Thursday, May 10, 2012

Ear Infections, Asthma, and More: Breastfeeding and Baby's Health

When NJ was a baby, he had quite a few ear infections - six, I believe, in the first 15 months of his life. It wasn't enough for the pediatrician to recommend ear tubes, but not far from it. At four months, he contracted RSV, which caused his airways to become inflamed, necessitating treatment with albuterol using a nebulizer. It also appears to have conditioned him to respond to future colds with what was called Reactive Airway Disease (RAD), basically asthma symptoms that are triggered by a cold. Almost every time he'd get a cold, he'd end up with a wheezy cough that lingered for a couple of weeks. Treatment with albuterol and sometimes oral prednisolone usually had him breathing easily again within a few days. Eventually, thankfully, he grew out of his RAD and he hasn't had a problem with it in several years now.

His ear infections and asthma were yet more fuel for my guilt over not having breastfed him. Maybe if he'd been breastfed, he wouldn't have had so many ear infections. Maybe if he'd been breastfed, he wouldn't have gotten RSV. Maybe if he'd been breastfed, he wouldn't have gotten so many colds. Maybe if he'd been breastfed, he wouldn't have had the RAD.

Indeed, SB's relative excellent health as an infant made me a believer. There's plenty of research out there to show that not breastfeeding increases a child's risk of ear infections, upper respiratory infections, asthma, diabetes, certain types of cancers, obesity, and so on, although the mechanism of protection is not always clear.

I remember reading, when NJ was a baby, that the average infant got 12 colds a year. That's one a month! NJ was certainly at the doctor almost once a month throughout his first year of life, not even counting his well baby checkups. He was rarely "well" even at those. That's not to say he was sickly, just that he often had a cold or drippy nose or cough or ear infection. It seemed like he was either just coming down with something or just getting over something or right in the middle of something, with the rare week of respite. Having a sick baby is frustrating and wearing, even if it's not a serious illness (thank G-d) or chronic condition. (I can't even imagine what it must be like if your child really is always sick. G-d bless all you parents dealing with that kind of stress.) What I began to wonder was, if formula feeding (or not breastfeeding) increases the risk of colds, ear infections, asthma, etc., then maybe it isn't "normal" for babies to be sick every month. Maybe breastfed babies aren't sick nearly so often, and that it's actually not normal (as in, natural) for infants to go around with drippy noses and achy ears almost constantly. Certainly, the fact that SB was rarely at the doctor except for well baby checkups throughout his first year bore out my expectation.

When GI was born, I placed a great deal of faith in the power of my breastmilk to protect him from his two older brothers' constant germy contact. NJ is kind enough to bring home and share every cold that comes his way at school. I will say that he appears to have quite the robust little immune system now, having been exposed to so many viruses when he was smaller. SB, however, being exposed only through NJ to all these viruses, still has not built up the wall of antibodies that appears to be working so well for NJ. At three, SB seems to come down with every cold he's exposed to, but he bears it well, mostly just getting snotty and sleepy for a few days. Both NJ and SB have the terrible habit of having fingers (and toys) in their mouths almost constantly. They like to amuse GI by blowing in his face, giving him raspberries (as in, spitting all over him), touching his hands, letting him put his hands in their mouths, touching his face, eyes, nose, and so on. Still, I had high hopes that breastfeeding would preserve him from the fate of constant colds.

Unfortunately, it seems like GI is sick more often than not, lately. After his bout of bronchiolitis not too long ago, he was healthy and happy for a few weeks. Then, suddenly, he was sick again, with the same cold both of his brothers had. NJ recovered quickly. SB is still a bit snotty but otherwise himself. But GI was up all night a couple nights back, coughing and wheezing. I took him to the doctor yesterday, where the wheeze was confirmed, and I was sent home with a nebulizer machine and a vial of albuterol, as well as oral prednisolone, and instructed to give him a nebulizer treatment up to four times a day and the prednisolone twice a day for five days to relieve the inflammation in his lungs. This was eerily familiar, as the nebulizer and the albuterol and the prednisolone were all standard features around our house when NJ was a baby, too. It's helping, though. He's breathing much more easily, coughing far less, and seems to be himself again. The only problem is that the steroids make it hard for him to sleep. But that will be over with soon enough, thank goodness.

What strikes me with all of this is that despite being 100% breastfed for the first six months and still mostly (like, 95%!) breastfed still at eight months, GI is sick almost as often as NJ was as a baby. The only difference is that GI's only had one ear infection. The doctor gave me the nebulizer machine because he sees this happening again, so we'll be prepared next time. It looks like GI is in the RAD camp alongside his big brother.

I still firmly believe that not breastfeeding increases the risk of a host of problems. I still agree that breastfeeding is normal and offers babies protection from all sorts of germs. I find myself saying, "But I did everything right! He's breastfed! We delayed cord cutting! I'm taking a Vitamin D supplement, and he gets sun almost every day. California sun!" And yet he comes down with so many colds, has this asthma problem now, and has had an ear infection. Let's face it, when the numbers aren't 100%, some people are on the "wrong" side.

So, you have your parents who say, "My kid was formula-fed, and he's healthy as a horse!" And you have your parents who say, "My kid was exclusively breastfed, and he had six ear infections and three asthma attacks by the time he was one." And both can be true, absolutely. But the issue isn't whether your kid fell into the expected category; it's whether most kids fall into the expected category.

I still remind myself that, if GI gets sick this often while breastfed, how much worse would it be if he weren't?  Perhaps the asthma symptoms would have manifested sooner. Perhaps he'd have had more ear infections. Perhaps, G-d forbid, he would have been hospitalized when he had bronchiolitis instead of recovering on his own. Who knows?

Anyway, the one benefit of breastfeeding that absolutely cannot be overlooked when your baby is sick is it's ability to comfort. Being close to Mommy, feeling her skin, hearing her heartbeat, suckling, the warmth of the milk on a raw, inflamed throat, and the calm of being where he feels safest is certainly the best medicine when your baby doesn't feel well. And lying down with him as your baby drifts off into a healing sleep makes it easier for you to handle the stress of his being sick.

GI is sleeping peacefully now, where I just returned to writing after nursing him back down. When all else seems to fail, at least I know I have that to offer.

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