Is it okay for nursing mothers to drink alcohol?

It seems like a lot of nursing mothers I know are enjoying more than an occasional glass of wine these days. This really surprised me because when I nursed only about two years ago, I barely drank a sip of alcohol during those months. I wanted to know if I was too cautious in my avoiding alcohol while nursing, and to see if drinking is at all harmful to the baby.

What is fascinating about my research is that the organization known to be the biggest proponent of breastfeeding, La Leche League, appeared to be the most supportive of nursing mothers being able to drink some alcohol, as to not put too many limitations on them and encourage them to nurse as long as possible. However, other key sources advise against nursing mothers consuming alcohol.

March of Dimes recommends that women do not drink alcohol while nursing since small amounts of alcohol accumulate in breast milk and are passed to the baby. The organization points to a study that found that breastfed babies of women who had one or more drinks per day were a little slower in acquiring motor skills (like crawling and walking) than babies who were not exposed to any alcohol.

The American Academy of Pediatrics states that alcohol passes through a mother’s milk to the baby, so it is best for women to avoid habitual use while breastfeeding. AAP warns of possible side effects if too much alcohol is consumed, including: drowsiness, deep sleep, weakness, and abnormal weight gain in the infant, and the possibility of decreased milk-ejection reflex in the mother. AAP also explains that one alcoholic drink—the equivalent of a twelve-ounce beer, four-ounce glass of wine, or one ounce of hard liquor—will probably not harm a child, but there are concerns about long-term, repeated exposures of infants to alcohol via the mother’s breastmilk, so moderation is advised.

Kidshealth.org explains that it takes about 2 to 3 hours after consuming one drink for the alcohol to be metabolized and no longer be a concern for nursing. They advice mothers to not give a baby breast milk for at least 2 to 3 hours for every drink of alcohol consumed.

With all the possible physical and behavioral health issues that a child could have, why increase the risk by drinking alcohol while nursing? It just does not seem necessary to this mom. And there are no guarantees that all of the alcohol will be removed from a mother’s body by the time of the next feeding. I think it is better to be safe than sorry in this case and forego the drinks until the child has been weaned. What do you think?

Can children have bad breath?

I never thought it was possible, but sometimes my toddler wakes up with bad “morning breath”. I was curious if this was common and what can be done about it.

According to Dr. Greene, it is not unusual for a child to wake up with bad breath, or halitosis. Throughout the day, saliva washes away unwanted food debris. As soon as a child falls asleep, saliva production decreases. Therefore, the longer a child sleeps, the more bacteria are produced in the mouth, causing bad breath. However, there are some cases in which bad breath can be a symptom of something more serious.

Causes of Bad Breath

• Poor dental hygiene—most common cause.
• Mouth-breathing—it dries out the mouth and allows bacteria to grow. Children who consistently breathe through their mouths might have a cold, sinus infection, allergies, or enlarged tonsils or adenoids blocking the nasal passages.
• Sucking—if a child sucks on fingers or a pacifier, the object may develop an odor from saliva and bacteria. A pacifier may also have food residue on it.
• Tonsil stones—collections of food and bacteria that get stuck in the crevices of the tonsils.
• Cavities or tartar buildup.
• Sinus infection—other symptoms include a cough, fever, face swelling, or a thick yellow-green nasal discharge.
• Pharyngitis (throat infection)—child would have a sore throat along with bad breath.
• Seasonal allergies—cause postnasal drip. Other symptoms include a dry cough that gets worse at night, itchy eyes, and a runny nose.
• A foreign object shoved up a child’s nose—if the object is left there, it can rot and cause an infection. The odor will come from the nose and not the mouth.
• Eating pungent foods like garlic and onions.

Tips for Preventing and Treating Bad Breath

• Teeth should be brushed three times a day after meals using a soft-bristled toothbrush. The tongue should also be brushed.
• Dental floss should be used everyday to reduce mouth odor. Young children will need help from parents.
• Children should eat a good breakfast to stimulate the flow of saliva and reduce oral bacteria. Fibrous foods are highly recommended.
• Have child rinse frequently with water and drink plenty of fluids to help reduce dry mouth.
• Child should consume frequent drinks and snacks throughout the day to provide opportunities for bacteria to be moved around the mouth and flushed away.
• Treat cold and allergy symptoms promptly to reduce post-nasal drip and prevent mouth breathing.
• Make sure your child’s hands are washed frequently with soap and water if fingers or thumb are sucked.
• Sterilize pacifiers or other sucking objects frequently by boiling or running them through the dishwasher.
• Take your child for regular dental checkups to make sure that teeth are healthy and clean.

It is important to note that young children should not use alcohol-based mouthwash since it can dry out and damage the oral tissue and be poisonous if ingested improperly or in large amounts (young children tend to swallow mouthwash).

When to Call the Doctor or Dentist

• If bad breath does not go away within five days after careful dental hygiene.
• If bad breath is accompanied by a cough that lasts more than 10 days.
• If bad breath is accompanied by a fever.
• If there is heavy, green nasal discharge from one nostril—this could be a sign of infection from a foreign object lodged in the nose.
• If there is bleeding around the gums, visible tooth decay, or a discolored tooth.

*Share your stories about how you dealt with your child's bad breath.

Should young children drink juice?

With the recent scare about lead in fruit juice boxes, I have to step back and ask why parents are even letting their young children drink fruit juice in the first place.

It surprises me that about 90 percent of infants drink fruit juice by their first birthday. Except for special occasions like birthday parties, I follow my pediatrician’s recommendation to not give fruit juice until age five. That means that only 10 percent of parents agree with me, so I looked into what the authorities are saying about fruit juice.

RECOMMENDATIONS
The American Academy of Pediatrics (AAP) recommends that fruit juice not be given to infants under six months of age since it offers no nutritional benefit to babies. For children between six months and six years old, juice is not recommended. However, if juice is given, it should be limited to 4 to 6 ounces (120–180 ml) per day.

Keep in mind that plain water is a much healthier option--for a lifetime. I encourage parents to start the habit early and choose water over juice from the beginning.

PROBLEMS WITH JUICE
There are several reasons why juice is not a good choice for young children.

Tooth Decay
Cavities are linked to juice consumption since teeth are exposed to the sugars found in juice. The AAP and the American Academy of Pedodontics recommend that juice be offered to infants in a cup--not a bottle--since allowing children to carry juice around all day leads to excessive exposure of the teeth to sugar. In addition, infants should never be put to bed with a bottle in their mouth (see my recent post).

Obesity
It has been found that some children who drink too much juice have an increased risk of being overweight. If parents serve juice to their child, they should regulate the amount being consumed by offering it with food to slow down the rate at which it is absorbed and mix one-half juice with one-half water.

Poor Nutrition
Fruit juice offers no nutritional benefits over whole fruit. Most fruit juices do not contain any significant amount of protein, fat, minerals, or vitamins other than vitamin C. Therefore, children should be encouraged to eat whole fruits, instead of drinking juice, to meet the recommended daily fruit intake. Also, whole fruits provide fiber and other important nutrients.

Stomach Upset
If a child drinks too much juice, sometimes the juice will not be digested properly, leading to gas or diarrhea. Also, keep in mind that infants should never be given fruit juice to treat dehydration or diarrhea.

Illness Due to Harmful Pathogens
Children should not consume unpasteurized juice, which can contain harmful pathogens like Escherichia coli, Salmonella, and Cryptosporidium that can cause serious disease.

Can dirt be good for our kids?

A new study shows that a bacteria commonly found in soil can help improve learning and reduce anxiety.

Professors Dorothy Matthews and Susan Jenks of The Sage Colleges in Troy, New York recently presented the findings of their study, Effect of Mycobacterium vaccae on Learning, at the 110th General Meeting of the American Society for Microbiology in San Diego.

Research
The research involved feeding the bacteria to mice and seeing how they performed in a challenging maze. The mice who ate food with the bacteria on it were able to figure out the maze twice as fast as those in the control group. They also showed less anxious behavior. Even weeks after the mice stopped snacking on the live bacterium, they still knew how to get through the maze. Three weeks later, the effect seemed to taper off, but since mice only live for about two years, the results were still impressive to researchers.

This research is especially interesting because it shows how germs may play a role in reducing anxiety and enhancing learning, which seems so counter-intuitive to many parents who spend much of their time worrying about their children being exposed to dirt and germs.

What this Means for Parents

Mycobacterium vaccae is a type of bacteria found in soil that we tend to ingest or breathe in while spending time outdoors in the natural environment. Children do not need to actually eat the dirt to reap its benefits. Professor Matthews suggests that spending time outdoors and interacting with nature--taking a walk in the woods, playing or gardening--may improve the way children learn and help reduce their anxiety as well.

There has been alot of concern in recent years about children with "nature deficit disorder" (term coined by Richard Louv in his book Last Child in the Woods). This research is just another reminder (using scientific proof) that children should spend more time outside learning about and enjoying nature.

How do you incorporate nature and outdoor play into your child's routine?

Is it dangerous to cook a child's food in the microwave?

I admit it…I cook or warm up my toddler’s food in the microwave almost daily. With about 90 percent of American households owning a microwave, I am sure that most mothers are nuking their kids’ meals in this very useful kitchen appliance. However, I often wonder if cooking in the microwave is safe. (Note: My concern in this post is the microwave radiation itself being harmful, not the type of container used to hold the food—that is for another entry.)

How Does a Microwave Work?
Microwaves are a form of electromagnetic radiation—waves of electrical and magnetic energy moving together through space. Microwaves fall into the radio frequency band of electromagnetic radiation, and are much less powerful than x-rays. Microwaves are good for cooking because they are reflected by metal; pass through glass, paper, plastic, and similar materials; and are absorbed by food.

Radiation Guidelines
Because there are still some questions about exposure to low levels of microwave radiation, FDA continues to enforce radiation protection requirements. The agency believes that ovens that meet its standard and are used according to the manufacturer's instructions are safe.

FDA’s standard limits the amount of radiation that can leak from a microwave oven throughout its lifetime to 5 milliwatts (mW) per square centimeter at approximately 2 inches from the oven surface. This is far below the level known to harm people. Microwave energy also decreases dramatically as one moves away from the source of radiation. In addition, FDA requires all microwave ovens to have two independent interlock systems that stop the production of microwaves if the latch is released or door is opened.

Current Research on Radiation
Although additional research is needed, it has been found that high levels of radiation (much greater than FDA’s standard) from microwaves can cause burns, cataracts, and temporary sterility in men. Researchers are still trying to learn more about potential effects due to low levels of microwave radiation. Much research has been done with animals, but it is difficult to translate the effects of microwaves on animals to possible effects on humans.

Chemistry of Food
Another concern is whether microwaves can alter food in a harmful way. The Daily Green blogged about this topic, exploring both sides of the issue. On one hand, any type of cooking changes the chemistry of food, either increasing or decreasing nutrient levels. The site pointed out that the “prevailing view is that microwaves do not alter foods in ways that are any more deleterious or harmful than other types of cooking. In fact, some have argued that the faster cooking time may actually preserve more nutrients versus other methods.”

On the other hand, some experts are concerned that there is not enough information to confirm that microwaves do not damage food. Holistic health expert Dr. Andrew Weil has written about the possible dangers associated with microwaving food and whether it negatively alters protein chemistry. Also, Dr. Fumio Watanabe of Japan's Kochi Women's University found that heating samples milk in the microwave for six minutes degenerated 30-40% of vitamin B12. Finally, in the late 1980s Swiss scientists reported decreases in hemoglobin and white blood cells in rats that had eaten microwaved food.

How to Reduce Your Risk

• Follow the manufacturer's instructions.
• Do not operate an oven if the door does not close firmly or is bent, warped, or otherwise damaged.
• Never use an oven if it will continue to operate with the door open.
• Do not stand directly against or in front of an oven for long periods of time while it is operating.

Please share your views. Do you use a microwave to heat your child's food? If not, what other cooking techniques do you use? Are you concerned about microwave radiation or altering the nutrients of the food?

What is the worst thing parents can do to their baby’s teeth?

I was recently at the dentist’s office and the hygienist and I were talking about dental care for young children. The most important point that she made was: Never put your baby to bed with a bottle.

First of all, I would be concerned that a baby could choke if left sucking on a bottle unsupervised all night. Besides that, milk, formula, and juice contain sugar. If a baby is left sucking a bottle filled with these liquids, the sugar can cause tooth decay. According to Dr. Sears, when a baby falls asleep, saliva production slows down, allowing the teeth to soak in the sugar all night. This can lead to bacterial growth, plaque, and eventually painful tooth decay.

How to Recognize Tooth Decay
Baby bottle tooth decay symptoms are hard to recognize since they are not very obvious at first. Look for:

• Fever from gum or tooth infection
• Bleeding or red gums
• Pain or irritability
• White spots on teeth

If you are concerned, see your pediatrician or a pediatric dentist for further evaluation.

Breaking the Habit

• If your infant is attached to a bottle in bed, only use water.
• If you need to wean the child off of juice in the bottle at bedtime, water it down more and more each night until there is only water in the bottle. During this process, remove the bottle as soon as the baby falls asleep and brush his/her teeth right away in the morning.
• Wipe a baby's gums with a washcloth after feedings.
• Once a child has teeth, brush them with a soft child-sized toothbrush and infant toothpaste.
• Begin dental checkups when the baby is 6-12 months old.
• Teach a child to drink from a cup as soon as possible (as early as 6 months) since it reduces the chance of liquids pooling around teeth and gums.

Please share your tips for how you broke the “bottle in bed” habit.

How often do young children need a bath?

I have to admit, I only bathe my toddler every other day. So many of my friends stick to a daily bath routine and swear by it, saying that their child will not go to sleep without it. I began to wonder if I was doing something wrong, so I looked into the research and recommendations regarding how often to bathe a child.

First of all, there is plenty of information available about bathing newborns and infants, but I could not find any recommendations geared toward toddlers and older children from any authorities. Overall, there is no right answer when it comes to bathing frequency, but there are some important points to consider.

Recommendations for Newborns and Infants
According to many resources—including the American Academy of Pediatrics, Dr. Sears, and Babycenter—it is not necessary to bathe a baby everyday because they are not getting that dirty. Some say once or twice a week is enough for young babies.

Skin Problems
Bathing a child too often can dry out skin and even cause skin problems like eczema. A baby's skin provides natural protection through bodily oils that prevent infection and irritation caused by factors like dirt and clothing. Bathing too often will strip those oils and lead to increased irritation. This is especially important to keep in mind during cold, dry weather.

According to thefamilygp.com, the number of infants with skin conditions is on the rise due to parents obsessively over-bathing their children. A survey highlighted on the site indicates that 35 percent of babies today suffer from sore, flaking, itchy skin.

How to Keep a Baby Clean without a Daily Bath

• It is most important to keep the diaper area clean, which can be done during regular diaper changes throughout the day.
• Wash the face frequently and thoroughly. When a baby spits up, wipe the mouth area and around the neck. These areas, especially in the skin folds, should stay clean and dry to avoid fungal or yeast infections.
• Do spot-cleaning in areas that get particularly sweaty, oily, or dirty, such as behind the ears, in the neck folds and in the creases of the groin.

Tips for Beyond the First Year
Since there are no specific recommendations for bathing children after the first year, here are some tips to keep in mind:

• Use common sense. If your child is visibly dirty, sweat a great deal during the day, or has an odor, it is time for a bath.
• Prioritize—A good rule of thumb it to always bathe children after swimming or playing on the beach.
• On days where there is no bath, make sure to wash the child's hands throughout the day, keep the diaper area clean, and wash the face as needed after meals.
• Stay flexible. Sometimes we are too busy or tired to give a bath as planned. Our children will not be endangered if they miss a bath.

What do you think about these tips? How often do you give your child a bath?