Hi Jennifer,
I have been following this thread for a while and have given it some
thought. I feel deep empathy for what you and this mom are going
through. I've seen individuals in the "medical establishment" say and
do things that make moms feel bad and moreover have no factual basis. A
few recent examples: a nurse telling a new mom not to bother with
breastfeeding her premature baby because the formula is better; or the
ob who says to go ahead and get the epidural because nobody gives birth
without one anymore; or the pediatrician that says your baby's weight
gain has slowed down because your milk doesn't have enough fat after 6
months. I sometimes wonder if they say such things to cover their
ignorance on the subject. It is most certainly tinged with prejudice
and an inability to see things from a different point of view. It is
hard for some HCPs to fully get it unless they have actually either
exclusively nursed a baby or watched their wives do so.
Dr. Carlos Gonzalez, a Spanish pediatrician, spoke at the LLL
International Conference this past July. His session was titled
"Children's Eating Problems: Why Children Refuse Food." A fascinating
fact he reported was that 100 years ago in 1905 Spain, child care books
recommended exclusive breastfeeding for one year. Cereals were
introduced at 12 months, fish at 21 months, fruits at 42 months, and
vegetables at 48 months. Only with the advent of formulas around WWII,
because they were so deficient in many nutrients, solids began to be
introduced much earlier.
This talk he gave, which is on CD-Rom available from LLLI, is based on
his book, also available from LLLI, and is definitely worth a listen.
He explains that one of the reasons some children refuse solids at that
6th month mark is that they prefer the high energy density food they
have been getting all along, breastmilk. He had a slide that compared
the different Kcal/100g of various foods with that of breastmilk -
boiled potato,65; apple,52; boiled carrot,27; veggies w/meat,50; vs.
breastmilk, 70.
I found this information fascinating because it explained my own
personal experience with my own children. My kids were Buddha babies
who began tasting foods on the average around the 10 month mark but were
not really interested in consuming significant amounts till months
later. Yet they grew so well. My first finicky solid eater's
"bloodwork" was perfect when done at one year. In fact the ped said
that he could count on one hand the number of kids in the practice whose
results were that good.
Then there is that recent study that was posted here on Lacnet regarding
the correlation between prolonged lactation and higher fat and energy
content in breastmilk:
Subject: fat and Energy contents of EBM in prolong lactation
1.1.1 Fat and Energy Contents of Expressed Human Breast Milk in
Prolonged Lactation
Mandel, Dror, Lubetzky, Ronit, Dollberg, Shaul, Barak, Shimon, and
Mimouni, Francis B.
Objective. To estimate fat and energy contents of human milk during
prolonged lactation.
Methods. Thirty-four mothers, of term, healthy, growing children, who
had been lactating for >1 year (12-39 months) were recruited. Control
subjects were 27 mothers, of term infants, who had been lactating for 2
to 6 months. Fat contents of the milk samples were estimated as
creamatocrit (CMT) levels. Energy contents of the milk were measured
with a bomb calorimeter.
Results. The groups did not differ in terms of maternal height and
diet, infant birth weight, gestational age, or breastfeeding frequency.
They differed significantly in terms of maternal age, maternal weight,
and BMI. The mean CMT levels were 7.36 {+/-} 2.65% in the short-duration
group and 10.65 {+/-} 5.07% in the long-lactation group. The mean energy
contents were 3103.7 {+/-} 863.2 kJ/L in the short-duration group and
3683.2 {+/-} 1032.2 kJ/L in the long-duration group. The mean CMT levels
and mean energy contents were correlated significantly with the duration
of lactation (R2 = 0.22 and R2 = 0.23, respectively). In multivariate
regression analysis, CMT levels (or energy contents) were not influenced
by maternal age, diet, BMI, or number of daily feedings but remained
significantly influenced by the duration of lactation.
Conclusions. Human milk expressed by mothers who have been lactating for
>1 year has significantly increased fat and energy contents, compared
with milk expressed by women who have been lactating for shorter
periods. During prolonged lactation, the fat energy contribution of
breast milk to the infant diet might be significant (Pediatrics 116[3],
e432-e435 1-9-2005)
And then, from LLLI's "Facts about Breastfeeding 2005": "The Oketani
method of breast massage, widely used in Japan and other Asian
countries, changes the composition of human milk by increasing total
solids, lipids, and casein concentration. Oxytocin and prolactin are
thought to increase gross energy and lipid content, satisfying the
infant and resulting in improved growth and development. Increased fat
content may also induce an anti-allergic effect."
Foda, M.I. et al. Composition of milk obtained from unmassaged versus
massaged breasts of lactating mothers. J Ped Gastro Nutr
04-5;38(5):484-87
So, it could be that continued breastfeeding (and a little breast
massage) would be the one thing that this mom and baby have going for
them right now offering benefits greater that just normalcy.
Cheers,
Carmen Clark, LLLL and (new) IBCLC
(mom to 4 boys, including my nursling 58 month old William, who said to
me as I typed, "Do you want me to be sick or healthy?" I said, "Healthy
of course." Then he said, "Then please give me more milkies." :-)
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