In this fast-food world breast-feeding offers the ultimate in slow, old-fashioned nutrition for babies. And although it may be slow food, breast milk is always ready to go with no mess, no fuss, no preparation and no washing of bottles. Nursing offers a mother a chance to spend time with her baby and to fully experience mother-infant bonding.
Breast-feeding has become more popular among American women in recent years, a trend health care workers are trying to encourage. In 2001, 70 percent of mothers breast-fed their infants at the time of discharge from hospital. By six months that number had fallen to 31 percent.
It’s hardly surprising that scientists declare breast milk the ideal food for developing infants. It comes with everything a growing baby needs for nutrition–the optimal mix of protein, sugars, fats, fatty acids and carbohydrates supplemented by substances that pass on protection from the mother’s heavy hitting immune system to the infant. It’s this immune protection that is at least partly responsible for the lower rates of many childhood illnesses such as ear infections, diarrhea and eczema in breast-fed infants.
Other lifetime health benefits of breast-feeding include a lower incidence of obesity and type 2 diabetes, lower blood pressure, lower cholesterol levels and a decrease in the risk of heart disease later in life. A number of studies have also shown an increase in the average IQ score for babies who were breast-fed for nine months or more.
The days and weeks after the birth are when problems are most likely to occur. Support from your partner and from relatives and friends as well as health care professionals is invaluable at this time.
It takes a couple of weeks for your body to establish a good milk supply. The more your baby nurses, the more milk your body will produce.
After the first three weeks when nursing is well established, a woman can pump her breasts after the first morning feeding. The milk can then be put in sterilized bottles or in plastic bags and stored in the refrigerator for up to a week or in the freezer for up to three months. (It’s important to always label and date the stored milk.) After six weeks most women find they can then leave the baby with the father or another caretaker who can give the baby breast milk from a bottle.
Most common nursing problems can be overcome with help.
Inadequate milk supply. The amount of milk produced depends on how often the breast is emptied, not on the size of a woman’s breasts. More frequent breast- feeding is an effective technique for increasing milk supply, as milk production depends on cyclical milk removal. An empty breast makes milk faster than a full one. If your infant doesn’t seem to be emptying the breast, pumping after a feeding will empty the breast and prompt more milk production.
No letdown. Impulses in the nipple area created by the sucking infant prompt the release of oxytocin, a key hormone that triggers milk letdown. If letdown doesn’t occur, relaxation techniques may help. Or your physician may prescribe oxytocin in a nasal spray form. Sometimes pumping the breasts for a couple of minutes will initiate letdown and get milk flowing so the baby doesn’t get frustrated.
Nipple problems. Women with flat or inverted nipples can nurse successfully although some may have trouble getting the baby to latch on to the breast. Some women use nipple shields to facilitate latch-on. They may also resort to nipple shields when they have problems with cracked or sore nipples. The risks are that the shield will decrease milk production and it is sometimes difficult to get the infant to make the transition back to the breast alone. When nipple shields are used they should be seen as a very temporary measure.
Returning to work. Although it takes commitment, it is possible to continue nursing after you return to work. Working women need a space where they can express milk in private. Milk needs to be expressed about as often as you nurse. Experts recommend either renting or buying a good quality double electric pump that makes it possible to pump both breasts at once, a significant time saver. In workplaces with no private office available some women use the company’s first aid room.
Although the majority of American women now breast-feed their infants for a short time, most stop before the baby is six months old, despite the fact that the health benefits of breast-feeding for at least one year are well-documented. The American Academy of Pediatrics says that breast- feeding is the gold standard when it comes to feeding your baby, offering multiple benefits not just for the baby but for the mother as well.
Breast-Feeding May Lower Depression for Mom
A study of 605 women who breast-fed their babies for the first year after birth found they had significantly lower rates of postpartum depression than a group of 378 women who did not breast-feed.
The study, reported by Dr. Mezzacappa of Columbia University, found that 15 per cent of women who breast-fed their babies became depressed in the year after giving birth compared with a depression rate of 29 percent for women who did not breast-feed. Roughly equal numbers of white and African-American women were included in the study.
[SOURCE: Carl Sherman, “Breast-Feeding May Halve Postpartum Depression Risk,” Family Practice News. August 1, 2002]
Baby-Friendly Approach
Encourages Breast-feeding
When hospitals support and encourage new mothers to breast-feed, women are more likely to make this choice. Boston Medical Center compared breast-feeding rates between 1995 and 1999, a period that saw the implementation of baby-friendly policies including Ten Steps to Successful Breastfeeding.
The breast-feeding initiation rate increased from 58 percent in 1995 to 86 percent in 1999. Exclusive breast-feeding rates increased from 5 percent in 1995 to 33 percent in 1999.
[SOURCE: “Baby-Friendly Hospital Initiative Improves Breastfeeding Initiation Rate in a US Hospital Setting,” Journal of the American Academy of Child and Adolescent Psychiatry, June 2002]
Breast-Feeding Fights Infection
A recent study of infants admitted to the hospital for lower respiratory infections found that bottle-fed babies were hospitalized for these infections three times more often than infants who were exclusively breast-fed for four months.
[SOURCE; “Breastfeeding Protects Against Infections,” GP March 17, 2003]
Got Milk? Need Privacy?
A room of one’s own may be the ideal solution for women who need to express breast milk after returning to work. Unfortunately many women don’t have the luxury of a private office and only six states (California, Connecticut, Hawaii, Illinois, Minnesota and Tennessee) have legislation guaranteeing women the time as well as a private place to express milk.
A woman wanting to breast-feed after returning to work should talk to her employer about establishing a private space such as a cubicle, the first aid room or some other area after returning to work.
Employers should be reminded that on average breast-fed babies are sick less often than bottle-fed babies, requiring less days off work for the mother.
For information about existing legislation concerning breast-feeding:
www.lalecheleague.org/LawMain.html
[SOURCE: Dana Sullivan, “Pumping at Work,” Fit Pregnancy, February-March 2003]
Breast-Feeding and IQ
Several studies have demonstrated that babies who are breast-fed for the first nine months of life average six points higher on IQ scores compared with bottle-fed babies. This effect remains after adjusting for age of mother, maternal education, economic status and other factors.
One possible mechanism for this advantage of breast milk are the long-chain polyunsaturated fatty acids AA and DHA present in breast milk. These acids are known to play an important role in the development of the brain and the retina. Fatty acids are also believed to be responsible for the slightly lower blood pressure rates breast-fed babies enjoy compared with bottle-fed babies.
[SOURCE: E.L. Mortensen et al, “The Association Between Duration of Breastfeeding and Adult Intelligence,’ JAMA, Vol. 287, pp.2365-2371, 2002]
Most Foods Okay
When Breast-Feeding
Women who breast-feed should try to eat a healthy diet, but even when the diet is less than ideal, breast milk should offer a perfect balance of nutrients.
Women should be careful about their intake of substances such as caffeine, alcohol, and certain medications, however. Moderate amounts of caffeine (two cups of coffee or tea per day) and an occasional glass of wine or beer are usually okay.
Babies are most vulnerable to the effects of medications in the first days and weeks of life. After that many medications such as antidepressants, most antibiotics, non-sedating allergy medications and drugs used to treat asthma and low thyroid are generally safe.
A woman should check with her physician and pharmacist about any medications she takes. If a particular antibiotic is not safe for nursing mothers, for example, her physician can prescribe an alternative drug. For information about the safety of a drug or a food, a woman’s physician or breast-feeding consultant can call the Breastfeeding and Human Lactation Study Center in Rochester, N Y. (716) 275 0088. The center operates a hotline for health care professionals.
If your infant has colic and you suspect an allergy to something in your breast milk, try eliminating one group such as milk products or foods from the cabbage/beans/broccoli/onions group for a week at a time to see if it relieves symptoms. Most women who breast-feed can eat a wide variety of foods without causing any problems for the baby.
[SOURCE: “Eat, Drink, But Be Wary,” Fit Pregnancy, June-July 2002. “How Can GPs Support Breast-Feeding Mothers?” Pulse, May 13, 2002]
REFERENCES:
“Breastfeeding Lowers a Child’s Risk of Developing Type 2 Diabetes, “ Diabetes Week, September 16, 2002.
“Breastfeeding Protects Against Infections,” GP, March 2003.
“Breast-Feeding Reduces Symptoms of Pain in Neonates,” Nutrition Research Newsletter, February 2003.
John Cahill and Carol Wagner, “Challenges in Breastfeeding: Maternal Considerations,” Contemporary Pediatrics, May 2002.
“Early Diet Affects Intelligence,” Southern Medical Journal, February 2003.
Manuela Gomez-Sanchiz et al, “Influence of Breast-Feeding on Mental and Psychomotor Development,” Clinical Pediatrics, January-February 2003.
“How Can Gps Support Breast-Feeding Mothers?” Pulse, May 13, 2002.
I. Kull et al, “Breast Feeding and Allergic Diseases in Infants,” Archives of Disease in Childhood, December 2002.
Alan S. Ryan, “Breastfeeding Continues to Increase into the New Millennium,” Pediatrics, December 2002.
Carl Sherman, “Breast-Feeding May Halve Postpartum Depression Risk,” Family Practice News, August 1, 2002.
Dana Sullivan, “Pumping At Work,” Fit Pregnancy, February-March 2003.
“Survery Shows More US Women Are Breastfeeding,” AORN Journal, February 2003.
