Showing posts with label breastfeeding. Show all posts
Showing posts with label breastfeeding. Show all posts

Wednesday, September 30, 2015

Compliance When It Comes to Making Sure Breastfed Babies Get Their Vitamin D: There’s Another Way to Do It


By: Lewis First, MD, MS; Editor-in-Chief       

          We are all aware of the need to supplement breastfed infants with vitamin D, especially in the first six months of life before the introduction of other vitamin D-enriched foods into their diet.  But we are also aware that remembering to give the baby vitamin D each day and making sure the baby easily takes their daily dose of D may be more easily said than done. So what about giving breastfeeding mothers a high dose of vitamin D daily and seeing if that is equivalent to a baby getting their daily requirement?  
       Hollis et al. (doi: 10.1542/peds.2015-1669) report on a randomized controlled trial of giving a group of lactating mothers 400, 2400 or 6400 IU of vitamin D while their babies got the recommended 400 IU if mothers got 400 IU as well, and other infants got 0 IU with the maternal higher doses.  So what happened?  Were there side effects of the higher doses in the mothers, and did the higher doses result in adequate vitamin D levels in babies even if they were not given their daily 400 IU?  The results may surprise and delight those of you, especially those looking for an alternative strategy to needing to directly supplement your youngest patients who breastfeed.   
      To add further import to the findings of this study, Dr. Lydia Furman (doi: 10.1542/peds.2015-2312), a member of our editorial board and an expert on helping mothers with breastfeeding, offers her insight on what we should take away from this study.  After reading the article and commentary that we are early-releasing this week, would you consider trying this strategy?  Keep us abreast of your thoughts by responding to this blog, sending us an e-letter or posting your comments on our Facebook or Twitter pages.

Related Links 

Friday, June 26, 2015

Yet Another Reason (and a New One to Us) As to Why Exclusive Breastfeeding for the First 6 Months of Life Is Recommended




          We certainly don’t have to reiterate what the AAP recommends on the basis of strong evidence gathered in the peer-reviewed literature to date—i.e. exclusive breastfeeding for the first six months of life carries more benefits than we would ever have time to list or mention in this blog!  Yet Peres et al. (doi: 10.1542/peds.2014-3276) this month add to that list of benefits by hypothesizing that breastfeeding has a protective effect in regard to primary dental malocclusions.   
     The investigators followed a birth cohort of more than 1300 infants and monitored them for their feeding preferences at birth, 3, 12, and 24 months of age and then examined them for malocclusions such as open bite, cross bite, and other types and variants of this problem while controlling for a variety of potential confounders in their analysis.  
       The results are mouth-opening and easy to bite into and include a 72% reduced rate of moderate and severe malocclusion if an infant had been exclusively breastfed for at least 6 months. If you are looking for that one additional reason to breastfeed, this study may have just the jaw-dropping results you were looking for to share with families who are less eager to breastfeed.

Related Links

Wednesday, May 20, 2015

Long-Chain Polyunsaturated Fatty Acids Added to Infant Formula: Does It Improve Cognition at 8 Years of Age?


By: Lewis First, MD, MS; Editor-in-Chief       


      Many of us can certainly remember when studies first heralded the importance of supplementing human milk and formula with docosahexanenoic acid (DHA) and arachidonic acid (AA), two long-chain polyunsaturated fatty acids (PUFAs) especially in very low birth weight (VLBW) infants so as to improve their cognitive function.  While studies indicated that there was evidence of improvement in such function in infancy and toddlerhood, you might wonder if the improvement continues into childhood. Well wonder no more.  
     Almaas et al. (doi: 10.1542/peds.2014-4094) share with us the long-term follow-up results of a randomized double-blinded, placebo controlled trial on a cohort of 129 VLBW infants whose human milk was supplemented with high doses of DHA and AA. The cohort was followed over the next 8 years and 98 children underwent a battery of cognitive tests as well as 81 had MRIs.  Do you think the cognitive differences seen early in life persisted into childhood?  If you did, you may be disappointed with the findings reported in that no significant differences were noted in terms of cognitive or neuroanatomic effects 8 years after the trial. 
     Does this surprise you?  Do you need a better understanding of why the results of this study might show no differences when the intent was to demonstrate the benefits cognitively of receiving PUFAs when VLBW infants were being fed so that cognitive gains would persist as these babies got older?  We asked nutritional experts Drs. Maria Makrides and Ronald Kleinman to share their thoughts on this study with an accompanying commentary (doi: 10.1542/peds.2015-0813) that is food for thought and well worth digesting.  Read both the study and commentary and see what we mean.

Related Links