The other weekend in my pediatric clinical (which is at an excellent children's hospital) I took care of a poor little 5 month old with RSV bronchiolitis. It's the common cold virus, but an infant's upper respiratory tract is so relatively close to their bronchial tree, which means what would be the common cold for you or I might travel down to their lungs very quickly. This poor girl was completely clogged from nostrils to lungs with the thick, tenacious mucus characteristic of RSV. I spent all of Sunday suctioning her and sitting her upright with her mom, but it helped keep her out of the PICU which is where the respiratory therapist and nurse thought she might be headed. One of our lecturers said that RSV infections before one year of age is correlated with a much greater incidence of asthma. She thought it has to do with oversensitizing the respiratory immune system.
I can't help feeling like breastfeeding would've prevented this. She was formula-fed. I mean, I don't know what the mom's situation is, so I didn't really say anything to her. Maybe I should've. But think about it: we are all exposed to RSV. I think I can safely assume the mom is actively immune to many forms of the common cold virus. And the antibodies which are produced in breastmilk——immunoglobulin type A—are chiefly antibodies of the mucus membranes, including the respiratory tract. (They also heavily protect the gut from unpleasant visitors like E. coli and rotovirus.)
So why would we not recommend the mother begin breastfeeding? Why aren't there breastmilk donor banks to help treat these children? Except there are, but I don't know if they're equipped for treating every RSV and gastroenteritis case that comes along. Why doesn't the government offer financial incentives for breastmilk donation?
Another of my instructors told us about the time her entire family came down with salmonella diarrhea—except her infant who she was breastfeeding. Apparently while she battled salmonellosis herself she had developed enough antibodies not only to fight her own enteric infection but to protect her infant. She said the day after she stopped breastfeeding, her infant spiked a 103 temp and began diarrhea. I don't know why she didn't resume—instead she went to Pedialyte mixed with formula—but the lesson seems clear.
I have a four month old. I was afraid of bringing RSV home to her after taking care of this poor infant. RSV is extremely communicable—it transmits easily from hand to mucus membranes, and can live for days on dry surfaces. I scrubbed my hands & arms within an inch of their life and used alcohol foam. Even thought about using chlorhexidine wipes like they use presurgically! But on the other hand, she is breastfed. I wouldn't play games with that, but I don't think it was as great a risk as I felt it was at the time.
Oh, I heart you. LOL Finding not just a hospital nurse, not just a man, but also a father who understands the value of vaginal ( hopefully natural, too ) birth, and breastfeeding ...
ReplyDelete:sigh: I only wish more WOMEN understood what they are doing to themselves and their babies. Maybe then more men would follow as well.
I'm all about breastfeeding. They call me the breastmilk nazi at work. Unfortunately strict breastfeeding will not keep ALL infants from being hospitalized from RSV. I'd say about 5-10% of the kiddos I see are strictly breastfed.
ReplyDeleteYou know what though, in my 5 years of Pediatric nursing, I have not once ever seen a strictly breastfed baby hospitalized for rotavirus. Not saying breastfed babies don't get it, but they never became so sick that mommas couldn't keep them hydrated and get them all better at home.
My first daughter didn't get sick until we stopped breastfeeding at 5 months (I got stuck with a dirty needle and stopped because I flipped out. Hindsight I probably could have continued, hindsight is always 20/20). After we stopped, she got sick every 2-3 weeks with whatever I brought home until about 2 1/2 years, I figure she's immune to it all now.
My second daughter got RSV at 3 months, rotavirus at 5 months and numerous other sickies despite strict breastfeeding until she was 17 months.
All in all though continue with telling mommas to keep it up with the breastmilk. Just yesterday I was working with one mom with a baby who we think has Hirshsprung's and I was really, really trying to convince her to keep it up and I was not getting though. A female pediatrician said the same thing as me. And then a male pediatrician said the same thing (who's wife had breastfed all 4 of her babies) and she listened to him. I think women feel they're being judged by other women rather than being supported when talking about breastfeeding and then when a guy says it sometimes it just clicks.
I strongly feel that breastfeeding is vital for the long term health of the child AND THE MOTHER. I can't remember the statistic right off the top of my head, but a shocking percent of women who do not breastfeed their children get breast cancer, and it was something to the effect of "36 consecutive breastfeeding made it 85% less likely to get breast cancer". So three years is what the boob is primed to do, and there is evidence that the long bone development is optemized by the consumption of breastmilk, and the growth of said bones happens between 2 and 3 years of age...yet another sign that we should be feeding our children breastmilk until they self ween, allowing nature to provide the perfect mix.
ReplyDeleteDid you know that there is two way communication between the baby and the milk factory? The infant's chemical signals will inform the boob of exactly what it need right then, at that very moment. So even banking milk is not optimal, though a much better option for every baby than formula.
I wrote a post about the subject (http://www.cafemom.com/journals/read/1388685/Why_I_am_passionate_about_breastfeeding?next=1#comments). It was actually one of my fellow moms who led me to your blog, MND, and I am really enjoying it so far. Keep up the good work.
I'm in agreement that breastfeeding is vital and should be continued as long as baby is willing, maybe even beyond. :) But I know that 2 of my 4 children got RSV while being breastfed exclusively. I have very weak lungs, could it be that some babies are genetically predisposed to lung illnesses? Just a thought. BTW, love your blog, I'll keep reading.
ReplyDeleteI breastfed my son for two years and breastfeeding my daughter from last one year, i don't think I will stop till she is 2.
ReplyDeleteNicole
While I'm sure you know this, perhaps it bears repeating that some women, however desperately they want to breastfeed, are physically incapable. It is a small percentage, but to that small number it is devastating to be scolded, chastised and have their feelings of inadequacy confirmed and reinforced. On another note, thank goodness for milk banks!
ReplyDeleteI'm a mom of a little girl who is 7 months old and now is in need of heart surgery. I breastfed her for the first month of her life, but then I was diagnosed with Grave's disease and am on Methimazole and cannot breastfeed her because of my meds. You need to take that into consideration before you judge mothers who cant or wont breastfeed. I wish I could!
ReplyDeleteAnonymous - there's no problem with not breastfeeding because you need to take a medication that shouldn't be passed on to your infant. I don't understand why you would think I would judge against that!
ReplyDeleteIn other words, breastmilk is medically best for your baby, unless it's medically contra-indicated.
The vast majority of parents using formula in this country are not doing so for medically necessary reasons, so I don't think anything I say here applies to them.
When my middle child was 5mo old, I was offered the H1N1 vaccine for her. They were willing to bypass the usual 6mo requirement because of the severity of the illness. I refused it. I have a mild egg allergy and didn't want to find out whether she had one or not.
ReplyDeleteThen I contracted H1N1.
I breastfed her through the entire time, even when I had a fever of 103F. (Note: Breastfeeding in a fever hurts!) I breastfed her exclusively. I recovered through rest and lowering my fever whenever it got a little harder to breathe.
She never showed a single symptom.
Hope she's feeling better now. If there are really breast milk bank out there, those whom donate would have to go through serious medical checkup before even allow to donate. Also how fresh would that be? And it's hard to find a lactating mother without a child needing it rite..
ReplyDelete