Friday, December 9, 2016

Breastfeeding is human rights, "formula is as good" is no reason to violet human rights

December 10 is Human Rights Day. And right before the Human Rights Day this year, I received an e-mail from a mother, crying about how her employer doesn’t support breastfeeding and how her supervisor told her “Not only breastfeeding moms are good moms, formula is as good.”

I was saddened. I am sad because I feel her. When I asked for breastfeeding accommodation from my previous employer, someone form the company told me, “You can just use formula. It’s as good. My son was formula-fed and he went to Harvard.”

I am sad because my hands are tight. I’ve been blogging about breastfeeding rights for more than three years and Wikipedia labeled me as a “breastfeeding activist,” yet my voice is small. The formula manufacturers spend $480 million each year marketing infant formula in the US. That’s more than six times the $68 million in total US federal government expenditures for breastfeeding support through the WIC Peer Counselor program and CDC initiatives.

Money talks. In spite of the government’s ongoing efforts on promoting breastfeeding, we hear more and more such saying, “Not only breastfeeding moms are good moms. Infant formula is as good.” Earlier this year, singer Adele slammed celeb chef Jamie Oliver over breastfeeding comments. When Oliver said he would campaign to improve the breastfeeding rates in Britain, Adele responded with “You can go fxxx yourself...(formula) Aptamil is just as good.”

A while ago, some infant formula company reached out and offered to pay me to write a “not only breastfeeding moms are good moms, infant formula is as good” post, which I refused. However there are numerous “influential bloggers” out there; I have no doubt the agent could easily find another blogger who is willing to write a few words and make several bucks.

I agree that not only breastfeeding moms are good moms, but I cannot pretend that infant formula is as good. Science has proofed it’s not. Breastmilk contains antibodies that help babies fight off viruses and bacteria, which is not found in infant formula. Breastfeeding lowers baby’s risk of having asthma or allergies, which formula doesn’t.

Just last month, UN experts warned that the under-regulation marketing practices of infant formula industry still negatively affect the choices women around the world make about how to feed their children. And breastfeeding is a human right issue for babies and mothers and should be protected and promoted for the benefit of both. Misleading, aggressive and inappropriate marketing of breastmilk substitutes is a violation of human rights.

The forceful promotion of products that compete with breastfeeding continues to undermine efforts to improve global breastfeeding rates, which have now been static for two decades, Independent reported.

The paper quoted UN report and pointed out, “Marketing practices often negatively affect the choices women make on how to feed their infants in the best way possible, and can impede both babies and mothers from enjoying the many health benefits of breastfeeding.”

I referred the mom who e-mailed me to her local breastfeeding support group. I wish I could to more than that. I certainly understand there will always be moms who can’t breastfeeding—It’s a myth to think that the non-breastfeeding community is the silenced one; for years they have made known their difficulties. There’s nothing wrong with that. But it is very wrong to claim infant formula is as good and push mothers who actually can breastfeed to formula by forceful marketing and unsupportive culture.

This is originally a post to San Diego County Breastfeeding Coalition by To-wen Tseng.

Tuesday, November 15, 2016

Allergic Proctocolitis in the Exclusively Breastfed Infant

Dr. Boies answers question at a recent San Diego Breastfeeding Coalition meeting.

Can food protein induced allergy happens to exclusively breastfed infants? The answer is yes, according to Dr. Eyla Boies (MD, FABM, FAAP), a clinical professor of pediatrics at UCSD.

Many confuse allergy wit tolerance. There is a difference. A true food allergy causes an immune system reaction that affects numerous organ in the body. It can cause a range of symptoms. In some cases, an allergic reaction to food can be severe and even life-threatening. In contrast, food intolerance symptoms are generally less serious and often limited to digestive problems.

The most common foods implicated in food allergies in breastfed infants include cow's milk, egg, soy, wheat, peanuts, tree nuts, fish, shellfish, sesame seeds, and corn. Other common foods include pork, tomatoes, onions, cabbage and berries. Cow's milk protein(CMP) is the most common food allergens in young children, with 2% of children under four years old allergic to CMP. The severity of a food reaction is generally related to the degree of baby's sensitivity. Meanwhile, cow's milk allergy is uncommon in adults; less than 0.5% of adults are allergic to CMP.

Food protein can induce enterocolits, protocolitis and enteropathy. When food protein induced enterocolitis and enteropathy happen, there will be an acute vomiting pallor one to four hours after food ingestion, and a chronic moderate to severe bloody stools with chronic diarrhea. Both diseases are rare in breastfed infant: Currently there are only 14 cases in the literature. Breastfeeding is likely to protect babies from them. Food protein induced protocolitis is considered a milder form of the spectrum of food induced allergy. It seen to be more often in breastfed infants (less than 60%) whose mothers are consuming cow's milk, sometimes soy or egg, compared to formula fed infants.

Food protein may also plays a role in gastroesophageal reflux disease (GERD), colic and eczema. Colic may be a result or an allergy to make protein in formula fed babies. Much more rarely, colic may be a reaction to specific foods in mom's diet in breastfed babies. An 1983 study found that cow's milk proteins can cause infantile colic in breastfed infants. Another 2005 study found that exclusion of allergic foods from the maternal diet was associated with a reduction in distressed behavior among breastfed infants with colic presenting in the first 6 weeks of life.

Management plans for food protein allergies in the exclusively breastfed infant can be formulated. DR. Boies recommends a careful history and exam including mother's diet and medications and then elimination diet for the mother as with food protein induced proctocolitis. DR. Boies also recommends counseling about nature course of colic and GERD, such as positioning including prone for period while awake, and less reliance on medications for GERD. The most important thing when treating GERD and colic is ensuring proper growth.

While food protein induced allergy can happen to exclusively breastfed infants, breastfeeding plays an important role in the prevention of allergic diseases(AD). Overall, breastfeeding less than three months is not protect against the development of AD. A 2004 study found that exclusive breastfeeding for at least four months can lower incidence of CMP allergy until 18 months. But a more general long term impact of breastfeeding on food allergies remains to be determined.

KellyMom provides a useful resource for mothers on dairy and other food sensitivities in breastfeeding babies, including how closely mother needs to watch what she eats, recognize possible signs of food allergy from normal baby fussiness, and find out what foods are most likely to be the problem.

This is an original post to SDCBC by To-wen Tseng.

Friday, November 11, 2016

The day after the election

This August in our neighborhood playground, a child threatened my toddler son, saying “Trump will kick you out of here when he becomes President.” For the past two months I’ve been praying for the victory of Hillary Clinton, so that I can tell my child “hate never wins”. The polls gave me some hope. But on the night of November 8, as the election results rolled in, I saw a very different America than the polls had predicted.

I put my child to bed that night right before the Canadian immigration website crashed. I stayed up late, thinking about how I would explain this to him. Before I was ready, he woke up full of questions. He asked me if she had won. I told him no.

“But I want Hillary to be my president!”
“I know, baby.” I held him tight. He is too young to understand the candidates’ policies; all he knows is that if Donald Trump is in the white house, the bullies in the playground get a good line to yell at him. 
Once again, I assured him, “We are American, this is our home, no one is going to kick us out of here, not even Trump.”

I’ve been repeating this to him for the past two months. Apparently it’s not good enough. He asked me if we’re moving to Asia to be with his grandparents. I told him no.

“But I don’t like Drump!” He mispronounced the president-elect's name as always.

“But you do like America, don’t you?”

He thought about it carefully and then nodded.

“That’s right, baby. As long as it doesn’t change, we’re here to stay.”

“But I’m upset.”

“That’s okay, baby. I’m upset, too. We all get upset sometimes. But we’ll be fine,” I told him.
“If anybody ever tells you that Trump will kick you out of the country, just say, ‘No, I am American, this is my home, no one can kick me out of here.’” 
He practiced the sentence a couple of times and seemed to be comforted.

There is so much more that I wanted to tell him. I wanted to tell him it’s not the end of the world. I wanted to tell him that human beings are resilient. I wanted to tell him that we can do better than running away. I just don’t know how to make a 3-year-old understand all of these things.

In spite of all the frustrations at this moment, I still believe in America. Sure, the election had modeled the exact opposite of the values I believe in and hope to instill in my children. The xenophobia that came directly out of Trump’s campaign has harmed my family. But I see that most of my fellow American don’t believe in the racism and sexism either. Clinton won the popular vote. Which means the majority of American believe that women should be paid the same as men, they care about climate change, they don’t want the implementation of aggressive surveillance programs that target certain ethnic groups.

This is the moment not to sit down with frustration, but to stand up against discrimination, bigotry and hate. And there is so much we can do. We can volunteer. We can donate. There is Showing Up For Racial Justice that combats racism, Planned Parenthood that gives women the opportunities for proper healthcare, ACLU that upholds the individual rights guaranteed by the US Constitution. Most of all, as parents, we can continue teaching our children the values we believe in: honesty, race and gender equality, love. The election changed none of that. Just like President Obama said on election day, “The sun will rise in the morning.”

This is an original post to World Mom Network by To-Wen Tseng. Photo credit to Mu-huan Chiang.

Tuesday, October 4, 2016

Breastfeeding in public is a civil right--in California, and anywhere in America

Recently in Georgia, a mom claimed deputy threatened to arrest her for being “offensive” by breastfeeding in a grocery store.

On Sunday, Savvy Shukla took to Facebook after a trip to Piggly Wiggly, a local grocery store in Muskogee County, Georgia, where the deputy told her she needed to cover up because someone might find her breastfeeding offensive.

Savvy said she told the deputy that Georgia law allows public breastfeeding, but the deputy said he could see her areola and that if someone else saw it, he would arrest her.

While most of us (the readers of SDCBC’s blog posts and myself) assume that everybody knows that breastfeeding in public is legal in our great country, apparently some people don’t. Breastfeeding-in-public harassment situations repeatedly hit moms everywhere in America, including here in San Diego.

A couple of years ago, Rebecca Garcia was harassed for breastfeeding her 8-month-old son in one of the courtrooms at the Chula Vista Courthouse. When her son started to fuss, the bailiff, Deputy Chong, approached to Rebecca and asked what she was doing. When Rebecca said she was breastfeeding, Deputy stated loudly in front of the entire courtroom, “You should be ashamed of yourself, it’s inappropriate, you need to leave and go outside, do that somewhere else private, it is illegal to breastfeed in court!”

Rebecca reported that, “I felt embarrassed and ashamed because of the way that the Deputy was staring me down.”

Fortunately, after contacting San Diego County Breastfeeding Coalition and filed a complaint to San Diego County Courts, Rebecca receives a formal, written apology for the action of Deputy Chong. And after the Georgian deputy reportedly threatens to arrest Savvy over breastfeeding at Piggly Wiggly, Muscogee County Sheriff defends the nursing mom and confirmed that public breastfeeding is legal in Georgia.

So what does the law actually say?

According to the Federal Public Breastfeeding Law, “Notwithstanding any other provision of law, a woman may breastfeed her child at any location in a Federal building or on Federal property, if the woman and her child are otherwise authorized to be present at the location.”

According to California Civil Code, section 43.3, “Notwithstanding any other provision of law, a mother may breastfeed her child in any location, public or private, except the private home or residence of another, where the mother and the child are otherwise authorized to be present.”

That says, a mother may breastfeed her child in any public space.

Yet mothers sill harassed for nursing in public. So what we can do?

There are several things you can do to make a difference.

  • Next time when you see a mother breastfeeding in public, please smile at her and show your support.
  • Learn about the laws in your state that protect the rights of mothers breastfeeding in public: United States Breastfeeding Laws at Nursing Freedom
  • When someone asks you to cover up in a store or restaurant, stay calm and breathe deeply. If the person is an employee of the establishment, you may ask, “Are you refusing to serve me because I am breastfeeding?” If the person respect your right, thank them and breastfeed on. IF they harass you, contact us here at San Diego County Breastfeeding Coalition. We are here to help. If you are not in San Diego county, call the Best for Babes NIP Harassment Hotline to report the incident: 1-855-NIP-FREE

Other resources:

This is an original post for San Diego County Breastfeeding Coalition by To-wen Tseng. Photo credit to Tribune Media Wire.

Tuesday, September 20, 2016

Doula supporting breastfeeding

No, this is not a doula. This is my mom with my 1-month-old son.
But when a new mom doesn't have her mom nearby to help, a postpartum doula can be as helpful :)

A doula is a new mom’s BFF—breastfeeding friend. Why and how? Breastfeeding consultant and doula Leilani Wilde shared her insights at a recent San Diego County Breastfeeding Coalition general meeting.

A doula is a woman experienced in birth and/or postpartum care who provides emotional, physical, and informational support to the mother before, during, and after the birth. A birth doula can play an important role in supporting mothers during labor, delivery, and initial breastfeeding at hospital, birth centers, or at home births.

When a brand-new baby is placed on a new mom’s breast shortly after the birth, it’s often hard for the mom to believe that she really has anything to feed the baby. The baby often doesn’t latch on right away, either. Having a doula there can be a wonderful reassurance that there was nothing strange about mom and baby both being unsure how to get started.

“As a birth doula, my job is to reduce moms’ pain and offer comforting measures and support to them,” said Wilde. A doula has a lot to do at birth: eliminating stress and keeping moms relaxed; reducing the likelihood of interventions; supporting dads; helping new parents understand what the postpartum journey is like.

Wilde shard one technique that she often uses when providing one-on-one support throughout labor: acupressure points. “When assisting moms through labor, acupressure points can be used to help facilitate labor and help avoid interventions.”

Once the baby arrives, a doula promotes on demand breastfeeding by assisting and observing mom and baby. First help mom recognize baby’s feeding cues, and then encourage frequent skin-to-skin that regulate body temperature and help baby seek out the nipple. “Doulas never leave their side until the baby gets feed,” said Wilde. When a breastfeeding attempt failed, doula assures mom, supports her, and comforts her.

When breastfeeding finally happens—“The first latch is always magical!” said Wilde. Now the doula’s job is to teach mom how to recognize a good latch. Wilde pointed out that while doulas are not educated to the level as lactation consultants, they are trained and know the breastfeeding basics. They should also be able to recognize red flags indicating further evaluation, intervention, and possible referral.

Families may benefit from referral to a postpartum doula, this is especially true for new parents. Day one after giving birth is often a chaos—nurses are telling the mom things, doctors are telling the mom things, family members are telling the mom things—the mother may heard a lot information about breastfeeding but not absorbing them. In this case a postpartum doula can answer all the questions that families may have.

Imagine a young couple looking down on their precious newborn. Baby is here! Now what?

Now the doula steps in, teaches parents the opportunities to feed, the needs of the baby, and supports the family with encouragements, gives them the current information.

New moms don’t always have their moms or their in-laws nearby to help them. Doulas can “mother” the new mother by helping with the chores so the new moms can rest, or by empowering them so they can succeed and lean to trust their own natural instincts.

Even when new moms do have their moms or in-laws nearby, there is still a role for the doula. The grandmas may aren’t as current as the new parents would like them to be when it comes to taking care of the new baby. The new mother may getting a lot of education but not enough support from her in-laws. “Just listen,” said Wilde. “Moms always need someone to that is non-judgmental talk to.”

This is an original post for San Diego County Breastfeeding Coalition by To-wen Tseng.

Wednesday, September 14, 2016

Where California ranks in Breastfeeding rates

When my son was born, I knew I wanted to at least try to nurse him. Although my mom had never breastfeed me—I was born in the era of “formula is best”—, it had been drilled into my head repeatedly throughout my pregnancy that “breast is best.”

That is the message apparently being resonating with many new mothers across the nation, as indicated in the latest edition of the U.S. Centers for Disease Control(CDC)’s annual Breastfeeding Report Card.

More than four out of five American mothers tried to nurse their babies at least once in 2013, the latest year of which data is available. But too many gave up breastfeeding too soon, according to the study recently released by the CDC. A number of factors drive the decision including a lack of resources and support, according to the study.

“High breastfeeding initiation rates show that most mothers in the U.S. want to breastfeed and are trying to do so. These rates suggest that mothers, in part, may not be getting the support they need, such as from healthcare providers, family members, and employers,” stated the CDC study. “The early postpartum period is a critical time for establishing and supporting breastfeeding.” 

Breastfeeding supports a child’s growth and development, according to the guidelines by the American Academy of Pediatrics (AAP). And the U.S. Surgeon General’s Office notes the practice can prevent illness and reduce future health issues, including asthma and the risk of sudden infant death syndrome.

The CDC’s 2016 survey of breastfeeding rates in each state was released during National Breastfeeding Month in August.

The U.S. average is 81.1 percent of mothers breastfeeding at least once. The states with the highest breastfeeding initiation rates are Utah at 94.4 percent, Idaho at 92.9 percent and Oregan at 92.5 percent. California average is 90.2 percent.

The survey shows progress across the country. But, at six months, nearly half of all mothers surveyed had stopped breastfeeding altogether. And only 22.3 percent were exclusively breastfeeding at six months, as recommended by AAP.

In California, though, women tend to breastfeed longer than the average American mom.

Of mothers surveyed in California:

  • 90.2 percent are breastfeeding at least once. 
  • 51.1 percent are breastfeeding exclusively at three months. 
  • 58.5 percent are breastfeeding at six months. 
  • 24.8 percent are breastfeeding exclusively at six months. 
  • 34.3 percent are breastfeeding at 12 months. 

Those numbers are up compared to California’s results in the 2007 survey. At that time, 52.9 percent of mothers in the state were breastfeeding at six months and only 17.4 percent were breastfeeding exclusively. A total number of 83.8 percent of mothers had tried to nurse at least once, as compared to 2013’s 90.2 percent. Still, it didn’t meet the U.S. Department of Health and Human Service’s Healthy People 2020 goal of having 60.96 percent mothers continue breastfeeding at six months. Only 12 states in 2013 met the goal. The Healthy People 2020 plan is a 10-year national objective plan initiated in 2010 for improving the nation’s health.

The CDC hopes the state-by-state Breastfeeding Report Card will urge all involved in the child’s first year to encourage mothers to breastfeed. The report goes beyond breastfeeding rates and looked at barriers to continued nursing. Sometimes it’s a lack of information and support provided to the moms at the hospital, sometimes it’s a lack of accommodations for moms to properly pump at work.

I overcame the odds and nursed past the 12-month benchmark. Breastfeeding was the right choice of nourishment for us, my child has only been sick for one time before turning two years old. Breastfeeding also brought us incredible bond of love, it always comforted my baby whenever he got hurt or scared. It’s the hope that moms can better achieve their breastfeeding goals with a more active support.

This is an original post for San Diego County Breastfeeding Coalition by To-wen Tseng.

Tuesday, September 6, 2016

"Trump will kick you out of here"

A while ago, when my toddler son was playing in our neighborhood playground, another child said to him, “Trump will kick you out of here when he becomes President.”

It happened in an afternoon of a hot summer’s day. My three-year-old bumped into an older child—probably five or six years old—when going down a slide. As much as I was tempted to defend my own child, I had to admit that it was his fault. I thought that I needed to remind him to apologize.

As I was walking up I heard, “Trump will kick you out of here when he becomes President.”

I froze in spite of the high temperature. It took me several seconds to realize that it was the other child who had spoken these words.

I wanted to ask, “I beg your pardon?”

I wanted to ask, “Why would you say that?”

I wanted to ask, “Do you believe that anyone should be kicked out of here?”

But before I could say anything, my son looked up at me and said, “Mama, I want to go home.”

So we left. I looked back a couple of times, trying to find the child’s parents. I didn’t, and I did not know what I would have done if I had found them.

My son was silent all the way home. Anyone who didn’t know him that well would have simply thought that he was tired. I drove, waiting for him to ask questions, but he didn’t.

So I broke the silence and said, “You know, you should say ‘sorry’ when bumping into other people.”
“Yes, mama.”
“And, you know, this is our home. No one is going to kick us out of here.” 
“Okay, mama.”

It was too hard to continue the conversation, so I stopped there. We went back to silence, and I hated myself for not being able to come up with anything better to say.

When it comes to unfriendly comments about immigrants and minority groups, many Asian American people, including me, often have an illusion of “safety”. Trump has accused Hispanic American of bringing crimes; he has called Muslims terrorists. But hey, we are Asian Americans. We are quiet and shy, we do our math and science, we don’t attract attention. Anyway, Trump said that he “had a very good relationship with China” right before having that crying baby ejected at one of his rallies!
But what happened in the playground in that afternoon taught me a lesson: when a hate movement and white nationalism becomes the mainstream, everyone can be a victim. Even a three-year-old boy can be threatened in his neighborhood playground. 
My son was quiet for the whole evening. At the dinner table his dad noticed that and asked, “Are you okay, buddy?”

“I want to go to bed now.”

He insisted that I sleep with him. I laid on his toddler bed with him. Just when I thought he was falling asleep, he asked, “Mama, who’s Drump?”

“Trump? He is a businessman. He is running for President.”

“Will he become the President?”

“Not necessarily.”

I got up and showed him the book “Hard Choices” with Hillary Clinton’s portrait on the cover. I was hired to translate the book into Mandarin Chinese when it published in 2014.

“This grandma is also running for president, and one of them will become President.”

“Will she let us stay here?”

“Oh baby! We are American, and we’ll stay here as long as we want, no matter who becomes the President.”

I was telling the truth. Both my husband and I came to the States as international students. He earned his PhD in computer engineering from NC State University and I earned my Master’s degree in broadcast journalism from Boston University. We eventually naturalized through H1B working visas and EB2 green cards, which requires an advanced degree and exceptional ability. We’ve been calling America home and contributing to this country for more than a decade, and I honestly don’t think anyone can legally “kick” us out of here, not even Trump.
What worries me is that this kind of hate speech will hurt our family and our children, turning our country into a place that is no longer suitable for living in. 
We’ve all heard Trump’s supporters shouting violent words and making provocative statements at the Presidential hopeful’s rallies, but it feels different when such words comes out of a young child’s mouth. I wonder if he really knew what he was talking about.

Either way, he certainly made it clear what Trump’s brand of hate is doing to this country. In spite of the frustration, I still hope for a hate free society to come. I'm not voting for hate. It’s not about political correctness. It’s about being a decent human being.

This is an original post to World Moms Network by To-Wen Tseng of the United States. Photo credit: Mu-huan Chiang.

Friday, September 2, 2016

Rise with Moms

MomsRising turns 10 years old this month! That’s a decade of gains of women, mothers and families. This makes me so excited that I have to write something about it.

I’ve been with MomsRising for three years. Three years ago this month, my son turned five month old and I’ve been back to work for two months after a three-month-long maternity leave. That two months were tough. I chose to breastfeed, which my company did not support. We didn’t have a nursing room, even though California law requires appropriate reasonable space for pumping. I had to pump in the restroom. When I tempted to wash my pump parts in the kitchen, some of my colleagues would say, “don’t wash your dirty panties in the office.” I reported that to Human Resources, but they never dealt with it. I spoke with my supervisor, but he insisted that I was overreacting, that I had a personal issue.

Stressed and helpless, I turned to Internet for some kind of support. I wasn’t sure what I was looking for, but I find when surfing the web. I saw a “share your story” button on the homepage, so I wrote about my unfortunate experience. That was a totally disorganized essay, filled with complaints and was actually very annoying, but I needed to get it out. Without thinking twice, I submitted it.

I immediately felt better. Later I decided to quit my job and sued my employer for sexual discrimination.

To my surprise, I got an email from Anayah of MomsRising a couple of days later. She comforted me with warm words and asked if I would like to blog with MomsRising.

I was cheered. Of course I’d love to blog with MomsRising. I was a working journalist but was about to lose my job. I would have plenty of time to write about what I really care about.

My first post “How to Pump at Work Like a Supermodel” was up in that December. My case was settled next August, and I donated part of the financial compensation to MomsRising.

Since then I’ve been getting inspiration and encouragement with like-minded moms at MomsRising. When FAMILY Act was introduced, I used the MomsRising template letter to write to my representative and ask them to support the bill. When children in my Sunday School were being fed candies, I organized a documentary screening to raise awareness on healthy eating with the help from MomsRising’s Good Food Force. When some kid told my child “Trump will kick you out of here” at our neighborhood playground, I turned to MomsRising Facebook page for support.

My son is now three years and three months old. The days of breastfeeding were long, but the years were short. He weaned himself last year; I still blog about breastfeeding rights at MomsRising. As he grow, I started to blog about healthcare, childcare, and early education.

One thing I really like about MomsRising is that the mothers here are not just rising for themselves, their own children and own families. They are rising for all the women, all the mothers and all the families in the country. I know some parents who mobilized to fight back on Epi-Pen price increasing are fully insured; the higher prices don't affect them. Some parents who support FAMILY Act live in California; they already have paid family leave.

MomsRising is now million-member-strong, with moms (and dads!) rise together to change the world. I may not be contributing much, but am certainly proud to be part of the movement. Happy birthday MomsRising :)

Thursday, August 18, 2016

Breastfeeding and co-sleeping: A biologic Imperative

Dr. McKenna speaking at UCSD 2016 Breastfeeding Week mini-seminar.
“Sleep like a baby” is a common expression, but what does it really mean?

According to Dr. James McKenna, an anthropology professor at University of Notre Dame and a world-recognized behavioral sleep expert, it means baby sleeps near the mother with frequent breastmilk delivery.

Then why parents in today’s industrialized world often believe that that solitary infant sleep is the norm?

At a recent World Breastfeeding Week MIni-Seminar sponsored by UCSD Medicine School and SDCBC, Dr. MeKenna discussed the historical and cultural circumstances that led to the assumption.

Until recent historic periods in the western world, no human ancestral or modern infant was ever separated from its caregiver. In the 1700s, Catholic Church in Europe banned bedspring to help prevent infanticide among poor, starving mothers who confessed to “overlaying their babies” due to lack of birth control and the means to support a family.

Then In 1901, Marianna Wheeler, a superintendent of the Babies’ Hospital in New York, published a book “The Baby” and wrote, “The constant handling of an infant is not good for him. The less he is lifted, held and passed from one pair of hands to another, the better… The newborn infant should spend the greater portion of his life on the bed.”

American psychologist John Watson believed that no child could get too little affection, his psychological school of behaviorism had a huge influence on models of child development in the 1920s. He once said, “never hug or kiss your children…Never let them sit on your lap. If you must, kiss them once on the forehead when they say goodnight. Shake hands with them in the morning.”

“The Motherhood Book” published in 1935 claimed “babies should be trained from their earliest days to sleep regularly and should never be woken in the night for feeding,” “baby should be given his own bedroom from the very beginning. He should never be brought into the living room at night.” 

And year later, Dr. Spock, the American pediatrician authority of the 1940s, promoted the same view. 
In the 1980s, America sleep research began when only 9% of American were being breastfed and formula feeding was the craze. AAP guidelines stated “never let a baby fall asleep at the breast.”

More recently, Dr. Richard Ferber, the inventor of famous Ferber Method, published “Solve Your Child’s Sleep Problems” and wrote “sleeping in your bed can make an infant confused and anxious rather than relaxed and reassured. Even a toddler may find this repeated experience overly stimulating…if you find that you actually prefer to sleep with your baby, you should consider your own feelings very carefully.” 

Dr. McKenna called this a “damaging statement.” In a matter of fact, Dr. Ferber changed his mind later and rewrote his famous “Solve Your Child’s Sleep Problems” in 2006. This time, he wrote, “Whatever yo want to do, whatever you feel comfortable doing, is the right thing to do, as long as it works…most problem can be solved regardless of the philosophical approach chosen.”

But even after that, the American authorities still warned mothers about co-sleeping. Just in 2008, Deanne Tilton Durfee, director of the LA County Inter-Agency Council on Child Abuse and Neglect, issued a warning, “We know that value of holding your child, cuddling your child, loving your child But if you take the baby to bed with you and fall asleep, you are committing a potentially lethal act.”

The truth is, co-sleeping doesn’t increase the chance of SUDI, sudden unexpected death in infancy. In most of the SUDI cases, babies were already in an unsafe sleeping environment,  they could die by sleeping all alone, it doesn’t matter if she’s sleeping with the parents. In many cases, the parent roll over the baby when high on drug. On the other hand, co-sleeping promote exclusive breastfeeding, which reduces SUDI rates by 80%.

Fortunately, the erroneous assumption is changing. “The whole fuzz is caused by 10 people,” said Dr. McKenna, “and I’, sure they can be easily replaced by another 10 people. Two decades from now, co-sleeping will be the norm.”

Many new researches show that co-sleeping benefits mother and infant in many ways. Dr. McKenna’s recent research stated that co-sleeping and breastfeeding is a mutual re-enforcing system; he called it “breastsleeping.” An 2007 research found that co-sleepers are more secure being left alone.
So what makes co-sleep safe? Dr. McKenna provided the following factors:
  • Supine sleep position.
  • Exclusive breastfeeding.
  • No maternal smoking.
  • No children co-sleeping with ​infant.
  • Adhere to routine practice. 
  • Avoid co-sleeping on couches, armchairs, reclines, or waterbeds. 
  • Avoid bed-sharing if the baby is bottle feeding or the parent is a smoker, place crib or bassinet next to bed instead.    
This is an original post for San Diego County Breastfeeding Coalition by To-wen Tseng.

Friday, August 5, 2016

Celebrate breastfeeding: A sustainable solution and a human right

Every woman has a breastfeeding story.

If you ask me, I’d tell you how I became a mother at the center of a lawsuit about the rights of women breastfeeding in the workplace, and why I turned down the financial compensation in my lawsuit.

If you ask my mother, she’d tell you why she never breastfed her children. That was before the Baby-Friendly Hospital Initiative took place, and the hospital staff gave her baby a bottle right after she gave birth.

If you ask my grandmother, she’d tell you how she breastfed her two toddler sons on a refugee boat and saved their lives.

It is because of my grandma’s experience, my mom’s experience, and my own experience that I am now part of my local breastfeeding coalition that works everyday to support moms reaching their breastfeeding goals and walk moms through it when breastfeeding becomes difficult. We celebrate breastfeeding all year long, especially during the first week of August—it is World Breastfeeding Week!

A Sustainable Solution

In 2015, the world’s leaders commented to 17 goals aimed at ending poverty, protecting the planet and ensuring prosperity. Together, they formed the sustainable development goals. The theme of this year’s WBW is “a key to sustainable development.” It reminds people that breastfeeding is a key element in getting us to think about how to value our wellbeing from the start of life, how to respect each other and care for the world we share.

Breast milk is a secure source of nutrition, always ready and safe on a daily basis, and in any emergency or natural disaster. Breast milk is the ultimate sustainable resource. It requires no packaging or processing, is local and fresh, and costs the nursing mom only a few extra calories a day.

Multiple scientific studies reveal that breastfeeding has numerous lifelong health benefits for mom and baby. Breastfeeding lowers a mother’s risk of developing type 2 diabetes, breast cancer and ovarian cancer. Breastfed babies have lower risk of serious health conditions such as asthma, obesity, childhood leukemia and sudden infant death syndrome.

These benefits save health dollars, which shouldn’t be a surprise. That says breast is the best, not for the moms or the babies, but for the Earth and all mankind living on the planet.

Everyone has a part to play in achieving the sustainable development goals by 2030. Everyone should care about the breastfeeding movement, even if you are not part of it.

A Human Right

The mention of “breastfeeding movement” might conjure up such images as a activist sit-in or a protester holding a “free the nipple” sign. But there’s more to the breastfeeding movement than its squeakiest wheels, and even women who have no intention of ever breastfeeding, or men who have no intention of ever having kids still have a personal stake in this issue.

On its face, the issue of breastfeeding rights might seem like a fight about what’s the best way to feed a baby. It is not. Surely it’s long been established that breastfeeding is beneficial, but that's not the point here.

The fight for breastfeeding rights isn’t about the milk that’s in the breast; it’s about the woman who’s attached to them. Breastfeeding rights is something everyone should care about, even if you don’t breastfeed, and even if you are not a mom. Breastfeeding rights is a women’s rights issue, and women’s right is human right. It is something that concerns all women, and men with souls.

Breastfeeding is about choice. In the United States, more than 90 percent of women start breastfeeding their babies at birth. They know breastfeeding is best for their babies and themselves. Sadly, most women report not meeting their own breastfeeding goals and quit before they really wanted to. Many challenges, including not being supported to breastfeed after returning to work or being shamed for breastfeeding in public, make continuing to breastfeed harder.

What matters is that women have the right to choose to breastfeed, are legally allowed to do so in public and legally supported to do so at work. People who never intend to use their own breasts to feed a baby can and should still support the rights of women who do.

Support breastfeeding is support human rights and the global goals for sustainable development. So happy World Breastfeeding Week! Let’s work together to achieve the sustainable goals by making the annual WBW celebration more than a week-long effort.

This is an original post for World Moms Network by To-wen Tseng. Photo credit to Ewa Samples Photographer .

Tuesday, July 26, 2016

Deciphering the Lactation Curve

What can a lactation consultant learn from the diary industry?

According to Lisa Marasco, MA, IBCLC, FILCA, the diary industry can provide a different prospect of milk production and help healthcare professionals decipher the lactation curve.

The concept of a lactation curve is well known in the dairy industry, but not in the human lactation world. When we look at milk production in the paradigm of this curve, we begin to understand the underlying drivers of milk production and why some women’s production seems more resilient than others.

At a recent SDCBC general meeting, Marasco explored the factors involved in the curve, the concept of persistency, and the importance of what happens in the beginning to long-term calibration. 

Marasco made an analogy between the lactation trajectory and the rocket forces: the trajectory is a path followed by a projectile flying or an object moving under the action of a given force. And our goal is long term maintenance of sufficient milk production.

Marasco introduced her famous milk supply equation inspired by the dairy industry to explain the key factors which make an ideal “trajectory” and allow moms to make enough milk:
Sufficient lactation tissue
+ Intact nerve pathways and ducts
+Adequate hormones and hormone receptors
+Adequately frequent, effective milk removal and simulation
=Good milk production

Marasco further explained what each piece of the equation means, so that her fellow lactation consultants can use it to solve milk supply mystery for the moms they work with.

Sufficient lactation tissue: This is the question whether the mother has “the right size of the rocket to do the job,” said Marasco. Some women have less glandular tissue than others, and as a result produce less milk. However this is not a question of breast size, but of the amount of milk making structures inside the breast.

Intact nerve pathways and ducts: If the mom had a breast injury or a breast surgery, she may have sustained damage to her milk ducts and/or nerves. Both are key to milk production.

Adequate hormones and hormones receptors: An often overlooked source of milk supply problems, adequate hormones are another part of the milk supply equation. Conditions such as PCOS, anemia, thyroid problems and postpartum hemorrhage can affect mom’s hormone levels and may cause problems with milk supply.

Adequately frequent, effective milk removal and stimulation: This part of the equation is at the heart of many breastfeeding problems.

  • Adequately frequent: Frequently empty of mom’s breasts signals her body to maintain a good level of milk production. In dairy industry is regular pump. In human lactation world it’s effective baby suck. "Mom may owns the equipment, but babies drive the supply!" said Marasco. What does adequately frequent mean? Generally it means 8 to 12 feedings in 24 hours, but some babies who don’t remove much milk at feedings require even more feedings. Pacifiers can mask feeding cues, so consistent use of them can reduce feeding frequency and lower milk supply. 
  • Effective milk removal: Removing a significant amount of milk at each feeding also signals mom’s body to maintain good milk production. But a baby who has a poor latch, is sleepy, s refusing the breast, has an anatomical barrier (such as tongue tie or eldest palate) to effective milk removal, or is otherwise unable to remove enough milk, will make it difficult to establish and maintain and adequate milk supply. Milk removal also occurs with a breast pump, so pumping problems can also results in lower milk supply. 

Fortunately, there are steps lactation consultants can take to remedy many of the causes of low milk supply. For measures to take to increase milk supply, Marasco recommend the Morton Maximizing Production video. This is an original post for San Diego County Breastfeeding Coalition by To-wen Tseng.

Monday, June 20, 2016

Benefits of Skin-to-Skin Contact (It’s for Dad, too!)

The other night before bedtime story, my three-year-old pulled up his pajamas, put his stuffed piggy on his chest, claiming, “I’m breastfeeding Piggy!”

“Oh that’s sweet!” I said, “But I’m not sure if you can do that—boys don’t have milk.”

“I’m a big MAN!” He corrected me. He likes to call himself a big man these days.

“Okay, big man. Still, men don’t have milk, either.”

He paused, then announced, “I’m skin-to-skin Piggy!”

I laughed. That was cute. I snapped a shot with my cellphone. I have no idea where he learned about the term “skin-to-skin.” But he was right—while skin-to-skin (baby naked, not wrapped in a blanket) contact between mom and baby helps breastfeeding, skin-to-skin contact between dad and baby can be beneficial, too. It is the easiest way to form a secure attachment and does a lot more than promote bonding.

It helps baby adapt
Thermal regulation is a very common problem with infants, especially preterm babies. When the baby was in the womb, he didn’t need to regulate his own temperature. Since parents’ skin is the same temperature as the womb, baby will find it easier to adapt to his post-birth environment.

It boosts baby’s mental and brain development
Skin-to-skin contact is a multi-sensory experience. Holding baby on parent’s skin increases the development of essential neural pathways, which accelerates brain maturation. According to a Canadian study, preemies who received skin-to-skin contact had better brain functioning at 15 years old—comparable to that of adolescents born full term—than those who had been placed in incubators. The research shows skin-to-skin contacted babies spend more time in quiet sleep, which stabilizes their heart rate, enhances organizational patterns in the brain and helps the brain develop better.

It promotes healthy weight
One Cochrane Library review concluded that skin-to-skin contact dramatically increases newborn weight gain. When babies are warm, they don’t need to use their energy to regulate their body temperature. They can use that energy to grow instead. Plus, skin-to-skin touched babies enjoy increased breastfeeding rates, which can’t hurt healthy weight gain.

It reduces baby’s stress and pain
Just 10 minutes of skin-to-skin contact reduces babies’ level of the stress hormone cortisol, and increases levels of the “cuddle hormone” oxytocin, which stimulates the parasympathetic nervous system to make babies feel calm and safe, according a research published in AACN Clinical Issues. “When preterm infants are held chest-to-chest, they react less to heel sticks, a minimally invasive way to draw blood, and a common source of pain among preemies,” said Dr. Susan M. Ludington, the lead author of the research.

It helps baby sleep Less stress equals to better sleep. Preemies who were cradled skin-to-skin slept more deeply and woke up less often than those who slept in incubators, reported the journal Pediatrics.

There are now a multitude of studies that show that mothers and babies should be together, skin-to-skin immediately after birth. After that, continued skin-to-skin can still be beneficial, either between mom and baby or dad and baby. The baby is happier, the baby’s temperature is more stable, the baby’s heart and breathing rates are more normal, and the baby’s blood sugar is more elevated.

From their time in the womb, babies recognize their fathers’ voice. Babies find skin-to-skin contact with dad calming, and it helps dad and baby bond. So get snuggling. Happy, happy Father’s Day!

This is an original post to San Diego County Breastfeeding Coalition by To-wen Tseng.

Tuesday, June 14, 2016

The Making of Breastfeeding Controversy

Last summer I had a chance to sit down in a indoor playground cafe and share my unfortunate workplace nursing story with Jennifer Grayson, an author, journalist, columnist, and a leading expert on environmental issues. She is also a mother of two. At that time she was working on a book about the breastfeeding debate.

Surely breastfeeding has been a hot topic and there were already plenty of books out there revolving around this topic. But I was happy to see one more book adding to the list. Not because I’m a crazy breastfeeding activist as Wikipedia labeled me, but because I see the fact that we have so many books, articles, discussions about breastfeeding points out another fact: breastfeeding, the bond that makes us human, is not deemed a nature and normal thing, but a topic worth debating. And this is exactly why breastfeeding mothers in today’s society aren’t getting the support they deserve. A book that explore the roots of the controversy is exactly what we need at this moment.

So I’m excited to know that Grayson’s book is finally coming out this July, titled “Unlatched: The Evolution of Breastfeeding and the Making of a Controversy.” And Grayson and I agree on at least one thing: while the benefits of breastfeeding have been well documented by many researchers, breastfeeding itself is not normalized in our society.

“The very fact that we refer to it as the ‘benefits’ of breastfeeding makes it very clear that breastfeeding is not normalized in our society,” Grayson told me in an earlier chat. “It seems more like formula is the norm and the natural elixir that our bodies have provided for eons is now seems as some sort of ‘boost’—like the one you might get from a pack of vitamins.”

Human milk is supposed to be the human norm, but since the rise of artificial formula, it has became the center of a never-ending controversy. Grayson believes that the root of the current mommy wars is the utter lack of support for most mothers in American society. She pointed out, “Nearly 80 percent of US mothers now start off breastfeeding, yet half give up entirely or start supplementing with formula after just a few weeks.”

And why is that? “We’re one of pitifully few countries in the world without paid maternity leave, there is scant medical support for nursing mothers, and there are zero regulations on formula advertising in the country,” said Grayson. “Many governments around the world have taken dramatic steps to rectify this, in the name of public health. But more and more in the US, being able to exclusively breastfeed for the six months recommended by the American Academy of Pediatrics and the World Health Organization boils down to a question of economic privilege. These are harsh truths, and I think it’s been easier to point fingers at each other than uncover the deal with the real issues.”

Grayson thoroughly explored the real issues in this book. The book is inspiring, well researched, and beautifully written. I sincerely think it’s a must read not just for mothers, but for anyone. Like I always said, breastfeeding is a human right. You don’t need to breastfeed--you don’t even need to be a mother--to support a human right issue.

I told Grayson that I’ll save the book for my now 3-year-old son when he becomes a father. She said, “Here’s hoping that by the time he becomes a father, he can’t imagine a time when a book like this would have ever need to be written!”

So we hope.

This is an original post to MomsRising by To-wen Tseng. Photo credit to HapperCollins.

Friday, June 10, 2016

"Your child is too big to be breastfed"

When my son was two months old and I was breastfeeding, everybody told me, “that’s great. Breast is the best.” When my son turned two years old and I was still breastfeeding, everybody told me, “your child is too old to be breastfed.”

Breastfeed a baby beyond age one is known as extended breastfeeding. The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months after birth, and breastfeeding in combination with solid foods until at least age one. Extended breastfeeding is actually recommended as long as the mother and her baby wish to continue, but, still, mothers decide to nurse their babies beyond age one often face unwelcome opinions and judging looks. Here are some questions I've heard and how I responded.

Aren’t you tired of watching your diet for such a long time?
“In fact, you don’t need to have the perfect diet to breastfeed. Of course, we need to take a bit more precaution when nursing, and we can’t be completely reckless with our bodies. But no breastfeeding mom should feel bad about eating the occasional doughnut or burger or drinking the once-a-while cup of coffee or tea.”

How long are you going to breastfeed?
“A lot of the time, women don’t know how long they’re going to breastfeed. Maybe a few years, maybe a few days. A lot of the time, extended breastfeeding is not planned, it just happened because both the mom and her baby enjoy the relationship.”

You’re still breastfeeding? Why?
“Yes, I’m still breastfeeding. I’m doing this because my baby and I wish to continue the relationship, also because of the many health and emotional benefits of extended breastfeeding.”

Once you give your baby solid food, you should stop nursing. Breast milk over 6 month is not nutritious. “This is a common myth. The truth is, breast milk is the gold standard for infant nutrition. As your baby gets older, the composition of your breast milk will continue to change to meet his or her nutritional needs.”

Aren’t you afraid your boobs are going to get stretched out? “I’m not thinking about what my boobs are going to look like in the future. I’m thinking about feeding my baby. My breasts are for babies, not a sexual organ or an object of fetishes.”

I never breastfed my kids, and they turned out fine. When I asked for lactation accommodation upon my return to work after giving birth, a supervisor told me “Just give him formula. We feed our kid formula and he went to Harvard.” I told him I think it’s great that his son went to Harvard, “But your kid is your kid, mine is mine. And breastfeeding is a human right.”

Your child is too old to be breastfed. “The World Health Organization recommends breastfeeding exclusively until my baby is six months old and then to continue breastfeed until they are two years of age or older. That’s two years of age OR OLDER.”

Breastfeeding a toddler is a controversial topic, as any mom who’s done so publicly can attest. When my son turned 18 months old and was still being breastfed, I stopped nursing in public. When he turned two years old and was still being breastfed, I let both my mom and mother-in-law believe that I had already weaned him. By so doing saved me some arguments. But in an ideal world, every mother chose to continue breastfeed her baby beyond age one should be able to proudly nurse her toddler!

Tuesday, June 7, 2016

The Evolution Of The Breastfeeding Controversy

Jennifer Grayson is an author, journalist, columnist, and a leading expert on environmental issues. UNLATCHED: The Evolution of Breastfeeding and the Making of a Controversy is her first book and her global exploration of the breastfeeding uproar and the bond that makes us human. I am honored to be featured in chapters six and seven of the book!

A conversation with Grayson:

What inspired you to write the book?

I had a few epiphanies that ultimately led me to write Unlatched, but the first one happened when I was pregnant with Izzy, my older daughter. One afternoon, I went to get the mail, and there was one of those maternity marketing “gift” packages waiting for me, with a large container of infant formula inside.

I had planned on breastfeeding, but like a lot of expecting moms I was nervous at the prospect of being my baby’s sole source of nourishment for the first six months. Could I really make it that long? So I went to the pantry to stash the formula, just “in case.” But before I could, my husband stopped me to look at the ingredients on the back of the package. I’m usually an obsessive label reader, so I was shocked when I turned over the container and saw corn syrup, soy oil, a plethora of unpronounceable ingredients… I had never even considered what was in this substitute that we so readily offer as an alternative to the breast. And then I realized: Hey, this is what I was exclusively fed as a baby! Those printed ingredients, on the back of that plastic package, were the building blocks of my life. I’ve struggled with chronic health issues since adolescence, and for the first time in my life I considered that there could be a connection.

The book is subtitled “The Evolution of Breastfeeding and the Making of a Controversy.” You explored some amazing and even shocking history about breastfeeding and bottle feeding. What impressed you the most?

One of the most surprising discoveries had to do with when, historically, the shift from breastfeeding to bottle-feeding first occurred. I had always thought it was during the 1940s and ’50s—the whole “better living through science,” post-war consumerism era where breasts became hypersexualized and Marilyn Monroe became an icon in a pointy bullet bra. But the shift actually began an entire half-century before, in the wake of America’s Industrial Revolution, in the late 1800s. For the first time in history, women were working in factories for long hours away from home, and they were living in big cities or even an ocean away from their own mothers and grandmothers who would have taught them how to breastfeed in generations past. It was these women—out of desperation—who first began experimenting with artificial breast milk substitutes, and to disastrous results. In fact, death by artificial feeding was one of the greatest public health issues of the early twentieth century.

And what’s really fueling the “mommy war” controversy?

I truly believe that the root of the current mommy wars is the utter lack of support for most mothers in American society. Nearly 80 percent of US mothers now start off breastfeeding, yet half give it up entirely or start supplementing with formula after just a few weeks. Why? Well, we’re one of pitifully few countries in the world without paid maternity leave, there is scant medical support for nursing mothers, and there are zero regulations on formula advertising in this country. Many governments around the world—like Taiwan’s, as you know—have taken dramatic steps to rectify this, in the name of public health. But more and more in the US, being able to exclusively breastfeed for the six months recommended by the American Academy of Pediatrics and the World Health Organization boils down to a question of economic privilege. These are harsh truths, and I think it’s been easier to point fingers at each other than uncover and deal with the real issues.

Throughout the book we see that the benefits of breastfeeding have been well documented by many researchers. Do you feel, however, that breastfeeding is normalized in our society?

Well, I think that the very fact that we refer to it as the “benefits” of breastfeeding makes it very clear that breastfeeding is not normalized in our society. It seems more like formula is the norm and the natural elixir that our bodies have provided for eons is now seen as some sort of “boost”—like the one you might get from a pack of vitamins. But human milk is the human norm, and there are very real risks associated with not breastfeeding a child—including increased incidence of gastrointestinal and respiratory infection, obesity, type 1 and type 2 diabetes, leukemia and SIDS.

As an environmental journalist and a mother who breastfed her oldest for four years, surely you’re aware of those benefits of breastfeeding in the first place. Did you learn anything new when writing this book?

One of the most profound things I learned was how little we truly know about breast milk—which is not merely a foodstuff but an extremely powerful human tissue packed with complex nutrients, hormones, bioactive molecules, ancient microorganisms, and thousands of other compounds that scientists have yet to understand or even discover. We finished sequencing the human genome more than a decade ago and yet we still don’t have a comprehensive library of what’s in breast milk!

As you point out in the last chapter, human milk is becoming a big business. Why is that unfortunate? What would breastfeeding be like in an ideal world?

As any nursing mother knows, breastfeeding is more than just the transfer of a “liquid gold” of nutrients; it enables a profound connection between mother and child—one that has persisted throughout human existence. So yes, as science continues to discover more exciting things about the compounds present in breast milk, hopefully society will be encouraged to prioritize breastfeeding. Still, we have to be careful not to fixate only on breast milk itself, which is already happening: Formula companies and biotech startups are racing to distill human milk down to its essence, and it is now one of the most valuable commodities in the world, worth four hundred times the cost of crude oil. But do we really want what is free and available to nearly all mothers to be sold back to us in a bottle one day? In an ideal world, alternatives to a mother’s own milk would always exist for those who need it, but mothers would have the critical support they need to be able to breastfeed their children as long as they want to.

This is an original post to World Moms Blog by To-Wen Tseng. Photo courtesy HapperCollins.

Tuesday, May 24, 2016

Zika and Breastfeeding

Last Thursday the Senate approved $1.1 billion in emergency funding to fight Zika virus, a mosquito-borne illness. The virus is transmitted to people primarily through the bite of a mosquito. Infection with Zika virus usually results in mild illness and symptoms may include fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache. Although Zika virus disease is generally mild, it can cause birth defects.

Five hundred people in the continental United States already have been infected by the virus. Those cases involved travel to Latin America or the Caribbean—the areas hardest hit by the disease so far. But federal health officials are worried about a locally spreading outbreak in the United States unless mosquito-extermination efforts, testing and vaccine research are expanded. Centers for Disease Control and Prevention (CDC) has issued an alert for travel to areas where Zika virus is spreading. Travelers who are pregnant or considering pregnancy should consult a doctor.

A pregnant woman can pass Zika virus to her fetus during pregnancy or the time of giving birth. Zika is a cause of microcephaly and other severe fetal brain defects and/or adverse neurological outcomes. CDC is studying the full range of other potential health problems that Zika virus infection pregnancy. 

Current widespread transmission of the virus and detection of the virus in breast milk from two mothers with Zika virus infection has also raised questions as to whether transmission can occur during breastfeeding, a practice essential to infant and young child survival and development. 

However, according to CDC, “to date, there are NO reports of infants getting Zika virus through breastfeeding.” Because of the benefits of breastfeeding, CDC encourages mothers to breastfeed even in areas where Zika virus is found. Also according to World Health Organization (WHO), “there are currently NO document reports of Zika virus being transmitted to infants through breastfeeding and in countries with ongoing transmission of Zika virus, no adverse neurological outcomes have been reported to date in infants with postnatally acquired Zika virus disease.

Based on the available evidence, which suggests that the benefits of breastfeeding for the infant and mother outweigh and potential risk of Zika virus transmission through breast milk, WHO has issued interim guidance, noting that the current WHO breastfeeding recommendations as below remain valid in the current context of Zika virus transmission.

  • Breastfeeding should be initiated within one hour of birth. 
  • Infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health. 
  • Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods, while continuing to breastfeed for up to two years or beyond.
WHO recommends mothers with suspected rubble of confirmed Zika virus infection during pregnancy of postnatally receive skilled support from health care workers to initiative and sustain breastfeeding, like all other mothers. Likewise, mothers and families of infants with suspected, probable or confirmed Zika virus infection should receive skilled support to adequately breastfeed their infants.

The best way to protect from Zika virus, according to WHO, is preventing mosquito bites. This can be done by using insect repellent; wearing light-colored clothes that cover as much of the body as possible; using physical barriers such as screens, closed doors and windows; sleeping under mosquito nets. CDC has confirmed that it is safe to use an insect repellent if a woman is pregnant or nursing. It is also important to empty, clean or cover containers that can hold even small amounts of water such as buckets, flower pots or tires, so that places where mosquitoes can breed are removed.

This is an original post for San Diego County Breastfeeding Coalition by To-wen Tseng. Photo credit to JAMES GATHANY/CDC VIA AP.

Read more: Zika Daily News

Friday, May 6, 2016

Meditating with my Terrible Two

When meditation became the big thing last year, just like yoga in the 1970s, my editor at Taiwan’s Commonwealth Parenting Magazine wanted me to write a piece about meditating with children. So I interviewed Jeff Zlotnik of Meditation Initiative for this assignment. He told me that kids can begin to practice meditation at the age of five, starting with a two minute session.

 “Seriously? Does that really work?”

 “Yes.” He then explained to me, while scientific evidence shows that human brains benefit from meditation sessions longer than 40 minutes, it is almost impossible to ask a 5-year-old to sit and meditate for that long. A two minute session is appropriate for a 5-year-old, and “even a short session like that helps relief stress and calm kids down.”

Calm kids down! The three words jumped out at me. My son was two years old, and there is surely a reason people call kids at that age “terrible two”. 

“How about with a 2-year-old?” I asked, with hope.

 “You can try. I think it still helps. But the session probably wouldn’t last two minutes,” he said.

Good enough. I went home with a plan. And just as I expected, that evening when we started the bed time routine my 2-year-old tried to negotiate like always.

“I want to brush my teeth for one more time! I have itchy teeth!” Itchy teeth? Is that even possible?!

“I want another glass of water so that I can go pee-pee again!” I know he’d just sit on the toilet forever if that means you don’t have to go to bed.

“I want two stories.”

“I already read you three stories, now it’s time for bed. I’m going to turn off the light. ”

And then—there it was! The two-year-old threw himself on the floor and started to howl.

“Okay, okay!” I picked him up. “How about a game?”

“Yes!” The howling stopped.

“It’s called the breathing game. Let’s close our eyes and concentrate on our breath,” I told him.

“What is concentrate?”

“Just listen to your breath.”

 He did. I closed my eyes, too. I could hear him breathing heavily on purpose, which made me want to laugh. I held the laugh in. After a while I felt his touch. “Mommy?”

I opened my eyes. He was looking at me, perfectly calmed down. “Are we still playing?”

“Yes,” I said. “That’s the point of the game—see who can keep breathing for longer.”

“I’m tired with breathing,” he said.

“Do you want to lay in your bed? I can sing you the dragon song.”

“Okay.” So he laid down and listened to me singing “Puff the magic dragon.” He fell asleep before I finished.

Our first meditation session lasted for 20 seconds! I was so proud of myself.

That night I told my husband about my great achievement. He scoffed at me, “You used a trick! I bet he’ll never play the breathing game with you again.”

But guess what—he actually did! The second night I used the same trick to calm him down and put him to bed. And the third night. And the fourth night. My son is now three years old. He finally figured out it’s a trick. “That’s not a game, mom,” he said to me one night. “You just want me to sleep.”

“It can be a game.” I told him. “It’s a game that helps you calm down.”

“Calm down?” Apparently the words are too hard to him.

“Makes you feel better when you are angry or upset.”


We still meditate together at bed time. Now my 3-year-old can meditate for one minute. My next plan is to find time to practice a 40-minute-session meditation for myself. Maybe I’ll get my husband to join me!

This is an original post for World Moms Blog by To-Wen Tseng. Photo credit to Chin-ling Ho.

Friday, April 29, 2016

The Difficult Feeder

Breastmilk is well established as optimal nutrition for nutritional, immunologic, and psychosocial child health. The ability of the newborn to latch and suckle effectively at the breast is critical to establish successful breastfeeding. Some newborns have significant difficulty, often related to anatomic and musculskelatal problems, thus requiring referral to specialists who have expertise in correcting newborn breastfeeding problems including lactation consultants, occupational therapists and physicians trained in the musculoskeletal basis of feeding dysfunction.

To address these issues, The San Diego County Breastfeeding Coalition (SDCBC) hosted a mini-seminar earlier this month for physicians and other health care providers. The purpose of this seminar is to familiarize maternal and newborn health providers with the types of expertise and interventions that different specialties—lactation consultants, occupational therapists, osteopaths—can offer and to aid in appropriate referral in order to assure successful breastfeeding.

Many issues might prevent a newborn from achieving a deep, effective latch to a normal mother’s breast. SDCBC’s Rose deVigne-Jackiewicz (RN, MPH, IBCLC) pointed out that premature babies and babies with real anatomical issues or jaundice are among those difficult feeders. An IBCLC should be able to recognize a “normal latch,” and form the strategy to establish a normal breastfeeding. She also believes that when having a long-term feeding plan, reasonable supplement and bottle usage is okay.

Bottle can be necessary when supporting the breastfeeding relationship for the infants who is hospitalized. However, “no nipple that resembles breastfeeding, ” said Robyn McMasters (MS, OTRL, SWC, CLEC) of Rady Children’s Hospital. She suggested evaluate every mother and baby before recommending a certain bottle system.

Bottle and breast are two different feeding systems. In strategies of supporting the transition to breastfeeding, McMasters recommended “educating moms early on being at bedside and participating in cares,” “kangaroo care,” “oral care with EBM,” and “exposure to breast.” Kangaroo care, also known as non-nutritive suck, can be a good transition to breastfeeding.

DeVigne-Jackiewicz said that an IBCLC should also be willing to acknowledge what s/he doesn’t know, refer the mom and baby promptly, and know who can refer to. This is where the cranial sacral therapy and osteopathic care kick in.

Cranial Sacral Therapy is a gentle, noninvasive form of bodywork that addresses the bones of the head, spinal column and sacrum. The goal is to release compression in those area which alleviates stress and pain. Cranial sacral therapy, said Bridgette K. Chelf (DC, CST) can help breastfeeding infants, for there are at least five bones of the cranium that effect suck. They are frontal bones, occipital bones, parietal bones, temporal bones and sphenoid bones. These bones also relate to nervous system that effect suck. When these bones are properly adjusted, baby’s sucking motion can be improved.

Dr. Hollis H. King (DO, PhD) introduced an osteopathic approach to treating the difficult feeder at the seminar. From his perspective OMT in pediatrics begins not at birth, but during pregnancy.

Dr. Viola Frymann, the founder of Osteopathic Center for Children, once said that the most important thing to do in treating children is to treat the mothers during pregnancy. Prenatal OMT helps the delivery process. And a traumatic delivery can result in somatic dysfunction that can have long term affects on the child.

Even delivered smoothly, 73% of newborns had at least one asymmetry, 10% had more than one. Both somatic dysfunction and asymmetry can lead to breastfeeding difficulties. They can both be corrected with osteopathic approach.

Eating is a learned behavior. Normal babies aren’t born with eating skills, they born with reflexive ability. The establishment of effective and successful breastfeeding often needs assistance from IBCLC and other professionals.

This is an original post for San Diego County Breastfeeding Coalition by To-wen Tseng. Photo credit to Mu-huan Chiang.