Way to go, Hannah! 🎉🎉 #ClevelandClinicChildrens!

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Way to go, Hannah! 🎉🎉
3-year old Hannah, born with cerebral palsy, has fun while learning to walk with our pediatric physical therapists at #ClevelandClinicChildrens!

We couldn’t think of a better way to celebrate National Physical Therapy Month than a walk around campus. Our therapists use play to work with children and their families on developmental skills, strength, flexibility, mobility and more!

5 Ways to Boost Your Child’s Immune System for Life @ClevelandClinic Adriane Lioudis, MD.

We all want to protect our kids whether it be from falls, bumps and bruises — or avoidable infections and diseases. To help your child avoid illness, it’s important to encourage good habits and take steps to boost their immune system from an early age.

“Most of what makes a child’s immune system strong is common sense,” says pediatrician Adriane Lioudis, MD. If you keep these five tips in mind, you’ll stack the deck in your child’s favor for a healthier life.

1. For newborns, consider breastfeeding

While it’s a very personal decision (that isn’t always possible), if you are able to exclusively breastfeed your child for at least six months, it may have benefits. Some research shows that breastfeeding your child might possibly reduce allergies, Dr. Lioudis says.

2. Promote regular hand washing

Eighty percent of infections are spread by touch. Teach your little one to take the time to wash their hands after sneezing, coughing and going to the bathroom. Washing hands with warm water and soap for at least 20 seconds can remove bacteria and viruses and can reduce the chance of lung infections by up to 45%.

3. Don’t skip immunizations

Follow your pediatrician’s advice when it comes to the childhood vaccination schedule. Immunizations start in infancy and continue to adulthood and prevent measlesmumpschickenpoxrotavirus and other infections.

“Get the flu shot for your child yearly, as well,” Dr. Lioudis says. This is particularly important for children with asthma and other chronic health conditions.

Also, if your family will be traveling internationally, it’s important to seek advice from your child’s healthcare provider about any needed vaccinations.

4. Make sleep a priority

To maximize immunity, children must get enough sleep.

Sleep requirements for each night vary by age:

  • Babies between 0 and 3 months need 14 to 17 hours of sleep. Those between 4 and 12 months need 12 to 16 hours of sleep.
  • Children between the ages of 1 and 2 need between 11 and 14 hours.
  • Kids between the ages of 3 and 5 should get from10 to 13 hours.
  • Children ages 6 to 12 should get between 9 and 12 hours.
  • Teens between the ages of 13 to 18 need 8 to 10 hours.

Not getting enough sleep limits the body’s ability to produce proteins called cytokines that help fight infection and reduce inflammation.

5. Encourage a healthy diet

healthy diet is also important for your child’s immune system.

Dr. Lioudis recommends encouraging your child to “eat the rainbow” when it comes to fruits and vegetables. A good selection of whole grains should be part of their diet as well. Keep processed foods to a minimum. Proper food choices can help ensure that your child gets enough vitamins — such as vitamin A and E. These vitamins are needed to maintain good health and a strong immune system.

You can’t avoid all illness, but some kids need extra protection

“Even if you follow these tips, your child might still get between seven and 11 colds each year,” says Dr. Lioudis. She adds that you can expect each one to last up to two weeks.

Also, keep in mind that some things billed as common “remedies” aren’t effective in boosting immunity. For example, there’s no definitive proof that large amounts of vitamin C or echinacea help prevent colds or shorten them, she says.

However, if your child has a compromised immune system, work closely with your pediatrician to find ways to improve his or her immunity. Each child needs a personalized approach because their individual immune system varies, Dr. Lioudis says.

“There’s generally a different protocol with immunocompromised children. There are some vaccines we have to add in on top of what most children have, but it’s something that we must determine on a case-by-case basis.

Take care of yourself …

May 28, 2024/Pregnancy & Childbirth

How Long To Breastfeed: What the Guidelines Say and What To Consider

Recommendations encourage breast milk exclusively for baby’s first six months and continuing to provide human milk until age 2 and beyond

How and what you feed your baby is probably one of the most basic — and yet deeply personal — decisions you’ll face when you become a parent.

You’ll hear things like “breast is best.” As in, breastfeeding (chestfeeding) is the absolute best way to nourish your baby.

And then you’ll hear the retort, “fed is best.” Meaning breast milk (human milk) and formula are both fine. As long as your baby is getting nutrients in their belly, all is well.

Then come the opinions on how long you should breastfeed. (You’re still breastfeeding? You gave up on nursing already? You fed your baby formula?)

It can feel like there’s no right way to do it. And there’s some truth to that.

Because what works for one family may not be feasible for another. But that’s OK.

Breast milk can provide certain benefits that formula can’t mimic. But breastfeeding, especially for long periods of time, might not work for everyone. Or you may have been given the impression that you’ve continued providing human milk long after others think you “should.”

No one should feel guilt, shame or otherwise crummy about how they feed their baby. Let’s face it, mom guilt is tough enough as it is.

So, we talked with board-certified breastfeeding medicine physician Heidi Szugye, DO, about breastfeeding recommendations.

How long to breastfeed

Science shows that if you can give your baby human milk (either your own or a donor’s), it has its benefits. And the longer, the better, experts recommend.

The American Academy of Pediatrics (AAP) and the World Health Organization (WHO) share these recommendations for breastfeeding duration:

  • Newborn to 6 months: Exclusive human milk.
  • 6 months to 12 months: Mostly human milk while introducing solid foods.
  • 12 months to 24 months (and beyond): Mostly solid foods with some human milk, as mutually desired by parent and child.

Previous recommendations called for providing breast milk until age 1. But these newer guidelines (implemented in 2022) are based on the understanding that human milk has benefits that continue long after baby’s first birthday. And they help to remove stigmas associated with people who choose to extend breastfeeding into toddlerhood.

“These recommendations are a call to action for everyone, and that includes hospitals, pediatricians and all physicians that are taking care of families,” Dr. Szugye states. “We want to make sure our practices and policies are set up to support people who choose to breastfeed beyond the first year of their child’s life.”

Think of the guidelines as the best-case scenario. If it works for you, your family, your child, your body and your life to breastfeed for two years or longer, you’re doing a great thing. And there’s no reason to stop until you and your child are ready.

If it doesn’t work for you, that’s OK, too. Your worth as a parent and your love for your child can’t be measured in ounces of milk.

Benefits of extended breastfeeding

The recommendations are based on research showing that human milk has some big benefits. And those perks continue for as long as you continue to supply it.

“Breastfeeding offers tremendous benefits — from custom-made nutrition and increased immunity to protecting you against some forms of cancer. And those benefits don’t go away as your baby ages,” Dr. Szugye shares. “We have more and more data supporting that there are benefits to breastfeeding for more than one year when possible.”

Breastfeeding can offer both you and your baby some big benefits:

Benefits for lactating parentsBenefits for baby
Lower risk of developing conditions like Type 2 diabetes, high blood pressure, cardiovascular disease, breast cancer and ovarian cancer.Decreased risk for ear infections, respiratory infections, gastrointestinal illnesses, SIDS, leukemia, diabetes, obesity, asthma and eczema.

“There are a lot of immunologic factors and components to human milk,” Dr. Szugye says. “One big advantage to human milk is that you pass antibodies to the baby. So, if you’re exposed to a respiratory illness or GI illness, those antibodies are passed on to the baby and then that makes them less likely to get sick. And if they do get sick, it’s less severe. It’s almost like a built-in immunity.”

Keeping up milk supply for the long haul

Some people can make enough milk to breastfeed for as long as they and their babies choose. But some don’t. At least not without taking some steps to keep it up.

If you suspect your supply is dwindling as your child gets older, there are ways to help promote more milk production if you want.

“Many people notice their supply drop and mistakenly assume it won’t return,” Dr. Szugye notes. “But if you want to continue to breastfeed, there are options that could help.”

If a supply boost is in order, you can try:

  • Nursing more often — Add sessions as long as your child will nurse. If you’re away from them during the day, try early evenings, mornings or weekends.
  • Pumping strategies — An extra session or several short “power pumping” sessions (think five to 10 minutes throughout the day) for several days in a row can trigger your body to make more milk.
  • Breast massage and compression — Easy-to-learn techniques can improve drainage when nursing or pumping.
  • Take care of yourself — Reduce stress, rest when possible, hydrate and eat a balanced diet with an extra 500 calories a day to support breastfeeding.

Not an ‘all-or-nothing’

If two or more years of breastfeeding seems daunting, remember that you have options.

For starters, giving your child human milk doesn’t always mean latching them to your breast and nursing. That’s just one way to do it. Pumping milk and putting it in a bottle, cup or spoon are also options.

And you may find that a donor bank could be a route to explore if you don’t lactate or if you have concerns about a low milk supply. Donor milk is pasteurized, screened for drugs, medications and infections, and tested for bacterial contamination before it’s stored and made available for purchase.

“Reach out to your pediatrician or women’s healthcare provider if you’re interested in obtaining donor milk. You may need a prescription from a healthcare provider,” Dr. Szugye suggests.

Remember, too, that any amount of human milk can be a benefit. If keeping up with your baby’s breastfeeding demands becomes too high a burden, there are alternatives.

Some parents may find that supplementing with formula (or other foods and milk after baby turns 1) can help give your child some human milk, while keeping up with their nutritional needs — and not burning yourself out in the process.

“It’s not an all-or-nothing thing,” Dr. Szugye reassures. “Any amount of human milk you can give is a benefit. If it doesn’t work for you to constantly supply human milk, that’s OK. We’re all just doing our best.”

If breastfeeding is going well for both you and your child, there’s no reason to give it up until you’re both ready to.

Feeding a baby is tough work, no matter how you do it. And chances are, you’re doing a fantastic job.

Take care of yourself …

May 28, 2024/Pregnancy & Childbirth

How Long To Breastfeed: What the Guidelines Say and What To Consider

Recommendations encourage breast milk exclusively for baby’s first six months and continuing to provide human milk until age 2 and beyond

How and what you feed your baby is probably one of the most basic — and yet deeply personal — decisions you’ll face when you become a parent.

You’ll hear things like “breast is best.” As in, breastfeeding (chestfeeding) is the absolute best way to nourish your baby.

And then you’ll hear the retort, “fed is best.” Meaning breast milk (human milk) and formula are both fine. As long as your baby is getting nutrients in their belly, all is well.

Then come the opinions on how long you should breastfeed. (You’re still breastfeeding? You gave up on nursing already? You fed your baby formula?)

It can feel like there’s no right way to do it. And there’s some truth to that.

Because what works for one family may not be feasible for another. But that’s OK.

Breast milk can provide certain benefits that formula can’t mimic. But breastfeeding, especially for long periods of time, might not work for everyone. Or you may have been given the impression that you’ve continued providing human milk long after others think you “should.”

No one should feel guilt, shame or otherwise crummy about how they feed their baby. Let’s face it, mom guilt is tough enough as it is.

So, we talked with board-certified breastfeeding medicine physician Heidi Szugye, DO, about breastfeeding recommendations.

How long to breastfeed

Science shows that if you can give your baby human milk (either your own or a donor’s), it has its benefits. And the longer, the better, experts recommend.

The American Academy of Pediatrics (AAP) and the World Health Organization (WHO) share these recommendations for breastfeeding duration:

  • Newborn to 6 months: Exclusive human milk.
  • 6 months to 12 months: Mostly human milk while introducing solid foods.
  • 12 months to 24 months (and beyond): Mostly solid foods with some human milk, as mutually desired by parent and child.

Previous recommendations called for providing breast milk until age 1. But these newer guidelines (implemented in 2022) are based on the understanding that human milk has benefits that continue long after baby’s first birthday. And they help to remove stigmas associated with people who choose to extend breastfeeding into toddlerhood.

“These recommendations are a call to action for everyone, and that includes hospitals, pediatricians and all physicians that are taking care of families,” Dr. Szugye states. “We want to make sure our practices and policies are set up to support people who choose to breastfeed beyond the first year of their child’s life.”

Think of the guidelines as the best-case scenario. If it works for you, your family, your child, your body and your life to breastfeed for two years or longer, you’re doing a great thing. And there’s no reason to stop until you and your child are ready.

If it doesn’t work for you, that’s OK, too. Your worth as a parent and your love for your child can’t be measured in ounces of milk.

Benefits of extended breastfeeding

The recommendations are based on research showing that human milk has some big benefits. And those perks continue for as long as you continue to supply it.

“Breastfeeding offers tremendous benefits — from custom-made nutrition and increased immunity to protecting you against some forms of cancer. And those benefits don’t go away as your baby ages,” Dr. Szugye shares. “We have more and more data supporting that there are benefits to breastfeeding for more than one year when possible.”

Breastfeeding can offer both you and your baby some big benefits:

Benefits for lactating parentsBenefits for baby
Lower risk of developing conditions like Type 2 diabetes, high blood pressure, cardiovascular disease, breast cancer and ovarian cancer.Decreased risk for ear infections, respiratory infections, gastrointestinal illnesses, SIDS, leukemia, diabetes, obesity, asthma and eczema.

“There are a lot of immunologic factors and components to human milk,” Dr. Szugye says. “One big advantage to human milk is that you pass antibodies to the baby. So, if you’re exposed to a respiratory illness or GI illness, those antibodies are passed on to the baby and then that makes them less likely to get sick. And if they do get sick, it’s less severe. It’s almost like a built-in immunity.”

Keeping up milk supply for the long haul

Some people can make enough milk to breastfeed for as long as they and their babies choose. But some don’t. At least not without taking some steps to keep it up.

If you suspect your supply is dwindling as your child gets older, there are ways to help promote more milk production if you want.

“Many people notice their supply drop and mistakenly assume it won’t return,” Dr. Szugye notes. “But if you want to continue to breastfeed, there are options that could help.”

If a supply boost is in order, you can try:

  • Nursing more often — Add sessions as long as your child will nurse. If you’re away from them during the day, try early evenings, mornings or weekends.
  • Pumping strategies — An extra session or several short “power pumping” sessions (think five to 10 minutes throughout the day) for several days in a row can trigger your body to make more milk.
  • Breast massage and compression — Easy-to-learn techniques can improve drainage when nursing or pumping.
  • Take care of yourself — Reduce stress, rest when possible, hydrate and eat a balanced diet with an extra 500 calories a day to support breastfeeding.

Not an ‘all-or-nothing’

If two or more years of breastfeeding seems daunting, remember that you have options.

For starters, giving your child human milk doesn’t always mean latching them to your breast and nursing. That’s just one way to do it. Pumping milk and putting it in a bottle, cup or spoon are also options.

And you may find that a donor bank could be a route to explore if you don’t lactate or if you have concerns about a low milk supply. Donor milk is pasteurized, screened for drugs, medications and infections, and tested for bacterial contamination before it’s stored and made available for purchase.

“Reach out to your pediatrician or women’s healthcare provider if you’re interested in obtaining donor milk. You may need a prescription from a healthcare provider,” Dr. Szugye suggests.

Remember, too, that any amount of human milk can be a benefit. If keeping up with your baby’s breastfeeding demands becomes too high a burden, there are alternatives.

Some parents may find that supplementing with formula (or other foods and milk after baby turns 1) can help give your child some human milk, while keeping up with their nutritional needs — and not burning yourself out in the process.

“It’s not an all-or-nothing thing,” Dr. Szugye reassures. “Any amount of human milk you can give is a benefit. If it doesn’t work for you to constantly supply human milk, that’s OK. We’re all just doing our best.”

If breastfeeding is going well for both you and your child, there’s no reason to give it up until you’re both ready to.

Feeding a baby is tough work, no matter how you do it. And chances are, you’re doing a fantastic job.

Avulsed Tooth

Overview

What is an avulsed tooth?

An avulsed tooth (knocked-out tooth) is a tooth that’s knocked out of its socket and, often, out of your mouth. Healthcare providers may call this dental avulsion.

Avulsed teeth are a type of dental trauma and require immediate treatment. If this happens to you or someone else, you may be able to save the tooth by putting it back in the socket right away. This is reinsertion or replantation. If you can’t put the tooth back, keep it moist and contact your dentist for an emergency appointment or go to an emergency room.

Are avulsed teeth common?

It’s a common issue. Every year, more than 5 million people in the U.S. have their teeth knocked out (avulsed). Most avulsed teeth involve your incisors. These are the teeth at the front of your mouth in your upper and lower jaw. While anyone can have a tooth knocked from their mouth, this issue mostly occurs in kids ages 7 to 11.

Symptoms and Causes

What are the symptoms of an avulsed tooth?

Symptoms of a tooth avulsion may include:

  • A gap in your mouth where your tooth used to be.
  • Mouth pain.
  • Bleeding.

What causes avulsed teeth?

It takes a lot of force to knock a tooth out of your mouth. The most common ways tooth avulsion happens are:

  • Falls.
  • Bicycle accidents.
  • Injuries from participating in contact sports like football, hockey, lacrosse, rugby and martial arts.
  • Traffic accidents.
  • Assaults.

Diagnosis and Tests

How are avulsed teeth diagnosed?

That depends on your situation. If you can place your tooth in its socket, a healthcare provider may check the tooth and then begin treatment. If you bring your tooth to the provider, they may examine your mouth for any other injury before replacing your tooth in its socket. They’ll ask what happened. For example, if your tooth was knocked from your mouth in a hard fall, they may check for signs of head injury, like a concussion.

Management and Treatment

What should I do if a tooth is avulsed?

Avulsed teeth are dental emergencies and require immediate treatment. To save your tooth, try reinserting (replanting) your tooth right away. Teeth treated within 30 minutes to one hour have the best chance of success. Here’s how to do that:

  • Pick up your tooth by the crown (white chewing surface).
  • Rinse your tooth with water or milk to remove any dirt. Avoid using soap, and don’t scrub or dry the tooth.
  • Gently place your tooth back into the socket, root first. Hold your tooth by the crown and avoid touching the root.
  • Bite on a napkin, gauze or handkerchief to anchor your tooth in place.
  • Contact a dentist for an emergency appointment so they can check your tooth.

If you can’t reinsert your tooth, store it in milk — not water — until you can see a dentist. Milk is the best protection. But you can also store your tooth in your cheek, tucked against your gum or under your tongue. Saliva pooling in your cheek or under your tongue will keep your tooth wet.

How do dentists treat an avulsed tooth?

If you put your tooth into its socket, your dentist will make sure your tooth is in the right position. They’ll place a splint on your tooth to anchor it to your surrounding teeth.

They’ll follow the same process if they need to reinsert your tooth. They may schedule a root canal if your tooth avulsion leads to an infection in your tooth pulp.

What should I do after my tooth is put back in its socket?

To help protect your tooth after reinsertion, you should:

  • Consume only soft food and liquids for two weeks.
  • Avoid foods that are too cold or too hot.
  • Brush gently with a soft toothbrush after each meal.
  • Rinse with an antibacterial chlorhexidine mouthwash two times a day for two weeks.
  • Take nonsteroidal anti-inflammatory drugs (NSAIDs) as needed for pain relief.
  • Avoid contact sports.

Complications of tooth replantation

You may develop some of the complications listed below:

  • Ankylosis: Your replanted tooth may fuse to your alveolar bone and sink into your gum tissue. Your alveolar bone is part of your jawbone. It holds your tooth sockets.
  • Apical periodontitis: The tissue around your tooth becomes inflamed and tender.
  • Inflammatory root resorption: If your tooth’s root system breaks down, your tooth will loosen in the socket and may fall out.
  • Pulp canal obliteration (PCO): This is when you have hard tissue deposits along the walls of the root canal space in your tooth. PCO is usually painless but can lead to pulp necrosis.
  • Pulp necrosis: Your tooth pulp may die. When that happens, you’ll need a root canal or your dentist may need to extract (pull) your tooth.

What happens if my tooth can’t be replaced in my socket?

If your dentist can’t replace your tooth, they may recommend one of the following treatments:

  • Partial denture: Dentures are removable oral appliances that replace missing teeth. A partial denture holds artificial teeth. The denture rests on your gums and hooks onto nearby teeth.
  • Dental bridge: Bridges fill the gap left by your avulsed tooth. They consist of dental crowns that fit over your natural teeth on either side of the gap and artificial teeth that bridge the gap between your teeth.
  • Dental implant: Dental implants are replacement teeth. They’re permanent metal screws that secure artificial or fake teeth — like dental crowns, dental bridges or dentures — in place.

Outlook / Prognosis

What can I expect if I have an avulsed tooth?

If you or your dentist reinserts your avulsed tooth, you’ll have regular follow-up appointments with your dentist so they can check on your tooth. You may see your dentist a month after treatment and then every three months after treatment for the first year. You’ll have annual checkups for the next five years.

How long do reinserted avulsed teeth last?

A reinserted tooth may stay in place for 10 to 20 years. But the tooth will come loose or fall out at some point during your lifetime. When that happens, you’ll need replacement treatment, like a partial denture, dental bridge or dental implant.

Prevention

Can I prevent an avulsed tooth?

You may not be able to prevent everything that can knock a tooth from its socket and your mouth, like being hit in the face in an accident or during a fight.

But this issue usually happens when people play contact sports where there’s a chance they’ll be hit in the mouth — like football, basketball or hockey. If you play those sports, wearing a mouth guard may protect your teeth.

Living With

How do I take care of myself?

The most important thing is to protect your replanted tooth while it heals:

  • Leave it be: Your dentist will put a splint on your tooth to keep it in place during healing, so don’t poke at it with your finger or your tongue.
  • Easy does it: Eat soft foods for at least two weeks, use a soft-bristled toothbrush and be gentle as you brush.
  • Follow-up: Your dentist will schedule regular follow-up appointments to confirm your replanted tooth is stable. Your dentist will also check for complications.
  • Protect your teeth: Wear a mouth guard anytime you play contact sports.

When should I see my dentist?

If you have a replanted tooth, you should see your dentist if you experience:

What questions should I ask my dentist?

You may want to ask the following questions about your avulsed tooth:

  • When will I know if the replantation process is successful?
  • Will I need a root canal?

Additional Common Questions

Why do I need to put an avulsed tooth in milk?

Milk has the best combination of proteins and antibacterial protection to protect your tooth until it’s replaced in your socket.

I only found part of my tooth. Can I put it back into its socket?

Never try to only put part of your tooth back into the socket. See a dentist as soon as you can. They may take a dental X-ray to look for root damage before treating your tooth.

Should an avulsed baby tooth be replanted?

No, it’s not a good idea to reinsert a baby tooth. Reinserting the tooth may lead to issues with the permanent tooth that’ll replace the baby tooth.

What should I do if I can’t find my tooth after it’s knocked out?

You may have swallowed or aspirated (breathed in) your tooth. Swallowed teeth are usually harmless. But breathing in a tooth may cause lung infections like aspiration pneumonia. Tell your provider you may have breathed in your tooth. They’ll do a chest X-ray to make sure your tooth hasn’t gone into your lungs.

A note from Cleveland Clinic

An avulsed tooth is a medical emergency. If you move quickly, you can save your knocked-out tooth. If you’re hit in the mouth and your tooth is knocked from its socket, your first step is to put it back into its socket. Your second step is contacting a dentist for an emergency appointment or going to the emergency room. If you or your dentist can reinsert your tooth, it may stay in place for many years to come.

Take care of yourself — Reduce stress, rest when possible, hydrate and eat a balanced diet with an extra 500 calories a day @ClevelandClinic

May 28, 2024/Pregnancy & Childbirth

How Long To Breastfeed: What the Guidelines Say and What To Consider

Recommendations encourage breast milk exclusively for baby’s first six months and continuing to provide human milk until age 2 and beyond

How and what you feed your baby is probably one of the most basic — and yet deeply personal — decisions you’ll face when you become a parent.

You’ll hear things like “breast is best.” As in, breastfeeding (chestfeeding) is the absolute best way to nourish your baby.

And then you’ll hear the retort, “fed is best.” Meaning breast milk (human milk) and formula are both fine. As long as your baby is getting nutrients in their belly, all is well.

Then come the opinions on how long you should breastfeed. (You’re still breastfeeding? You gave up on nursing already? You fed your baby formula?)

It can feel like there’s no right way to do it. And there’s some truth to that.

Because what works for one family may not be feasible for another. But that’s OK.

Breast milk can provide certain benefits that formula can’t mimic. But breastfeeding, especially for long periods of time, might not work for everyone. Or you may have been given the impression that you’ve continued providing human milk long after others think you “should.”

No one should feel guilt, shame or otherwise crummy about how they feed their baby. Let’s face it, mom guilt is tough enough as it is.

So, we talked with board-certified breastfeeding medicine physician Heidi Szugye, DO, about breastfeeding recommendations.

How long to breastfeed

Science shows that if you can give your baby human milk (either your own or a donor’s), it has its benefits. And the longer, the better, experts recommend.

The American Academy of Pediatrics (AAP) and the World Health Organization (WHO) share these recommendations for breastfeeding duration:

  • Newborn to 6 months: Exclusive human milk.
  • 6 months to 12 months: Mostly human milk while introducing solid foods.
  • 12 months to 24 months (and beyond): Mostly solid foods with some human milk, as mutually desired by parent and child.

Previous recommendations called for providing breast milk until age 1. But these newer guidelines (implemented in 2022) are based on the understanding that human milk has benefits that continue long after baby’s first birthday. And they help to remove stigmas associated with people who choose to extend breastfeeding into toddlerhood.

“These recommendations are a call to action for everyone, and that includes hospitals, pediatricians and all physicians that are taking care of families,” Dr. Szugye states. “We want to make sure our practices and policies are set up to support people who choose to breastfeed beyond the first year of their child’s life.”

Think of the guidelines as the best-case scenario. If it works for you, your family, your child, your body and your life to breastfeed for two years or longer, you’re doing a great thing. And there’s no reason to stop until you and your child are ready.

If it doesn’t work for you, that’s OK, too. Your worth as a parent and your love for your child can’t be measured in ounces of milk.

Benefits of extended breastfeeding

The recommendations are based on research showing that human milk has some big benefits. And those perks continue for as long as you continue to supply it.

“Breastfeeding offers tremendous benefits — from custom-made nutrition and increased immunity to protecting you against some forms of cancer. And those benefits don’t go away as your baby ages,” Dr. Szugye shares. “We have more and more data supporting that there are benefits to breastfeeding for more than one year when possible.”

Breastfeeding can offer both you and your baby some big benefits:

Benefits for lactating parentsBenefits for baby
Lower risk of developing conditions like Type 2 diabetes, high blood pressure, cardiovascular disease, breast cancer and ovarian cancer.Decreased risk for ear infections, respiratory infections, gastrointestinal illnesses, SIDS, leukemia, diabetes, obesity, asthma and eczema.

“There are a lot of immunologic factors and components to human milk,” Dr. Szugye says. “One big advantage to human milk is that you pass antibodies to the baby. So, if you’re exposed to a respiratory illness or GI illness, those antibodies are passed on to the baby and then that makes them less likely to get sick. And if they do get sick, it’s less severe. It’s almost like a built-in immunity.”

Keeping up milk supply for the long haul

Some people can make enough milk to breastfeed for as long as they and their babies choose. But some don’t. At least not without taking some steps to keep it up.

If you suspect your supply is dwindling as your child gets older, there are ways to help promote more milk production if you want.

“Many people notice their supply drop and mistakenly assume it won’t return,” Dr. Szugye notes. “But if you want to continue to breastfeed, there are options that could help.”

If a supply boost is in order, you can try:

  • Nursing more often — Add sessions as long as your child will nurse. If you’re away from them during the day, try early evenings, mornings or weekends.
  • Pumping strategies — An extra session or several short “power pumping” sessions (think five to 10 minutes throughout the day) for several days in a row can trigger your body to make more milk.
  • Breast massage and compression — Easy-to-learn techniques can improve drainage when nursing or pumping.
  • Take care of yourself — Reduce stress, rest when possible, hydrate and eat a balanced diet with an extra 500 calories a day to support breastfeeding.

Not an ‘all-or-nothing’

If two or more years of breastfeeding seems daunting, remember that you have options.

For starters, giving your child human milk doesn’t always mean latching them to your breast and nursing. That’s just one way to do it. Pumping milk and putting it in a bottle, cup or spoon are also options.

And you may find that a donor bank could be a route to explore if you don’t lactate or if you have concerns about a low milk supply. Donor milk is pasteurized, screened for drugs, medications and infections, and tested for bacterial contamination before it’s stored and made available for purchase.

“Reach out to your pediatrician or women’s healthcare provider if you’re interested in obtaining donor milk. You may need a prescription from a healthcare provider,” Dr. Szugye suggests.

Remember, too, that any amount of human milk can be a benefit. If keeping up with your baby’s breastfeeding demands becomes too high a burden, there are alternatives.

Some parents may find that supplementing with formula (or other foods and milk after baby turns 1) can help give your child some human milk, while keeping up with their nutritional needs — and not burning yourself out in the process.

“It’s not an all-or-nothing thing,” Dr. Szugye reassures. “Any amount of human milk you can give is a benefit. If it doesn’t work for you to constantly supply human milk, that’s OK. We’re all just doing our best.”

If breastfeeding is going well for both you and your child, there’s no reason to give it up until you’re both ready to.

Feeding a baby is tough work, no matter how you do it. And chances are, you’re doing a fantastic job.

7 Reasons Why Cottage Cheese Is Good for You @ClevelandClinic

This dairy product can help you lose weight, manage blood sugar and strengthen bones

Cottage cheese doesn’t typically receive a lot of attention. It gets left out from the fancy cheese counter at the grocery store. It doesn’t make the cut for a charcuterie (meat and cheese) board. And it isn’t typically included in recipes for favorite foods such as pizza, grilled cheese or baked ziti.

It’s a soft, white, fresh cheese that’s different in texture and taste than more popular cheddar, Parmesan and blue cheeses. But cottage cheese holds a prominent place in the dairy aisle for good reasons, says registered dietitian Julia Zumpano, RD, LD.

“It’s a portable food that’s easy to add to your diet,” she says. “And cottage cheese offers lots of health benefits.”

As a dairy product, cottage cheese is a great calcium source, which is important for bone health. Having healthier bones makes you less likely to get osteoporosis (weak bones). Cottage cheese in your diet can even help with your blood sugar levels.

Thinking about giving cottage cheese a go? Zumpano explains what you need to know.

Is cottage cheese healthy?

Cottage cheese is low in calories while providing protein and vital nutrients, Zumpano says, making it one of the healthiest cheeses you can eat. It’s made by curdling pasteurized (sterilized) cow’s milk — when milk turns acidic, the milk protein separates and forms curds (clumps). These loose curds serve as the base for cottage cheese.

Depending on the fat content of curdled dairy milk, cottage cheese is available as nonfat, low fat (1% or 2%) or whole fat. The milk type affects the nutritional content.

“To get the most bang for your buck, choose a low-fat or even full-fat cottage cheese,” Zumpano advises. “Nonfat cottage cheese may sound like a good idea, but it contains less protein and won’t be as satisfying.” Full-fat cottage has 1.5 grams more of saturated fat when compared to 2% but can be the most satisfying.

Health benefits of cottage cheese

Cottage cheese may be mild in flavor, but it packs a punch when it comes to potential health benefits. Some of the many benefits of cottage cheese include:

Provides good nutrition

A 100-gram serving (just under a half cup) of low-fat (2%) cottage cheese provides:

Source: U.S. Department of Agriculture

Aids in weight loss

Three factors make cottage cheese a great choice if you’re looking to lose pounds or maintain your weight:

  • High in protein: Research finds that eating a high-protein diet helps curb your appetite and manage hormones associated with appetite, digestion and insulin release.
  • Low in fat: Full-fat cottage cheese contains less fat than some other cheeses (4% fat versus 30% fat in cheddar), and its high protein makes it an excellent low-fat option.
  • Provides calcium: Studies show that increasing calcium can help you lose weight when combined with a calorie-restricted diet.

Cottage cheese isn’t the only dairy food to provide these advantages. Greek yogurt can also check these boxes. But if you’re deciding between the two, Zumpano recommends cottage cheese. “Full-fat cottage cheese and full-fat Greek yogurt have the same amount of fat, but cottage cheese has 25% more protein.”

Provides essential amino acids

Cottage cheese is rich in casein (pronounced “KAY-seen”) protein. It’s a complete protein that provides essential amino acids, which are all the building blocks of protein that your body needs.

Amino acids help your body work smoothly. They affect your:

“Eating cottage cheese as part of a balanced diet is an easy way to ensure your body gets everything it needs,” says Zumpano.

Supports bone health

Cottage cheese has three nutrients that help promote healthy bones:

  • Calcium helps prevent osteoporosis that can lead to bone fractures.
  • Phosphorus is critical for proper bone development and strength, especially during growth spurts or when healing from a fracture.
  • Protein helps maintain bone mineral density and can reduce the risk of fractures.

Bone health is critical as you age,” Zumpano shares. “Adding cottage cheese to your diet is an easy way to strengthen them.”

Helps you control blood sugar levels

Plain cottage cheese is low in carbohydrates, making it a great option for anyone watching their blood sugar. The slow-digesting casein protein in cottage cheese also helps prevent blood sugar spikes.

“To get this benefit of cottage cheese, choose plain cottage cheese,” Zumpano recommends. “Avoid cottage cheese pre-packaged with fruit and check the label for added sugar.”

Contributes to a balanced gut

Probiotics are live microorganisms that can improve the balance of good and bad bacteria in your gut (gut microbiota). The curdling process used to produce cottage cheese adds beneficial bacteria that can promote better gut health. But unlike Greek and regular yogurt, which almost always contain probiotics, not all cottage cheese is created equal.

“If you want cottage cheese that provides probiotics,” Zumpano says, “check the label to see if it says it contains ‘live and active cultures.’”

Promotes muscle development

The slow-release protein in cottage cheese doesn’t just help with digestion. It’s also important for building muscle tissue and helping your muscles recover after a workout.

“Casein protein provides your cells with amino acids consistently over a longer period, which helps muscles recover instead of breaking down,” Zumpano explains. Consider having cottage cheese after a workout to get the maximum benefit for your muscles.

Reduces your risk of some cancers

Research shows that increasing dairy intake may lower your risk for some (though not all) cancers. “There’s still a lot to learn about the connection between dairy and cancer prevention,” Zumpano states. “But it’s clear there are protective benefits to including dairy in a balanced diet.”

Experts believe getting more calcium may offer protection from:

  • Bladder cancer.
  • Breast cancer.
  • Colorectal cancer.
  • Stomach (gastric) cancer.

Tips for adding cottage cheese to your diet

The United States Department of Agriculture (USDA) recommends that adults get three cups of dairy daily. Cottage cheese can help you reach that goal.

When you incorporate cottage cheese into your diet, remember to:

  • Check the nutrition label: Single-serve containers of cottage cheese may vary in size and nutritional content.
  • Consider your lactose tolerance: The lactose in cheese decreases with age. As a fresh, unripened cheese, cottage cheese often contains more lactose than aged cheeses. If you have lactose intolerance, consider a cottage cheese that’s lactose-free.
  • Keep an eye on sodium: Cottage cheese can be high in sodium, so opt for low-sodium or sodium-free cottage cheese to protect yourself from high blood pressure and heart disease.
  • Get creative: There are many ways to eat more cottage cheese. Consider adding cottage cheese to your eggs or pancake mix. Bake it into muffins or cakes. Or use it as a substitute for sour cream or ricotta cheese.

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New Study: No Level of Alcohol Is Entirely Safe @ClevelandClinic – Jamile Wakim-Fleming, MD,






Cleveland Clinic

@ClevelandClinic
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Even casual drinking can put your long-term health at risk. Our liver specialist explains the findings of this study.

New Study: No Level of Alcohol — Even Casual Drinking — Is Entirely Safe

Leading cause of death of those age 15-49

Stopping for happy hour with colleagues after work. Cracking open a cold beer (or two) while watching the game. Meeting up with girlfriends for a glass of pinot noir. Having an alcoholic beverage of choice is a common way to unwind. But according to a recent study, even casual drinking can put your long-term health at risk.

Liver specialist Jamile Wakim-Fleming, MD, did not take part in the study, but says the research found that alcohol was a leading risk factor for both disease and premature death.

“They found that alcohol was the seventh leading cause of death worldwide,” she says. “But even more alarming, is that it was the first leading cause of death of people between the ages of 15-49.”

What the study examined

The study looked at global data from hundreds of previous studies and found that for all ages, alcohol was associated with 2.8 million deaths each year.

Researchers found that alcohol-related cancer and heart disease, infectious diseases, intentional injury, traffic accidents and accidental injury were some of the leading causes of alcohol-related deaths.

But isn’t alcohol good for your heart?

Dr. Wakim-Fleming says people often believe that a little bit of alcohol, wine in particular, may be good for their heart. But the study results didn’t show any health benefit to drinking any amount of alcohol.

She says this information, along with previous research that has shown more young people are dying from alcohol-related liver disease, indicates that excessive drinking among young adults is a growing problem.

The damage grows over time

And like any substance-abuse problem, Dr. Wakim-Fleming says the damage to the body from alcohol increases over your lifespan.

“It’s a cumulative effect,” she explains. “If you do it all at once, then you’re going to have the effect now. If you drink on a regular basis, over years it’s going to be cumulative and you will end up with a problem later on.”

Dr. Wakim-Fleming notes that anything we do in life involves risk, but it’s important to know what the risks are so that we can make the best decisions for our health.

Complete results of the study can be found in The Lancet. Facebook Twitter Linkedin Pinterest alcoholalcohol and healthalcohol-related liver disease