The Secret to Pain Free Breastfeeding

Breastfeeding Help And Baby Care For New Parents

The Breastfeeding Help Video Compilation By Australian International Board Certified Lactation Consultant Kate Hale is full of useful information about breastfeeding and how to manage low supply. It is very clear and concise in its content. It also has a lot handy tips for new mothers, including how to bath, massage and dress an infant. Learn how to care for a new-born, including how to deeply latch your baby and breastfeed without pain within minutes for a contented baby and an end to sore nipples. It is the only Dvd of which I am aware that is readily available to new mothers with an actual demonstration on how to correctly latch a baby on and off the breast using a couple of alternative feeding positions. Reading about breastfeeding in a book is nowhere near as useful as watching the Dvd. More here...

Breastfeeding Help And Baby Care For New Parents Summary


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Author: Kate Hale
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If She Is Breastfeeding

In contrast, exclusive breastfeeding reliably delays ovulation for up to 6 months, providing a 98 contraceptive efficacy (60-63). While a woman is exclusively breastfeeding, ovulation is delayed and all methods used have a low failure rate when used correctly. Exclusive breastfeeding when used as birth control is called lactation amenorrhea method (LAM). To use LAM properly, women need to start exclusive breastfeeding immediately postpartum, breastfeed at least every 4 h during daytime and 6 h during nighttime, and avoid milk supplementation. Another method should be used if menses resumes or 6 months have passed since delivery or if supplemental feeding is used. The cumulative pregnancy rate at 6 months with LAM is up to 1.2 (95 CI, 0-2.4 ) (62). During the newborn period, the contraceptive needs of the mother should be assessed. Intercourse may be less frequent with the demands of motherhood. Women may be reluctant to take unnecessary medication while breastfeeding. Encouraging the...

Breastfeeding and Cows Milk Protein

Borch-Johnsen et al. (130) proposed an inverse correlation between the frequency and duration of breastfeeding and the frequency of Type 1 diabetes in Norway, Sweden and Denmark. They postulated that breast milk provides protection against environmental factors that lead to the selective destruction of pancreatic -cells in genetically susceptible children. It could also be that commercially available milk substitutes or baby foods contain chemicals toxic to the pancreatic -cells or that cow's milk contains certain proteins that could be harmful to islet -cells. If it could also be shown in other countries that the duration of breastfeeding is relevant to the incidence of diabetes, then education campaigns for prolonged breastfeeding could be started. This might also have other beneficial health aspects besides Type 1 diabetes prevention. The case-control study design provides a better way to determine whether the exposure and the disease are directly linked. The reviews of published...

Question Can Hormonal Contraception Be Used During Breastfeeding

The level of steroid hormones transferred to breast milk is less than 1 of the maternal dose and is comparable to hormone levels observed during ovulatory cycles. A review examining the limited available studies comparing the effect of COC and PO-OC on breast milk found that PO-OC use during the first 6 weeks postpartum had no effect on breast milk volume but the evidence was inconclusive for COC use (64). Importantly, neither PO-OC, COC, nor progestin implants affect infant growth and weight. Lacking evidence-based data, the recommendations for when to initiate hormonal contraception in breastfeeding women come from expert committees (65-67). In breastfeeding women, PO-OCs can be started on day 21 postpartum without additional protection, noting that using PO-OC before 6 weeks is outside of the product license. The ACOG states that COCs should not be started before 6 weeks postpartum, after lactation is well established and the infant's nutritional status is well monitored. In...


They may need to eat more carbohydrate (about 100 g or ten portions a day in those who measure this) and reduce their insulin dose according to blood glucose levels. They should snack before feeding and drink more fluid. With disturbed nights and erratic exercise patterns there is a risk of hypoglycaemia. I usually suggest that glycaemic balance is relaxed from the pregnancy normoglycaemia to around 6-9 mmol l during this time. Do not forget that contraception needs to be restarted unless further pregnancies are planned.

Understanding Diet Challenges at Every

1 The newborn Hopefully, the newborn is breast-feeding, but if breastfeeding isn't possible, formula may be used for a baby with T1DM. It's unusual for a newborn to develop T1DM, but should it occur, the high fat content of breast milk (50 percent fat) will result in very slow absorption of the sugar in milk. Short-acting insulin should be given before each breast or formula feeding. Very small amounts of insulin are required, sometimes measured in half units.

Using insulin during and after pregnancy

Immediately after delivery, as a result of the drop in hormones, your insulin needs drop below what you needed before the pregnancy. However, as the pituitary gland produces prolactin to stimulate breast milk, your insulin needs increase. You may find that you need less long-acting insulin and more rapid-acting insulin when you breast-feed.

Dietary strategies for preventing the onset of diabetes

It has been suggested that for type 1 diabetes an early exposure to cows' milk proteins may play a role in triggering the immune response that destroys pancreatic beta-cells.2 Observational studies have shown that breastfeeding is associated with a lower incidence of type 1 diabetes.3'4 It is hoped that the multicentre study, 'Trial to Reduce Type 1 Diabetes in the Genetically at Risk' (TRIGR) started in May 2002 will give a definite answer to this hypothesis. In this study, an offspring of someone with diabetes or first degree relative who possesses a high-risk genetic susceptibility to type 1 diabetes should be breastfed for at least 6 months of life. If the mother is unable to exclusively breastfeed, her child will then be randomly assigned to one of two groups. One group receives breastfeeding supplements of a special formula based on extensively hydrolysed cows' milk proteins the other group receives a normal formula containing cows' milk with a small amount of hydrolysed...

Question Which Methods Can Be Used in Postpartum Women with Diabetes

Encouraging breastfeeding in women with diabetes should be a priority for her physician. Studies in women with diabetes found that only half had received information about breastfeeding during pregnancy (69). In addition to decreasing childhood allergies by decreasing exposure to cow's milk antigens and improving bonding, breastfeeding importantly appears to reduce childhood obesity in offspring of women with prior gestational diabetes (70) and obesity (71), and it reduces the risk of type 2 diabetes in mothers with prior gestational diabetes (72). Thus, promoting LAM with condom use offers excellent pregnancy protection, promotes exclusive breastfeeding, and removes the woman's worry of ingesting additional medication. Special exceptions related to breastfeeding should be noted in women with prior gestational diabetes. The use of PO-OC while breastfeeding was associated with an increased adjusted risk of development of type 2 diabetes (HR 2.87 95 CI, 1.57-5.87) compared with COC use...

Final Postpartum Visit

The final postpartum visit, which is usually done 6 weeks after delivery, is comprehensive and covers a wide range of systems from general well-being, coping with changes since delivery, and breastfeeding support. The visit focuses on questions pertaining to diabetes care, insulin requirements, blood pressure control (especially if preeclampsia occurred), eye health, maternal weight loss, a thorough physical exam, and contraception. Please see Chap. 9 for a more comprehensive review of fertility control.

Maintaining your health after pregnancy

If you are breastfeeding, which is always a good idea, you need to consume about 300 kilocalories above your usual needs. You cannot take oral agents for diabetes because these pass through the milk into the baby. For more information about breastfeeding, see Breastfeeding For Dummies by Sharon Perkins and Carol Vannais (Wiley).

Infant feeding patterns

Whether breastfeeding protects from or early introduction of supplementary foods causes type 1 diabetes, remains unsolved, although these aspects of the diet have received more research attention than many other areas in the etiology of type 1 diabetes (Virtanen & Knip 2003). Findings from prospective studies with enough statistical power are awaited. Putative protecting effects of breastfeeding could be due to protection against infections provided by breast milk through, for example, secretory IgA antibodies and enhancement of the infant's own immune responses, increased beta-cell proliferation (Juto 1985), or delayed exposure to foreign food antigens. Breast milk contains cytokines and growth factors, which affect the maturation of the gut-associated lymphoid tissue (GALT) (Srivastava et al. 1996). An early introduction of cow's milk-based infant formulas and other cow's milk products may increase the risk of type 1 diabetes according to case-control evidence, although the...

Nutritional risk factors in the onset and prevention of type diabetes

Large geographical differences in incidence and linearly increasing incidence seen in many countries during the last five decades cannot be explained solely by genetic factors (Onkamo et al. 1999 Karvonen et al. 2000 Green et al. 2001). The relatively low concordance of identical twins also confirm the important role of environmental factors in the aetiology of this disease (Barnett et al. 1981). So far there is little firm evidence on the role of nutritional factors. Breastfeeding, vitamins C, D and E, nicotinamide and zinc have been reported as possibly protecting from type 1 diabetes, whereas N-nitroso compounds, cow's milk, some cereals, increased linear growth, and obesity may increase the risk (Virtanen & Knip 2003).

Postpartum careclinical implications

Type 2 Diabetes campaign recommends breastfeeding and achieving prepregnancy weight within 12 months after delivery. If BMI is still > 25 kg m2, then an additional 5-7 of body weight should be reduced slowly over time through healthy food choices and increasing physical activity to at least 30 min 5 days per week (33).

Maternal Diabetes and Cardiovascular Disease Risk

Low, seemed to be primarily attributable to their greater risk of diabetes (9). Contraception and breastfeeding are important aspects of postpartum care addressed in other chapters, so the subsequent section addresses postpartum diabetes screening and risk factors for diabetes among women with histories of GDM.

Public Health Consequences

Public health efforts to prevent type 2 diabetes, therefore, should focus not only on adult lifestyle risk factors such as obesity and sedentary lifestyle, but also on prenatal exposure to overnutrition and diabetes in utero. Reduced obesity in women of reproductive age and prevention of excessive weight gain during pregnancy would reduce the risk of developing gestational diabetes in the mother and would likely also reduce the risk of excess fetal growth, high birth weight, and future obesity and diabetes in the offspring. Another potential target for public health policy is the encouragement of breastfeeding and healthy postnatal nutrition for infants, particularly among infants of women whose pregnancy was complicated by diabetes, as better postnatal nutrition can attenuate some of the effects of the diabetic intrauterine environment. More information is needed about the most effective public health measures to combat the worldwide epidemic of type 2 diabetes.

Genetic Factors vs Environment

Interactions between the prenatal and postnatal environment have been reported to influence the risk of type 2 diabetes in offspring of pregnancies complicated by diabetes as well. An example is the report that among Pima Indians, breastfeeding attenuates the increased risk of developing type 2 diabetes in the offspring of mothers with diabetes (30.1 in children who were breastfed vs. 43.6 in bottle-fed children) (38). These findings suggest that the risk of developing type 2 diabetes is a complex combination of prenatal, postnatal and genetic factors. Targets for prevention, therefore, may include reducing the effects of the diabetic intrauterine environment on fetal programing through stricter glycemic control, as well as encouragement of breastfeeding for infants born to mothers with diabetes during pregnancy.

Question Can She Use Estrogen Containing Contraception

Postpartum and breastfeeding May initiate 6 weeks after delivery in breastfeeding and nonbreastfeeding women Product license does not support COC use in breastfeeding women - PO-OC and DMPA may accelerate development of diabetes in breastfeeding women with prior GDM Postpartum and breastfeeding

Because I had gestational diabetes I might get diabetes when Im older

Don't forget that you can become pregnant again soon after you give birth. Even if you have not had a period, you can still ovulate. And breastfeeding does not necessarily prevent you from becoming pregnant. So, before you resume having intercourse, be sure you are using effective birth control. Although virtually every aspect of your life may seem turned on its head after the birth of a new baby, the four basic management tools remain the same insulin or oral diabetes medication (oral diabetes medications cannot be used while you are breastfeeding), blood glucose monitoring, meal planning, and exercise. Exercise may be the last thing you are thinking about after the baby is born. But as soon as you feel well enough and you have your doctor's okay, taking your baby for a daily walk can help you feel better and more relaxed.


After your baby is born, you will experience a tremendous decrease in your insulin requirements. If you have a planned induced delivery date, you will need only half of your pre-pregnancy insulin dose. This may last several weeks. Keep a careful record of your blood sugar levels your medical team will need this information to determine appropriate insulin adjustments. If you decide to breast feed your baby, you will need less insulin, more calories, and lots of fluids. Hypoglycemia can occur rapidly in breast-feeding mothers, so keep sugar close by.

Neonatal Nutrition

One potential environmental influence is neonatal nutrition. It has been proposed that consumption of cow milk proteins may increase susceptibility to Type 1 diabetes (45). A number of studies have examined the relationships amongst breast milk feeding, introduction of cow milk proteins, and the frequency of Type 1 diabetes, with conflicting results (46-48). A meta-analysis has suggested both that exclusive breast feeding may be protective and that early cow milk consumption may confer risk (49). A small prospective Finnish study has suggested that exclusive breastfeeding may reduce the likelihood of disease development (50). Although controversial and not reproducible, in one study a group of diabetic children were found to have elevated levels of antibodies directed against bovine serum albumin, which may be the relevant cow's milk protein (51). A suggested mechanism is molecular mimicry between the beta-cell surface protein ICA-69 and a 17 amino acid sequence of bovine serum...


Oxidative stress has been implicated in maternal and neonatal diseases, and uncontrolled production of ROS is related to their morbidity. Oxygen is usually required as therapy in premature or depressed infants but excessive oxygen causes physiologic damage because infants have less protection against oxidative stress. Breast feeding of infants appears beneficial in providing antioxidative protection. The supply of nutritional substances for the improvement of infant formula should take into account a possible increased risk of oxidative stress. Antioxidant therapies have not yet been sufficiently established for diseases related to oxidative stress in the perinatal period. Further biochemical and clinical investigations are needed to define effective antioxidative therapeutic approaches.

Primary Prevention

To date, there is only one primary prevention trial, the Trial to Reduce IDDM in the Genetically at Risk (TRIGR) from Finland (38). The hypothesis of TRIGR is that avoidance of cow's milk protein in the first 6-8 mo of life can prevent subsequent diabetes. The premise was based on early epidemiologic data from Norway and Sweden that reported that the duration of breast-feeding was inversely proportional to the risk of developing diabetes (63). Other Finnish studies of sibling pairs revealed that the siblings with diabetes had higher levels of cow's milk protein antibodies than their age-and HLA-matched sibling pair, and they hypothesized that high levels of IgG antibovine serum albumin (BSA) were an independent risk factor for the development of type 1 diabetes, serving as an environmental trigger (64-66). Diet experiments in the nonobese diabetic (NOD) mouse using a casein hydrolysate formula (which contains no large proteins or BSA) were promising, revealing a marked decreased...


Immediately postpartum there is a rapid decline in insulin requirements, once the fetus and placenta are delivered. For the first 24-72 h after delivery, most women with type 1 diabetes require very small doses of insulin (approximately 1 3 to xh of the preconception dose), and some women with type 2 diabetes require no insulin at all. Breastfeeding is encouraged in all patients and contributes to the reduced insulin requirements. Breastfeeding will be discussed in greater detail in Chap. 22.

Maternal diet

Maternal diet and composition of breast milk may play a role in the development of immune-mediated diseases. It has been shown that small amounts of cow's milk proteins may be carried over to breast milk from the maternal diet (Axelsson et al. 1984), and sensitive infants may develop cow's milk allergy on exclusive breastfeeding (Host 1994). Per capita coffee consumption correlated positively with incidence of type 1 diabetes in an international ecological comparison (Tuomilehto et al. 1990). However, maternal coffee or tea consumption during pregnancy was not related to the risk of type 1 diabetes in the offspring in two case-control series (Virtanen et al. 1994a Soltesz et al. 1994). A positive association was seen between maternal nitrite intake and the risk of diabetes in the child independently of the child's own intake and when adjusted for several sociodemographic factors (Virtanen et al. 1994b). Paternal use of coffee or tea or intake of nitrate or nitrite at the time of...


However, other researchers have looked for but not found an increased risk of type 1 diabetes if cow's milk is given early in life and if breastfeeding is done for a short period. Cow's milk is only one kind of food that may play a role in the development of type 1 diabetes. Studies in diabetes-prone rats show that withholding wheat and soy helps delay or prevent diabetes.

Siri L Kjos

Question Can She Use Intrauterine Contraception Breastfeeding and Postpartum Contraception Stepwise Questions References Key words Diabetes mellitus Contraception Oral contraceptives Intrauterine device Hormonal contraception Contraception and breastfeeding Progestin-only contraception Estrogen.

New Mothers Guide to Breast Feeding

New Mothers Guide to Breast Feeding

For many years, scientists have been playing out the ingredients that make breast milk the perfect food for babies. They've discovered to day over 200 close compounds to fight infection, help the immune system mature, aid in digestion, and support brain growth - nature made properties that science simply cannot copy. The important long term benefits of breast feeding include reduced risk of asthma, allergies, obesity, and some forms of childhood cancer. The more that scientists continue to learn, the better breast milk looks.

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