120 pages to slog thru :-(  up to page 63 :-) 

Read so far: Study Design, Infant Feeding and Transitions During First Year of Life; Effects of Maternity-Care Practices on Breastfeeding; Characteristics of Breastfeeding Practices Among US Mothers; BF and Employment.

To read : Prevalence of Breast Milk Expression; Why Mothers Stop BF; Association of BF Intensity and Bottle-emptying Behaviors at Early Infancy With Infants' Risk for Excessive Weight at Late Infancy; Infant Formula-Handling Education and Safety; Selected Complementary Feeding Practices and Their Association with Maternal Education; Sources of Supplemental Iron Among Breastfed Infants During the First Year of Life; Maternally Reported Food Allergies and Other Food Related Health Problems in Infants; Infant Sleeping arrangements and Practices Durig the First Year of Life. Whew!

The abstracts are available at www.pediatrics.org  Be sure and go read the conclusions!

Positives
No formula sponsorship that I have seen so far!  All DHHS, CDC,DofAg etc.
They spell breastfeed, breastfeeding correctly :-)
Key phrases pop up regularly (exclusive, baby friendly, continue breastfeeding as long as mutually desired by mother and infant)
Breastfeeding baby at work increases duration, pumping at work increases duration- just not as much, doing neither results in weaning earlier [of course!] 

Causes for concern:
almost half of breastfed infants were supplemented with formula in the hospital.
41% of infants receiving solid foods before 4 mo. (risk factor for early cessation of BF)
increased consumption of sugary, fatty foods by age 1 (lousy US nutrition and advertising)
Cereal universal first food.  Meats begun late (8 mo) altho babies can use them earlier. ("Pureed meats have shown to be well tolerated by infants as a first complimentary food")
Large sample, but  skewed.  Minorities under rep.  Ed level higher than national average.  Self selection - sort of, moms had to answer a monthly questionnaire for 1 
year.
Most US hospitals only use a few of baby friendly policies.  Increased # of policies = increased duration of babies BF.

Nearly half of moms said they BF less than 8 x per day and for shorter amounts of time.  Do we need to  look at common advice (8-12 x/day; 10-15 min each side each feed) Neat comment "The physiology of human lactation is extremely complex[duh], but effective lactation is not determined by frequency, duration, intervals, and pairing of feedings." (numerous ref.)  "Instead, it is influenced by interactions among 4 major elements: (1)characteristics of how mother's body makes and stores milk that may vary by time of day; (2) how completely the child empties the breast at an individual feeding; (3) variations across 24 hours in the child's need for breastfeeding; (4) which breast the child feeds from first-the breast that is dominant or non dominant milk-producing breast.  Because none of these elements are related to the themes of common breastfeeding advice, some mothers whose infants' behaviors fail to match up to specific expectations inherent in common breastfeeding advice may unnecessarily (and prematurely) stop breastfeeding as a result of misinterpretation of a benign variation as a problem."

Reading on...Pat in SNJ


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