Tag Archives: Human breast milk

Having A Moment Of Milk Doubt? How Often To Nurse Past 1 Year Old.

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Every so often I have a breast milk fuelled wobble.

I start thinking about pouring the little guy a couple of cups of milk a day. I worry that his calcium intake is not sufficient for his bone development. Should I be supplementing with vitamin drops, am I really doing the best thing letting him feed several times daily still.

At times like this, I need to find reassurance that I am still doing the right thing for my guy, that I am not depriving him of any vital nourishment, and that in fact he is getting the fullest of fattiest milk to develop his brain and the most bioavailable source of vitamins and minerals possible.

There isn’t an enormous amount of information out there about extended breastfeeding, even less of it is properly researched…so it took some time to find rthe reassurance I was seeking.

You can read some of my previous research here, I looked into exactly why breast milk is so good past one year…

But how much should a toddler be drinking?

There is no official minimum intake guideline for milk. Form what I managed to round up from various sources, it seems like between 1-3 years of age, 15-18 oz of cows milk is a good amount (400-500ml). But how does that translate to the invisible measures of breast milk.

According to KellyMom, as long as your toddler is nursing at least 3-4 times a day then there is no need add cups of cows milk.

The reasoning…milk-splash.jpg

Cows milk is just a convenience, a convenient source of calcium, vitamin D and fat.

Check out my detailed research here to see exactly why breast milk is more than adequate, but just quickly, it is super full fat, with high levels of vitamins and minerals designed specifically to be easily absorbed by the human child.

So if your child is nursing regularly still, then go with it, combined with the varied diet that he will be getting, then all should be good in the brain and bone!!

If you want the figures in detail, the NHS website recommends the following as a guideline daily intake, but it can be averaged out over a week:

Ages 1 to 3 years: 700 milligrams (mg) per day
Ages 4 to 8 years: 1,000 mg per day

Here are some serving recommendations:

  • 1/4 cup raw tofu prepared with calcium sulphate: 217 mg (The calcium content of tofu varies, depending on how it’s processed. Check the label.)
  • 1/2 cup plain yoghurt: 207 mg
  • 1 tablespoon blackstrap molasses: 172 mg
  • 1/2 cup fruit yoghurt: 122 to 192 mg
  • 1/2 cup calcium-fortified orange juice: 133 to 250 mg
  • 1/4 cup ricotta cheese: 167 mg
  • 1/2 cup milk: 150 mg
  • 1/2 cup chocolate milk: 144 mg
  • 1/2 ounce Swiss cheese: 112 mg
  • 1/2 cup vanilla frozen yoghurt, soft-serve: 102 mg
  • 1/2 ounce cheddar cheese: 102 mg
  • 1 slice whole grain bread: 24 mg
  • 1/2 ounce mozzarella cheese: 103 mg
  • 1/4 cup collard greens: 66 mg
  • 1/4 cup homemade pudding (from mix or scratch): 76 mg
  • 1 tablespoon tahini (sesame seed butter): 64 mg
  • 1/4 cup turnip greens: 50 mg
  • 1/4 cup cooked spinach: 60 mg
  • 1/2 cup calcium-fortified cereal (ready to eat): 51 mg
  • 1/2 cup calcium-fortified soy beverage: 40 to 250 mg

 

Entering Extended Feeding Territory…Better Than Cows Milk.

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Hopefully, we have just had our final encounter with the health visitor!!!

We are at the one year mark (already) and a check up was in order according to the NHS guidelines.  So far we have managed six months of exclusive breast feeding, we have continued and plan to continue breast feeding for a good while longer and we have hit the 50th percentile consistently at every weigh in…

I feel proud of our achievements, as any parent would…

So why did I leave that check up feeling so agitated?

There was not one word of praise for reaching our breastfeeding milestone, in fact  the health visitor tried several times to push a pint of cows milk a day at us, then she tried to shove multi-vitamin at us and finally told me that he needs to eat more than the three meals and two snacks a day that he already feasts upon.

The reason?

“Well if he was drinking formula milk he would be getting all of the vitamins and minerals he needs.”

Aarrhggh…What kind of support is that?  There was nothing about the little guy to suggest he was in ‘need’ of anything!  She clearly wasn’t listening to anything I had told her about his healthy appetite and seemed concerned that I was just forcing breast milk for my own agenda.

I had a rant to a fellow boob-a-holic mum, she had received similar advice, that breast milk is nutritionally redundant at one year, ooh my blood is boiling!

So where is this information coming from?

The WHO recommends breast feeding for at least two years. It is widely recognised that breast milk past 12 months still passes immunity and nutrition to the child, it provides comfort and security to the child and for the bonus point, extended feeding increases protection against breast and ovarian cancers and osteoporosis in mothers.  Why would I even consider stopping now?

The WHO summarise that breast milk is the natural first food for babies:

  • It provides 100% of the energy and nutrients that the infant needs for the first months of life.
  • It provides up to 50% or more of a child’s nutritional needs between 6-12 months.
  • It provides up to 33% of a child’s energy and nutritional needs during the second year of life.

As for the nutritional composition of breast milk past 12 months, there is little documented research, but it does exist.  Nothing spectacular happens at 12 months that reduces breast milk to water.  I was curious about the nutritional content when I expressed some milk recently…The milk in the bottle just seemed different to me, it seemed richer, creamier and thicker, it didn’t separate into the two layers that I was familiar with earlier on in his life…I found a little bit of info that went some way to explain why…

Research shows that the fat and energy content of milk over the one year mark to be significantly higher than in milk at the 2-6 month mark.  Good news in the full fat cows milk war that was being waged on me!

Anyway, as this woman was so intent on selling me shares in her dairy farm, I thought I would take a look at this wonder milk of the cows to see how it compares to breast milk in its composition and content.

Milk Crate With Cow

Fat

Starting with the fat content of milk, medical professionals seem keen to get a whole lot of whole milk into growing children…by that I mean full fat, regular milk, cheese, yoghurt etc.  The reason being that babies and children grow so rapidly, they need to meet their calorie intake in the form of fat, 1g of fat has more than double the amount of calories of 1g of protein or carbohydrate.  It is also an essential part of the formation and development of the brain

Breast milk has up to 5% fat.

Whole cows milk on average has 3.25% fat.

Good but not quite as fatty as my specialist supply!

Carbohydrate

The main carb in breast milk is lactose.  At around 7% the carbohydrate content provides around 40% of the total amount of calories from breast milk.

Cows milk comes in at just over 4% lactose.

Good but not as good as my personal milk stash.

Protein

This is an interesting one.  Cows milk seems to pull ahead in the competition on this one with just over 3% protein content compared to the 1% of breast milk.

How these percentages are made up is the interesting bit…

Breast milk is split 60% whey, 40% casein.

Cows milk is split 20% whey, 80% casein.

It is the unique balance of proteins in human milk which is easy to digest, whey in particular being most suited to little people.  Importantly it is less taxing on the kidneys and stomach.

Once again breast milk seems best balanced and is more than adequate for a growing child based on protein composition.  Another point to mothers milk!

Vitamins

Vitamin content seems to be directly related to mothers intake, so babies can become deficient in a few areas.  In particular:

  1. Vitamin B12
  2. Thiamin
  3. Folate
  4. Vitamin D

It is important to keep taking a vitamin supplement to keep these levels up, however vitamin D is usually always deficient in mothers milk.  Cows milk is usually always fortified with vitamin D.

For this reason, and the fact that sunshine needed for the body to make vitamin D, I will probably introduce some vitamin drops to the little guy to keep his vit D levels up.

Minerals

Human Milk Cow’s Milk Formula
Calcium (mg/100 ml) 27 124 46
Phosphorus (mg/100 ml) 15 93 32
Sodium (mEq/100 ml) .7 2.1 .8
Zinc (mg/100 ml) .27-.07 .4 .5
Iron (mg/100 ml) 0.04 .0.05 0.11 (1.28)

I found this table of mineral content courtesy of nutritioncare.org as well as the following piece of info:

Interestingly as with all vitamins and minerals in breast milk, they are highly bioavailable (better absorption &/or conservation). So even at lower concentrations than in cows milk, human milk generally meets the mineral requirements for normal infants. (Levels added to formulas are higher to compensate for the less favourable absorption.)

The relatively low protein, sodium, potassium, and chloride levels in human milk also place the kidneys under less of a load than cows milk or formula, which is beneficial to the underdeveloped organs while they mature.

Concentrations of minerals in human milk generally decline over time, probably due to slower growth rate of the child, of course this reduces the demand on mothers body so she can start to replenish her own reserves.

Conclusion

It seems that extended breast feeding has many benefits and advantages, for both mother and baby.  I am ready to answer anyone who questions my choice to continue feeding the little guy, I may even go back to the health visitor and baffle her with some of the science!!!

I will definitely be looking for a vitamin D supplement for him to take, but I certainly will not be too worried about the amount of cows milk he is getting as my milk is as good as, if not better for him than any homogenised, pasteurised, fortified cows milk.  A good varied diet for mother and baby and my milk on demand should be just fine!

So have you had any negative experiences about extended breast feeding.  Have you ever started to doubt the quality of your supply?  Please let me know and leave your comments below.

Express Delivery. The Gift Of Donated Breast Milk

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When I first started to plan this blog, I wanted to share information about breast feeding and breast milk.

As I battled through my own breastfeeding journey (read more here),  I came across such interesting information on websites and in books and I wanted to share what I was discovering.

The statistics shocked me…The facts about formula angered me…More than anything I became incredibly passionate about the topic.  I was certain that if other mums were aware of some of the theory, for example the virgin gut, they might look at formula in a different light.  I imagined if people knew how common and painful some normal breastfeeding problems could be, then they might persevere longer knowing that they were not alone.

I also wanted to spread the word about milk banking and milk donation.

Basically…I wanted to change the world!

By the time I put pen to paper for my first post, I was well into my baby led weaning journey, friends were asking for my recipes and ideas, and so the outline of my blog started to change.

Anyway, just the other day I had a need to express some milk while I was away from the baby for a rare solo day trip.  Although I don’t think he is taking as much of my milk as I try and thrust at him, I wanted to leave a good 5oz bottle with grandma just in case he was desperate.

I dusted off the Medela pump and started it up.  It took me four separate sessions to collect a paltry 4 ounces of milk.  I guess at nearly 11 months old, the little guy isn’t taking from me what he used to, mums’ milk production is going down!!

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Milk donation.

It has been a few months since we last donated milk to Kings College Hospital milk bank, and after my recent session with the breast pump, I don’t think we will be donating again any time soon.

But let me tell you a little bit about how donating breast milk can help…

Just 1oz (30ml) of breast milk will feed  a tiny premature baby for a day and a half.  We all know the benefits of breast milk, but it is especially helpful when the gut is underdeveloped as it is in a pre-term baby,  the special balance of proteins are much easier to break down and absorb the nutrients from.  It also actively helps fight off infections, giving those little babies all the help they can use.

So it is extra distressing for a mother, at a time when her milk is most important to her baby, that a she may be struggling to produce it, or maybe struggling to express it with the pressure of the situation.

That is where we we can help, us lactating mums.

Eewww gross…

People feel squeamish about sharing milk.

I would happily nurse a baby for a family member or a friend, I am that passionate about breast milk.  But milk donation is a whole lot more civilised for those who may be worried!

Donors are screened, milk is tested and is flash pasteurised, briefly heated to destroy any lurking nasties.

The unit that I donated to at Kings College Hospital had a milk room overflowing with about to expire formula…mothers on the unit were so committed to breast milk that not one of them turned down the offer of donor milk.

I think that’s great!

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How to donate?

There are many ways to donate, but here in the UK a great place to start is the UKAMB website.  It is full of information on how to donate and how the milk is used.  Follow the link here to a list of locations of milk banks.

I simply contacted a few of the hospitals closest to me and waited to hear back from them.  Kings College Hospital were brilliant.  They have a courier service (man on bike with freezer box) who, with a couple of days notice would deliver sterile bottles to me and collect my frozen milk.

The only time I had to make the trip to the hospital was for the coffee morning, hardly a chore, tea cake and meeting the fantastic team, Jude and Hayley, who showed us around the unit and explained exactly how every drop of our milk counts.

Please please please, consider donating your milk the next time you are in a milky situation

It really could help give a tiny baby the best start in life.

The Virgin Gut. How Important Is Gut Flora In Babies

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Something that makes me a little uneasy is seeing a four month old being spoon fed baby rice.

Why?

How much do you know about the virgin gut?

I didn’t know about the virgin gut until many months into motherhood. I haven’t been a mum for that long, I pretty much learn on the go, in fact I was still totally clueless about parenthood until I had the guy in my arms. Like a lot of things that I am passionate about today, my knowledge of the virgin gut grew from a seed of information which I became totally obsessive over.

I have been desperate to share my understanding of it ever since, but I have been too chicken to spout to all but one close friend. So now I am ready to dazzle my captive audience…because if you have got this far, I know you are interested.

What is it about?

The virgin gut is all about gut flora, immature, open guts and and what can pass into the blood stream from that gut. And before you reach for that bowl of baby rice (see more reasons here), or that bottle of formula, just small quantities of anything other than breast milk can quickly upset the gut flora of baby’s tiny digestive system, before it has had a chance to fully mature.

The consequences of introducing foreign substances can have lifelong effects, asthma, eczema and allergies…which is why the WHO recommends six months exclusive breast milk…here is the reasoning…

A theory.

At the heart of the theory is the gastrointestinal tract – the digestive system – the alimentary canal – or simply, as I will refer to it – the gut – from food in, to food out and most importantly for this article the stomach and intestines.

An adult gut contains thousands of species of bacteria, how they get there is a process that starts on that journey out into the world. (There is current research that suggests the process of colonizing the gut with bacteria starts in the womb, with the swallowing of the amniotic fluid, but lets assume as is more widely accepted that the process of colonizing the gut starts as the baby is being born.)

sleeping babyDuring a natural birth, through labour and delivery, baby starts swallowing all those bacteria hanging around the birth canal and rectum. The bacteria travel through the stomach and the small and large intestines and multiply over the first few weeks of life to establish a pretty diverse microbiota (a community of micro-organisms, bacteria, viruses, and fungi that normally live in or on a given organ in the body.)

Interestingly, the type of bacteria of the gut of an emergency c-section baby is different to a vaginally born baby, and a planned c-section baby has a different gut flora altogether, this is due to different environmental factors being introduced to the baby, and less chance of swallowing mums personal bacterias!

Why is this gut flora so important?

The colonization of the gut flora at the beginning of life is massively important because it impacts the development of the immune system and has a major role in immune system functioning. It has been suggested that 80-85% of the immune system is in the gut. So from birth, right from the outset, the gut is building to protect from autoimmune and metabolic diseases.

What is happening inside baby?

Back to baby…In newborns the gut is not fully matured, it is referred to as an open gut, full of tiny holes or spaces through which things can pass into the blood stream.
From breast milk it will be antibodies, friendly bacteria, vitamins, minerals, hormones, enzymes, growth factors and many other special substances that will pass through. From formula and other foods, allergy triggering milk proteins, less desirable bacteria and other nasties will pass through.

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Breast milk.

So lets take a newborns gut and colonize it with mothers helpful bacteria. Then fill it with the good stuff, exclusive breast milk, and throw in a few helpful bacteria picked up from mums boob as well…it is only this combination of milk and breasts which can results in the development of biofilms. Biofilms are groups of micro-organisms which in the gut, create a protective lining against harmful pathogens. This is how breast milk reduces incidences of diarrhoea, influenza and respiratory infections during infancy, and begins to protect against the development of allergies, type 1 diabetes and other illnesses, because the beneficial bacteria are present and correct and doing their job!

baby bottleFormula milk.

Now…introduce anything else to your little ones gut before it has had a chance to mature and the resulting effect strips the gut of all of its original flora, the gut opens up, the tiny microscopic spaces are left wide open. Even adding probiotics (live bacteria) and prebiotics (oligosaccharides) to make the microbiota of formula milk similar to that of breast milk is futile because milk proteins strip away the biofilms lining the gut, and leave it literally wide open.

It is these milk proteins, themselves allergens, which pass into the blood stream and stimulate or trigger protective processe. The immune system sees the proteins as the enemy and tries to fight it off. For the unluckiest of babies it can lead to a life blighted with sensitivities, asthma, eczema, and many different food allergies.

I am a breast feeding mum, I am not against your personal choice to formula feed or combine feed, but personally I would do my utmost to avoid my feeding my baby a drop of artificial milk. In rare cases, I understand that there can be complications with mum and formula may become a necessity.

However, I do believe that if more people understood exactly what formula is doing inside that tiny gut, then society may become less convinced that formula is a fantastic alternative and more people may battle through the frequent feeding, night waking, pain, and hungry demands of baby really make breast feeding work.

References:

WHO | Exclusive breastfeeding. 2013. WHO | Exclusive breastfeeding. [ONLINE] Available at: http://www.who.int/nutrition/topics/exclusive_breastfeeding/en/. [Accessed 31 March 2013].

Maternal Factors Pre- and During Delivery Contribute to Gut Microbiota Shaping in Newborns. 2013. [ONLINE] Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3417649/. [Accessed 31 March 2013].

Breast Milk Promotes a Different Gut Flora Growth Than Infant Formulas – DukeHealth.org. [ONLINE] Available at: http://www.dukehealth.org/health_library/news/breast-milk-promotes-a-different-gut-flora-growth-than-infant-formulas. [Accessed 31 March 2013].

Intestinal microflora in early infancy: composition and development. 2013. . [ONLINE] Available at: http://www.medicinabiointegrata.com/doc/probiotici/Microflora%20intestinale%20nel%20bambino.pdf. [Accessed 31 March 2013].