Posts Tagged ‘cracked nipples’
Tuesday, August 31st, 2010
 As an OB, my patients ask me just as many questions about breastfeeding as they ask about pregnancy itself. I don’t mind at all because it is such an important topic. Over the years, I have scribbled many of these questions in my notebook so that I could research the most current information for new mothers eager to learn how to feed their babies the natural way.
 Now, these questions are the basis for this week’s blog which is written just for you, with a completely different mindset and format than all my previous articles. Before writing however, I decided to interview the head lactation consultant, Ms. Renate Abstoss at Stamford Hospital in Connecticut, to get a second opinion and gather her responses. Ms. Abstoss sat for the first International Board Exam for Lactation Consultants in 1985 and has continuously worked in the field since that time in California, New York, Germany, Austria, Switzerland, and Connecticut. She was the first lactation consultant appointed as State Certified Teacher for Bavarian Midwifery schools.
There are probably many variations of responses to these questions so please consider this information helpful, but not absolute. I welcome any additional “pearls” from other lactation consultants or experienced moms so we can share the knowledge and promote the best nutritional health for babies everywhere.
- What are the most common problems that women encounter when pumping?
Dwindling milk supply is probably the foremost problem that women encounter when pumping milk. This can be attributed to many different factors.
- Infrequent pumping
A working woman should try and pump every 3 hours for 10 to 15 minutes or at least for every missed feeding.
- Inefficient pumping
Pump being used may have inadequate pressure or not enough cycles per minute causing a decrease in the milk supply.
- Lack of breast feeding
Even when mom is home from work, she should try and breast feed the baby to stimulate milk production. For convenience, babies may be bottle fed too frequently.
- Painful nipples
This can be due to a bad pump due to excessive suction pressure, pumping for too long a period of time, or poor latch when the baby does breast feed.
- Fatigue and exhaustion
The stress of taking care of a newborn along with pressure from work and home can result in exhaustion and fatigue which can decrease the milk supply.
- How do I increase my milk supply?
There are several medications and herbal products available to help with increasing the milk supply. To increase an existing milk supply, one can take two herbal supplements in combination fenugreek and blessed thistle, both of which are available in health food stores and have no known contraindications.
The two most commonly used prescription drugs are Metoclopramide and Domperidone both of which were designed as stomach medications but were found to increase prolactin production in the brain. The medication Domperidone, (Motlium) is not approved for use in the United States and the FDA has issued warnings against the use of this drug as a galactagogue because in higher dosages, when given intravenously, Domperidone it was associated with cardiac arrhythmias and cardiac arrest. However, the small dosages that are used when given orally to increase lactation (30–40 mg/day) and for the short duration of three to six weeks does not seem to be a great concern. Patients generally obtain this medication from Canadian pharmacies or from Mexico and Europe where it is over the counter. Studies are now being conducted by ILCA (International Lactation Consultant Association) regarding the safety of domperidone.
Metoclopramide (commonly known as Reglan), used to treat severe nausea in pregnancy, has been known to have a side effect of depression so its use has to be carefully monitored in the postpartum mother. The drug can be detected in breast milk and the long term side effects to infants is unknown.
- How do I treat plugged milk ducts?
Milk ducts that do not drain can cause the milk to back up resulting in a plugged milk duct. Often the the surrounding breast tissue becomes hardened and inflamed. This area can eventually become infected resulting in a mastitis requiring antibiotic therapy. Plugged ducts often occur when:
- Mom misses feedings
- Mom fails to pump frequently
- The breast fails to empty
- Nursing more frequently
- Changing positioning
- Improving the latch of the baby (sometimes a shield is necessary). A lactation consultant would be very instructive in this situation.
- This can be a result of incorrect positioning, inadequate pressure from a pump, or restriction of milk flow from poorly fitting bras or any kind of breast trauma that damages the duct. Fatigue, stress, or failure of the baby to latch on properly can also contribute to this problem.
- Standard Treatment consists of moist heat beforehand for approximately 5 minutes, empty breast as much as possible, cool compresses afterwards, and reduce swelling in between feedings. Massaging the duct towards the nipple may also be helpful. If the plug comes out, it may look like dried milk in a string. One should continue to nurse to fully clear the plug. Apply cold compresses via an ice pack or a plastic bag of frozen peas for approximately 15 to 20 minutes. Fresh cabbage leaves to the area is another herbal remedy that can be used in between feedings to help with engorgement. Cabbage leaves can be left in the bra for approximately one hour until it wilts. It is important to avoid the nipple area when applying the cabbage leaf because the cabbage is caustic and can cause irritation.
- Other helpful treatments include:
- What do I do if the baby does not latch on?
Latch problems can depend upon the situation causing them:
- It may be due to a newborn who is just learning how to latch.
Assistance from a lactation consultant can be very helpful in making sure the baby is latched deeply with a mouth very wide to get all the breast tissue. The baby should be latched well beyond the tip of the nipple. Often latching problems occur because the baby fails to flare the bottom lip.
- Is it due to flat or inverted nipples?
If the problem is due to flat or inverted nipples, a suction device, pump, or nipple shield may be used to avoid engorgement by expressing the milk. This will avoid a lowered or disappearing milk supply. Different lactation consultants and hospitals may prefer one modality over another, however all agree that care has to be taken when using any device that serious trauma or damage does not occur to the nipple.
Once the baby is “educated” that the breast is his or her “food supply”, generally the baby will nurse fine. It is helpful to try and get beyond the first few days when only colostrum is present, until the milk comes in. Try and avoid avoid artificial nipples at the very beginning.
- Is the baby not hungry at this time?
- Is there a nursing strike?
A “nursing strike” can occur if a well nursing baby, beyond the newborn period suddenly refuses to nurse. This can occur often after 4 months of age when a mother will state “my seven month old baby just suddenly weaned herself.” These babies are not weaning but are actually facing a situation where nursing has become unpleasant, boring, or painful. Often these infants need to be taught to return to a functional breastfeeding pattern with increased skin to skin contact, trying to nurse in a quiet, calm environment without distractions, such as nursing at night in bed. Bottles should be avoided but spoon or cup feeding with expressed milk is acceptable. If the underlying cause is treated, most babies will happily go back to their normal nursing pattern.
- Is the baby getting sick?
Causes of poor latch can be an undiagnosed ear infection, a urinary tract infection, or an upper respiratory infection. Check with your pediatrician to be sure an illness is not being missed. Maternal stress can also cause this problem.
Regardless of the problem, it is important to remove the milk as efficiently as possible if an established supply exists to avoid engorgement which will lower or cause the milk supply to disappear.
If the baby is not latching, it is important to stimulate the establishment of milk production through use of a pump.
- How do I wean the baby when I have decided to transfer to a bottle?
Weaning is the time the baby transitions away from the breast. Time frames for weaning can vary from weeks to months.
Slow weaning is always more optimal. Some mothers will use the pump for weaning and stop breastfeeding entirely. One option for weaning would be to reduce the time per pumping, ie instead of pumping for 15 minutes, reduce it to 10 minutes. This can gradually be dropped down to 2 to 3 minutes per session. An alternative way to wean is to increase the interval between pumping sessions, ie from every 3 hours to every 4, 6 or even 8 hours. If desired, one can use ice packs after pumping for comfort. Also, Motrin can be used for anti-inflammatory pain relief. A comfortable, tight bra can also help with support and relief. Nursing pads can be used to prevent excess leakage. A recommended herbal remedy can be drinking 3 cups of sage tea which is available in health food stores. It has a strong and astringent taste so adding honey makes it more palatable. Do not use this if currently pregnant since it has abortive action.
On occasion, sudden weaning becomes necessary. Discomfort is generally greater since the breast continues to make milk and the breast remains engorged. Nursing can be replaced with pumping but only pump the breast to allow comfort and not to completely drain. Increase time frame between pumpings.
Three days of Sudafed can help dry up the milk production. The milk supply decreases as you feed less. The milk quality also changes becoming more salty and colostrum-like which many babies do not like. Consequently, this also helps diminish the nursing.
Tags: Bavarian Midwifery school, bfeeding, bottle feeding, breast engorgement, breast engorgment, breast feeding, breast milk, breast pump, Breastfeeding, breastfeeding FAQ, cracked nipples, doctor answers questions on breastfeeding, Domperidone, drug can be detected in breast milk, engorged breasts, galactagogue, healthy baby, increase lactation, International Board Exam for Lactation Consultants, International Lactation Consultant Association, is the baby latching, la leche league, lactation, lactation consultant, latching on breast, Metoclopramide, Motlium, Ms. Renate Abstoss, nipple gel, nursing an infant, nursing mother, painful nipples, pumping milk, questions on breastfeeding, Reglan, sore nipples, Stamford Hospital, weaning the baby
Posted in Breastfeeding | 4 Comments »
Monday, August 23rd, 2010
 Let’s face it. A breast pump is not the most romantic, or glamorous, piece of equipment ever invented. They can be bulky and uncomfortable, hard to clean and very expensive. Even worse, when lifted out of their boxes, they may seem extremely intimidating to use on something as delicate as our breasts. Personally, I would rather spend this kind of money on a cute Kate Spade purse, or a nice pair of Gucci pumps… not a breast pump!
Does a breastfeeding woman really need one of these things?
The answer is maybe…
It’s a well known fact that breast feeding has significant benefits to both mother and baby. (Breast Feeding Experts Weigh in on SIDS)(Breastfeeding Cuts Breast Cancer Risk)(Breast Feeding Can Reduce the Risk of Heart Disease) Previous blogs discussed how over 60% of the 4 million pregnant women in America are currently employed and the majority will want to return to the workforce soon after delivery. (Is Pregnancy a Disability?)( Breastfeeding and the Law) This should not be a deterrent for breastfeeding and therefore, it becomes extremely important for women to be encouraged to continue to breastfeed their newborns in a safe, efficient, and effective way while still carrying on their daily work lives. Since women are not available for demand feeding, it becomes vital to know how to use a breast pump so another caregiver can provide milk for the newborn. The blog this week will deal with the nuances of choosing the correct breast pump.
Who should use a breast pump?
Learning how to use a pump is important in the following situations:
- Women returning to work and not available for feeding.
- Premature infants lacking a good suck reflex can benefit from breast milk that is pumped making it easier for them to feed.
- Mom is unable to breastfeed due to sickness.
- Infants having difficulty removing milk from the breast due to anatomy when other techniques to correct fail (flat or inverted nipples of the mom or a facial abnormality in the infant).
How does the breast pump work?
Pumping milk from the breast has its origins from the dairy industry in the 1950”s by Einar Egnell. Pumps have been designed to simulate the sucking action of a nursing infant by mimicking both the suction pressure and the frequency of a baby’s suckling. Pumps are designed so that the amount of pressure and the cycle frequency can be regulated by the mother.
The volume of expressed milk with a breast pump is higher compared to manual expression.
Pressure
The pump has to have enough pressure to extract milk from the breast but not so high that it causes pain and skin trauma. The pump relies on the physics of a fluid moving from an area of higher pressure to an area of of lower pressure. The breast pump creates a pressure differential with negative pressure on the breast reducing the resistance to the outflow of milk from the milk ducts of the mother, which is at a higher pressure. Babies breast feed with a suction pressure of 50–220 mm Hg so the pumps are designed to suck at maximum negative pressures at about 220–250 mm Hg. Levels at less that 150 mm Hg are ineffective in emptying the breast and pressures greater than 220 mm Hg cause nipple pain which will result in the mother terminating her breast feeding.
Pumps can vary in the configuration of the flange (cup applied to the breast). The smaller the cup, the more pressure is exerted over a smaller area of space.
Frequency
The other important factor is the length of time the vacuum is applied. Babies suck at a frequency of between 40 and 126 sucks per minute and pumps are designed to mimic the breast by pumping at 40–60 cycles per minute.
How do you select the proper breast pump?
There are so many pumps available today with countless cycle and suction settings, different sizes, power sources, single vs. double set-ups and varying prices that it becomes a great enigma in choosing the right one for an individual. Important considerations in choosing a breast pump include baby’s age, mother’s work needs (full time or part time), support from the mother’s work environment, mother’s finances,and family’s health insurance. Price differences can be based on the durability of the motor, length of the manufacturers warranty, style of packaging, personal amenities, and have single or double set-ups.
Talking with a lactation consultant before you leave the hospital can help you sort through the morass of information. Many pumps are generally not refundable once used so trialing in the hospital or through a lactation consultant may be a good idea. Here are some of the factors to consider when deciding .
Price
The cost of a breast pump is approximately 1,500 dollars for a hospital grade variety to about 150–350 dollars for a personal use style. Prices will increase depending upon the accessories that are packaged with it. Pumps can also be rented for from 30 to 75 dollars per month. but mothers will need to buy all the accessories which include bottles, tubing, and breast flanges for about 50 dollars. If plans are to pump for several months, it may be more valuable to purchase one. Personal breast pumps in the long run are cheaper than formula which can run over 2,000 dollars a year.
Single vs. double pumping
Bilateral pumping is quicker and use more powerful machines with greater cycles per minute and use more pressure to express a greater amount of milk in less time.
For women that use a single pump, the breast should be switched every 5 minutes. It may take 15 to 20 minutes as opposed to 10 minutes with a double pump.
Power source
Electric pumps produce the most milk, followed by battery operated pumps and finally hand pumps. Some pumps have car adapters. For a non-working mother who does occasional pumping, a hand pump or small battery operated pump can work well. Try to make sure the pump has a one year warranty on the motor.
Other factors to consider
Noise level, ease of use and assembly, and difficulty in cleaning are also variables that must be considered when choosing a breast pump. Also ease of obtaining spare parts is a consideration.
Other accessories
Some pumps have more discreet carrying cases to make for easy transport. Also some packages contain gel or ice packs to keep the milk cool.
Different Categories of Pumps
Hand pumps
Two different types exist:
 Milk can be pumped from many kinds of mothers. This one has four spigots instead of two.
- Cylinder pump—Has a double cylinder set-up with suction created by pushing and pulling one cylinder inside the other.
The main problem can be the gasket inside which may need replacement because of shrinkage or its inability to maintain a seal after continued use. The gasket can also harbor bacteria.
- Hand squeeze pump— Suction is created with a hand lever that is squeezed and released.
The advantage is that it is portable, easy to use, quick to assemble, no need for electricity, and is inexpensive.
The disadvantage is the difficulty in obtaining a good milk supply due to difficulty in cycling at baby’s normal suck reflex. Many have a poor suction or excessive suction. Women can also fatigue easily with continued use, especially those with wrist problems or carpal tunnel syndrome (very common in pregnancy.)
Semi-automatic pumps
These pumps can be used manually, with a battery or with an electric adapter. The motor is generally small and not meant for frequent use.
The advantage is that they are portable, lightweight, small and do not require electricity. They can be double and often come with a cooler case.
The disadvantage is that they are not meant for heavy use and are not very durable. The short battery life can be expensive. The cycle frequency slows as the battery wears down. Some can also be noisy.
Personal use electric double pumps
These are automatic, light weight, durable, portable, and double-pump with controls to regulate the pressure and frequency for comfort. They generally include chill packs and storage compartments. They are run by electricity but can have battery and adapters included.
Hospital grade rentals
These are the most powerful and effective with different control settings for suction and frequency. They are the most expensive. Physically, they are large and heavy, and not meant to be portable. Therefore, there is no carrying case and no compartments for storing milk. They run on electricity. They are designed to be multi-user and you must supply your own collection kit which generally must match the pump brand.
Are there FDA standards for breast pumps?
In the United States, there are currently no standards for breast pumps to ensure the safety and quality of the products. However, the FDA does consider personal (not industrial) pumps to be used by one person only. Unfortunately certain pumps are impossible to clean and can produce high bacterial counts making a woman more prone to infection which is a reason not to buy or share a used personal pump.
Summary:
Choosing the right breast pump depends upon the individual needs of each mother. Factors to consider include the home and work situation, the amount of use, and cost factors. The assistance of a qualified lactation consultant is indispensable in guiding a new mom in choosing what works best for each given situation.
Tags: breast feeding, breast milk, breast pump, Breastfeeding, cracked nipples, healthy baby, nursing mother, working mothers
Posted in Breastfeeding | 3 Comments »
Tuesday, August 3rd, 2010
Renate Abstoss IBCLC
 While life does sometimes becomes a juggling act, most of us have learned how to keep all the balls in the air. For a new mother with a job outside the home, however, the simple desire to continue breastfeeding her baby may seem impossible.
Don’t give up!
It’s a well known fact that breast feeding has significant benefits to both mother and baby. I have written several previous blogs addressing these benefits. Just last week I wrote about how 60% of the 4 million pregnant women in America are currently employed and that the majority of these new mothers will want to return to the workforce soon after delivery. This should not be a deterrent for promoting optimal infant health and therefore, it becomes extremely important for women to be encouraged to continue to breast-feed their newborns in a convenient way while still carrying on their daily work lives. Since women are not available for demand feeding, it is vital they know how to use a breast pump and how to store milk so that another caregiver can provide milk for the newborn. The blog this week will deal with the proper way to store breast milk.
What is the length of time that I can store milk?
Breast milk storage follows the rule of 3:
- Freshly pumped breast milk at room temperature (77 degree F or 25 degree C) should be used within 3 hours.
- Freshly pumped breast milk that is refrigerated (39 degree F or 4 degree C) should be covered and used within 3 days.
- Freshly pumped breast milk can be frozen (4 degree F or -16 degree C) for up to 3 months. (Check your home freezer for temperature—freezers may run as low as 0 degrees F and deep freezes may run at -10 degrees F.)
Can I refrigerate or freeze milk after it has been sitting out for the 3 hours?
No. One cannot follow one step after the other. The milk is at the end of its shelf life after one of the above 3 steps is followed. However, if small amounts of milk are pumped at a sitting, it is possible to put the freshly pumped milk in the refrigerator to cool and then immediately add it to frozen milk in order to obtain the accumulated 4 oz. feeding. The milk will often freeze in layers and needs to be shaken before use. Shelf life is determined by the older milk in the container. Some sources suggest using the milk for longer periods of time, but often the taste of the milk deteriorates due to breakdown of flavonoids, which may cause the baby to reject the milk. The taste deterioration occurs before the milk becomes contaminated due to elevated bacterial counts.
What guidelines should I follow for freezing milk?
Similar to the way food stock is rotated in a supermarket, the newest milk should be placed in the back of the freezer where it is colder and older milk moved to the front, as a reminder to use it first. Dates should be placed on the container. If frozen for storage in a day care center, place the baby’s name on the container. Freezing in small allotments of 2 to 4 oz. is recommended since it takes less time to defrost and less is wasted if the baby is unable to finish the feeding. Leave room at the top of the container when freezing since liquid expands when frozen.
Disposable bags with freezer ties are fine to use since they take up less refrigerator space. Less expensive generic bags are just as good as brand name bags. It is a good idea to double bag the milk to eliminate and risk of contamination due to leakage. Several smaller bags can be placed in a larger zip lock bag. Plastic or glass storage containers can also be used, but there is risk of breakage. Avoid containers that have BPA.
How do I reheat the refrigerated or frozen breast milk?
Milk that has been frozen or refrigerated can be reheated to room temperature by putting it in a cup of hot water or in a bottle warmer. Refrigerated milk may take about 5 minutes to reheat and frozen milk may take about 20 minutes. Frozen milk left in the refrigerator to thaw takes approximately 12 hours. Never microwave frozen or refrigerated breast milk. This will destroy some of the beneficial properties of the milk. In addition, microwaved milk may be unevenly heated which could be potentially dangerous to the newborn. Milk that has been defrosted may appear layered due to the fact that the fat content will rise to the top. You may want to mix the milk by shaking before feeding to the baby.
Where do I get further information on storing pumped milk?
The La Leche League has a website that reviews storage guidelines. Guidelines may vary depending upon the lactation consultant. Also, the Human Milk Banking Association of North America (HMBANA) is a non-profit organization that sets standards and operates human milk banks in Canada, Mexico, and the United States. They provide information to the medical community on the storage of human milk and also serve as a resource for both potential milk donors and recipients for mothers that are unable to provide breast milk. We must keep in mind that there are new mothers who for one reason or another are not able to breast feed (gender, medications, illness, decreased supply, adoption/surrogate birth, etc.) and want the best nutrition and immunity protection for their baby.
Renate Abstoss IBCLC
Born and educated in Austria, Renate sat for the first International Board Exam for Lactation Consultants in 1985 and has been continuously certified and worked in the field since that time. She is currently the Lactation Consultant at The Stamford Hospital, a position she has held since 1997.
Tags: baby, breast feeding, breast milk, Breastfeeding, cracked nipples, health, nipple gel, nursing mother, pregnancy
Posted in Breastfeeding | 3 Comments »
Tuesday, June 22nd, 2010
 We all love to watch an adorable baby sucking on a bottle, but breast fed babies, although less likely to develop cavities compared to formula fed babies, can develop baby bottle syndrome when feeding is done on demand. Until recently, a child would only visit the dentist after dental disease occurs. Sadly, some children with decay developed pain, infections, abscesses, chewing difficulties, malnutrition and low self esteem. Others experienced malocclusion, poor growth, difficulty in speech, bruxism (grinding) and decay of the permanent teeth. Delayed treatment was expensive and often children required general anesthesia and/or frightening restraint for needed repairs.
As if these outcomes were not terrible enough, many people have had to endure mouthful’s of fillings, crown’s and bridges later in life as the conditions worsened over time. I suppose this all may seem better than the infamous wooden teeth of the George Washington era, but honestly, not by much.
Now that dentistry has, thankfully, shifted to prevention of cavities by proper oral hygiene and treatment with antibacterial and tooth protecting substances, I thought it would be important to write an article focused on oral care guidelines for the newborn infant. This very new information, based upon many years of research, will crown my series of blogs focused on dental guidelines focused on pregnant mothers (and how to avoid gingivitis and periodontal disease and their possible associations of poor obstetrical outcomes). Now it’s time to turn to the babies.
But my baby has no teeth yet!
Not true! Although a baby is born without visible teeth, development of two sets of teeth has begun in earnest by the 6th week of gestation. By the time the baby is born, both the primary and permanent teeth are present below the gums in an early developmental stage.
Now that you understand that all your baby’s teeth are “in there”, it’s clear why early preventative care will help prevent traumatic dental care issues from cropping up any time during life.
What will a good dentist do?
Believe it or not, children should be visiting the dentist by 1 year of age and be seen twice a year after that. Dentists should discuss diet, provide oral hygiene instructions and detailed directions for fluoride intake. They should also offer behavioral recommendations including the use of pacifiers, the ramifications of thumb sucking and the prevention of baby bottle syndrome.
Will my baby’s diet affect her teeth?
Nutrition continues to play an important role in prevention of tooth decay. Cariogenic foods such as crackers, teething biscuits, fruits and fruit juices, sweetened and acidic soft drinks should be limited. Carbohydrates, broken down by the enzymes in saliva along with bacteria in the mouth leave acid residue that dissolves the tooth enamel. Gums and newly erupted teeth should be cleaned after eating these types of foods. Dairy foods, especially aged cheese, can be protective.
Is flouride good or bad for my baby?
Fluoride use, which prevents tooth decay by increasing the density of the enamel, helps the teeth resist acid dissolution and is recommended after birth to limit cavities (caries).
Fluoride content of water should be tested and fluoride given by 6 months of age if the water is not supplemented or if the supplementation is less than .6 parts per million. Excessive intake of fluoride is not recommended because it produces mild dental fluorosis. This can also occur when children swallow large amounts of toothpaste that is supplemented with fluoride.
Fluoride use during pregnancy is controversial, with broadly divergent opinions.
The opinions range from “absolutely not” to “absolutely, positively yes” based on studies, some of which are interpreted to find that there is great benefit provided by the use of fluoride supplements during the pregnancy, to commencing fluoride use with the eruption of the infant’s teeth, to those who express the greatest concern about the generation of fluorosis and other undesirable or even dangerous conditions. Please consult your physician and your dentist for the recommendation in your individual case. Be sure to tell those you ask whether you live an an area that has a fluoridated water supply or well water.
Pacifiers and Thumb Sucking
Pacifiers have both advantages and disadvantages. Pacifiers, which exert less abnormal pressure on the teeth than a thumb or other fingers, might prevent thumb sucking and thereby reduce the risk of developing severe malocclusion (overbite) and abnormal growth patterns of the structures that support the teeth (the maxilla and the mandible). If thumb sucking continues after the permanent teeth have erupted, it has an even higher probability of causing permanent damage. Pacifier use can be controlled in a child in contrast to an appendage such as a thumb. Pacifiers have also been associated with a reduced incidence of SIDS.
It has been shown that long term use of pacifiers can cause dental problems. Misalignment of the teeth or malocclusions have been reported when infants use them beyond the age of 4. There is also a higher risk of otitis media with their continuing use. Limiting the use of pacifiers to the first 6 months or limiting their use to sleep times is recommended. Continuous use of pacifiers may also stunt speech development.
There is little evidence that orthodontic pacifiers are any better than conventional ones.
Choose pacifiers made of a more durable substance like silicon rather than latex, and be sure that the pacifier is made in one piece to avoid smaller parts from being detached and swallowed.
Pacifiers have not been associated with cavities but pacifiers should not be coated with sweets. Contrary to popular belief, pacifiers do not shorten the duration of breast feeding.
What is Baby Bottle Syndrome?
This syndrome that results from excessive baby bottle use is characterized by the development of severe tooth decay with pain and infection leading to extractions and extensive dental treatment. Bacteria in the mouth use milk and other sweetened beverages for metabolism and create an acidic environment in the mouth causing the destruction of tooth enamel and creating cavities. Children suffering from baby bottle syndrome feed poorly and often fail to thrive. The damage initially appears as white lesions on the teeth and then later progresses to brown or black discoloration. When the damage is severe, the crowns break down and permanent teeth may also be damaged. Malnutrition, with deficiencies in calcium and Vitamin D, may also lead to tooth enamel defects which predisposes the teeth to caries. The overall incidence of baby bottle syndrome varies from 3% to 6% in the general population but can go up to 72% depending upon the population. The teeth most affected are the maximally and mandibular primary incisors followed by the primary molars.
Breast fed babies, although less likely to develop cavities compared to formula fed babies, can develop baby bottle syndrome when feeding is done on demand. Breast milk does not support the growth of bacteria, doesn’t lower the acidity in the mouth and is therefore not as destructive. This is another reason why all mothers should be encouraged to breast feed their infants. Proper use of nipple gels, such as the Beauté de Maman Nipple Gel, will heal the chapped, sore breasts that often prevent women from continuing breast feeding.
Summary of DOs and DON’Ts of Proper Infant Dental Care
Things to Do
- Mouth cleaning in infancy should be part of a daily routine.
- Clean gums, newly erupted teeth, (after 6 months of age) and tongue, with clean washcloth, piece of gauze, or very soft moist toothbrush after feedings and before bed.
- Clean mouth with toothbrush or washcloth after giving sweetened medications.
- Introduce solid foods after 6 months of age and avoid cariogenic foods.
- Bottles should only contain plain water if being given for naps, bed or pacifier.
- Schedule first dental visit after the first year of life.
- Encourage breast feeding, especially for the first 6 months of life when fluoride is not recommended.
Things NOT to Do
- Do not allow the infant to sleep or nap with a bottle filled with juice or milk.
- Do not dip pacifiers in sweet or sweetened foods such as honey, sugar, or juice—sugars will feed bacteria in the gums, causing tooth decay even before teeth have erupted. Do not give fluoride supplementation till 6 months of age-the American Dental Association does not advocate use of fluoride at this age because there is an increase of fluorosis (white spots on the teeth) in infants who are supplemented.
Like so much about having a new infant in the house, dental care may seem daunting. My advice to new parents is to find yourself a reputable dental professional, carefully follow the advice given, and then watch your baby’s teeth arrive sparkling, white and pain free.
Tags: Breastfeeding, cracked nipples, dental care, gingivitis, healthy baby, nipple gel, nursing mother, periodontal disease, teeth
Posted in Oral Hygiene | 2 Comments »
Monday, August 3rd, 2009
Allow me to inform you about the current state of most nipple gels on the market. Currently, most breastfeeding women are given a lanolin based product to help relieve their sore, cracked nipples. As you may know already, lanolin is an animal based product—100% cholesterol—
 Contains no pesticides (more…)
Tags: beaute de maman, breast feeding, Breastfeeding, cracked nipples, is lanolin safe for baby?, lanolin and pesticides, lanolin based products and breastfeeding, nipple gel, nipple products for nursing mothers should not contain lanolin, pesticides, products for breastfeeding mothers
Posted in Breastfeeding | 6 Comments »
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