information for parents, telling them when their baby is ready for sleep. Many parents know that when they miss their baby’s sleep time, it could become much harder for her to calm down and fall asleep. This is because their baby, like an adult, has an internal biological clock that makes it easy to fall asleep at certain times, and difficult to fall asleep at others. Keeping to a regular schedule and a relatively constant bedtime helps the baby (and her parents) to regulate the biological clock and develop healthy sleep patterns.”

3. The Dangers of Soy (back to top)

(The following is taken from West A Price Foundation by Sally Fallon http://www.westonaprice.org/soy/infant.html)

An estimated 25% of North American babies receive infant formula made from processed soybeans. Parents use soy formula in the belief that is it healthier than formula based on cows' milk. Soy promotional material claims that soy provides complete protein that is less allergenic than cows' milk protein. When soy infant formula first became commercially available, manufacturers even promised that soy formula was "better than breast milk."
Parents have a right to know how these extravagant claims compare to scientific findings related to soy infant formula.
While soybeans are relatively high in protein compared to other legumes, scientists have long recognized them as a poor source of protein because other proteins found in soybeans act as potent enzyme inhibitors. These "anti nutrients" block the action of trypsin and other enzymes needed for protein digestion. In test animals, diets high in trypsin inhibitors depress growth and cause enlargement and pathological conditions of the pancreas, including cancer.
The soy industry recognizes that trypsin inhibitors are a problem in infant formula and have spent millions of dollars to determine the best way to remove them. Trypsin inhibitors are large, tightly folded proteins that are only deactivated after a considerable period of heat treatment. This process removes most—but not all—of the trypsin inhibitors, but has the unfortunate side effect of over-denaturing the other proteins in soy, particularly lysine, rendering them difficult to digest and possibly toxic. Even in low amounts, trypsin inhibitors prevented normal growth in rats.
The main ingredient in soy infant formula is soy protein isolate, a powder extracted from soybeans through a process that involves not only high temperatures but also caustic chemicals. The alkaline soaking solution produces a carcinogen, lysinealine, and reduces the cystine content, which is already low in the soybean. Other carcinogens called nitrosamines are formed during high temperature spray drying.
Soybeans also contain high levels of phytic acid or phytates. This is an organic acid, present in the outer portion of all seeds, which blocks the uptake of essential minerals-calcium, magnesium, iron and especially zinc-in the intestinal tract. Soybeans have very high levels of a form of phytic acid that is particularly difficult to neutralize. As early as 1967, researchers testing soy formula found that it caused negative zinc balance in every infant to whom it was given. Scientists have found a strong correlation between phytate content in formula and poor growth, even when the diets were additionally supplemented with zinc. High amounts of phytic acid in soy foods and grains have caused retarded growth in children on macrobiotic diets. A reduced rate of growth is especially serious in the infant as it causes a delay in the accumulation of lipids in the myelin, and hence jeopardizes the development of the brain and nervous system.
Soy formula can also cause vitamin deficiencies. Soy increases the body's requirements for vitamin B12, a nutrient that is absolutely vital for good health. Early studies with soy formula indicated that soy blocks the uptake of fats. This may explain why soy seems to increase the body's requirements for fat-soluble vitamin D.
Aluminum content of soy formula is 10 times greater than milk based formula, and 100 times greater than unprocessed milk. Aluminum has a toxic effect on the kidneys of infants, and has been implicated as causing Alzheimer's in adults. Soy formulas lack cholesterol, another nutrient that is absolutely essential for the development of the brain and nervous system; they also lack lactose and galactose, which play an equally important role in the development of the nervous system. A number of other substances, which are unnecessary and of questionable safety, are added to soy formulas including carrageenan, guar gum, sodium hydroxide (caustic soda), potassium citrate monohydrate, tricalcium phosphate, dibasic magnesium phosphate trihydrate, BHA and BHT.
What about the claim that soy formula is less allergenic than cows milk formula? Studies indicate that allergies to soy are almost as common as those to milk. Use of soy formula to treat infant diarrhea has had mixed results, some studies showing improvement with soy formula while others show none at all.
The most serious problem with soy formula is the presence of phytoestrogens or isoflavones. While many claims have been made about the health benefits of these estrogen-like compounds, animal studies indicate that they are powerful endocrine disrupters that alter growth patterns and cause sterility. Toxicologists estimate that an infant exclusively fed soy formula receives the estrogenic equivalent of at least five birth control pills per day. By contrast, almost no phytoestrogens have been detected in dairy-based infant formula or in human milk, even when the mother consumes soy products. A recent study found that babies fed soy-based formula had 13,000 to 22,0000 times more isoflavones in their blood than babies fed milk-based formula. Scientists have known for years that isoflavones in soy products can depress thyroid function, causing autoimmune thyroid disease and even cancer of the thyroid. But what are the effects of soy products on the hormonal development of the infant, both male and female?
Male infants undergo a "testosterone surge" during the first few months of life, when testosterone levels may be as high as those of an adult male. During this period, the infant is programed to express male characteristics after puberty, not only in the development of his sexual organs and other masculine physical traits, but also in setting patterns in the brain characteristic of male behavior. In monkeys, deficiency of male hormones impairs learning and the ability to perform visual discrimination tasks-such as would be required for reading-and retards the development of spatial perception, which is normally more acute in men than in women.
It goes without saying that future patterns of sexual orientation may also be influenced by the early hormonal environment. Pediatricians are noticing greater numbers of boys whose physical maturation is delayed, or does not occur at all, including lack of development of the sexual organs. Learning disabilities, especially in male children, have reached epidemic proportions. Soy infant feeding-which floods the bloodstream with female hormones that could inhibit the effects of male hormones-cannot be ignored as a possible cause for these tragic developments.
As for girls, an alarming number are entering puberty much earlier than normal, according to a recent study reported in the journal Pediatrics. Investigators found that one percent of all girls now show signs of puberty, such as breast development or pubic hair, before the age of three; by age eight, 14.7 percent of white girls and a whopping 48.3 percent of African-American girls had one or both of these characteristics. New data indicate that environmental estrogens such as PCBs and DDE (a breakdown product of DDT) may cause early sexual development in girls and a study in Puerto Rico implicated soy feeding as a cause of early menarche. The use of soy formula in the WIC program, which supplies free formula to welfare mothers, may explain the astronomical rates of early menarche in African American girls.
The consequences are tragic. Young girls with mature bodies must cope with feelings and urges that most children are not well-equipped to handle. And early maturation in girls is frequently a harbinger for problems with the reproductive system later in life including failure to menstruate, infertility and breast cancer.
Other problems that have been anecdotally associated with children of both sexes who were fed soy-based formula include extreme emotional behavior, asthma, immune system problems, pituitary insufficiency, thyroid disorders and irritable bowel syndrome.
Concerns about the dangers of soy have prompted consumer groups in New Zealand and Canada to call for a ban on the sale of soy infant formula. Milk-based formula contains a better protein profile and does not flood the infant with antinutrients and female hormones. Breast feeding is best IF the mother has consumed a healthy diet, one that is rich in animal proteins and fats, throughout her pregnancy and continues to do so while nursing her infant. Mothers who cannot breast feed, for whatever reason, should prepare homemade formula based on whole milk for their babies. The rare child allergic to whole milk formula should be given a whole foods meat-based formula, not one made of soy protein isolate. Parents who invest time in preparing homemade formula will be well rewarded with the joys of conferring

4. SOUR SMELLING BREAST MILK (back to top)

(The following is taken from: http://www.kellymom.com/bf/pumping/lipase-expressedmilk.htm)

“A few mothers find that their refrigerated or frozen milk begins to smell or taste soapy, sour, or even rancid soon after it's stored, even though all storage guidelines have been followed closely. Per Lawrence & Lawrence (p. 781), the speculation is that these mothers have an excess of the enzyme lipase in their milk, which begins to break down the milk fat soon after the milk is expressed. Most babies do not mind a mild change in taste, and the milk is not harmful, but the stronger the taste the more likely that baby will reject it.
Lipase is an enzyme that is normally present in human milk and has several known beneficial functions:
Lipase helps keep milk fat well-mixed (emulsified) with the "whey" portion of the milk, and also keep the fat globules small so that they are easily digestible (Lawrence & Lawrence, p. 156).
Lipase also help to break down fats in the milk, so that fat soluble nutrients (vitamins A & D, for example) and free fatty acids (which help to protect baby from illness) are easily available to baby (Lawrence & Lawrence, p. 156).
The primary lipase in human milk, bile salt-stimulated lipase (BSSL), "has been found to be the major factor inactivating protozoans" (Lawrence & Lawrence, p. 203).
Per Lawrence & Lawrence (p. 158), the amount of BSSL in a particular mother's milk does not vary during a feed, and is not different at different times of day or different stages of lactation. There is evidence that there may be a decrease in lipase activity over time in mothers who are malnourished.
What can I do if my storage problem is due to excess lipase? Once the milk becomes sour or rancid smelling/tasting, there is no known way to salvage it. However, newly expressed milk can be stored by heating the milk to a scald to inactivate the lipase and stop the process of fat digestion. Scald the milk as soon after expression as possible.

To scald milk:
Heat milk to about 180 F (82 C), or until you see little bubbles around the edge of the pan (not to a full, rolling boil).
Quickly cool and store the milk.
Scalding the milk will destroy some of the anti-infective properties of the milk and may lower some nutrient levels, but this is not likely to be an issue unless all of the milk that baby is receiving has been heat-treated.
“Per Lawrence & Lawrence, bile salt-stimulated lipase can also be destroyed by heating the milk at 144.5 F (62.5 C) for one minute (p. 205), or at 163 F (72 C) for up to 15 seconds (p. 771).

5. LE LECHE LEAGUE GUIDELINES FOR STORING BREAST MILK (back to top)

STORAGE GUIDELINES

Storing milk in 2-4 ounce amounts may reduce waste. Refrigerated milk has more anti-infective properties than frozen milk. Cool milk in refrigerator before adding to frozen milk. All milk should be dated before storing.

Human milk can be stored:

- At room temperature (66-72°F, 19-22°C) for up to 10 hours
- In a refrigerator (32-39°F, 0-4°C) for up to 8 days - in a freezer compartment inside a refrigerator (variable temperature due to the door opening frequently) for up to 2 weeks
- In a freezer compartment with a separate door (variable temperature due to the door opening frequently) for up to 3 to 4 months.
- In a separate deep freeze (0°F, -19°C) for up to 6 months or longer.

What Type of Container to Use:

Refrigerated or frozen milk may be stored in:
- hard-sided plastic or glass containers with ill-fitting tops
- freezer milk bags that are designed for storing human milk
Disposable bottle liners are not recommended.

How to Warm the Milk:

Thaw and/or heat under warm, running water.
Do not bring temperature of milk to boiling point.
Gently swirl milk before testing the temperature. Swirling will also redistribute the cream into the milk. (it is normal for stored milk to separate into a cream and milk layer.)
Do not use a microwave oven to heat human milk.

Thaw Milk:

If milk has been frozen and thawed, it can be refrigerated for up to 24 hours for later use. It should not be refrozen. It is not known whether milk that is left in the bottle after a feeding can be safely kept until the next feeding or if it should be discarded.

According to THE BREASTFEEDING ANSWERR BOOK, research indicates that human milk has previously unrecognized properties that protect it from bacterial contamination. One study, Barger and Bull 1987, found that there was no statistically significant difference between the bacterial levels of milk stored for 10 hours at room temperature and milk that had been refrigerated for 10 hours. Another study, Pardou 1994, found that after 8 days of refrigeration some of the milk actually had lower bacterial levels than it did on the day it was expressed.

6. Did Mother's Kiss Kill Her Baby? (back to top)

(Feb. 27) - A loving mother may have killed her own baby by kissing the newborn girl -- and infecting her with the herpes virus. Jennifer Schofield was just 11 days old in November 2006. Her organs failed after she contracted the herpes simplex virus, which can cause cold sores. An inquest in Lancaster, northeastern England, heard the baby contracted the virus either through her mother's kisses or breastfeeding, the BBC reported Friday.

A Mother's Grief Manchester Evening News 3 photos Jennifer Schofield was just 11 days old when she died in November 2006 of multiple organ failure caused by the herpes simplex virus. The newborn was infected by her mother, Ruth Schofield, either through kisses or breastfeeding. "The hardest thing any woman can do is watch her baby die," Schofield told the BBC on Friday.

Source

Jennifer's mother, 35-year-old Ruth Schofield, probably caught the virus late in her pregnancy, the inquest was told. She experienced flu-like symptoms before Jennifer's birth and developed mouth ulcers after the birth. Although her doctor gave her a mouthwash, the herpes virus was not diagnosed, the BBC said. HSV can be extremely hard to detect, the inquest heard. "If I had known I was suffering from HSV and the risks of being near a newborn baby, then Jennifer could be here today," Schofield said, according to the Daily Mail. The coroner returned a narrative verdict, meaning the cause of death is recorded without attributing the cause to a named individual. The coroner, Dr. James Adeley, said neither Jennifer's family nor medical staff should blame themselves. Schofield told the BBC she wanted all mothers to be aware of the risks of passing HSV to their babies. She said she has written to British Prime Minister Gordon Brown, asking for more literature about the virus to be provided in health clinics. "The hardest thing any woman can do is watch her baby die," she said