Selected Podcast
The Benefits of Breastfeeding
Dr. Anna Ferwerda discusses the benefits of breastfeeding.
Featuring:
Dr. Ferwerda earned her Doctor of Medicine from Ponce Health Sciences University in Ponce, Puerto Rico. She completed her residency at Allegheny Health Network in Pittsburgh, PA where she served as Chief Resident in her final year. Before moving to Florida, she practiced general OB/GYN at MetroHealth Medical Center in Cleveland, OH and was an instructor for Case Western Reserve University.
Dr. Ferwerda is a member of the American College of Obstetrics and Gynecology, the American Medical Association, the American Association of Gynecologic Laparoscopists and the Florida Medical Association. Her areas of interest include disparities surrounding contraception and sterilization, improving access to prenatal care and patient-centered quality of care. She is committed to providing every patient the highest quality of care.
The Brumback Clinics provide medical, dental, pharmacy and behavioral health services for adult and pediatric patients, regardless of their ability to pay, and offer a sliding fee scale. A Mobile Health Clinic provides medical care and behavioral health services to the homeless and underserved patients. The Brumback Clinics also provide a Medication Assisted Treatment (MAT) program for patients with substance use disorders and play a lead role in the county’s new and innovative Addiction Stabilization Center. Over 46,000 clinic patients across the county received care at the clinics last year.
Thanks to the efforts of Dr. Ferwerda and the medical team, the Brumback Clinics were honored in 2019 as a gold-level Health Center Quality Leader, ranked among the top 10% of health centers nationally for clinical quality. In 2017, the Brumback Clinics received an “80% by 2018 National Achievement Award” from the National Colorectal Cancer Roundtable (NCCRT) for achieving a colorectal cancer-screening rate that is twice the national average for community clinics and one of the highest in the country. In 2016, the clinics received NCQA Patient-Centered Medical Home (PCMH) recognition.
Anna Ferwerda, MD, F.A.C.O.G.
Anna Ferwerda, MD serves as the Medical Director of the ten C. L. Brumback Primary Care Clinics, Federally Qualified Health Centers owned and operated by the Health Care District of Palm Beach County. Dr. Ferwerda joined the Health Care District in 2016 and developed the OB/GYN program. She served as Director of Women’s Health and was instrumental in increasing access to Women’s Health Services for the C. L. Brumback patients.Dr. Ferwerda earned her Doctor of Medicine from Ponce Health Sciences University in Ponce, Puerto Rico. She completed her residency at Allegheny Health Network in Pittsburgh, PA where she served as Chief Resident in her final year. Before moving to Florida, she practiced general OB/GYN at MetroHealth Medical Center in Cleveland, OH and was an instructor for Case Western Reserve University.
Dr. Ferwerda is a member of the American College of Obstetrics and Gynecology, the American Medical Association, the American Association of Gynecologic Laparoscopists and the Florida Medical Association. Her areas of interest include disparities surrounding contraception and sterilization, improving access to prenatal care and patient-centered quality of care. She is committed to providing every patient the highest quality of care.
The Brumback Clinics provide medical, dental, pharmacy and behavioral health services for adult and pediatric patients, regardless of their ability to pay, and offer a sliding fee scale. A Mobile Health Clinic provides medical care and behavioral health services to the homeless and underserved patients. The Brumback Clinics also provide a Medication Assisted Treatment (MAT) program for patients with substance use disorders and play a lead role in the county’s new and innovative Addiction Stabilization Center. Over 46,000 clinic patients across the county received care at the clinics last year.
Thanks to the efforts of Dr. Ferwerda and the medical team, the Brumback Clinics were honored in 2019 as a gold-level Health Center Quality Leader, ranked among the top 10% of health centers nationally for clinical quality. In 2017, the Brumback Clinics received an “80% by 2018 National Achievement Award” from the National Colorectal Cancer Roundtable (NCCRT) for achieving a colorectal cancer-screening rate that is twice the national average for community clinics and one of the highest in the country. In 2016, the clinics received NCQA Patient-Centered Medical Home (PCMH) recognition.
Transcription:
Robin Kish: Should new moms, nurse, their babies? You may have heard pros and cons about breastfeeding, but what are the facts? What about the risk of Coronavirus? We boil it all down on this edition of Here for Your Health. Welcome to the Health Care District of Palm Beach County’s podcast, Here for Your Health. I'm your host Robin Kish. The Health Care District is a unique healthcare system located in Palm Beach County, Florida. Did you know the Health Care District provides County residents access to primary care, skilled nursing and hospital care? Or that we staff registered nurses in nearly all of our public schools? Or that we fly, maintain, and operate the counties two lifesaving Trauma Hawk air ambulances? Through all of these programs, the Health Care District serves as the healthcare safety net for Palm Beach County. On this edition of Here for Your Health, we'll discuss the benefits of breastfeeding for moms and babies, we'll also separate fact from fiction, so parents understand why, what they've heard about nursing infants may or may not be true. Our guest today is Dr. Anna Ferwerda, Medical Director of the C. L. Brumback Primary Care Clinics operated by the Health Care District of Palm Beach County. Welcome, Dr. Ferwerda.
Dr. Ferwerda: Thanks for having me, Robin.
Host: Dr. Ferwerda, the American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of a child's life and then ongoing breastfeeding while parents introduce complimentary foods until one year or older. Now with COVID-19 transmission being such a big concern, is it safe for moms to breastfeed?
Dr. Ferwerda: It is. So many of our professional organizations like the, WHO, ACOG, have put out opinions on whether it's safe for moms to breastfeed, even if they are positive for COVID-19 and the benefits of breastfeeding significantly outweigh the risks for them. So if a mom was potentially positive for COVID-19, they should take precautions, wash their hands, wear a mask, and practice proper hygiene to make sure that they don't transmit it to their infant, but they definitely should consider breastfeeding as their first option for feeding.
Host: Dr. Ferwerda, your background as an OB GYN translates to your patients now, you're caring for women's health, and I'm sure you're telling your patients many of them who are expectant moms, what to do regarding nursing their own children.
Dr. Ferwerda: I do. It's important to start the conversation early in the pregnancy and to explain to new and expectant moms who may not have experience with breastfeeding within their families or their social situations, that breastfeeding is good for them as well as for their baby. And it's the perfect food made by nature for babies. It will change to meet the baby's nutritional requirements as the infant grows, and it is protective for the baby against some short and long-term illnesses and diseases. So, I always recommend that they exclusively breastfeed for at least the first six months, as much as possible.
Host: And just to go back to something you had said earlier, that it's okay if mom is COVID positive, she can still continue breastfeeding her baby?
Dr. Ferwerda: Yes, the current recommendation from ACOG and the World Health Organization is to continue breastfeeding, even if the patient is COVID positive. You should follow proper hygiene. So hand washing and wearing a face mask when you're in contact with the infant, as long as you're positive for COVID-19. But since the benefits significantly outweigh the risks, mothers should continue to breastfeed their infants as long as possible.
Host: What are some of the illnesses that breastfeeding protects against?
Dr. Ferwerda: Babies who have been breastfed, tend to have a lower risk of asthma, obesity, type one diabetes, ear infection, SIDS or sudden infant death syndrome. And they tend to have less GI infections like diarrhea and vomiting.
Host: Moms who breastfeed also benefit.
Dr. Ferwerda: There's a significant benefit for moms who breastfeed. If you breastfeed, it helps you reach your prepregnancy weight much faster. It decreases your risk of breast cancer, ovarian cancer, Type Two diabetes, and high blood pressure
Host: With all of these benefits, you'd think that moms would be more inclined to nurse their infants, but it's not something that we are born knowing how to do. I mean, I personally, I learned how to nurse thanks to a team of dedicated maternity nurses who taught me after delivering my first child while I was still in the hospital. And not only did I learn how to get my newborn to latch on, I also learned how to pump so I could store and freeze my milk. It takes a lot of time, effort and dedication to commit to nursing. And for some moms it's really difficult. Dr. Ferwerda, what are some of the challenges that mothers face
Dr. Ferwerda: The biggest challenge that mothers face is not inherently knowing how to breastfeed and babies who don't know how to breastfeed immediately. So it can be challenging to establish that connection with the baby and make sure that everyone's doing what they're supposed to. Hospitals in the last few years have been very helpful in hiring more lactation consultants that can provide support and instruction while patients are hospitalized. And there are special community programs, even in Palm Beach County that provide extra support to patients and new moms while they're learning to breastfeed and can help them become more comfortable with doing it. We at our hospital in Belle Glade Lakeside Medical Center, and at the primary care clinics, we can refer or provide help from certified lactation counselors so that new moms can learn how to nurse their baby and figure out a few tips and tricks of how to make things go a little bit more smoothly.
Host: And that support is critical, especially in certain areas of the country like here in South Florida, according to national survey results published in 2018 by the Centers for Disease Control and Prevention, infants living in the southeast are less likely to be breastfed at six months, than infants who live in other areas of the country. In addition, infants in rural areas are less likely to ever breastfeed than infants living in urban areas. And the survey results also found that fewer non-Hispanic, black infants are breastfed compared with non-Hispanic, white infants and Hispanic infants. And younger mothers between the ages of 20 to 29 years are less likely to ever breastfeed than mothers who are 30 years or older. Why does some of these disparities exist do you think?
Dr. Ferwerda: This is something my patients struggle with on a daily basis. I think there are a lot of racial and ethnic disparities when it comes to breastfeeding. And a lot of it has to do with support in the work environment. A lot of patients are not able to have a long enough maternity leave to really establish that bond with the infant and continue to really kind of become proficient at breastfeeding. And with a really quick return to work, it also makes it difficult that many of them don't have adequate spaces and the time to pump, and then to save the milk or don't have access to refrigerators where they can store the milk while they're at work. So some of the biggest problems that they really face are really logistical problems that tend to cause a lot of difficulty for them to both pump and save their milk for their babies, as well as a lot of times, family support or preconceived ideas about formula being superior to breast milk, which over the last few years, I think we've really dispelled that myth.
Host: Yes, and there are also some concerns about infants’ nutrition and weight.
Dr. Ferwerda: That's probably the most common question I get from new moms is, “How do I know my baby is getting enough milk, because I can't measure how much breast milk I'm producing?” And that is really difficult to quantify. It's much easier to measure how much you're giving a baby in a formula bottle. Right? So most of the time, what I tell patients is new babies who are breastfed will probably lose a few ounces of weight in their first days of life. Once they've really established breastfeeding, they should gain between four and seven ounces in that first month. But the really critical thing to watch to make sure that the baby's getting enough milk is the number of diapers that their wetting. So if your baby is wetting between six and eight diapers per day, you can be sure that your baby is getting enough nutrition from the breast milk without having to measure out ounces and knowing exactly how much is coming out every couple of hours, when the baby is feeding. For the first six months, gaining a pound or two each month is considered healthy. And then between seven and 12 months of age, a pound a month is adequate. Breastfed babies can also gain up to an inch in length each month during the first year of life. And your baby will probably go through several two to four-day growth spurt periods. So during this time you may notice that the baby wants to eat more or almost around the clock.
Host: Should you ever wake a sleeping baby to breastfeed?
Dr. Ferwerda: No. So most of the time your baby will wake you and be ready to eat every two and a half to three hours. Every baby's different. And I've had patients who say that every hour and a half, their baby wants to eat. And some that say their baby wants to eat every four hours, but typically you should just let the baby rest when they're asleep and feed them when they are hungry.
Host: And there’s actually a motion that the baby makes with his or her mouth too, that shows they're ready to eat sometimes, I remember that.
Dr. Ferwerda: So babies have a reflex, like a rooting reflex inherent in all human babies that kind of lets you know, that they're going to latch or that they can.
Host: When should a mother refrain from breastfeeding?
Dr. Ferwerda: So there are actually very few situations where mothers should refrain from breastfeeding. Since breast milk provides really the best nutrition for most babies, including premature and sick newborns, unless you have HIV infection or active varicella or even active herpes lesions on the breast, you should be able to breastfeed. One question I get pretty commonly is can patients with substance use disorder continue to breastfeed? And the answer is if they are on a maintenance medication like Subutex or Suboxone, they can continue to breastfeed. And it's actually encouraged because the benefits of the breastmilk really do outweigh any risks from the medication. So my advice would be as well that all moms check with their doctor, especially if they have any underlying medical conditions or take any medications before deciding that they're going to either breastfeed or stop breastfeeding.
Host: And to that point, the CDC has a complete listing of those exceptions and medications on their website at ww.cdc.gov/breastfeeding. The website even addresses breastfeeding in the new Coronavirus or COVID-19. Here's a question that I had back in the day, how long does breast milk stay good in the refrigerator, stored in the freezer and on the counter?
Dr. Ferwerda: That's a very good question. So according to the American Academy of Pediatrics, containers that are covered can stay on a table in room temperature, no higher than 77 degrees for up to four hours, it's important that you keep it in a cool temperature. Any leftover milk after you've fed the babies should be discarded within two hours of the last feeding and you can store breast milk in the refrigerator or in the freezer. In the refrigerator, it will last at least four hours in the freezer it can last six to 12 months, but you probably want to use it at the six month mark if possible.
Host: What should moms be eating when they're nursing their baby? And do they need to increase how many calories they're eating?
Dr. Ferwerda: What's really interesting about this is to maintain a pregnancy, you only need about 300 extra calories a day. And to breastfeed, you can even expend up to 500 extra calories a day. So you need to make sure to eat healthy foods like lots of fruits and vegetables, apples, bananas, whole grain breads, peanut butter are great options to supplement your calories, but overall focusing on making healthy choices to help fuel milk production, as well as to consider that that's what your baby is going to be receiving. So, protein-rich foods like meats, eggs, dairy, beans, and lentils and foods that are low in mercury. So, a diet very similar to what you may have had in pregnancy and sticking to two portions of fish per week. And then choose a variety of whole grains as well of fruits and vegetables, and make sure to wash any fruits and vegetables to reduce any exposure to pesticides or bacteria.
Host: That's really good advice. And I remember clearly adjusting my diet when my newborn had colic so that I reduced foods that potentially caused gas. I was told that when you nurse, what you eat, the baby also eats. How do you know when to make changes to your diet?
Dr. Ferwerda: So that's a great question and an issue that a lot of new moms have, the baby's pediatrician can really help guide you and give you good feedback to know if your baby is having adequate bowel movements, if you're wetting enough diapers and those kinds of things, and also to make sure that your food choices are appropriate for the baby's growth.
Host: And the CDC also lists helpful resources. As I mentioned, as does Floridahealth.gov, womenshealth.gov/breastfeeding and LA Leche League international at llli.org. Trained volunteers provide one on one help to breastfeeding mothers on the phone and conduct monthly group support meetings. You can call 1-800 L A L E C H E. And Dr. Ferwerda, before we wrap up in light of COVID-19, what is your top tip overall when it comes to staying well?
Dr. Ferwerda: I think practicing proper hand hygiene is probably the most important thing that we can do to reduce any transmission to the infant or in contracting the virus yourself. It has never been so important as now, to practice social distancing and to make sure that you are not subconsciously touching objects in public places and then touching your face or touching your baby's face. And just to remember as well that even if you're wearing gloves in a public place, you have to remove those gloves before touching yourself or touching your infant because the gloves can be contaminated from anything that you've been touching in an outside location.
Host: Good advice for moms and everyone else. Dr. Ferwerda, thanks again for joining us today, you've provided some great information that will help keep moms and babies healthy. And I can tell you on a personal note, I found nursing to be very rewarding. And the bonding I shared with both of my daughters during those first six months of their lives was really priceless. So getting my sleep when they slept was also key to staying rested. So thank you.
Dr. Ferwerda: Thanks for having me. It's a really special experience that you can share with your infants. I'm glad that I'm here to talk about it today.
Host: Thanks to all of our listeners as well. If you find this podcast helpful, share it on your social channel and check out our full podcast library for topics of interest to you at healthcaredistrictpodcasts.org. Let us know what you think, your review helps us reach more people just like you. And if you have a suggestion about a future podcast topic, have questions or some feedback, please call (561) 804-4111. And tell us about it. Today's podcast is brought to you by the Health Care District’s Federally Qualified Health Centers, the C. L. Brumback Primary Care Clinics. If you or someone you know, could benefit from having a medical home, please call the Brumback Clinics at (561) 642-1000 to make an appointment for a medical visit, testing, medication assisted treatment, or other services. You can also visit www.Brumbackclinics.org.
Robin Kish: Should new moms, nurse, their babies? You may have heard pros and cons about breastfeeding, but what are the facts? What about the risk of Coronavirus? We boil it all down on this edition of Here for Your Health. Welcome to the Health Care District of Palm Beach County’s podcast, Here for Your Health. I'm your host Robin Kish. The Health Care District is a unique healthcare system located in Palm Beach County, Florida. Did you know the Health Care District provides County residents access to primary care, skilled nursing and hospital care? Or that we staff registered nurses in nearly all of our public schools? Or that we fly, maintain, and operate the counties two lifesaving Trauma Hawk air ambulances? Through all of these programs, the Health Care District serves as the healthcare safety net for Palm Beach County. On this edition of Here for Your Health, we'll discuss the benefits of breastfeeding for moms and babies, we'll also separate fact from fiction, so parents understand why, what they've heard about nursing infants may or may not be true. Our guest today is Dr. Anna Ferwerda, Medical Director of the C. L. Brumback Primary Care Clinics operated by the Health Care District of Palm Beach County. Welcome, Dr. Ferwerda.
Dr. Ferwerda: Thanks for having me, Robin.
Host: Dr. Ferwerda, the American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of a child's life and then ongoing breastfeeding while parents introduce complimentary foods until one year or older. Now with COVID-19 transmission being such a big concern, is it safe for moms to breastfeed?
Dr. Ferwerda: It is. So many of our professional organizations like the, WHO, ACOG, have put out opinions on whether it's safe for moms to breastfeed, even if they are positive for COVID-19 and the benefits of breastfeeding significantly outweigh the risks for them. So if a mom was potentially positive for COVID-19, they should take precautions, wash their hands, wear a mask, and practice proper hygiene to make sure that they don't transmit it to their infant, but they definitely should consider breastfeeding as their first option for feeding.
Host: Dr. Ferwerda, your background as an OB GYN translates to your patients now, you're caring for women's health, and I'm sure you're telling your patients many of them who are expectant moms, what to do regarding nursing their own children.
Dr. Ferwerda: I do. It's important to start the conversation early in the pregnancy and to explain to new and expectant moms who may not have experience with breastfeeding within their families or their social situations, that breastfeeding is good for them as well as for their baby. And it's the perfect food made by nature for babies. It will change to meet the baby's nutritional requirements as the infant grows, and it is protective for the baby against some short and long-term illnesses and diseases. So, I always recommend that they exclusively breastfeed for at least the first six months, as much as possible.
Host: And just to go back to something you had said earlier, that it's okay if mom is COVID positive, she can still continue breastfeeding her baby?
Dr. Ferwerda: Yes, the current recommendation from ACOG and the World Health Organization is to continue breastfeeding, even if the patient is COVID positive. You should follow proper hygiene. So hand washing and wearing a face mask when you're in contact with the infant, as long as you're positive for COVID-19. But since the benefits significantly outweigh the risks, mothers should continue to breastfeed their infants as long as possible.
Host: What are some of the illnesses that breastfeeding protects against?
Dr. Ferwerda: Babies who have been breastfed, tend to have a lower risk of asthma, obesity, type one diabetes, ear infection, SIDS or sudden infant death syndrome. And they tend to have less GI infections like diarrhea and vomiting.
Host: Moms who breastfeed also benefit.
Dr. Ferwerda: There's a significant benefit for moms who breastfeed. If you breastfeed, it helps you reach your prepregnancy weight much faster. It decreases your risk of breast cancer, ovarian cancer, Type Two diabetes, and high blood pressure
Host: With all of these benefits, you'd think that moms would be more inclined to nurse their infants, but it's not something that we are born knowing how to do. I mean, I personally, I learned how to nurse thanks to a team of dedicated maternity nurses who taught me after delivering my first child while I was still in the hospital. And not only did I learn how to get my newborn to latch on, I also learned how to pump so I could store and freeze my milk. It takes a lot of time, effort and dedication to commit to nursing. And for some moms it's really difficult. Dr. Ferwerda, what are some of the challenges that mothers face
Dr. Ferwerda: The biggest challenge that mothers face is not inherently knowing how to breastfeed and babies who don't know how to breastfeed immediately. So it can be challenging to establish that connection with the baby and make sure that everyone's doing what they're supposed to. Hospitals in the last few years have been very helpful in hiring more lactation consultants that can provide support and instruction while patients are hospitalized. And there are special community programs, even in Palm Beach County that provide extra support to patients and new moms while they're learning to breastfeed and can help them become more comfortable with doing it. We at our hospital in Belle Glade Lakeside Medical Center, and at the primary care clinics, we can refer or provide help from certified lactation counselors so that new moms can learn how to nurse their baby and figure out a few tips and tricks of how to make things go a little bit more smoothly.
Host: And that support is critical, especially in certain areas of the country like here in South Florida, according to national survey results published in 2018 by the Centers for Disease Control and Prevention, infants living in the southeast are less likely to be breastfed at six months, than infants who live in other areas of the country. In addition, infants in rural areas are less likely to ever breastfeed than infants living in urban areas. And the survey results also found that fewer non-Hispanic, black infants are breastfed compared with non-Hispanic, white infants and Hispanic infants. And younger mothers between the ages of 20 to 29 years are less likely to ever breastfeed than mothers who are 30 years or older. Why does some of these disparities exist do you think?
Dr. Ferwerda: This is something my patients struggle with on a daily basis. I think there are a lot of racial and ethnic disparities when it comes to breastfeeding. And a lot of it has to do with support in the work environment. A lot of patients are not able to have a long enough maternity leave to really establish that bond with the infant and continue to really kind of become proficient at breastfeeding. And with a really quick return to work, it also makes it difficult that many of them don't have adequate spaces and the time to pump, and then to save the milk or don't have access to refrigerators where they can store the milk while they're at work. So some of the biggest problems that they really face are really logistical problems that tend to cause a lot of difficulty for them to both pump and save their milk for their babies, as well as a lot of times, family support or preconceived ideas about formula being superior to breast milk, which over the last few years, I think we've really dispelled that myth.
Host: Yes, and there are also some concerns about infants’ nutrition and weight.
Dr. Ferwerda: That's probably the most common question I get from new moms is, “How do I know my baby is getting enough milk, because I can't measure how much breast milk I'm producing?” And that is really difficult to quantify. It's much easier to measure how much you're giving a baby in a formula bottle. Right? So most of the time, what I tell patients is new babies who are breastfed will probably lose a few ounces of weight in their first days of life. Once they've really established breastfeeding, they should gain between four and seven ounces in that first month. But the really critical thing to watch to make sure that the baby's getting enough milk is the number of diapers that their wetting. So if your baby is wetting between six and eight diapers per day, you can be sure that your baby is getting enough nutrition from the breast milk without having to measure out ounces and knowing exactly how much is coming out every couple of hours, when the baby is feeding. For the first six months, gaining a pound or two each month is considered healthy. And then between seven and 12 months of age, a pound a month is adequate. Breastfed babies can also gain up to an inch in length each month during the first year of life. And your baby will probably go through several two to four-day growth spurt periods. So during this time you may notice that the baby wants to eat more or almost around the clock.
Host: Should you ever wake a sleeping baby to breastfeed?
Dr. Ferwerda: No. So most of the time your baby will wake you and be ready to eat every two and a half to three hours. Every baby's different. And I've had patients who say that every hour and a half, their baby wants to eat. And some that say their baby wants to eat every four hours, but typically you should just let the baby rest when they're asleep and feed them when they are hungry.
Host: And there’s actually a motion that the baby makes with his or her mouth too, that shows they're ready to eat sometimes, I remember that.
Dr. Ferwerda: So babies have a reflex, like a rooting reflex inherent in all human babies that kind of lets you know, that they're going to latch or that they can.
Host: When should a mother refrain from breastfeeding?
Dr. Ferwerda: So there are actually very few situations where mothers should refrain from breastfeeding. Since breast milk provides really the best nutrition for most babies, including premature and sick newborns, unless you have HIV infection or active varicella or even active herpes lesions on the breast, you should be able to breastfeed. One question I get pretty commonly is can patients with substance use disorder continue to breastfeed? And the answer is if they are on a maintenance medication like Subutex or Suboxone, they can continue to breastfeed. And it's actually encouraged because the benefits of the breastmilk really do outweigh any risks from the medication. So my advice would be as well that all moms check with their doctor, especially if they have any underlying medical conditions or take any medications before deciding that they're going to either breastfeed or stop breastfeeding.
Host: And to that point, the CDC has a complete listing of those exceptions and medications on their website at ww.cdc.gov/breastfeeding. The website even addresses breastfeeding in the new Coronavirus or COVID-19. Here's a question that I had back in the day, how long does breast milk stay good in the refrigerator, stored in the freezer and on the counter?
Dr. Ferwerda: That's a very good question. So according to the American Academy of Pediatrics, containers that are covered can stay on a table in room temperature, no higher than 77 degrees for up to four hours, it's important that you keep it in a cool temperature. Any leftover milk after you've fed the babies should be discarded within two hours of the last feeding and you can store breast milk in the refrigerator or in the freezer. In the refrigerator, it will last at least four hours in the freezer it can last six to 12 months, but you probably want to use it at the six month mark if possible.
Host: What should moms be eating when they're nursing their baby? And do they need to increase how many calories they're eating?
Dr. Ferwerda: What's really interesting about this is to maintain a pregnancy, you only need about 300 extra calories a day. And to breastfeed, you can even expend up to 500 extra calories a day. So you need to make sure to eat healthy foods like lots of fruits and vegetables, apples, bananas, whole grain breads, peanut butter are great options to supplement your calories, but overall focusing on making healthy choices to help fuel milk production, as well as to consider that that's what your baby is going to be receiving. So, protein-rich foods like meats, eggs, dairy, beans, and lentils and foods that are low in mercury. So, a diet very similar to what you may have had in pregnancy and sticking to two portions of fish per week. And then choose a variety of whole grains as well of fruits and vegetables, and make sure to wash any fruits and vegetables to reduce any exposure to pesticides or bacteria.
Host: That's really good advice. And I remember clearly adjusting my diet when my newborn had colic so that I reduced foods that potentially caused gas. I was told that when you nurse, what you eat, the baby also eats. How do you know when to make changes to your diet?
Dr. Ferwerda: So that's a great question and an issue that a lot of new moms have, the baby's pediatrician can really help guide you and give you good feedback to know if your baby is having adequate bowel movements, if you're wetting enough diapers and those kinds of things, and also to make sure that your food choices are appropriate for the baby's growth.
Host: And the CDC also lists helpful resources. As I mentioned, as does Floridahealth.gov, womenshealth.gov/breastfeeding and LA Leche League international at llli.org. Trained volunteers provide one on one help to breastfeeding mothers on the phone and conduct monthly group support meetings. You can call 1-800 L A L E C H E. And Dr. Ferwerda, before we wrap up in light of COVID-19, what is your top tip overall when it comes to staying well?
Dr. Ferwerda: I think practicing proper hand hygiene is probably the most important thing that we can do to reduce any transmission to the infant or in contracting the virus yourself. It has never been so important as now, to practice social distancing and to make sure that you are not subconsciously touching objects in public places and then touching your face or touching your baby's face. And just to remember as well that even if you're wearing gloves in a public place, you have to remove those gloves before touching yourself or touching your infant because the gloves can be contaminated from anything that you've been touching in an outside location.
Host: Good advice for moms and everyone else. Dr. Ferwerda, thanks again for joining us today, you've provided some great information that will help keep moms and babies healthy. And I can tell you on a personal note, I found nursing to be very rewarding. And the bonding I shared with both of my daughters during those first six months of their lives was really priceless. So getting my sleep when they slept was also key to staying rested. So thank you.
Dr. Ferwerda: Thanks for having me. It's a really special experience that you can share with your infants. I'm glad that I'm here to talk about it today.
Host: Thanks to all of our listeners as well. If you find this podcast helpful, share it on your social channel and check out our full podcast library for topics of interest to you at healthcaredistrictpodcasts.org. Let us know what you think, your review helps us reach more people just like you. And if you have a suggestion about a future podcast topic, have questions or some feedback, please call (561) 804-4111. And tell us about it. Today's podcast is brought to you by the Health Care District’s Federally Qualified Health Centers, the C. L. Brumback Primary Care Clinics. If you or someone you know, could benefit from having a medical home, please call the Brumback Clinics at (561) 642-1000 to make an appointment for a medical visit, testing, medication assisted treatment, or other services. You can also visit www.Brumbackclinics.org.