Tuesday, January 29, 2013

The Virgin Gut?

As many of you who have read my blog in the past know, I am a big proponent of breastfeeding.  It is the one topic that I have written about the most on my blog.  New parents are constantly being given the message these days that "breast is best."  We hear about the usual benefits which include among other things:  "a protective effect against respiratory illnesses, ear infections, gastrointestinal diseases, and allergies including asthma, eczema and atopic dermatitis. The rate of sudden infant death syndrome (SIDS) is reduced by over a third in breastfed babies, and there is a 15 percent to 30 percent reduction in adolescent and adult obesity in breastfed vs. non-breastfed infants."  Organizations such as the World Health Organization and the American Academy of Pediatrics recommend exclusive breastfeeding for the first six months of life.  Despite these recommendations, many mothers still choose not to breastfeed and give formula to their baby instead.  Mothers may have legitimate reasons such as not having adequate breast tissue or not producing enough milk.  However, I think with our society's portrayal of breastfeeding, many mothers simply choose not to attempt it.  It is tiring and a lot of work.  

In the event of a mother not entirely convinced that "breast is best," there is yet another reason to attempt breastfeeding and that is the case for the "virgin gut."  This is something that I had not heard about with my first baby but am hearing more about with my second baby.  I first heard about it on some of the message boards that I frequent so I began doing some research.  I came across the following blog and an excellent paper written with lots of scientific citations.  Both of these are worth reading and go into great detail (better than I could do with my limited time for blogging) about the "case for the virgin gut."

I will do my best to "summarize" the theory.  A baby is born with a  "sterile" gastrointestinal tract.  "The gastrointestinal tract of a normal fetus is sterile. During the birth process and rapidly thereafter, microbes from the mother and surrounding environment colonize the gastrointestinal tract of the infant until a dense, complex microbiota develops."  The type of colonization is influenced by delivery (vaginal vs. cesarean) and perhaps most importantly by the method of feeding the baby (formula vs. breastfeeding). The gut flora of a formula vs. a breastfed infant is different.  It is believed that the flora that is established with breastfeeding can have protective effects for the baby throughout their lifetime.  Some believe that even one bottle of formula can upset this balance and may take weeks of exclusive breastfeeding to undo.

A part of this theory also addresses the "open gut."  Essentially, when a baby is born, their gastrointestinal system is "immature."  As a result, there are openings in the gut which allow large, potentially allergy causing proteins and disease causing pathogens to pass directly into a baby's blood stream.  It is theorized that mother nature "intended" for these openings for large maternal antibodies to pass into the baby's blood stream to protect the baby from disease.  The antibodies will also coat the lining of the gastrointestinal tract to confer passive immunity to a baby.  Feeding formula (which many contain cow's milk protein) or introducing solids before the age of six months is believed to increase the likelihood of the development of food allergies or illness.  It is believed that the "closing" of the gut occurs around six months which is why food should not be introduced until after a baby has reached six months of age.  This is especially important in babies with a family history of food allergies.  It is also believed that a baby is less likely to get sick after six months when a baby begins to produce their own antibodies and do not have to rely as much on passive immunity from the mother.

I had always been a believer in exclusive breastfeeding for the first six months of life.  My older son received one tiny bottle of formula when he was four days old since my milk was slow to come in because of a bad latch.  My second baby who just turned six months old yesterday has not had a single drop of formula.  He has only had breastmilk and nothing else (not even water) to drink.  Breastfeeding with either baby has not been easy but after reading about the "virgin gut," I am more than happy that I did.  I had a lot of pressure from well meaning family and friends to give my babies formula or start them on solids before six months of age.

I had a lot of allergies as a kid.  There are pictures of me getting solid foods at two months old (which was apparently common in the 1970's).  So far, with my older child, he does not appear to have any allergies.  This includes foods that I was allergic to.  I am hoping the same will be the case for my younger son.  Since he is past the six month mark, we will start introducing solid foods to him in a few days.  It will be the beginning of an exciting new chapter for us.  We are keeping our fingers crossed that this may help us get some much needed rest.

So what if you cannot breastfeed?  This something that I know really torment a lot of women.  If you cannot breastfeed, there are different ways to go about getting breastmilk for your child.  Unfortunately, in today's society, many people would opt for formula before exploring some of these alternatives.  However, if you're really determined, I think the following are good choices.  There is wet nursing.  This was something done long ago before the advent of formula and it seems to be enjoying a resurgence in recent years.  There are even websites which show you how to become a wet nurse if you so desire.  Another option is through peer to peer sharing through organizations like human milk 4 human babies.  You can literally look this organization up on facebook in your area to post an ad or look for ads posted by mothers in your area who are looking or willing to donate their breastmilk.  If you want breastmilk that has been tested for diseases (much like blood donations are), then a milk bank is another option.  You can look up a milk bank in your area.  Since this milk is tested and pasteurized, there is usually a fee associated with getting the milk.  In my area, a prescription from a physician is required and it costs $3/ounce (shipping not included).  Since a prescription is required, some insurance companies will pay for the use of banked milk.

It is nice to know that there are alternatives to formula should you choose to preserve the "virgin gut."

Sunday, January 27, 2013

Reverse Cycling?

Has anyone heard of "reverse cycling" or have a baby doing this?  Apparently, this is what my little guy is doing.  He will literally eat only 2-3 ounces all day when I am at work and then nurse almost continually once I return home from work.  Kellymom has a great article about this.  Basically, "if mom is away from baby during the day, baby may take just enough milk (by bottle or cup) to 'take the edge off' his hunger, then wait for mom to return to get the bulk of his calories. Baby will typically nurse more often and/or longer than usual once mom returns. Some mothers encourage reverse cycling so they won’t need to pump as much milk. Reverse cycling is common for breastfed babies who are away from mom part of the day, especially those just starting out with the bottle."

They say that I should "Be patient. Try not to stress about it. Consider it a compliment – baby prefers you!" This is OK if one does not have to go to work and be functional the next day.  It is also OK if one has the luxury to nap when baby naps during the day.  Unfortunately, the reality is I have a job that I must be alert for and a toddler who does not necessarily nap when baby naps.  If anyone has experienced this, I would LOVE to hear your stories and how you were able to break this cycle.  Being up all night to nurse a baby is wearing me down.  Co-sleeping is something I had never thought I would do but it is seriously the only way I can get any sleep these days.  I literally spend all night just rolling him from one boob to the other.

If there is an upside to all of this, I pump much more milk than my baby will ever eat.  As a result, I have been exploring my options with breastmilk donation.  In my area (Northern California), there are two options that I am exploring, the San Jose Milk Bank and Human Milk for Human Babies.  Does anyone have experience with either of these donation methods?  One is more formal than the other.  I would love your input on this as well.