4.6: Breastfeeding

Breastfeeding

Breastfeeding has many benefits for you and your baby. It helps build your baby’s immune system and offers the perfect nutrition. Breast milk is considered the ideal diet for newborns. Colostrum, the first breast milk produced during pregnancy is very rich in nutrients and antibodies. Breast milk changes by the third to fifth day after birth, becoming much thinner, but containing just the right amount of fat, sugar, water and proteins to support overall physical and neurological development. Breast milk contains everything your baby needs to grow and develop. It provides a unique and specific formula of vitamins, minerals and antioxidants.

Breast milk supports a baby’s health because it

• is easy for their developing tummy and intestines to digest
• contains antibodies that protect against infection and boost immunity.
• promotes healthy weight gain.
• changes in composition to meet your baby’s nutritional needs over time.
• contains substances that naturally soothe your baby

Figure 4.17 – A nurse helping a new mother to breastfeed.

Image Source: World Breastfeeding Week spotlights lifelong benefits of nursing. Health.mil. July 11, 2023.

A Historic Look at Breastfeeding

The use of wet nurses -lactating women hired to nurse others' infants- during the Middle Ages eventually declined and by the late 1800s mothers increasingly breastfed their own infants.

In the early part of the 20th century, breastfeeding experienced another decline. By the 1950s, formula was viewed as superior to breast milk, and breastfeeding was practiced less frequently.

During the late 1960s and 1970s, greater emphasis began to be placed on natural childbirth and breastfeeding and the benefits of breastfeeding were more widely publicized. Gradually rates of breastfeeding began to climb, particularly among middle-class educated mothers who received the strongest messages to breastfeed.

Today, many women receive consultation from a lactation specialist or consultant before being discharged from the hospital to ensure that they are informed of the benefits of breastfeeding and how to breastfeeding effectively by helping mothers understand the basics of breastfeeding and offer guidance on proper positioning and latch techniques to ensure the baby is getting enough milk and the mother is comfortable. They can address any concerns or challenges related to breastfeeding, such as latch issues, milk supply, or pain. This guidance and support for first-time mothers, especially, is important. Without it new mothers may become upset or discouraged and stop breastfeeding.

Maternal Benefits of Breastfeeding

Several recent studies have reported that it is not just babies that benefit from breastfeeding, mothers do as well, and in multiple ways.

• stimulates contractions in the mother’s uterus to help it regain its normal size
• quicker recovery form childbirth
• may make it easier for to lose the weight gained during pregnancy
  • breastfeeding burns extra calories, which can help with weight loss
• contributes to certain health outcome
  • lower risk of developing breast cancer particularly among higher risk racial and ethnic groups
  • lower rates of ovarian cancer
  • reduced risk for developing Type 2 diabetes and rheumatoid arthritis

It's recommended mothers exclusively breastfeed for the first 6 months if possible. This early period is the most crucial for providing your baby with the nutrients and antibodies they need to grow and develops

Challenges to Breastfeeding

According to the CDC, 60% of mothers do not breastfeed for as long as they intend. How long a mother breastfeeds her baby is influenced by many factors, including

• issues with lactation and latching
• concerns about infant nutrition and weight
• mother's concern about taking medications while breastfeeding
• unsupportive work policies and lack of parental leave
• cultural norms and lack of family support
• unsupportive hospital practices and policies

If mothers are unavailable to their infants at feeding them, they can provide breast milk for their babies by using a breast pump and expressing the milk and freezing it to be bottle-fed later. However, some mothers find that even after the initial encouragement they receive in the hospital to breastfeed, the outside world is less supportive of such efforts. Some workplaces support breastfeeding mothers by providing flexible schedules, private rooms where they can pump, and even welcoming infants, but many do not, and mothers are forced to stop breastfeeding.

In addition, not all women may be able to breastfeed. Women with HIV are routinely discouraged from breastfeeding as the infection may pass to the infant. Similarly, women who are taking certain medications or undergoing radiation treatment may be advised against breastfeeding.

Figure 4.18 – A father bottle-feeding his infant

Image Source: Ilya Haykinson. Mateo. is licensed under CC BY-SA 2.0

Alternatives to Breastfeeding

There are many reasons that mothers struggle to breastfeed or should not breastfeed, including:

• low milk supply
• previous breast surgeries
• illicit drug use
• medications
• infectious
• disease
• inverted nipples

Other mothers choose not to breastfeed. Some reasons for this include

• lack of personal comfort with nursing, the
• time commitment of nursing,
• inadequate or unhealthy diet, and
• needing or wanting more convenience and flexibility as to who can feed the infant

For these mothers and infants, formula is available. Besides breast milk, infant formula is the only other milk product that the medical community considers nutritionally acceptable for infants under the age of one year (as opposed to cow's milk, goat's milk, or follow-on formula). Formula can be used in addition to breastfeeding (supplementing) or as an alternative to breast milk.

The most used infant formulas contain purified cow's milk whey and casein as a protein source, a blend of vegetable oils as a fat source, lactose as a carbohydrate source, a vitamin-mineral mix, and other ingredients depending on the manufacturer. In addition, there are infant formulas which use soybeans as a protein source in place of cow's milk (mostly in the United States and Great Britain), and formulas which use protein hydrolysed into its component amino acids for infants who are allergic to other proteins.

Cost of Breastfeeding

In addition to the nutritional benefits of breastfeeding, breast milk does not have to be purchased. This may be an important incentive for choosing to breastfeed. But there are also those who challenge the belief that breast milk is free. For breast milk to be completely beneficial for infants the mother's life choices will ultimately affect the quality of the nutrition an infant will receive.

Cost of the nutritional intake of the mother is a factor. Breastfeeding will both limit some food and drink choices as well as necessitate an increased intake of healthier options. A simple trip down the supermarket aisles will show you that nutritious and healthier options can be more expensive than some of the cheaper more processed options. A large variety of vegetable and fruits must be consumed, accompanied by the right proportions and amounts of the whole grains, dairy products, and fat food groups. Additional cost accrue as breastfeeding mothers are encouraged to take vitamins regularly.

Both breastfed and bottle-fed infants benefit from the bonding and healthy emotional development for infants that takes place at feeding time. This is good news for mothers who may be unable to breastfeed for a variety of reasons and for fathers who might feel left out.

Sources

• About Breastfeeding Data. CDC Breastfeeding Data. Centers of Disease Control and Prevention. June 28, 2024.
• Benefits of Breastfeeding. HealthLibrary. ClevelandClinc.org. July 17, 2023.
• Leon, Ana R. Children’s Development. Licensed under CC BY 4.0.