Breast Is Best?

I've been wanting to write about this topic for a while.  As I sit here pumping away, wondering how I'll ever make it the two years of breastfeeding recommended by the World Health Organization, I remind myself just how good this is for my baby girl.

Now, I'm not judging those who choose not to breastfeed, or don't have the ability to breastfeed - it's a decision only a new mom can make for her and her baby.  So for those that took a different road than me, that's fine.  I can say without a doubt in my mind though, that breastfeeding Sienna was/is the absolute BEST choice for my family.  And while I know CF is a progressive disease, I still attribute her good health to-date to the fact that she is breastfed - and so does her Pulmonary doctor.

This was actually a topic of discussion at the most recent North American Cystic Fibrosis Conference held in October in Salt Lake City, Utah.  Another CF mom attended the conference and blogged about the session - which I highly encourage you to read here.

To summarize what I have read across numerous articles, blogs, and in speaking with our clinic team:

• Research suggests that breastfeeding a CFer may delay the onset of symptoms.  Since CF is a progressive disease, the later symptoms kick in, the better the person is likely to fair against the disease.  Once damage is done to the lungs, there is no reversing it.  Sure, there are other factors that play a part in how the disease presents itself and no two cases of CF are the same, but this is still encouraging news! It actually makes me never want to stop breastfeeding her.  Would it be weird to give breast milk to a 10 year old? 18 year old? 30 year old? Probably :)
• Breast milk contains lipase, which contains its own enzymes to aid in the digestion of fat.  Sienna's pancreatic enzyme levels were pretty low when tested at 4 weeks old, so she very well could be insufficient.  Once she moves on to a diet of solids, it will be pretty telling if she will need to take enzymes with her food to aid in digestion.  I plan to have her pancreatic elastase tested again next clinic visit anyway as I'm not sold on her being pancreatic insufficient.
• Vitamins and minerals found in breast milk are in a form that is maximally digestible for an infant.  We also had Sienna's vitamin levels tested when she was 4 weeks old, and everything came back at normal levels.  Most CFers will need to take special supplemental vitamins in order to get the necessary nutrition.  We only supplement Vitamin D at this time, as it is not passed through breast milk. 
• Immunity! This goes for every baby, but breast milk helps protect an infant from sickness by passing antibodies on.  This is critical as it takes time for the human body to develop a strong immune system AND babies under two months old are completely un-vaccinated (and therefore unprotected!).  I'll also call out here that individuals with Cystic Fibrosis have normal immune systems.  CFers are just more susceptible to pick up bad bugs due to the sticky mucus in the lungs.  We routinely take throat cultures at clinic to see if any bacteria is growing in Sienna's lungs.  So far, she has cultured e.coli and staph.  However, we don't treat these unless she were to show symptoms.  Apparently staph is everywhere, and e.coli is incredibly common in newborns.  You and I may even "culture" bugs like this if we were to be throat swabbed.  Bugs like pseudomonas aeruginosa and burkholderia cepacia complex are the dangerous ones, and if "cultured," are treated immediately with an aggressive antibiotic regimen.  What's also scary is that if someone cultures b. cepacia complex, they may be denied a lung transplant - something many CFers rely on in order to survive with this disease (see CFF.org for more on lung transplants).

I'm sure I could go on, but I'll end it with those points.  For more on breastfeeding and CF, check this non profit company's site. 

For those CF moms that wonder about treatments and feeding.  We ended up introducing a bottle earlier than planned in order to give her extra salt daily.  I add a pinch of pink, Himalayan salt in all of her bottles.  Again, everyone's situation is going to be different and you will need to do what's best for your little one.  Most CFers see a Nutritionist to help guide these discussions anyway.

I plan to keep nursing and pumping for as long as I can.  It's not easy, but I believe it's important to Sienna's health.  It takes a big commitment...pumping when I wake up, three times at my office, before I go to bed, and nursing at night.  It requires endless hours cleaning and sanitizing pump parts and bottles.  When I traveled for work in November I even set an alarm clock for the middle of the night to get up and pump.  I was terrified my supply would drop if I didn't, and I was already used to getting less sleep!

It's worth the challenge, the frustration, and the commitment.  It's worth it for this little face.