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Bottle-fed babies may eat more, study hints

Got milk? Breast-feeding still best option for babies - unless you can't (PDF)

Breastfeeding after Breast Reduction (PDF)

Helping Mothers

The Art of Breastfeeding - about Carol Chamblin and how she has successfully helped two mothers breast-feed their babies.

The Life of a Lactation Consultant

Bottle-fed babies may eat more, study hints

Last Updated: 2010-05-10 10:17:57 -0400 (Reuters Health)
By Amy Norton

NEW YORK (Reuters Health) - Babies who are bottle-fed early on may consume more calories later in infancy than babies who are exclusively breastfed, a study published Monday suggests. Researchers found that among 1,250 infants followed for the first year of life, those who were bottle-fed during their first six months -- whether formula or pumped breast milk -- showed less appetite "self-regulation" later in infancy.

The investigators say this so-called "bottle effect" could be one reason that studies have found a correlation between breastfeeding and a lower risk of childhood obesity.

In most research on the question of whether and how breastfeeding might protect against excessive weight gain, the focus has been on the components of breast milk. For instance, breast milk contains certain hormones, including leptin and adiponectin, which could help regulate infants' appetite and metabolism.

But the new findings suggest that the way infants are fed also matters, lead researcher Dr. Ruowei Li, of the U.S. Centers for Disease Control and Prevention, said in an interview. That is, breastfeeding may encourage greater appetite self-regulation in the long term.

In this study, self-regulation was measured when the babies were 7, 9, 10 and 12 months old; mothers were asked how often their babies drank an entire bottle or cup of milk (formula or pumped breast milk).

Li's team found that among infants who had been exclusively breastfed during their first six months, 27 percent always or usually finished their cup or bottle. That compared with 54 percent of babies who had been both breast- and bottle-fed, and 68 percent of those who had been bottle-fed only.

When the researchers accounted for a number of variables -- like mothers' weight and education, family income and race -- bottle-feeding itself was still linked to lesser self-regulation later on in infancy.

Babies who had had more than two-thirds of their feedings via bottle in early infancy were twice as likely to routinely empty their milk cups as babies who'd had less than one-third of their feedings via bottle.

What's more, the pattern was seen whether those early bottle-feedings contained formula or pumped breast milk.

Li pointed out that obesity is a complex matter, with factors ranging from genetic susceptibility to social and economic factors, to exercise habits all coming into the equation.

But bottle-feeding may be one controllable early-life factor, she said.

It's not certain why breastfeeding might encourage better eating self-regulation. But Li explained that when infants breastfeed, they are in control of how much milk they consume; when parents bottle-feed, they may try to get the baby to empty the bottle each time. It's possible that this interferes with infants' innate ability to regulate their calorie intake in response to internal "appetite cues."

Many women who breastfeed use a breast pump at some point, particularly after they return to work. Li suggested that parents who use bottles pay attention to cues that their baby is full -- such as trying to push the bottle away with the tongue or shaking the head to move away from the bottle.

"You don't have to push until the bottle is empty," she said.

Further research, according to Li, is needed to see whether early bottle-feeding is associated with appetite self-regulation in older children as well.

SOURCE: Pediatrics, June 2010.

Helping Mothers

By Ann Harmon Stewart
Kane County Chronicle, March 8, 2005

ST. CHARLES -- Whether they are just learning to take care of a newborn or deep in the turmoil of life with a toddler, moms can find advice, answers and a sympathetic ear at the office of Carol Chamblin.

An International Board Certified Lactation Consultant and registered nurse, Chamblin specializes in helping mothers and babies form successful breastfeeding relationships.

Over the years, however, she has also expanded her practice, adding support groups to address other issues that many mothers struggle with, including feelings of isolation, questions about parenting styles and returning to work.

"I see this as a resource to empower women and help them make choices," Chamblin said of her practice. "So much information gets shared here just through moms interacting with other moms. We talk about sleep and baby development and many other things."

As a private lactation consultant, Chamblin offers in-hospital and in-home consultations to new mothers. Many of these interactions with mothers and babies led her to realize that modern day mothering presents unique challenges to many women.

"We live in a much more fragmented society than in the past," Chamblin explained. "It used to be that there were trusted relatives around a new family, but now there are often no mothers, sisters or aunts around who can help a mother with her baby, and that can be very stressful for new parents."

Many new mothers also feel isolated by their new role after trading in their former professional identities and the camaraderie of the workplace.

In response, Chamblin began the Mothers Tea Support Group, welcoming any mothers with children less than age five to gather one morning a month at her office. Amid dozing babies and frolicking toddlers, mothers have a time to talk about any topic on their minds, from diapers brands and child care to how to discuss death with a three-year old.

Women also are free to peruse Chamblin's lending library, which offers books on topics such as breastfeeding while returning to work, dealing with sleep issues and more.

As part of her lactation practice, Chamblin also began teaching breastfeeding classes, Breastfeeding 101, to pregnant women.

"Breastfeeding is natural, but it can also be very difficult for some women," Chamblin said.

"Again, there is a lack of experienced relatives to learn from for a lot of women. We're getting the first generation of women born in the '60s and '70s whose own mothers did not breast-feed, because those were the years in which many healthcare professionals steered women towards formula for their babies. So that kind of family support and experience is not there for them."

In Chamblin's classes, she offers many practical "how to" tips that can help get breastfeeding off to a good start, and also discusses situations in which extra care may be needed.

Chamblin also makes it a point to dispel common breastfeeding myths that first-time mothers may have heard.

"Breastfeeding should never be painful, even at first," Chamblin said. "If there is any pain a woman needs to adjust her baby's latch and positioning at the breast.

"Sometimes the number of feedings a new baby needs is underestimated, too. Mothers are told to feed their babies on a schedule, but babies can't tell time. A better way is to feed your baby whenever he or she exhibits any signs of hunger."

She also extolls the many lifelong advantages that breast-fed babies enjoy, including lower rates of allergies, ear infections and digestive disorders.

For women returning to work or planning an extended separation from their babies, Chamblin offers the Medela line of breast pumps and Avent breastfeeding supplies for rent or sale. Along with each pump Chamblin provides consultations in proper use.

Custom nursing bra fittings, along with the Bravado, Leading Lady and Beautiful Beginnings lines of nursing bras are available, too.

In the Parent-Infant Massage classes, Chamblin instructs moms and dads on the art of massaging their babies, which can be a playful, relaxing time in addition to offering health benefits.

By operating her own private practice, Chamblin can offer women the advantage of consistency in their care.

"Many women really like the fact that they deal only with me," she said. "I really get to know them and their babies, and we form ongoing relationships. It's so amazing to see all these babies as they grow."

As a child, Chamblin often pretended to be a teacher or a nurse. With Breast 'N Baby Lactation Services, she said that she can take on both roles while helping babies to get the healthiest possible start in life.

The Art of Breastfeeding
Instinctive Practice Aided by Invention, Information

by Martha Quetsch
Kane County Chronicle, November 7, 2001

Jaqi Cecchi, of North Aurora,weighs her 2 month-old daughter, Isabella on a scale designed for infants, before breastfeeding the baby. After the feeding, Jaqi weighs Isabella again to determine exactly how much milk she consumed.

Several weeks ago, new mother Jaqi Cecchi, of North Aurora, was anxious about whether her baby, Isabella, was getting enough to eat.

Cecchi was breastfeeding her baby. A month after her birth, Isabella had started spending less time nursing, down to five minutes from 45. And when Isabella caught a slight cold as was less inclined to nurse, Cecchi became even more concerned.

Compelled by motherly instinct, Cecchi sought assistance from a local lactation consultant Carol Chamblin. Chamblin suggested Cecchi try weighing Isabella before and after feedings to determine exactly how much she had consumed.

So, Checchi rented a baby scale from Chamblin, and began weighing Isabella before and after nursing. Cecchi discovered, to her relief, Isabella actually was taking in plenty of milk, despite the shorter feedings.

Cecchi returned the scale to Chamblin this week, after using it daily for a month. Having taken action and received positive results, Cecchi was glowing with maternal bliss. "I'm confident now. I'm reassured," said Cecchi.

Cecchi said each feeding varies in duration - from a short 'snack' to a hearty meal. But by weighing Isabella before and after each feeding, and totaling the weight differences for the day, Cecchi knows how much her baby has consumed. Cecchi's success with the scale is just one example of how the art of breastfeeding can be enhanced through science - and information. According to Chamblin, many new mothers who breastfeed their babies experience anxiety an discomfort.Chamblin said women shouldn't feel guilty if they're having trouble breastfeeding.

While breastfeeding is a natural practice, it takes practice to do it right. And, good advice.

Chamblin said one of the most common problems experienced by breastfeeders is sore nipples, caused primarily by the infant improperly"latching on" to the nipple.

The mother must guide the baby to the proper position so that the baby can "suckle" effectively and the mother can nurse comfortably. Although breastfeeding is an instinctive act, women are lucky they can rely on sources other than instinct.

Certified lactation consultants like Chamblin offer information, counseling and demonstrations to help breastfeeders.

For women who want to store their breast milk for later use hand operated or electric breast pumps are available for rent or purchase. With any rental from Chamblin, she provides instruction and a demonstration of the product's assemble and use.

Sometimes, women already have purchased a breast pump but do not know how to use it properly. If the pump isn't on the right pressure setting, it doesn't encourage milk production the way normal breastfeeding should. Inadequate milk production also can result of improper latch-on.

While Chamblin recommends breastfeeding, she said nursing may not be right for every mother.

"I believe in giving moms information so they can make informed decisions," said Chamblin.

The Life of a Lactation Consultant
as Viewed Through Mary's Story of Breastfeeding Jake