Search for tag: "milk"

Announcer: Have a question? Ask it. Send your listener question to hello@thescoperadio.com.

Interviewer: It's time for another listener question and we're here with Dr. Kirtly Parker Jones. Dr. Jones, the question sent in was, "Could my baby be allergic to my breast milk? I've noticed that he's not really absorbing it, he's not really taking it, but he's fine with formula milk."

Dr. Jones: To start at the beginning, babies cannot be allergic to your breast milk.

Interviewer: The answer is just no?

Dr. Jones: The answer is no. However, there are proteins in what you eat that are absorbed into your bloodstream that then come out in the breast milk, and certainly there are flavors in what you eat that come out in the breast milk. In fact, there are flavors of what you eat when you're pregnant that flavor the amniotic fluid, and the baby is already kind of drinking your garlic or your hot sauce, or whatever it might be. The babies will not be allergic to your breast milk. Newborns don't actually form an allergic response. So it takes a while for babies to be able to even form an allergic response.

So, if newborns are throwing up, you start to really worry that maybe they have a problem with their stomach. So sometimes babies actually have a weakness in their stomach that allows the fluid to come back up. So some babies actually have to be fed kind of thickened milk or have to be slept tilted like people who have reflux. So babies can have reflux and newborns can have reflux until they're a little older. So babies can have reflux and that can make them throw up, and it's not they're allergic, it's just that they can't keep the fluid down.

Secondly, there are some babies with congenital malformations that cause a blockage in the esophagus. This is very rare and it's devastating. So there's a blockage in the esophagus and the fluids go down into their lungs. This is called a TE, a tracheoesophageal fistula. Once again, it's the baby that's not actually absorbing because it's going down the wrong way.

Now, let's take babies a little bit older. They actually can be allergic and develop an allergy to things that are in your food, and the most common is milk. So milk proteins in milk, of course, when . . . oh, cow's milk, there is something called casein and this is a protein that a mom might actually have in her blood and that the baby might actually develop an allergy to. That being the case, babies might get a little distended, they might be a little uncomfortable, and sometimes, they may even have a rash around their rear where it's kind of irritating.

Now, what about the baby that seems to be fine with formula and not so well with breast milk? Well then, the questions is, is the baby getting better suckling with the nipple . . . the formula? Is there something in the mother's food that's flavoring her breast milk? Meaning is she eating a lot more garlic, or is she eating spicy things that are getting through and the baby doesn't like the taste? And then the question is, is the mother putting anything on the nipple that the baby doesn't like the taste of? So we put all these lotions on our bodies and women put lotions and Bag Balm, which doesn't really taste very good. Bag Balm is something they put on nipples of cows when the nipples break down with nursing cattle, and so that may not taste very good.

So what are you putting on the skin and the answer is nothing, is the baby actually latching on well? So sometimes the baby has to struggle getting the whole nipple in their mouth, but it's easy to put the nipple from the bottle. There are many cultural norms about what you should and should not eat because of what goes in your breast milk, like don't eat cabbage because it will make your baby bloated. Well, unfortunately, cabbage won't make your baby bloated. It might make you bloated, but not your baby.

Of the things that they worry about, cow's milk is the first and about 2% to 3% of babies might actually be allergic to the cow's milk that their mother has in their food. And if a baby seems like it's not absorbing or is irritated by the breast milk, the question is what is it? And you have to kind of take things away. The top ones are peanut, soy, and cow's milk, but there may be other things. So moms need to eat carefully. The baby may not like garlic in their breast milk. By the way, wine goes right through the breast milk, too, so be careful.

So the long and the short of it is the baby is not allergic to your breast milk, but it can be allergic to what you're eating. There are lots of cultural superstitions about what mom should and shouldn't eat, and what should go in the breast milk. There's not much science, but if you take away one thing at a time and see if the baby does better, you might figure out what it is. And of course, your pediatrician can really help you work this out.

Announcer: Have a question? Ask it. Send your listener question to hello@thescoperadio.com.

Dr. Jones: Breastfeeding, it should be easy. Mice do it, deer do it, cats do it. But if you have questions or problems as a new mom, who should you talk to? This is Dr. Kirtly Jones from Obstetrics and Gynecology at University of Utah Health Care and today we're talking to an expert on The Scope.

Announcer: Covering all aspects of women's health, this is The Seven Domains of Women's Health with Dr. Kirtly Jones, on The Scope.

Dr. Jones: I was born in Germany and my mother, who was a good Boston girl, was told by the nuns at the hospital where she delivered, that she should drink beer, dark beer, to bring her milk in. Well, it worked and then on the trip back to the United States on a boat, supposedly I got sick and wouldn't nurse and she didn't have the nuns to help her to turn her milk off.

Well, when my son was born and I was worried about my milk supply, by the way, obstetricians are not very smart about breastfeeding, I actually brought my sister in to help me, cause she'd done it twice, and she brought me a beer. And 30 minutes later, it was a done deal. so a superstition and a tradition, were born in my family about breastfeeding and beer.

Around the world, there are customs and old wives' tales about breastfeeding do's and don'ts but there are actually some people and some science about it. New moms, here at the university hospital who have questions, can get help from a breastfeeding specialist. Today in Scope Studio, we're talking with Mary Erickson, a lactation specialist, on our postpartum floor.

Welcome, Mary. So you're a lactation consultant?

Mary: That's correct.

Dr. Jones: Did I say that correctly?

Mary: Mm-hmm.

Dr. Jones: And we have a couple of them here at the U?

Mary: Absolutely, we do.

Dr. Jones: Is there somebody during the weekday that's always available? Is there somebody always on-call?

Mary: There is always, seven days a week, there is always going to be a lactation consultant. Also, a lot of the nurses that don't actively work as the consultant but they have gone through the process, so there's typically someone who knows how to help.

Dr. Jones: Okay and they have a certificate and . . . so it's not your mother who is going to feed you a beer?

Mary: Right, that's right.

Dr. Jones: Oh good, oh good. So what are some of new moms' most common questions or concerns?

Mary: Probably the most common concerns are discomfort. There are some discomforts that are associated with the breastfeeding. And also her inability in her mind, that she cannot meet the demands of the baby and this might include baby's crying, won't sleep in his crib, baby's hungry, or wants to be held all the time, and all of those she usually internalizes and figures it's her own fault.

Dr. Jones: And it's her breast milk, rather than, who knows?

Mary: Right, yeah.

Dr. Jones: So that's some that the lactation specialist or consultant can help the mom interpret what's hunger and what's fussiness, and what's just, you know, "Wrap me up a little tighter," or, "I'd rather be with you, Mom, than by myself over there in the corner."

Mary: Right, so a lot of my job is educating what is normal newborn feeding behavior and just normal newborn behavior? When is the crying normal?

Dr. Jones: Yeah, right. Well, so how do you help moms who seem to be worried about not enough milk? Remember now, our patients who have a normal vaginal delivery, go home in 48 hours, even before their breastmilk has even come in. So how do you help those moms about their fears that they won't have enough, or help a mom who really maybe, her baby got sick and she didn't breastfeed for a while and now she's not got enough? What can you do for those moms?

Mary: So first of all, I think it's important that they understand what is normal behavior, as far as . . . a lot of them want very concrete, this is what's going to happen but . . .

Dr. Jones: Get ready for parenting.

Mary: Exactly. So Just talking to them about, the first 24 hours, this is what your baby is going to act like. And then when babies' 48 hours is going to be totally different. And then 72 hours, when your milk comes in, different again. And just preparing them, that every single day is going to be a little bit different, and trying to help them recognize when it's okay and when it's not okay. And then what to do when it's not okay.

Dr. Jones: Okay, so for moms who don't seem to have enough milk, it's hard. Moms may be going back to work. Now once again, they're heading to the hospital so can they still call? If they have delivered here, can they call, cause their problems may arise because their breast milk didn't even come in 'til they went home?

Mary: Right, right, and we're very fortunate, we do have a breastfeeding clinic, so moms do need support past the hospital period, so they do need someone to call. And it's very nice to be able to bring them in, have them a doctor, a pediatrician will look at their baby, make sure baby's okay, and then have them work one-on-one with a breastfeeding person that can help to troubleshoot and figure out what's going on and also hopefully, to give her a lot of reassurance.

So if she felt like she did not have enough milk, for me, it depends on where she's at on that timeline. If she's day five, six, seven, I would expect that she should've had breast changes and that she should be a little more reassured that she does have enough milk and if not, I would definitely want her to be seen.

Dr. Jones: Well, I remember, after that beer which was probably just given at the right time. I don't think it was the beer but it did relax me. My milk came in like a milk truck and then I thought, "Oh my gosh, I have way too much." And then I remembered that we were setup to maybe even nurse twins, so at the beginning, we have a lot. We probably have more than we need, so I figured that was just a chance to put it in my bank in my freezer. But some women actually let-down very quickly or have a lot of milk, and that doesn't settle down to a pattern. What do you do for those women?

Mary: Well, first of all, not enough milk is a lot more difficult to deal with than too much milk. But too much milk can also be a problem, especially for the baby. It is like trying to drink from a fire hose sometimes and that can be pretty challenging. So if that's the case, there are different things that she can do.

One thing that I like is I tell moms after the breast is empty, to do ice. Ice will decrease the blood flow and that should help her get on top of the volume a little bit better. Other things that they can try is breastfeed the baby on one breast per feeding, so they get a good milk mix of the hindmilk and the foremilk.

Dr. Jones: So you do ever suggest that the mom, with the milk comes out like a fire hose, just express some milk just so the pressure is down a little bit? So then maybe the baby can latch on a little easier, and not get flooded the first mouthful, and then get disrupted, and get upset. How do you deal with that?

Mary: Very good strategy would be to go ahead and get that first let-down over. That first let-down is going to be the most forceful so after that first let-down, the milk flow will be a little more gentle. So some moms do have to do a little bit of pumping or just a little hand expression and get that first let-down passed. Dr. Jones: It's great to have some professionals here helping us out. It's good news because in fact, I really didn't like beer.

So thanks for joining us on The Scope.

Mary: You're welcome, thank you.

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