What a Difference 24 Months Can Make

By Micah Walton, father of Hannah Walton

Hannah_1st_day_at_CHPAbout two years ago, all seemed well as we were registering our 18-year-old daughter, Hannah, for college in Ohio where we live. She had not been feeling well, but we didn’t think it was anything that needed special medical attention.  That all completely changed when she had a fainting spell at work and ended up in our local emergency department.  We were shocked when the doctors said that her blood tests indicated she may have leukemia. The diagnosis was confirmed and we were forced to set aside all plans for Hannah’s education to start the journey to find appropriate treatment for her leukemia, which ultimately led us to Children’s Hospital of Pittsburgh of UPMC.

A few days later, Hannah became a resident on the 9th floor at Children’s Hospital where she would begin chemotherapy for acute myeloid leukemia (AML), a type of blood cancer. She spent a major portion of the following seven months as a resident of the 9B unit at Children’s. Over that long span, there were a couple of short stays in the Pediatric Intensive Care Unit at Children’s, and there were a few short weeks at home. The 9B suite became a home-away-from-home for our family. We got to know the nurses and other staff on a first name basis and they treated us with genuine compassion.

Looking back on our time on 9B, we are very thankful for the kind and highly skilled staff
who have contributed to Hannah’s care. Everyone was so caring and compassionate —Hannah_Chemo_Sick from the staff member who came to fix the television remote, the food service staff, housekeepers, the patient care technicians, nurses, volunteers, all the way through to the staff at the front desk — the list could go on and on. We are especially fond of Dr. Paul Finch and Dr. Michael Wollman, along with the rest of the Division of Pediatric Hematology/Oncology who treated our daughter like a person with strengths and weaknesses, rather than a lab project that needed to be solved.

We wouldn’t want to mislead you by saying it has all been goodness and light. There were
plenty of dark days, plenty of fears, tears and prayers, and lots of concern for Hannah’s future. But, we must also admit that so many good things have happened that it’s hard to believe it has only been two years since her fight with cancer first began.  In the 18 months since her chemotherapy ended, Hannah has been gaining back her strength, reevaluating her life goals, and planning for a productive and meaningful future.

Hannah_at_SEBTSIn mid-August, Hannah had one of her regularly scheduled checkups at the Hematology/Oncology clinic and we are thrilled that all is well and Hannah remains in remission! Only a few days after that appointment, we were with our daughter while she registered as a new student and became a resident in the dorms at the College of Southeastern Baptist Theological Seminary in Wake Forest, North Carolina.

We have been very blessed and we have also learned that despite the serious and scary diagnosis of AML, there truly can be a normal life after cancer!  Hannah’s future is bright and it’s beginning to look like she will be able to move forward in life having faced a difficult, but winnable, battle with cancer.

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Pertussis Vaccines for Expecting Mothers: Protecting the Health of Newborn Babies

By Dr. Sharon Cowden, CCP–Pittsburgh Pediatrics; Dr. Mark Diamond, CCP–South Hills Pediatric Associates; and Dr. Mike Green, Infectious Diseases, Children’s Hospital

Pregnant women should get the pertussis vaccine (commonly known as whooping cough vaccine) during the third trimester of pregnancy, regardless of whether they have had it previously, according to the Centers for Disease Control and Prevention (CDC).

Expecting mothers who get the pertussis vaccine can create protective antibodies, some of which are passed to the baby before birth. These antibodies provide short-term protection in the early days of life before the baby is old enough to receive his or her own vaccine at 2 months of age.

10446554_10152537124078844_8602296215558716020_nThe antibodies are the highest about two weeks after getting the vaccine, so expecting mothers should get the vaccine late in their pregnancy, ideally during the 27th through 36th week, to offer the greatest protection to their newborn babies.

“We cannot stress enough the importance of mothers getting vaccinated for pertussis during pregnancy,” advises Michael Green, MD, Division of Pediatric Infectious Diseases at Children’s Hospital of Pittsburgh of UPMC. “Newborns who contract pertussis are at great risk for serious and life-threatening complications. In fact, Children’s Hospital has cared for several infants in recent years who have died as a result of pertussis. The unfortunate reality is that these deaths may have been prevented if mothers had received the pertussis vaccine when they were pregnant.”

The CDC and a panel of experts state that the pertussis vaccine is very safe for pregnant women and their unborn babies.  Getting the vaccine during pregnancy does not increase the risk for pregnancy complications.

Talk to your doctor about getting the pertussis vaccine. Not all primary care doctors or obstetricians have the vaccine readily available in their offices, but they can direct you to the appropriate location.

For more information on pertussis and other vaccinations, please visit www.chp.edu/immunize.



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Bus Safety Tips as New School Year Gets Under Way

By Chris Vitale, Injury Prevention Manager, Children’s Hospital of Pittsburgh of UPMC

VITALE_C_RN_CAMEO_CHP_20100803As summer vacation has ended, we want to make sure families and drivers are cautious about kids riding the bus to and from school. School buses are one of the safest forms of transportation, and it should be known that children are much more likely to be injured getting on or off the bus than while riding the bus.

From 2003 to 2012, 119 school-age pedestrians were killed in the United States in school bus related events; 65 percent were hit by the bus and 30 percent were hit by other vehicles around the bus, according to the National Highway Traffic Safety Administration.

Since 2010, 15 children have been admitted to Children’s Hospital of Pittsburgh of UPMC who were hit by a school bus or another vehicle while waiting for the bus, or after being dropped off by the school bus.

Parents, administrators, teachers and other adults need to teach students the appropriate78457245-150 safety measures to ensure a safe trip to and from school. Below are some safety tips to always remember:

  • Whenever possible, parents should walk to and from the bus stop with their child.
  • Teach children to stand three giant steps back from the curb while waiting for the bus and not to begin boarding until the bus has come to a complete stop.
  • If a child needs to cross in front of the bus, he or she should walk five giant steps in front of the bus and make eye contact or wave at the driver to make sure the driver sees him or her. Also, always look left, right, left, while passing in front of the bus.
  • Always use handrails when exiting and entering the bus and avoid strings and items hanging off of backpacks, which could get caught in the door.
  • If your child drops something, tell him or her to notify the bus driver before stopping to pick it up.
  • Drivers – please stay alert! Expect children to do the unexpected – even if they are looking right at you, they may run out. Follow school speed zones and stop as soon as school bus lights begin to flash (yellow then red).

For more information and safety tips, please visit http://www.chp.edu/CHP/School+Bus+Safety.

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Powering Up School Lunches: A Back-to-School Guide the Whole Family Can Enjoy

By: Kim Autore, MS, RD, LDN, Children’s Hospital of Pittsburgh of UPMC

KimAutoreIt’s that time of year again — time for kids to go back to school!

Whether you have small children, or teenage boys and girls heading into their senior year of high school, back to school is an exciting time for both students and families.

Everyone can relate to that last minute checklist in some way: Did my teen finish his or her summer reading? Are the kids satisfied with their new sneakers? How long until they grow out of those jeans?

One of the last things that might be on your checklist, though, is planning for school lunch. No matter the age, it is a constant task and one that is essential to everyone’s routine. At times, the task of planning lunch day after day may seem dull or even daunting.

It is important to remember to make quality nutrition part of your family’s daily habit, especially in the form of healthy school lunches and snacks, which can make a big difference. Balanced meals and snacks will provide lasting energy for the day, which can improve your child’s focus, motivation, and overall performance both during school and after-school activities, such as sports.

So this year, let’s view lunch differently. I’d like to take the stress out of planning by offering this simple guide to powering up school lunches that can last all year.

5 Steps to Powering Up School Lunch 

1.    Plan Ahead

The planning process is the perfect time to involve your children in their own meal preparation. Before summer vacation is over, browse the grocery store with your children to see what appeals to everyone. Do they prefer simple sandwiches and snacks? Or is a hot meal more their style?

Consider the types of staples your kids prefer to have for lunch and then140092155 brainstorm together to reinvent the recipes. Don’t be afraid to get creative or check out Pinterest for simple and successful ideas.

Also, did you know most large grocery store chains allow customers to sample items right off the shelf? Don’t be afraid to ask an associate for help before purchasing new snack items.

Additionally, planning lunch meals ahead of time may benefit your budget. Take advantage of store circulars or coupons, and plan a week’s set of meals around featured sale items. Depending on the price of purchasing lunch at school, planning to pack may help you save money in the long run.

2.   Balance

A balanced lunch is important for to maintain focus and energy during those long afternoon hours.

So whether you are packing or buying daytime meals and snacks, aim for foods that provide a good mix of carbohydrates, fats, and protein.

When you are planning ahead, try to choose meals with servings of each:

  • Protein (meat- or plant-based)
  • Whole grains
  • Fruit and vegetables
  • Low-fat dairy

myplateUse MyPlate as your guide. Think: Half the meal fruits and vegetables, one-quarter protein, one-quarter whole grains, and a serving of low-fat dairy.

If you’ve managed all of those, throw in a small dessert to save for later.

Use the grocery shopping list below as a guide.



3.    Batch Prep and Pack

Sometimes the easiest way to pack your family’s lunch is to prep several days’ worth of meals and snacks at one time.

Consider making a large batch of tuna or pasta salad that will store well in the refrigerator.11 Pack individual portions into small containers for easy access when it’s time to fill the lunch boxes.

Keep raw veggies on hand for simple side items. For example, pack assorted portions of baby carrots or sliced bell peppers into plastic bags and store in the refrigerator for grab and go convenience that can last all week.

4.   Stock Your Pantry

Focus on portable, nutrient-dense snacks that are low in sugar and saturated fat. For teens who always on the go, stash these snacks in backpacks, lockers, and that side pocket of the gym bag.

Choose some simple favorites: trail mix, granola bars, protein bars, dried fruit, pudding snacks, vacuum-packed tuna packs, sunflower seeds, and nuts (peanuts, cashews, almonds, and walnuts).

5.    Keep Things Cool 

Practicing proper food safety is the cool thing to do! If you don’t already have them, invest in small reusable ice packs to keep meals at the correct temperature throughout the morning. Foods will taste fresh and make the meal more enjoyable.

Keep lunch cool and stylish with a sturdy lunch box. Also, reusable plastic containers that have spots for entrees and sides can help simplify packing for your family.

This guide can be followed on days your kids prefer to purchase lunch at school, too. Try to plan ahead by scoping out the menu, making balanced choices, and carrying snacks from home for between meals or after school.

No matter how you slice it, school lunch can be a nutritious and fun opportunity to power up your family’s day.

I’ve provided two simple recipes below to kick-start a year of healthy lunches! Remember, when batch -prepping large recipes, portion ingredients to make as much or little as you need in the end.

12Protein Packed Tuna Salad     

Makes 3 servings



3 cans of 5-oz tuna packed in water – drained
6 oz. Greek yogurt, plain
1 cup grapes, green or purple, quartered
¼ cup sunflower seeds
½ cup celery, chopped

1. Quarter the grapes and dice the celery. Set aside.
2. Drain the tuna fish.
3. Mix tuna, celery and grapes in a large bowl.
4. Thoroughly mix in the Greek yogurt
5. Blend in the sunflower seeds, continue to mix
6. Store in the refrigerator. Portion into several containers for grab and go convenience.

Substitution options: shredded chicken or turkey (right off a rotisserie chicken or from leftovers, canned chicken, diced apples, dried cranberries or raisins, mayonnaise, diced nuts; pecans, walnuts, almonds, season to taste.

14Rainbows and Bowtie Pasta Salad

Recipe courtesy of Ellie Krieger


Makes 3 servings

8 ounces bowtie pasta (can substitute penne or whole wheat varieties)
4 tablespoons olive oil
1 cup corn (thawed from frozen or drained from a can)
1 cup shelled soy beans (edamame) (thawed if frozen)
1 medium bell pepper, diced (any color will do!)
½ cup shredded carrots
1/3 cup cheese, grated (pick your favorite!)
Salt and pepper to taste

1. Cook the pasta as directed.
2. Drain pasta. Toss with 1 teaspoon olive oil to prevent sticking. Let cool.
3. In a large bowl, toss the cooled pasta with corn, bell pepper, edamame and carrots. Drizzle with remaining olive oil and toss to coat.
4. Blend in shredded cheese
5. Season to taste
6. Store in the refrigerator. Portion into several containers for grab and go convenience.

Personalize your favorite pasta salad recipe with any varieties of pasta or rice; substitute your favorite veggies, sautéed spinach, black beans, garbanzo beans, and any types of cheeses. Season to taste.

School Lunch Grocery List

Grains – Make half your grains whole
• Bread, rolls, bagels,
• Pasta
• Rice
• Tortillas, corn or whole grain flour
• Crackers
• Granola and granola bars
• Whole grain cereal
• Popcorn
• Muffins

Meats and Plant-Based Proteins
• Fish (tuna is a convenient lunch go-to)
• Poultry (sliced turkey or chicken breast, leftover legs, thighs, or fried chicken)
• Lean meats (ground beef, lean pork)
• Lean deli meats (ham, turkey, pepperoni, salami)
• Eggs (hard-boiled, egg salad, etc.)
• Soy (soybeans, tofu, or edamame)
• Beans (black, garbanzo, kidney, pinto, etc.)
• Other legumes, lentils, hummus
• Nuts and nut butters (almonds, cashews, peanuts, pecans, pumpkin seeds, sunflower seeds, walnuts, peanut butter, sun butter, etc.)

• Milk (whole, chocolate, strawberry, soy milk)
• Yogurt (low-fat, Greek, plain or flavored)
• Cheese (low-fat string cheese, sliced cheese)
• Cottage cheese

Vegetables – Think raw, cooked, or leftovers!
• Fresh
• sliced bell peppers
• baby carrots
• broccoli
• salads with dark green lettuce/spinach
• sugar snap peas
• tomatoes
• sweet potatoes
• Frozen

• Fresh: bananas, sliced or whole apples, oranges, grapes, berries, pineapple, peaches, pears, plums and more
• Canned: apple sauce cups, fruit cocktail
• Frozen
• Dried: raisins, cranberries, plums, pineapple, mango, apricots
• 100% juice

• Granola bars
• Clif® bars
• Trail Mix
• Peanut butter cups

Good Luck and Happy Packing!

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Down Syndrome Prenatal Education Act (“Chloe’s Law”) Passed

By Kishore Vellody, Medical Director, Down Syndrome Center of Western Pennsylvania, Children’s Hospital of Pittsburgh of UPMC

Vellody_Kishore_MD_Diagnostic_ROn July 18, 2014, a Pennsylvania law was signed by Gov. Tom Corbett requiring that a mother who receives a prenatal diagnosis of Down syndrome be given information about the condition.   As medical director of the Down Syndrome Center of Western Pennsylvania, but even more importantly as a sibling to someone who has Down syndrome (Ds), I think the passage of the Down Syndrome Prenatal Education Act, also known as Chloe’s Law, is an important first step toward providing accurate prenatal information about Ds to parents.

Down syndrome (Ds) is the most common genetic condition resulting in intellectual disability.  It results when a person has an extra chromosome 21.  The Centers for Disease Control and Prevention estimates that 1 in 691 live-born infants in the United States are born with Ds.  Children with Ds have an increased chance of medical issues, but, with appropriate medical attention, the vast majority will live healthy and fulfilling lives.

Prior to the advent of genetic testing, infants with Ds could only be diagnosed after the baby was born.  Over the past several decades, it has become possible to prenatally diagnose Ds.  Until very recently, this would involve sending three to four blood tests on the mother and obtaining an ultrasound on the fetus.  With this combination of tests, statistical ratios could estimate what the chances of the baby having Ds would be.  If there was a strong likelihood of the baby having Ds, the mother would be offered more invasive testing like amniocentesis or chorionic villus sampling to know definitively if the baby had Ds.  This testing carries with it a small chance of miscarriage.  Given the invasive testing required for a definitive diagnosis, more than 80 percent of babies born with Ds are diagnosed with the condition after they are born.

Within the past couple of years, a new method using noninvasive prenatal testing (NIPT) called “cell-free fetal DNA analysis” has become available. This testing is able to detect the extra chromosome 21 from the fetus with more than 99 percent accuracy just from checking the mother’s blood. This testing can be done in the first trimester of pregnancy. This is undoubtedly a scientific breakthrough, but it raises some new challenges.  Given the relative ease of testing, far more women will get prenatal diagnoses of Ds than ever before.  Accurate information must be available readily regarding what Ds means for somebody today. If the person giving the diagnosis is not current in their understanding of Ds, he or she could provide incorrect information to the family. I have found that this happens far too often.

Published data show that when mothers are surveyed after receiving the diagnosis of Ds, they frequently feel that the information they receive is outdated and inaccurate.  As such, they are unable to make an informed decision about how to proceed with the pregnancy.  Therefore, I applaud the Pennsylvania legislature for passing “Chloe’s Law” in an overwhelmingly bipartisan fashion.  We need that type of unified stance over accurate information sharing not only within government but in medicine as well.  Parents receiving a prenatal diagnosis deserve up-to-date and accurate information about Ds from their medical providers.  Through our work at the Down Syndrome Center, we have been personally involved in prenatal discussions with local families so that we can share accurate, up-to-date information about Ds. However, we only reach local families in this way; there are many regions all throughout Pennsylvania that do not have easy access to a Down Syndrome Center. The requirements of Chloe’s Law should increase the access to accurate information on Ds for parents throughout the state.

For more information about the Down Syndrome Center of Western Pennsylvania, please visit http://www.chp.edu/downsyndrome.  You can also download our audio podcasts on iTunes. Visit http://www.chp.edu/dscpodcast to learn more.

For more information on Down syndrome, visit the following websites:

National Down Syndrome Congress

National Down Syndrome Society



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Hayden’s Journey with Biliary Atresia and Liver Transplant

By Heather Vanzandt, mother of Hayden

CAM00324My son, Hayden William Vanzandt, was born Oct. 17, 2012 in Seneca, Pennsylvania. Weighing 8 lbs., 6 oz., and ranging 23” long, he was a perfectly healthy baby boy, except for his bilirubin level. He had jaundice. I was told by doctors it should go away, but it never did. This continued on for two months. Finally, I told his doctor that I wanted blood work done, as his jaundice was getting worse. They complied, and referred us to Children’s Hospital of Pittsburgh of UPMC. What was to come I thought could only happen in nightmares.

The first time I ever heard the words “liver disease” was on Dec.13, 2012. The doctors explained how Hayden’s bilirubin level was very high and it could mean he has a disease called biliary atresia. If left untreated, Hayden would not live past the age of 1 or 2. I was devastated, and didn’t know how or why this happened. He was so happy and playful; how could he have this disease?

Thankfully, the amazing doctors at Children’s Hospital were able to diagnose him early and on Dec. 18, Hayden had the Kasai procedure, a procedure that is done to temporarily “fix” biliary atresia, as there is no cure at the moment. The statistics for the Kasai are not very good: Only one-third of recipients live 20 or more years with only the Kasai done, one-third live for a short while with only the Kasai before needing a liver transplant (this was Hayden), and the other one-third need a liver transplant right away, because the Kasai immediately fails.

Fortunately, the Kasai procedure was able to buy Hayden some time before his transplant: 15 months to be exact. In that short time, Hayden continued to meet his developmental milestones. We took him to see family members, enjoyed the park, and went shopping. We did everything we could to make him happy and give him a normal childhood as he had been through so much already.

During the summer of 2013, approximately six to seven months post-Kasai, he was CAM00353hospitalized for about a week with fever and bleeding issues. Fevers became a serious matter as they could mean an infection in his liver called cholangitis. Typically, they would treat this with a peripherally inserted central catheter, or PICC line, in his arm and antibiotics for two to three weeks. Hayden had about six of these PICC lines in between the Kasai and transplant. We also found out that Hayden had portal hypertension and esophageal varices, which are quite common in kids with biliary atresia. Due to Hayden’s enlarged liver, there was a great deal of pressure on his veins and blood vessels in his belly, which caused some veins to become enlarged. These enlarged veins would occasionally burst at any given time when the pressure became too great. Due to this recent diagnosis, his chances for a transplant increased significantly. The doctors were convinced it would happen within five years. Despite all of this new information, we continued to live our lives as normally as possible, putting all our focus and attention on Hayden and making him happy.

We were able to go the rest of 2013 without a single hospitalization. But when the New Year approached, the constant sickness began. Our entire household, including Hayden, was sick with the flu. On top of that, in February, Hayden had another fever and minor bleeding, which required multiple scopes over the next couple of weeks in order to treat his varices. Then, on March 20, 2014, Hayden suffered a massive bleed that required an ambulance ride to our local hospital, and he then was transported to Children’s once he was stable. Unfortunately, about 30 minutes upon arrival to the Emergency Department, Hayden had another bleed that sent him into cardiac arrest. He needed chest compressions in order to be revived. He was intubated and sedated, then moved to the Pediatric Intensive Care Unit (PICU) for a week. During that week, he had several tests and it was clear that he would need a liver transplant soon. The doctors said it would be beneficial to try to find a live donor, because this would speed up the waiting process of finding a liver for him.

Out of nowhere, a woman I only knew through a liver support group on Facebook messaged me saying that she was Hayden’s blood type (Type A-positive) and would like to help in any way she could, including being his living donor. I was flabbergasted! Here is a complete stranger offering to give part of her liver to save my son’s life!

That Monday morning, she contacted the hospital requesting to be tested to see if she was a match for my son. Normally, the tests are done in two to three days, but she was able to have her tests completed in a day since she lives in New York and was in town during the week with her daughter, who also received a liver transplant and had an appointment at Children’s. Finally, a week later, we got the wonderful news that she was a match, and the transplant would happen the following week! I was so excited and shocked; everything had happened so fast and was such a blur, but I was so happy that my little boy was getting a second chance at life because of this amazing stranger!

CAM00471Transplant day finally arrived. It was April 9, 2014, Hayden’s second birthday as we will know it from this moment on. Just eight days shy of him being 1-½ years old. My family and I were a ball of nerves. I was dreading the call that something terrible had gone wrong, or that his new liver wasn’t working properly. Thankfully none of that happened, and his surgery was completed in eight hours. He even came up into the PICU extubated. Within two days, he was in a regular room on the Transplant Unit and doing great. Within a week, we were out and about, taking strolls to the cafeteria and the gift shop, and just walking the halls. Hayden’s new liver was working perfectly, and it was all thanks to his living donor who selflessly gave of herself to help someone she had never met before. We will never be able to thank her for what she did!

Now that we are almost four months post-transplant, we are home and doing very well.  He had a mild case of rejection at the end of May, but has been on steroids to treat it, and his numbers have been improving ever since. Hayden has grown so much and is exploring everything and enjoying life with his new liver.

I am looking forward to celebrating his 2nd birthday in October and having Thanksgiving and Christmas with the family so that they can see how well he is doing. It’s hard to believe what he has been through in his short life. I still sometimes wonder why it had to happen, but it doesn’t matter anymore, because I have my baby boy with me, and I’ll always be thankful for that.

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World Breastfeeding Week

By: Debra Bogen, MD, FAAP, FABM

Bogen_Debra_MD_Pediatrics_CHP_11_17_2006This week is World Breastfeeding Week and August is National Breastfeeding Month! Most people know that breastmilk feeding is “good for babies”, but breastfeeding is far more than nutrition for infants. Breastfeeding is ESSENTIAL for maternal health, infant health and development, and society. The American Academy of Pediatrics (AAP) recommends that babies be fed ONLY breastmilk for the first 5 to 6 months of life and that babies continue to breastfeed until at least the baby’s first birthday while also receiving food.

Can you name at least three benefits of breastfeeding for women, infants, and society?

Breastfeeding and Women’s Health: Compared to women who formula feed, women who breastfeed:

  • are less likely to develop adult onset diabetes
  • are less likely to develop high blood pressure
  • have lower rates of breast cancer and ovarian cancer
  • have differences in their brain activity when they see and hear their own baby

Breastfeeding and Infant Health: Compared to infants who are formula fed, babies who are breastfed:

  • have fewer ear infections, less severe diarrhea, and fewer urinary tract infections
  • are less likely to develop asthma, eczema, and allergies
  • are less likely to be hospitalized for lung infections
  • score higher on IQ testing, even after taking into consideration mother’s education and IQ
  • are less likely to die of SIDS (sudden infant death syndrome)

Breastfeeding and Society:

  • Breastmilk is free of charge; formula costs $1,500 to $2,000 per year
  • Breastmilk is never recalled; formula recalls happen more often than you would think – check out the FDA website for details
  • Breastmilk is environmentally “green”; there are no manufacturing, packaging or shipping costs
  • Breastfeeding saves the health care system huge amounts of money in reduced sick visits and hospital visits
  • Mothers who breastfeed miss fewer days at work

In 2011, 79 percent of women in the Unites States started to breastfeed, but 20 percent gave formula by 2 days of age, and by 6 months, 30 percent of women who had started to breastfeed stopped all breastfeeding. In Pennsylvania, only 72.9 percent of women fed their baby any breastmilk.

Women supplement with infant formula or stop breastfeeding for many reasons – but our goal is to support women to fully breastfeed according to national recommendations.

Breastfeeding is natural and essential for health but it is NOT always easy. The first few weeks can be particularly challenging and is a time that women need encouragement and support. Women who receive support from family, friends, medical professionals, and society are more likely to have a successful and rewarding breastfeeding experience. We are fortunate to have many resources available to help women breastfeed both in our community and nationally (see end of blog for list of resources).

Breastfeeding and skin-to-skin care that starts in the delivery room sets the stage for breastfeeding success. In another blog post, I’ll share tips about getting breastfeeding started – but for now I will refer you to the Office of Women’s Health website.

Returning to work is one reason many women give for stopping breastfeeding or introducing formula. However, we are in a new era of breastfeeding support – women have protection under the law to breastfeed.

In 2007, PA Senate Bill 34 was passed; it allows mothers to breastfeed in public without penalty and states that breastfeeding may not be considered a nuisance, obscenity or indecent exposure under this law.

In 2010, the Fair Labor Standards Act (FLSA) was modified. The Act indicates that employers are required to provide “reasonable break time for an employee to express breast milk for her nursing child for 1 year after the child’s birth each time such employee has need to express the milk.” Employers are also required to provide “a place, other than a bathroom, that is shielded from view and free from intrusion from coworkers and the public, which may be used by an employee to express breast milk.” Sadly – some workers are not covered so read the details.

I have helped and supported countless women to breastfeed over the past 15 years. An important lesson I have learned is that breastfeeding should not cause breast pain if it is done properly – pain is the body’s way of saying there is something wrong. Therefore, if you have breast/nipple pain while breastfeeding, please get professional help from a board certified lactation consultant or other health care professional trained in breastfeeding right away! It is far easier to resolve breastfeeding problems when they first start then after they have festered for days, so don’t hesitate to get help with breastfeeding.


At Children’s Hospital of Pittsburgh of UPMC’s Primary Care Center in Oakland, we have an experienced certified lactation consultant on-site, Angie Kirkwood, BSN, as well as experts in breastfeeding to help. For more information, please call 412-692-6000.

The Pennsylvania Health Department maintains a list of Pennsylvania breastfeeding resources by county.

Breastfeeding Help Lines:

  • PA WIC Breastfeeding Warm Line: 1-855-427-5666, available Monday to Friday, 8 a.m. to 8 p.m., Saturday and Sunday, 9 a.m. to 1 p.m.
  • Allegheny County Breastfeeding Help Line 412-687-2243 (Staffed by IBCLCs – 8 a.m. to 4 p.m. daily)
  • PA Department of Health Healthy Baby Line: 800-986-BABY or 800-986-2229
  • National Women’s Health Information Center: 800-994-9662
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