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The mischievous grandma.
The young revolutionary.
The mischievous grandma.
The young revolutionary.
Would you look at his smile!!! Even his eyes are smiling!
SLG, I don't know anything about taking infants to high altitude from zero, so you'd have to look it up - I mean, babies live at altitude, but how long would they adapt? I know our younger was taken to this height at age of 7 and had headache and threw up, but that could be him. Although at the same time it never happened again.
Europeans rocks:)
Awwww, what a cute pic of the Bois!! He just gets cuter by the day! :-)
Oh, and I read on SR's blog that you're running a HM this weekend. Funny, because I am running my FIRST HM this weekend, too!!! Of course, you guys will beat the pants off me (because I am soooooooo slow!!!), but that's OK. Sometimes it's about the journey, not how fast you finish, you know?
Good luck this weekend!
Cute picture!!!!!!
I just googled altitude and infants:
Sounds like you would need to make sure he doesn't turn blue.
Oh, and look out for dingos. ;)
SLG, try to keep busy while SR is away-time will pass quickly...and don't be upset if you cook something that is not so fancy. That kid is so cute.
Olga-you don't look old enough to have kids. LOL! Child bride?
Meghan said: When will these human beings simply put their heads down and do their own life? What makes them so anxious to sniff around in the business of others so seemingly judgmentally?
OK, let's do a reality check here. It's not like we (meaning those of us who posted negatively about the bike trailer incident) read your diary or something. You're posting on a PUBLIC BLOG. So you're implicitly inviting anyone/everyone to read this, including the nutjobs!
You are obviously interested in publicly sharing your life, your opinions, your choices or you wouldn't be blogging. And you do not strike me as a fool, so I know you must know that many of your choices are controversial, so of course people are going to disagree with them. And when the issues are very emotional ones like child safety, you can bet that people are going to react very strongly.
While I'm not condoning rude or nasty comments, I think you should expect them. Anything else is just naive.
Sea Legs,
This is a really adorable post. There is just love going in every direction. The smiling Bois in the last picture is like the cherry on top, soabsolutelyadorable. He looks like SR, I think. What do you think? I hope SR arrives home shortly and safely.
I agree that folks are free to read (and criticize) as they please on these public blogs we do.
What I think just plain sucks is the way folks talk about Sea Legs over on Runango. To put it bluntly, the things people have said about Sea Legs over there aren't socially acceptable in the real world, non-online version of human interaction. What makes it okay, then, in the online world, to pass judgement without full knowledge, to call Sea Legs rude and foul words, and to critize with nary an iota of constructiveness? If people can't behave in a civilized manner, then I do think they should keep their heads down and mind their own business.
My personal opinion, though, Runmomma. If people are going to act in a socially unacceptable way (as they are entitled to do), I'm going to point it out. Especially when it happens with someone I am connected to, like Sea Legs.
For whatever it's worth, people seem to make rather constructive commentary here on Sea Leg's blog (Or at least that's what I see. Who knows what kinds of comments Sea Legs has had to delete?), it's over on Runingo where I saw it get really nasty.
Hey, Sea Legs,
I just saw SR's race report on his blog. You two rocked that HM! Great, great job!! :-)
Hope you post a race report, too!
Meghan - I assumed that your comments must be pertaining to what was being said here on this blog. I don't know about what folks "over on Runango" have been saying so I have no opinion on that.
But I still maintain that if you publish something in a public forum, you must be prepared roll with whatever people decide to say about it, be it constructive, rude, socially acceptable, or otherwise.
Just as those folks "over on Runango" have to roll with whatever you say about them over here.


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In our operations and our products, environmental sustainability is a top priority. At every opportunity, we strive to reduce our use, make smarter choices, and do our part for a greener tomorrow.
In our products, we are striving to eliminate the use of heavy metals and toxic substances. Our comprehensive Green Policy requires our suppliers restrict or eliminate use of these chemicals, and we work closely with regulatory organizations to report this information. To monitor compliance, we conduct periodic lab testing and supplier audits. We have also made significant efforts to minimize our packaging. Our warranty and quick start guides are now found online. And we use materials that are easy to recycle."
Our products meet applicable worldwide environmental regulations and requirements, including the European Union Restriction of Hazardous Substances (EU RoHS) and the European Union Regulation, Evaluation, and Authorization of Chemicals (EU REACH).
We strive to maximize operational efficiency while minimizing environmental impact at our facilities worldwide.
We conducted our first Carbon Disclosure Project (CDP) assessment in 2011, which showed us on par with other industry leaders.
We conducted our second CDP assessment in 2012, with significant improvements in the areas of governance, verification, emission management, and reporting. We will continue to strive to become a CDP leader in the future. Read our full CDP disclosure.
Aligning our business goals with our green initiatives is an ongoing emphasis. We advance green IT through technology selection, architecture, and employee use of technology throughout the company.

subset: commoncrawl


text:
Welcome to the Fine Seafood Company
We make the highest quality Seafood Products from our purpose built factory near London. Our products are pre-packed for sale in retail shops across the south, a list of our stockists are shown.Find Out More
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text:
On January 16, 2012 I looked like this:
|BEFORE: No idea why I am wearing pink undies on the internet.
Chest: 102cm; Waist: 99cm; Thigh: 83cm
|AFTER: Still in pink undies and now with added crazy
CHEST: 94cm; WAIST: 87cm; THIGH: 64cm
I wrote about my Bali Blowout. It wasn't really the 700g or so I gained that was the problem though. It was the fact that I had a taste of free-eating, and I had exactly the same pattern as I did before the program. I seemed to be able to forget about healthy eating, listening to my hunger cues or eating to a schedule.
I just seem to be able to block out sensible eating. When it suits me. I seem to be able to go into a trance and ignore myself. I refuse to get on the scales too. Another sign of denial. If I don't weigh myself, maybe it won't count?
And so when I got home, I initially lost the Bali weight. I was 74.8kg the next week. Then we had Easter. And Nugget's 7th birthday. And my niggly hip issue became an actual problem so I couldn't exercise without ridiculous amounts of pain. And it rained. And I got really stressed at work. And before too long, I had gone from the odd chocolate here, to a couch potato with a regular night time snacking habit and a hell of a lot of excuses.
So hard to stop. So bloody easy to start again.
I completed the challenge at 75.6kg. A total weight loss of 11 kilos (which is fantastic). The program works. It really does. It is just that my issues with food aren't really about being able to lose some weight. I have done that successfully now, and before too. It is about maintaining weight loss. It is about redefining my relationship with food. I know the Food Patrol can help me with this. I just have to get back into the head space. And it has to be about more than 90 days.
So if you think about it, I have now had a few weeks off the program if you count the weeks during the challenge where I actually put on weight and ate crap. I am already feeling the heady out of control feeling I get when I spiral downwards and pack on weight.
So it stops today. All the denial.
I woke up today and I thought, write the damned post. Admit you are out of control again, and get back on the program. Get back on the horse. Finish the damn job.
So I am. Today is Day 1. I am determined to kick this butt's butt.
Thanks so much for the Food Patrol for sponsoring And then there were four during this challenge. You had helped me in more ways than I can say :-)


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Always enter the Court assigned ECF user login and password first. If prompted for a login and password again, enter the PACER login and password. This fixes many problems.
Internet Explorer
- From the menu click on Tools --▸Internet Options
- On the General tab under the Temporary Internet Files heading, clock on the Settings button
- Make sure Every Visit to the Page is selected under Check for Newer Versions of Stored Pages
- Click OK button
- Click OK button
ECF Free Document First Look
- If the document is in a Criminal, Magistrate or Social Security case, or any document with security, when you click on the link for the document for the first time, you will be prompted to login to the ECF/Pacer account. LOGIN USING YOUR ECF ACCOUNT LOGIN AND PASSWORD. This should take you straight to the document – this is your free look. If you use your PACER account login and password, you will lose your free look, and will have to take up any billing disputes with the PACER company.
- If the document is for a non-Social Security civil case, when you click on the document link for the first time, it should take you straight to the document without asking for a login. This is your free look.
- If you click on the case number link that takes you to the docket you will receive a login prompt. You should login with your pacer account login and password. You do not get a free look at a docket sheet. YOU WILL BE CHARGED.
- If you login to ECF or PACER without using the e-mail link, YOU WILL BE CHARGED.
How to tell what type of case it is:
- Criminal - The case number will contain a "cr" (i.e. 4:06CR941)
- Magistrate - The case number will contain a "mj" (i.e. 4:06MJ00941)
- Civil - The case number will contain a "cv" (i.e. 4:06CV941)
When you click on the document number and are taken to a login screen
- If the case is a Criminal, Magistrate or Social Security case, or a document with security, first login using your Court assigned ECF login and password
- If you have already viewed the case using the link in the e-mail, you will be charged for this subsequent look.
Viewing Restricted documents
- You must be logged in with your e-filing login, when viewing restricted documents. If you do not login with your e-filing login, CM/ECF will not know who you are and will not recognize you as a authorized user. The PACER login will only give you access to public documents and entries. It is recommended that you always login with your e-filing login and if you are required to pay for viewing a document or docket sheet, you will be prompted for a PACER login. You should then login with you PACER information.
When you click on the document number link and nothing happens.
- his happens sometimes with AOL users. If you are using AOL mail and the AOL browser, you will have to change your e-mail notification from HTML to text
- Occasionally something will have been docketed in error and then deleted by the Court. The attorney will receive an NEF with the document number in it. When you click on the document number, you will receive an error because it no longer exists. You should login and look at the docket sheet. When a docket entry has been deleted there should be a follow-up entry explaining why it was deleted. The attorney should also get an e-mail for this entry.
When I click on the document link, my Acrobat Reader says it can't display the file.
Make sure you have the most current version of Acrobat Reader.
Internal Error 47
- This error is the result of a docket entry being done incorrectly. Make sure you fill all necessary fields and select the appropriate options.
While docketing you are prompted for a PACER login
- This usually is due to the user clicking on the hyperlink for the case instead of clicking on the NEXT button. After choosing an event to docket and entering the case number, the next screen will have a hyperlink with a NEXT and CLEAR button underneath it. You should click on the NEXT button instead of the hyperlink.


text:
|Click Me For New Forum
|This forum is now a read only archive. You can view the contents but you will not be able to make new posts and registration is closed to new members. Please visit our new forum at www.aranockonline.com/forum where our community is now based. Thank you for your patience!


text:
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text:
San Francisco 49ers linebacker Ahmad Brooks said he suffered a left shoulder sprain during the team's NFC Championship Game victory over the Atlanta Falcons, but he's confident he'll play Sunday against the Baltimore Ravens in Super Bowl XLVII.
Brooks said he has a Grade 1 acromioclavicular joint sprain in the shoulder, which he suffered in the second quarter against the Falcons. He said he tweaked his shoulder again near the end of the game when he hit Falcons quarterback Matt Ryan.
Brooks said he could have played last Sunday if there was a game and that he missed some practice time last week.
In 16 games this season, Brooks recorded 34 tackles and 6½ sacks.


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Gloria Rachel Allred (née Bloom; born July 3, 1941(1941-07-03)) is an American lawyer noted for taking high-profile and often controversial cases. She is the mother of former Court TV hostess Lisa Bloom.
Gloria Rachel Bloom was born in a Jewish family in Philadelphia, Pennsylvania, on July 3, 1941. After high school, she attended University of Pennsylvania, where she met her first husband. In 1961, the couple had their only child Lisa and, shortly after, divorced.
Allred moved back in with her parents and continued her education. In 1963, she earned a Bachelor's degree in English, graduating with honors. She tried her hand at a variety of jobs before she decided to become a teacher, taking a position at Benjamin Franklin High School. She began work on a graduate degree at New York University, where she became interested in the civil rights movement, then gaining momentum. After earning a Master's degree, she became a teacher and, in 1966, moved to Los Angeles, California and lived in Watts.


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OJ: The Ultimate Orange Jeep Part 3Posted in Ultimate Adventure: 2012 on October 1, 2012
Every year Editor-in-Chief Rick Péwé leads us on a weeklong on- and off-road adventure through the craziest trails he can find in a random portion of the U.S., and every year we build something new and outrageous to lead the group with. A year ago we built a very cool fullsize 4x4 pickup to lead the Ultimate Adventure ("Ultimate F-150," July '11–Jan. '12). It worked great, but if there was one thing that we would have changed it would have been the size. It had a huge wheelbase, and though capable, it wasn't the best vehicle for weaving through tight trail obstacles. This year we decided a small two-door Jeep Wrangler would be our lead machine wherever Péwé decides to take us, and we'd build it to be nimble to twist around obstacles.
You saw the two-door '12 Wrangler Rubicon being built in Toledo in the Aug. '12 issue ("OJ the Ultimate Orange Jeep," part 1) and then fixed up in Sept. '12 with a Zone 4-inch suspension and 35-inch Nittos. This worked great for trail wheeling in Moab ("Moab Mecca," Aug. '12). It has lockers, GenRight aluminum fenders, and a Warn winch in a Synergy front bumper and easily could have passed tech inspection for the UA. The problem is it would look like every other Jeep on the trail, and we wanted something that would be twice as capable as a standard Jeep JK and somehow stand out from the crowd—a tall order indeed.
Our next step was hauling OJ to the Hazzard Fabworx shop near Spokane. Proprietor Luke Shuman and Employee of the Month (every month) Rocky Dorame listened to our most harebrained idea ever for an Ultimate Adventure build and signed on wholeheartedly. These guys make a living building everything from street-driven diesel trucks to desert-bombing, rock-racing buggies. They aren't afraid of a challenge and were more than willing to help chop our Jeep in half with just 3,000 miles on the odometer.
Our little OJ is getting stretched, a fair bit of body modification too (as you'll see), and most importantly the ability to steer front and rear. Our goal is a Jeep that can weave through trees and boulders like a snake while still cruising down the road like a Jeep just off the showroom floor.


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Most accounts by witnesses and authorities reported that the victims included a teacher at the Ozar Hatorah Jewish school and two of his young children, ages 3 and 6. Another child under 11-years-old was also killed. And one of the injured may have been the daughter of the school principal, according to media reports.
"He shot at everything he could see, children and adults, and some children were chased into the school," local prosecutor Michel Valet was quoted as saying after the attack. No suspects or motives have been identified yet, Valet added.
Witnesses described the scene of horror. "I saw two people dead in front of the school, an adult and a child. Inside, it was a vision of horror, the bodies of two small children,'' a father whose child attends the school was quoted as saying by Reuters. "How can they attack something as sacred as a school, attack children only 60 centimeters (about two feet) tall?''
According to a statement by prosecutors in Paris, the government has launched a terrorism investigation into the shooting. The team will also be probing the recent attacks on military personnel.
Last week, three French paratroopers in the same region were killed in two separate attacks with similar characteristics. A fourth soldier was seriously injured. Both attacks were carried out by a gunman on a motorcycle, and preliminary investigations indicate that the same gun was used in the two incidents.
At least one French newspaper reported that the same caliber weapon was used in all of the murders, including the attack on the children. But it remains unclear whether the killing spree at the Jewish school is linked to the attacks on military targets, officials said.
"There are some similarities but it's much too early to say if there is a real link or not," French President Nicolas Sarkozy was quoted as saying. "Only the police and the judiciary will tell us what conclusions to draw."
Sarkozy and other top officials vowed to pursue the attacker. And security has been increased at Jewish schools throughout France, according to authorities cited in press reports. Soldiers throughout the region have been warned not to wear their uniforms off base.
Jewish groups in France, which has one of the largest populations of Jews in the world at more than 500,000, condemned the attack. Prominent French Jews also suggested the killings were motivated by anti-Semitism.
"For someone to locate this school in a place like Toulouse means he knew what he was doing. He went there to kill Jews," Vice President Gil Taieb of the French Jewish umbrella group CRIF told the Jerusalem Post. "There are occasional anti-Semitic attacks but they are small, nothing like this. We haven't had something like this in at least ten years."
The Israeli government spoke out about the tragedy, too. "We are horrified by this attack and we trust the French authorities to shed full light on this tragedy and bring the perpetrators of these murders to justice," Israeli Foreign Ministry spokesman Yigal Palmor was quoted as saying by the AFP news agency.
Sarkozy and his opponent in the upcoming presidential race were both reportedly on their way to the crime scene. At least 50 police officers and multiple top officials are working on the case.
Photo: French President Nicolas Sarkozy, center, speaks in front of the Ozar Hatorah Jewish school following a shooting incident in Toulouse, southwestern France, March 19, 2012: AP Images


text:
Games support
Add a game to home
How to add a game tile to your home in Xbox.
Broadcast your game
How to stream your Xbox gameplay on the Mixer channel through your console or mixer.com.
Find your games and apps
How to locate your games and apps on the console.
Create a tournament
How to create a multiplayer tournament for Xbox games.


text:
Better Blokes Peer Support Groups are weekly meetings of men recovering from the affects of childhood trauma-:emotional ,verbal, physical and sexual abuse facilitated by a man who also has experienced childhood sexual trauma.
The meetings are held in three Auckland locations: Henderson , Three Kings and Papatoetoe. There is one Northland meeting held in Whangarei.
The number of men that can be accommodated at each peer support group is limited to eight.
Contact Us for More Information: 09 889 2553 or 021 174 9252
The foundation of the Peer Support Group is the:
Peer Support Group Guidelines
A support group of this nature needs guidance in order to achieve its goals and to help members understand how the group works. All members joining the group must agree to the following guidelines, although the guidelines are open to modification. The guidelines of the group are as follows:
• No comment to another man's sharing during or after the meeting unless he asks for feedback, or unless you ask and he says yes to feedback.
• The support group is not an "open group". Anyone wanting to attend will first speak with the contact person.
• Confidentiality must be maintained. No names or identifying information about members can be used outside the group.
• Anyone who, as an adult, has sexually abused a child cannot attend the support group.
• Alcohol or other drugs are not to be consumed immediately before or during the group meeting. Cigarette smoking is not permitted inside.
• Members may not discriminate against each other and to the best of your ability give acceptance to each man's: –
Racial and cultural identity.
Belief system.
Sexual orientation.
• In this support group there is no dominant race, culture, sexual orientation, belief system or spiritual practice.
• If you want to offer comfort to someone please ask how they would like you to show that support. Avoid uninvited physical contact.
• Meetings will start on time.
• Sexualised contact with the other members during the life of the group is to be avoided.
• No violence between group members.
• Members will take responsibility for themselves, their opinions and feelings by using "I" language. Generalisations about other groups or individuals in the community should be avoided where possible.
• Members unable to attend should inform a facilitator or another member beforehand.
• Any contact outside of the group, including phone calls, is mentioned at the next meeting to avoid secrecy.
• For the safety of the group there will be no admittance to this support group after 8:10pm.
• This is a sharing group – not for raging or screaming. Sharing about angry feelings is welcome here. If you need to do cathartic work with anger, this can be done outside of the group.
• If you feel a guideline has been broken please say "Guidelines" and we will have an open group discussion.
• If conflict arises between members during a meeting that is proving difficult to resolve, each man will be given an agreed time (5mins) to express their views without interruption or comment from other members. At the conclusion of this round members will indicate as to whether the meeting can continue as per the meeting plan.
• You may leave a meeting at any time but be aware a facilitator will contact you at the conclusion of the meeting to check on your wellbeing.


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Tuesday, April 6, 2010
Mild Jackassery
In a rare deviation from football, I recently attended the first round of the NCAA tournament in Milwaukee with some beanbag-tossing cohorts. The first thing everybody pointed out was that the Bradley Center wasn't serving alcohol. We all had done our homework. So we pooled some money and went on a fast and furious booze run, clearing out the liquor store's selection of airplane bottles minus the gin.
Getting through security at the game was a breeze thanks in part to our good friend, Dingleberry. His ingenious plan of duct-taping the bottles to his leg and then wrapping bunch of Ace bandages over it and limping in as if he got hit by a car totally worked. Once in, we maneuvered through the crowd to the nearest bathroom where we unwrapped Dingleberry and divvied up the goods. I ended up with ten Jagermeisters, seven Absolute Citrons, some Jameson and a Sex on the Beach (nice!) for the day. I was set.
Unfortunately, it was probably the most boring first round in the entire tournament but the group was content to enjoy ourselves with some outrageous banter, numerous bets and the occasional nudie pic courtesy of Woody and his fancy iPhone. As the empty bottles piled up, we got louder and more obnoxious (shocking). Then, as we were discussing the cheerleaders at the concession area, Dingleberry interjects, "There's AJ Hawk!"
Sure enough, #50 and his unmistakable medieval warrior hair walked right by us. My whole world turned upside down. It was the last place I would think to see a Packer. But then again, his alma mater Ohio State was playing. Of course!
"AJ!!" I blasted. He looked and I froze. "Um…2010! Best…year…EVER!" He continued walking without a reaction.
I immediately came to the realization I was Drunk Fan. You know, the one who screams whatever comes to mind because the alcohol had dissolved the verbal filter he once had. I felt especially bad doing this to one of the Packers. Any other team/player, fine. But not one of our own. When the players talk about Green Bay and living in Wisconsin, it's not uncommon for them to mention that community all knows who they are but let them go about their business without making a deal out of their celebrity. No one else among the hundred crowded in the concession area bothered Hawk. Just me.
Woody then noted he heard Rodgers was in the building, too.
"WHERE??!!" I demanded to know. Surely I could've prepared something better for him.
10 comments:
- AnonymousApril 6, 2010 at 10:34 AM
I've put some thought into this, and if you get into your hot tub time machine, you could go back and yell out Packerranter.com! Maybe that would have gotten a reaction. Maybe he's a loyal reader?ReplyDelete
awesome postReplyDelete
I have the same kind of story only on a much crappier scale. I was at at Cubs game (I live in the dasterdly town) and CBS 2 sports guy Tim Weigel walked by rather quickly.ReplyDelete
I said: "HEY YOU ARE THAT GUY!"
He said: "Yeah yeah I am"
He passed away of brain cancer like a year later.
LOL. It's not your fault.ReplyDelete
- AnonymousApril 6, 2010 at 9:23 PM
Don't be so sureReplyDelete
- for shizzleApril 7, 2010 at 2:13 PM
So ominous!ReplyDelete
Moral of the story? Committing an act of mild jackassery never ends on a positive note.
On the other hand, some might consider "2010! Best... year... EVER" to be a positive note. I mean, best year ever?! That would be a pretty good year! Athough 1984 was a pretty good year too; I think someone wrote a book about it.
I saw Big Papi at Oneida Casino the night before the Packer/Viking game this past season. He was being led into the high roller lounge while I was ordering a couple Spotted Cows. Good thing Robert was in the can, or who knows what he would have yelled.ReplyDelete
- Pashaww!!April 8, 2010 at 11:19 AM
Good point Shizzler. 2010 could very well shape up to be the "best... year... EVER!"ReplyDelete
Like every year, 2010's rating will come down to pad-level.
Pad-level, of course, speaks to conditioning, flexibility and strength, but mostly the will to win!
Will-to-win, as everyone knows, is fed 60-40 by a deep seated insane desire to inflict violence on others, and fan support.
Fan Support = Franklin in front of the tube, alone in the dark on his couch, shirtless, cutting slices off a block of cheese the size of a car batter that rests on his belly, screaming "CLOCK MANAGEMENT!"
Robert's inner-voice rising up like a 47 year-old biker chick hurling her panties on stage at a Nugent concert at the Dodge County Fair.
I thank you both for your efforts.
I'm pretty sure Robert and I were out in downtown Appleton in the late 90's and saw some of the Super Bowl crew at the "club." One of them might have been Gilby B. These men were far to enormous for me to yell out anything absurd. I'd feel more comfortable now, day 25, P90X, definite results.ReplyDelete
- PackersRSApril 10, 2010 at 11:59 PM
You know what... You should've shouted Lightning Bolt...ReplyDelete


text:
Breastfeeding and the Use of Human Milk
Considerable advances have occurred in recent years in the scientific knowledge of the benefits of breastfeeding, the mechanisms underlying these benefits, and in the clinical management of breastfeeding. This policy statement on breastfeeding replaces the 1997 policy statement of the American Academy of Pediatrics and reflects this newer knowledge and the supporting publications. The benefits of breastfeeding for the infant, the mother, and the community are summarized, and recommendations to guide the pediatrician and other health care professionals in assisting mothers in the initiation and maintenance of breastfeeding for healthy term infants and high-risk infants are presented. The policy statement delineates various ways in which pediatricians can promote, protect, and support breastfeeding not only in their individual practices but also in the hospital, medical school, community, and nation.
Extensive research using improved epidemiologic methods and modern laboratory techniques documents diverse and compelling advantages for infants, mothers, families, and society from breastfeeding and use of human milk for infant feeding.1 These advantages include health, nutritional, immunologic, developmental, psychologic, social, economic, and environmental benefits. In 1997, the American Academy of Pediatrics (AAP) published the policy statement Breastfeeding and the Use of Human Milk.2 Since then, significant advances in science and clinical medicine have occurred. This revision cites substantial new research on the importance of breastfeeding and sets forth principles to guide pediatricians and other health care professionals in assisting women and children in the initiation and maintenance of breastfeeding. The ways pediatricians can protect, promote, and support breastfeeding in their individual practices, hospitals, medical schools, and communities are delineated, and the central role of the pediatrician in coordinating breastfeeding management and providing a medical home for the child is emphasized.3 These recommendations are consistent with the goals and objectives of Healthy People 2010,4 the Department of Health and Human Services' HHS Blueprint for Action on Breastfeeding,5 and the United States Breastfeeding Committee's Breastfeeding in the United States: A National Agenda.6
This statement provides the foundation for issues related to breastfeeding and lactation management for other AAP publications including the New Mother's Guide to Breastfeeding7 and chapters dealing with breastfeeding in the AAP/American College of Obstetricians and Gynecologists Guidelines for Perinatal Care,8 the Pediatric Nutrition Handbook,9 the Red Book,10 and the Handbook of Pediatric Environmental Health.11
Child Health Benefits
Human milk is species-specific, and all substitute feeding preparations differ markedly from it, making human milk uniquely superior for infant feeding.12 Exclusive breastfeeding is the reference or normative model against which all alternative feeding methods must be measured with regard to growth, health, development, and all other short- and long-term outcomes. In addition, human milk-fed premature infants receive significant benefits with respect to host protection and improved developmental outcomes compared with formula-fed premature infants.13–22 From studies in preterm and term infants, the following outcomes have been documented.
Infectious Diseases
Research in developed and developing countries of the world, including middle-class populations in developed countries, provides strong evidence that human milk feeding decreases the incidence and/or severity of a wide range of infectious diseases23 including bacterial meningitis,24,25 bacteremia,25,26 diarrhea,27–33 respiratory tract infection,22,33–40 necrotizing enterocolitis,20,21 otitis media,27,41–45 urinary tract infection,46,47 and late-onset sepsis in preterm infants.17,20 In addition, postneonatal infant mortality rates in the United States are reduced by 21% in breastfed infants.48
Other Health Outcomes
Some studies suggest decreased rates of sudden infant death syndrome in the first year of life49–55 and reduction in incidence of insulin-dependent (type 1) and non–insulin-dependent (type 2) diabetes mellitus,56–59 lymphoma, leukemia, and Hodgkin disease,60–62 overweight and obesity,19,63–70 hypercholesterolemia,71 and asthma36–39 in older children and adults who were breastfed, compared with individuals who were not breastfed. Additional research in this area is warranted.
Maternal Health Benefits
Important health benefits of breastfeeding and lactation are also described for mothers.83 The benefits include decreased postpartum bleeding and more rapid uterine involution attributable to increased concentrations of oxytocin,84 decreased menstrual blood loss and increased child spacing attributable to lactational amenorrhea,85 earlier return to prepregnancy weight,86 decreased risk of breast cancer,87–92 decreased risk of ovarian cancer,93 and possibly decreased risk of hip fractures and osteoporosis in the postmenopausal period.94–96
Community Benefits
In addition to specific health advantages for infants and mothers, economic, family, and environmental benefits have been described. These benefits include the potential for decreased annual health care costs of $3.6 billion in the United States97,98; decreased costs for public health programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)99; decreased parental employee absenteeism and associated loss of family income; more time for attention to siblings and other family matters as a result of decreased infant illness; decreased environmental burden for disposal of formula cans and bottles; and decreased energy demands for production and transport of artificial feeding products.100–102 These savings for the country and for families would be offset to some unknown extent by increased costs for physician and lactation consultations, increased office-visit time, and cost of breast pumps and other equipment, all of which should be covered by insurance payments to providers and families.
Although breastfeeding is optimal for infants, there are a few conditions under which breastfeeding may not be in the best interest of the infant. Breastfeeding is contraindicated in infants with classic galactosemia (galactose 1-phosphate uridyltransferase deficiency)103; mothers who have active untreated tuberculosis disease or are human T-cell lymphotropic virus type I–or II–positive104,105; mothers who are receiving diagnostic or therapeutic radioactive isotopes or have had exposure to radioactive materials (for as long as there is radioactivity in the milk)106–108; mothers who are receiving antimetabolites or chemotherapeutic agents or a small number of other medications until they clear the milk109,110; mothers who are using drugs of abuse ("street drugs"); and mothers who have herpes simplex lesions on a breast (infant may feed from other breast if clear of lesions). Appropriate information about infection-control measures should be provided to mothers with infectious diseases.111
In the United States, mothers who are infected with human immunodeficiency virus (HIV) have been advised not to breastfeed their infants.112 In developing areas of the world with populations at increased risk of other infectious diseases and nutritional deficiencies resulting in increased infant death rates, the mortality risks associated with artificial feeding may outweigh the possible risks of acquiring HIV infection.113,114 One study in Africa detailed in 2 reports115,116 found that exclusive breastfeeding for the first 3 to 6 months after birth by HIV-infected mothers did not increase the risk of HIV transmission to the infant, whereas infants who received mixed feedings (breastfeeding with other foods or milks) had a higher rate of HIV infection compared with infants who were exclusively formula-fed. Women in the United States who are HIV-positive should not breastfeed their offspring. Additional studies are needed before considering a change from current policy recommendations.
Certain conditions have been shown to be compatible with breastfeeding. Breastfeeding is not contraindicated for infants born to mothers who are hepatitis B surface antigen–positive,111 mothers who are infected with hepatitis C virus (persons with hepatitis C virus antibody or hepatitis C virus-RNA–positive blood),111 mothers who are febrile (unless cause is a contraindication outlined in the previous section),117 mothers who have been exposed to low-level environmental chemical agents,118,119 and mothers who are seropositive carriers of cytomegalovirus (CMV) (not recent converters if the infant is term).111 Decisions about breastfeeding of very low birth weight infants (birth weight <1500 g) by mothers known to be CMV-seropositive should be made with consideration of the potential benefits of human milk versus the risk of CMV transmission.120,121 Freezing and pasteurization can significantly decrease the CMV viral load in milk.122
Tobacco smoking by mothers is not a contraindication to breastfeeding, but health care professionals should advise all tobacco-using mothers to avoid smoking within the home and to make every effort to wean themselves from tobacco as rapidly as possible.110
Breastfeeding mothers should avoid the use of alcoholic beverages, because alcohol is concentrated in breast milk and its use can inhibit milk production. An occasional celebratory single, small alcoholic drink is acceptable, but breastfeeding should be avoided for 2 hours after the drink.123
For the great majority of newborns with jaundice and hyperbilirubinemia, breastfeeding can and should be continued without interruption. In rare instances of severe hyperbilirubinemia, breastfeeding may need to be interrupted temporarily for a brief period.124
Data indicate that the rate of initiation and duration of breastfeeding in the United States are well below the Healthy People 2010 goals (see Table 1). 4,125 Furthermore, many of the mothers counted as breastfeeding were supplementing their infants with formula during the first 6 months of the infant's life.5,126 Although breastfeeding initiation rates have increased steadily since 1990, exclusive breastfeeding initiation rates have shown little or no increase over that same period of time. Similarly, 6 months after birth, the proportion of infants who are exclusively breastfed has increased at a much slower rate than that of infants who receive mixed feedings.125 The AAP Section on Breastfeeding, American College of Obstetricians and Gynecologists, American Academy of Family Physicians, Academy of Breastfeeding Medicine, World Health Organization, United Nations Children's Fund, and many other health organizations recommend exclusive breastfeeding for the first 6 months of life.‡2,127–130 Exclusive breastfeeding is defined as an infant's consumption of human milk with no supplementation of any type (no water, no juice, no nonhuman milk, and no foods) except for vitamins, minerals, and medications.131 Exclusive breastfeeding has been shown to provide improved protection against many diseases and to increase the likelihood of continued breastfeeding for at least the first year of life.
Obstacles to initiation and continuation of breastfeeding include insufficient prenatal education about breastfeeding132,133; disruptive hospital policies and practices134; inappropriate interruption of breastfeeding135; early hospital discharge in some populations136; lack of timely routine follow-up care and postpartum home health visits137; maternal employment138,139 (especially in the absence of workplace facilities and support for breastfeeding)140; lack of family and broad societal support141; media portrayal of bottle feeding as normative142; commercial promotion of infant formula through distribution of hospital discharge packs, coupons for free or discounted formula, and some television and general magazine advertising143,144; misinformation; and lack of guidance and encouragement from health care professionals.135,145,146
Pediatricians and other health care professionals should recommend human milk for all infants in whom breastfeeding is not specifically contraindicated and provide parents with complete, current information on the benefits and techniques of breastfeeding to ensure that their feeding decision is a fully informed one.147–149
When direct breastfeeding is not possible, expressed human milk should be provided.150,151 If a known contraindication to breastfeeding is identified, consider whether the contraindication may be temporary, and if so, advise pumping to maintain milk production. Before advising against breastfeeding or recommending premature weaning, weigh the benefits of breastfeeding against the risks of not receiving human milk.
Peripartum policies and practices that optimize breastfeeding initiation and maintenance should be encouraged.
Education of both parents before and after delivery of the infant is an essential component of successful breastfeeding. Support and encouragement by the father can greatly assist the mother during the initiation process and during subsequent periods when problems arise. Consistent with appropriate care for the mother, minimize or modify the course of maternal medications that have the potential for altering the infant's alertness and feeding behavior.152,153 Avoid procedures that may interfere with breastfeeding or that may traumatize the infant, including unnecessary, excessive, and overvigorous suctioning of the oral cavity, esophagus, and airways to avoid oropharyngeal mucosal injury that may lead to aversive feeding behavior.154,155
Healthy infants should be placed and remain in direct skin-to-skin contact with their mothers immediately after delivery until the first feeding is accomplished.156–158
The alert, healthy newborn infant is capable of latching on to a breast without specific assistance within the first hour after birth.156 Dry the infant, assign Apgar scores, and perform the initial physical assessment while the infant is with the mother. The mother is an optimal heat source for the infant.159,160 Delay weighing, measuring, bathing, needle-sticks, and eye prophylaxis until after the first feeding is completed. Infants affected by maternal medications may require assistance for effective latch-on.156 Except under unusual circumstances, the newborn infant should remain with the mother throughout the recovery period.161
Supplements (water, glucose water, formula, and other fluids) should not be given to breastfeeding newborn infants unless ordered by a physician when a medical indication exists.148,162–165
Pacifier use is best avoided during the initiation of breastfeeding and used only after breastfeeding is well established.166–168
In some infants early pacifier use may interfere with establishment of good breastfeeding practices, whereas in others it may indicate the presence of a breastfeeding problem that requires intervention.169
This recommendation does not contraindicate pacifier use for nonnutritive sucking and oral training of premature infants and other special care infants.
During the early weeks of breastfeeding, mothers should be encouraged to have 8 to 12 feedings at the breast every 24 hours, offering the breast whenever the infant shows early signs of hunger such as increased alertness, physical activity, mouthing, or rooting.170
Crying is a late indicator of hunger.171 Appropriate initiation of breastfeeding is facilitated by continuous rooming-in throughout the day and night.172 The mother should offer both breasts at each feeding for as long a period as the infant remains at the breast.173 At each feed the first breast offered should be alternated so that both breasts receive equal stimulation and draining. In the early weeks after birth, nondemanding infants should be aroused to feed if 4 hours have elapsed since the beginning of the last feeding.
After breastfeeding is well established, the frequency of feeding may decline to approximately 8 times per 24 hours, but the infant may increase the frequency again with growth spurts or when an increase in milk volume is desired.
Formal evaluation of breastfeeding, including observation of position, latch, and milk transfer, should be undertaken by trained caregivers at least twice daily and fully documented in the record during each day in the hospital after birth.174,175
Encouraging the mother to record the time and duration of each breastfeeding, as well as urine and stool output during the early days of breastfeeding in the hospital and the first weeks at home, helps to facilitate the evaluation process. Problems identified in the hospital should be addressed at that time, and a documented plan for management should be clearly communicated to both parents and to the medical home.
All breastfeeding newborn infants should be seen by a pediatrician or other knowledgeable and experienced health care professional at 3 to 5 days of age as recommended by the AAP.124,176,177
This visit should include infant weight; physical examination, especially for jaundice and hydration; maternal history of breast problems (painful feedings, engorgement); infant elimination patterns (expect 3–5 urines and 3–4 stools per day by 3–5 days of age; 4–6 urines and 3–6 stools per day by 5–7 days of age); and a formal, observed evaluation of breastfeeding, including position, latch, and milk transfer. Weight loss in the infant of greater than 7% from birth weight indicates possible breastfeeding problems and requires more intensive evaluation of breastfeeding and possible intervention to correct problems and improve milk production and transfer.
Breastfeeding infants should have a second ambulatory visit at 2 to 3 weeks of age so that the health care professional can monitor weight gain and provide additional support and encouragement to the mother during this critical period.
Pediatricians and parents should be aware that exclusive breastfeeding is sufficient to support optimal growth and development for approximately the first 6 months of life‡ and provides continuing protection against diarrhea and respiratory tract infection.30,34,128,178–184 Breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child.185
Complementary foods rich in iron should be introduced gradually beginning around 6 months of age.186–187 Preterm and low birth weight infants and infants with hematologic disorders or infants who had inadequate iron stores at birth generally require iron supplementation before 6 months of age.148,188–192 Iron may be administered while continuing exclusive breastfeeding.
Unique needs or feeding behaviors of individual infants may indicate a need for introduction of complementary foods as early as 4 months of age, whereas other infants may not be ready to accept other foods until approximately 8 months of age.193
Introduction of complementary feedings before 6 months of age generally does not increase total caloric intake or rate of growth and only substitutes foods that lack the protective components of human milk.194
During the first 6 months of age, even in hot climates, water and juice are unnecessary for breastfed infants and may introduce contaminants or allergens.195
Increased duration of breastfeeding confers significant health and developmental benefits for the child and the mother, especially in delaying return of fertility (thereby promoting optimal intervals between births).196
There is no upper limit to the duration of breastfeeding and no evidence of psychologic or developmental harm from breastfeeding into the third year of life or longer.197
Infants weaned before 12 months of age should not receive cow's milk but should receive iron-fortified infant formula.198
All breastfed infants should receive 1.0 mg of vitamin K1 oxide intramuscularly after the first feeding is completed and within the first 6 hours of life.199
Oral vitamin K is not recommended. It may not provide the adequate stores of vitamin K necessary to prevent hemorrhage later in infancy in breastfed infants unless repeated doses are administered during the first 4 months of life.200
All breastfed infants should receive 200 IU of oral vitamin D drops daily beginning during the first 2 months of life and continuing until the daily consumption of vitamin D-fortified formula or milk is 500 mL.201
Although human milk contains small amounts of vitamin D, it is not enough to prevent rickets. Exposure of the skin to ultraviolet B wavelengths from sunlight is the usual mechanism for production of vitamin D. However, significant risk of sunburn (short-term) and skin cancer (long-term) attributable to sunlight exposure, especially in younger children, makes it prudent to counsel against exposure to sunlight. Furthermore, sunscreen decreases vitamin D production in skin.
Supplementary fluoride should not be provided during the first 6 months of life.202
From 6 months to 3 years of age, the decision whether to provide fluoride supplementation should be made on the basis of the fluoride concentration in the water supply (fluoride supplementation generally is not needed unless the concentration in the drinking water is <0.3 ppm) and in other food, fluid sources, and toothpaste.
Mother and infant should sleep in proximity to each other to facilitate breastfeeding.203
Should hospitalization of the breastfeeding mother or infant be necessary, every effort should be made to maintain breastfeeding, preferably directly, or pumping the breasts and feeding expressed milk if necessary.
Hospitals and physicians should recommend human milk for premature and other high-risk infants either by direct breastfeeding and/or using the mother's own expressed milk.13 Maternal support and education on breastfeeding and milk expression should be provided from the earliest possible time. Mother-infant skin-to-skin contact and direct breastfeeding should be encouraged as early as feasible.204,205 Fortification of expressed human milk is indicated for many very low birth weight infants.13 Banked human milk may be a suitable feeding alternative for infants whose mothers are unable or unwilling to provide their own milk. Human milk banks in North America adhere to national guidelines for quality control of screening and testing of donors and pasteurize all milk before distribution.206–208 Fresh human milk from unscreened donors is not recommended because of the risk of transmission of infectious agents.
Precautions should be followed for infants with glucose-6-phosphate dehydrogenase (G6PD) deficiency. G6PD deficiency has been associated with an increased risk of hemolysis, hyperbilirubinemia, and kernicterus.209 Mothers who breastfeed infants with known or suspected G6PD deficiency should not ingest fava beans or medications such as nitrofurantoin, primaquine phosphate, or phenazopyridine hydrochloride, which are known to induce hemolysis in deficient individuals.210,211
Many pediatricians and other health care professionals have made great efforts in recent years to support and improve breastfeeding success by following the principles and guidance provided by the AAP,2 the American College of Obstetricians and Gynecologists,127 the American Academy of Family Physicians,128 and many other organizations.5,6,8,130,133,142,162 The following guidelines summarize these concepts for providing an optimal breastfeeding environment.
Promote, support, and protect breastfeeding enthusiastically. In consideration of the extensively published evidence for improved health and developmental outcomes in breastfed infants and their mothers, a strong position on behalf of breastfeeding is warranted.
Promote breastfeeding as a cultural norm and encourage family and societal support for breastfeeding.
Recognize the effect of cultural diversity on breastfeeding attitudes and practices and encourage variations, if appropriate, that effectively promote and support breastfeeding in different cultures.
Become knowledgeable and skilled in the physiology and the current clinical management of breastfeeding.
Encourage development of formal training in breastfeeding and lactation in medical schools, in residency and fellowship training programs, and for practicing pediatricians.
Use every opportunity to provide age-appropriate breastfeeding education to children and adults in the medical setting and in outreach programs for student and parent groups.
Clinical Practice
Work collaboratively with the obstetric community to ensure that women receive accurate and sufficient information throughout the perinatal period to make a fully informed decision about infant feeding.
Work collaboratively with the dental community to ensure that women are encouraged to continue to breastfeed and use good oral health practices. Infants should receive an oral health-risk assessment by the pediatrician between 6 months and 1 year of age and/or referred to a dentist for evaluation and treatment if at risk of dental caries or other oral health problems.212
Promote hospital policies and procedures that facilitate breastfeeding. Work actively toward eliminating hospital policies and practices that discourage breastfeeding (eg, promotion of infant formula in hospitals including infant formula discharge packs and formula discount coupons, separation of mother and infant, inappropriate infant feeding images, and lack of adequate encouragement and support of breastfeeding by all health care staff). Encourage hospitals to provide in-depth training in breastfeeding for all health care staff (including physicians) and have lactation experts available at all times.
Provide effective breast pumps and private lactation areas for all breastfeeding mothers (patients and staff) in ambulatory and inpatient areas of the hospital.213
Develop office practices that promote and support breastfeeding by using the guidelines and materials provided by the AAP Breastfeeding Promotion in Physicians' Office Practices program.214
Become familiar with local breastfeeding resources (eg, WIC clinics, breastfeeding medical and nursing specialists, lactation educators and consultants, lay support groups, and breast-pump rental stations) so that patients can be referred appropriately.215 When specialized breastfeeding services are used, the essential role of the pediatrician as the infant's primary health care professional within the framework of the medical home needs to be clarified for parents.
Encourage adequate, routine insurance coverage for necessary breastfeeding services and supplies, including the time required by pediatricians and other licensed health care professionals to assess and manage breastfeeding and the cost for the rental of breast pumps.
Develop and maintain effective communication and coordination with other health care professionals to ensure optimal breastfeeding education, support, and counseling. AAP and WIC breastfeeding coordinators can facilitate collaborative relationships and develop programs in the community and in professional organizations for support of breastfeeding.
Advise mothers to continue their breast self-examinations on a monthly basis throughout lactation and to continue to have annual clinical breast examinations by their physicians.
Encourage the media to portray breastfeeding as positive and normative.
Encourage employers to provide appropriate facilities and adequate time in the workplace for breastfeeding and/or milk expression.
Encourage child care providers to support breastfeeding and the use of expressed human milk provided by the parent.
Support the efforts of parents and the courts to ensure continuation of breastfeeding in separation and custody proceedings.
Provide counsel to adoptive mothers who decide to breastfeed through induced lactation, a process requiring professional support and encouragement.
Encourage development and approval of governmental policies and legislation that are supportive of a mother's choice to breastfeed.
Promote continued basic and clinical research in the field of breastfeeding. Encourage investigators and funding agencies to pursue studies that further delineate the scientific understandings of lactation and breastfeeding that lead to improved clinical practice in this medical field.216
Although economic, cultural, and political pressures often confound decisions about infant feeding, the AAP firmly adheres to the position that breastfeeding ensures the best possible health as well as the best developmental and psychosocial outcomes for the infant. Enthusiastic support and involvement of pediatricians in the promotion and practice of breastfeeding is essential to the achievement of optimal infant and child health, growth, and development.
Section on Breastfeeding, 2003–2004
*Lawrence M. Gartner, MD, Chairperson
Jane Morton, MD
Ruth A. Lawrence, MD
Audrey J. Naylor, MD, DrPH
Donna O'Hare, MD
Richard J. Schanler, MD
*Arthur I. Eidelman, MD
Policy Committee Chairperson
Nancy F. Krebs, MD
Committee on Nutrition
Alice Lenihan, MPH, RD, LPN
National WIC Association
John Queenan, MD
American College of Obstetricians and Gynecologists
Betty Crase, IBCLC, RLC
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- Copyright © 2005 by the American Academy of Pediatrics


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Superbowl Playlist Compiled by Red Rooster Harlem Resident Qool DJ Marv/
If you can't make it to Ginny's on Sunday for the big game and are hosting at home, here's a great playlist put together by DJ Qool Marv, one of our favorite Rooster DJs.
We've got a great mix with everything from the classics (Whitney & Michael) to a little New York/New Jersey Flavor (Frank & Bruce)
Just under 3 hours of music, this can serve as your pre-game, during game and post-game atmosphere. If you start playing the mix around 3:30pm (EST), by the time you hear Frank Sinatra singing, it's just about gametime.
Cheers to your team and cheers to you!
Download or stream the playlist at the link below:
Superbowl Playlist Compiled by Red Rooster Harlem Resident Qool DJ Marv


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Classic 2 Full Sandblast Starburst
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Hematologist-Oncologists Who Accept Humana HMO Premier MRF Near Temple, TX
A dual subspecialty certification by the Board of Internal Medicine. Practitioners have expertise in blood diseases and cancer. The Hematologist/Oncologist treats diseases of the blood and blood-forming organs (spleen, lymph nodes, bone marrow, and thymus) as well as neoplastic diseases arising in any organ system.