Baby

Many Women Quit

Breast-Feeding Early

Insufficient maternity leave poses a significant barrier, experts say.

By Karen Pallarito
HealthDay Reporter

SUNDAY, Dec. 27 (HealthDay News) -- Though a growing percentage of American moms start their infants on human milk, relatively few continue breast-feeding for the baby's first six months of life, let alone an entire year.

Why not stick it out longer? Numerous obstacles can prove difficult for new moms, but California researchers say they found that returning to work soon after giving birth presents a major barrier to successful breast-feeding.

"What we saw is if women take very short maternity leaves, of six weeks or less, they run more than a three times higher risk of quitting breast-feeding compared to those still at home who haven't returned to work," said Sylvia Guendelman, a professor who chairs the maternal and child health program at the University of California, Berkeley, School of Public Health.

Their study, published earlier this year in Pediatrics, was part of a larger analysis called "Juggling Work and Life During Pregnancy," funded by the U.S. government's Maternal and Child Health Bureau.

The American Academy of Pediatrics recommends that women breast-feed exclusively for six months and continue breast-feeding for at least an infant's first year of life. Exclusive breast-feeding -- meaning no water, juice, formula or foods -- has been shown to improve protection against many diseases, including bacterial meningitis, diarrhea and ear infections, the academy says.

In the first half of the decade, the number of breast-fed infants increased somewhat, from 71 percent in 2000 to 74 percent by the end of 2006, according to a report from the U.S. Centers for Disease Control and Prevention.

But those figures doesn't tell the whole story.

"Initiation of breast-feeding, although it is one measure, doesn't mean much," Guendelman said. "You can put your baby to the breast for two times and say, 'Well, I tried it and I didn't like it,' or, 'I didn't succeed,'" she said. "But what you really want to look at is, of women who initiate, how many breast-fed successfully for at least six months?"

On that score, the United States has made little progress. Of infants born in 2006, 43 percent were breast-feeding at 6 months and 23 percent at 12 months. Just 14 percent, however, had been exclusively breast-fed for six months.

The numbers fall short of national objectives for breast-feeding. Healthy People 2010, the government's health promotion and disease prevention agenda, seeks to boost the number of breast-feeding women to 75 percent by 2010. The six-month and one-year targets are 50 percent and 25 percent, respectively.

Unlike other industrialized counties, the United States does not have a national maternity leave policy.

To find out whether maternity leave makes a difference for breast-feeding success, Guendelman and her team examined data from 770 full-time working women in Southern California.

Full-time workers with short postpartum maternity leaves were more likely to quit breast-feeding early. Those at highest risk were women in non-managerial and inflexible positions and women with higher stress levels.

Women who had access to workplace benefits such as paid maternity leave or a private office might have greater success, noted Chris Mulford, a retired lactation consultant in Delaware County, Pennsylvania, and member of the U.S. Breastfeeding Committee, a nonprofit group. "They're usually more able to sustain breast-feeding as they return to work than women who work without their own office, without a place at the job where they can express their milk," she said.

Laws related to breast-feeding in the workplace are in place in 24 states, the District of Columbia and Puerto Rico, according to the National Conference of State Legislatures. An Oregon law, for example, allows women to take a 30-minute, unpaid break during each four-hour shift to breast-feed or pump. Oregon has the highest rate of breast-feeding at 12 months, at 37 percent, and the second-highest rate of breast-feeding at six months, at 63 percent, after Utah, where the rate is 69.5 percent, according to the CDC.

All things considered, though, working moms might have a tougher time with breast-feeding than women who are able to take more time with their infants, said Kay Hoover, a lactation consultant at a Philadelphia-area hospital. "If you're separated from your baby, it's hard to maintain milk production," she said.

Guendelman said she would like physicians to advocate for extended postpartum maternity leaves for working women. "If you know you have some time off," she said, "you are more likely to establish breast-feeding in the first 30 days and not just give up so quickly."

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Baby

U.S. Births Reach Record High

Teen deliveries and infant mortality remain areas of concern

By Steven Reinberg
HealthDay Reporter

MONDAY, Dec. 21 (HealthDay News) -- More babies were born in 2007 in the United States than ever before, with an increase seen in all age groups, including teenagers aged 15 to 19.

More than 4.3 million births were recorded, a 1 percent increase from 2006, U.S. health officials report.

But along with more babies come more problems. Teen births are up for the second year in a row, reversing a long-term decline; births among unmarried women are rising, and the infant mortality rate remains higher than in many other countries, including France and Japan, according to the U.S. Centers for Disease Control and Prevention.

Births to teenage mothers had been declining since 1991, "but since 2005 we have seen an increase in the rate of teen births," said report co-author Paul D. Sutton, a geographer/demographer at the CDC's National Center for Health Statistics.

No clear reason for this trend is apparent, Sutton said. The decline seen in the 1990s may have been the result of effective pregnancy prevention programs, some experts say. "We might need to rethink the messages to what we are communicating to the kids," he said. However, he cautioned that these data are from 2007, noting newer statistics may show some change.

The report is published in the Dec. 21 online edition of Pediatrics.

Infant mortality rates remain high, and a CDC report released in November might give a clue as to why. The main cause of the United States' high infant mortality rate when compared with Europe is the very high percentage of preterm births in the United States, that report said.

Cesarean deliveries have increased, but the reasons why are still unknown, Sutton said.

Highlights of the report include:

* The teen birth rate rose about 1 percent, to 42.5 births per 1,000 teenagers.
* Birth to women aged 15 to 44 went up 1 percent, to 69.5 per 1,000 women.
* Births to unmarried women in all ethnic/racial groups increased to 39.7 percent, up about 1 percent.
* Cesarean deliveries rose 2 percent, to 31.8 percent of all births.
* The rate of multiple births remained unchanged between 2005 and 2006.
* Preterm births declined 1 percent, to 12.7 percent.
* The rate of low-birth-weight infants fell slightly, to 8.2 percent.
* The infant mortality rate was 6.77 deaths per 1,000 live births -- similar to the 2006 rate.
* Life expectancy at birth reached a record high of 77.9 years.
* Death rates for children aged 1 to 19 fell 2.5 percent.
* Leading causes of death to children and adolescents were unintentional injuries and homicide.

Dr. Steven E. Lipshultz, chairman of pediatrics at the University of Miami Miller School of Medicine, said prematurity and infant mortality rates are a measure of the overall quality of children's health care in the United States.

"One of the greatest expenditures we have in health care relates to prematurity," he said. "This suggests that children must be more of a priority. Much of premature delivery is preventable."

In France and Japan, the infant mortality rate is three deaths for every 100 live births, Lipshultz said. "In the U.S., this has been about seven per 100," he noted.

Among blacks in Florida's Miami Dade County, the infant mortality rate is 11.5 per 100 births, Lipshultz said. "That's a rate that's more than 2.4 times greater than white infants, indicating that health-care disparities and racial inequities are present."

These data clearly show that health care for expectant mothers and their children leaves a lot to be desired, Lipshultz said.

Nothing is more important than a healthy start in life, Lipshultz said. "Access to affordable, quality and comprehensive health care is vital to a child's well-being," he added.

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Baby

Docs Not Giving Clear Advice on Infant Sleep Positions

Survey finds it might explain why number of caregivers putting babies on backs has leveled off.

By Amanda Gardner
HealthDay Reporter

MONDAY, Dec. 7 (HealthDay News) -- New research finds that although far more caregivers now place babies on their backs to sleep -- a practice that reduces the risk of Sudden Infant Death Syndrome (SIDS)-- that encouraging trend has leveled off since 2001.

The study also shows that black mothers and caregivers are more likely than whites to place infants on their stomachs to sleep.

But among all races, the most common reasons for using the stomach position were concerns about infant choking and infant comfort, said Dr. Eve Colson, lead author of the study published in the December issue of the Archives of Pediatrics & Adolescent Medicine.

"It also still looks like the really important thing is that they get very specific advice that they should only put the baby on its back," added Colson, an associate professor of pediatrics at Yale University School of Medicine.

The onus to deliver that message, she said, lies largely with physicians and health-care providers.

According to background information in the study, which was funded by the National Institutes of Health, SIDS is the leading cause of death after birth in the United States.

"SIDS is extremely tragic, but the risk period is relatively short. Most occur between 0 and 6 months and the peak period is 2 to 4 months, although cases can occur during the first year," said Marian Willinger, special assistant for SIDS research at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

Since the NICHD launched its Back to Sleep campaign in 1994, the number of babies placed on their backs to sleep jumped from 25 percent to about 70 percent and the SIDs rate declined by more than 50 percent.

Still, black infants have more than double the incidence of SIDS as white infants and are also more likely to be placed on their stomachs for sleeping, the researchers found.

This National Infant Sleep Position study consisted of telephone surveys of nighttime caregivers (usually mothers) of babies aged 7 months or younger. About 1,000 interviews were conducted each year between 1993 and 2007 across the United States.

Throughout the period, the rate of supine sleep (on the back) increased while prone sleeping (on the stomach) decreased over all groups.

But in 2001, that downward slope leveled off across the board.

Those putting babies to sleep on their stomachs, regardless of race, were more likely to express worries about comfort and choking and say they had not been given a clear directive from a doctor.

Yet neither choking nor comfort should be a concern.

"There have been a couple of good studies that babies do not choke on their backs, that there are no adverse health outcomes of putting babies on their back," Colson said.

"Stomach sleepers spend more time in deeper sleep but that doesn't mean they're not sleeping when they're on their back," Willinger said. Back sleepers "may wake up more frequently but young babies like that are going to be up to nurse anyway."

Even sleeping on the side can be risky for babies, Willinger stressed. That's because babies placed on their sides often roll on to their stomachs.

Almost half the mothers surveyed in the study said that they had received no advice at all from their physician or that he/she had recommended stomach sleeping.

"This gives us a very strong warning signal that we're not doing a very good job in part of our population, and signal that there may be more ethnic differences," said Dr. Andrew Colin, director of pediatric pulmonology at the University of Miami Miller School of Medicine.

In fact, those ethnic differences may even be biological, he stated, and not resolvable by placing babies on their backs.
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Baby

Music of Mozart Soothes the

Preemie Baby

Repetitive melodies encourage less energy use, more growth, study finds.

By Serena Gordon
HealthDay Reporter

MONDAY, Dec. 7 (HealthDay News) -- Could the music of the 18th century classical genius Wolfgang Amadeus Mozart help tiny infants born today?

Yes, suggests an Israeli study that found that listening for just 30 minutes a day helped premature babies use less energy, which may help them grow faster.

"Within 10 minutes of listening to Mozart music, healthy infants [born prematurely] had a 10 percent to 13 percent reduction of their resting energy expenditure," the study authors wrote. "We speculate that this effect of music on resting energy expenditure might explain, in part, the improved weight gain that results from this Mozart effect."

The findings were published online Monday in Pediatrics, and are slated to appear in the January print issue of the journal.

In the 1990s, researchers released a small study that found that when adults listened to a Mozart sonata they performed better on intelligence tests. Numerous studies have been done since, including studies on premature infants that have found the "Mozart effect" can decrease the heart rate, lower stress hormone levels and ease distressed behavior in premature infants, according to background information in the new study. Babies exposed to music have also shown an increase in their levels of oxygen and weight gain.

However, none of these studies have been able to look at how the music might be causing these changes.

To get an idea of how Mozart's music might help weight gain, the researchers designed a prospective, randomized trial that included 20 healthy babies who were born prematurely. The babies weren't eating on their own, but instead were being tube-fed consistent quantities of food.

The babies were randomly assigned to listen to no music or to Mozart for 30 minutes for two consecutive days.

During the first 10 minutes, the resting energy expenditure was similar in both groups. But during the next 10 minutes, the researchers noted a change in the babies who were exposed to Mozart -- their resting energy expenditure decreased, and the effect continued through the next 10-minute period as well. Overall, there was a 10 percent to 13 percent drop in resting energy expenditure.

"When you're born early, lots of the pathways in the brain are still being laid down and developing, and then babies are put in an environment where there are lots of unfamiliar sounds and other stimuli, which may cause sensory overload. Music may help decrease those noxious influences," said Dr. Cheryl Cipriani, director of the neonatal intensive care unit at Scott & White Memorial Hospital, in Temple, Texas. "It's an area that needs further explanation."

Dr. Beverly Brozanski, clinical director of the neonatal intensive care unit at Children's Hospital of Pittsburgh, said that "developmental inputs, whether music or touch or something else, are very important to infant brain development."

Both experts said that while this study's results are intriguing, it's only a small pilot study, and that no definitive conclusions can be drawn from it.

Whether the effect seen in this study is exclusive to Mozart or could be replicated with other music is also unknown. The researchers suggest that the effect may be unique to Mozart because his music tends to repeat the melody more than music of other composers.

Brozanski said that she suspects that lullaby-type music that contains a soothing repetition would probably produce similar effects.

Cipriani said she doesn't know if playing different music would change the outcome, but like Brozanski, she suspects the repetition probably is key. "The baby is used to hearing a beat before it's born -- the whoosh of the blood, the heartbeat -- and it may be that certain types of music do a better job of soothing them and reminding them of the womb," she said.

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Baby

Health Tip: Create Baby's Bedtime Routine

Better habits usually mean a better night's sleep

URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_91501.html (*this news item will not be available after 02/03/2010)

HealthDay Diana Kohnle Thursday, November 5, 2009

(HealthDay News) -- Babies are never too young to benefit from a bedtime routine, the U.S. National Library of Medicine says.

The agency offers these suggestions for developing bedtime habits from the start:

• Don't give your baby a bottle in bed. Make sure the last bottle of the day is given a sufficient amount of time before bed.
• Enjoy quiet relaxation time with your baby.
• Put baby to bed when sleepy, but not when he or she is actually asleep. This way, baby gets used to falling asleep alone.
• When baby cries, speak in a soothing tone. Or rub baby's back until calm. But don't pick baby up.
• Avoid turning lights on when you feed baby in the middle of the night.
• Whatever your routine, make sure you're consistent, and try to ensure that both of you enjoy it.
• Don't sleep in the same bed with a baby that's 12 months or younger. This may increase the risk of sudden infant death syndrome (SIDS).

HealthDay Copyright (c) 2009 ScoutNews, LLC. All rights reserved.

Date last updated: 06 November 2009