Tuesday, February 26, 2013

Breastfeeding I: Colostrum, Antibodies, diarrhea prevention

Human milk provides protection against disease for a baby. There are many ways that it does this, much beyond what I can delineate in my non-studying time allotted. So I will start at the very beginning and then continue later.

A vaginal birth allows the baby's gut to be colonized by healthy bacteria which will deter disease by preventing the growth of unhealthy bacteria. #2 provide essential nutrients such as vitamin K. The proper colonization of the gut is why adults take probiotics, which will be another post.

The first milk secreted by the mother after birth is called colostrum because it is soooo different from 'mature' milk. It actually selectively facilitates the establishment of healthy gut bacteria Lactobacillus bifidus along with aiding the passage of meconium, or baby fecal matter that is still sterile from being in the mother, or not yet full of healthy bacteria.

Colostrum has less kcal than mature milk that will be secreted a few days later but has a higher amount of protein, fat soluble vitamins, and minerals. Further, it has a VERY high level of antibodies against bacteria and viruses that may be present in the birth canal.

These secreted antibodies are called IgA (immunoglobulin A) and are fascinating because the act like little pac-men for the viruses and bacteria. They are secreted by the adult gut and are specific for the topography of bacteria, viruses, etc. The immunoglobuns thus grab onto the bacteria or viruses and hold onto them preventing them from infecting you. In the adult,  IgA is secreted in the nose, the salivary glands, and throughout the gut along with into the breast milk.

In the second trimester of pregnancy, the human breast fills with inflammatory cells and it is thought that it is for this purpose: to identify and greatly increase the amount of secretory IgA made against any bacteria or viruses present in the environment and therefore protect the baby. Not only that but the degree of protection against organisms causing disease is proportional to the amount of HUMAN milk the infant receives, meaning exclusive breast feeding = greater protection vs diseases that cause diarrhea, nausea, etc. It is well established in the medical community that ingested antibodies from human milk provide gastrointestinal immunity against the following digestive tract/enteric pathogens that cause diarrhea: E. Coli, Salmonella typhirium, Shigella, V. Cholerae, Giardia, rotavirus, C. Diff, C jejuni. Therefore the antibodies in human breast milk in combination with the nutrients that help healthy bacteria survive protect the baby against diarrhea, GI ilnesses, etc.

Further the mother secretes immune cells (lymphocytes, T-Cells) that give specific immunity for bacteria present in the environment to the baby whose immune system cannot yet make those bacteria.

Saturday, February 9, 2013

A Brief Update

It is discouraging and scary to be coming back from this injury. Strange that I say this as I have come back from two ACL reconstructions. But there the injury was fixed. This time I know I have no miniscus and a meniscal tear. It is not "fixed" and it is up to me to change my training accordingly. Also running cannot be my priority. My schooling is my priority and that takes up a lot of time and effort. There is no clear path forward.

I went for a 14 mile run on tired legs on Thursday and really died at the end; my legs felt like lead. That used to be easy and at an easy pace (~7:30). Now it is difficult to brutal. My physical therapist said on Friday that people have come back from worse and that I will be back out there. And I will try. I know I am not alone when I run, I know I have my mom and my cat (who I put to sleep when her kidneys failed the day after my mom had been hospitalized with her final seizure. She sometimes visits me in dreams. She had been abused by previous owners, so I spent a lot of time sitting with her until I was the first person with whom she connected.) But is is hard to have loved something so much and have it taken away suddenly, whether it be a mother, a cat, or running. But hopefully I can get it all back.

I know I have strength in me. But between school and being in the worst shape since my ACL reconstructions, it is scary. I'm going to keep plugging away at my schoolwork and keep going to physical therapy and hopefully soon I will be back out there racing with my friends and comrades. I won't be at the front of the pack. That isn't how the body works. I will have to take some time to earn my way back up there. Wish me luck; I need it!

Monday, February 4, 2013

It's okay to be a chubby runner!

It was around 3 o'clock on what was a Tuesday or Wednesday afternoon when I got the call. I was fourteen and was doing nothing much after getting home from school. It was my dad's voice on the phone:

"I've got it Courtney"
"What dad, what have you got?"
"I've got the sport that will take you to the Olympics"
[pause... I'd never thought about going to the Olympics .. didn't have any idea why I was getting this call out of the blue]
"And what sport is that dad?"
[another pause... thoughts of being like the guys in Cool Runnings going through my head]

"Why bobsledding?"
"Because you can run fast and weigh a lot"

[pause as I get kind of excited, sounds like fun, but then I realize....]

"Dad, did you just call me fat?"

Yes that is the call that no fourteen year old girl wants to receive.... the fat call. I was chubby and kinda short. One guy who tried to date me in middle school ACTUALLY tried to flirt with me by calling me Courtney FAT-man before giving me his nike wrist band and trying to hold my hand! But I could still out-sprint most everyone in a soccer game. One time I remember hearing the parents from the other team commenting on how long my legs were... and I am 5'4" now, probably was shorter then, and weighed probably ~140lbs. So I knew didn't have long legs, I could just run faster then their daughters. And I remember telling my dad about that and wondering how fast I had to be running to create the illusion of long legs...

I think that training as a chubby athlete all my life has prevented a lot of injury. It takes a lot more muscle to run in a 140lb body than a 110lb body. Then as I dropped weight while living in Montana, I could sustain those speeds.

Now after having been injured I'm back up to ~127, which is 10-15lbs higher than my ideal racing weight. It will come back off if I keep training. But earlier today I did 5 mile repeats at a sub-6 minute pace (between 5:56 and 5:39) while weighing about 15 lbs more than most girls that can run like that.... As great as it would be to be a bobsledder, I can just stick with running for now and see how far this woman who was a happy-go-lucky Chubby girl can get in the running world :)