While summer is thought of as a time for relaxation and vacations, it is also the most deadly time for children 0-14, as nearly 3 million children will be rushed to emergency rooms during May through August for unintentional injuries.  To keep your children safe this summer you need to keep these safety tips in mind:

• Actively supervise your child when engaging in summertime activities, such as swimming and playing on playgrounds and backyards.
• Use the appropriate safety gear when your child is participating in summer activities.  Such as helmets when biking, a car seat when traveling in a motor vehicle, and life jackets when in or near open bodies of water.
• If you have a pool or a spa, it should be surrounded on all four sides by a fence at least four feet high with self-closing, self-latching gates, and it should be equipped with an anti-entrapment drain cover and safety vacuum release system. An inflatable pool needs to be surrounded by a fence, just like any other pool, and parents need to empty these pools when not in use.
• Make sure your home playground is safe. Keep 12 inches safe surfacing, such as mulch, shredded rubber or fine sand, extending at least six feet in all directions around the equipment. Remove hood and neck drawstrings from your child’s clothing.
• Keep children away from the grill area while preheating and cooking, and while the grill is cooling.
• Remove potential poisons from your yard, including poisonous plants, pesticides and pool chemicals.
• Walk all the way around a parked vehicle to check for children before entering a car and starting the motor.  Don’t let children play in driveways, streets, parking lots or unfenced yards adjacent to busy streets.
• Apply sunscreen rated SPF 15 or higher to your child’s exposed skin 15 to 30 minutes before going out, and reapply frequently.
• Make sure your child drinks plenty of water. A child who seems tired or achy should rest in the shade or go inside for a while. Get immediate medical help any time a child’s skin is hot to the touch (with or without perspiration), if a child has a seizure, or if they become disoriented in hot weather.

Following these simple tips will keep your kids away from danger this summer, which means more time for fun for the entire family!

by:  Kristin Wedding, Safe Kids Coordinator

Request an appointment with a MUSC provider.

Breast pumps

Many mothers return to work after having their baby and desire to continue providing breastmilk for their infants.  Using a breast pump while at work is an efficient and convenient method of expressing milk and maintaining your milk supply when you and your infant are apart.

There are many types of breast pumps on the market, the most reputable brands are Medela and Avent-Hollister.  Prices range from $30 to $400 and depend on the type of breast pump you purchase: manual, single electric, or double electric.

Plan ahead

I suggest that mothers introduce a bottle of pumped milk to their infants around 4 weeks of age, once latch and milk supply are well-established.  This can be continued at least once a day or every other day so the infant learns how to suck the bottle nipple which is quite different from your nipple, both in shape and milk flow.  The mother may need to be out of the room when introducing a bottle so that the infant cannot see or hear her, as many infants prefer the breast over the bottle and will not take it if they know their mother is near.

A woman can start pumping once her milk has come in to start storing milk for when she returns to work.  It is important to remember that your body makes milk in response to breast stimulation, whether that is a breast pump or your infant sucking at the breast.  Therefore, if you begin to pump before you return to work, be consistent and pump the same time every day.  If your infant only takes one breast for a particular feeding, or all feedings, you can pump the other breast to empty it of milk.

Work and Pump

When separated from her baby, a woman should pump at least every 3-4 hours to maintain her milk supply.  She should completely drain her breasts of milk at each pumping session.

Milk can be stored safely in the refrigerator for up to 5 days and then can be transferred to a freezer and stored for up to 6 months.  Milk can be stored in bottles or bags specifically made for breastmilk storage.  It should be stored in 2-3 oz portions; the infant can always be given more if needed but you cannot store milk once it has been reheated.  If using breastmilk bags, place them flat in the freezer, this will save space.

As the milk sits, the cream will naturally separate and rise to the top.  When reheating the milk, gently swirl the cream back into the watery portion of the milk.  Reheat breastmilk by placing warm water into a cup, do not microwave or heat the breastmilk in a container on the stove, hot spots can develop and burn the infant’s mouth.

by:  Pamela K. Murphy, PhD, CNM, IBCLC
Lactation Consultant
MUSC Lactation Center

MUSC offers a class on basic newborn care once every month for expectant parents.  The classes are open to the community and free of charge.  The purpose of the class is to provide information on baby topics such as - baby's appearance and behavior, skin care and dressing, feeding, minor problems and signs of illness, safety, immunizations and follow-up care, and sibling behavior.  The goal of the class is to increase parental knowledge and comfort level regarding newborn care.

The instructors for the classes are registered nurses who work in the newborn/special care nursery at MUSC, so you may see them again when you come to the hospital.  They are specially trained in assisting parents in caring for their newborns, and they have a sincere interest in parent education.  The instructors use lecture, PowerPoint presentations, handouts and demonstrations for teaching, and these individuals constantly seek ways to improve their teaching strategies and to remain current in the information provided.  Parent involvement is encouraged and questions are always welcomed.

All classes are held the second Thursday of each month from 6:30 - 8:30 p.m. Classes are held in 2 West Classroom in Main Hospital. Parking is available in the garage or G-lot.  To register, please call (843) 792-5300.

by:  Deborah West, MSN, RN
Neonatal Educator

Request an appointment with a MUSC provider.

For those of you who missed my talk on February 4th about “Common Breastfeeding Myths,” I will address a question seen on this blog about which is best “breast milk or formula.”   I will explain below the benefits of breast milk and why The American Academy of Pediatrics and the World Health Organization both recommend breastfeeding for at least the first 6 months of life.

Infection fighting
The infection fighting factors of breastfeeding cannot be replicated in formula. A breastfed infant is protected against infection. Breast milk strengthens the infant’s immune system by increasing the barriers to infection and decreasing the growth of organisms like bacteria and viruses. The breastfed child is protected from allergies, asthma, diabetes, obesity, and sudden infant death syndrome. As a group breastfed babies have fewer infections and hospitalizations than formula-fed infants.

Perfect food
Breast milk is often called the “perfect food” for a human baby’s digestive system.  Breastfed babies generally have less difficulty with digestion than do formula-fed infants, therefore less diarrhea and constipation. Breastfeeding is also equally convenient for parents since there are no last minute runs to the store for formula and there is no need to warm bottles in middle of the night since breast milk is always fresh and available. It is easy for moms to be on the go with their babies since all they need is a quiet and private place to nurse when the baby is hungry.

Free
A big advantage of breast milk is that it does not cost anything and formula costs can quickly add up. Because of the immunities and antibodies passed onto babies through their mother’s breast milk, breastfed infants are sick less often than infants who receive formula. Research has shown that infants who are breastfed exclusively have fewer episodes of ear infections. This means fewer trips to the doctor’s office, fewer co-pays, prescriptions, and fewer days missed from work.

Benefits mom, too!
Breastfeeding is beneficial for mom as well. The ability to nourish a baby helps a new mother feel confident in her ability to care for baby. Breastfeeding also burns calories and helps shrink the uterus, so nursing moms may be able to return to their pre-pregnancy shape and weight quicker. Studies show that breastfeeding helps lower the risk of breast cancer and also may also decrease the risk of uterine and ovarian cancer.

So you see while manufacturers have tried and tried they just cannot improve on nature’s “perfect food!”

Classes at MUSC
MUSC offers a breastfeeding class free of charge as a service to our patients and community.  All classes are held from 6pm - 8pm, in the 2 West Classroom in the main University Hospital.  To register, please call (843) 792-5300.

by:  Adina Garner, BSN, RNC, IBCLC, MUSC's 2008 Nurse of the Year

Request an appointment with a MUSC provider.

Delivering your infant prematurely is not planned. Therefore, preterm delivery often disrupts a mother's plans including whether she intends to breastfeed or not. Preterm delivery alters breastfeeding plans in two ways. For the mother who did not intend to breastfeed, the neonatology team will be asking this mother to pump her breast milk, while her infant is in the hospital, so that she can provide this excellent "medication" to her preterm infant. For the mother who intends to breastfeed, she also will be asked to pump her breast milk until her infant can receive adequate nutrition from the breast.

Breast milk as medicine
Infants do not develop the ability to take breast or bottle feeds until approximately 32-34 weeks gestational age (about 7 months of pregnancy). Until they reach that age, they receive mother's breast milk through a tube from the mouth or nose to the stomach. In addition, even when preterm infants develop the ability to breastfeed, they often require additional nutrition through at least 9 months of life. Breast milk is by far the best nutrition for preterm infants, but it is lacking in calcium, phosphorus, vitamin D, and protein for very preterm infants. The strong benefit of breast milk lies in its antibacterial and antiviral properties and its enzymes that help a baby's intestines absorb fats, carbohydrates, and protein. Breast milk even contains stem cells that likely help grow the infant's intestine! We call breast milk a "medication" because of the many benefits to protect the infant from infection and support growth of the body and the brain. Nonetheless, even for mothers who strongly desire to breastfeed their infants, providing breast milk to a preterm infant is not easy. To maintain a good milk supply, a mother must pump her breast 6-8 times a day. If a mother does not pump regularly and instead waits for her breast to feel full, her breast milk supply will decrease. Even if a mother pumps 6-8 times a day every day, maintaining milk supply still can be difficult.

Breastfeeding support
Fortunately, we do have some ways to support mothers' milk supply. One is "Kangaroo Care" which allows a mother to hold her infant directly on her chest for a few hours each day. For a mother who wants her infant to learn to breastfeed, we can position her infant on her chest to try some "non-nutritive suckling" where the infant gets the feel of suckling on the breast. When a preterm infant reaches the gestational age to try feeding at the breast, we have more ways to support mother and infant! Preterm infants often do not have much energy for feeding, so the neonatology team works hard with mother and infant to make it easier. To calculate how much milk a preterm infant takes at the breast, we have very precise scales to weigh the infant before and after a breastfeeding! We want to support mothers of preterm infants in all ways to help them succeed in providing breast milk for the infant and to breastfeed if desired. Breast milk is truly the best medicine for a preterm infant, and, therefore, is the greatest gift that a mother can give her preterm child. However, it is not easy, and the MUSC neonatology team greatly admires and appreciates the preterm infant mothers who work so hard to provide this resource to their infants. 

by:  Sarah Taylor, M.D.

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