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Warning Signs Of Primary Immunodeficiency

Approximately 13,000 Canadians suffer from Primary Immunodeficiency.

Your Immune System is a vast internal network of cells, tissues and organs whose job it is to protect your body from harmful invasion by foreign bodies such as viruses, bacteria and toxins. Primary immunodeficiency (PI) refers to an immune system that is either broken or completely missing from birth. It is not acquired after birth from infection or accident. It is a genetic malfunction, unique to an individual. Early diagnosis is crucial. Untreated PI can lead to serious damage to organs, physical disabilities and, in the most severe cases, death.

There are warning signs of PI, like recurrent infections of the ears and skin, pneumonia, bronchitis and sinusitis. For some, the first infection will be serious and life- threatening—a definite red flag that there may be a problem with their immune system. Some will suffer recurrent infections from infancy. However, some infants with PI will not show symptoms early on due to Immunoglobulin A (IgA), an antibody that plays a critical role in mucosal immunity. Babies receive IgA through breast milk from the mother or from antibodies that cross the placenta in the womb and remain in the infant’s body until four to six months of age when normal infants start to make their own antibodies. In some cases, warning symptoms will not show up until later in life, sometimes as far along as middle age.

Diagnosis begins with the understanding and recognition of the warning signs. Are there more infections than normal? Do infections recur after treatment with medications? Do infections not respond to usual medications? The infections involved differ for adults and children. Please see the charts to the right. All too often the significance of the warning signs is overlooked, sometimes because they may seem quite mild.

 

Here is our favorite article from the July issue of Saskatoon Well Being Magazine.

Here is our favorite article from the July issue of Saskatoon Well Being Magazine.  This month our favorite article forcuses on infant wellness.

Most experts agree that breastfeeding is the best way to go when it comes to giving your baby the nutrition she needs during those all-important formative years. Breast milk contains over 100 ingredients including antibodies that protect babies from illness and strengthen their immune systems. Plus, your breast milk is specially formulated for your baby and its composition changes as your baby grows.

Sometimes, however, breastfeeding is not an option or a mother may choose to switch from breastfeeding to bottle feeding. A study published in Pediatrics in 2008 showed that “Breast milk alone did not satisfy my baby” was the most frequently cited reason by mothers who decided to stop breastfeeding their babies. Early on, many women have problems with sore, cracked nipples or clogged ducts and infections of the breast tissue (mastitis), which can make breastfeeding an unpleasant or even painful experience. Some babies have trouble latching on in order to feed properly and this can be frustrating to the mother.

Whether it is a medical issue or a lifestyle choice that motivates the decision to bottle feed, Well Being wants you to know the basics of what you’ll need to do it correctly to make sure your baby is getting all the nutrition she requires.

INGREDIENTS

Although they cannot imitate breast milk exactly, commercially manufactured infant formulas contain many of the vitamins and nutrients a baby would get from breast milk as well as others only available in supplements. Infant formulas come in powdered, concentrated and ready-mixed versions and are either cow-milk-based, soy-based or specially formulated for specific conditions. An iron-fortified formula is recommended for babies younger than one year.

Both the Food and Drug Administration (FDA) and Health Canada advise against attempting to make your own baby formula at home since it is difficult to make a homemade formula nutritionally complete.

HOW OFTEN AND HOW MUCH

Formula-fed babies generally have to eat less often than breast-fed babies. This is because formula is slower to digest than breast milk. (More complicated digestion is also the reason that formula-fed babies have smellier bowel movements.)

On average, your baby should consume between 150 and 200ml of formula per kilogram of body weight each day (between 2.5 and 2.5 oz per pound).

As your baby grows, feeding habits and amounts will change.

CHOOSING BOTTLES

When it comes to choosing the right bottle for your new little one, the choices can be staggering.

The first decision to make is glass or plastic. Glass is regaining popularity lately due to concerns over harmful chemicals in plastic bottles. There is a risk of breakage with glass, but they are made quite sturdy and you can purchase wraps made of silicone or foam to cushion the glass from falls. Plastic bottles are cheaper, but may not last as long as glass. Always look for BPA-free plastic bottles.

The size and shape of the bottle are the next considerations. Newborns won’t need more than four ounces, but as your baby grows, she will need up to eight or nine ounces in a sitting. You may want to buy bigger bottles from the start and just not fill them up entirely for your newborn. Bottles with air vent systems and ones with an angled shape may help prevent your baby from swallowing too much air along with her food, which can result in gas and digestion issues. If you chose a specially shaped bottle, make sure it is dishwasher safe and that it fits in your bottle warmer (if used). Drop-in plastic bottle liners are another option for reducing your baby’s air intake while feeding and they also cut down on cleaning time since the liners can be thrown away after use. Of course, liners do have a larger environmental impact.

Finally, you’ll want to decide on the type of nipple for the bottle. If your baby is exclusively formula- fed, the shape of the nipple is not as important, but if you plan to go back and forth between breast and formula feeding, it is a good idea to choose a wide-base nipple that resembles the breast so the baby won’t get confused and have latching on problems. Different nipples are designed to allow a faster or slower rate of flow and you may have to experiment with flow rate until you find one your baby likes. Slower is usually better to start out with and you can increase as the baby ages.

PREPARATION

Before using bottles and nipples for the first time, you can sterilize them in a rolling boil for two minutes. It is unnecessary to sterilize bottles before each subsequent use. Proper washing with hot water and soap is sufficient. If you do choose to sterilize, you can boil, steam, microwave or use a sterilizing solution.

Follow the instructions on the package of formula to figure out the proper amounts of powder or concentrate and tepid water you should mix together in the bottle, then screw on the nipple tightly and shake. If your tap water is considered safe for consumption, it is fine to use for formula, but you can boil your water before making formula if you have concerns. Warming is not necessary, but if your baby prefers it, warm the bottle by placing it in a container of hot (not boiling) water or by using a bottle warmer. Don’t use a microwave as it may create hot spots that can burn your baby’s mouth.

The formula is ready to eat immediately, but can be stored in the refrigerator for up to 24 hours. If the bottle is left out for longer than an hour or two, throw the formula out. Discard any remaining formula when your baby is done eating.

COSTS

The costs of using formula can add up. Powdered formula is the least expensive option, followed by concentrated and ready-made formulas being most expensive. Specialty formulas will also cost more than basic ones. You can expect to pay between $1,500 and $2,000 for formula in your baby’s first year.

CONVENIENCE

You can’t beat the convenience of bottle feeding your baby. Being able to prepare bottles ahead of time means that you can enjoy some time away from your baby while your partner or other helpers assist with the feeding process. You may also be able to head back to work sooner since your baby won’t be as dependent on you.

BONDING

Some women worry about missing out on the bonding that happens during breastfeeding between mother and baby. If you spend time with your baby while you feed her, cuddling, making eye contact and placing her bare skin against yours, you should have no trouble creating a connection.

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