A time for reflection!
As the end of the year approaches we'd like to take this opportunity to thank you for making it so interesting and enjoyable for us. Your feedback and comments about our newsletters has helped us to focus on what you need.
The end of a year gives us a chance to reflect on what we've done. Health e-Learning's raison d'être is to provide high quality lactation education for health professionals as conveniently as possible. Did we do it this year? Online education has proven to be a time and cost-saving boon to busy health professionals. And with the global financial crisis looming our goal to provide you with further opportunities that will save you time and money is an imperative we don't take lightly.
This year the GOLD08 online international conference brought together, in cyberspace, delegates from 35 countries who learnt from the world's best researchers and clinicians in our field, without having to leave home! We've made many of these presentations available to everyone in our Experts in Lactation Lectures. Breastfeeding a Baby with Cleft Lip/Palate, the first of the new Advanced Practice series, is designed to provide advanced skills for lactation professionals.
Our next generation of Lactation Consultants are well catered for. The BreastEd program was one of the first to proudly display AARC-approval, the all-important designation by IBLCE and ILCA that denotes a course of quality and comprehensiveness suitable for Lactation Consultant preparation. This series has been translated into Italian by the wonderful members of AICPAM in Italy.
Breastfeeding Essentials has been enthusiastically embraced by hospitals and community health districts in 6 countries for their staff professional development. The convenience, time saving, financial savings and easy administration, particularly for the many hospitals that gained their Baby Friendly accreditation, was a common comment.
Plans for the New Year are well underway. The first change you'll notice is a new, exciting website where you can join a like-minded community. There'll be a forum for discussions, the latest news in the lactation field posted regularly and lots of new free resources for you. The
GOLD09 international conference
once again will bring world-acclaimed researchers and clinicians to you, wherever you are! The Advanced Practice courses will keep your skills developing and growing.
2009 is a year holding promise and we are looking forward to it with enthusiasm. I hope you will continue to enjoy our regular Newsletters, join our forum (not till next year!), and get all the education you need and your CERPs with us too.
Until then,
Enjoy those mothers and babies,
Denise Fisher, IBCLC
denise@health-e-learning.com
Alcohol and Breastfeeding
With the festive season rapidly approaching for many people, breastfeeding mothers will find themselves invited to parties and some will want to share some alcoholic drinks with friends.
Giglia (2007), from a focus group they ran, found that mothers didn't know what alcohol consumption, if any, was safe during breastfeeding, and they wanted to know. Better education was recommended.
Breslow (2007) reported that in the USA, compared to artificially-feeding mothers, breastfeeding mothers of 3-month-olds were less likely to be drinking 2 or 3 glasses of alcohol a week, but just as likely to be drinking 1 glass a week.
An advantage for lactating women is their metabolism. Pepino (2007) found that blood alcohol concentration stayed lower in lactating mothers than an equal amount did in either formula-feeding mothers or nulliparous women.
The mother's body provides further protection for her baby by alcohol having a disruptive effect on lactation hormones - oxytocin in particular is reduced, which means there's a delay to milk ejection and ultimately decreased milk yield (Mennella, 2005) [I hope you're actively telling your colleagues and mothers that alcohol is NOT a galactagogue - that's an old myth!]
Little (1989) found a motor developmental delay in 12-mth-old infants who were subjected to alcohol on a daily basis via breastmilk, though in 2002 the same author was unable to replicate this detrimental effect when studying 18-mth-olds. Some developmental data was affected, but overall not.
The concentration of alcohol in breastmilk is directly related to the concentration in the mother's blood stream - as the mother's blood alcohol level rises, so does her milk alcohol level; and conversely as her blood alcohol level falls, alcohol moves out of the breastmilk at the same rate. The liver metabolizes alcohol at a rate of about one standard drink per 1.5 hours, removing it from the blood and hence the breastmilk. A standard serve of alcohol is usually about a 5 oz (150ml) glass of wine. Most countries advise women (non-lactating) to have no more than 7 - 10 standard drinks per week, with no more than 4 in one day.
So what do we know you can tell breastfeeding women?
- alcohol passes into and out of breastmilk at the same rate it is in the bloodstream, therefore 'pumping and dumping' serves no purpose.
- breastfeeding with alcohol in the blood stream reduces the amount of breastmilk the baby can take
- waiting for about 1.5 hours to breastfeed per standard drink will mean the baby is exposed to virtually no alcohol
- exposing the baby via breastmilk to more than 1 standard drink per day could result in developmental delays.
If the mother is 'feeling drunk' she is in no state to care for her child safely, let alone breastfeed. If she anticipates she may drink heavily, pumping and storing some alcohol-free breastmilk before drinking will give the child's caregiver something to feed the baby.
When she is no longer feeling intoxicated her breastmilk levels of alcohol will be low enough for her to breastfeed.
There has been promotion of an alcohol testing kit for breastmilk. As you can see from the information above it is not necessary and is likely to worry mothers that alcohol in breastmilk is so dangerous the levels must to be checked. If a mother is not prepared to purchase the kit she may consider it is safer or easier to wean.
Giglia RC, Binns CW. Alcohol and breastfeeding: what do Australian mothers know? Asia Pac J Clin Nutr. 2007;16 Suppl 1:473-7.
Breslow RA, Falk DE, Fein SB, Grummer-Strawn LM. Alcohol consumption among breastfeeding women. Breastfeed Med. 2007 Sep;2(3):152-7.
Pepino MY, Steinmeyer AL, Mennella JA. Lactational state modifies alcohol pharmacokinetics in women. Alcohol Clin Exp Res. 2007 Jun;31(6):909-18. Epub 2007 Apr 13.
Mennella JA, Pepino MY, Teff KL. Acute alcohol consumption disrupts the hormonal milieu of lactating women. J Clin Endocrinol Metab. 2005 Apr;90(4):1979-85.
Little RE, Anderson KW, Ervin CH, Worthington-Roberts B, Clarren SK. Maternal alcohol use during breast-feeding and infant mental and motor development at one year. N Engl J Med. 1989 Aug 17;321(7):425-30.
Little RE, Northstone K, Golding J; ALSPAC Study Team. Alcohol, breastfeeding, and development at 18 months. Pediatrics. 2002 May;109(5):E72-2.
|
Health e-Matters