From the minute my oldest child was born, I have found myself singing. There have been the traditional nursery songs, the cherished lullabies, the dusted-off golden oldies, and the educational ditties. In a class of their own are the improvisations, made up on the spot to encourage a child searching for a lost item, coax him upstairs at bedtime, get him to lie still during a diaper change, or tease him into his winter gear.

It is easy to imagine Alison Blenkinsop’s musical imagination similarly taking hold as she prepared to teach a new mother about breastfeeding, to explain to expectant parents the role of midwives and doulas, and to discuss the pure goodness of breast milk. Not many women would choose to sing—or songwrite—about these topics, but Blenkinsop (a former midwife, now a lactation consultant) puts her musical skills to the task, with verve and humor that are sure to have her audience laughing from page to page.

Although the word “breastfeeding” is nowhere to be found in the book’s title, Fit to Bust: A Comic Treasure Chest, each page is a celebration of the wholesomeness of breastfeeding and mother’s love. Original lyrics about infant feeding are set to the tunes of well-known songs, with accompanying details about Blenkinsop’s inspiration for the piece, the occasion for which it was first performed, reflections on her experiences in foreign countries, stories about breastfeeding dyads, and more.

As a whole, Fit to Bust (2008) celebrates breastfeeding mothers; at the same time, it acknowledges that breastfeeding is not always easy and encourages parents who may face challenges such as tongue-tie, nipple pain, lack of support, and persistent formula advertising. New parents and expectant parents will find it to be a quick read that provides a wealth of practical information in a fun, easy-to-digest manner. Photographs, cartoons, song lyrics, and humorous anecdotes provide many passages readers will be eager to share.

While parents may enjoy most of this book, there are sections that seem to be included expressly for an audience of midwives, doulas, parent educators, and lactation consultants. For example, Blenkinsop’s discussion of how to make and use a knitted breast model to explain concepts to breastfeeding mothers simply is not relevant for a general parent audience. Also, a series of brief poems that ran monthly in a lactation consultant newsletter seems an odd fit to the book. In fact, parents may choose to skip Chapter 14, “Breastfeeding Supporters and Specialists,” altogether. But that would be a shame since Blenkinsop’s helpful “Thrush and Mastitis” (set to the tune of “Morning Has Broken”) is contained in that section.

Blenkinsop is British, so many of her reflections and statistics are about breastfeeding in the U.K., but the themes and concerns she addresses are universal. This book serves as a valuable, funny reminder to relax and enjoy this important, loving aspect of the parent-child bond. Proceeds benefit the non-profit Baby Milk Action in its effort to limit the damage of artificial infant feeding.

©iStockphoto.com/Mishella

We know that breastfeeding reduces the risk of childhood obesity, but how? A new study published in the journal Pediatrics found that it may have to do with babies inability to self-regulate their milk intake—whether that’s expressed breast milk or formula—when they drink from bottles.

Around 17 percent of children and adolescents ages 2-19 are obese, according to the Centers for Disease Control and Prevention (CDC). For children 2-5 years old, obesity increased from 5 to 10.4 percent between 1976-1980 and 2007-2008; for children 6-11 years old, the obesity rate increased from 6.5-19.6 percent; and for 12-19-year-olds, it increased from 5 to 18.1 percent.

Obese children are more likely to become obese adults, putting them at risk for high cholesterol levels, high blood pressure, abnormal blood sugar levels, asthma, hepatic steatosis (liver damage due to high levels of liver enzymes), sleep apnea, and Type 2 diabetes.

That breastfeeding reduces the risk for childhood obesity is old news. Breastfeeding has long been linked with a reduced risk of obesity, based on research from 2004, 2006, and 2007. But this new study is the first to look at infant’s self-regulation of food intake as the possible mechanism.

Research
The question posed by the study authors—“Do Infants Fed From Bottles Lack Self-Regulation of Milk Intake Compared With Directly Breastfed Infants?” demands just one answer, and, according to the study results, that answer is yes.

Researchers Ruowei Li, Sara B. Fein, and Laurence M. Grummer-Strawn analyzed data from the 2005-2007 Infant Practices Study II, a large-scale study conducted by the Food and Drug Administration and the CDC. Participants received monthly questionnaires, and researchers were able to look at complete data for 1,250 infants.

Results
Data showed that babies who were bottle-fed in early infancy were more likely to empty their bottles or cups in late infancy, regardless of the type of milk in the bottle or cup. The numbers are substantial:

• 27 percent of babies who were exclusively breastfed in early infancy emptied their bottles in late infancy
• 54 percent of babies who were both breast- and bottle-fed emptied their bottles in late infancy
• 68 percent of exclusively bottle-fed babies emptied their bottles in late infancy

“Bottle-feeding, regardless of type of milk in the bottle, is distinct from feeding at the breast in its effect on infants’ self-regulation of milk intake,” the study’s authors wrote.

So, do babies who keep drinking until the bottle is dry—regardless of whether they are actually still hungry—repeat this behavior with food and drink as kids? Well, no one can say for sure; in fact, that is one of the study’s self-proclaimed limitations (along with underrepresenting black and Hispanic mothers, and the possibility that reporting errors may have occurred.)

It would make sense that eating patterns established in infancy would affect later childhood. But there is more at work here.

The study authors suggest three main reasons to explain the disparity in self-regulation:

1. Breastfeeding babies control intake since they decide when to start and stop suckling; bottle-fed babies are less likely to control milk intake. When babies are encouraged to finish a bottle completely despite being full, they don’t learn to regulate their intake.
2. Breastfeeding requires both non-nutritive and nutritive sucking. The baby’s sucking triggers the let-down reflex, so there are moments in which the baby is sucking but not actually getting any milk. This very transition in sucking styles may affect self-regulation: when babies control the milk flow by adjusting their sucking, “they may establish a greater level of responsiveness to internal cues of hunger and satiety,” according to the study. This way of sucking does not exist in bottle-feeding.
3. Breast milk varies in composition and taste. Near the end of a feeding, the fat content in the breast milk is higher, which may signal to the baby that the nursing session is coming to an end. This signaling doesn’t happen with bottle-feeding. The study’s authors also suggest that missing out on the “sensory experience” of varied breast milk flavors may effect the regulation of food intake later in life.

Recommendations
All children, regardless of how they were fed as infants, can maintain a healthy weight throughout their lives—with their parents’ guidance.

If you bottle-feed your baby, remember that newborns may take only an ounce or two of formula at each feeding; by two months, it may be just 3-4 ounces. Watch for hunger cues (your baby may smack his lips or put his hands to his mouth) and check for his rooting reflex (turning his head toward your hand when you touch his cheek). And remember that crying is actually a late indicator for hunger, so don’t wait for your baby to cry to feed him.

When your child is older, continue to encourage healthy eating habits and regular physical activity; you can find inspiration in the CDC’s tips on preventing childhood obesity. If you struggle with weight, become an example for your child and strive to stay healthy together. Take a look at the newest version of the food pyramid and be an active participant in your child’s life.

The best advice for new moms is to breastfeed your baby for at least a year (exclusively for the first six months). However, any amount of breastfeeding for any length of time benefits your child—and you.

©iStockphoto.com/madisonwi

Listening to a concerned mother describe her newborn baby’s condition, I was amazed at how quickly she had picked up what took me a semester in nursing school to learn. She described her baby as jaundiced. (I remember my babies looking a bit yellow.) He had a bilirubin of 17. (I recall some mention of 20 being a trigger point.)  She was concerned that phototherapy (light treatment) might be necessary. (I distinctly remember parking my diaper-clad baby in the shade of a tree where he could benefit from the indirect sunlight while I mowed the grass!) But what was most concerning was that she had been told to stop breastfeeding. (I was sure I was told to breastfeed more not less.)  I realize treatments change as our knowledge of specific medical conditions grows. But given the serious consequences of untreated jaundice, and the differing views on how to best manage breastfeeding babies with jaundice, it is easy to see why parents and health professionals alike are so concerned about jaundice.

Management of jaundice has been rife with inconsistencies—some clinicians managing newborn jaundice aggressively, despite concerns that they are undermining breastfeeding. And others taking a more relaxed approach—that some feel may threaten the health of newborns. In an effort to facilitate appropriate management and support continued breastfeeding, the Academy of Breastfeeding Medicine (ABM) has released revised guidelines for the management of jaundice in breastfed babies. Although these guidelines are intended for clinicians, parents of breastfeeding babies will benefit from knowing what they can do to prevent serious jaundice in their babies.

Nearly one-half of all healthy newborns develop elevated bilirubin—a condition many experts refer to as physiologic hyperbilirubinemia—a condition thought to be normal and characterized by jaundice. Bilirubin is found in red blood cells. After birth, red blood cells breakdown releasing bilirubin, which is excreted in the stool—one of the reasons why frequent poops are so important! If there is too much bilirubin in the blood, it can act as a toxin, causing a yellow discoloration of the skin (jaundice) and can eventually damage brain cells. In addition to physiologic jaundice, there are other types of jaundice—each with a specific cause. Jaundice that lasts longer than a week (and sometimes up to 8-12 weeks) is commonly seen in breastfed babies and is referred to as “breast milk jaundice.”  The cause of breast milk jaundice is unclear, but it is thought to be linked with a substance in the mother’s milk. When babies are poorly fed, a condition described by some as “not enough breast milk jaundice” and others as “starvation jaundice” can occur—poor feeds lead to fewer poops and higher levels of bilirubin.

How jaundice in breastfeeding babies is treated varies with the cause and severity of the condition. The ABM recommends the following guidelines (suggestions that clinicians should be giving breastfeeding moms) as a means for preventing excessive weight loss, ensuring adequate weight gain, and minimizing the risk for dangerously high levels of hyperbilirubinemia.

• Encourage mothers to breastfeed as soon as possible after birth, ideally within the first hour.

• Encourage mothers to breastfeed exclusively, avoiding all supplements unless medically indicated.

• Provide optimal breastfeeding support.

• Teach parents early feeding cues.

• Identify mothers and babies at risk for jaundice.

These may seem like obvious recommendations, but data show that too many parents fail to breastfeed within the first hour after birth, are unable to identify hunger cues, and supplement inappropriately.

Take home message
Jaundice happens. It usually resolves within 7-10 days, but can persist for weeks. If the cause is not easily identified, a thorough medical evaluation may be necessary. Taking your baby for routine medical check-ups during the early days and weeks will ensure that jaundice or other common conditions are quickly identified and appropriately treated. Jaundice which appears after your baby leaves the hospital, or in between check-ups, should be reported to your baby’s doctor right away. Only sunflowers look good in yellow!

©iStockphoto.com/Mari

Taxed with too many questions and too little time, but intent on meeting the needs of parents and health professionals alike, Dr. Thomas Hale is planning to create a national call center at Texas Tech University Health Sciences Center. The InfantRisk Center will be associated with the Laura W. Bush Institute for Women’s Health and will give callers up-to-date, evidence-based information on the use of medications during pregnancy and while breastfeeding.

Hale, Professor of Pediatrics at Texas Tech University and author of Medications and Mother’s Milk, hopes to have the call center up and running by the end of July 2010 and is asking for help in building the center. Those interested in partnering with Dr. Hale can make an online donation.

With more than 4 million babies born each year in the U.S., and an increasing number of pregnant women taking a variety of medications, InfantRisk will serve not only as a source of information but as repository for data on specific medications and related side effects. The Texas Tech facility will complement existing sources of information on the use of drugs in pregnant and breastfeeding moms including local poison control centers and LactMed, a database maintained by the U.S. National Library of Medicine.

For more information contact the call center at (806) 352-2519.

THIS CONTEST IS NOW CLOSED.

Motherhood is full of funny moments—seeing your baby bounce to the beat of her favorite song or make a spaghetti wig during dinner. The same is true of breastfeeding. When you were a new mom feeding your baby 8, 10 or 12 times a day, chances are you experienced a funny moment or two. We are hoping you will share your “Funniest Breastfeeding Experience” in 300 words or less.

What will I win?
The winning entry will be published on babygooroo.com and the author will receive a copy of the newly released, ninth edition of BREASTFEEDING: A Parent’s Guide (2010).

How to enter:
Email your “Funniest Breastfeeding Experience” in 300 words or less to contests@babygooroo.com. Contest ends July 22, 2010 at 11:59 PM EST.

How entries are scored:
Points will be awarded based on comedic value and originality.

Earn extra points!
Email us at contests@babygooroo.com to let us know:

• You are a Facebook Fan (+1 point)
• You suggest to your Facebook friends that they become a fan of baby gooroo (+1 point)
• You are a follower on Twitter (+1 point)
• You retweet our contest post on Twitter (+1 point)

Good luck!

See Contest Rules here and our Privacy Policy here.

©iStockphoto.com/wdunn

A significant number of breastfeeding mothers report having “not enough milk.” In an effort to boost their supply, many turn to galactagogues (drugs or herbs used to increase milk production)—some have proven successful, others not so much. Given the scant data on galactagogues, particularly lacking is information on side effects, Drs. Thomas Hale and Kathleen Kendall-Tackett are conducting an online research study—a survey of women’s experience with two drugs commonly used to increase milk production—domperidone or metoclopramide.

Any mother who has taken either drug is asked to complete a 30 minute on-line survey. The study has been approved by the Institutional Review Board at Texas Tech University Health Sciences Center and all information will be confidential. The greater the number of participants, the more valid the data will be, so please let other mothers know about this important study. For more information about the study please contact Dr. Kendall-Tackett at kkendallt@aol.com or click here to access the survey.

©iStockphoto.com/onebluelight

Not ready for another baby just yet? Breastfeeding mothers everywhere struggle to find a method of birth control that is most likely to prevent pregnancy and least likely to affect their milk supply. Although hormonal methods such as combined oral contraceptive pills, patches, and rings (products containing both estrogen and progesterone) are commonly used in the U.S., their early use by breastfeeding mothers has been discouraged—until now. The Centers for Disease Control and Prevention (CDC) as part of its Morbidity and Mortality Weekly Report (MMWR) has released new recommendations on the use of methods of birth control.

The CDC report is based on a similar report by the World Health Organization (WHO)—Medical Eligibility Criteria for Contraceptive Use (MEC)—first published in 1996 and now in its 4^th edition. With the help of a group of experts, the WHO document was adapted by the CDC for use in the U.S. But several of the revised recommendations are creating a stir in the breastfeeding community—specifically those related to the use of hormonal methods (contraceptives containing estrogen or progesterone) by breastfeeding mothers in the first days after birth.

Previously, breastfeeding mothers were told to wait six months before taking combined oral contraceptives (COC)—those containing both estrogen and progesterone; and six weeks before using progesterone-only methods, including progesterone-containing intrauterine devices (IUDs), DepoProvera (a shot containing progesterone), and progesterone-only pills (POP). The new CDC guidelines allow for the use of COC immediately after birth. But given that the risks associated with early use usually outweigh the advantages, breastfeeding mothers should be counseled to wait four weeks, at which time the advantages generally outweigh the risks. The guidelines also allow for the immediate use of hormonal contraceptives containing only progesterone, stating that the advantages of immediate use generally outweigh the theoretical or proven risks, and that by four weeks there is no discernible risk.

Dr. Jerry Calnen, president of the Academy of Breastfeeding Medicine, expressed concern that the new guidelines ignore basic facts about how breastfeeding works. “The data are limited,” says Calnen. “But for now, the state of the science suggests that early progesterone exposure undermines breastfeeding.”

Those, like Dr. Calnen, who oppose the revised recommendations, worry that early use of hormonal methods will reduce milk production and have a negative effect on breastfeeding rates—both exclusivity and duration. Those who support the new guidelines argue that early access to hormonal methods of birth control will prevent a greater number of unintended pregnancies.

Dr. Robert Hatcher, professor of obstetrics and gynecology at Emory University and author of Contraceptive Technology, and Dr. Miriam Labbok, professor of public health at the University of North Carolina, were among the 31 experts brought together by the CDC to review the scientific evidence and the proposed guidelines.

According to Dr. Labbok, “The CDC bases its decisions on published research. Admittedly, there is little research on immediate postpartum use of hormonal contraceptives during lactation because many institutional review boards (IRBs) and researchers feel such research would put lactation at risk.”

“Aside from anecdotal data there is no evidence to support the theory that early use of COC (those containing estrogen and progesterone) causes problems,” says Hatcher. “Use during the first four weeks is a no, but after four weeks, the benefits may exceed the risks.”

“Historically, I did not provide COC to breastfeeding mothers until they were no longer breastfeeding exclusively, recommending a progestin-only method instead,” added Hatcher. “But if a woman, despite my encouragement to use a progestin-only method insists on using a COC—due to cost, availability, or concerns over irregular bleeding—I would accommodate her request.”

With regard to the use of contraceptives containing only progesterone, Hatcher says, “Currently there is no scientific evidence to show that early use of progestin-only contraceptives interferes with milk production—only anecdotal reports. The recommendation could change as more evidence becomes available, but until then, science does not support delaying their use.”

“The problem with the argument for early use of progesterone-only contraceptives,” says Labbok, “is that the science also does not support the safety of early use. There are no good studies on the use of hormonal contraceptives during the first days after birth that show the short- and long-term effects in breastfeeding mothers and babies.  DepoProvera is commonly given to breastfeeding mothers before they leave the hospital, with little or no counseling as to the risks. That DepoProvera is most often given to low income, minority women, makes the ethics of this practice all the more concerning.”

“Clients should be counseled as to all available family planning options and the risks and benefits of each,” says Labbok. “Describing a contraceptive method as ‘generally acceptable’ in the absence of new data is in my opinion a leap of faith that good counseling will be a part of each encounter.”

Given the concerns surrounding hormonal methods and the proven effectiveness of intrauterine devices (IUDs) why don’t more women, breastfeeding and non-breastfeeding, opt for IUDs?

According to Hatcher, data coming out of the Choice project, a family planning program at Washington University in St. Louis, show a trend toward greater use of IUDs and other long-acting reversible contraceptives (LARC) including implants and shots (DepoProvera). More than 6,000 women have participated in the program so far. Nearly 70 percent have chosen either an IUD (the progestin-containing Mirena or the copper-containing ParaGard) or an implant (Implanon) compared to less than 5 percent of women nationwide.

How did this program achieve such high rates of LARC use? There are two reasons. First, the researchers recognized that cost is a deterrent to choosing an IUD or implant, so both devices are provided free of charge. Second, as a prerequisite for joining the study, participants must agree to change their current method of birth control. Researchers have found that when women are told the many benefits of LARC—cost-effective, convenient, less bleeding and pain with monthly periods, less risk for anemia, less risk for endometrial cancer, and less blood loss and pain caused by endometriosis and uterine fibroids—many will choose an IUD or implant.

In addition to concerns over early use of hormonal contraceptives, Labbok points out that the new CDC guidance has no data showing the effectiveness of breastfeeding (exclusively or almost exclusively) in family planning. “Birth spacing is very important for maternal health, but so is breastfeeding. While there are many contraceptive options that can be considered instead of hormonal contraceptives, there is no effective alternative to breastfeeding given its impact on maternal and child health,” says Labbok.

Many would agree that breastfeeding can and should be an integral part of any family planning program. Exclusive breastfeeding is one of the most common strategies for spacing births worldwide, providing protection comparable to to that of birth control pills. Commonly referred to as the lactation amenorrhea method (LAM), exclusive or almost exclusive breastfeeding is a highly effective method, albeit a temporary one. Suckling is the key ingredient. The more time a baby spends suckling at the breast, the less risk the mother has of becoming fertile. As the baby’s suckling time goes down due to the use of pacifiers, supplements, solid foods, or long stretches of sleep, the mother’s risk for ovulation (the release of an egg from her ovary) goes up, along with her risk for pregnancy. For LAM to be effective three criteria must be met:

• Mothers must not have resumed menstrual periods;
• Babies must be fully or nearly fully breastfed day and night; and
• Babies must be less than 6 months old.

According to Labbok, “LAM has been shown to be effective for 9 to 12 months in mothers who have maintained a high frequency of feeds and who breastfeed before each complementary feed.”

While the effectiveness of LAM is well-documented, if any of the criteria are not met, another method of contraception should be used.

Birth control pills along with female sterilization are the leading methods of birth control in the U.S. A recent survey by the National Center for Health Statistics found that during 2006-2008 an estimated 10.7 million women ages 15 to 44 used the pill and another 10.3 million chose to be sterilized. Despite these figures, half of all pregnancies in the U.S. are unintended, highlighting the need for greater use of long-acting reversible contraceptives including IUDs, implants, and shots.

Even among breastfeeding mothers, contraceptive needs vary. Talk with your health care provider about the birth control method that is best for you with consideration given to cost, convenience, availability, and effectiveness. Learning all that you can about the benefits and the risks of various options will allow you to make an informed decision based on a clear understanding of the facts.  For more information about contraception visit Managing Contraception.

“Personally, I believe contraceptives should be treated like immunizations and be made available to everyone regardless of their ability to pay,” says Hatcher, and Labbok agrees, adding the need for proper counseling. This is sage advice, given the public health implications of immunizations, contraceptives, and breastfeeding.

©iStockphoto.com/ChepeNicoli

Many parents switch from breast milk (or formula) to pasteurized cow’s milk around one year of age. A few months ago, we made the switch with our son, thinking it would be easy. But he flat-out refused to drink it—at first. We continued to try (using the tips in this article to coax!) until we finally succeeded, but a lingering question remained for me and my wife: Knowing how important breast milk and breastfeeding is for a child, was our son missing out on essential nutrients by making this switch from breast milk to cow’s milk? Here, experts explain why many parents make the switch and how to handle the transition.

Why switch?
According to the American Academy of Pediatrics (AAP), once your baby celebrates his first birthday, you can begin to offer him cow’s milk, provided he is eating a variety of solid foods (cereals, vegetables, fruits, and meats). Many parents continue to breastfeed beyond their child’s first birthday. And the World Health Organization actually recommends breastfeeding (in addition to age-appropriate solid foods) until a child is at least 2 years old given the many benefits of breastfeeding and human milk. But if you (or your baby) are ready to wean and your baby is at least 1 year old, you can safely transition to cow’s milk.

Whole milk or low-fat?
Whole milk provides many of the important nutrients babies needs. If you’re concerned (like we were) that your child might be missing out on important nutrients, don’t be. According to Heather Russell, R.D., a pediatric registered dietitian at St. Joseph’s Children’s Hospital in Paterson, New Jersey, “It is appropriate to advance the child to whole milk after one year, so the child will continue to receive calcium, phosphorus, and vitamin D to help with development and growth of teeth and bones.”

If a mother and her baby are ready to transition from breast milk to cow’s milk, the consensus among our experts is that whole, vitamin D-fortified cow’s milk is the best choice unless the child has weight issues. At this age, fat should make up about half of a baby’s daily caloric intake, so the higher fat content in whole milk is essential. Babies also need the vitamin A available from whole milk.

However, according to the AAP, if your baby is overweight or at risk of being overweight, or you have a family history of obesity, high blood pressure, or heart disease, your baby’s pediatrician might recommend 2 percent milk as an alternative. One percent or skim milk are not recommended until your baby reaches his second birthday. For babies with no risk factors, whole milk is preferred.

“I usually recommend whole milk until the second year of age due to its higher fat content, which is necessary for proper brain development and growth,” says Russell. “However, in certain cases if the child is already overweight or has a history of cardiac issues such as high cholesterol, I would recommend 2 percent milk.”

Some parents choose organic milk because of concerns over the use of bovine growth hormone in dairy cows. “There is no data concerning bovine growth hormone sufficient enough to recommend organic,” says Ari Brown, M.D., a pediatrician in Austin, Texas, and co-author of Expecting 411, Baby 411 and Toddler 411. “Plus, some manufacturers of commercial non-organic milk are rBGH free now, too.”

Tips for making the switch
Sometimes, switching to whole milk can be challenging not only for parents, but for the baby, too. At first, your baby might refuse to drink the milk, especially if he doesn’t like the taste or isn’t accustomed to drinking from a cup. Here are some tips for helping your baby transition to cow’s milk:

• Gradually switch from breast or bottle to a cup before your baby’s first birthday, says Dr. Russell, so that he can get used to drinking from another source.

• If your baby is rejecting the cow’s milk because of the taste, start by combining it with breast milk. “Sometimes if mom can pump some milk and mix some of the cow’s milk with it to get them used to the taste, that helps,” says Kenneth Wible, M.D., medical director of the Pediatric Care Center at Children’s Mercy Hospitals and Clinics in Kansas City. “Then they can gradually increase the percentage of cow’s milk and reduce the amount of breast milk.”

• Russell adds that persistence is key as you make the transition. “Parents might find it helpful to offer the milk in small spoonfuls or mixed with familiar foods until the child gets more accustomed to the new taste,” she says. “Using a fun or colorful cup might also help to encourage the child to try the milk.”

Generally, your 1- to 2-year-old should have between 16 and 24 ounces of milk each day. The AAP cautions parents to limit a baby’s milk intake to one quart (32 ounces) per day. More than this can provide too many calories and may decrease a baby’s appetite for other foods. Offer cow’s milk at mealtimes, along with some water, or in between meals as a snack. If you’re struggling with getting your baby to drink milk, you can try whole-fat yogurt made especially for babies, or calcium-rich vegetables like broccoli, Brussels sprouts, leafy greens, or pinto beans. Juices fortified with calcium or whole soy milk can also be good choices.

Some babies transition to cow’s milk at age 1, others at age 2 or 3, and some never acquire a taste for cow’s milk. Every baby is different. Your baby will let you know when he is ready for a new skill (drinking from a cup) and a new taste (cow’s milk).

©iStockphoto.com/Anpet2000

For all those breastfeeding moms who risk being told by well-meaning health care providers to “pump and dump” for 2 to 24 hours following a CT (computerized tomography) scan—help has arrived under the title, “Manual on Contrast Media v7.”

Written by the American College of Radiology (ACR) and now available online, the Manual on Contrast Media v7 states that less than one percent of iodine-based contrast medium (substances that increase picture quality during imaging tests such as CT scans and MRIs) used in imaging studies is excreted into breast milk and less than one percent is absorbed from the baby’s gastrointestinal tract. Agents containing gandolinium, another common contrast medium, are also safe with less than .04 percent of the contrast medium excreted into breast milk and less than one percent absorbed from the baby’s gut. These low absorption rates are true of contrast agents given intravenously as well as those taken orally or rectally.

While there is no evidence to suggest that it is unsafe for babies to ingest a small amount of contrast agent, some mothers find even the smallest risk unacceptable and prefer to interrupt breastfeeding for 24 hours. You can express your milk ahead of time, and feed it to your baby. In addition, you will need to express your breasts (manually or with a pump) to relieve fullness and maintain your milk supply.

©iStockphoto.com/abu

Be careful when you Google “Booby Trapper.” Because there’s a horror movie by the same name that apparently is about a bloody hatchet colliding with some unfortunate campers.

No, the “Booby Trapper” you will want to look for is the latest tent-like device designed to give you privacy while you breastfeed, all the while shielding the eyes of passersby who might faint when confronted with a baby eating.

This Booby Trapper was recently named the grand prize winner of the Progress2Capital business planning competition organized by the Regina Regional Opportunities Commission.

Baby gooroo mentioned the Booby Trapper when it was included in the Golden Globes gifting suite (you can see photos from the day here. From the photos, it looks like the women are wearing a gigantic apron, which, frankly, draws much more attention than a latched-on baby whose head covers nearly everything a shirt would cover.

Clever names aside, what does it mean that such a product exists?

It means that women want to nurse in public (yay!) and want to feel comfortable doing so (of course!). It means that some women uncomfortable with breastfeeding in public may give it a go (big yay!). This is something we can get behind: a feeling of empowerment and comfort that encourages mothers to breastfeed.

But it’s unlikely that many women will be encouraged to breastfeed as long as the act remains invisible. Hidden breastfeeding perpetuates the idea that public breastfeeding is shameful, weird, possibly gross, and definitely not normal. And that needless concept is just what the Booby Trapper (along with other similar nursing cover-ups) offers.

Boo. Big, big, boo!