On Magic Milk

I just wrote and audiology paper and wanted to share it with my lactivist friends. It is nothing special but I think a few of you will find it interesting. :)

Breastfeeding’s Role in Reducing Otitis Media Induced Hearing Loss

Most new mothers have heard the advertising slogan “Breast is Best”. It is part of an advertising campaign by the federal government to increase breastfeeding rates among American mothers. Much research has been done to uncover the many benefits of breastfeeding which include reduced risk of obesity, reduced incidences of allergies, increased immune systems, and reduced risk of many types of cancer (Sears, 2011). Yet, as wonderful as breast milk is for babies, could there really be any reason to write an audiology paper about the subject? As it turns out, yes there is! Not only does breast milk have all the properties mentioned above, but it also plays a role in preventing hearing loss (Bauman, 2011). Increased immune system, a more hygienic angle for feeding, and natural genetic therapy all lead breastfed babies to have reduced rates of chronic otitis media. As chronic otitis media is a leading cause of conductive hearing loss in children, having fewer incidences of chronic otitis media leads to reduced rates of conductive hearing loss in children.

The first way in which breastfeeding reduces chronic otitis media induced hearing loss is that breastfeeding has been proven to increase a child’s immune system (Sears, 2011). Breast milk contains live cells, like those in blood. These cells contain active antibodies and anti-infective properties. As a result of these properties, breastfed babies, on average, experience fewer hospital stays, doctor’s visits, and illnesses in general. Specifically, researchers at the University of New York's School of Medicine and Biomedical Sciences found that 25% of exclusively breastfed babies had had an ear infection by six months. In comparison, 54% of formula fed babies had experienced an ear infection by six months of age. Further more, these researchers found that formula-feeding was the most significant predictor of chronic inner ear infections (Duncan, 1993).

When a child has otitis media there is almost always fluid in the middle ear. The average hearing loss in ears with fluid is 24 decibels. Thicker fluid can cause a loss, up to 45 decibels. This loss can cause significant detriment to a child’s speech development. (American Academy of Otolaryngology-Head and Neck Surgery, 2011). Therefore, as breastfeeding reduces the incidence of otitis media, it by default reduces the rates of conductive hearing loss in children.

The reduction of otitis media is not limited to the time in which the child is breastfeeding either. It has been shown that the antibodies and anti-infective properties consumed in breast milk continue to protect children against otitis media through their 5th birthdays, and possibly beyond (Duncan, 1993).

The second manner in which breastfeeding protects against otitis media induced hearing loss is that children that are breast fed are naturally held at an inclined position to feed. When the head is held tilted up the milk follows a normal path down the esophagus. However, when a baby is lying flat on his back and sucking on a bottle, formula can find its way into the eustation tubes. (See examples of common feeding positions below.) In infants the eustation tube is much shorter and is more angled. This makes it much easier for bacteria to migrate from the nose and throat up into the middle ear space (American Academy of Otolaryngology-Head and Neck Surgery, 2011). Having formula inside the eustation tubes creates a breeding ground for bacteria and leads to otitis media. (Sears, 2011). As breastfed babies are fed at an angle that is hygienic for the eustation tubes, as a group they experience fewer incidences of otitis media due to this benefit.


Examples of common bottle-feeding and breastfeeding positions:



Pictures are from stockphoto.com


The last way in which breastfeeding guards against otitis media induced hearing loss is perhaps the most exciting. In 2006 the University of Texas Medical Branch at Galveston performed a study that indentified two genes that are common in children who have chronic otitis media. These two genes generate immune proteins known as tumor necrosis factor alpha (TNF-alpha) and interleukin 6 (IL-6). (University of Texas Medical Branch at Galveston, 2006). Beyond merely identifying the genes that make children prone to chronic otitis media, the researchers found that breast-feeding neutralized the effect of the genes. Not only that, children were found to be protected from recurrent infections even later in childhood when they were no longer breastfeeding. This is not just another example of the anti-infective properties of breastfeeding, but evidence that breastfeeding has genetically therapeutic qualities. (University of Texas Medical Branch at Galveston, 2006)

Nearly all of the articles referenced in this paper were linked on Le Leche League International’s website. http://www.llli.org/nb/nbbenefits.html. This site and organization is dedicated to promoting the benefits of breastfeeding and supporting mothers whom breastfeed or wish to breastfeed. Le Leche League International reports that despite the benefits of breasting listed above and many, many more, only 15% of American mothers are exclusively breastfeeding at 6 months, as is recommended by the American Academy of Pediatrics. ("Breastfeeding statistics," 2008) Although this number is not simply due to lack of education on the benefits of breastfeeding alone, this lack does play a role in the low rate. It is therefore the role of all medical professionals, including Audiologists and Speech Pathologists, to educate parents and potential parents on the benefits of breastfeeding as a way to reduce the risk of otitis media induced hearing loss.

References

The American Academy of Otolaryngology-Head and Neck Surgery (2011, November 15). Fact sheet: Chronic otitis media (middle ear infection) and hearing loss. Retrieved from http://www.entnet.org/HealthInformation/otitisMediaHearingLoss.cfm

Bauman, N. (2007, November 03). Breast-feeding reduces ear infections. Retrieved from http://hearinglosshelp.com/weblog/breast-feeding-reduces-ear-infections.php

Breastfeeding statistics . (2008, September 29). Retrieved from http://www.llli.org/cbi/bfstats03.html

Duncan, B. (1993) “Exclusive breastfeeding for at least four months protects against Otitis Media”, Pediatrics 91: 872

Sears, W. (2011, November 15). Ear infections. Retrieved from http://www.askdrsears.com/topics/childhood-illnesses/ear-infections

University of Texas Medical Branch at Galveston (2006, December 9). Breast-feeding Overcomes A Genetic Tendency Toward Ear Infections, Scientists Discover. ScienceDaily. Retrieved November 15, 2011, from http://www.sciencedaily.com¬ /releases/2006/12/061209083450.htm

On How Much You Should Explain to a Three Year Old- Part Two

The first blog post in this series was meant to be sort of funny.

This one is meant to be more reflective.

As those who are acquainted with me already know, I am a big supporter of breastfeeding.

The stay at home mom circle I run with is pretty breastfeeding friendly. Contrary to national trends, almost all of my stay-at-home mom friends nurse or have nursed their kids. Even ones who would not identify as AP, for the most part, nurse their kids.

I try not to be to militant about breastfeeding, but it can be hard when you hear LLL leaders and friends telling you advocate, advocate, advocate. And they are right, you can't make breastfeeding the norm without normalizing the act.

In an attempt to normalize breastfeeding at our house I tried not to let my daughter play with bottles. Most that came with dolls got tossed in the garbage. Somehow, though, one slipped through the cracks. Incidentally, my daughter is in love with it. She started exclusively bottle feeding her "girls".

Then one day she told me one day that she was going to go to the store to get "baby milk".

I have no idea where that came from. We have always called breast milk "mama milk" and the kid can't possibly remember having a bottle since the last one she took was when she was, like, 3 weeks old.

I was at a loss. All the lactivists tell you to treat breastfeeding as the norm. I don't really want her to think that you can get baby milk from a store, I want her to think it comes from boobs. But, obviously, you can get formula from the store. So I told her that baby milk doesn't come from a store, it comes from mamas. Then I told her that some mamas can't feed their babies from their breasts so they buy baby milk from the store.

I kind of felt like I should tell her about donated breast milk or something or go into how formula marketing can be evil, but I refrained. I don't think her 3 year old mind can handle all that.

So, how do you treat bottles and dolls at your house?

On Weaners and a Public Thank You Note

I think it is official. I have a weaner. As in wean-er. A child who has weaned. :P

This could have been a way more scandalizing post if it was about me having a weenier.

We nursed for 37 months. 18 months of that I was dairy free for her and 31 months I was egg free. It sucked a little, but honestly, it wasn't that hard. It sounds harder to do then it is.

In total I have nursed both of my children 45 months. So, for over 4 and a half years I have nursed. Nearly 15% of my life.

Hopefully this gift I have given to my kids will help them to be smarter, healthier people.

I am right now giving myself a huge, self satisfied pat on the back.

I am awesome.

It was not easy in the beginning. I almost quit multiple times during the first 6 months with my son. It hurt. It sucked. I bled. I added it up and I spent at least about 400 dollars on lactation aids and consultants. Both of my children used nipple shields for abut the first 8-9 months of nursing. It was not always sunshine and roses. Far from it.

But motherhood is about sacrifice and it was worth it.

I was also lucky to have supportive local friends to guide me. Only in a group of lacating mothers is it not considered weird to ask someone to look at your nipple to see if your duct looks clogged. Thank you to all of you. Even if some of us are no longer close.

I was lucky to have a mother who had nursed and could provide first hand support and knowledge. We live in a society where that is becoming more and more rare. Thank you to my mom.

I was lucky to have a supportive husband. Lucky that he was able to support our family allowing me to stay home. If I had had to go back to work when my son was 8 weeks I can guarantee I would have nursed less then 6 months. Thank you to my husband.

It is a little bittersweet, but I was really ready to be done.

My "baby" is growing up.

On Beer Ads and Breastfeeding

I am a stay at home mom.

My job is raising my kids.

Some people might think this is an anti-feminist sort of role, but I would have to disagree.

Since becoming a mother and not being part of the outside the home workforce I think I have become more strongly pro-woman and woman's rights.

Most notably, I have become a strong supporter of breastfeeding and VBAC rights. Some might question whether these are feminist issues, but I would argue that they very much are.

We live in a society that has sexualized breasts to an absurd degree. Absurd because they have been sexualized right on past their primary function. Feeding babies. Breasts are for feeding babies. To turn this into something disgusting and sexual takes power away from women. My body created two little human beings. Then, once they were born, my body and my breasts continued to support and nourish them. I can think of nothing more powerful and womanly then that. To quote a somewhat corny line from God knows where, "I make milk, what's your superpower?"

There is nothing sexual about breastfeeding. I have read a few blogs and even heard a few snippy comments that imply or outright state that a breast feeding mother must be "getting off" on it. Bullshit. Comments like these only serve to diminsh a woman's self estemm and power and turn her into sexual object. I know dozens of nursing moms and I feel pretty confident saying that I doubt a single one gets anything other then a sense of bonding and maternal love from the act of breastfeeding.

But you can't sell beer with "those" sorts of breasts.

Everytime I breast fed in public I looked at it as a feminist act. It was me normalizing breasts. Not just normalizing breastfeeding but normalizing breasts. Taking them back from the beer ads and magazine covers and putting them back in their natural place. Which is a very feminist act. I know it made some people uncomfortable. I was glad it made some people uncomfortable. Uncomfortable meant it was challenging them. Change is always uncomfortable.

So to the woman who glared at me at Applebees while I was feeding my daughter, or the old woman who chastised my friend for feeding her son at Panera. You're welcome. Women who nurse in public are doing you, your daughters, and your grandaughters a favor.

And you're welcome.