It’s understandable if you feel confused and here’s why:

No one can tell you what’s right for you and the more knowledge you acquire the more confident you can feel with your decisions as a parent. Carefully weigh out your family history when considering which of these options is the best for you.

If you think your child may be having symptoms related to any one of the following choices try first eliminating that food for a minimum of 4 weeks. These are usually sensitivities that can be outgrown in most people but does require reduction and possibly elimination.

Breastmilk

The Canadian Pediatric Society recommends exclusive breastfeeding up until age 6 months whenever possible.  If experiencing difficulties with colic or infant temperament, food elimination (dairy, chocolate, garlic, onions, brassica (cabbage, broccoli, brussels sprouts, cauliflower)) can be very effective at stabilizing babies’ bowels and mood. Keep in mind that human breast milk is a reflection of the mother’s diet. Whatever you eat, your baby eats too!

Controversy:

• Toxins and pollution are stored in fat tissue (breast) and blood and are dumped into breast milk.
• Colic is common in all infants whose families have an inherited susceptibility to foods such as dairy, wheat, gluten, nuts etc. In which case, nutritional advice is 90% successful. When it’s not, it could be reflux or other undiagnosed allergens or other digestive issues. Food sensitivity testing and intolerance testing is available from the age of 2.

Unfortunately dietary elimination can be stressful and time consuming.

• Some women have difficulty with milk flow and do not know that there is complementary care and pharmaceuticals are available to help them increase their milk supply.

Infant Formula

For those mothers who cannot breastfeed, formula is a good option.

Calcium absorption from dairy-based foods is higher than other alternatives.

Dairy-free and lactose-free formulas are available as well.

Controversy:

• Most are dairy-based and there is a significant rise in dairy intolerances making it an unfeasible option for many families.  Any sensitivity could present with frequent illness, acne, eczema, skin and diaper rashes, cradle cap, colic (bloating and discomfort), diarrhea or constipation, dark circles under eyes, horizontal line across bridge of nose or reflux.

Cow’s milk

This is the best source for calcium absorption. Cow’s milk is widely available and the most cost effective, with many options available, such as skim, buttermilk, 1%, 2%. 3.25%, 10%, half and half, 18%, 35% etc.

• Organic whole and/or raw milk are less processed. They contain all the enzymes necessary to digest and are a cleaner source.
• Please note, higher fat content milk leads to easier calcium absorption due to Vitamin D naturally occurring in fat.

Controversy:

• Unfortunately, the agricultural industry today uses animal feed that contains pesticides. In addition, animals are regularly and systematically treated with preventative broad-spectrum antibiotics and hormones, which is what most parents are concerned about.

Did you know?

That calcium content is not the same as calcium absorption? This is part of the controversy regarding milk substitutes. To help give a clearer comparison see below to make an informed choice.

Each brand will have unique calcium content, but the absorption should be the same.

E.g. Cows milk: 1 cup = 300mg calcium, at the fractional absorption of 32%, the total calcium absorption is 96mg.

Soy Milk

Soy is a highly controversial subject at the moment. It is the most available non-dairy alternative to formula, however many physicians are reticent to suggest it.

Controversy:

• Soy hasn’t been used as a substitute for dairy for long enough in the Western world to fully know the long lasting effects it may have. The main concern is the level of phytoestrogens per body mass, with soy as a sole source of nourishment.  (As in infant formulas)
• Finding an organic non-GMO (genetically modified) soy formula can be difficult, however it is a far superior source.
• Contains Carrageenan which we recommend clients with Ulcerative Colitis or Crohns to avoid.
• Studies show that human breast milk from mothers consuming soy foods provided significant levels of phytoestrogens. For the developing male infant, these environmental estrogens can have long-lasting consequences to the reproductive and urogenital system. However, Asian societies have consumed soy products in much higher quantities than Western countries for many years, and haven’t suffered any notable developmental effects or issues.

All of the following alternatives to dairy are meant to be rotated in your diet to avoid or lessen sensitivity to any one therefore some supplementation will be necessary to obtain all vitamins and minerals required for a growing infant.

Coconut Milk

Coconut milk is very tasty, rich and high in caprylic acid, lauric acid and electrolytes and very appropriate for babies with thrush. It has a good fat content at about 17%.

Coconut milk is different from coconut juice or water. Coconut water was used in WW2 and in the Vietnam War in IV’s as saline replacement, because it is very close to our own blood plasma.

Controversy:

• Use with caution in families with history of nut allergies.
  • Contains Carrageenan which we recommend clients with Ulcerative Colitis or Crohns to avoid.

Almond Milk

Almond milk is easy to make yourself, as needed, and does not contain the additives, preservatives or added sugar, which the store-bought varieties contain.

Controversy:

• Use with caution in families with history of nut allergies;
• The calcium content in almond milk is lower than in cow’s milk, but is higher than soy. Nevertheless, packaged almond milk is calcium fortified.
• Some varieties contain soy lecithin and should be avoided by people with soy allergies or sensitivities.
  • Contains Carrageenan which we recommend clients with alcerative Colitis or Chrohns to avoid.

 Rice Milk

Rice milk contains more carbohydrates than cow’s milk, . Commercial brands of rice milk are often fortified with vitamins and minerals, including calcium, vitamin B12, vitamin B₃, and iron. As this is a relatively new option, changes to the current available formulas will evolve over time with customer feedback and more research.

Controversy:

• Rice milk does not contain significant amounts of calcium or protein;

Goat Milk

Whole goat’s milk contains more fat than cow’s milk. Goat’s milk casein is more similar to human milk. Goat’s milk is also easier digested than cow’s milk. Though goat’s milk contains lactose, it can still be drunk by some of those with lactose intolerance, though no one is quite sure why…

Controversy:

• Because goat’s milk contains less than ten percent of the amount of folic acid contained in cow’s milk means that it must be supplemented with folic acid in order to be adequate as a formula or milk substitute for infants and toddlers.

Potato and oat: Not widely available, but interesting alternatives. Google to get recipes or to find a retailer near you.

Conclusion:

It is our opinion that a rotation diet focused on variety is the best option to minimize allergies and sensitivities in your family.

No one can tell you what’s right for you and the more knowledge you acquire the more confident you can feel with your decisions as a parent.

Carefully weigh out your family history when considering which of these options is the best for you.

Hair can be used to gather information about heavy metal toxicity and mineral levels. Hair is an excretory tissue rather than a functional tissue. As protein is synthesized in the hair follicle, elements are incorporated permanently into the hair with no equilibration with other tissues.

Extensive research has shown that scalp hair element levels are related to systemic levels. Unlike blood, hair is not controlled by homeostatic systems/mechanisms. Thus, deviations in hair often appear prior to overt symptoms and can thereby be a valuable tool in predicting the development of physiological abnormalities.

Hair analysis is not diagnostic in and of itself, but when used with symptoms and other lab values, it can help diagnosis, monitor treatment and or prevent deficiencies.

Scalp hair is easy to sample (even in infants or toddlers), the cost is $90, and gets sent to a lab in Calgary.  This test is a valuable and inexpensive screen for physiological excess, deficiency or mal-distribution of elements.

Here is an example of how it can be useful. A pediatric patient with excessive dental cavities (4 extractions and 4 fillings at age 2) was tested and revealed high heavy metals and deficiencies in 3 essential bone-building minerals (but not calcium, magnesium or other typical ones). This helped tailor the treatment specifically to his needs and his body. He is now 4 and at the last check up had 2 minor fillings. I expect this to continue to improve as treatment progresses.

I have used this test with fertility issues, pregnancy preparation, osteoporosis and bone building programs. If you haven’t gotten answers to your health questions, keep asking and seek other testing alternatives.

Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) are difficult to define and diagnose. There are many possible causes and, as a result, many possible treatments. The following information has been found to be helpful in most instances and so can serve as the basis for an overall treatment plan.

• Eliminate refined sugars and dairy products from the diet.
• Minimize food dyes as much as possible, especially red and yellow dyes.
• Foods should be eaten in their most natural and unrefined state. Limit the  amount of food preservatives ingested.
• The diet should include all fruits and vegetables, except those containing salicylates which may aggravate the symptoms. Such foods include almonds,      apples, apricots, cherries, currants, all berries, peaches, plums, prunes, tomatoes, cucumbers, and oranges.
• Avoid carbonated beverages, which often contain large amounts of phosphates. High levels of phosphates (and low levels of calcium and         magnesium) have been shown to indicate a potential for hyperactivity.

The medical community has adopted a wait-and see attitude towards the beneficial impact of diet on those diagnosed with ADD/ADHD. The clinical evidence suggests, however, that while such a regimen does not work for all cases it does seem to have a positive result in many instances.

ALLERGY CONSIDERATIONS

• An elimination diet may be useful for determining food sensitivities and allergies that have been shown to aggravate ADD/ADHD symptoms. The most common offending foods are dairy, soy, chocolate, grapes, oranges, peanuts, wheat, corn, tomatoes, eggs, refined carbs, sucrose and food colorings.

• Several studies have shown that the combination of eliminating both food additives and allergenic foods were required for favorable response. Try to maintain a hypoallergenic diet.

Possible causes for ADD/ADHD:

• Heavy metal toxicity (such as: lead, arsenic, mercury, aluminum, cadmium)
• Environmental toxicity (PCBS, dioxius, phenols, pesticides, herbicides, parabens)
• Low protein/high CHO diets = abnormal glucose tolerance.
• Mineral imbalances
• EFA and Phosplolipid deficient
• Amino acid deficient (GABA, Tyrosine, Tryptophan, D=L Pheylamine, histidine, isoleucine, glycine)
• Thyroid disorders
• B-vitamin deficient + phyto nutrient deficient
• Dysbiosis + gut imbalances + stool abnormalities.

List of additives as possible causes:

• Tartrazine
• Yellow dyes
• MSG
• Benzoic Acid
• FCF
• Carmolic acid
• Sulfur dioxide
• Sodium nitrate
• Sodium Benzoate
• BHT
• BHA
• Potassium Nitrate

SUPPLEMENTS:

Vitamin 86 (pyridoxine)

• Involved in the utilization of amino acids and in proper brain and nerve cell function.

• Several studies showed vitamin B6 therapy as effective and lasting longer than Ritalin.

• Dosage : 75-1000 mg per day with a good quality multi vitamin/mineral. B6 needs a B-vitamin complex at higher doses.

Magnesium

• Needed for B6 to be metabolized properly.

• 300 mg per day is needed for children.

• 95% of kids tested for ADHD are deficient.

Zinc

• Important in many metabolic functions, including increasing the alertness and overall cooperation of subjects.

• 80-200 mg per day

Iron

• Deficiencies are associated with decreased attentiveness, attention, persistence and voluntary activity.

• Dose of 1-2.25 mg (up to 50 mg) for a 50- 100 lb. child, only if tested and found low.

Essential Fatty Acids and DHA (omega 3’s)

• Several studies have shown that ADD/ADHD patients with EFA deficiencies may be benefited by supplementation.

• 1-2 tablespoons per day.

• · Changes seen within 3 months and better results the longer it is taken.

Gamma-amino-butyric acid (GABA)

• Several studies have shown that GABA decreases hyperactivity, as well as tendencies towards violence, epilepsy, mental retardation, and learning disabilities.

• 100-750 mg daily

Herbs

• Reishi has been found to be very effective in many cases of ADD/ADHD patients.

• Other nervines such as Valerian root extract, hops, catnip, and chamomile can also be helpful. Take under proper supervision.

Empower Plus

Probiotics

L-Theanine and Green Tea

100-200mg daily. Chewable or capsules into yogurt.

OTHER:

Kids are keen for responsibility and choice, allowing them to play an active role in creating their healthcare plan goes a long way in achieving a desired outcome. This most obviously applies to nutrition. I habitually encourage young patients to participate in meal planning and preparation as one method for giving them power and pride in the process.

It often takes 4-6 weeks to feel confident breastfeeding – be patient…

This handout covers the most frequently asked questions about breastfeeding and resources.

Contact your local Naturopath, Midwife, or Lactation Consultant for personalized assistance.

Why Breastfeed? Nursing is convenient, cheap, your best means of bonding and the perfect food for your child even if you are sick or on medication.

Why Breast milk?

• Specific to our species
• Less digestive upset, diaper rashes and constipation is rare. Your child will have fewer or less severe colds, ear infections, and allergies. Breast milk protects from viruses and bacteria because the mother quickly develops relevant antibodies, passing resistance to the baby through the milk. Baby can still get sick but the immune system will be supported and thus hasten recovery.
• Better jaw development and optimal teeth positioning because breastfeeding is harder than drinking from a bottle. Children show fewer cavities if nursed longer than 4 months.
• Better brain development and higher IQs.
• Essential nutrients: milk will change with your diet (i.e. garlic can be found in milk)
• Protein is easy to digest = 60% whey protein and 40% casein (Cow’s milk is 20:80 respectively). Protein is lowest in AM and highest in PM.
• Fats (60% of calories needed in first year) – especially DHA which promotes brain, nerve and intestinal health
• Lipase – an enzyme that keeps the fats (most efficient energy source for baby) easy to digest
• Lactose – a sugar important for brain and central nervous system development. Also helps absorb calcium and promotes overall growth. (Lactose is higher in human milk vs. cow’s milk). Lactose is higher in the afternoon.
• IMMUNE FACTORS: Antibodies, White blood cells, Cytokines, Interferon, and Lysozymes – relevant to local bacteria, viruses and fungi – hours after exposure milk will change to suit mom and baby’s health
• Bifidus and Oligosaccharides – both aid in intestinal health and colonization
• (attacks bacterial cell walls) for immunity
• Water – all that baby needs till solids are introduced (baby should be sitting unassisted, showing curiosity in foods, have a good pincher grasp and teething, ~6 mos).
• Vitamins, minerals and trace elements. Vitamin D and iron levels are low but absorbed easier than iron in formulas or supplements. If your stores are low talk to the appropriate health care professional. Going outside for 5-10 minutes at least twice a week (face and arm exposure) can help establish vitamin D levels.
• Hormones and enzymes promoting healthy intestinal tract and ensures protective organisms dominate in the digestive tract.
• Formula has no immune factors like breast milk

• Composition changes during feeds, during day, and at different stages of development:
• Colostrum in the first few days is extremely high in antibodies suited to pathogens in your environment. It also helps prevent and clear jaundice. A laxative to expel meconium (black, tarry stool) from the intestines & prepares the gut for milk. Colostrums is yellowish, sticky, thicker and loaded with white blood cells – 100X more than in your blood
• Foremilk – considered mature milk by week 1 or 2 – bluish white color
• Hind milk fattier content for appetite control
• Pre-term babies get milk that is higher in protein, sodium, white blood cells, iron and polyunsaturated fats to make up for less time in the womb.
• The number of white blood cells decreases but by 6 months, breast milk still has 10-20X more than found in your blood.
• Other factors that alter breast milk constituents: offering same breast twice in a row, having your menstrual period, multi-parity (more than this child), expressing or pumping.

• Self-regulating to meet your baby’s needs. Demand equals supply. The more you feed and stimulate letdown to feed or pump – the more milk you will have.
• High potassium and low sodium levels are thought to protect against high blood pressure.
• Less likelihood of Diabetes later in life.

What are the benefits to a breastfeeding mother?

• Oxytocin, a hormone produced when nursing, contracts the uterus, reduces bleeding and encourages the uterus to return to pre-pregnancy size
• Helps your figure return to pre-pregnant state
• Lowers breast & ovarian cancer risk
• Improves re-mineralization of bone after pregnancy
• Prolactin, a hormone that relaxes you to help cope with becoming a new mother. Prolactin also suppresses ovulation (delays menstruation and allows iron stores to build)
• Nursing is easier at night so you get more sleep
• Milk is always available, properly mixed and heated
• Easier to travel with baby if breastfeeding – less to pack/carry
• Satisfying and empowering. Once mastered, nursing is pleasurable, relaxing and nurturing for you because motherhood is often a time for feelings of great inadequacy.

What are the negatives/risks to breastfeeding?

You may experience one or some of the following: Engorgement, sore nipples, cracked nipples, plugged ducts, mastitis, low milk supply, and the demands of your time (up to an hour per feed, every 2-3 hours (believe it or not bottle feeding takes more when cleaning and prep time is factored in)). Your naturopath can help with all of these conditions. Help is available.

What is a good latch?

• Babies breastfeed, NOT NIPPLE feed. Ensure wide-open mouth before latching. There should be no pain, however, tenderness from stretching of nipple could feel like mild sunburn.
• Remove blankets
• Position baby close – tummy to tummy
• Make mouth level with nipple
• Have baby’s head, shoulder, and hips in a straight line
• Cup your breast with hand, thumb on top and fingers underneath well back from areola.
• Make sure baby’s chin is up
• Touch the lips with your nipple and wait for big open mouth
• Bring the baby to the breast not the breast to the baby
• Practice different holds to finds what works best for you

How do I know if I’m doing it right?

• Listen to hear your baby swallow. If you can’t hear it look for the jaw pause.
• You might feel a “let-down” sensation (tingling, pins, warmth, ache) some women report when milk is flowing. If concerned about flow, break the suction with a finger, apply pressure and squeeze down from the areola.
• Most babies will lose weight after birth, which normalizes by 2 weeks. Do not panic about weight loss unless it is excessive.
• By day five baby’s stool will be golden yellow, liquid and seedy, this can last till solids are introduced but will vary every so often. If there is a problem baby or you will be uncomfortable and unhappy.

How do I know I have enough milk?

Most women do. Baby will want to feed 8-12 times per day. Usually milk amount is assessed by diaper counts. Baby should be having > 4-6 heavy wet diapers/day (after 6 weeks) and ~0-5 yellow seedy stools by 6 weeks. This can also assessed by baby’s weight gain. Contact your naturopath or lactation consultant for ideas to increase milk production if you are concerned.

When should I feed?

• Most babies are ready to feed within the first few hours after birth
• Frequent feedings are important as breast milk is digested in less than 2 hours. Baby will usually feed every 2-3 hours in the day and 1-2 feeds per night.
• Offer the breast whenever your baby shows interest
• Keeping your baby near you day and night will help you learn your baby’s feeding cues such as stretching, stirring, rapid eye movements, hand to mouth activity, rooting, licking, sucking, and waking. Crying is the last cue to feed and you may have to calm the baby in order to help him to focus to breastfeed.

How long should I feed?

• Breastfeed as long as baby is swallowing on one breast and then when baby slows down or comes off, offer the second breast or burp, then change before offering.
• It is normal for cluster feeds (several nursings close together) when growing and when baby is about to accomplish another milestone (like sitting, rolling, etc.)

What if I’m sick or what if my baby is sick and needs to be in NICU?

Keep nursing and get help if you need it. Have friends or family bring the baby when it is hungry and feed in bed, side lying if weak. Be sure to keep your fluids up. For particular diseases and recommendations see Dr. Jack Newman’s book below. If your child is ill, all the more reason that breast milk is essential. Pump or express and try your best to breastfeed.

What about Medication?

The Compendium of Pharmaceuticals and Specialties (CPS), is a thick volume that doctors refer to when deciding about a particular medication, which is provided by drug companies. It is in their best interest to protect against lawsuits to say that everything is contraindicated in lactation. It states that 4 hours after ingestion of caffeine, 1% of how much the mother drank shows up in her breast milk. “The baby almost always gets tiny amounts, if any”.¹ If you are that concerned about your child’s exposure, pump enough ahead of time to allow for drug administration and body clearance. In some instances, the medication does not pass into the milk at all. In others, the amount is tiny. Breastfeeding is so valuable to the growing child that Dr. Jack Newman, a Toronto pediatrician, specializing in working with breastfeeding mothers and babies, advocates no interruption of the nursing relationship. See his book and/or the Mother risk website, or contact any of the organizations below for specific indications.

What about pollutants in breast milk?

Sometimes the news discusses new research about toxins found in breast milk (like fat soluble dioxins). If you weren’t able or did not dry sauna for ~100 hours (recommended by naturopaths before pregnancy to detoxify) breast milk is still preferred to formula. Remember that breast milk has only really been studied in the last generation. We are still discovering all the beneficial ingredients – it only makes sense that we may find some bad ones. What the news doesn’t report is that formula is 100x higher in aluminum, lead, cadmium and manganese than breast milk.

BREASTFEEDING TIPS:

• Avoid or minimize medication during labor and delivery to facilitate a solid first latch
• Nurse your baby as soon as possible after birth. If not possible, hand express or pump and feed baby via cup, finger, spoon, or lactation aid before trying a bottle with breasmilk. Remember bottles are easier than breastfeeding wait till breastfeeding is established.
• Room in and/or sleep with your baby
• Establish proper latch – skin to skin tummy to tummy contact facilitates this best
• Avoid artificial nipples, including pacifiers and bottles or at least wait until breastfeeding is well established (4-6 weeks) to avoid nipple confusion and preference for bottle (faster flow)
• Feed your baby as often as necessary. Frequent feedings stimulate your milk supply, gives you practice, alleviates engorgement, helps your figure return to pre-pregnant state, lessens post-partum hemorrhage and provides perfect nutrition for your child.
• Sleep when your baby sleeps – Quickest and 1^st way to improve breastfeeding – SLEEP resting also helps you both heal from the birthing journey. Rest while nursing too.
• Establish a nursing station: comfy chair, pitcher of water, tea, juice, snacks. Use thirst as your most reliable guide to your hydration.
• Eat well – this is not the time to diet. Your caloric intake is actually higher now than in pregnancy! Roughly 500 calories more.
• Avoid under wire and/or tight bras, especially in first weeks.
• Use pillows to support you and baby while nursing
• PAIN: Fix the latch then green, cold, raw, rippled cabbage leaves applied to the breast whole for 10-20 minutes 2x/day may help engorgement and sore nipples. You can also try hot or cold compresses (which ever feels best). Acetaminophen (Tylenol) and Ibuprofen (Advil) are safe if absolutely necessary.
• If you have any pain or difficulties – seek help and support – many will visit you at home. Breastfeeding should not hurt.
• When you become sexual with your partner again (not recommended before 6 weeks) you might get milk ejection during orgasm – this is normal for some women.
• Have confidence in your abilities to successfully breastfeed. Enjoy and cherish the special and close relationship nursing provides. YOU CAN DO IT! Be patient and remember it is a LEARNED SKILL.

RESOURCES:

LaLeche League International   www.lalecheleague.org

1-800-LA-LECHE or 1-800-665-4324

International Lactation Consultant Association. www.ilca.org

919-787-5181

Canadian Lactation Consultants Association   www.clca-accl.ca

403-462-1848

Dr. Jack Newman. newman@globalserve.net

416-813-5757

Information on common drugs during lactation   www.motherisk.org or neonatal.ttuhsc.edu/lact/

Ontario Health Hotline

1-866-797-0000

REFERENCES:

1.     Newman J. & Pitman T. Dr. Jack Newman’s Guide to Breastfeeding. Rev. ed. Harper Collins. Toronto. 2003.

2.     Pryor K & Pryor G. Nursing Your Baby. Pocket Books. Toronto. 1991.

3.      Balaskas, Janet. The Natural Baby – An instinctive approach to nurturing your infant. 2002.