Healthy Women Today. A Newsletter from the National Women's Health Information Center (www.4woman.gov, 1-800-994-9662). The Office on Women's Health, U S Department of Health and Human Services

August 2001 edition

FROM THE COMMUNICATIONS DIRECTOR

Office on Women’s Health, U.S. Department of Health and Human Services

It's now August, and many summer activities are well underway. Thank you for requesting to receive the National Women's Health Information Center e-newsletter HEALTHY WOMEN TODAY! We hope that you have included healthy habits in your summer activities, such as cooking healthy recipes. This issue of HEALTHY WOMEN TODAY features information on healthy recipes to help keep you in shape this summer, highlighted information on Breastfeeding in support of World Breastfeeding Week (August 1-7), and updates on health information from the Office on Women's Health, in the Department of Health and Human Services (HHS). We have just released a publication on African American Women and Breastfeeding (http://www.4woman.gov/owh/pub/aabreastfeeding/) which you can also request free copies of by calling NWHIC at (800-994-9662). The HHS Blueprint for Action on Breastfeeding (http://www.4woman.gov/Breastfeeding/bf.cfm?page=233) and other publications can also be obtained by visiting our web site our calling our toll-free number listed above.

This month, NWHIC is also featuring feedback from Leah, a web site user utilizing the NWHIC web page for research on disabilities. We selected Leah's e-mail from many other comments received through the NWHIC feedback form (http://www.4woman.gov/search/contact.cfm). Please continue to contact us and tell us how NWHIC's services have made a difference in your health or your health lifestyle. You might be our next featured user! If your comments are chosen, we will contact you for permission to feature you (first name and city only) in the next edition of Healthy Women Today! You can send your comments via the feedback form on www.4woman.gov. Your comments are important in shaping the information we provide to women everywhere!

Until our next edition, enjoy the warm days of summer and be sure to warm-up and stretch before that swim or walk (remember to wear sunscreen!), and eat as much healthy produce as you can (see the healthy recipes provided below.

Carol Krause

FEATURED NWHIC USER COMMENTS

Each month, NWHIC will feature comments from people like you in our newsletter. These comments are sent to us through the on-line feedback form found at http://www.4woman.gov/search/contact.cfm. We want to hear how the NWHIC web site or call center made a difference in your health or health lifestyle! Here's what one of our users had to say about our web site:

Hello, I just thought that I would write and tell you how much this web page is helping me in my class. I am doing a presentation on why parents should have to enroll in a class on exceptional people and children. As a freshman my major was Deaf education and due to my own problems with my ear that I found out about when I got to college I did not continue in the major. I have been learning about disabilities since the 4th grade and love learning about it. I think that it would be beneficial because everyday mothers give birth to babies with disabilities and either don't know that they have one or is unaware of what the disability is. This information on your site will help back up my reasons along with my paper called "The diary of my exceptional child". Thanks for your help.

From Leah Philadelphia, PA

AUGUST FEATURED HEALTH ARTICLE: BREASTFEEDING IS GOOD FOR BABIES AND MOMS

Did you know that August 1-7 is World Breastfeeding Week? This month, NWHIC is getting the word out on breastfeeding information. We hope that you will read the article below, and if you would like more free information on breastfeeding, call our toll-free number at (800) 994-9662. We have numerous free publications on this topic, as well as a new publication on African American women and Breastfeeding (found at http://www.4woman.gov/owh/pub/aabreastfeeding/.)

Why should I breastfeed?

More than two decades of research have established that breast milk is the best or most complete form of nutrition for infants and that it protects infants from a wide array of infectious and noninfectious diseases. Some of these include diarrhea, respiratory tract infection, otitis media or ear infection, pneumonia, urinary infection, necrotizing enterocolitis (damage to the intestine and colon), and invasive bacterial infection. Breastfed infants, compared with formula-fed infants, also seem to have stronger immune systems to fight infection, resulting in lower rates of chronic childhood diseases, such as diabetes, celiac disease, inflammatory bowel disease, childhood cancer, and allergies and asthma. As a result, breastfed babies have lower rates of hospital admissions. Some studies also suggest that the type of fatty acids available in breast milk enhances brain growth and development in infants, giving them earlier visual acuity and cognitive function.

How is breast milk different from formula?

Breast milk has greater nutritional value than infant formula. Human milk contains just the right amount of fat, sugar, water, and protein for human digestion, brain development, and growth. Cow's milk contains a different type of protein that may be good for calves, but human infants can have difficulty digesting it. Bottle-fed infants tend to be fatter than are breastfed infants, but not necessarily healthier. Breast milk also contains immunologic agents or the mother's antibodies to disease. These antibodies are transferred to the infant and act against bacteria, viruses, and parasites. Anti-inflammatory agents in breast milk help to regulate the body's immune system response against infection. Also, a breastfed baby's digestive tract contains large amounts of Lactobacillus bifidus, beneficial bacteria that prevent the growth of harmful organisms. Since the infant's immune system is not fully mature until about 2 years of age, breast milk provides an advantage that formula-fed infants do not have. Human milk straight from the breast is always sterile, and is never contaminated by polluted water or dirty bottles, which can lead to diarrhea in the infant.

For how long should you breastfeed your baby?

The Surgeon General, in the newly released Blueprint for Action on Breastfeeding, recommend that babies be breastfed exclusively for the first four to six months of life, preferably six months, and ideally through the first year of life. Protection against infection is strongest during the first several months of life for infants who are breastfed exclusively. Breastfeeding into the second 6 months of life protects against infection, and longer duration of breastfeeding may provide an even stronger protective effect. The only acceptable alternative to breast milk is infant formula. The guidelines from the American Academy of Pediatrics state that solid foods can be introduced when the baby is 4 to 6 months old, to complement the breast milk diet. In the first 6 months, water, juice, and other foods are generally unnecessary for breastfed infants. A baby should drink breast milk or formula, not cow's milk, for a full year.

Why is breastfeeding good for mothers?

Breastfeeding is good for new mothers as well as for their babies. There are no bottles to sterilize and no formula to buy, measure and mix. It may be easier for a nursing mother to lose the pounds of pregnancy as well, since nursing uses up extra calories. Lactation (breastfeeding) also stimulates the uterus to contract back to its original size and reduces post-partum bleeding. Breastfeeding also may lower the risk of pre-menopausal breast cancer and ovarian cancer. A nursing mother must get needed rest; otherwise her body may decrease milk production. She must sit down, put her feet up, and relax every few hours to nurse. Nursing at night is easy. No one has to stumble to the refrigerator for a bottle and warm it while the baby cries. If she's lying down, a mother can doze while she nurses. Nursing also is nature's contraceptive--although not a very reliable one. Frequent nursing suppresses ovulation, making it less likely for a nursing mother to ovulate, menstruate, or get pregnant. There are no guarantees, however. Mothers who don't want more children right away should use contraception even while nursing. Hormone injections and implants are safe during nursing, as are all barrier methods of birth control. The labeling on birth control pills says another form of contraception should be used if possible, until the baby is weaned, since estrogen may be harmful to infants. The only safe oral contraceptive for nursing mothers is a progestin-only birth control pill, also called the "mini-pill." Unlike oral contraceptives that contain both estrogen and progesterone, the mini-pill only contains progesterone and will not affect milk production. Breastfeeding also is economical. Even though a nursing mother works up a big appetite and consumes extra calories, the extra food for her is less expensive than buying formula for the baby. Nursing saves money while providing the best nourishment possible.

Who else benefits from breastfeeding?

Breastfeeding is not only good for infants and mothers, but can benefit the family, the health care system, the employer, and the nation as a whole. Even after accounting for the costs of breast pump equipment, if necessary, families can save several hundreds of dollars they would have spent on formula. Because breastfed infants are sick less often, they require fewer visits to the doctor, prescriptions, and hospitalizations. This results in lower medical costs for the nation. In companies with established lactation programs, absenteeism rates and medical costs are lower, and productivity is higher.

Is there any time when a woman shouldn't breastfeed?

Most common illnesses, such as colds, flu, skin infections, or diarrhea, cannot be passed through breast milk. In fact, if a mother has an illness, her breast milk will contain antibodies to it that will help protect her baby from those same illnesses. A few viruses can pass through breast milk, however. HIV, the virus that causes AIDS, is one of them. Women who are HIV positive should not breastfeed. Also, women with human T-cell leukemia virus type 1 (HTLV-1) should not breastfeed because of the risk of transmission to the child. Hepatitis C is another virus that may be transmitted through breastfeeding if the mother has cracked or bleeding nipples. Otherwise, the risk of Hepatitis C is the same whether breast or bottle fed. An infant born with a condition called galactosemia cannot metabolize lactose, a sugar found in all mammalian milk, and must be fed plant-derived formula. Infants with phenylketonuria can be successfully breastfed, but doing so requires special clinical management.

Do breast implants affect breastfeeding?

It is not known whether breastfeeding by women who have breast implants has an effect on the nursing infant. Many women with implants lactate successfully. Women who have had reduction mammoplasty may not be able to lactate if the glandular tissue has been removed or the connection between it and the nipple is interrupted.

What are some of the challenges of breastfeeding?

For all its health benefits, breastfeeding can be challenging. In the early weeks, it can be painful if it is not done properly. A woman's nipples may become sore or cracked if she allows her infant to latch on to the nipple, instead of the areola. She may experience engorgement more than a bottle-feeding mother, when the breasts become so full of milk that they're hard and painful. She can reduce the risk of painful engorgement by using proper latch-on and positioning, as well as by allowing the baby to nurse on-demand. Engorgement can be relieved by frequent feedings, massaging the breast, and by applying warm or cold compresses between feedings. Nursing women may also develop clogged milk ducts, which can lead to mastitis, a painful infection of the breast. While most nursing problems can be solved with home remedies, mastitis requires prompt medical care. Another possible challenge is that nursing can affect your lifestyle. A nursing mother must wear clothes that enable her to nurse anywhere. She must take special care to eat well and avoid food that might irritate the baby. She should stop smoking and check with her doctor before continuing taking prescription drugs. Drinking alcohol should be limited, since alcohol appears in breast milk.

How can someone go back to working outside the home and still breastfeed?

Women who plan to go back to work soon after birth will have to plan carefully if they want to breastfeed. If her job allows, a new mother can pump her breast milk several times during the day and refrigerate or freeze it for the baby to take in a bottle later. Or, some women alternate nursing at night and on weekends with daytime bottles of formula. Her milk production can adapt to the alternating schedule. If a woman's workplace does not have a lactation program, she should ask her supervisor or Human Resources department to arrange for her needs. Working mothers who are breastfeeding need a private, clean relaxing environment where they can pump milk, an adequate storage place for the milk, adequate breaks during the day to pump, more flexible work schedules, and, ideally, onsite childcare facilities. If an employer gives a woman resistance to her needs, she can refer the employer to the Surgeon General's Blueprint for Action on Breastfeeding, which encourages employers to make accommodations for breastfeeding mothers.

OWH NEWS, INITIATIVES & CAMPAIGNS

LUPUS TOWN HALL MEETING FOLLOW-UP:

We have received numerous phone calls and e-mails requesting additional information regarding the Lupus Town Hall Meeting held on Capitol Hill on May 16, 2001. The Lupus Foundation of America partnered with the Office on Women's Health to sponsor the Town Hall Meeting, and now has free copies of a video about the event. You can call NWHIC (800-994-9662) or the Lupus Foundation of America (800-558-0121) to request a free copy. Quantities are limited, so please call soon if you would like information on the Town Hall Meeting.

For more information on the Lupus Town Hall Meeting, visit the following URL: http://www.4woman.gov/lupus/, or contact the Lupus Foundation of America for more information at (800) 558-0121.

COOKING HEALTHY IS EASY – START EATING RIGHT TODAY

It's not too late to get in shape for the summer! This month, NWHIC is featuring recipes from the National Cancer Institute's 5 A Day program:

AUGUST'S NATIONAL HEALTH OBSERVANCES:

IMPORTANT NEWS AND ANNOUNCEMENTS

New Study Profiles Women's Use of Health Care was released by The Center for Disease Control and Prevention's (CDC) National Center for Health Statistics on July 25. This report is one of the first reports regarding women's health that is comprehensive in respect to women, and is not focused on childbirth or pregnancy. The report can be found in the Women's Health News Today section of the NWHIC home page: http://www.4woman.gov/.

The Featured Health Articles this month are:

"Breast Milk or Formula: Making the Right Choice for Your Baby," from the Food and Drug Administration (FDA)

Spanish Guest Editor: "�Qu� sabemos sobre la lactancia materna?" by Carolina Chevallier, Coordinadora de producci�n m�dica BuenaSALUD.com.

GUEST EDITOR PROGRAM

COMING SOON to NWHIC!!

NATIONAL HEART, LUNG, AND BLOOD INSTITUTE (NHLBI) ANNOUNCES NEW DIGITAL HEALTH INFORMATION RESOURCE FOR HEALTH PROFESSIONALS

Health professionals and students with an interest in cardiovascular, respiratory, and sleep health are invited to join the National Heart, Lung, and Blood Institute (NHLBI) Health Information Network. The NHLBI Health Information Network is the Institute's digital link to health professionals, designed to provide quick, convenient access to trustworthy information applicable to everyday practice.

To sign up, simply point your Internet browser to http://emall.nhlbihin.net/hp2010; this will take you to the member sign-up page. There is no cost to join the Health Information Network.

Members receive notifications that keep them current on NHLBI's key research findings, clinical guidelines, advisories, programs, and services. Email notices include:Health Action E-Bulletins, Electronic newsletters featuring articles about NHLBI education programs, Online Continuing Education, and Webcasts.

If you subscribe, you can expect to receive a new email from NHLBI about twice a month. If at any time you do not wish to receive further emails, simply respond to any Network email with the word "UNSUBSCRIBE" in the subject line.

PICK YOUR PATH TO HEALTH

The Pick Your Path to Health Campaign

(http://www.4woman.gov/PYPTH/) helps women take simple and time-sensitive steps to improve their health, and provides tools for local communities to promote practical, culturally relevant action steps to wellness.

AUGUST PICK YOUR PATH TO HEALTH THEME -

AUGUST PICK YOUR PATH TO HEALTH PERSONAL ACTION STEPS:

You can also join the PYPTH listserve for regular updates and community action steps. Visit our home page for details: http://www.4woman.gov.

THIS MONTH'S SPECIAL PUBLICATIONS FOR YOUR HEALTH

WHO IS USING NWHIC’s SERVICES?

Last month, the NWHIC web site had 192,638 visitors and received 3,391,856 hits to the site!

In June, our toll-free Information and referral line received the most calls from Texas. Help your state become our "number one" state by encouraging your friends, colleagues and family members to call our toll-free center if they need information on women's health topics!

The most popular NWHIC web pages in June were:

Health Topics

USER SUPPORT

LEAVING THE LIST:

To unsubscribe to this newsletter, users should send an e-mail to listserve@list.nih.gov with the following inserted as the (only) body of the message:
Unsubscribe nwhic_news

JOINING THE LIST:

Pass this e-mail on to a family member of friend! Instructions for joining the HEALTHY WOMEN TODAY newsletter are available at: www.4woman.gov/about/listserv.htm.