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Research Article – Should You Breastfeed?

Should You Breastfeed? By Kasia Labocki, MPH

Breastfeeding is a mother’s unique ability to provide nutrition and nourishment to their infant. This process begins after birth and continues for as long as a mother decides. Within the first hour of arriving into this world infants are capable of latching on to a mother’s breast to obtain superior nutrition and optimal heat from their mother. Simply said, a child was born to be breast fed. It’s recommended by the nations top medical institutions, including but not limited to: American Academy of Pediatrics, American Academy of Family Physicians, American College of Obstetricians and Gynecologists, American College of Nurse-Midwives, American Dietetic Association and American Public Health Association that most infants breastfeed for at least 12 months and exclusively breastfeed for the first 6 months. Despite these recommendations, exclusively breastfed infants are not common. Less than one-third of infants are exclusively breastfeeding at 3 months of age and almost 80% of infants in the United States stop breastfeeding before the recommended minimum of one year.  Many mothers utilize the alternatives available to breastfeeding with artificial breastmilk, known as baby formula, due to the misconception that it is equivalent to human breastmilk.   But despite the many varieties and great advances in baby formula, it does not and cannot replicate breast milk.  A mother’s milk has a specifically designed, species specific, unique chemical composition that meets ALL of a child’s biological needs and is very different than artificial breast milk.  Know the facts . . .

Baby formula has gone through advances in chemical composition and chemical manipulation in efforts to imitate breast milk.  In 1980, Congress passed the Infant Formula Act requiring minimum amounts of essential nutrients, vitamins and minerals to be included in all baby formula compositions.  Babies may now receive adequate nutrition from these compositions, but the quantities and quality of proteins, carbohydrates and fats differ from formula to formula. The substrate, bovine milk, that formula primarily utilizes is used to support a less intelligent herbivore – cows.  Formula is digested differently than breast milk and takes up to twice as long. It’s also important to realize that the baby formula industry is a business.  They have provided society with a conception that bottle feeding is the norm.  Manufactures are quick to distribute free products and coupons to hospitals, doctors offices and new mothers.  Marketing strategies are cleverly implemented to make the product desirable to the consumer.  Due to the human thought that richer milk is better, baby formula may even contain palm or coconut oil purely for the purpose of providing a creamy appearance.  So yes, baby formula and breastmilk are compositionally different.  The purpose of this article is not to minimize the effectiveness of baby formula.  Children successfully grow, thrive and receive more than adequate nutrition from this product. Baby formula by no means is “bad” for children.  It’s important to recognize however that although it is a great substitution, it does not replace breastfeeding. Researchers consider breastmilk to be the “gold standard” and optimal form of infant feeding over formula because formula does not provide the same benefits.

The benefits of nursing are abundant, and to be more specific include health, nutritional, immunologic, developmental, psychological, social, economical and environmental benefits (as stated by the American Academy of Pediatrics).  Research does not replicate all the benefits of breastmilk with baby formula. When infants are brought into this world they have a underdeveloped and not fully functioning immune system. Breastmilk aids in the full development of the immune system and brain development. When a mother is at risk for infection the same organism is likely to effect the infant.  The mother’s infectious agent sets off a series of events that migrate into the breast milk to fight the specific infectious agent challenging the mother, therefore enhancing the infant’s resistance to infection.  Infants benefit from this unique host recognition system available through the breastmilk.  Breastfeeding has been linked to decreased rates of infectious diseases including but not limited to bacterial meningitis, diarrhea and urinary tract infections. Research also indicates that breastfeeding is linked to decreased rates of overweight and obesity, asthma, ear infections, stomach viruses, type 1 and type 2 diabetes and certain cancers such as lymphoma, leukemia and Hodgkin’s disease.  Mother’s benefit from breastfeeding as well.  Research has found mother’s to be linked to lower rates of diabetes, breast and ovarian cancer, decreased postpartum bleeding, earlier return to pre-pregnancy weight and decreased risk of hip fractures and osteoporosis in post menopausal period.  Infant mortality rates are also reduced by 21% (in the United States) in breastfed infants.  Additional research continues and as time progresses other benefits are added to this list daily.

Research based evidence clearly demonstrates that breastfeeding is good for both mother and child baby.  So why is it that 80% of infants stop breastfeeding before the recommended time of one year? Breastfeeding doesn’t come without its challenges and obstacles.  Although it’s a natural process a mother’s body was made to do, it may not come naturally to everyone.  Breastfeeding can be difficult, painful and frustrating.  A child may have a difficult time latching on causing great discomfort to the mother.  Breasts become engorged and swollen and nipples can be raw and even bleeding.  There are also conditions by either the mother or child where breastfeeding is not in the best interest for the child.  In this situation breastfeeding should not be continued. The work place and society often provide insufficient support. Legislation does allow a mother to breastfeed their children in public in almost every state. But this can still be a very awkward and uncomfortable scenario for a new mother. Even hospitals and health care professionals are often under trained and lack the answers, guidance and support a mother needs.  This included with the commercial promotion of formula and the belief that bottle feeding is normative all works against instead of for a mother to nurse.  But things are improving as society is recognizing more and more the full benefits of breastfeeding a child. Nursing covers have advanced in convenience and breast pumps are ingenious.  Employers are recognizing that support to a nursing mother is good for their overall business.  Children’s stores and malls are implementing nursing rooms.  Pediatricians and hospitals are hiring lactation consultants.  Medical organizations are calling all health care professionals and leaders to enthusiastically promote and support breastfeeding mothers and babies.  There are also community organizations, such as La Leche League, that are readily available and to answer any questions and provide hands on support to mothers.

New and expected mothers need to educate themselves and make informed decisions on how to feed their newborns.  Just because formula is received in the hospital or in the mailbox does not mean it has to be used.  Mothers often give up on breastfeeding because they lack the confidence and knowledge to continue.  Common misconceptions include that a child prefers the bottle, enough milk is not being produced by the mother and formula supplementation is necessary.   This is often not the case.  Breastfeeding is not easy. But if a mother can overcome all the obstacles and receive support from friends, family, health care professionals and society – not only will mother and child benefit – but society overall.  Efforts to promote breastfeeding supports “a public health movement that not only provides optimal nutrition to infants, but also lessens the occurrence of infectious and chronic diseases, thereby improving the health of our nation,” states former Acting Surgeon General, Dr. Steven Galson.

Sources:

American Academy of Pediatrics: Policy Statement (2005).  Breastfeeding and the Use of Human Milk.  Pediatrics, 115(2), 496-506.

Galson, S.K. (2009). Surgeon General’s Perspectives. The 25th Anniversary of the Surgeon General’s Workshop on Breastfeeding and Human Lactation: The Status of Breastfeeding Today.  Public Health Reports, 124, 356-258.

La Leche League International. (2004).  The Womanly Art of Breastfeeding, Seventh Revised Edition. New York: Plume.

Moore, M.L. (2001).  Research Update:  Current Research Continues to Support Breastfeeding Benefits. The Journal of Perinatal Education 10(3), 38-41.

Newton, E. R. (2004). Breastmilk: The Gold Standard.  Clinical Obstetrics and Gynecology, 47(3), 632-642.

Shealy, K.R., Scanlon, K.S., Labiner-Wolfe, J., Fein, S.B., Grummer-Strawn, L.M. (2008). Characteristics of Breastfeeding Practices Among US Mothers. Pediatrics, 122, 550-555. Retrieved from http://www.pediatrics.org/cgi/content/full/122/Supplement_2/S50

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What they don’t tell you about breastfeeding…

**hospital picture

Okay, we all hear about the benefits of nursing – for both mother and child. So as a new mom trying to do what’s best for my little one I was determined to breastfeed. Now granted everyone has a different experience…but seriously, this was no easy task for me. So much harder than I thought it would be!!! Here is what I learned those first few weeks:

  • It’s harder than it looks and not necessarily so “natural” right away
  • IT HURTS! Your nipples become raw, your boobs swell and LEAK
  • In the beginning you feel like all you do is feed the baby . . . ALL the time – seriously, you feel like a cow
  • It is initially inconvenient (unless you’re extremely comfortable nursing in public)
  • There is no cute and comfortable nursing bra out there (if there is – please tell me)
  • You can’t wear dresses (for the most part anyways…and  living in Florida I really like to wear summer dresses)

So yes, it can be a pain. But don’t allow this to be a discouragement! Once you get over that “hump” it gets easier, less painful and actually more convenient as you are not busy making and washing bottles all day! Feedings can become more scheduled (if you choose to do this) and decrease in number. It’s really one of the most miraculous feats God gives your body the ability to do.  I love having that special time and bond with my little one, it’s worth sticking this one out.

My Necessary Basics…for breastfeeding “survival”:

  • Lanolin cream
  • Breast pump
  • (a cute) Nursing cover
  • Nursing pads (lots of them)
  • (good) Nursing bras
  • Emotional support from loved ones!!
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those first few weeks

After three days in the hospital we were happy to be heading home.  Two of my sisters (I have three) came to help out with this process.  I didn’t really bring much, but I sure had a lot leaving (take all the freebies with you as you go through things within days!).  Crazy feeling leaving the hospital with three people instead of two. I remember how nervous I was just putting her in the car seat and driving home, we were completely 100% responsible for this precious cargo!!  We had a really sweet surprise once we arrived home,  my family had prepared a clean house, welcome banner and announcement sign (thank God for wonderful family!) I have 3 sisters, 3 nieces, 1 nephew, 1 grandma, and 1 set of parents that ALL that live within a 1.5 mile radius from my home – it’s pure madness but amazing at the same time. Anyways, the husband quickly kicked everyone out of the house (he enjoys his peace and quiet) and we settled in to enjoy our new life. That lasted maybe about 2 hours…

So I heard that the time you spend in the hospital is a “honeymoon” period during which your sweet baby eats wonderfully and sleeps all day.  Well we did discover that this lovely period was over that first night home, I think it was probably  one of the worst nights we had.  It couldn’t have been more than 3 hours after my dear husband kicked my sisters out when we were calling them to come back and help.

We (or rather I) was all of a sudden having a difficult process with nursing.  I was able to finally calm her down, nurse and go back to sleep only to run into the same problem later that evening.   It is the worst feeling ever to have this little baby cry her heart out and you can’t make her stop.  My goal was to breastfeed 100% due to all of its benefits, but sheesh, apparently my milk came in that evening and the whole process was miserable.  Adeline couldn’t latch on and it was just an overall a painful, uncomfortable, horrible experience for me l – definitely nothing “natural” about it.   I finally ended up pumping a bit and bottle feeding her – it worked great.  It took some figuring out (and a visit from my sister),  but we were finally able to feed and calm down this little princess successfully. I would like to take the time to note that my husband somehow learned how to sleep like a rock that day and hasn’t changed ever since.  All of a sudden he can sleep through screaming, feedings, fussing and not even nudge – how amazing and convenient all at the same time – ha!

But overall the first few weeks were tough.  Adeline got the breastfeeding down but it was still a painful process for me (thank goodness for Lansinoh).  She was also gassy A LOT with tummy aches.  We were constantly burping and carrying this little girl around to ease the fussiness.  I remember calling my mom a few times and asking “Since when do babies cry so much for no reason? No one tells you this.” She seemed to get particularly fussy around 6-7 pm in the evening.  You would just have to hold and soothe her till it passed.  During the day I would put her for naps on her tummy and that seemed to help her a bit.  Someone gave us baby gas drops at the baby shower, the first time we used them it was fabulous, really seemed to work right away.  Other times it didn’t seem to do anything at all.  Then we discovered the pacifier and it worked wonders with Adeline.  She really like to suck so she taught herself to use the pacifier and sooth herself when something was bothering her.

So all in all, those first few weeks – probably the first six (for us) were tiring, busy and stressful.  Getting up in the middle of the night for feedings was tough due to the obvious lack of sleep and I am not a big napper. But I really can’t complain too much as from the beginning Adeline would mostly only wake up once for a nightly feeding.  I had a co-sleeper bassinet right next to the bed, which made things much easier.  Personally, one of the hardest things was recovering from the C-section.  Those first few nights it was difficult to even sit up or walk around.  My dear hubby James would have to change her diapers and bring her to me for middle of the night feedings.   It was difficult to deal with as I’m used to being pretty active and independent.  I would say experiencing delivery and then those first few days home with my husband,  has definitely made our relationship stronger in a whole different sort of way.

So overall – here is what I learned those first few weeks as a first time mom:

  •  C-section recovery is extremely painful and disabling

  • Breastfeeding is a lot more painful and difficult (in the beginning) than I expected

  • Babies will sometimes just cry for no reason

  • Family and sleep are extremely valuable

  • I love people that bring me food (I actually always love this but it became especially significant those first few weeks)

  • Coffee is the best thing ever (but not too much)

  • Never change a diaper on your bed without a changing pad underneath

  • Babies spit up a lot

  • Your hormones are not quite yet stable

  • It’s still a crazy and surreal feeling that you’re a mommy to this little person

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