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Are Organic Foods Better Than Conventional Foods?

2019-12-01T20:12:00.000-08:00

Not necessarily...

Firstly, there is ever growing evidence to dispel the myth that organic/non-conventional produce is superior to conventional produce in terms of health & nutrition; organic produce and conventional products have similar nutritional and health benefits.

Secondly, there is no control or regulation over the term "organic" which means that anyone or any company may use this term in their labelling and advertising without any justification. In fact, the labelling & advertising terms on products are intended to manipulate and infer a better/superior status or product (unlike drugs/medication, labelling regulations are very lax and do very little to protect the consumer when products are classed as food, supplements, cosmetics or personal care products)

Thirdly, there are a variety of "certified organic" logos used by differing certification companies; each certification company/body have their own set of "standards". These standards may greatly vary from one body to another.

Fourthly, many people are misled to believe that "organic" produce are free from pesticide/fungicides or additives, due to the misleading advertising/labelling and false claims!
Nothing is further from the truth. All commercial produce utilise agents & additives to ensure their products survive, look, feel and taste their best. Unfortunately, the truth is, organic produce end up using significantly more organic/natural pesticides/agents, simply because the agents used are far less effective than conventional agents.

Let's look at "nitrate-free" products such as ham. These are labelled as nitrate-free, however, take a closer look at the ingredients... All products claiming to be "nitrate-free" will instead use celery powder/extract to preserve/cure their products. Why celery? Because celery is naturally high in nitrates! (Nitrates are found in many vegetables, not just celery eg beets, lettuce, endive, parsley, rhubarb)

So, instead of using the standard regulated form of nitrate, where the amount of nitrate used is predictable, these companies are relying on the nitrate amount contained in each batch of celery powder/extract, which is not only unregulated, but as an unstandardised ingredient, the actual amount of nitrate delivered (as every batch/crop of celery will contain varying amounts of nitrate & other nutrients depending on the season/weather etc).
Not only is this "nitrate-free" product claim completely false and misleading, we can't even be certain there is adequate nitrates to safely preserve the product from pathogenic growth! There is no regulated maximum safe level of celery powder /extract stipulated, so there is also a risk that excessive/toxic amounts of nitrates may also be used in these products!

Contrary to popular myth, organic/natural pesticides/agents/additives in NO WAY confer a safer nor healthier option. This is a dangerous assumption. In fact, there is growing evidence, that these natural alternatives, (particularly natural pesticides & fungicides) may cause potentially serious health risks.

Why aren't natural/organic substitutes safer?
One important factor, mentioned earlier, is that organic additives/pesticides/fungicides are much less effective on pathogens, and therefore less effective in inhibiting bacterial/mold/fungal growth, making these natural alternatives an inferior choice for pest/pathogen control and food preservation. Such food produce will be more prone to bacteria, mold & fungal growth, causing serious health risks.

The other crucial fact quite simply is, the dose makes the poison!
No matter what the substance/ingredient is, no matter how good/healthy it may be for you...consuming too much (or high exposure) will cause it to become toxic/poisonous to our bodies.
Natural does NOT equate to healthy nor safe. No matter what the substance/ingredient is or how it is sourced, the health risks and potential for toxicity is dependent on the amount/concentration used/consumed. Substances are absorbed into the plant, so washing will only remove superficial contamination, at best.

Fourthly, it will shock many people to know that, the organic/non-conventional farming industry does not have regulations to minimise or limit the amount of organic pesticides/fungicides/additives used in their production process. If the amount of additives and substances used are not regulated by safe limits, ANYTHING used can become a potential a health risk/toxic.

With traditional conventional farming & food production, there are regulations to restrict and limit the amount/concentration of additives/substances (eg fertilisers, pesticides, fungicides etc) used, thereby giving the public a safety margin.

In contrast, organic/non-conventional farming & food production practices are NOT regulated in the same way, and are not restricted or limited in how much, or how often these natural/organic additives can be used in the farming & production process.

Why is there no maximum limit for these non-conventional substances?
It is not because they are proven to be safe, but rather because there is a lack of data, research and outcome data, and a general lack of awareness and demand by the general public for this.
"Organic" farming & food production is relatively new on a commercial level, in comparison to conventional farming/food production methods. Not only is the data and research for organic/natural methods is lacking, but the data which we should really be interested in (the medium to long-term health effects & outcomes of these ingredients) requires take many, many years to gather and analyse. There is, however, emerging data (particularly in europe) with some commonly used organic pesticide posing potentially serious health risks.

So, even when produce is "certified organic", the certification body's standards (whichever that may be) only regulates the use of certain substances/additives/ingredients to be used or excluded.
They do NOT limit how much of the natural/organic substance is used in production.
This means, unlike conventional farming methods which have a predetermined maximum limits to ensure safety in consumption, we do not know how much pesticides, fungicides etc is actually being used in organic farming produce. The fact that natural/organic pesticides/fungicides are significantly inferior to their conventional counterparts, which leads to this very liberal use, with much higher concentration and usage rates!

Mother nature has an array of naturally poisonous plants and animals/venom. If this isn't proof enough to discard the perpetual myth that natural is healthier or better, we should be reminded that many substances that are naturally occurring that are poisonous in our everyday foods (eg formaldehyde from pears, or cyanide from apple seeds) which can be safely consumed in small/moderate amounts so our bodies are able to readily detoxify these naturally. If you overload your body with anything, even water, it will become toxic.

Tips for making better food choices:

1. Moderation is the key to health. Any ingredient/substance used or consumed in its excess may be potentially harmful/toxic, no matter if it is naturally or synthetically derived. The "excessive" amount varies for each food/ingredient/substance. For example the excessive amount of cyanide greatly differs to the excessive amount of vitamin C. Both are safe if consumed within their safe limits, and both may also have the potential to cause toxic side-effects if their respective limits are exceeded.

2. The best food/produce are those that are intended to be consumed fresh with minimal storage/preservation, and produce that you know & understand what has gone into it, from planting to end product.

3. Don't assume a natural ingredient/additive is better. Understand the ingredients/agents employed, why they are used, and check that they are first, and foremost effective & reliable in performing their function within the production process, and that they have regulated recommended safe limits, with acceptable long-term safety data. This is a must if you want convenient, commercial produce that can be stored.

I hope this has been helpful :)

Uyen Dinh
Consultant Pharmacist

Do Sunscreens Really Prevent Sunburn?

2017-03-03T22:09:00.003-08:00

Yes, they really do, BUT....this depends on what's in your sunscreen and how you are using it.

Sunburn is often the result of incorrect use of sunscreen, insufficient understanding of Sunscreen SPF, and insufficient understanding of UV Radiation exposure.

Here are some very important basic points to remember & pass on:

1. Sun damage to the skin occurs regardless of whether you experience symptoms of sunburn or not. The effects of sun damage (skin cancer, aging etc) is insidious as it's often asymptomatic and accumulates over your life-time.

2. The best sun protection is a physical barrier (hat, long sleeve shirt, sunglasses etc). Please note that not all clothing provide the same degree of SPF. For example, darker colours and tighter weave will confer more protection compared to lighter colours and light/open weave fabrics. To ensure maximum SPF protection, opt for SPF rated clothing, as these are manufactured with an SPF additive (although this effect may be reduced with with time/laundering).

3. You can still receive substantial UV radiation exposure even when shaded from direct sun, due to the scattering & reflection of UV from the environments eg atmosphere, light coloured concrete/buildings/clothing, sand, water and snow. Cloudy/overcast conditions minimally reduce UV radiation exposure, while reflection from water, sand & grass (& snow) increase UV radiation exposure by reflecting up to 70% of sunlight.

4. Babies & Toddlers should always be covered with appropriate hat and SPF clothing as their skin is very sensitive and will burn easily. Babies less than 12months of age should avoid direct sun exposure, and babies under 6mths should avoid using sunscreen due to their highly absorptive skin.

5. SPF is a UV filter and not a UV block. Unfortunately, sunscreens are often incorrectly referred to as 'Sun Block'. SPF relates solely to UV-B protection, and not UV-A.
UV-A = relates to increasing risk of skin cancer & responsible for age-related skin damage.
UV-B = relates to Sunburn & Skin Cancer

6. Always choose Broad Spectrum Sunscreens to protect against both UV-A & UV-B. (titanium/zinc oxide will offer some UV-A protection) A physical blocker (hat, shirt, shade etc) is always best. Sunscreen should only be one part of a comprehensive sun protection regimen (see point 1.)

7. SPF rating of 30-50 is best. Anything lower than 30 offers inadequate protection, while anything higher than 50 is only very marginally more protective, & gives the wearer a false sense of security (this is why SPF is capped at 50+ in Australia)

8. Your maximum SPF = your burn time without sunscreen X the sunscreen's SPF. So if you normally burn in 10min, a sunscreen with SPF50+ will give you 10x50 = 500mins of protection.
*Please Note: In reality, your SPF time is much less than this (approx only 30%) due to factors like inadequate sunscreen application, sweating/swimming/clothing/touch reducing amount of sunscreen on the skin. This is very important to factor in, to prevent sunburn.

9. On average, you require approx a shot glass of sunscreen to cover your whole body optimally (this is roughly the amount of sunscreen thickness necessary to achieve the SPF level stated on the sunscreen). And reapplication is essential every 2hours.

10. Reapplication of sunscreen does NOT increase your burn time nor reduce your dose of sunburn. Once you reach your burn time, you must avoid the sun & get away from UV light. No amount of sunscreen will stop you from burning once you exceed burn time, so always apply before sun-exposure & before burn time begins.

11. Your dose of sunburn can take hours to appear, so burn time is exceeded well before the effects can be seen. This is a common misconception - people assume they are only starting to burn when they can the skin turn pink/red or peel.

11. All sunscreens should be applied at least 20-30min before sun exposure to allow it to the product to bond and set on the skin properly. for optimal protection.

13. All skin types burn - some just have a higher baseline protection factor.

I hope this has been helpful :)

Uyen Dinh
Consultant Pharmacist

Which Foods Are Calcium Rich?

2015-10-22T00:14:00.002-07:00

Dietary Calcium

Dietary calcium is the body's best source of calcium. Food sources or calcium are easily & readily utilised by our bodies without the ill effects experienced by many calcium supplements (e.g. constipation, bloating, gas).

In recent years, there has talk about whether the use of calcium supplements contribute to cardiovascular disease. At this stage, the evidence & data is still inconclusive, and mainly refers to calcium supplements (higher amounts of calcium as opposed to small amounts that may be found in some multivitamin combinations etc). So, the general recommendation is to ensure a plentiful supply of dietary calcium intake from various foods, and take calcium supplements only as prescribed by your doctor.

If you feel that you may require supplementation, please see your doctor .

Since Vitamin D is a necessary for our bodies to absorb calcium, it's equally as important to maintain adequate Vitamin D intake.

Calcium Requirements:

These are general guidelines only, and requirements may vary from person to person, depending on how well the calcium is absorbed. (Factors such as the presence of sodium, protein, oxalic acid & phytic acid in foods may influence calcium excretion & absorption).

Recommended Daily Intake (RDI)	Reason for RDI
Infants 0 - 6 months 210 mg/day 7-12 months 270 mg/day Children 1 - 3 years 500 mg/day 4 - 8 years 700 mg/day 9 - 11 years 1000 mg/day Teenagers 12 - 18 years 1300 mg/day	Peak bone mass is achieved by early twenties. Nearly 40% of Peak Bone Mass is acquired during puberty.
Adults 19 years + 1000mg/day	Adequate calcium is necessary to maintain bone strength.
Older Adults - Women over 50 years 1300mg/day Men over 75 years 1300mg/day	Calcium intake is needed at higher levels because it is absorbed less effectively from the intestines, and more calcium may be lost through the kidneys.

Calcium-Rich Foods

Dairy is a great source of calcium, however, there are also many non-dairy options.
Here are some examples of excellent sources of calcium-rich foods:

Produce	Serving Size	Estimated Calcium*
Collard greens, frozen	1cup/225g	360 mg
Green Turnips	1 cup	249 mg
Broccoli rabe	1cup/225g	200 mg
Kale, frozen	1cup/225g	180 mg
Soy Beans, green, boiled	1cup/225g	175 mg
Bok Choy, cooked, boiled	1cup/225g	160 mg
Okra, cooked	1 cup	135 mg
Iceberg Lettuce	1 head	97 mg
Figs, dried	2 figs	65 mg
Broccoli, fresh, cooked	1cup/225g	60 mg
Oranges	1 whole	55mg
Black Eyed Peas, boiled	1 cup	210 mg
Bakes Beans, canned	113g	160 mg
Baked Beans, canned	113g	160 mg
Sardines, canned with bones	85g	325mg
Salmon, canned with bones	85g	180 mg
Shrimp, canned	85g	125mg
Trail Mix (nuts,seeds,choc chips)	1 cup	159 mg
Almonds	24nuts	70 mg
Soy Yoghurt, commercial	170g	300 mg
Calcium-set Tofu	85g(¼block)	163 mg
Soy Milk	1 cup	93 mg
Tahini	2Tablespoon	128 mg
Blackstrap Molasses	2Tablespoon	400 mg
Dairy	Serving Size	Estimated Calcium*
Ricotta, part-skim	113g	335 mg
Yoghurt, plain, low-fat	1 cup/225g	415 mg
Yoghurt, plain whole milk	1 cup/225g	275 mg
Milk, skim, low-fat, whole	1 cup/225g	300 mg
Yogurt with fruit, low-fat	170g	260 mg
Mozzarella, part-skim	28g	210 mg
Cheddar	28g	205 mg
Yogurt, Greek	170g	200 mg
American Cheese	28g	195 mg
Feta Cheese	113g	140 mg
Cottage Cheese, 2%	113g	105 mg
Frozen yogurt, vanilla	1 cup/225g	105mg
Ice Cream, vanilla	1 cup/225g	85mg
Parmesan	1 Tablespoon	55mg

Uyen Dinh
Consultant Pharmacist

Is There Any Difference Between Infant Formulas?

2011-12-03T07:02:00.000-08:00

Absolutely!

Infant Formulas are based on Cows Milk, Soy Milk or Goats Milk. And they are categorised as:

100% Whey dominant = HA Formulas
Whey dominant = most Birth-6mth Formulas / Infant Formulas / Step 1 Formulas
Casein dominant = From 6mth Formulas / Progress Formulas / Step 2 Formulas or Toddler Formulas

Within the Cows Milk range, there are choices of Lactose Free, Anti-Reflux, and HA (Hypo-Allergenic), Gold (contains LCPs), and of course Organic.

Cow's milk, Goat's Milk, Soy Milk and all other milk besides human Breastmilk, was never intended for human infants. Each mammal species produces a milk composition ideal for it's own particular species. Therefore, the composition of Whey proteins to Casein proteins in Cow's milk or Goats milk (and every other milk) will be different to breastmilk. The nutritional content (vitamins, minerals and enzymes) of other milk will also be vastly different to breastmilk, and will lacks many key nutrients present in breastmilk, which is vital for the development of human babies.
It is actually dangerous to feed any fresh milk that is not breastmilk, to human babies, as it is not only completely unsuitable for a human baby's gut but it also does not support the vital growth and development of human babies. Other than breastmilk, any fresh milk (meaning unmodified and unfortified milk) must not to be given to infants, and not to be given to older babies as a food until after at least after 12 months of age, or older if possible. All milk sources for Formulas must first be modified in both protein composition, as well as nutritional composition, with the goal of becoming as close to breastmilk as possible.

Once you've made the decision to complementary feed with Formula or fully Formula feed, there are some factors to take into consideration before selecting the most appropriate Formula type and Formula brand.

For a healthy baby without any allergies or intolerances, these are my tips for selecting formula:

Choose a Whey dominant formula or preferably 100% Whey formula, known as HA Formula. Whey dominance is extremely important because cows milk proteins are larger than breastmilk proteins and therefore more difficult to digest. HA Formulas ensure that these proteins are partially hydrolysed, which means they are broken down to help babies to digest properly and thereby reducing digestive problems like constipation, wind, making it the best choice for baby, if breastmilk is not an option. Breastmilk is Whey predominant until around 8mths where Whey to Casein ratio is 50:50
Choose an accessible Formula. It's convenient to choose a formula that you can purchase from most places, rather than an exclusive Formula that can only be found in certain stores. This avoids the frustration of when you run low on Formula at home, or when the manufacturing of the Formula is short on supply,
Consider selecting a certified Organic Formula. Organic Formulas are not as readily available as some other Formulas (however, many supermarkets and pharmacies DO stock them), and they are, to date, not available as HA Formulas, but the benefits of having a Formula made from certified organic milk, free from chemicals is something that all new mothers should explore before taking the plunge into a 'regular' non-organic Formulas.
Selecting a formula with Gold or LCP containing formulas is optional, and may be of benefit, but this option would come well after points 1-3 as we don't know for sure if babies can or can not absorb these properly, and there are some babies who may not tolerate the LCPs and do better on formulas without the added oils.
Choose a formula based on price AFTER all the other criterias have been met. HA Formulas are the most expensive and Whey dominant Formulas come a close second, in pricing. Casein Formulas are cheapest and there's not much modification of the proteins which tends to cause belly aches, constipation and wind in babies. It is the Casein protein in milk that is linked to dairy-based allergies in babies. The metabolism of Casein proteins produces larger amounts of end products and electrolytes in the urine, which can pose a problem for babies who are not adequately hydrated with water.
For healthy babies, there is no need to consider Soy or Goats Milk Formulas. There are some discussions about Phyto-oestrogens and Thyroid disease surrounding Soy formulas which are better left alone if there is no need to go down this path. Goats Milk Formula is an unnecessarily expensive option for a healthy baby.
From 6 months of age, there's usually no need to change your baby from an infant/Step1/from birth Formula (Whey dominant formula) to a progress/Step2/from 6mths Formula (Casein dominant formula). Breastmilk becomes equal in Whey and Casein at around 8 months, which is still much less in Casein proteins than the progress formulas which start at 6 months of age. Manufacturers will argue that the proportion of nutrients has been adjusted to suit an older baby, however, from 6 months, additional nutrients will be gained by the introduction of solid food.
Casein dominant Formulas definitely satisfy the "hungry" baby for longer, but it's at the expense of proper digestion in baby's gut - a fullness caused by bloating and indigestion. Just think, if you eat something that makes you feel bloated because you can't digest it properly, you'd feel full, wouldn't you?! But it's a very uncomfortable fullness.

I hope this has been helpful :)

Uyen Dinh
Consultant Pharmacist

"Excuse me....Where is the information for my prescription medicine?"

2011-11-21T06:02:00.000-08:00

Have you ever been surprised, or even frustrated with the lack of written information that comes with something as important as your prescription medications?

Perhaps when you are prescribed something for the first time? Or perhaps it's a medicine you've been taking for a while but you needed to check if it's ok to have a few drinks at the party tonight? Or maybe you've just had one of those days and you need something to alleviate that headache?

Why is it that your basic over-the-counter mouth ulcer gel is hidden in a roll of detailed information, but your important 'Prescription Only' medication comes with next to nothing??

Gone are the days where the pharmacist would hide behind a wall and make up a special 'secret concoction' ordered by the doctor, which the pharmacy assistant would then hand to you labelled 'The Mixture' or 'The Tablets'. We now live in the in age of information and we now not only demand information, we are also entitled to it, and medicines are certainly no exception.

So, how much information should be provided? Is more always better? Should you jump on the computer and start 'googling' away and take advantage of all the information available on the Internet?

My response would be, information is power. BUT, only if the information is accurate, reliable and correctly interpreted and in context (appropriately personalised in to your current circumstance).
The problem is where the source of information is coming from and whether the person receiving the information fully understands the context in which it's conveyed.

The Internet has a seemingly limitless amount of information of just about everything. And as it's unregulated it's a huge task to separate accurately published information from an abundance of mis-information. Specifically, truly accurate and legitimate drug, medical and health information can be particularly difficult to find. Many medical academics make a career of interpreting countless studies to ensure the studies, data and information are legitimate and accurate to current standards. Therefore, it would be fair to say that interpreting drug and medical information requires a certain level of training, skill and experience.

So, where can you find reliable information?

All Australian drug manufacturer's are required by law to have a CMI (Consumer Medicine Information which are dose and brand specific) available for their medicines, but not all will provide it with the packaging. A copy can be obtained at the pharmacy.

The other thing to note is that CMI's are designed to convey common and important information to the general public in a general and simplified manner, designed to be accompanied by personalised advice from your doctor or pharmacist.

Your doctor or pharmacist will be able to tell you, given your medication history and lifestyle, which side-effects you are most likely to experience and how you can alleviate it, which side-effects are serious requiring attention, and which aren't. They will also be able to tell you which side-effects are unlikely to affect you based on your history. They will even be able to give you some helpful tips and caution based on their professional experience, which can not be found on the CMI.

For those who crave information and think that 'more is better', think again....

Technical drug information is also far from personalised, and although it is in-depth, it requires careful interpretation by qualified healthcare professionals to determine which components are relevant, and is therefore unsuitable for distribution to the general public.
Any information without adequate interpretation by a qualified healthcare professional can result in anxiety, non-compliance and mismanagement. Just Imagine reading through a long list of reported side-effect ranging from seemingly mild and funny, to serious and often foreign-sounding side-effects, which, in itself can sound scary. This alone would likely deter most of us from initiating or continuing medication therapy, unless this information is accurately interpreted to determine it's relevance with a great deal of professional perspective.

My Tips for Obtaining Reliable Drug or Medication Information:

1. Always raise concerns and questions with your doctor before leaving the consult. This is the time to decide if you wish to initiate drug therapy of any sort, or not. This is the point where your Dr will be able to give you all your options, and be able to take you through the risk vs benefits of your options. It's vital that you make this decision together, and fully disclose your compliance with any treatment plans with your doctor upon subsequent visits so that your progress can be accurately monitored and reassessed to maintain optimal therapy, medication or otherwise.

2. When handing your script into the pharmacy, tell pharmacy staff when you commence a new drug medication or when your medication dosage changes. This should prompt them to ensure that the pharmacist gives you appropriate medication counselling & CMI & other written material. This also gives the pharmacist time to prepare both personalised verbal & written material for you upon collecting your script.

3. If this is not your first time taking your medications & you require information ask to speak to the pharmacist as well as requesting a CMI or other written material.

4. Always provide the doctor and pharmacist with your current & complete medication, medical & lifestyle history, as this is the only way they can truly personalise the information, determine which information is relevant for your situation & provide you with the best health outcome.

5. Always ask if there is something you do not fully understand or require more information about.

6. Feel free to do your own research but always validate and discuss your information with your doctor and / or pharmacist. Good communication, honesty and rapport with your doctor, pharmacist or healthcare professional is essential for an optimal therapeutic relationship.

7. Ask for more resources. Rather than trawling through the internet for hours on end searching for shreds of valuable factual information, your doctor or pharmacist can often provide you with additional resources such as books, other reading material, legitimate websites, hotlines, other healthcare providers etc This ensures you always deal with legitimate and accurate information providers.

8. Allow your doctor, pharmacist & healthcare professionals time to provide you with additional information as it may require more time and resources to give you more individualised/personalised or detailed information. This generally requires follow-up consultation/s with your doctor, & follow up visits or phone calls to the pharmacy.

Your doctor, pharmacist and healthcare providers are your most legitimate and accurate sources of drug, medical & health information. By keeping clear, open & honest communication with them, you will become better informed and equipped to manage your medications and medical conditions in the best possible way.

I hope this has been helpful :)

Uyen Dinh
Consultant Pharmacist

Breastfeeding....Is It Really Worth It?

2011-11-17T16:13:00.000-08:00

In short....absolutely yes!
Breast milk is the perfect food for human babies and provides unmatched immunity .

Benefits of Breastfeeding:

Breastmilk is the "Gold" standard, living food for human babies, packed with nutrients and vital immunity again foreign organism.
Breastmilk composition changes to suit baby's growing needs (breast milk when baby is 3months is nutritionally different to when baby is 6 or 9 months), and also varies throughout the day (think breakfast, morning tea, lunch, afternoon tea, dinner, snack etc)
Ideal for family history of allergies and lactose intolerance.
Breastmilk is easily digested and therefore well tolerated by baby's immature digestive system.
Fosters good healthy oral development - breastfeeding naturally promotes the use of the baby's correct oral muscles during suckling, unlike teats on bottles.
Helps mother and baby sleep - sleep hormones are released in both mum and baby during breastfeeding to aid in sleep.
Reduces allergies associated with formula ingredients (which is ultimately refined and man-made).
Saves money - cost of formula, bottles, teats, sterilisers etc.
Saves time - no preparing feeds, cleaning.
Portable - no preparation required except a breastfeeding cover/muslin cloth etc for modesty.
Helps mum burn those extra calories much faster - speeds up mums metabolism and terrific for getting back to your pre-baby weight.

(Note that I have not included bonding time to be a benefit exclusive to breastfeeding, as I believe this can be achieved through any means of contact and feeding time, be it breast or bottle, breastmilk or formula)

Disadvantages of Breastfeeding (& Remedies):

Nipples may become cracked or sore - this may occur when breastfeeding begins in the first few weeks until the nipples toughen a little for this purpose, and baby learns to latch on properly. To remedy this, simply express a few drops of breastmik and rub over affected nipple area and allow to air dry, and repeat at least after each feed. Breastmilk has a natural healing action and is also antibacterial. Avoid using creams and lotions on this area (even if they are labelled specifically for this purpose) as attempts to clean these products off the nipple before breastfeeding will not only further aggravate the nipple area, but also will not remove the residue left behind, posing an unnecessary risk to the baby.
Getting the perfect attachment from your baby is often very difficult in the first few weeks, and this can cause some mums a bit of pain until baby learns to latch on properly for effective feeding. This simply takes lots of practice, and persistence to perfect, especially with the aid of a breastfeeding consultant.
Mastitis (inflammation of the breast glands) can occasionally occur if baby refuses several feeds due to illness etc and mum forgets or neglects to express, or if the bra worn fits too tight or incorrectly. Simply express any excess milk or express to compensate for any missed feeds. Getting into the habit of massaging the breasts gently in a warm/hot shower each day will prevent this issue as it will great eliminate or reduce the possibility of any blocked milk ducts. And of course, ensure your bra fits firmly and comfortably, not tight and restrictive.
Increased frequency of breastfeeding ie duration between feeds may shorten for a couple days whenever baby has a growth spurt, until mums body increases milk production. Remember, the more often baby latches on and breastfeeds, the more quickly mum's body will respond to produce more milk.

To put it simply, breastmilk is evolved by nature to nourish human babies for optimum health. Nature ensures that the composition is perfectly suited to the human infants digestive system. There is nothing that can compare with that. Formula is predominately derived from cow's milk. Cow's milk is intended for baby cows (calves), and therefore the composition of cow's milk is completely different to breastmilk. The proteins in cow's milk is larger, and the nutritional content is lacking for human babies. This is the reason why fresh cow's milk must not be given to children under 12 months of age, and preferably not under 2 yrs of age. Manufacturer's of Infant Formula must modify cow's milk in an attempt to replicate breastmilk so that human babies can drink and absorb it. They do this by breaking down the cow's milk proteins and modifying/adding fat, carbohydrate, vitamins and minerals.
Yes, cows milk is a source of calcium (but calcium can found in many other foods), so drinking cows milk becomes more of a flavour treat.

I always recommend that new mothers try to breastfeed their newborns for at least the first 4-6 months.
My main reason for this, is to ensure that the baby gains extra protection from antibodies, other proteins and immune cells in human breastmilk. This helps babies avoid disease and illness which is particularly beneficial during the first few months of life, when infants often cannot mount an effective immune response against foreign organisms.

Why do I suggest breastfeeding for at least 4-6 months? As any mother knows, the first 3-4 months of life is already a the most difficult for a new baby and this is the "settling in" period which we often term "The Fourth Trimester". Ideally this Fourth Trimester would be completed in the womb, however, as nature would have it, the size of the baby by the end of this fourth trimester would be both dangerous and impossible to deliver the way nature had intended. So, this leaves us with newborns who are not quite ready for life outside the womb, with an immature immune system and digestive system, among a host of other things. So anything that can be done to help protect baby throughout this sensitive and vulnerable period is worth pursuing. Should baby become ill after 5-6 months of age, there are a very small number of products and medicines available that have been safely administered to babies after the 4th trimester, and preferably after the 6 months. This is simply due to the fact that by 6 months, the majority of organs and body systems have developed beyond that initial immature newborn stage, to cope better with any treatments that may be administered.

My Practical Points For Breastfeeding:

Make an informed decision before baby arrives if breastfeeding something that you want to pursue. Do not romanticise that breastfeeding is an easy and natural skill, that will simply happen! As most new mums can contest, this is definately not the case! Success in any undertaking is when preparation meets opportunity. Breastfeeding is a new skill and so it's essential that you are well prepared by reading up on breastfeeding and researching before the birth, when you can focus and concentrate better and gain the most detailed information. If you only rely on learning after you've had the baby, while you recover from childbirth and while you are in the thick of sleep deprivation, the likelihood of breastfeeding success is much reduced, and so is your motivation to learn any new skill.
Once the decision to pursue breastfeeding is made, ensure you commit to this for at least 3-4 months (if possible until past the first 12 months). And remember that it takes this period of time to iron out all difficulties and breastfeed successfully. Ensure that your baby fully empties the 1st breast of milk before beginning on the second breast by allowing your baby suckles for a significant amount of time (this time will increase from 5 mins as a newborn, to 10-20 minutes as your baby grows, depending on how hard and fast your baby suckles). Adequate suckling time ensures that your baby receive the hind milk which is rich and fatty, and satisfies him/her for longer. The foremilk is thinner and thirst quenching, but too much of this (caused by switching breasts too quickly after feeding commences) may result in your baby becoming windy or bloated, which can, in turn, encourage or compound colic.
Drink plenty of water - this is necessay throughout the day and absolutely vital before feeds.
Eat well - eat well balanced nutritionally packed meals for breakfast, lunch and dinner, and always have plenty of healthy snacks on hand for in-between meals. If your meals are not nutritionally well balanced, your body will be the first to suffer to ensure that your breastmilk quality is the best that it can be.
Exercise sensibly and in moderation. Breastfeeding is a continual process and your body is in a state of high metabolism as it continually produces breastmilk, so exercising excessively can burn off those extra calories that is required to make your breastmilk more filling, fatty and nutritional for your baby.
The more feeds your baby has (frequency and quantity), the more your body will make. Your body is designed to produce more milk the more frequently your baby breastfeeds, so ensure that you freely and frequently offer the breast to stimulate this production. Your baby is growing rapidly every day, and the first few months will be the fastest rate that he/she will ever grow, so you may sometimes lag behind a couple of days in breastmilk production.
Expressing breastmilk is another skill that all breastfeeding mums should undertake. This is important for periods of time where you are require someone else to look after and feed your baby, as well as allowing you to quarantine yourself briefly from your baby when you are unexpectly ill. Just ensure that you continue to express, during the times when your baby is being bottle-fed your expressed milk. Keeping up the expressing is essential to maintaining adequate breastmilk production.
Avoid complementary feeding with formula as it will almost always result in diminished breastmilk supply, because your baby will naturally reduce his/her breast suckling time and frequency. Be prepared for your breastmilk supply to diminish over time. Expressing breastmilk does offer some stimulation for breastmilk production but does not offer the same level of stimulation to increase breastmilk production. Formula is harder to digest and will generally satisfy your baby for longer.
Supportive chairs, pillows and cushions are vital for comfortable and effective breastfeeding. Back pain and other problems may occur as a result of incorrect posture during breastfeeding. A physiotherapist can offer terrific advice to help manage and prevent any postural issues you may have.

Summary: Although breastfeeding is a natural process, in which the female body is prepared and equipped to undertake after birth, this does not mean that it is always an easy process for new mothers. In most cases it requires determination, persistance and patience to successfully breastfeed. Generally, the good news is, if you can persist solely breastfeeding your baby past the first 2 months of life, it does get easier, and once sole breastfeeding exceeds the first 3 months of life, the both mother and baby will tend to stay with this process until weaning is required. Breastfeeding requires that mum is reasonably well rested and eating a healthy well balanced diet, as well as eating frequently, as this greatly influences the quality of milk in terms of nutrition and quantity. The key to breastfeeding success is knowledge and determination. Do your homework before the birth so that you are prepared for any difficulties when you proceed after the birth. This way, you can best process and utilise the information, advice and coaching of the mid-wives, nurses and lactation consultants made available to you immediately after your baby is born. Formula definitely has a role to play, and has it has it's own set of benefits. It can play a huge role in the nourishment of infants who's mother's breastmilk quality is lacking due to long-term illness, and formula is also often additional option for new mums who don't have the adequate support (emotionally or physically) to persist with primary breastfeeding (eg working mums, mums with other infants or toddlers who already lack sleep etc) but personally and professionally, it's very difficult to overlook the digestive and protective benefits of breastmilk. And should breastfeeding prove to be too physically challenging for mother and baby, I would always recommend that mum try to express as often as possible so that baby can benefit from having breastmilk. So, bottle-fed breastmilk is an excellent option to complement any formula-fed infant.

I hope this has been helpful :)

Uyen Dinh
Consultant Pharmacist

For more information check out these links:
http://www.breastfeeding.asn.au/

Generic Medications....Good or Bad?

2011-11-17T07:42:00.002-08:00

In short....Generic medicines are good. As long as you follow certain guidelines to ensure you are taking the appropriate generic medicines for the appropriate conditions or ailments.

Generics (non branded) are common these days and can be a safe and cheaper alternative to the "original medication" (branded). However, there are some pitfalls which one needs to be aware.

Generic medications are not always identical to their branded versions. Yes, they contain the same amount of the active drug, however, they may vary markedly in the other components which make up the medication (what we call excipients). These other components are fillers and binders etc which make up the medication, hence, generic medications will vary in shape, colour and tablet/capsule size. This variation may give rise to allergies to adverse reactions to individuals who may not tolerate certain ingredients.
Accidental over-medicating is a very common and serious side-effect of generic medication. All generic medications differ in packaging and labelling from their branded versions, and most generic medications differ in tablet / capsule shape and size (the only exceptions are those generics produced by the same manufacturer as their branded versions, in which they usually only repackage the box and labelling). This causes a lot of confusion with those patients who take several different types of medications, as well as the elderly. It is not uncommon for patients to be taking 2 or 3 generic brands of the SAME medication at the SAME time, and only discovering this to be the case when they are queried by their pharmacist or doctor, or when they develop symptoms of overdosing, or worse. This issue used to predominantly affect the elderly and those on multiple medications, but now with the market being flooded with generics, these alternative brands can affect everyone. Even those who only take the occasional course of antibiotic - the medication looks different, but is it actually a different type of drug to the medication taken previously which caused a severe allergy?
Generic medications contain the same active drug and dosage as their branded version, but they may not produce an identical clinical / therapeutic effect. The FDA and TGA and other government bodies regulating medicines allow for a certain "window" of clinical equivalence (what we term bio-equivalence). If the drug company can show that their generic version falls in this "bio-equivalent window" then they are approved to be a generic version. As this "window" indicates a range rather than a single figure, this means that the generic may not produce the exact same therapeutic effects. This is a problem with patients who take long term medications where their doctor has made dosage adjustments (termed "dosage titration") over the period of time to give the patient the most beneficial and appropriate therapeutic effect from their medications. An example is an individual with Bipolar who has been titrated on "Epilim" for mood control, who may destabilise when changed to a generic version.

But generic brands have their place, and can save you a lot of money over time. However, before you say "yes" to generics, it's important to understand what you are saying "yes" to.

My advice when considering a generic brand is:

If it's your first time taking the medication, this is an ideal situation to start on a generic brand.
Ask your doctor which of your medications your doctor would be comfortable for you to switch to generic brands and discuss these with your pharmacist. Your pharmacist is a valuable source of information and can give you much detail about generics.
Ask for a generic brand that is made by the same manufacturer, whenever possible. The packaging is different but the tablet / capsule is likely to be identical in colour & shape because it is actually the same medication repackaged, sometimes with the exception of the imprint on the tablet / capsule.
Ask to see the generic brand. Have a look at the packaging and the contents. Will you confuse them with other different medications that you currently take because they are similar in appearance?
Ensure that the pharmacist clearly labels your new generic medication both on the outside packaging and on the internal packaging (because if you throw the outside packaging out, you still need a clear reminder of what the medication is). This label should clearly show you which medication it is a substitute for.
Always finish your previous medication pack before starting a new generic to avoid confusion. Don't stock up on your medications as this causes much confusion when you switch generics and have several different types of packaging floating around. This also imposes a danger when the doctor changes your drug strength.
Insist on the same generic brand. Avoid switching to different generic brands of the same medication as this will simply add to the confusion. When you make a switch, stick to it and avoid changing unless therapeutically necessary. Sometimes it's not possible for every pharmacy to stock every generic version of a particular medication, so often they will offer you a generic that they stock so that you don't have to search for it elsewhere or go without. This problem can be minimised if you are a regular pharmacy customer of one or two pharmacies only, as they will always keep your medication on hand ready for your next refill. Also, be organised and don't refill your script upon taking your last dose of medication, to enable you time to find the same generic brand.
Try to stay with the same pharmacy and doctor. This will give you a double checking safety measure, because if they are familiar with what you normally take, and have a reliable computer history of your medications, then they will be able to pick up any discrepancies including medication brands.

I hope this has been helpful :)

Uyen Dinh
Consultant Pharmacist