Vaccination

Answering Pro-Vaccination Questions


Recently I got into an online discussion about vaccines (which prompted me to write this post). Two people in particular where adamant vaccines were 100% safe, and that anyone who disagreed was an ignorant quack. They went on to quote what they called "facts" (that were flat out untrue) but they were adamant they were right.

I presented many valid points and studies but they were ignored, and instead I got this response:
‎There is no comparison between the scientific method and a bunch of yahoos who publish stuff over the internet.
But I was quoting REAL, scientific studies. It made me realise the vaccine debate has been drawn away from facts - instead pitting people against hated stereotypes to gain a following. I'm not a hippy, I'm not easily sucked in, I like facts, logic, and clear, unbiased stats. So I said to her:
It's not a matter of anti-vax versus pro-vax, it's a matter of decifering common sense and accurate stats from a myriad of bull shit.
But it fell on deaf ears. On and on the discussion went, back and forth, until I had to leave for a family outing - feeling mentally drained and wondering whether anything I'd said made any difference at all.

The draining discussion did present a gift though, it showed me what questions many pro-vax parents have about vaccines, that NEED to be addressed publicly. Below are statements taken from our conversation and answers to them:

"Thimerosal has not been used in childhood vaccines for 10 years."
Thimerosal (contains 50% mercury) HAS indeed been used in vaccines since the 1930's right through to today, and I'm sure will continue to until there is a law prohibiting it. Ten years ago there was a major enquiry into the effect thimerosal had on young children. As a result major health organizations issued a joint statement recommending it's removal as soon as possible (excerpt from the CDC website):
The Public Health Service (including the FDA, National Institutes of Health (NIH), Center for Disease Control and Prevention (CDC) and Health Resources and Services Administration (HRSA) and the American Academy of Pediatrics issued two Joint Statements, urging vaccine manufacturers to reduce or eliminate thimerosal in vaccines as soon as possible (CDC 1999) and (CDC 2000).1
Despite the above statement, no recall of the vaccines containing mercury was ever issued and companies continued to sell lots already manufactured with expiration dates as late as 2007. It is plausible then that vaccines containing large amounts of thermerosal were still being administered to children as recently as 2007. The removal of thimerosal in vaccines has been more of a gradual phasing out, than a sudden halt.

While most vaccines manufactured today have abided by the above recommendation to reduce or eliminate thimerosal, 11 different vaccines in the U.S still contain it, and some are part of the current childhood vaccine schedule:
(Table excerpts from the CDC)2

Vaccine
Trade Name
Manufacturer
Mercury
Pediatric Dose
DTaP
Tripedia2
Sanofi Pasteur,
Inc.
≤ 0.3 µg
/0.5 mL dose
Persons 6 weeks
to 7 years, same dose
DT
No Trade Name
Sanofi Pasteur,
Inc.
< 0.3 µg
/0.5mL dose
Persons 6 weeks
to 7 years, same dose
Sanofi Pasteur,
Ltd.3
25 µg
/0.5 mL dose
Persons 6 weeks
to 7 years, same dose
Link
Td
No Trade Name
Mass Biologics
≤ 0.3 µg
/0.5 mL dose
Persons 7 years and
over, same as
adult dose
Decavac
Sanofi Pasteur,
Inc.
≤ 0.3 µg
/0.5 mL dose
Persons 7 years and
over, same as adult dose
TT
No Trade Name
Sanofi Pasteur,
Inc.
25 µg
/0.5 mL dose
Persons 7 years and
over, same as adult dose

Link
Influenza
Afluria
CSL Limited
0 (0.5mL
single dose)
24.5 µg (0.5 mL multidose)
Persons 5 years and
over, same as adult dose
Fluzone5
(multi-dose presentation)
Sanofi Pasteur,
Inc.
25 µg
/0.5 mL dose
Persons 6 months and
over, N/A
Fluvirin
(multi-dose vial)
Novartis Vaccines
and Diagnostics Ltd.
25 µg
/0.5 ml dose
Persons 4 years and
over, same as adult dose
FluLaval
ID Biomedical
Corporation of Quebec
25 µg
/0.5 ml dose
Persons 18 years and
over
Meningococcal
Menomune A, C, AC and A/C/Y/W-135
Sanofi Pasteur,
Inc.
25 µg
/0.5 dose
Same as adult dose
Table Footnotes
Thimerosal is approximately 50% mercury (Hg) by weight. A 0.01% solution (1 part per 10,000) of thimerosal contains 50 µg of Hg per 1 ml dose or 25 µg of Hg per 0.5 ml dose.
Sanofi Pasteur's Tripedia may be used to reconstitute ActHib to form TriHIBit. TriHIBit is indicated for use in children 15 to 18 months of age.
This vaccine is not marketed in the US.
COMVAX is not licensed for use under 6 weeks of age because of decreased response to the Hib component.
Children under 3 years of age receive a half-dose of vaccine, i.e., 0.25 mL (12.5 µg mercury/dose.)
Note to New Zealander's: Mercury was used in the NZ infant vaccine schedule until 2000, when NZ moved to phase out all mercury containing vaccines in the NZ childhood vaccine schedule. In NZ, there are still 5 vaccines in use that contain mercury, including the flu shot, however none of the vaccines listed on the infants standard vaccine schedule contain mercury. 3

Is the level of Mercury in pediatric vaccines safe?
The Environmental Protection Agency (EPA) recommends ingesting no more than 0.1mcg of methyl-mercury per kg of body weight per day to avoid toxicity.4 This recommendation is for methyl, not ethyl mercury, which is the type of mercury contained in vaccines. There are very few studies on ethyl-mercury, and as such, there is no other choice but to use the EPA's recommendations for methyl-mercury. Also keep in mind this is for 'ingesting' not 'injecting', injecting has a much more potent effect. Currently there are no recommendations for the limit of injected mercury to avoid toxicity, but bearing in mind the limit for ingested mercury, one would hope the limit for injected mercury should be well below it.

Using the EPA's guideline of 0.1mcg of mercury per kg of body weight per day, we can calculate that an average 7.5kg 6 month old infant therefore must not exceed 0.75mcg in a single day. With this example we can see that the current pediatric vaccines do finally fit within the EPA guidelines. Until recently this has not been the case. Many children in the past have received accumulated doses of mercury, most reaching between 30mcg and 100mcg by six months, exceeding the EPA's limit many times over throughout the infants first year.5  A study conducted by the CDC in 2000 examined these children and concluded:
"This analysis suggests that in our study population, the risk of tics, ADD, language and speech delays, and developmental delays in general may be increased by exposure to mercury from thimerosal containing vaccines during the first six months of life."5
There is now a fund set up by the US government for those children and their families who have suffered the damaging effects of vaccinations, called the National Vaccine Injury Compensation Program – a kind of ‘here's some money now shut up' fund.6
"Since the first Vaccine Injury Compensation claims were made in 1989, 3,149 compensation payments have been made, $2,396,574,630.52 disbursed to petitioners and $96,060,500.79 paid to cover attorney's fees and other legal costs."6
But I can never imagine there will be any public accountability or indication of actual wrong doing from the government or pharmaceutical companies. In the face of insurmountable evidence, their stance will always be to deny.

"There has been no fall in the rate of Autism since thimerosal's removal from vaccines."
The removal of thimerosal from vaccines has been a gradual phasing out, not a sudden halt. And it is still in 6 different types of vaccines, in no way has it been entirely "removed". The below graph shows the prevalence of autism in Minesota from 2003 to 2008, grouped by birth year. (Click for a larger view)7

This graph shows some important details:
• Older children with autism are continuing to be identified.
• It takes from 2 to 7 years or longer for older children who have autism to be identified, with the highest peaks being around 7 to 8 years old.
• Children under three years of age lag in being diagnosed.
• Prevalence for each birth year will continue to rise until all persons in that birth year are identified.

The problem is current charts often show a continued dramatic increase in overall autism rates, which on the surface is misleading. It makes it seem as if each year the number of babies born with autism is sky rocketing. When in fact it is the older children who are only now being diagnosed with autism who are making up the bulk of the current statistics.

Still, we can see from the graph above that autism continues to gradually rise each year, so what's going on? The problem is that while thimerosal was being phased out of most vaccines, the amount of aluminium in vaccines multiplied exponentially to levels never seen before, well in excess of EPA and FDA safety levels. Aluminium is well known neurotoxin and studies show it is implicated in autism:

"A significant correlation exists between the amounts of aluminium administered to preschool children and the current prevalence of autism spectrum disorders in seven Western countries, particularly at 3–4 months of age." 17
"These current data implicate aluminium injected in early postnatal life in some central nervous system alterations that may be relevant for a better understanding of the aetiology (cause) of autism spectrum disorder." 18
"In young children, a highly significant correlation exists between the number of pediatric aluminum-adjuvanted vaccines administered and the rate of autism spectrum disorders." 19
"We propose that children with the autism diagnosis are especially vulnerable to toxic metals such as aluminum and mercury due to insufficient serum sulfate and glutathione. A strong correlation between autism and the MMR (Measles, Mumps, Rubella) vaccine is also observed." 20
"It may be that mercury and aluminium from vaccines as well as other sources, by accumulating in the brain, are acting as the innate (immune) trigger. It has been shown that both of these metals can trigger microglial activation and neurodegenerative (damage and death of nerve cells) effects." 21

For more information on aluminium in vaccines see the posts:
Vaccines & Autism: The Evidence
Childhood Vaccination: Aluminium

"All evidence that vaccines have caused autism has been refuted."
As mentioned earlier, a study by the CDC in June 2000 concluded:
"This analysis suggests that in our study population, the risk of ticks, ADD, language and speech delays, and developmental delays in general maybe increased by exposure to mercury from thimersoal containing vaccines during the first six months of life."
Studies have continued to examine whether there is a link between vaccines or mercury and vaccines, and the link is very clear:
"A thorough review of medical literature and U.S. government data indicates (i) that many and perhaps most cases of idiopathic autism, in which an extended period of developmental normalcy is followed by an emergence of symptoms, are induced by early exposure to mercury; (ii) that this type of autism represents a unique form of mercury poisoning (HgP); (iii) that excessive mercury exposure from thimerosal in vaccine injections is an etiological mechanism for causing the traits of autism; (iv) that certain genetic and non-genetic factors establish a predisposition whereby thimerosal's adverse effects occur only in some children; and (v) that vaccinal mercury in thimerosal is causing a heretofore unrecognized mercurial syndrome." 8
"The overwhelming evidence from the peer-reviewed scientific and medical literature favours acceptance that mercury exposure is capable of causing some Autism Spectrum Disorders, particularly in children who are biochemically and/or genomically susceptible to mercury intoxication. A review of treatments suggests that Autism Spectrum Disorder patients who undergo protocols to reduce mercury and/or its effects show significant clinical improvements in some cases." 9 
"The children with Autism Spectrum Disorder:
Had elevated levels of androgens.
Excreted significant amounts of mercury post chelation challenge.
Had biochemical evidence of decreased function in their glutathione pathways.
Had no known significant mercury exposure except from Thimerosal-containing vaccines/Rho(D)-immune globulin preparations.
Had alternate causes for their regressive Autism Spectrum Disorders ruled out.
Had a significant dose-response relationship between the severity of the regressive Autism Spectrum Disorder and the total mercury dose children received from Thimerosal-containing vaccines/Rho (D)-immune globulin preparations.
Were exposed to significant amounts of mercury from Thimerosal-containing biologic/vaccine preparations during their fetal/infant developmental periods, and subsequently, between 12 and 24 mo of age.
Were previously normally developing children prior to mercury exposure.
Suffered mercury toxic encephalopathies (brain injury) that manifested with clinical symptoms consistent with regressive Autism Spectrum Disorders." 10 
"Boys aged 3 to 17 years (born before 1999 with a vaccination record) who received the first dose of hepatitis B vaccine during the first month of life were 3 times more likely to be diagnosed with autism, than boys either vaccinated later or not at all."11
"The higher the proportion of children receiving recommended vaccinations, the higher was the prevalence of Autism or Speech or Language Impairment. A 1% increase in vaccination was associated with an additional 680 children having Autism or Speech or Language Impairment. Aluminum, which is found in at least 20 U.S. childhood vaccines (Centers for Disease Control and Prevention, 2010), is not only a neurotoxin, but also an immunosuppressant that may allow measles-containing vaccines to create cytokines that damage the brain.Enhanced exposure to aluminum via vaccines may be associated with an increase in the prevalence of neurological disorders such as autism, especially if an aluminum-containing vaccine is administered along with a measlescontaining vaccine." 12
"Children with severe Autism Spectrum Disorder had biomarkers consistent with mercury toxicity such as significantly increased mercury intoxication-associated urinary porphyrins (pentacarboxyporphyrin, precoproporphyrin, and coproporphyrin); significantly decreased plasma levels of reduced glutathione (GSH), cysteine, and sulfate; significantly increased plasma oxidized glutathione (GSSG). This study concluded mercury intoxication is significantly associated with autistic symptoms." 13
"Boys who were vaccinated with the Hep B triple series vaccine were 9 times more likely to need early intervention or special education services, than boys who were not vaccinated with the Hep B vaccine." 14
*Note: The Hep B triple series vaccine contained thimerosal at the time this data was collected
"The anti-vaccination movement twist facts"
To that I replied, "ALL studies and publications twist facts. Yes that's right, every single study is funded by someone, and each person has their own personal point of view, their own bias." Again this was brushed off.

It's an illusion that because a study was conducted by a researcher the contents of it are pure truth. We can never be sure a study was accurately conducted, but often it's all we have to go on. And the stats themselves can be interpreted literally any way you like, the way in which it's delivered to you will sway you in whatever direction the commentator wants you to go.

For an example of the integrity of today's scientific studies, there was a recent study, ‘Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years' published in The New England Journal of Medicine on September 27, 2007 that was touted as a ‘Weight of Evidence Against Thimerosal Causing Neuropsychological Deficits' by many medical publications. But by looking just little closer major flaws in the study became self evident:15

- The study specifically eliminated any children with autism or a neurological condition.  Children who had had encephalitis and meningitis were also eliminated. This literally makes the study null and void. And I'm quite dumbfounded every time I read it. They removed any child that would conflict with the outcome they wanted: to show thimersoal does not cause neuropsychological deficits. What a novel way to deal with the problem, just remove the evidence and continue as it you're conducting a valid study. If the study were conducted honestly these would have been the children they were specifically looking for, they were what the whole study was supposed to be about.

- The authors went on to eliminate 70% of the study participants. The authors themselves also acknowledge that selection bias might have been a factor in the findings. It really sounds more like it was an audition to find the healthiest children, than a valid, randomized group of study subjects.

- The primary concern about thimerosal, that it causes autism, was not addressed or included in the study. The study noted that autism itself - the condition most often connected with thimerosal - was not considered.

- The authors of the study had major conflicts of interest.

Dr. Offit
Serves on the scientific advisory board of Merck (major vaccine manufacturer). Holds a patent on the RotaTeq vaccine produced by Merck.

Dr. Thompson
The lead investigator, is a former employee of Merck.

Dr. Marcy
Has received consulting fees from Merck, Sanofi Pasteur, GlaxoSmithKline, and MedImmune.

Dr. Jackson
Received grant money from Wyeth, Sanofi Pasteur, GlaxoSmithKline, and Novartis. He received lecture fees from Sanofi Pasteur and consulting fees from Wyeth and Abbott. Currently, he is a consultant to the FDA Vaccines and Related Biological Products Advisory Committee.

Dr. Lieu
Is a consultant to the CDC Advisory Committee on Immunication Practices.

Dr. Black
Receives consulting fees from MedImmune, GlaxoSmithKline, Novartis, and Merck, and grant support from MedImmune, GlaxoSmithKline, Aventis, Merck, and Novartis.
Dr. Davis - Receives consulting fees from Merck and grant support from Merck and GlaxoSmithKline.

As you can see you've got to be very careful which studies you tout as evidence.

Below is a large excerpt from WAVES NZ, with some rather damning info regarding the integrity of scientific studies:16

Conflict of Interest
The burgeoning problem of conflict of interest was discussed in a paper in a 2002 issue of the Journal of the American Medical Association:
The vast majority of doctors involved in establishing national guidelines on disease treatment have financial ties to the pharmaceutical industry that could potentially sway their recommendations and inappropriately influence thousands of other physicians… 38% of respondents said they had served as employees or consultants for pharmaceutical companies and 58% had received financial support for medical research. In addition, 59% had links with drug companies whose medications were considered in the particular guidelines they authored… 19% said they thought their co-authors' recommendations were swayed by their relationships and 7% said they thought their own relationships influenced recommendations.
On the same topic a Lancet editorial asks just how tainted by commercial conflicts has medicine become? The author concluded that the answer was heavily tainted, and damagingly so.

A paper published in the British Medical Journal in 2003 found that:
Research sponsored by the drug industry was more likely to produce results favouring the product made by the company sponsoring the research than studies funded by other sources. The results apply across a wide range of disease states, drugs, and drug classes, over at least two decades and regardless of the type of research being assessed.
In another paper, published in the journal Psychological Medicine in 2006, Researchers found that in studies on psychiatric drugs favorable outcomes were significantly more common in studies sponsored by the drug manufacturer (78%) than in studies without industry sponsorship (48%) or sponsored by a competitor (28%).

Another study into bias in reported research on psychiatry drugs in 2007 "confirmed previous findings that industry-funded studies are less likely to report negative findings." The authors went on to say that their "novel finding is that this effect appears to be largely or exclusively due to the presence of a company employee among the authorship."

These are just three of many, many papers on conflict of interest within the pharmaceutical industry and the reporting of drug trial results. Such conflict of interest is so widespread and has become such a significant problem that is has begun to be addressed by the major peer-reviewed medical journals. Many medical journals have initiated stricter ethics codes for publishing research funded by pharmaceutical or medical device-makers, including many journals that have instituted zero-tolerance policies for study authors with financial ties to drug companies.

However, this doesn't avoid the problem of many studies that produce negative results never being published at all. Added to this is the use of spin to convince readers of a more favorable result.

In a 2009 report, Dr Isabelle Boutron said that more than 40% of studies with negative findings were "spun" and even in trials with favorable outcomes, 49% of phrases considered to be positive "spin" weren't accompanied by any mention of a statistically significant result.

The researchers defined spin as an attempt to "convince the reader that the treatment is important" even though the trial had nonsignificant findings.

Another problem can be the mismatch between what is reported in the media from a study, or even between an abstract and the rest of the paper. If possible don't just rely on reading an abstract as they can mislead and conclusions drawn may not match the actual results of research.

For example, in a 1998 study of the efficacy of the hepatitis B vaccine in Gambia, the researchers found that, 14 years after administration of the vaccine 37.4% of participants in the study in had been infected, and of the uninfected, 36% had undetectable levels of antibodies. In total, 61% of the adolescents and young adults had no immunity to hepatitis B only 14 years following vaccination. Incomprehensibly, the authors concluded in the paper and the abstract of the paper that vaccine efficacy was remarkably well maintained. Only by reading the full paper was it clear that the vaccine had a very low efficacy. No refusal to publish here, just conclusions that are diametrically opposed to the facts.

More Fraudulent Activity from Vaccine manufacturers
Major vaccine manufacturer GlaxoSmithKline has recently plead guilty in a massive fraud case. They have been fined $3 billion for bribing doctors with, “lavish trips and spa treatments in order to pursuade them to prescribe the drug for uses not approved of through testing.”
”Glaxo also hired a company to write a medical journal article downplaying the risks. The company admitted illegally marketing the popular antidepressants Paxil and Wellbutrin and also withholding the data on the health risks of its best-selling diabetes drug, Avandia. For seven years Glaxo failed to report data showing drug Avandia increased the risk of heart attack by as much as 40 per cent.” 22
Another major vaccine manufacturer Merck has been accused by two of their own scientists of trying to...
"...defraud the United States through Merck’s ongoing scheme to sell the government a mumps vaccine that is mislabeled, misbranded, adulterated and falsely certified as having an efficacy rate that is significantly higher than it actually is." 23
I hope this info has answered some of the questions that linger around in vaccination debates. I know there's plenty more questions, so I'll continue researching.

Sources:

1. Thimerosal in Vaccines

2. Mercury in Vaccines Chart, FDA

3. New Zealand Immunisation Schedule, New Zealand Ministry of Health

4. Thimerosal in Vaccines

5. Risk of neurologic and renal impairment associated with thimerosal containing vaccines
Thomas Verstraeten et al, 2000

6. National Vaccine Injury Compensation Program

7. Changes in the California Caseload An Update: June 1987 – June 2007
Andrew T. Cavagnaro, Ph.D.

8. Autism: A Unique Type of Mercury Poisoning
Sallie Bernard et al, 2000

9.A comprehensive review of mercury provoked autism
D.A. Geier, 2008

10.A Case Series of Children with Apparent Mercury Toxic Encephalopathies Manifesting with Clinical Symptoms of Regressive Autistic Disorders,&nbsp, David A. Geier et al, 2007

11. HEPATITIS B VACCINATION OF MALE NEONATES AND AUTISM DIAGNOSIS
NHIS 1997–2002

12. A positive association found between Autism prevalence and childhood vaccination uptake across the U.S. population
Gayle Delong, 2011

13.Biomarkers of environmental toxicity and susceptibility in autism

14. HEPATITIS B TRIPLE SERIES VACCINE AND DEVELOPMENTAL DISABILITY IN US CHILDREN AGED 1‐9 YEARS

15. Dissecting a Thimerosal Study
Heidi Stevenson
16. Making an Informed Decision
17. Do aluminum vaccine adjuvants contribute to the rising prevalence of autism?
Lucija Tomljenovic et al. J Inorganic Biochemistry Vol 105, Issue 11, 2011, Pg 1489–1499
18. Administration of aluminium to neonatal mice in vaccine-relevant amounts is associated with adverse long term neurological outcomes. Shaw CA, et al. J Inorg Biochem. 2013 Jul 19. pii: S0162-0134(13)00177-3.
19. Aluminum in the central nervous system (CNS): toxicity in humans and animals, vaccine adjuvants, and autoimmunity. Shaw CA, et al. Immunol Res. 2013 Jul;56(2-3):304-16. 
20. Empirical Data Confirm Autism Symptoms Related to Aluminum and Acetaminophen Exposure
Stephanie Seneff, et al. Entropy, November 7, 2012

21. A possible Central Mechanism in Autism Spectrum disorders, Part 1,2 & 3
Russell L Blaylock. Altern Ther Health Med. 2008 Nov-Dec;14(6):46-53.

22. GlaxoSmithKline fraud case: Does crime pay?

Other sources:

Autism - Statistics, Incidence, Prevalence, Rates
by Thoughtfulhouse.org

Critique of CDC's Thimerosal Study
by Thoughtfulhouse.org

by CALIFORNIA DEPARTMENT OF DEVELOPMENTAL SERVICES

by Generation Rescue

Baby Led Latching

Baby Led Latching

The concept of 'Baby Led Latching' is so endearing and natural. It's the opposite of the techniques I experienced in hospital with my son – the second my newborn dared to open his little mouth the attending nurse would grab my breast and shove it in his little mouth. I get the importance of a deep latch when breastfeeding, but the roughness just felt wrong and unnecessary (and it's not a sight you'll ever see in nature).

In my opinion, getting the right latch can be made unnecessarily stressful by over bearing nurses or lactation consultants (though I know there are so many fantastic professionals out there). The basis of baby led latching is to provide baby with a calm, relaxed environment, allowing him to follow his own instincts – no rush, no pressure.

Babies aren't the helpless beings they're made out to be, they're a lot smarter than we give them credit for. They come equipped with reflexes that help them find and attach to the breast:

  • Getting to the breast: stepping and crawling motions
  • Finding the breast: searching and rooting
  • Attaching: rooting and opening
  • Sucking: stimulated by the presence of the nipple at the palate

Allow baby the opportunity and support to use his instinctive reflexes and you'll be pleasantly surprised. Dr. Smillie, a pediatrician, lactation consultant, and baby led latching advocate puts it perfectly:

"I tell moms their job is not to "make" the baby latch, but simply to "allow" the baby to latch."

Baby led latching is particularly helpful for newborn babies who are learning to latch, or for babies that have been put off breastfeeding by negative experiences. For them it's important to allow the full sequence of instinctive reflexes to unfold, where one behaviour leads to the next.


The basic steps of baby led latching
    1. Start with a calm (even sleeping) baby
    Start with baby either sleeping or in a quiet, alert state. If baby is really hungry, feed him a little milk first to take the edge off (1/2 to 1 oz). If sleeping, let the baby wake up on his own.

    2. Get relaxed and comfortable together
    Hold and cuddle baby, skin to skin – baby in a diaper only, mother with no shirt or bra. Hold baby upright (vertically versus horizontally) between breasts – support baby's neck with one hand, and support his bottom with the other. This position promotes both relaxation and alertness in baby, and is something we naturally do to comfort a distressed baby. Just cuddle together for a while.

    3. Let baby take the lead
    There's no rush, no pressure. You're on baby time here. If the baby wants to sleep on mom's chest, let the baby sleep. It is important for both baby and mother to be calm, alert, and comfortable. If either one isn't calm, then the anxiety will be communicated to the other and sabotage the feeding attempt.

    4. Recognize baby's 'hungry cues'
    When baby is hungry he'll squirm and twist, bob his head against you, or may look up at your face and make eye contact.

    5. Support baby as he moves around
    Support his neck and shoulders with one hand and his hips with the other, and just follow him as he moves. Avoid the temptation to try to make him latch on or even to try to line up his mouth with the nipple.

    6. Support baby as he latches
    As the baby moves down, his lower cheek might brush the nipple or the breast and that makes him turn towards it — the rooting reflex. When baby's chin hits the breast, the firm pressure of the breast against his chin makes him open his mouth wide and reach up and over the nipple. As the baby approaches the nipple, it is his nose, not his mouth, that will first be positioned over the nipple. As he presses his chin into the breast and opens his mouth, he'll get a large mouthful of breast and a deep latch.

    7. Reposition baby as needed
    Nipple pain is a guide indicating you need to adjust baby's position. If the pain is mild you can adjust the baby's position without unlatching — usually by pulling the baby's bottom in more snugly, which moves the baby's whole body and the baby's head will tip back a little bit more, allowing his jaw to open wider. This way the baby gets a bigger mouthful of breast.

    8. Be patient, especially when the baby gets frustrated and upset
    Calm the baby by talking in soothing tones. Bring baby back to the vertical, midline position.When baby calms, then start again. If baby is too hungry to try again, then feed a small amount of milk to the baby via cup, spoon, syringe, or finger-feeding tube (which ever baby prefers).

    The Breast Crawl
    Here's a great clip of a latching technique called the "Breast Crawl". It's a chance to see the amazing reflexes a newborn is born with, mentioned earlier. Many of the same principals apply to the breast crawl as in baby led latching, but it's practiced lying down, and usually takes place immediately after birth. Though the instinctive crawling reflex is still present in babies up to several weeks after birth.



    Sources:
    Baby-led Latching: A "intuitive" approach to learning how to breastfeed
    By Mari E Douma, DO