Breastfeeding after a natural disaster

Posted by Lauren

breastfeedingBaton Rouge, LA recently experienced severe flooding in what has been called the worst US natural disaster since Hurricane Sandy in 2012. Every year nearly 850,000 people in the US are affected by a natural disaster. When a disaster strikes, power can go out, water supplies can become contaminated and food supplies may become limited. But continuing to breastfeed can give your baby protection against illnesses, which is especially important following a natural disaster.

How does breastfeeding help your baby?

  • Protects her from the contaminated water supply
  • Protects against illnesses such as diarrhea
  • Helps comfort and soothe
  • Reduces stress for both mom and baby
  • Your breast milk is ready when your baby needs it

Is my milk safe?

According to the experts at Mother To Baby, substances enter breast milk in very small amounts, so they are not likely to harm a breastfeeding baby. The benefits you are providing your baby through your breast milk usually outweigh risk from an exposure.

Some infections are common after a natural disaster, such as West Nile virus, hepatitis A virus and hepatitis B virus. Most of the time, mothers who have an infection can continue to breastfeed. However if you notice anything different about the way you are feeling, or you are concerned, reach out to your health care provider. If you need medication, be sure to ask your provider if your prescription is safe to take while breastfeeding.  For more information about breastfeeding after a natural disaster, please see Mother-to-Baby’s fact sheet.

Can I feed my baby formula?

If you need to feed your baby formula, use single serving ready-to-feed formula, if possible. Ready-to-feed formula does not need to be mixed with water so you won’t run the risk of contamination. It also does not need to be refrigerated, so you do not need to worry about electricity. Be sure to discard unused formula from an unfinished bottle after one hour of feeding. If you need to use powdered or concentrated formula, mix it with bottled water. If neither option is available, use boiled water. Just be sure you do not use water treated with iodine or chlorine tablets to prepare your baby’s formula unless you do not have bottled water and cannot boil your water.

How to breastfeed after a disaster

Feed your baby when she is hungry or expressing feeding cues. Keep in mind, breastfeeding is not only for nutrition; your baby may also nurse for comfort. And it’s good for you too – nursing will allow the release of hormones which can help reduce your stress.

Staying safe after a flood or other natural disaster

Posted by Sara

rainFlooding can have devastating effects on your home and the community. After a flood or other natural disaster, there may still be many dangers. It is important to take the appropriate precautions when you are returning home or if you are living in a temporary shelter.


  • All hard surfaces, including walls, floors, and counter-tops should be cleaned with soap and water and disinfected with a solution of 1 cup of bleach to 5 gallons of water.
  • Wash all sheets, towels, and clothes in hot water (or have them dry cleaned).
  • Mattresses and furniture should be air dried in the sun and then sprayed with a disinfectant.
  • Any carpeting should be steam-cleaned.
  • Throw away any objects that cannot be cleaned and disinfected.

Health and safety

  • Keep children and pets away from the area until cleanup is complete.
  • Always wash your hands with soap and water after touching anything that has been in flood water or if you touch flood water.
  • Wear waterproof boots, gloves, and goggles during cleanup, especially if there was any contamination with sewage.
  • If you get a deep cut or wound, check with your health care provider to see if a tetanus shot is necessary.
  • Listen for any recommendations from local or state health departments.

If you’re pregnant

  • Drink plenty of bottled water and rest as often as you can.
  • Seek prenatal care, even if it isn’t with your typical provider.  And make sure that the provider is aware of any health conditions that you may have.
  • If you are in a shelter, make sure that the staff knows you are pregnant (or if you think you may be pregnant).
  • If you do not have any prescription medications that you need, contact your provider and the pharmacy to try to get them.
  • Make sure you avoid infections and other exposures that may be harmful. This would include fumes, flood water, and other toxins. Let others do the cleanup.
  • Even though you are taking care of others, make sure you take care of yourself too. Try to find healthy ways to reduce stress and talk to others about your feelings.
  • If you have any signs of preterm labor, call your health care provider or go to a hospital right away.

Other hazards

  • Shut off electrical power, natural gas, or propane tanks to avoid fire, electrocution, or explosions.
  • Avoid downed power lines.
  • If you smell gas or suspect a leak, leave your house right away and notify the gas company and police or fire department. Do not return to your home until you have been told it is safe.
  • Do not operate any gas-powered equipment (such as a generator) indoors. This can cause carbon monoxide to build up inside your home.
  • Avoid swiftly moving water (even if it is shallow). Cars can be swept away quickly. Make sure children do not play in flood water.

The CDC has more information about what to do after a flood. They also have helpful information for children.

Have questions? Email us at

Preemies need vaccines, too

Posted by Barbara

Special thanks to the CDC for sharing this post with us in honor of National Immunization Awareness Month.

NICU babyHaving a premature baby can be stressful, and as a parent of a preemie, you may have many questions about keeping your baby healthy. One of those questions may be about whether or not you should follow the Centers for Disease Control and Prevention’s (CDC’s) recommended immunization schedule for your baby, or if you need to adjust vaccine timing based on your baby’s early arrival.

The CDC and pediatricians agree that preterm babies, regardless of their birth weight and size, receive most vaccines according to their chronological age (the time since delivery). In fact, vaccinating as early as possible is important, because according to The Children’s Hospital of Philadelphia, preterm babies don’t get as many maternal antibodies through the placenta as full term babies do. This means they are more vulnerable to diseases during their first months of life. The recommended immunization schedule protects against 14 of these diseases, which can be very serious for babies.

Vaccines are safe for preemies, but like any medication, vaccines can cause side effects. The most common side effects are mild (such as redness where the shot was given) and go away within a few days. The side effects associated with vaccines are similar in preterm and full term babies.

There is one exception to following the recommended schedule — the hepatitis B vaccine, which is typically given at birth. This vaccine might not work as well in preterm babies weighing less than 70.5 ounces (2,000 grams). If a baby weighs less than 70.5 ounces and the mother is not infected with hepatitis B, the baby should receive the first hepatitis B dose one month after birth. If the mother is infected or her status is unknown, the baby should receive the vaccine at birth, but it should not be counted as part of the three-dose hepatitis B vaccine series. Then one month after birth, the baby should begin the full three-dose series.

The rotavirus vaccine may also be given differently to preterm babies. Babies usually get the first dose of the vaccine at 8 weeks, although vaccine is licensed for use as early as 6 weeks of age. CDC recommends that if a baby 6 weeks or older has been in the hospital since birth, the rotavirus vaccine should not be given until discharge.

Preemies are vulnerable to diseases and serious infections. Vaccinating according to the recommended schedule is one of the best ways to keep them healthy. For more information, talk to your child’s doctor or visit CDC’s vaccine website for parents.

Have questions? Send them to our health education specialists at


Breastfeeding and your diet

Posted by Lauren

mom breastfeedingWe received a question from a new mom asking if there are certain things she should eat while breastfeeding. Or more importantly, are there things she should avoid? The answer is that most likely, your milk will be just what your baby needs, even if your diet isn’t perfect. But eating healthy foods is still important in order to take care of yourself and your new baby.

The dietary restrictions you had during your pregnancy will not apply while you are breastfeeding. But you will still need to limit your intake of alcohol, caffeine and foods containing mercury.

What about allergies?

Most breastfed babies do not have allergic reactions to their mom’s milk. However, the proteins from foods such as cow’s milk and peanuts do pass through breast milk so if your family has a history of food allergies, you may want to discuss this with your Lactation Consultant. If you have a family history of food allergies, be sure to watch your baby for any allergic reactions such as green, mucus-like stools with signs of blood.

So what should you eat? The La Leche League International has these great ideas:

  • A well-balanced diet – choose meals with whole grains, vegetables, fruits, milk products and proteins (eg. lean meats, fish and eggs)
  • High-calorie foods – breastfeeding burns calories, so add in peanut or nut butters, olive or canola oils, whole-milk cheeses and yogurts
  • Easy to handle meals – with your baby in one arm you may find yourself only having one hand available to use for feeding yourself. Simple finger food types of meals will be easier to manage.
  • Large recipes – make or ask your family and friends to provide large dishes or casseroles so you can freeze leftovers.

Bottom line:

By breastfeeding you are providing your baby with the best start. And by maintaining a healthy diet you will be better able to take care of yourself, as you tend to your new bundle. if you have questions about your diet while breastfeeding, reach out to a Lactation Consultant.

Is it a boy or a girl?

Posted by Sara

its-a-girl-storkFinding out the sex of your baby is such an exciting part of pregnancy. While some people choose to be surprised at the time of delivery, many couples want to know the sex of the baby before they give birth. its-a-boy-stork

XX or XY

Your baby’s sex is determined at the moment of conception.  Of the 46 chromosomes that make up your baby’s genetic material, two chromosomes–one from the egg and one from the sperm–determine your baby’s gender.  A woman’s egg contains only X sex chromosomes.  A man’s sperm, however, may contain either an X or Y sex chromosome.  If, at the instant of fertilization, a sperm with an X sex chromosome meets the egg (another X chromosome), your baby will be a girl (XX).  If a sperm containing a Y sex chromosome meets the egg, your baby will be a boy (XY).  It is always the father’s genetic contribution that determines the sex of the baby.

How can I find out the sex of my baby?

Most women find out their baby’s sex during a routine ultrasound in the second trimester—usually between 18-20 weeks.  Traditional ultrasound is approximately 93% to 100% accurate at detecting the baby’s sex. But, just remember that sometimes the sex is not clearly identifiable from an ultrasound. This is usually due to the position of the baby.

While ultrasound is accurate, if you want to be absolutely certain of your baby’s sex, you would need a diagnostic test, such as a CVS (done between 10-12 weeks of pregnancy) or amniocentesis (done between 15-20 weeks of pregnancy). It is important to keep in mind that these prenatal tests are invasive and are done primarily to diagnose certain genetic conditions, such as Down syndrome.

Another way you may find out if you are having a boy or a girl is through cell-free fetal DNA testing (also called noninvasive prenatal testing or NIPT). NIPT tests your blood for your baby’s DNA to see if he may have certain genetic conditions, like Down syndrome. While this test is not used specifically to determine the baby’s sex, it can provide that information. It can be done after 10 weeks of pregnancy.

Did you find out if you were having a boy or a girl? Did you reveal it in a special way? Let us know—we’d love to hear your stories!

Have questions? Email us at

Babies and bug spray

Posted by Barbara

CDC's insect repellent application on kidsYou’ve heard about the Zika virus in certain parts of the United States, Puerto Rico and other countries, such as Brazil. One of the ways to combat Zika is to protect yourself from mosquito bites. Babies and children need protection, too, but certain precautions should be taken.


Here are the CDC’s guidelines:

  • Do not use insect repellent on babies younger than 2 months old.
  • Do not use products containing oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD) on children under 3 years old.
  • Always follow instructions (on the label) when applying insect repellent to children.
  • Do not apply insect repellent onto a child’s hands, eyes, mouth, and cut or irritated skin.
    • Adults: Spray insect repellent onto your hands and then apply to a child’s face.

What about “natural” or non-EPA registered repellants?

We do not know the effectiveness of non-EPA registered insect repellents, including some natural repellents.

  • To protect yourself against diseases like chikungunya, dengue, and Zika, CDC and EPA recommend using an EPA-registered insect repellent.
  • Choosing an EPA-registered repellent ensures the EPA has evaluated the product for effectiveness. The EPA’s search tool can help you find the one that is best for you or your child, depending on different factors.

Other things you can do:

  • You can protect your baby or child from insect bites by dressing him in pants and shirts with long sleeves, shoes and socks.
  • Cover the crib, bassinet or stroller with mosquito netting.
  • Take steps to reduce mosquitoes inside and outside of your home by using screens or staying indoors where there is air conditioning.
  • Once a week, empty and scrub, turn over, cover, or throw out items that hold water, such as tires, buckets, planters, toys, (kiddie) pools, birdbaths, flowerpots, or trash containers.

The American Academy of Pediatrics offers more tips on using repellents safely.

They also note that the following products are not effective repellents:

  • Wristbands soaked in chemical repellents
  • Garlic or vitamin B1 taken by mouth
  • Ultrasonic devices that give off sound waves designed to keep insects away
  • Bird or bat houses
  • Backyard bug zappers (Insects may actually be attracted to your yard).


  • Always follow the product label instructions.
  • Reapply insect repellent as directed.
    • Do not spray repellent on the skin under clothing.
    • If you are also using sunscreen, apply sunscreen first and insect repellent second.
  • Permethrin should not be applied to skin – apply it to your child’s clothing only.

See our article on Zika for more information on how to keep your family safe.

Questions? Text or email

Buying breast milk online – is it safe?

Posted by Barbara

Amy-Hair-MD-PFWToday we welcome guest blogger Amy Hair, MD, neonatologist at Texas Children’s Hospital. Dr. Hair specializes in neonatal nutrition.

Online shopping, in many cases, seems to be the way to go; it’s faster, cheaper and more convenient for the consumer than visiting the store. But, a study published in the May 2015 issue of Pediatrics shows convenience isn’t always best, especially when it comes to your infant’s health.

There are many reasons a mother may turn to purchasing breast milk. In the case of a premature birth, mothers may not be producing enough breast milk. In addition to lower production due to an early birth, the stress and shock that a mother feels after giving birth pre-term can be exacerbated by the requirements of expressing breast milk at all hours of the day and night. In many of these cases, a mother may think to buy breast milk online.

Online human milk donation and sharing has become more popular in recent years with an estimated 13,000 advertisements popping up annually on popular seller sites. Some mothers turn to the internet to obtain breast milk because purchasing it from milk banks can be expensive. Prices often range from three to five dollars an ounce, leading some people to refer to the commodity as “liquid gold.” Although many sellers may be posting and donating altruistically, not everyone has the purest of intentions, as proven by this new study.

Researchers tested 102 samples from donor milk advertised online and found that 1 in 10 samples were contaminated with cow’s milk. Of the 11 total samples which contained bovine DNA, 10 had enough contamination to be considered non-accidental. This contamination poses a large and dangerous risk to infants who may have an allergy or intolerance to cow’s milk. Additionally, the researchers found that nearly all of the bags of milk they purchased online arrived without meeting the correct temperature requirements for breast milk and that 75 percent of the samples had high levels of bacterial contamination or detectable levels of disease-causing pathogens, such as Salmonella and E. coli, which would make the milk unsafe for infant consumption.

Unlike milk bank systems that follow the criteria set by the Human Milk Banking Association of North America (HMBANA), online sharing systems do not usually include the rigorous screening and pasteurization required by HMBANA banks. Without proof of regulated and monitored screening, the risks and dangers in receiving contaminated and sometimes infected human breast milk are present.

The bottom line is that when you purchase breast milk online, you don’t know if the milk you are receiving is safe. The risks of inadequate screening and pasteurization include viral and bacterial infection and remind us about the reality that some potentially-transmitted viruses and diseases are asymptomatic. Talk to your infant’s pediatrician about if you have any questions and you are not able to produce enough milk to feed your baby. You can also consult lactation support organizations for advice. Though we often hear “breast is best,” it is safer to supplement your baby’s nutrition with formula than unscreened donor milk.

Since January 2009, all infants at Texas Children’s Hospital weighing less than 3 pounds are fed specially tested, processed and pasteurized donor breast milk if their mothers are unable to provide enough of their own breast milk. As a result of this initiative, we had a large drop in our incidence of necrotizing enterocolitis (NEC), a devastating intestinal disorder, from the national average of 12% down to just 2-3%.

Whether your child is a patient in Texas Children’s NICU, a premature infant at another hospital or a healthy baby, try to take advantage of lactation support services in your area. The importance of mother’s milk to the health and development of newborn babies is priceless.

Vaccinating on time is important for disease protection

Posted by Sara

Special thanks to the CDC for sharing this post with us.

baby vaccinationParents agree that feeding and sleep schedules are important to help keep their children healthy. The same goes for childhood immunizations. Vaccinating children on time is the best way to protect them from 14 serious and potentially deadly diseases before their second birthday.

“The recommended immunization schedule is designed to offer protection early in life,” said Dr. Candice Robinson, a pediatrician at the Centers for Disease Control and Prevention (CDC), “when babies are vulnerable and before it’s likely they will be exposed to diseases.”

Public health and medical experts base their vaccine recommendations on many factors. They study information about diseases and vaccines very carefully to decide which vaccines kids should get and when they should get them for best protection.

Although the number of vaccines a child needs in the first two years of life may seem like a lot, doctors know a great deal about the human immune system, and they know that a healthy baby’s immune system can handle getting all vaccines when they are recommended.

Dr. Robinson cautions against parents delaying vaccination. “There is no known benefit to delaying vaccination. In fact, it puts babies at risk of getting sick because they are left vulnerable to catch serious diseases during the time they are not protected by vaccines.”

When parents choose not to vaccinate or to follow a delayed schedule, children are left unprotected against diseases that still circulate in this country, like measles and whooping cough.

In 2014, 667 people in the United States were reported as having measles; this is highest number of measles cases since the disease was eliminated from the United States in 2000. Staying on track with the immunization schedule ensures that children have the best protection against diseases like this by age 2.

Parents who are concerned about the number of shots given at one time can reduce the number given at a visit by using the flexibility built into the recommended immunization schedule. For example, the third dose of hepatitis B vaccine can be given at 6 through 18 months of age. Parents can work with their child’s healthcare professional to have their child get this dose at any time during that age range.

“I make sure my kids are vaccinated on time,” said Dr. Amanda Cohn, a pediatrician at CDC. “Getting children all the vaccines they need by age 2 is one of the best things parents can do to help keep their children safe and healthy.”

If you have questions about the childhood immunization schedule, talk with your child’s health care provider.

You can also visit our website for more information.

Have questions? Email us at


The Zika virus: What we know and what we don’t

Posted by Barbara

We know that…

  • Zika infection during pregnancy can be passed to your baby. It can cause a birth defect called microcephaly and other brain problems. Also, Zika may be linked to miscarriage and stillbirth, hearing and vision problems, and joint issues.
  • the Zika virus is spread mostly through the bite of an infected mosquito, but it also can be spread by having sex with someone who is infected, and possibly through blood transfusions. Zika can be spread through laboratory exposure in a health care setting, too.
  • the mosquitoes that live in many parts of the U.S. are capable of spreading the virus if they become infected. They become infected by biting someone who has the virus. At this time, in the continental United States, mosquitoes are spreading the virus in only one area of Florida.
  • infected mosquitoes spread the virus by biting people. Roughly 4 out of 5 people who get the Zika virus don’t have any signs or symptoms and aren’t aware that they have the virus.
  • by applying bug spray/lotion for 3 weeks after you return from a Zika-affected area, or if you were diagnosed with Zika, you will help prevent the spread of Zika to others.

 We don’t know…

  • how often Zika causes microcephaly or birth defects when a baby is exposed to the virus in the womb.
  • if or when mosquitoes in other areas of the U.S. may become infected with Zika and consequently start spreading the virus.
  • when a vaccine will be available.

Here’s what you can do

The March of Dimes #ZAPzika campaign provides essential information on Zika protection that everyone should follow and share:

  1. Use spray, keep mosquitoes away: make sure it’s EPA registered, and contains at least one of mosquito_3Dthe following ingredients: DEET, Picaridin, oil of lemon eucalyptus, para-menthane-diol, or IR3535, which are safe to use during pregnancy. Don’t use products that contain oil of lemon eucalyptus or para-menthane-diol on children younger than 3 years. When applying, always follow the product label directions;  do not put bug spray/lotion under your clothes, and put sunscreen on first (then bug spray/lotion over sunscreen). Find a repellant that is right for you.
  1. Say you will, embrace the chill: use air conditioning and window screens if possible. Repair holes on screens.
  1. If it’s wet, it’s a threat: remove still water. Mosquitoes can breed in tiny amounts of water. To prevent water from pooling and becoming mosquito breeding grounds, the CDC says “Once a week, empty and scrub, turn over, cover, or throw out items that hold water, such as tires, buckets, planters, toys, pools, birdbaths, flowerpots, or trash containers.”
  1. Get protected, not infected: wear clothes to prevent bites, such as long pants, a long-sleeved shirt, socks, shoes, and a hat. If you or your partner may be infected with Zika, use a barrier method (like a condom) every time you have sex or don’t have sex at all.
  1. If you suspect, then connect: call your health care provider if you are at risk of infection, or if you think you may have the Zika virus.

If you are thinking about getting pregnant, CDC guidelines suggest waiting at least 6 months from the first sign or symptom if a male partner was diagnosed with the virus, and waiting at least 8 weeks from the first sign or symptom if a woman tested positive for Zika.

If you or your partner may have Zika but neither of you have signs or symptoms and neither of you has been tested, wait at least 8 weeks from when you think you may have been exposed to Zika before trying to get pregnant. Keep in mind that research is ongoing to confirm these waiting times.

If you have questions about Zika, please see our article at or send them to


Feeling depressed when you breastfeed?

Posted by Lauren

Contemplative woman with babySome women experience feelings of depression during milk letdown and the beginning of breastfeeding. This experience is called Dysphoric Milk Ejection Reflex or D-MER and is caused by a drop in dopamine, a hormone that is released in the brain. Dopamine affects your mood, behavior, and the way you think and process information.

A mom with D-MER may experience a range of feelings such as sadness, depression, anxiety, irritability, anger or restlessness. Anything that causes a milk release, whether it is breastfeeding, manual milk expression, a breast pump, thinking about your baby or just having full breasts, can generate the negative feelings associated with D-MER.

D-MER is a reflex, which means the feelings cannot be controlled and symptoms can vary from mild to severe. Symptoms may decrease over a period of months or they may continue throughout the breastfeeding experience. D-MER is not the same as postpartum depression and is not associated with breastfeeding aversion, a severe lack of interest in breastfeeding.

D-MER is a newly diagnosed condition – receiving its name in 2008; more research needs to be done to learn about it. If you think you may be suffering from D-MER, speak with your health care provider. You can also visit Share Your Story, where you may connect with other moms, and perhaps start a conversation forum.