"I Get Letters"
Below is a small portion of questions sent to Dr. Linda Palmer over the years, along with her replies. Dr. Palmer occasionally answers short questions via e-mail but her time for these is limited and she finds that most challenges require more attention. Dr. Palmer provides Telephone Consultations for breastfeeding, maternal and infant nutrition, attachment parenting, and child health challenges such as reflux, colic, weight faltering, allergies, and more.
For More Answers: Check-Out Dr. Palmer's Book:
The BABY BOND
The New Science Beahind
What's Really Important When
Caring for Your Baby
Also Visit Dr. Palmer on Mothering's Expert's Panel
SMOKING & SIDS:
HELP WITH SORE NIPPLES!!
QUESTION : Please
help me with my wife's health and challenges as she is breastfeeding.
Owen, our first child, breastfed for 14 months, but Mom and baby had challenges with thrush (my wife had high levels of yeast in her bloodstream) treated intially with Lansinot (for the nipples), Gentian Violet (which caused ulcerations in Owen's mouth), Yeast-free diet, Nystatin, Canestin, and ultimately an oral antifungal Fluconazol which stopped the yeast and allowed continuation of breast feeding (we were near the end anyways). However, Shauna's nipples became damaged (cut, bleeding, extremely painful) from the yeast and physical damage from the feeding. We had several midwives check her latch and technique from the beginning and all said it was 'perfect'.
With our second baby, Shauna is already experiencing painful feeding, tender, sensitive nipples. It is so painful that she needs an Advil (the midwife has told us that none should get into the breastmilk, is that true?) to help her cope with the pain. It is creating severe distress and depression and at times she wants to discontinue breastfeeding because she cannot imagine this pain for another year continually, not to mention the lack of sleep. We need some help, preferably in a natural way. I hope you can help.
REPLY: The first thing to do is to make sure there's no vaginal or colon yeast overgrowth going on. If she's getting a little diaper rash (mom) herself, then it's in the colon. Over-the-counter yeast treatment cream is great stuff, as is inserting acidophilus/bifidus capsules rectally. Treating mom with the oral anitfungal medication wasn't such a bad idea, once it got that bad, but often one will then develop a secondary bacterial infection, (which happens very quickly either way, and is very likely in your wife's situation), and one may need antibiotics with the antifungal meds at the same time. This is major stuff, so let's hope it doesn't get that bad this time, but certainly these options are preferrable to quitting breastfeeding.
Number two is that the gentian violet or alcohol often recommended are very drying and for some may cause tiny fissures in the skin that create safe haven for infection to linger. Gentian violoet does kill yeast and many swear by the 1% solution (don't use the stronger 2%). Don't use soap on the nipples. While you want the nipples "dry," you don't want them "dried out." This causes microscopic fissures in the skin and the bugs make themselves a happy home in there. Moisturize with anything that seems right, after each nursing. Try applying Tea Tree Oil to the nipples regularly as it may help reduce and prevent yeast and bacterial infection, while preserving some normal flora to keep normal defenses up. If this is used in small amounts and has had plenty of time to soak in, it's OK for baby to nurse. If the application has been recent when baby wants to nurse, try to rinse the nipples first. Aloe vera and vitamin E oil may help speed nipple healing and are not a concern for baby's exposure.
If there's any white anything in baby's mouth, or any yeasty-looking bottom, baby needs to be treated too or mom will never recover. The first route is acidophilus/bifidus (powder or liquid into mouth several times/day). Next may be the Nystatin, or whatever is needed. Again, Gentian violet can be tried but may be too harsh or it may just need to be diluted. Tiny amounts of Tea Tree Oil can be tried, painting it over yeasty areas of mouth. This is used orally in some natural toothpastes and other cavity care routines but there are concerns about consuming very much of it. I'd use a little as a paint occasionally, and no more.
I suppose it's pretty cold up there in Canada this time of year. UV light kills yeast and bacteria and some find a lot of help from sunlight on the nipples, but this may not be the easiest for you —— and the UV dosage is very low in the winter. You can buy a UV light bulb and use UV treatment (very carefully, short exposure times, read a little about it) on the breasts, in baby's mouth a bit (cover eyes!), and on any bottoms in need.
A cotton bra is best, or no bra, (some can't stand the shirt rubbing or need the support for the enlarged breasts). Wash bras in hottest water and use hot dryer (it makes them not last very long, but helps to kill the bugs). When nipples are way too sore to nurse, find a rubber nipple shield at one of the old-fashioned-type of pharmacies. Baby will give mom weird looks, but finally get hungry enough & both will survive it well. Don't just cut back on nursing, or there'll be mastitis before you know it. Some mothers find they prefer to express milk and bottle feed some, when really sore. You might need to cut-back on the comfort nursing (non-nutritive sucking), even though it's valuable nurturing for the child. You need to replace it with a finger (adult's or baby's) or pacifier. It may save the nipples so he can nurse when he needs to. The nighttime comfort nursing can especially be a problem. If baby sleeps next to mom and keeps the nipple for hours... saliva doesn't flow in sleep and the bugs grow faster. The mouth keeps the nipple at the perfect temperature for growth too.
Oh, the thing that works best for some is Neosporin on the nipples after every nursing. It's an over-the-counter antibiotic cream, but it has antifungal stuff in it too, and the bacteria become part of the picture very quickly. You need to understand that yeast settle into the membranes and alter the nature of the tissues to their own liking, making it a more favorable environment for themselves to live extended lives in. They can stay there at a subclinical stage for a long time, waiting for a chance to go forth and multiply.
OH yes, the Advil. If she needs it, she needs it, but beware it reduces her immune system. Very little gets into the milk, supposedly. She could also try buying the numbing baby teething gel and applying that to her nipples for some relief. Best of luck to your family.
WHY IS FORMULA-FED DEATH RATE SO MUCH HIGHER?
QUESTION: Dr. Palmer, You say that 3 extra babies per thousand die when bottlefed versus breastfed — double the rate of breastfed babies in the U.S. What do they die of, specifically, that is a direct result of not
REPLY: Babies are born with very minimal, immature immune systems. They receive some IgG antibodies during labor (if labor is allowed), but these are also minimal in protection when compared to the many, many kinds of protection provided by breastmilk.
Breastmilk IS their immune system. Deaths from infectious diarrhea, necrotizing enterocolotis (an intestinal inflammatory disorder), respiratory illnesses, and all infectious illnesses are multi-fold when babies receive formula from birth or very early on. Deaths from drugs used to treat such illnesses occur as well. Even babies with many various congenital problems fair much better on natural feeding. Cancer and diabetes are also much higher in the formula-fed, although those deaths are later.
Babies also have immature digestive and absorptive systems. Failure to thrive is higher in formula-fed infants, resulting from major intolerance of bovine proteins and sometimes corn or soy proteins, and sometimes just poor ability to absorb the more difficult-to-handle nutrients available. Non-infectious diarrhea from intolerance to formulas causes many deaths. Necrotizing enterocolitis is a serious intestinal disorder found almost entirely only in formula-fed babies and is a significant cause of infant deaths.
If a baby cannot receive mother's milk for some reason, donor breastmilk is the next best choice. If having to supplement with any formula, acidophilus and bifidus powder supplements and possibly bovine colostrum can help the intestinal flora a little, providing a bit of added protection. Bottle-fed babies should still be "nursed" — that is held tightly and lovingly in a caretaker's warm arms. Skin-to-skin contact is a big plus, hormonally and neurologically.
There are many factors that more-often go along with breastfeeding that are also known to increase survival, such as sleeping right next to mom's bed or body, more nearness to mother in general, no smoking in the home, fewer drugs for baby, and a higher education level of mother. Certainly some of these account for the wide disparity in survival rates between breastfed and formula-fed babies in this country, although even when studies take "socio-economic" and many other factors into account, breastfeeding still comes out way ahead.
LET HER NURSE ALL NIGHT? OR BEGIN NIGHT-WEANING?
QUESTION: My daughter is 16 months and she loves to night nurse. Should I continue to let her nurse all night or try to start the weaning process?
REPLY: There's surely no need for baby's sake to stop or reduce the night nursing, unless she's getting cavities or your family is very cavity-prone. If this is the case, then you may want to limit it some, or just pay more vigilance during the night. To prevent milk from pooling around the teeth during sleep, allowing for decay, try to see that she's swallowed all the milk in her mouth before falling back to sleep ― either by just stirring her a little, or giving her a little sip of water to rinse out the milk.
Many moms sleep wonderfully with night-nursers as the hormones released from nursing are meant to send mom and baby back to sleep, but it doesn't work this way for everyone. Lots of moms start thinking about night-weaning because mom is losing more sleep than she wants. This is a different matter. Some succeed, some give-up and decide to wait it out another year... It all depends on whose needs seem to be greater. Just remember, night nursing is so natural and valuable for baby, and you are going to be missing these precious times before you know it.
BABIES SHARING HOSPITAL BEDS DIE TOO OFTEN
QUESTION: I received a lengthy letter about what seemed to the writer to be a large number of babies dying in the hosptial when sleeping in bed with a parent. Of course, there was no comparison here to the number dying while sleeping elsewhere but I still wish to repeat my response:
REPLY: Yes it's true. Hospital beds are not designed to be safe for infant co-sleeping. That doesn't mean don't do it, but it's risky. A co-sleeper attachment could be provided (or brought in?) if the hospital cared to provide the benefits of safe cosleeping, where some babies are especially stressed by the sudden abandonment after birth (and others are too sleepy to notice for a week or so).
The numbers on SAFE co-sleeping show that there is still a slightly greater risk for baby in bed (at home) with parents in the first two weeks or so after birth or for tiny preemies, compared to sleeping next to the parental bed. This statistical risk is certainly much smaller than other risks seldom opposed, like feeding/supplementing with formula at that age or giving antibiotics that are not entirely necessary.
The hospital letter also mentioned dads cosleeping in the hospital. A dad needs to learn to cosleep safely whereas a mom has been doing it for months already (aware every time she moves her big body in bed) and her maternal hormones are tuned in for such awareness. The risk numbers are a little higher in some studies for early cosleeping with dads.
A mother or baby that have been exposed to drugs during labor are at much greater risk for an accident. Some report that babies exposed to pain meds during labor or other taxing interventions can be overly sleepy for a week or more. These babies would not have their normal instinctual responses to covering of the face or decreased oxygen. (Hold a pillow over your baby's face and see what she does.) No one has looked to see but I suspect this to be a partial link to the statistical risk of cosleeping in the first couple of weeks.
Does anyone ever mention the studies that show that a baby sleeping in a crib in another room of the house, rather than next to parental bed, has 5 to 10 times the risk of SIDS??? That's HUGE!! And you've likely never heard it.
For further information, I have several articles on cosleeping: ARTICLES
WHEN TO START MULTI-VITAMINS FOR BABY
QUESTION: When should a child start taking multi-vitamins?
My daughter is 15 months old and she eats whole foods and breastfeeds.
I was thinking after she is no longer nursing but I'm not sure.
Any recommendations on a good brand of childrens vitamins?
REPLY: It sounds as though your daughter has an excellent diet. There should be no need for vitamins, but I eat pretty healthy and I take them too. I figure it can't hurt ― it fills in around the edges for all the nutrients our foods have lost, our soil has lost, that are taxed out of our system from stress and pollution and such, and for the white flour and sugar we inevitably consume. I guess maybe when she's down to less than half of her calories from breastmilk? Or when she starts eating white flour and sugar? Most of the multi vitamins are pretty sufficient. Don't megadose any particular vitamin. The healthfood stores have some nice liquid and chewable options for little ones. As for minerals, don't get one with much calcium unless it also has magnesium. If your child is getting dark greens, and maybe some beans, along with your milk, she's getting good calcium already. Don't go high on zinc, and only go for a very small amount of iron, (or no iron), unless anemia is suspected or diagnosed or the child is drinking much cow's milk. As for parental concerns about the sugar in many children's vitamins, it's such a tiny amount of sugar compared to juice or so many other things ― don't even start to worry about it. Just make sure it isn't left sitting on her teeth.
IS THAT WHY SOME SAY FIRST FOODS SHOULD BE MEAT?
QUESTION: You talk about delaying solid foods. Is that because they recommend you start your baby on rice cereal and other carbohydrates? I'm not sure about when to start my baby on solids so I started researching and I read an article on the Weston A. Price Foundation. It says that babies' first foods should be animal foods as their immature digestive system is better able to supply enzymes for the digestion of fats and proteins rather than carbohydrates. So I wonder if starting on animal foods would help keep their iron levels up so it won't be such a high risk time, and especially if they are better able to digest it, rather than carbohydrates. And if so, when would be an ideal time to start doing that? Leslie
REPLY: Yes, as I discuss in the article, BEYOND BREASTMILK, the first iron-containing foods of any kind not only bind with mom's lactoferrin, rendering her iron mostly unavailable, but they feed the iron-hungry, (more disease-causing) bacteria in the intestines and are thus used up in feeding these. Hence, there's little iron left available for baby until the gut is fully recolonized and the diet provides adequate iron beyond mom's milk, which little bits of first foods like applesauce or (unfortified) rice cereal will not do.
You mention "animal foods" as first foods but this would include animal milks like cow's milk and these cause anemia, not prevent it. They're highly allergenic and lacking in so many vitamins and minerals and their extreme calcium levels interrupt absorption of other important minerals in the diet, so let's just say meat, fish and poultry.
The carbohydrate information you mention is a little off as well. Sugars are simple carbohydrates and babies don't usually have problems digesting these. I don't think complex carbs are such a challenge either. I believe it's more the gluten in grains that poses the major challenge. Rice doesn't have much gluten but it's just nutritionally empty, outside of calories that replace more nutritious options.
Formula is, essentially, a solid food as a formula-fed or formula supplemented baby has already lost this protective environment provided only by exclusive breastmilk. Formula-fed babies often do very well with introduction of other solid foods around 4 to 6 months as it gives them a break from the difficult to digest proteins and difficult to aborb nutrients of artificial feeds.
While I DO think it's natural to have a wide variation in timing for natural infant introduction to solids, (the initial weaning process), and final weaning, I don't think it's naturally common for first foods to begin so early as 6 months in most babies. I have another article on archeological findings that suggest our Natural Weaning Ages. They often find that little solid food is fed before the ages of one or two years. I also have to imagine that the first food-like thing in baby's mouth was likely a bone to teeth upon (given the lack of plastic teething rings in past millennia), with little bits of meat attached. Meat is a, excellent first food. It's not allergenic at all. I think that all the allergies in the first year should be a really big clue about solid food introductions right there. Meat is very simple for a baby to digest and is so full of iron and zinc, the first nutrient challenges for solid-food-eaters. Of course, mom would prechew meat for a younger babe though babies who need their food pre-chewed (or electrically ground and filtered) aren't really designed to be eating, are they?
When is an ideal time?? Baby knows. The ideal time is when baby begins grabbing and eating food for herself ― and not to be confused with teething and exploration. I don't think there's any reason to push or encourage solid foods at all in most babies, though milk supply problems and other challenges do give good reason for some. On the other hand, feeding a baby is so much fun ― people love it so. It apparently isn't harming our babies much, outside of initial anemia attached with solid food introduction in some, allergic responses in some, choking in some, and bringing on earlier than may be optimal that big immune challenge that breaking of exclusive breastmilk causes. Starting solids should begin at a time when baby's health is good and stable ― prepared to meet the immune challenge and likely illnesses it brings.
I support those who choose vegetarian and vegan diets but one must remember that natural mother's milk is an animal food and babies are designed to depend upon such food for their first two years; at the very least. Iron and zinc fortified cereals are available for first foods for vegan babies but one still must remember to see to B12, taurine, DHA, choline and other vegetarian and vegan challenges.
HOW COULD SMOKE COMING OUT OF LUNGS (AFTER THE CIGARETTE IS GONE) AFFECT BABY?
QUESTION: Dr. Palmer, In a piece on your website about co-sleeping, it says:
"Parental smoking, whether in the bedroom or not, (toxins come out of the lungs through the night), is a high SIDS risk factor for co-sleeping."
I (the mother) don't smoke, but my husband does. He was committed to quitting when our daughter was born but now a year later is back up to several cigarettes a day. He cares about our daughter's health, and believes that by not smoking indoors or in her presence, there is no harm potentially done to her. Mostly I sleep with just the baby and he sleeps in the guest room, but occasionally he sleeps with her, and he definitely sometimes holds/plays with her immediately after a cigarette.
I am concerned about the effect of toxins on his clothes, in his lungs after the cigarette, or on his hands. Could you point me to any research about toxins released from the lungs after smoking? Wendy
REPLY: Dear Wendy, This is an important question ― one that needs further research and investigation. I can't give you a clear-cut answer. I can tell you what seems to be known at this time. It is known that there is a higher rate of birth defects in children of smoking fathers ― even when the father is not living with the expectant mother (but less-so than when he is). I know you're beyond this point now.
It is known that SIDS is higher in children of a smoking parent. Some studies report the SIDS to be much higher when the child sleeps in the same room as the smoking parent, whether they smoke in that room or not. Other studies suggest that the SIDS is equally higher no matter where the child sleeps. Then there's a study that suggests that the higher SIDS in smoking households is a relic of the damage done to the fetus from conception with "smoked sperm" or during the exposure in the womb. It is impossible for me to believe that the pre-birth smoking is the only SIDS factor, as there are so many other studies about asthma and frequent illness being associated with smoking in the house ― even from a non-biological parent.
The study designs are not perfect in any of these and the truth probably lies somewhere in all of them ― that some damage could occur pre-conception ― some during gestation ― more infant deaths when living with a smoking parent and even more when sleeping with them. Of course we speak of infant deaths because it is an easy thing to measure, but there's much more in between simply dead or alive during infancy and in the child's future. I know that it is this kind of potential harm that you are concerned about.
I searched hard for research on just why being around a smoking person, even when they are not smoking, can cause the apparent harm that it does. I found little in the form of concrete studies. I extracted my assumption from two experiences. First, I knew that when I had a patient in my office who smoked, but never smoked in my office, my husband would smell the smoke on me when I came home hours later. Something was there and penetrated my hair and clothing, thus probably my lungs and blood.
The other experience I derived from was my husband's work in a clean-room in a semi-conductor processing facility over 20 years ago. They had a long and troubling challenge of determining where major particulate matter was coming from when all of the "clean" guidelines were being followed. They finally discovered it was coming from the lungs of one of the scientists. They were able to measure on their delicate instruments that this man polluted the air even several hours after having a cigarette, and even though his clothing was changed.
Tell the daddy that regardless of how large or small an impact his smoking may have on his daughter's health today (and I'm glad he behaves with great concern), and on her behaviors tomorrow, his own long-lived, healthy presence in her adult life can make a world of difference for her and her children.
WHAT ABOUT RAW COW'S MILK?
QUESTION: Dear Dr. Palmer, I recently
discovered an article you wrote about The
Dangers of Cow's Milk. I am a bit perplexed about some of your
claims regarding the dangers of cow's milk. I seriously doubt that
you ever did any research about babies fed raw cow's milk. There is
absolutely no comparison between raw and pasteurized. One is a live,
vital food. The other devitalized, undigestible crap. I was raised
on raw cow's milk and of
all the people I am aware of who drank it, no one ever reported getting
sick from dangerous microorganisms. Live foods are resistant to this
problem. The dairy industry corrupted the age old, time tested process
of delivering milk which resulted in contamination in processing.
result the FDA sentenced milk to death. In real (raw) milk, live
enzymes are present that aid in it's digestion. If you are aware of any
research into the dangers of raw milk, please let me know. As for
our 6 week old baby seems to really like it.
REPLY: Hi Chuck, Thank you so
much for writing. No, I had not heard anything positive about raw
milk prior my researching and writing my first edition of Baby Matters. (The article you read
was a pieced-together excerpt). I have since heard enough information
to open my mind and make me read what research I can find, which is very little. I imagine the raw has definite advantages. Still,
some of the difficulties from milk I imagine would remain. It's possible that the protein
would not be as problematic, as raw milk is suggested to contain possibly enzymes
that go along to assist in its digestion and absorption. Still, most
milk-protein-intolerants I know cannot tolerate raw milk either, and the studies suggest that raw milk is just as allergenic. Thus,
the inflammatory development potentials (links to bowel disease and
heart disease) would still hold some ground. Lactose is lactose, whether
raw or not, and grown mammals are simply not designed to consume this
baby sugar. I have more info about this in my book. Milk fat is turning
out to not be the villain it was once thought to be, and raw may be
better?? However, it is the fatty portion of the milk that contains
the hormones naturally found in all mammal milks ― and no grown mammal
is intended to be consuming hormones ― thus links to cancers and
early puberty still remain a valid topic. It is only conjecture right now but there's a possibility that the artificial homogenization of milk fats creates something as horrid as the artificial hydrogenation of vegetable oils has (trans fats) and this may be part of the link between milk and heart disease, although some studies implicate non-fat milk even more than whole.
I would consider most of the microorganisms found in raw milk to be an advantage to the immune system and there are no confirmed reports of illness from raw milk from organic farms (while there are definitely confirmed reports of illnesses from processed milks). However, raw milk consumption from standard dairy farms is a danger in that large dairy farms purposely keep their cows in a chronic stage of leukemia. The leukemia is definitely transmittable to humans. Pasteurization kills the virus. There are strong pockets of leukemia around large dairy-farm areas. Organic farms however need to keep their cow's healthy so they do not need all the drugs needed to keep leukemic cows and thus leukemia is not a factor in well-run organic farms. One of the most dangerous microorganisms found often in milk, Mycobacterium tuberculosis, is found in pasteurized milk as well. This bacterium can lead to Crohn's disease in the person whose intestinal defenses have been compromised (such as from milk-protein intolerance reactions, chronic antibiotic use, steroid usage, or severe intestinal infection).
Read my article: MilkingYourBones about the concerns over calcium and milk. Raw milk still has excessive amounts of calcium, phosphorous and protein and is very lacking in magnesium. I can't see how these links to poor bone growth would affect humans very differently with raw milk.
It is dangerous to provide unfortified cow's milk of any kind to young babies to any considerable percentage of their total intake because the balance of vitamins and minerals is extremely different from that of human babies' needs. There is plenty written about this. Raw or not, the incredibly high calcium level, binding with iron, selenium, and zinc, and making them unavailable, will not change. The excessive protein levels, compared to human needs, can lead to dangerous dehydration and kidney troubles, and leave baby deficient in important brain-feeding carbohydrates and fats. Read my letter about feeding raw goat's milk to baby on Mothering.com. It's near the bottom. This may give you some ideas about how you may want to proceed with providing raw milk to your baby.
Because you are clearly a parent who does read and evaluate information, you are already ahead of 95% of families and I know yours will be a healthy and happy one.
ASTHMA OR FORMULA INTOLERANCE?
QUESTION: Dear Doc, I just recently started feeding my 6m.o. formula. Since then I've noticed she's had the symptoms of a cold. Her pediatrician says its baby asthma, but I am wondering: Could she be not tolerating milk-based formula? How can I tell the difference??
Gail, It is actually rather common for a child to become ill when
first weaned. Their immune system takes time to adjust to the new more challenging intestinal flora (which affects even the respiratory tract) and just to convert from reliance
on mom's antibodies and infection fighters to their own. If her
symptoms continue (longer than a cold should), then yes, you may wish
to suspect the cow's milk proteins.
How can you tell the difference? A cold should typically cause some fatigue and some thick discharge (thick after the first day or two) from nose. Intolerance to her formula may alter her stools ― either being loose and a little watery and maybe a little green, or being somewhat constipated. A transition to non-breastmilk diet does cause a transition in the stools itself, to a browner, firmer, and more odiferous (smelly) stool, with some change in frequency. If you have any sense that she's experiencing abdominal pains, or if she's spitting-up (more than "normal" for her), do suspect the diet. Also, an allergy-ring around the anus, or the appearance of eczema anywhere are other food-intolerance clues. Usually a child with a cold sleeps rather soundly and a child with food intolerance reactions going on may be more sleepless, restless, and fussy.
Corn and soy are two other possible offenders in formulas, besides bovine (cow) proteins. A hydrolyzed formula would be less allergenic, although even this is not allergen-free enough for some (then we'd have more to discuss). Alimentum is one such formula, and the liquid version these days is also free of corn products (dextrose or corn syrup) that do appear in the powdered form. Don't be fooled by lactose-intolerance claims. Babies are designed to digest lactose. Temporary lactose-intolerance occurs as a result of milk protein intolerance reactions.
response to the question of "baby asthma" is: asthma comes
for a reason ― usually an allergic reason. If the symptoms began
with the introduction of formula, do suspect the formula.
I have a post of mine referring to asthma on Mothering.com that you may be interested in reading: www.mothering.com/experts. Good luck!!
WHAT FORMULA FOR AN ADOPTED BABY?
Hello, We are adopting a baby who will be 5 months when he is placed with us. I understand it is too late to breast feed him since he has been used to a bottle from birth. He is presently on baby formula Enfalac with Iron. Can you advise if this formula is good,and if not, can you recommend another baby formula for him (there is an Organic Soya Formula?). I would appreciate your recommendation.
Dear Patricia, My best wishes for your new family addition. What exciting news!! I have actually heard of older adoptees being nursed after being bottle-fed, but I think it would be a huge effort for possibly minimal return (although I would certainly push for breastmilk for a newborn). When it comes to the many immune/allergy/diabetes... reasons of breastmilk, those first 5 months are the most important. I've heard that the supplementers used for adoptive moms to try and breastfeed are sometimes more difficult and interruptive of the bonding process (another valuable reason to breastfeed) than helpful. If you have nursed a child before in your life, you might feel inclined to just give him a try to see if he develops any interest. My cousin nursed her daughter for 4 years without any milk production at all... just for the bonding, hormone releases, neurological development...
Anyway, that's all just food for thought, but your question was what for food? My favorite choice for a younger baby would be a hydrolyzed milk formula. Again though, the hydrolyzing is chiefly for dairy intolerance concerns ― that often are sublime enough to not be detected outwardly, but still irritating enough to possibly encourage diabetes or other such concerns ― and then these concerns are highest in the first 5 months.
I am not powerfully persuaded that soy formula is a danger and decades of soy-fed babies reveal no more complications than milk formula-fed babies. If you are seeing great fussiness (hard to determine the cause of course with the change in caretakers occurring, but there are clues), rashes, diarhhea, constipation... you may try a switch of formula to non-dairy or highly hydrolyzed to see if there is any improvement. I don't know why people become so attached to feeding just one formula (marketing I'm sure). Why not give some soy and some dairy to gain any benefits of either and reduce any negatives?
Our non-high-iron formulas in this country are almost the amount of iron in "high-iron" formulas in other countries. One paper I read where they did their darndest to decide what is the best level of iron, came up with a level that's half-way between our high-iron formulas here and our regular formulas. I always thought in my head I might just mix the two for the half-way level... There are reasons why one doesn't want high iron, such as constipation, and also competition for calcium, zinc, and selenium absorption ― all important concerns.
There are some organic milk-formulas available as well as the soy you mentioned. These may be better in ways. Fat is where we store most toxins and hormones and the milk fat is removed from standard milk for formula (and replaced by other, not-necessarily-better fats), so the organic difference may not be as great as in some foods.
Boy what a long way of saying ― if he seems to be doing very well on his Enfalac, you may as well go with it ― maybe reducing the iron some. I do believe strongly from what I've read that 18 months on formula is greatly superior to one year (before the switch to regular milk or soy drink or...) Also remember, YOU CAN "NURSE" A BOTTLE-FED BABY TOO, by holding him tightly in your warm arms, preferably with some skin-to-skin contact, rather than propping a bottle in his crib. By 5 months, baby is becoming low on some nutrients stored from birth and less accessible in formula. As soon as baby is ready, bringing in some dark veggies for the fiber, glyconutrient, anti-oxidant and mineral qualities would be a healthy move. Meat is another good first-food choice, helping with zinc and iron stores and other particular nutrients, even if you are planning a vegetarian diet for baby later on.
WHAT WHEN BREASTFEEDING IS NOT AN OPTION, COW FORMULA NOT TOLERATED, AND SOY NOT PREFERRED?
Dr. Palmer, It seems as though you are a great proponent of breastfeeding
which I also am. However, although I breastfed my first two children,
major breast surgery prevents me from breastfeeding my third. I am seeing
a holistic family practitioner who okayed the use of an organic soy
formula for my son (now 2 months old who suffered with vomiting and
diarrhea with commercial cow milk based formulas from week 2 through
6). He is doing fine on it, but I am concerned about the recent discoveries
of the negative effects of soy (estrogen), particularly with respect
to a male's fertility later in life.
My question is...what do you recommend when breastfeeding is not an option and soy is not a preferred feeding alternative? Ana
REPLY: Dear Ana, You sound like a very dedicated mom. The jury is out on the soy formula. While some information about it sounds rather frightening, babies have been surviving on it comparably to cow's milk formulas for many decades. Researchers are still following the issue to look for more subtle effects but if there were any major or moderate effects, they would have absolutely been discovered by now. Since there are plenty of people in their 50's now who were fed exclusively on soy formula from birth, a few more good studies should give us the answers we're looking for.
My current impression of the soy is that it seems to be no worse than cow's milk formula, which we already know leads to a doubled cancer risk over natural feeding.
Without further information, it looks most likely as though your son has intolerance of cow's milk proteins. You may try to see how your son does on hydrolyzed milk formulas (Nutramigen is one). There are no completely hydrolyzed formulas available in the U.S. though. "Most" of the reaction-causing milk proteins are broken down into pieces that should not cause reaction. A small percentage of larger protein pieces remain in these, and the most sensitive babies will still react to these. Most of these formulas still contain corn, which is another possible allergen. I know that organic versions of these are available in Europe, but I don't believe any have crossed the ocean yet. There are some concerns with hydrolyzed proteins also. Truly, I'd feel more comfortable feeding the soy formula if baby is doing well on it.
The older your son is, the more likely he is to handle the proteins in these, (Maybe stick with what you have for just a few more weeks and then try the change).
Elemental formula is completely hydrolyzed milk protein and there should be no possibility of reaction to that ― the problem with these is that, at least the last time I checked, it's at least very difficult to find one without corn ingredients. I won't even recommend a name, because the ingredients seem to change frequently. The taste of these is even more unfavorable than standard hydrolyzed formulas. I have seen a couple of babies who had to become very hungry (and unhappy) before they would swallow it. One mom sweetened it a bit, which helped a lot ― not a highly recommended move of course, but not terrible and it's better than not eating at all, or losing all of one's meal.
If baby were younger, I'd recommend you try to obtain donor breastmilk. I don't know why this valuable option isn't taken advantage of more often.
Giving your son a mixture of probiotic bacteria (acidophilus, bifidus and such), sold in liquid form, would make-up for a tiny bit of the lost immunity, and also helps those with food intolerance.
COSLEEPING 10 YEAR OLD IN DIVORCE
Dr. Palmer, I'm doing research for my sister who is having problems with
her ex-husband and the fact the she sleeps with her 10 year old son. Her
ex is going nuts, saying all kinds of things like she is ruining him,
holding him back, etc. He is a very emotional and sensitive boy. He does
cry easily, but I don't believe that it is from sleeping with his Mom.
Her ex has even gone as far as to seek help from a counselor, who basically
sided with her ex (who hired him). He suggested that she set a timer in
my nephew's room starting at 5 minutes, making him stay in there until
it goes off. Then he can join her in her bed, working up time increments
to 7 minutes, 10 , 14, 18 etc. up to the point that he will fall asleep
before the timer goes off. That sounds like a fine idea, however my nephew
is not ready to be alone in his room. The counselor brought up the fact
that my sister did not want a boy going through soon-to-be puberty (and
I quote) "doing what boys do at that age." I'm guessing that
by the time my nephew is ready to start self exploring, (and who says
he doesn't already), there are lots of other places to explore other than
the bedroom. Since their separation and subsequent divorce, my sis and
nephew have moved to and from quite a few houses and towns. They are settled
now, and live 1 block from our parents.
Can you suggest ANYTHING to help us? Thank You, Kathy
Dear Kathy, Your nephew is so lucky to have a means of getting his emotional needs met. While a child in a "normal" family reaps great benefits from having this special bonding time with his or her parents, a child from a torn family has even greater bonding needs. He has suffered so much separation from both parents, and uncertainty about his relations with them, and about his own security, that should be highly beneficial to have this dependable, steady, bonding opportunity with his mom. It is sad he cannot enjoy this when with his father as well. In our busy days, we often don't find all the time we should to hold and be there entirely for our children. Nighttime sharing is a time they can depend on and look forward to ― sort of a steady rock to cling to. When awaking during the night, in a distressed young life, it is especially valuable to have a parent close-by for re-assurance that they are not abandoned.
it is entirely normal all around the world and throughout the millennia
for a child to cosleep with his parent, parents, grandparent, siblings,
or cousins. Isn't it funny that "sleep experts" tell us we
need to "teach" our children how to sleep, and force independence
upon them, yet our nation has the greatest amount of sleep disorder and
insecure diagnoses of any nation in the world ― with one of the lowest
rates of cosleeping? All of the research of Ainsworth, Bowlby, and
Main, as well as much more current research, demonstrate that the most
securely attached child becomes the most independent, psychologically
healthy adult ― yet responsive to parental wishes ― a kind of dependence
that is desirable ― especially as the teen years set-in.
Becoming Attached by Robert Karen, PhD, is an excellent book about the importance and values of attachment. There are excellent books about cosleeping as well, The Family Bed being my favorite. While much of these speak of early childhood, the arguments do not fade, and are pertinent to cosleeping, at least until your nephew is well into his dating years. With any questions about the value of attachment ― or troubles believing the more the better ― one should definitely read Dr. Magid's High Risk, Children Without a Conscience. The teen years are so frightening and precarious these days. All of our insecurely attached children who were taught not to depend on their parents from babyhood on are then suddenly expected to trust and confide in their parents and follow their commands. The first people to treat them as real family, to show they really care about their feelings and are able to spend time with them, be there when needed, buddy with them or hold and caress them, be it their parents, a girlfriend, new peers, or a gang ― these are the people whose ideas they will follow during their teens.
What a funny argument: she's "holding him back." Holding him back from what?? From an opportunity to mull in his insecurity and abandonment? She is carrying him forward ― nursing some of his wounds, and filling him up with a good reserve of positive attachment that he can build upon in his adult life and turn to inside himself in times of trouble.
It is so common for a young man of a divorced couple to have many relationship and marital problems ― either regularly re-enacting his abandonment, or simply expecting to be abandoned. A strong sense that he is important enough for his mother to spend her time with him and truly be with him can help to prevent this.
The boy will likely not be doing any major exploring of himself at his mother's side ― the taboo of that in this society is not spoken, but is quite obvious to all children/teens. And, as you said, if he needs to do so (and he may have less-frequent need when gaining good emotional and physical security from a parent), he will not have any problem finding a place and a time. Between the boy and his mother, and no one else, they will know when the time is right for a change in sleeping arrangement, and the change does not have to be a 100% deal either.
Certainly it will not be difficult for the father to find many badly informed psychologists who will say that the child is being harmed by being loved so much ― many are stuck in their medieval Freudian teachings or simply never thought to read current research and re-evaluate the preachings of their own childhood; although many of them chose such a profession only as a means to heal from their own insecurely attached upbringings.
Jan Hunt ― found on "The Natural Child Project" website ― is a family counselor experienced in dealing with cases of older children. I also know of attorneys who deal with attachment issues ― it doesn't sound as though it's gotten this serious yet though.
I wish you luck in helping to protect your nephew from being torn one more time from what is solid for him.
50/50 VISITATION FOR 6 MONTH OLD?
I am a social work BSW student. I was recently asked my opinion on a matter that involves custody of a 6 month old baby girl. The mother and father just split up and he wants to still see the child a lot. He wants to split their time with the baby 50/50. His idea is every other day the baby would go between the mom's and dad's house. For example Monday with mom, Tuesday with dad, Wednesday with mom etc. My opinion was that was too much moving around for a baby. I emphasized the fact that she is forming attachments right now and to be bounced back and forth was not healthy. The mother is not willing to be away from her baby for days on end yet but the father still wants to see the baby really bad. I am not quite sure what the best plan would be for this family. I also feel that mom and baby need to develop a strong bond just in case dad decides to skip out some day. I told the mom I would look into attachment and I stumbled upon this site in the process. If you can help me help her by giving me your advice on the matter I would greatly appreciate it. Thank you so much for your time.
An available father
is a very valuable addition to a child's healthiest development and security,
however, this plan sounds awfully disturbing for a young developing child.
With each switch, she would be suffering from abandonment, not nearly
old enough yet to look forward and understand that she'll have mom or
dad back in another day. This kind of abandonment issue is thought to
create what attachment psychologists refer to as "ambivalent attachment,"
or, even more severely, (and more likely in this case), "disorganized
attachment." I give you these terms incase you wish to look these
topics up. According to the researchers, (Main, Ainsworth, and Bowlby
are the big names), these cause permanent, negative effects leading to
the ADHD child, antisocial teenager, and insecure adult with failing marriages
and chronic psychological disorders, chiefly depression. Males resort
often to violence, with females more-often resorting to becoming victims.
There is much written about the permanent neural receptor patterns and
cortisol release patterns that develop according to one's environment,
(whether it's one of security or one of abandonment), demonstrating from
a biochemical point of view the same outcomes that the psychology studies
suggest. I have much of this summarized in my attachment parenting book,
Baby Matters. Becoming Attached, by Robert Karen, is a great book on attachment,
and "High Risk, Children Without a Conscience," by Magid, is
a great one for demonstrating what kind of effects could develop from
such an upbringing as this custody plan suggests.
I assume the baby is not breastfeeding? Breastfeeding is one of nature's designs to insure that baby is never far from a consistent caretaker, while developing relationships with others. Father bottle-feeding baby will help to develop their relationship, but this doesn't change the biological needs for baby to know she can depend on the availability of one solid caretaker. Healthy hormonal and neurological development depend upon solid attachment behaviors. Baby's neurons and hormones work hard to see that it will happen, and become developmentally damaged when it doesn't.
A better alternative would be for father to have generous daytime visitations with outings with the baby that gradually increase in length ― within the baby's displayed comfort zone. He can try putting baby down to sleep at mom's home regularly, and coming over at baby's wake-up time, to help baby with the transition to having only dad around at times.
Before baby is ready
to be living with dad half the time, the only way dad can consider himself
a 50% parent is if he helps with the laundry, food preparation, shopping,
doctor visits, playdate and party planning, toy picking-up, etc. These
are all part of the picture. Otherwise, monetary assistance may help take
the place of these before the child is old enough to be transferring from
one home to another.
My best to the baby and let me know if I can help more. Regards, Linda Palmer, DC
MY 8 Y.O. DAUGHTER IS GROWING BREASTS
I have an 8 year old daughter that has started breast tissue growth and has started to get pubic hair. She was breast feed until 1 year of age. She is 60 lbs and 54 inches tall and does very well in school. What are the long and short term affects of starting puberty to soon? Yes, we have seen a doctor who has sent a to a specialist ... whom we can't see for a month. Sincerely, Vicki
Your daughter's "condition" is more and more common all the
time. One of the chief causes in today's children is being overweight
(fat makes estrogen and growth hormones) ― but your daughter sounds to
be just about "right," if that's a barefoot height, altho she
may be the tallest in the class??
The second biggest link is to dairy consumption (which is also often responsible for obesity when it's butter, cheese, and ice cream). All mammals' milks contain growth hormones and sex hormones, designed for the optimal growth of babies and youngsters. Cow's milk has incredible amounts of growth hormones, (no I'm not just talking about the stuff that's being added now), first, because a baby calf has to grow very large very quickly, and secondly because they've been bred to have optimal milk production (meaning more reproductive hormones), and fastest/greatest growth (more growth hormones) for market. Nature designs it's mammal babies to be weaned in early childhood and then never again return to drinking milk. Older children and adults are NOT supposed to be consuming hormones. The rates of reproductive organ cancers around the world parallel very strongly with the consumption levels of dairy products. That's my first recommendation ― cut the dairy. Worried about her bones?? Read my article: http://www.babyreference.com/MilkingYourBones.htm . Just as eating gobs of protein won't make your muscles any stronger, but exercise does, eating gobs of calcium doesn't make your bones any stronger, altho it does cause nutritional problems. Exercise makes bones stronger. The greatest portion of the hormones in dairy occur in the milk fat.
There's some concern as well about links to plasticizers, the hormones in meats, and the pesticides on our fruits and vegetables.
Regular, high levels of exercise help to slow/delay puberty. You may want to add to your daughter's physical activities on a regular basis.
The concerns about early puberty? One concern is that the earlier a girl begins her menses, the (much) greater her statistical risk for reproductive organ cancers, including "early" uterine, ovarian, or breast cancer, (early means like in the 50's or even late 40's). She will also statistically have a greater risk of heart disease. Another problem is the mental development of sexual interests and urges before she is really mentally and chronologically mature enough to handle such things. Of course, there's the early interest in her body from others as well...
The good news is that you still have time to slow things down. If you alter her diet and increase her exercise and things still just go on, then at least you'll know that you've done all that you could, including having breastfed her for a year. You will then want to take extra efforts to monitor her social development, interactions, and moods throughout her teenage years and teach her about anti-cancer diets high in dark colored fruits and vegetables (and again low in dairy). Protect her heart by restricting trans/hydrogenated fats and adding omega-3 fats (as in fish and walnuts) to her diet.
See my article on Early Puberty
WHAT ABOUT SOY MILK FOR TODDLERS?
Hi, Ive been reading back and don't recall anything negative about using organic soy milk for toddlers... its fortified, has lots of protein, fat and low sugar (1/2 that of goat milk or cows milk).... I have had conversations with friends that are concerned about the estrogens messing with normal development of sexual organs but I have chalked that up to clever marketing by the dairy industry..... Any thoughts on soy for kids? Cari
The phytoestrogens in soy are antioxidants that provide many of the known health benefits of soy as well as fodder for real and exaggerated concerns. Flax, the new popular health food, has close to quadruple the amount of phytoestrogens per milligram without any public outcry, plus flax is often eaten raw where soy is almost never presented raw. Heating reduces phytonutrient activity.
What about those phytates, called "antinutrients?" There are more phytates in whole wheat than soy. Enough said in terms of those sensational articles.
Phytates lower blood glucose levels, a good thing, and are a key component of soy's protective effect against colon cancer. Phytates are known to be able to reduce zinc absorption (hence the name anti-nutrient) and are found in most grains, beans and nuts. Cooking and other processing reduces phytate contents. Meat is the best source of zinc. Zinc deficiency may be a concern for vegetarians whose diets are high in raw, whole grains, legumes and nuts and these vegetarians simply need to pay special attention to this issue. Fermentation of soy (miso) reduces phytates and fermentation provides wonderful probiotic bacteria as found in yogurts. While overt zinc deficiencies are rare in industrialized countries, iron deficiencies are common in children and the most common cause is high cow or goat's milk consumption. These milks blocks zinc absorption as well.
I know this is a little outside of your usual areas of advice but how do you feel about water fluoridation? It's coming to our town very soon and I don't really know how to respond.
Why have "they" chosen cavities as something to medicate our water for? Why not something much more deadly like heart disease? Or what about depression? There's much more evidence about aspirin and heart disease than there is with fluoride and cavities. Why not add aspirin to our water? Why not some vitamin C and D while they're at it? What about that purple pill that's supposed to be so good for us all ― why not some of that?
Truly, if you look at the studies, and I mean the bulk of the studies not just the politically selected studies, you'll see the results are very equivocal in terms of cavity protection, and all one really needs to do is brush their teeth, and use fluoridated toothpaste if desired. The supposed idea is to protect the poor (Who what? Can't afford toothbrushes?) Then there are all kinds of conspiracy ideas on the other side of the reasoning behind forcing medicated water upon us. The real truth is somewhere in between, but ridiculous none-the-less.
If it helps at all, fluoridation only works for the very young, so why force medication upon us all, especially when the public has very strong concerns? Why ignore public outcries when we're the ones drinking it? Why not put it into milk? It doesn't make much sense to me and if you want to know what I'm planning to do (it's coming to our house soon!!) is to purchase a reverse-osmosis filter and then create a settling tank with marble chips in it to return healthy minerals without heavy metals. I believe that the production, discarding and even recycling of plastics for bottled water is very polluting. A big stop in the wrong direction.
Here's a great link by the way: 50 Reasons to Oppose Fluoridation