Did you know that 88% of working mothers will not get one minute of paid leave after they have a baby! And half of mothers who have access to unpaid maternity leave (FMLA)* at their workplaces will be deemed ineligible. Learn about the impact and far reaching implications in this fantastic talk by Jessica Shortall. Also check out her book, Work. Pump. Repeat. here.

www.workpumprepeat.com and photo credit Laura Legg Photography

*The Family and Medical Leave Act of 1993 (FMLA) is a United States federal law requiring covered employers to provide employees job-protected and unpaid leave for qualified medical and family reasons.

Check us out on Amazon!

New Native Baby Carrier Organic by New Native   Learn more

Our products are manufactured in California, employing moms and therefore enabling families to spend more time together. CMTC has put together an awesome list of company's who manufacture in CA. See our profile HERE and yay California!

Photo: Gregory Daulton

http://www.askdrsears.com Download. Website.

Babywearing Reduces SIDS

Babywearing vs. SIDS

If SIDS is basically a disorder of respiratory control and neurological immaturity (and I believe it is), anything that can help a baby’s neurological system mature overall will lower the risk of SIDS. That’s exactly what babywearing does.

While wearing our own babies, I noticed how my breathing affected theirs, especially when I was sitting still with a sleeping baby nestled in a sling against my chest. Whenever I took a deep breath, so did baby. Sometimes the stimulus was the rise and fall of my chest, at other times the air exhaled from my mouth and nose against baby’s scalp or cheek-stimulated baby to take a deep breath.

Have you ever wondered why mothers in other cultures have for centuries worn their babies in homemade slings? I used to believe this old custom’s purpose was simply to protect babies from jungle dangers or to enable mothers to do manual labor. Wrong! When I was researching parenting styles in other cultures, I interviewed African mothers who wore their babies in slings that were extensions of their clothing. They agreed that babywearing protected their infants from dangers, but that wasn’t the main reason for doing it. Instead, they said, “It makes life easier for the mother,” or “It does good things for babies.” “What good things?” I inquired. These mothers replied, “The babies seem happier,” or “They cry less,” or “They seem more content,” or “The babies grow better.”

Note: these observations were not from mothers who attended parenting classes, read books on baby bonding, or relied on scientific studies. These were mothers whose “sources” were their own powers of keen observation and centuries of tradition, both of which told them babies thrive better when carried in slings. Now, modern researchers have scientifically proven what these intuitive mothers have long known: Something good happens to babies who spend a lot of time nestled close to nurturing caregivers. Here’s why.

Babywearing Reduces SIDS And Gives a Vestibular Connection

Babywearing exerts a regulatory effect on the baby, primarily through the vestibular system. This tiny system, located behind each ear, controls baby’s sense of internal balance. It is as if there are three tiny carpenter levels back there—one tracking side- to-side motion, another for up-and-down motion, and a third for back-and-forth motion—all functioning together to keep the body in balance. Every time the baby moves, the fluid in these “levels” moves against tiny hair-like filaments that vibrate, which sends messages to the brain to help baby balance her body.

In the womb, the baby’s very sensitive vestibular system is constantly stimulated because a fetus experiences almost continuous motion. Babywearing provides the same kind of three-dimensional stimulation and “reminds” the baby of the motion and balance he enjoyed in the womb. The rhythm of the mother’s walk, which baby got so used to in the womb, is experienced again in the “outside womb” during babywearing.

Activities such as rocking and carrying stimulate the baby’s vestibular system. Vestibular stimulation is a recently appreciated tool for helping babies breath and grow better, especially premature infants—those at highest risk of SIDS. Some studies showed premature babies placed on professionally-monitored, oscillating waterbeds grew better and had fewer apnea episodes than other preemies did (although one study disputed this.) Babies themselves recognize that they need vestibular stimulation; infants deprived of adequate vestibular stimulation often attempt to put themselves into motion on their own, with less efficient movements, such as self-rocking. Researchers believe that vestibular stimulation has a regulating effect on an infant’s overall physiology and motor development.

Kangaroo care

Newborn nurseries have recently begun using a method of vestibular stimulation called “kangaroo care,” in which a premature baby is wrapped, skin-to-skin, up against the mother’s or father’s chest. The parent rocks, holds, and gently moves with the baby. The rocking motion, the skin contact, and the rhythmic motion of the parent’s chest during breathing produces the following beneficial effects:Babies show:

• More stable heart rates
• More even breathing
• Fewer episodes of periodic breathing
• Fewer and shorter episodes of apnea
• A healthier level of oxygen in their blood
• Faster growth
• Less crying and increased time in the state of quiet alertness
• Better sleeping

Researchers believe that using kangaroo care helps the parent act as a regulator of baby’s physiology, including reminding the baby to breathe. In other experiments, infants with breathing difficulties were placed next to a teddy bear stuffed with a mechanism that seemed to “breathe”; these babies also had fewer apnea episodes. When this “breakthrough” in teddy technology hit the newspapers, a reader wrote in, “Why not use the real mother?”

From http://www.askdrsears.com, Download. Website.

Breastmilk: The Milk, The Mother, Or The Method

Whether it is the milk, the mother, or the method that is responsible for the lower SIDS risk in the breastfed infant is hard to tell. It’s probably a combination of all three which proves breastfeeding reduces SIDS.

THE MILK

There are hundreds of substances in human milk that aren’t in artificial milk. These cannot be manufactured or bought; they can only be made by mother. Each year researchers discover new factors in human milk that are beneficial to baby. I suspect that researchers have only scratched the surface of what amazing factors exist in human milk. The following is what we know. What is even more intriguing is what we do not yet know about how human milk benefits human babies in general and how it lowers the risk of SIDS in particular.

1. Breastmilk Fights Against Infection

Respiratory and gastrointestinal infections contribute to the SIDS risk, and breastfeeding infants get fewer respiratory and gastrointestinal infections. Breastfeeding protects against RSV (respiratory syncytial virus) infections, and this virus has been implicated in causing inflammation of the lungs that could contribute to SIDS.

Between two and six months of age (which, you’ll recall, is also the peak period of SIDS risk), a baby’s immunity is lowest and the vulnerability to infection is highest. The newborn baby derives much of his immunity from his mother’s antibodies while in the womb. After birth these antibodies gradually disappear. Meanwhile, baby is making his own antibodies, so that by age six to nine months he is more capable of defending himself against infection. Between two and six months, when the antibodies derived prenatally from mother are at low levels and baby has not yet made enough of his own, the immunity factors in breastmilk fill in, taking over where the placenta left off and protecting the baby while his own immune system matures.

One of the ways in which breastmilk protects the infection-vulnerable infant is through the enteromammary immune system. When mother is exposed to a new germ, glands in her intestine make infection-fighting cells specifically for this germ. These special cells travel through her bloodstream to her breasts, where they announce the presence of the enemy germ. The breast glands respond by manufacturing antibodies, which are delivered to the baby through the milk. Because she can make new antibodies better and more quickly than her tiny baby can, mother updates her baby’s immunity with every feeding. Would it be presumptuous to call breastmilk a SIDS vaccine? Read on.

2. Breastmilk Builds Better Brains

“MOTHER’S MILK: FOOD FOR SMARTER KIDS.” This was the headline in USA Today on February 2, 1992. While both experience and research have long suggested that breastfed babies are intellectually advantaged, the difference has usually been attributed more to the nurturing or to the character of the mother than to the type of milk. But new research suggests that it’s human milk itself rather than (or in addition to) the process of breastfeeding (or the skills of the mother) that enhances brain growth. Brain-building substances and elements called “growth factors” have recently been discovered in human milk. Researchers in England studied three hundred babies who were very premature and weighed less than four pounds, a group that is at high risk for SIDS. They divided their subjects into two groups: those who were fed their mother’s milk and those who were not. Because of their prematurity, these infants received the milk by tube rather than directly from the mother’s breasts, thereby separating the effects of the milk from the effects of the nurturing. Those premature babies who got their mother’s milk during the first five or six weeks of life averaged 8.3 points higher on IQ tests at age seven-and-a-half to eight years. Also significant in this study was that the more breastmilk the babies received, the higher these children scored. Since this study, over eleven more studies have concluded that breastfeeding builds better brains.

Why does human milk build better brains? Special nutrients in human milk that are not in artificial baby milks may be the answer. Human milk contains substances (such as cholesterol, linolenic acid, and taurine) that enhance the development of the central nervous system in several ways, the most convincing of which is that it provides vital fats, namely DHA for myelin, the insulating sheath around nerves that helps impulses travel faster. (Postmortem examinations have shown deficient myelination—the covering around nerves that lets impulses travel faster—in the nerves around the respiratory control center in some infants who died of SIDS). These areas show changes that could be the result of delayed development and/or oxygen deprivation. So vital are these brain builders that if a mother’s milk is short on these special nutrients, the mammary glands themselves make and deposit them into her milk. Although myelination continues well into early childhood, the greatest degree of myelination occurs during the first six months of life.

3. Breastmilk is Kinder to Tiny Airways

Besides reducing respiratory infections that clog baby’s air passages, breastfeeding also helps keep little airways open by not exposing them to the allergens in foreign milk. Stuffy noses and airways and recurrent respiratory-tract infections are frequent signs of allergies to artificial milk made from cow’s milk or bean milk (such as soy). Breastfeeding helps breathing in two ways: by helping the brain systems that control breathing to mature, and by helping to keep tiny air passages open. It is also interesting to note that breastfeeding infants have higher blood levels of the hormone progesterone, and progesterone stimulates breathing. In summary, babies who get breastmilk breath better.

As a final perk, even if human milk goes down the wrong pipe and enters baby’s lungs, it does not irritate the lungs as much as formula can. Human milk is not a foreign substance. Also, studies on experimental animals have shown that the introduction of water or cow’s milk into the upper trachea (the beginning of the airway) can lead to apnea. This did not occur when normal saline (a physiological solution similar to the infant’s own blood) or the species’ own milk was squirted into the trachea. These researchers concluded that aspiration of water or foreign milk may cause a stop-breathing episode in infants, a life-threatening episode that might not occur if mother’s milk accidentally goes down the wrong way.

4. Breastfeeding Reduces Reflux

Gastroesophageal reflux (GER) is less severe in breastfed infants than in infants fed artificial baby milks, probably due to the fact that human milk is emptied faster from the stomach. Since GER has been implicated in apparent life-threatening events (ALTEs) and ALTEs may be a forerunner of SIDS, reducing GER could also reduce SIDS.

5. Breastfeeding Promotes Safer Sleep

6. Breastfeeding organizes baby. I believe that an important piece of the SIDS puzzle is that some babies at risk of SIDS have an overall “disorganized physiology.” Breastfeeding has a calming effect on a baby. The harmony between a breastfeeding mother and her suckling infant has an organizing effect on baby’s sleep/wake cycles, probably as a result of the cue-response sensitivity of the breastfeeding pair.

THE MOTHER

Not only does breastmilk have protective qualities for baby, breastfeeding does good things for mother, which indirectly may reduce the risk of SIDS.

7. Breastfeeding Increases Mother’s Awareness

Breastfeeding is an exercise in babyreading. It increases the sensitivity of a mother to any changes in her baby. The increased maternal hormones (primarily prolactin and oxytocin) that are stimulated by baby’s sucking appear to provide a biological basis for the concept of mother’s intuition. During my 30 years of watching mothers and babies, I have been impressed by the increased sensitivity breastfeeding mothers have toward their babies. They’re able to read subtle cues and changes in their infants. Cindy, a breastfeeding mother, told me: “I can tell when my baby has an ear infection by the way she sucks.” Breastfeeding mothers tend to sleep with their babies, a nighttime parenting style that I believe decreases SIDS risk. A breastfeeding mother also sleeps differently than her formula-feeding friends. She may be more aware of changes in her baby, even while they both are sleeping. (See Co-sleeping and SIDS)

Can formula-feeding mothers attain this high level of sensitivity to their babies? I suspect they can, especially if they practice the rest of the attachment-parenting package, such as sharing sleep and wearing their baby. Yet without the hormonal boost that breastfeeding provides, bottle-feeding mothers have to work harder at developing this heightened awareness.

THE METHOD

Besides the good stuff in breastmilk and the act of breastfeeding itself with its increased “touch time,” the way an infant breastfeeds may also lower the risk of SIDS.

8. Breastmilk Improves Breathing/Swallowing Coordination

Newborns have to learn to coordinate breathing and swallowing during feeding. For premature infants (those at highest risk for SIDS), this is a gradual learning process. Studies show that premature babies who breastfeed coordinate sucking, swallowing, and breathing more efficiently than do their bottlefeeding mates. Breastfeeders also tend to feed more frequently than their bottlefeeding friends, therefore getting more practice coordinating their swallowing and breathing. Since tiny infants tend to have weak points in muscle support of their upper airways, their breathing passages are narrower, especially during sleep. Any exercise of the mouth and throat muscle is helpful in keeping the airways open.

In full-term infants, breastfeeding helps keep tiny airways open by helping the jawbone and muscles of the upper airway develop better. Dental studies show that breastfeeding babies develop better alignment of the oral cavity. Dr. Shirley Tonkin, a New Zealand researcher, told me she believes that breastfeeding infants are more likely to use their jaws and pharyngeal muscles in a sucking motion that enhances the development of muscles, bones and lips—all of which helps keep their airways open better than those of bottlefeeding babies. Dr. Tonkin, a pathologist, speculated that the different muscle actions involved in bottlefeeding may contribute to the growth of larger tongues, thus further narrowing the already unstable airway of tiny infants. A recent postmortem finding that SIDS babies have larger tongues lends support to Tonkin’s theory. The more stable the airway to breathing, the lower the risk of SIDS.

Putting infants to sleep on their backs or sides rather than on their stomachs may lower the risk of SIDS. When my wife, Martha, breastfed our eight babies, she invariably put them to sleep on their backs or sides, believing that in this position the breastfeeding pair had easier access to nursing at night. Breastfeeding mothers I have interviewed, especially those who share a bed with their infant, most often place their babies on their sides facing them; or the infant often sleeps in the crook of mother’s arm, necessitating a back or side position.

As we await the results of more research, we can continue to rely on common sense. The milk of each species of mammal is different and designed to insure the best chances of survival for the young of that species. (Consider what happens if you put the wrong fuel into a car. Sooner or later it doesn’t run right and its engine control systems fail.) I believe that someday a researcher will discover what savvy mothers have long suspected: there are nutrients in mother’s milk that help keep new lives living. In the meantime, it’s possible that any one of the protective effects of breastfeeding could lower the SIDS risk, even slightly. When you put together all the benefits of breastfeeding, the good stuff in breastmilk, the special touch of breastfeeding, and the special actions of breast suckling, you have a compelling case that breastfeeding increases an infant’s chances of health and well-being.

The current paper examines subcortically based early emotional learning in infants from diverse cultures. We speculate about some longterm deleterious or beneficial effects of this early learning. 

Emotional Learning in Infants: A Cross-Cultural Examination 1*

Michael Lamport Commons Patrice Marie Miller

Harvard Medical School Harvard Medical School and Salem State College

Commons@tiac.net PatriceMarieMiller@Mediaone.net

Download, website

The current paper examines subcortically based early emotional learning in infants from diverse cultures. We speculate about some longterm deleterious or beneficial effects of this early learning. According to their specific goals for children, different cultures provide different child rearing environments and obtain different behavioral outcomes. As a result, the behavior of infants, young children and older individuals varies across cultures. Although we would not argue that these early experiences are completely formative by themselves, there tends to be continuity of socialization over time. The fundamental behavior patterns set into place during early socialization are further elaborated on as the child grows, and they persist into adulthood. Cultures may have markedly different goals and socialization practices. In addition, what is viewed in one culture as normal emotional learning and obviously the correct methods for achieving that learning, may be seen by another culture as strange, deficient or even pathological. As will also become clear, although there is considerable work on early emotional learning (during the first 6-8 months), there is little work explicitly and directly relating this early learning to later behavior. This paper will conclude with some suggestions for doing so. In particular, it is suggested that early stressful experiences may result in a differential ability to handle stressful experiences later in life. The mechanisms by which this is accomplished are: a) that early child care practices that produce stress in infants, may result in higher levels of cortisol on a long term basis, and b) that certain emotional  behaviors may be learned subcortically during the first few months of life, and that these behaviors will persist.

Early Learning

Much emotional and interactive behavior is learned during the first 6- to 7-months of life, and much of this learning takes place subcortically. According to Emde and his colleagues (1976) as well as others (e.g. Fischer & Rose, 1995) seven to nine months is the time of a major bio-behavioral shift. During this shift, changes take place in the frontal lobes of the cortex such that the cortex becomes more involved in planning and carrying out deliberate actions. These changes involve both myelination of the frontal cortex, the growth of connections between that area and other brain areas, and the death of some of the extra neurons present in these areas. Therefore, we would infer that before this biobehavioral shift is the period during which subcortical learning might be most prevalent. Even after this biobehavioral shift, when the cortex is more involved in behavior, there is a variety of different evidence that suggests that subcortical processing may continue to be an important part of learning and experiencing emotions. For example, Todd et al. (1995) summarize evidence suggesting that myelination continues in some areas of the brain until 6 years of age (for example, for the primary motor and sensory areas of the brain), and in a few areas (for example, some of the associative areas) even beyond that. Other evidence suggests that at least some emotions, such as fear, may be learned subcortically at least into early childhood (for example, Izard & Harris, 1995; Jacobs and Nadel, 1985; or LeDoux, 1987). Today, we focus on experiences that infants have before the 7- to 9- month bio-behavioral shift takes place. A more detailed paper would show either that the continuation of practices into early childhood and beyond could strengthen patterns already established, or that a shift in practices might change the eventual outcome. Rather than relying on data from one study, this paper integrates results from a variety of published studies. None of these data were originally collected with the purpose of this paper in mind. We feel that this gives us a relatively conservative method of evaluating the hypothesis that a large amount of emotional learning can take place early in life. In examining how infant behavior develops in different cultures we will use the model proposed by Sigel (1985). Sigel proposes a model that relates parental beliefs and goals to parental behavior, which is then related to child behavioral outcomes. Others (e.g. LeVine et al., 1994) have proposed similar models. Differing Parental Goals and Behavior Parents in different cultural settings have different goals for their children. LeVine and colleagues (LeVine et al., 1994) contrast North American (that is, U.S.) parents with Kenyan Gusii parents. The U.S. parents, he argues have a pedagogic model. The major goals are for children to learn to feel emotionally independent from their parents and to develop interactive and language skills. We will outline a number of features of this model. Independence and Sleeping Patterns In order to accomplish their goals, American parents engage in a number of behaviors. Richman, Miller & Solomon (1988), Morelli et al. (1992) and others have described the North American practice of placing even newborn infants in their own beds and often in their own rooms. In Morelli et al.’s sample of 18 North American families, not a single family reported bringing their newborn into bed with them, although 15 allowed the infant to sleep in a bassinet or crib in the parental room. For the vast majority, this lasted only for the first 3 months or so of life, at which time infants were moved into their own rooms. The Gusii would be quite shocked by these practices. Other Separation North American parents are also relatively tolerant of other separations: infants are left with unrelated nonresident babysitters on a routine basis by many parents. More extended separations continue to be tolerated by some. For example, parents of young infants may go away for the weekend and leave their infant with a non-resident grandparent. There are no data on the extent of this practice. One practice that reflects the degree of comfort of the culture as a whole with such separations is the fact that until relatively recently, parents were not allowed to stay with their infants and children in hospitals. Most traditional societies are aghast at this practice and have not followed it when introduced to it by Northern Europeans and Americans. The lack of co-sleeping and the tolerance for separation have been added by us to other practices of the pedagogical model seen as essential by LeVine et al. (1994). Verbalizing and face to face interaction As detailed by many investigators (e.g. Brazelton, Koslowski & Main, 1974; LeVine et al., 1994) American mothers behave as if their infants have the capacity to be active participants in interactions with adults: they talk to, look at, smile at and otherwise actively interact with infants from birth. In the absence of actual vocal responses from these very young infants, mothers respond to burps, hand movements, and other behaviors as if these are conversational overtures. Accompanying this strong emphasis on verbal interaction is a deemphasis on physical contact when compared to many other cultures. For example, Richman, Miller & Solomon (1988), and Miller (1994) detailed the low rate of touching and holding among U.S. mothers when compared with Kenyan Gusii mothers in one case and with Mexican mothers in another case. Miller (1994) has suggested that one could have high rates of touching and high rates of verbal interaction, but at least in the U.S., this does not occur. Consoling In contrast to the U.S. parent’s high responsiveness to positive vocal/verbal behavior, LeVine et al., 1994) reported that American mothers are relatively tolerant of infant crying, allowing it to continue for much longer than mothers in other cultures would. For example, Gusii mothers watching videotapes of U.S. mothers were upset by how long it took these mothers to respond to infant crying.

Pediatric Model

In contrast to the pedagogical model, LeVine (LeVine et al., 1994) described some cultures as having a pediatric model, that is, a model in which the most important goal is protecting the health and survival of the infant. Although he used this term specifically in describing the Gusii of Kenya, aspects of this model apply to other cultures as well (and perhaps particularly to cultures in which infant mortality is still high or has only recently decreased).

Co-sleeping and Breast Feeding on demand. In many cultures, including the Gusii studied by LeVine et al. (1994) and the Mayans studied by Morelli et al. (1992), mothers and infants sleep together. This practice generally lasts until the mother’s next child is born. Sleeping together allows the mother to more easily breast feed the infant, and breast feeding on demand both at night and during the day typically continues into the second year, and perhaps beyond. LeVine et al. (1994) argue that frequent breast feeding has played an essential role in cultures where infant mortality was very high, by helping to ensure early weight gain and the possible maintenance of hydration in the presence of diarrhea. Consoling Mothers whose behavior can be described as following the pediatric model tend to respond rapidly to crying, and show high rates of holding and touching. By responding rapidly to infant distress, and otherwise keeping  the infant as quiet as possible (not encouraging other types of interaction that may excite the infant too much), and by engaging in higher rates of holding and touching (Miller, 1994) mothers in these cultures aim to produce children who are quiet, and when older are respectful and obedient to adults. As shown by experimental studies (Barr, 1990) increased holding by mothers tends to result in infants who cry less. LeVine argues that minimizing caloric expenditure due to excessive crying and too much activity may have improved infant survival under difficult conditions.

Verbalization and face to face interactions. Mothers in cultures like the Gusii do not typically talk to their infants extensively (e.g. Ochs & Schieffelin, 1984; LeVine et al., 1994) nor, in the case of the Gusii of Kenya at least, engage in much or any eye-contact with them. They do not see infants as capable of communicating or of understanding language and so do not engage in the type of stimulating face-to-face interactions with them that are seen among U.S. mothers and infants. Middle class mothers from the U.S. tend to find this bizarre.

What Infants Learn. What do infants learn in these situations? Much of the existing evidence has focused on the more overt, cortically controlled behaviors. We know, for example, from the work of LeVine and his colleagues (LeVine et al., 1994; Richman, 1983) that older U.S. infants and children are more active and talkative than the Kenyan (Gusii) infants and children. What types of subcortically controlled behaviors might they also be learning? There is less actual evidence of these types of behaviors, but knowing something about what systems are involved we can offer some possibilities for future exploration. This discussion will focus on nonverbal behaviors and on emotions. A first difference might involve an infant or child’s general level of arousal. Because interactions with U.S. infants involve a lot of stimulation and reinforcement of vocal/verbal behaviors, and elicitation of smiling and laughing, these interactions have been observed to involve high peaks of excitement, longer interactions that involve play and other exciting activities, and generally higher levels of arousal in the infants (Dixon, Tronick, Keefer & Brazelton, 1981). Dixon and colleagues contrasted this with the style of interaction of the Kenyan (Gusii) mothers. These mothers engaged in the more exciting types of interactions for only very brief periods of time, and when their infants began to get too aroused and excited they were observed to avert their eyes and/or turn away. It is inferred that in general, the U.S. infants spend more of their time in highly aroused and excited states and infants in soothing/distress responsiveness cultures (like to Gusii) spend more of their time in less aroused and excited states. Later on, U.S. children may be more likely to be stimulus seeking, although Gusii children may not or may even prefer quietness, sedateness and low key interactions. Due to relative tolerance of crying among U.S. mothers, and less holding, American infants are expected to be more fussy (Barr, 1990). It may be inferred that the holding and soothing strategies used by Gusii mothers, among others, produce infants that spend less time distressed. U.S. infants and children, therefore, are more likely to spend time in both excited and happy states of arousal and in distressed states of arousal. Infants who are soothed and held will be less likely to experience both peaks of excitement and peaks of distress. The question we will take up below is whether exposure to such peaks of both positive and negative arousal helps infants to cope better with later stresses, or not. Finally, it is apparent that U.S. infants must learn to cope early with being alone and specifically with being separated from their mothers. Tennes (1982) has shown that in human infants there is a positive linear relationship between amount of separation protest and the amount of cortisol secreted. The information we have about sleep patterns in American infants and children also suggests that these produce stress in them. Although we are not aware of studies that have measured cortisol levels in infants sleeping apart from their parents and those sleeping with their parents, there is some evidence that these sleeping practices are stressful for American infants. For example, bedtime rituals seem to occur in U.S. settings, where infants and children are put to bed at set times and in separate areas, but rarely in other settings (e.g. Morelli et al., 1992). These rituals may last up to an hour in some cases and seem to be a response to the difficulty the infant or child has with going to bed on their own. A majority of U.S. infants in the Morelli et al. study also required transitional objects such as pacifiers, “blankies” or stuffed animals. It is well known from studies of adults (as summarized by Fackelmann, 1998) that cortisol is produced during all types of stressful events, and that high levels of cortisol seem to be associated with a number of effects, including low immune system functioning.

Implications

We are suggesting two possible early effects of early child rearing practices: a) different emotional behaviors related to arousal versus lack of arousal, expectations for contact with consoling individuals when one is upset or alone, and differential anticipations for other features of interactions with others (Commons, 1991). b) possibly long term differences in the release of cortisol and possible related changes in brain structure due to the relative stressfulness of certain practices It is expected that much of the early emotional learning takes place subcortically and results in children who have quite different expectations from their interactions with other people. As discussed above, such subcortically learned expectations may not be accessible to conscious awareness and therefore control and relearning. One implication is that cultures that train for independence, and therefore self-responsibility, risk having more PTSD later in life. That is because these cultures do not support infants (nor adults) during stressful and traumatic events to the same extent as do cultures that emphasize dependence and mutual support. Whether distressed or not, Individuals are isolated or separated and do not experience as much physical contact, which is known to be soothing (it has been shown to reduce blood pressure and so on). Early stressful practices may produce lasting effects, as these areas of the brain are still developing. As has been suggested by numerous investigators, the pathways that remain in place after early development are very determined by experience (as summarized in Todd et al., 1995). There may therefore be permanent alterations in stress-related neurotransmitter systems (such as the release of higher levels of cortisol). It is also the case that even later on, these individualistic cultures do not make coping with stress and trauma easy, as they tend to view trauma as shameful, something the individual should have controlled or avoided as part of their independence, and typically something to be dealt with alone. Because of the shameful nature of most trauma, it is not openly discussed, which seems to worse its effects.

1* Paper presented at the American Association for the Advancement of Science, Philadelphia, PA, February, 1998. For further information please write to Michael L. Commons, Program in Psychiatry and the Law, Department of Psychiatry, Harvard Medical School, Massachusetts Mental Health Center, 74 Fenwood Road, Boston, MA 02115 or send e-mail to commons@tiac.net.

See Download for references here.

By Jackie Hunt Christensen | EcoMall.com | Download

Ever wonder what your child's toys are made of? Chances are, if the toys aren't wood or metal, they're some kind of plastic. But what kind? Unlike most food containers or packaging, toys generally aren't marked with the triangle of "chasing arrows" and a "1," "2," or "4" in the middle that indicates the type of plastic used in its manufacture.

As a curious environmental activist and concerned parent of two, I decided to do some checking. I started with one of my girlhood icons, BarbieTM. Over a year ago, McDonald's restaurants were giving away miniature Barbies with their Happy Meals. A friend of mine was collecting them for her niece. I scanned Barbie's body for some sort of resin code (the ones that appear in the "chasing arrows" triangle) and found none. I called McDonald's to see what McBarbie (not her real name) was made of. They seemed perplexed that I should ask this question-why did I want to know? So I said my son had pulled off Barbie's leg and I wanted to know if she was recyclable. They assured me that yes, she was, but they didn't know what she was made of. So I called Mattel, the company that manufactures Barbie. Customer service representatives said that all Barbies are made of a plastic called polyvinyl chloride, or PVC.

Hearing this concerned me a great deal, and I began looking at my son Alex's plastic toys. Most of them were not labeled either, and the ones that were tended to be "2s" (high density polyethylene) or "5s" (polypropylene).

What's Wrong with PVC?

I'm concerned about PVC in my sons' toys for a couple of reasons: its potential for affecting their health, and its potential for harming the environment.

My son Bennett is almost 18 months old, and is working on his last four teeth. Everything goes into his mouth and is chewed with abandon. From my research, the risks to him come primarily from plasticizers called "phthalates" that are used to make the flexible PVC items like teethers. There are several phthalates that may be used in PVC, but the most common are di-ethylhexyl-phthalate (DEHP), di-isodecyl phthalate (DIDP), and di-isononyl-phthalate (DINP). Phthalates are not chemically bound to the PVC. Instead, they sit side by side with the polymer. This means that the phthalates can leach out of the PVC and into the surrounding environment-which may include my son's mouth. The Danish Department of Environmental Chemistry recently studied teething rings sold in Denmark and reported that "significant migration of certain phthalates was found...."

A large variety of health effects in wildlife and humans have been associated with phthalates. One of the most frightening, I think, is the possibility that phthalates may be chemicals that behave similarly to hormones in our bodies. Eight phthalates have been shown to be weakly estrogenic, which means they can cause responses in the body similar to those elicited by estrogen. As you probably know, estrogen is a hormone involved in reproduction and sexual development. Both men and women produce estrogen to regulate those important functions, but I don't want my son exposed to anything that might upset his body's own delicate balance.

Other effects of phthalates:

• DEHP has been shown to cause liver cancer in rats and is considered a potential human carcinogen.

   

• Rats exposed to dehp over long periods exhibited kidney damage similar to that seen in humans undergoing long-term kidney dialysis.

   

• High doses of DEHP and di-n-butyl-phthalate (DBP) have also been shown to affect reproduction and sperm production in rats.

   

• In the human body, dehp is converted to mono-2-ethylhexyl-phthalate (MEHP). MEHP has been found to cause cardiac and respiratory arrest in rats.

   

It must be noted that other than DEHP, many of the phthalates have not been well-evaluated for their possible health effects to humans. In my opinion, this means that my children are serving as guinea pigs. I would have hoped that our actions on thalidomide and diethylstilbestrol (DES) would have taught us to heed the warning sirens sounded by effects on animals.

The Consumer Product Safety Commission's (CPSC) Chronic Hazard Panel has met several times to discuss DEHP, but to date, the only action has been a voluntary reduction by domestic toy makers in its use for children's toys; the CPSC has not taken action on other phthalates or called for more studies on other phthalates, despite mounting evidence about their possible hormone-disrupting properties and other health effects. Personally, I would prefer that if toys must be made of plastic for some reason, a resin which does not require plasticizers should be used.

Alex, who is six, doesn't put his toys in his mouth much anymore. Ben, however, who doesn't yet understand the "laws" of toy ownership, does not discriminate between his own toys and Alex's. Were I to let him, Ben would just as soon chew on the PVC-stuffed Beanie Baby Alex got for his sixth birthday as his own polyester-filled terrycloth cow. That Beanie Baby, as well as other plastic toys in my house, has posed health as well as environmental dilemmas for me. Here's why:

The PVC Lifecycle

One of the reasons that PVC is bad for people and the environment is that two of the chlorine-based chemicals involved in pvc production, ethylene dichloride and vinyl chloride monomer, are hazardous in and of themselves. Ethylene dichloride is a possible human carcinogen and vinyl chloride monomer is a known human carcinogen. Production of those pvc "building blocks" can also produce dioxin, one of the most toxic substances known to humans. In the process of making vinyl chloride monomer into polyvinyl chloride for Barbies or thousands of other uses, more dioxin and other toxic by-products are also likely to be produced.

Dioxin is an unwanted by-product of a number of industrial processes, including incineration, chlorinated bleaching wood pulp cellulose, and the manufacture of PVC. It doesn't degrade easily and so builds up both in the environment and in our bodies, where it is stored in fat. Dioxin has been linked to a host of health effects in wildlife and humans, including various cancers, endometriosis, and problems with the body's hormone system, which is responsible for growth, sexual development, and reproduction.

PVC by itself is very brittle, so depending on the intended use, a variety of plasticizers and stabilizers may be added. Many of these compounds are toxic, too. Some common stabilizers used in PVC include lead and organotin compounds.

In 1996, lead was found to leach out of imported vinyl (PVC) mini-blinds, creating a lead hazard for small children. Lead affects the nervous and reproductive systems and in children, can cause permanent brain damage. We know lead is bad-that's why we don't let our kids eat paint. Why should we let them have toys that might contain lead? Organotins have been linked to birth defects in rats. All three of these heavy metals are suspected hormone-disrupting chemicals.

A 1997 report by Greenpeace USA sampled 131 toys and children's products for lead and cadmium. More than 20 percent were found to contain greater than 100 parts per million of lead. Most of the toys were purchased from chain stores like Toys R Us, Kmart, Wal-Mart, or Target and/or were major labels, like Disney or Barbie.

Lastly, because PVC contains so much chlorine (about 57 percent by volume), it can also produce dioxin when it is incinerated or accidentally burned. Burning PVC can also release the heavy metal stabilizers into the air and the environment. If I were to throw out that Beanie Baby in my household trash, it would be taken to our local garbage incinerator, where it could release any number of pollutants into the environment. So for now, we're stuck with it.

What About Recycling?

If Barbie or any other toy made of PVC happens to be labeled with a recycling code, it will be a "3." Recycling PVC is problematic, particularly because most PVC in commerce-including toys-is not labeled. PVC is a common contaminant in plastics collected for recycling, and its high chlorine levels may render polyethylene terephthalate (pet) or high-density polyethylene (hdpe) unrecycleable. When burned, pvc creates hydrochloric acid, which can "eat" the other resins. In fact, one PVC item can destroy up to 100,000 pet bottles.

PVC and Toys Around the World

Many European countries have already seen some action taken on PVC in toys. For example, some manufacturers voluntarily withdrew soft PVC toys from the market after the Danish Environmental Protection Agency (EPA) found that phthalates could leach from teething rings. One Swedish manufacturer, KF, voluntarily withdrew 75 products for testing. The International Council of Toy Industries of Europe has reportedly set up a working group on the health risks associated with PVC. The Danish EPA plans to use a system of taxes, labels, and public purchasing policies to eventually phase out phthalates. Sweden's government is considering a ban on phthalates in PVC toys for kids under age three and also promises that, "If the environmental impact of PVC is not reduced, PVC plastic will be banned."

As of this writing, the European Commission (EC) has just agreed to draw up a directive, to be prepared by EC Consumer Protection Commissioner Emma Bonino, that will address the use of phthalates in PVC products. Ms. Bonino had requested the EC to support a three-month ban on the sale of chewable soft pvc toys. Teething rings and other toys would have been banned because of health concerns-particularly liver damage-over the levels of DEHP and DINP found to leach out of the products. Yet our own US Commerce Department and Consumer Product Safety Commission may have played a role in the EC's decision not to invoke a ban which "might cause trade misunderstandings between the United States and the European Union."

As Swedish environment minister Anna Lindh has said, "The PVC industry has had a very long time to find substitutes for hazardous compounds but it evidently has not managed to do so.... It is the fault of the industry that PVC is no longer acceptable."

What's a Concerned Parent to Do?

Here are a few of the strategies I've employed to reduce my children's and the environment's risks from pvc toys. Next time you're shopping for a birthday or holiday gift, these are a few things to consider:

• Buy toys made of other materials, like wood, metal, or cloth. If you do buy plastic toys, look for ones made of non-chlorinated plastics, such as polyethylene ("2" or "4") or polypropylene ("5"). If it's not labeled, don't buy it.

   

• Contact your local outlets for chain stores like Toys R Us, Kmart, Wal-Mart, Target, etc., and tell them you want them to sell safe toys. Ask them to use their buying power as retailers to state a preference for (ideally) non-PVC toys, or at least, toys that are labeled as to which type of plastic is used, so that their customers can make informed buying decisions.

   

• Call Greenpeace at 1-800-326-0959 for more information on pvc and the campaign to get it out of toys.

   

• Contact Children's Environmental Coalition at 310-573-9608. CHEC is a grassroots organization that educates on the need to protect children from environmental toxins.

   

• Contact toy manufacturers and ask them to use non-chlorinated plastic resins when making toys.

   

• Ship discarded toys back to the manufacturers, or to the Vinyl Institute (a PVC-industry trade association). In my community, garbage gets burned in the local solid-waste incinerator, and I don't want my sons' discarded toys to emit toxic dioxins and lead into our local environment. Sending the toys back sends a message to the manufacturers that we want them to take responsibility for the pollution they create.

   

• Talk to other parents, teachers, daycare providers, etc. about PVC toy facts. Together, we can create "critical mass" to get safer toys made for our children.

Greener Paths for Plastics

Liz Borkowsk | Real Green Living | Feature article - Jan/Feb 2006 | GreenAmerica.org | Website | Download

Conventional plastics can pollute the environment and leach harmful chemicals. Here's what you need to know to stay safe.

When plastic manufacturing took off in the early 20th century, plastic was heralded as a miraculous material—lightweight, flexible, and sturdy. Eventually, though, plastic’s down sides started to emerge: Toxic chemicals such as benzene and dioxin are released into surrounding communities during the manufacture of certain types of plastic, and some types leach chemicals as we use them. A plastic bottle tossed into a landfill will take hundreds of years to break down. Plastic bags that litter the landscape will kill animals that try to eat them, and they’ll harm aquatic life when dropped into bodies of water. Several studies have uncovered health risks associated with exposure to fumes from its incineration.

Plastic recycling has lightened some of the environmental burden of disposal, but the majority of plastics are landfilled or incinerated after a single use; the US plastic-bottle recycling rate is less than 25 percent, according to the American Plastics Council. Even if we raised that percentage, recycling plastic isn’t an ideal solution; the plastic we recycle doesn’t turn into more of the same kind plastic we tossed into the bin, but has to become lower-quality plastic that has limited applications, such as plastic lumber.

By reducing your use of plastic, choosing plastic products carefully, and using them safely, you can reduce the risks that plastics pose to the Earth and your family’s health.

Problems with Plastics 3, 6, & 7

Of most concern to your health and the environment are the types of plastic coded for recycling as #3, #6, and #7.

#3 (Polyvinyl Chloride): The nonprofits Center for Health, Environment & Justice (CHEJ) and Environmental Health Strategy Center have asked companies to phase out the use of polyvinyl chloride (PVC), a type of plastic widely used in construction and consumer goods, because it poses serious health threats at every stage of its life cycle. In a report entitled “PVC: Bad News Comes in 3s,” the groups explain that PVC production requires highly polluting and cancer-causing chemicals that have contaminated the areas where PVC is manufactured. They also point out that PVC is often made with plasticizers such as phthalates, which can leach out of or evaporate from the finished products and have been shown to cause developmental and reproductive damage. And, they point out that PVC incineration leads to the emission of dioxins, which are known to cause cancer, as well as reproductive, developmental, and immune problems. Landfilling PVC can cause the plastic’s toxic additives to leach into groundwater. PVC is very difficult to recycle and contaminates other kinds of plastics when recycled with them.

#6 (Polystyrene): Polystyrene is used in foam food trays, egg cartons, carry-out containers, opaque plastic cutlery, and other disposable food service items. It’s a concern because the chemical styrene can leach from it into food and beverages. According to the EPA, short-term styrene exposure at levels above the Maximum Contaminant Level (used to set drinking-water standards) can cause nervous-system effects such as loss of concentration, weakness, and nausea. Long-term exposure can cause liver and nerve damage and cancer.

#7 (Polycarbonates and Others): Although the #7 designation is a catchall for plastics that don’t fit into one of the other categories, products marked with this number are often polycarbonates, which are used in plastic baby bottles, the plastic liners of metal food cans, sport water bottles, and other items. Bisphenol-A (BPA) is an endocrine disruptor that is used in making polycarbonates and can leach from them when they’re used. A recent review of studies regarding BPA’s effects (Environmental Health Perspectives, August 2005) finds that more than 80 percent of published studies assessing the effects of low-dose BPA exposure on laboratory animals found significant effects, including alterations to brain chemistry and structure, behavior, the immune system, and male and female reproductive systems.

Be a Smart Plastic User

Here are ways to make your plastic use healthier and more environmentally friendly.

Reduce and Reuse: There are a few cases—such as that of medical supplies—in which it’s necessary to use plastic once and then discard it, but it’s often possible to find a better alternative. Avoid single-use items such as disposable bottles, plates, and cutlery. Carry a refillable bottle or mug for beverages on the go, and bring reusable cloth bags to stores. For leftovers and takeout food, reusable containers are better than foam boxes or plastic wrap and bags. If you regularly buy products that are only available in plastic packaging, buy the largest container available, rather than the multiple smaller ones, to cut down on the total amount of plastic used.

Take precautions: When you do use plastic, it’s best to choose those labeled #1, #2, #4, and #5 and avoid those labeled #3, #6, and #7. Even if you’re choosing the best plastic, though, there are still chemical leaching concerns associated with long storage or heat. The Institute for Agriculture and Trade Policy has issued a “Smart Plastics Guide” that includes the following recommendations for using any type of plastic:

• Avoid using plastic containers in the microwave. Instead, use glass or ceramic containers free of metallic paint.
• Beware of cling wraps, especially for microwave use.
• Avoid plastic bottled water, if possible.
• If you do use plastic water bottles, take precautions. If you use a polycarbonate water bottle, to reduce leaching of BPA, do not use for warm or hot liquids, and discard old or scratched water bottles. Water bottles from #1 or #2 plastics are recommended for single use only. For all types of plastic, you can reduce bacterial contamination by thoroughly washing daily. However, avoid using harsh detergents that can break down the plastic and increase chemical leaching.

Take Care With Kids: The rapid development and immature immune systems of fetuses and children make them particularly susceptible to damage from toxins, so pregnant women and parents should exercise extra caution with plastics. The Children’s Health Environmental Coalition (CHEC) advises choosing cloth and wooden toys and avoiding plastic toys, which are often made of PVC and can leach harmful chemicals when chewed on. Or, consult Greenpeace’s Toy Report Card to learn which toy manufacturers have eliminated PVC from their products.

Plastic baby bottles are of particular concern to parents. Breastfeeding can eliminate the need for a lot of plastic, but parents may still want to use bottles for pumped breast milk or juice. CHEC recommends avoiding polycarbonate bottles, which are generally clear and rigid and bear the #7 symbol, and choosing bottles made of tempered glass or polyethylene and polypropylene (#1, #2, or #5); they note that Medela and Evenflo make bottles from safer plastics. CHEC also recommends using bottle nipples made of clear silicone rather than yellow rubber, because the silicone hides less bacteria and is heat resistant.

Recycle Responsibly: Recycle your plastics following the instructions given by your local recycling program. If you have a curbside program that doesn’t accept certain plastics, consult www.earth911.org to find an alternative drop-off site near you. Advocate for more extensive plastic recycling collections, and purchase items made from or packaged in post-consumer content.

New Trend: Bioplastics

Concerns about the rising price and supply limits of petroleum, as well as environmental factors, have spurred the use and development of bioplastics synthesized from corn, soy, sugar cane, and other crops. Toyota has started using bioplastics in some of its cars; Wild Oats, Newman’s Own, and Del Monte have adopted them for deli and food packages; and even Wal-Mart has begun using a corn based packaging for cut fruit and vegetables. Most of the bioplastic packaging used in the US is polymerized lactic acid (PLA) made by NatureWorks LLC, a company owned by Cargill.

Bioplastic's Benefits: Unlike conventional plastics, bioplastics biodegrade relatively quickly under the right conditions, and they’re made from annually renewable crops rather than petroleum. PLA can also be recycled into more of the same product repeatedly, while plastic can’t.

Early reports suggest that bioplastic can be an effective substitute for petroleum-based plastic. Last July, the Los Angeles Times published an article about Cargill’s Nebraska facility that manufactures PLA from corn. “The end products—which include T-shirts, forks and coffins—look, feel and perform like traditional polyester and plastic made from a petroleum base,” the article reports. “But the manufacturing process consumes 50 percent less fossil fuel, even after accounting for the fuel needed to plant and harvest the corn.”

Concerns: Since relatively few people in the US have access to commercial or industrial composters, which help bioplastics degrade, lots of bioplastic is ending up in landfills or recycling bins. In landfills, PLA will lack the light and heat it needs to degrade. Plastic recycling is unlikely to be adversely affected by PLA, which can’t currently be processed by mainstream recyclers, until it makes up a far greater percentage of plastic than it does now. The best option would be to develop a separate recycling stream for PLA.

The Sustainable Energy & Environmental Demand (SEED) Initiative of the organization Future 500 brings together NGOs, corporations, and governments to develop markets for emerging technologies that will reduce petroleum dependence. SEED is helping NatureWorks and environmental groups work together to make PLA as eco-friendly as possible. Issues include the large amounts of energy and chemicals used to grow and process the corn, the use of GMO corn, and waste disposal. NatureWorks has already taken positive steps in these areas by purchasing green-power offsets, offering customers options to buy non-GMO-corn offsets or GMO-free PLA, and buying baled PLA back from recyclers. They continue to work with stakeholders through SEED.

One danger of increased bioplastic use is that people might end up buying a lot of it if they think it’s less problematic than petroleum-based alternatives. A shift to bioplastics still needs to be accompanied by waste reduction.

Best Uses:When reuse isn’t feasible, bioplastics can be the best alternative. For instance, our Green Festival® events, a joint program of Green America and Global Exchange, are held in venues where vendors can’t wash and reuse food service items. Instead, we use compostable plates, cups, and utensils from Biocorp and serve BIOTA water, which comes in compostable bottles. Hundreds of volunteers help attendees sort their waste into the appropriate bins, and we send the composting to a municipal composter afterwards.

Bioplastic is also a good option for collecting kitchen compost and yard trimmings destined for commercial composting, because the bags can be composted along with their contents. With a little forethought, we can all reduce our use of plastics and make the healthiest choices for our families and the planet.

—Liz Borkowski

See download or link for resources

Relation of infant diet to childhood health: seven year follow up of cohort of children in Dundee infant feeding study.

Andrea C Wilson, J Stewart Forsyth, Stephen A Greene, Linda Irvine, Catherine Hau, Peter W Howie

Abstract

Objective: To investigate the relation of infant feeding practice to childhood respiratory illness, growth, body composition, and blood pressure. Design: Follow up study of a cohort of children (mean age 7.3 years) who had detailed infant feeding and demographic data collected prospectively during the first two years of life. Setting: Dundee. Subjects: 674 infants, of whom 545 (81%) were available for study. Data on respiratory illness were available for 545 children (mean age 7.3 (range 6.1ˇ 9.9) years); height for 410 children; weight and body mass index for 412 children; body composition for 405 children; blood pressure for 301 children (mean age 7.2 (range 6.9ˇ10.0) years). Main outcome measures: Respiratory illness, weight, height, body mass index, percentage body fat, and blood pressure in relation to duration of breast feeding and timing of introduction of solids. Results: After adjustment for the significant confounding variables the estimated probability of ever having respiratory illness in children who received breast milk exclusively for at least 15 weeks was consistently lower (17.0% (95% confidence interval 15.9% to 18.1%) for exclusive breast feeding, 31.0% (26.8% to 35.2%) for partial breast feeding, and 32.2% (30.7% to 33.7%) for bottle feeding. Solid feeding before 15 weeks was associated with an increased probability of wheeze during childhood (21.0% (19.9% to 22.1%) v 9.7% (8.6% to 10.8%)). It was also associated with increased percentage body fat and weight in childhood (mean body fat 18.5% (18.2% to 18.8%) v 16.5% (16.0% to 17.0%); weight standard deviation score 0.02 ( - 0.02 to 0.06) v - 0.09 ( - 0.16 to 0.02). Systolic blood pressure was raised significantly in children who were exclusively bottle fed compared with children who received breast milk (mean 94.2 (93.5 to 94.9) mm Hg v 90.7 (89.9 to 91.7) mm Hg). Conclusions: The probability of respiratory illness occurring at any time during childhood is significantly reduced if the child is fed exclusively breast milk for 15 weeks and no solid foods are introduced during this time. Breast feeding and the late introduction of solids may have a beneficial effect on childhood health and subsequent adult disease.

Introduction

The extent to which adult health is determined by nutritional factors in early life has been the subject of much debate since Barker observed that low birth weight and weight at 1 year are associated with adult disease.1 One of the explanations for these findings is that nutritional deficiencies at critical periods of fetal and infant growth may induce permanent changes in physiological function.2 Whether infant feeding practice influences childhood or adult health remains uncertain. Breast feeding is associated with health gain during infancy, with reduction in gastroenteritis and respiratory disease,3 but whether these benefits extend into childhood has not been established. Infant feeding practice varies widely throughout the United Kingdom. Exclusive breast feeding is recommended for at least four months, with solid foods being introduced thereafter,4 5 but currently in the United Kingdom 64% of infants are breast fed initially, with only 19% still being breast fed at 4 months of age. Additionally, 90% of infants start eating solid foods before the age of 4 months.6 With this variance between recommendation and practice, robust evidence is needed to support the national policy. We determined the relation between infant feeding practice and childhood health. Outcome measures were episodes of respiratory illness and measurements of growth, body composition, and blood pressure. Infant feeding data from the first two years of life were collected prospectively as part of the Dundee infant feeding study.

Download and read full study here.