Family Health & Parenting

Extended breastfeeding is referred to those who breastfeed their child beyond one year of age. Which is kinda funny since 2 years is the MINIMUM recommended age (by WHO, UNICEF and the American Academy of Family Physicians). There is also lots of research, studies, information, facts and figures that point the the benefits of nursing beyond one year of age.

My 2 year old nurses at bedtime. I am 18 weeks pregnant so she is probably not getting a whole lot. If you had asked me when I was pregnant if I would be nursing a toddler, I would have thought you were nuts. I used to be in the camp that thought nursing beyond a year was “weird.” However, having been through the nursing experience, I see how ignorant I was and how beneficial breastfeeding a toddler is. She is very healthy and we are fortunate that she rarely catches any sickness that goes around at daycare. I truly believe this is because she received and still receives the benefits of breastmilk. 

Here is a page from KellyMom.com that shares some of the benefits of nursing a toddler.

• Although there has been little research done on children who breastfeed beyond the age of two, the available information indicates that breastfeeding continues to be a valuable source of nutrition and disease protection for as long as breastfeeding continues.

• “Human milk expressed by mothers who have been lactating for >1 year has significantly increased fat and energy contents, compared with milk expressed by women who have been lactating for shorter periods. During prolonged lactation, the fat energy contribution of breast milk to the infant diet might be significant.”
  – Mandel 2005

• “Breast milk continues to provide substantial amounts of key nutrients well beyond the first year of life, especially protein, fat, and most vitamins.”
  – Dewey 2001

• In the second year (12-23 months), 448 mL of breastmilk provides:
  • 29% of energy requirements
  • 43% of protein requirements
  • 36% of calcium requirements
  • 75% of vitamin A requirements
  • 76% of folate requirements
  • 94% of vitamin B₁₂ requirements
  • 60% of vitamin C requirements

  – Dewey 2001

• Studies done in rural Bangladesh have shown that breastmilk continues to be an important source of vitamin A in the second and third year of life.
  – Persson 1998

• It’s not uncommon for weaning to be recommended for toddlers who are eating few solids. However, this recommendation is not supported by research. According to Sally Kneidel in “Nursing Beyond One Year” (New Beginnings, Vol. 6 No. 4, July-August 1990, pp. 99-103.):

  Some doctors may feel that nursing will interfere with a child’s appetite for other foods. Yet there has been no documentation that nursing children are more likely than weaned children to refuse supplementary foods. In fact, most researchers in Third World countries, where a malnourished toddler’s appetite may be of critical importance, recommend continued nursing for even the severely malnourished (Briend et al, 1988; Rhode, 1988; Shattock and Stephens, 1975; Whitehead, 1985). Most suggest helping the malnourished older nursing child not by weaning but by supplementing the mother’s diet to improve the nutritional quality of her milk (Ahn and MacLean. 1980; Jelliffe and Jelliffe, 197 and by offering the child more varied and more palatable foods to improve his or her appetite (Rohde, 1988; Tangermann, 1988; Underwood, 1985).

References

• The American Academy of Family Physicians notes that children weaned before two years of age are at increased risk of illness (AAFP 2001).

• Nursing toddlers between the ages of 16 and 30 months have been found to have fewer illnesses and illnesses of shorter duration than their non-nursing peers (Gulick 1986).

• “Antibodies are abundant in human milk throughout lactation” (Nutrition During Lactation 1991; p. 134). In fact, some of the immune factors in breastmilk increase in concentration during the second year and also during the weaning process. (Goldman 1983, Goldman & Goldblum 1983, Institute of Medicine 1991).

• Per the World Health Organization, “a modest increase in breastfeeding rates could prevent up to 10% of all deaths of children under five: Breastfeeding plays an essential and sometimes underestimated role in the treatment and prevention of childhood illness.” [emphasis added]

References

• Many studies have shown that one of the best ways to prevent allergies and asthma is to breastfeed exclusively for at least 6 months and continue breastfeeding long-term after that point.

  Breastfeeding can be helpful for preventing allergy by:

  1. reducing exposure to potential allergens (the later baby is exposed, the less likely that there will be an allergic reaction),
  2. speeding maturation of the protective intestinal barrier in baby’s gut,
  3. coating the gut and providing a barrier to potentially allergenic molecules,
  4. providing anti-inflammatory properties that reduce the risk of infections (which can act as allergy triggers).

References

• Extensive research on the relationship between cognitive achievement (IQ scores, grades in school) and breastfeeding has shown the greatest gains for those children breastfed the longest.

References

• According to Sally Kneidel in “Nursing Beyond One Year” (New Beginnings, Vol. 6 No. 4, July-August 1990, pp. 99-103.):
  
  “Research reports on the psychological aspects of nursing are scarce. One study that dealt specifically with babies nursed longer than a year showed a significant link between the duration of nursing and mothers’ and teachers’ ratings of social adjustment in six- to eight-year-old children (Ferguson et al, 1987). In the words of the researchers, ‘There are statistically significant tendencies for conduct disorder scores to decline with increasing duration of breastfeeding.’”

• According to Elizabeth N. Baldwin, Esq. in “Extended Breastfeeding and the Law”: 
  “Breastfeeding is a warm and loving way to meet the needs of toddlers and young children. It not only perks them up and energizes them; it also soothes the frustrations, bumps and bruises, and daily stresses of early childhood. In addition, nursing past infancy helps little ones make a gradual transition to childhood.“

• Baldwin continues: “Meeting a child’s dependency needs is the key to helping that child achieve independence. And children outgrow these needs according to their own unique timetable.” Children who achieve independence at their own pace are more secure in that independence then children forced into independence prematurely.

References

• The American Academy of Pediatrics recommends that “Breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child… Increased duration of breastfeeding confers significant health and developmental benefits for the child and the mother… 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.” (AAP 2005)

• The American Academy of Family Physicians recommends that breastfeeding continue throughout the first year of life and that “Breastfeeding beyond the first year offers considerable benefits to both mother and child, and should continue as long as mutually desired.” They also note that “If the child is younger than two years of age, the child is at increased risk of illness if weaned.” (AAFP 2001)

• A US Surgeon General has stated that it is a lucky baby who continues to nurse until age two. (Novello 1990)

• The World Health Organization emphasizes the importance of nursing up to two years of age or beyond (WHO 1992, WHO 2002).

• Scientific research by Katherine A. Dettwyler, PhD shows that 2.5 to 7.0 years of nursing is what our children have been designed to expect (Dettwyler 1995).

References [see also position statements supporting breastfeeding]

• Extended nursing delays the return of fertility in some women by suppressing ovulation (References).

• Breastfeeding reduces the risk of breast cancer (References). Studies have found a significant inverse association between duration of lactation and breast cancer risk.

• Breastfeeding reduces the risk of ovarian cancer (References).

• Breastfeeding reduces the risk of uterine cancer (References).

• Breastfeeding reduces the risk of endometrial cancer (References).

• Breastfeeding protects against osteoporosis. During lactation a mother may experience decreases of bone mineral. A nursing mom’s bone mineral density may be reduced in the whole body by 1 to 2 percent while she is still nursing. This is gained back, and bone mineral density may actually increase, when the baby is weaned from the breast. This is not dependent on additional calcium supplementation in the mother’s diet. (References).

• Breastfeeding reduces the risk of rheumatoid arthritis. (References).

• Breastfeeding has been shown to decrease insulin requirements in diabetic women (References).

• Breastfeeding moms tend to lose weight easier (References).

Page last modified: 01/04/2006
Written: 3/12/98

Extended Breastfeeding Links @

Extended Breastfeeding References @

This article was in US News and World Report. A new drug regimen helps prevent the HIV virus from being passed from an infected mother to her infant via breastmilk. This is significant particularly for African mothers who rarely formula feed. There, they have little or no access to clean water for mixing formula or sterilizing/cleaning bottles.

Another interesting point of the studies finding is that duration of breastfeeding had no impact on the risk of passing the virus, so limiting the duration of nursing does not offer any further protection. It also said that stopping breastfeeding in an HIV infected infant was harmful.

This is great news and I hope all infected mothers will be able to take advantage of this.

Read the entire article…

And for even more details on the study, this article was posted in Science Daily. It gives a more detailed version of the study. Very interesting stuff!

Wow!! What an amazing story!! A Chinese police officer and new mother, has taken in 8 babies to nurse. Three of the infants mother’s were traumatized by the event and it affected their milk supply. Five of the infants were orphaned. This mother is truly a hero.

In such tragic events, artificial feeding becomes dangerous because water supplies often becomes contaiminated. So mixing formula and cleaning necessary supplies becomes a challenge and can endanger the health of an artificially fed infant. Read more here….

This is a great “cheat sheet” that was compiled by SafeMama. It’s a very extensive list, so I wanted to share. If you are aware of a BPA-free bottle or sippy that is not on the list, please let me know and I will add it. That said, this may not be a comprehensive list as new products are released all the time. Additionally, please be aware that Avent, Dr. Brown’s, Nuby and others do have products made of polycarbonate plastics, so please choose wisely. I hope this relieves some concerns or helps you select products that are considered safe.

BPA Free Bottle Products

• Adiri Natural Nursers
• Avent “Via” disposable bottles
• BornFree - All bottles and cups BPA free *see note
• EvenFlo Glass bottles
• Playtex Opaque Soft Bottle, Playtex Drop in liners
• Gerber: Gerber Clearview, Fashion Tints (also called “Plastic Pastels”), Gerber GentleFlow
• Medela: All bottles
• Sassy MAM bottles (UltiVent), Baby Food Nurser Kit
• Green to Grow Bottles **see note
• Sassy Baby Food Nurser Kit
• ThinkBaby Bottles
• Momo Glass Bottles
• Nuby: Standard Neck Non-Drip Bottle, Wide-Neck Non-Drip Bottle, Wide-Neck Bottle with Handles and Non-Drip Nipple, Standard Neck Bottle with Handles and Non-Drip Nipple, 3-Stage Wide Neck Easy Grip Feeding System with Non-Drip Nipple.
• Nuture Pure Glass bottles
• Babisil Silbottles
• Weego Glass Bottles
• Siliskin Glass Bottles
• Dr Brown’s: Glass Bottles (all vent system pieces BPA Free), Dr. Browns Polypropylene bottles (due in store’s April 15th)

BPA Free Sippy Cups

• Avent Magic Cups
• Playtex: Coolster Tumbler, Insulator, Einstein Training Cup, Sipster, Create My Own, Quick Straw, Insulator Sport, Sip and Discover, First Sipster
• Gerber: Sip & Smile Spill-proof Cup, Easy Grip Insulated Soft Straw Cup, Insulated Cool Cup, Fun Grips Color Change Spill-proof Cup, Grins & Giggles Spill-proof Cup (source)
• BornFree sippy/drinking cups
• Kleen Kanteen
• Thermos Foogo Sippy Cups, and drinking bottle with straw
• SIGG Toddler Water Bottles
• Kid Basix The Safe Sippy
• Boon Sippy
• GrowPure Multi-Stage Feeder and Sippy Cup
• iPlay Aqua Bottle
• ThinkBaby Training Cup
• Sassy Snack Time Infa-Trainer Cup
• Munchkin: Cupsicle, Cupsicle Straw Cup, Big Kid Sippy Cup, Mighty Grip Flip Straw Cup, Mighty Grip Trainer Cup, licensed character Sports Bottles, Re-usable Straw Cups, Re-usable Spill-proof Cups
• Nuby: No-Spill Sports Sipper, Insulated Soft Silicone Spout Cup, Soft Spout Easy Grip Cup, Gripper Cup with Soft Silicone Spout, 2-Handle Cup, Tinted Mega Sipper
• The First Years: Take & Toss, Spill-proof Cup, Insulated Cup, Licensed character sippy cups, Insulated Spill-proof Cup, 2 Handled Cups

BPA Free Milkand Food Storage

• Avent Via 8-oz. Nurser Kit
• Avent Snack Cup / Formula Dispenser
• Mother’s Milkmate Storage bottles
• Medela Milk Storage bottles and breastpump accessories
• Playtex Breastmilk storage kit
• Lansinoh® Breastmilk Storage Bags
• Lansinoh® Breastmilk Storage Bottles
• Gerber Breastmilk Storage Bags
• So Easy Fresh Baby Food Kit
• Baby Cubes
• Laptop Lunch System

*If you are currently using Dr. Browns polycarbonate bottles and would like to switch, the Dr. brown’s venting system (the internal pieces) are BPA Free and are made of polypropylene plastic. Also, they FIT and work with BornFree bottles which could be a little bit of a money saver.

** Dr Browns bottle nipples fit with Green to Grow bottles. As we know once a baby is comfy with something it’s sometimes a pain to change so it’s good to know we don’t have to change everything if we don’t have to. Alicia of The Soft Landing did a more exhaustive report on what nipples fit what bottles. Read about it on her blog here.

Visit Z Recommends for product reviews on many of these BPA-free products. They have done an outstanding job of researching and reviewing these products.

What is Bisphenol A?
Bisphenol A is a harmful chemical found in polycarbonate plastic which is used to make many popular baby bottles and sippy cups, among other things. Bisphenol A (BPA) is a chemical that mimics the action of the human hormone estrogen, which alters our body’s natural pattern. BPA can leach from polycarbonate plastic, usually a hard, clear plastic that is common of many products we use everyday. Effects at even low BPA exposure include prostate cancer, breast cancer, early puberty onset, alterations in gender-specific behavior, decreased sperm count, affects on fertility, behavioral effects including hyperactivity, increased aggressiveness, impaired learning and other changes in behavior, and other problems.

Many companies use this chemical in their packaging including cans, soda cans, and plastic food containers. There is a risk of absorbing this chemical through the use of containing foods and liquids but can also leech into our water systems through landfills.

Many leading experts argue that the use of Bisphenol is safe to the human public but research may begin to further prove otherwise. No level of BPA has been deemed as safe by independent research.

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• US Government says BPA is harmful
• Pregnant women told to avoid BPA
• Today Show report on BPA & plastic safety
• BPA may lead to health problems such as obesity and ADD/ADHD
• Whole Foods private label canned food contain BPA
• Canned foods and BPA
• BPA is found in infant formula
• Gerber baby food containers
• BPA and other plastic safety
• Z Recommends: The Z Report on BPA In Infant Care Products, Third Edition
• Environmental Working Group: Guide to Baby Safe Bottles & Formula
• Environmental Working Groups Report on BPA in Baby Formula
• Breastmilk contains stem cells
• Breastmilk cures
• Can breastmilk cure cancer?

I saw this article this morning. Good advice for pregnant & lactating women in avoiding the hormone mimicking BPA.

Pregnant women told to avoid BPA packaging
By Charlotte Eyre
 
03-Apr-2008 - A US health-advocacy group has warned that pregnant women should reduce their exposure to packaging that contains bisphenol A (BPA) to avoid passing the controversial chemical to their unborn children.

The warning, from the Center for Science in the Public Interest (CSPI), will serve as yet more negative publicity for packaging companies, many of which use BPA when manufacturing polycarbonates for water bottles, canned soups and drinks, and baby food bottles.

“We don’t want to tell people not to eat canned beans or tomatoes,” said CSPI nutritionist David Schardt. “But at the same time, it makes sense for all parents, and especially pregnant and nursing women, to minimize the exposure of their kids’ developing bodies and brains to BPA.”

The group cites a scientific study published by the National Institute of Environmental Health (NIEH) in August last year, which warned that rats exposed to BPA experienced “a wide range of adverse effects”.

While the influence on humans has not yet been fully studied, the NIEH said that the changes in the animals indicated that BPA may provoke childhood health problems such as early onset of puberty, obesity, attention deficit hyperactivity disorder (ADHD) and urogenital abnormalities.

According to the CSPI, these findings are worrying enough to call for pregnant women to boycott packaging products containing BPA.

“In fact, the food industry could make life easier by phasing it out entirely,” Schart said.

Bisphenol A was first studied in the 1930s as a possible mimic of the hormone estrogen in women. The chemical was later developed to make clear plastics for use in the food industry.

Several scientific results have been conducted into the safey of BPA in recent years, and researchers have also linked it to adult health concerns, especially breast and prostate cancer.

In 2007, the European Food Safety Authority (EFSA) set a maximum limit for human daily intake of BPA of five milligrams per kilo of body weight per day, but stressed that more studies were needed to link the chemical with human health problems.

The Canadian government has also launched a study into BPA, the results of which are expected later this year.

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Breastfeeding Makes Top Ten List of Cancer Preventers

Breastfeeding has been named as one of the Ten Recommendations to Prevent Cancer by the American Institute for Cancer Research (AICR) following analysis of a major new study.

The five-year study, released on October 31st found a strong correlation between breastfeeding and the prevention of both pre-menopausal and post-menopausal breast cancer.

According to the study, breastfeeding lowers a woman’s risk of developing breast cancer throughout her lifetime. Equally important, the evidence shows that infants who are breastfed are likely to have a lower risk of becoming overweight or obese throughout their lives. This also translates into a lower cancer risk.

Because the evidence is so strong that breastfeeding offers cancer protection to both mothers and their children, the AICR has made breastfeeding one of its “Ten Recommendations to Prevent Cancer.”

The study states, “at the beginning of life, human milk is best. The evidence that lactation protects the mother against breast cancer at all ages is convincing.” Furthermore, “The evidence on cancer … shows that sustained, exclusive breastfeeding is protective for the mother as well as the child.” This is the first major report to specifically recommend breastfeeding to prevent breast cancer in mothers, and to prevent overweight and obesity in children.

The study goes on to say that “Other benefits of breastfeeding for mothers and their children are well known. Breastfeeding protects against infections in infancy, protects the development of the immature immune system, protects against other childhood diseases, and is vital for the development of the bond between mother and child. It has many other benefits.” For a complete copy of the AICR report, visit: www.dietandcancerreport.org.

Throughout its 51-year history, La Leche League International (LLLI) has supported breastfeeding mothers and their children. Celebrating its 50th year in 2006, LLLI continues to reach out to women seeking information, support, and encouragement for breastfeeding their babies. Local LLL Leaders across the United States offer support through local Group meetings and telephone help, online meetings, and a national toll-free 24-hour help line.

For more information about breastfeeding and for mothers needing assistance with breastfeeding, contact… www.llli.org or 1-800 LA LECHE

Related Articles:

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• Breastmilk cures
• Can breastmilk cure cancer?
• BPA-free milk storage, bottles and sippy cups
• What if I want to wean my baby?
• Breastfeeding Language
• Formula feeding is easy
• Importance of Breastfeeding
• Disturbing news about ARA / DHA in infant formula
• Long journey for mother’s milk

This is a GREAT article by Diane Wiessinger. If you are debating or wanting to wean your baby, she offers great guidelines and the benefits of breastmilk at every age. Even a day is the best gift you can give your baby.

And for those who do not want to wean, but feel the pressure to will also find comfort in this article.

What if I want to Wean My Baby?

Related Articles:

This is a great article written by a lactation consultant.

Watch Your Language
By Diane Wiessinger, MS, IBCLC

The lactation consultant says, “You have the best chance to provide your baby with the best possible start in life, through the special bond of breastfeeding. The wonderful advantages to you and your baby will last a lifetime.” And then the mother bottlefeeds. Why?

In part because that sales pitch could just as easily have come from a commercial baby milk pamphlet. When our phrasing and that of the baby milk industry are interchangeable, one of us is going about it wrong…and it probably isn’t the multinationals. Here is some of the language that I think subverts our good intentions every time we use it.

Best possible, ideal, optimal, perfect. Are you the best possible parent? Is your home life ideal? Do you provide optimal meals? Of course not. Those are admirable goals, not minimum standards. Let’s rephrase. Is your parenting inadequate? Is your home life subnormal? Do you provide deficient meals? Now it hurts. You may not expect to be far above normal, but you certainly don’t want to be below normal.

When we (and the artificial milk manufacturers) say that breastfeeding is the best possible way to feed babies because it provides their ideal food, perfectly balanced for optimal infant nutrition, the logical response is, “So what?” Our own experience tells us that optimal is not necessary. Normal is fine, and implied in this language is the absolute normalcy–and thus safety and adequacy–of artificial feeding. The truth is, breastfeeding is nothing more than normal. Artificial feeding, which is neither the same nor superior, is therefore deficient, incomplete, and inferior. Those are difficult words, but they have an appropriate place in our vocabulary.

Advantages. When we talk about the advantages of breastfeeding–the “lower rates” of cancer, the “reduced risk” of allergies, the “enhanced” bonding, the “stronger” immune system–we reinforce bottlefeeding yet again as the accepted, acceptable norm.

Health comparisons use a biological, not cultural, norm, whether the deviation is harmful or helpful. Smokers have higher rates of illness; increasing prenatal folic acid may reduce fetal defects. Because breastfeeding is the biological norm, breastfed babies are not “healthier;” artificially-fed babies are ill more often and more seriously. Breastfed babies do not “smell better;” artificial feeding results in an abnormal and unpleasant odor that reflects problems in an infant’s gut. We cannot expect to create a breastfeeding culture if we do not insist on a breastfeeding model of health in both our language and our literature.

We must not let inverted phrasing by the media and by our peers go unchallenged. When we fail to describe the hazards of artificial feeding, we deprive mothers of crucial decision-making information. The mother having difficulty with breastfeeding may not seek help just to achieve a “special bonus;” but she may clamor for help if she knows how much she and her baby stand to lose. She is less likely to use artificial milk just “to get him used to a bottle” if she knows that the contents of that bottle cause harm.

Nowhere is the comfortable illusion of bottlefed normalcy more carefully preserved than in discussions of cognitive development. When I ask groups of health professionals if they are familiar with the study on parental smoking and IQ (1), someone always tells me that the children of smoking mothers had “lower IQs.” When I ask about the study of premature infants fed either human milk or artificial milk (2), someone always knows that the breastmilk-fed babies were “smarter.” I have never seen either study presented any other way by the media–or even by the authors themselves. Even health professionals are shocked when I rephrase the results using breastfeeding as the norm: the artificially-fed children, like children of smokers, had lower IQs.

Inverting reality becomes even more misleading when we use percentages, because the numbers change depending on what we choose as our standard. If B is 3/4 of A, then a is 4/3 of B. Choose A as the standard, and B is 25% less. Choose B as the standard, and A is 33 1/3% more. Thus, if an item costing 100 units is put on sale for “25% less,”the price becomes 75. When the sale is over, and the item is marked back up, it must be marked up 33 1/3% to get the price up to 100. Those same figures appear in a recent study (3), which found a “25% decrease” in breast cancer rates among women who were breastfed as infants. Restated using breastfed health as the norm, there was a 33-1/3% increase in breast cancer rates among women who were artificially fed. Imagine the different impact those two statements would have on the public.

Special. “Breastfeeding is a special relationship.” “Set up a special nursing corner.” In or family, special meals take extra time. Special occasions mean extra work. Special is nice, but it is complicated, it is not an ongoing part of life, and it is not something we want to do very often. For most women, nursing must fit easily into a busy life–and, of course, it does. “Special” is weaning advice, not breastfeeding advice.

Breastfeeding is best; artificial milk is second best. Not according to the World Health Organization. Its hierarchy is: 1) breastfeeding; 2) the mother’s own milk expressed and given to her child some other way; 3) the milk of another human mother; and 4) artificial milk feeds (4). We need to keep this clear in our own minds and make it clear to others. “The next best thing to mother herself” comes from a breast, not from a can. The free sample perched so enticingly on the shelf at the doctor’s office is only the fourth best solution to breastfeeding problems.

There is a need for standard formula in some situations. Only because we do not have human milk banks. The person who needs additional blood does not turn to a fourth-rate substitute; there are blood banks that provide human blood for human beings. He does not need to have a special illness to qualify. All he needs is a personal shortage of blood. Yet only those infants who cannot tolerate fourth best are privileged enough to receive third best. I wonder what will happen when a relatively inexpensive commercial blood is designed that carries a substantially higher health risk than donor blood. Who will be considered unimportant enough to receive it? When we find ourselves using artificial milk with a client, let’s remind her and her health care providers that banked human milk ought to be available. Milk banks are more likely to become part of our culture if they first become part of our language.

We do not want to make bottlefeeding mothers feel guilty. Guilt is a concept that many women embrace automatically, even when they know that circumstances are truly beyond their control. (My mother has been known to apologize for the weather.)

Women’s (nearly) automatic assumption of guilt is evident in their responses to this scenario: Suppose you have taken a class in aerodynamics. You have also seen pilots fly planes. Now, imagine that you are the passenger in a two-seat plane. The pilot has a heart attack, and it is up to you to fly the plane. You crash. Do you feel guilty?

The males I asked responded, “No. Knowing about aerodynamics doesn’t mean you can fly an airplane.” “No, because I would have done my best.” “No. I might feel really bad about the plane and pilot, but I wouldn’t feel guilty.” “No. Planes are complicated to fly, even if you’ve seen someone do it.” What did the females say? “I wouldn’t feel guilty about the plane, but I might about the pilot because there was a slight chance that I could have managed to land that plane.” “Yes, because I’m very hard on myself about my mistakes. Feeling bad and feeling guilty are all mixed up for me.” “Yes, I mean, of course. I know I shouldn’t, but I probably would.” “Did I kill someone else? If I didn’t kill anyone else, then I don’t feel guilty.” Note the phrases “my mistakes,” “I know I shouldn’t,” and “Did I kill anyone?” for an event over which these women would have had no control!

The mother who opts not to breastfeed, or who does not do so as long as she planned, is doing the best she can with the resources at hand. She may have had the standard “breast is best” spiel (the course in aerodynamics) and she may have seen a few mothers nursing at the mall (like watching the pilot on the plane’s overhead screen). That is clearly not enough information or training. But she may still feel guilty. She’s female.

Most of us have seen well-informed mothers struggle unsuccessfully to establish breastfeeding, and turn to bottlefeeding with a sense of acceptance because they know they did their best. And we have seen less well-informed mothers later rage against a system that did not give them the resources they later discovered they needed. Help a mother who says she feels guilty to analyze her feelings, and you may uncover a very different emotion. Someone long ago handed these mothers the word “guilt.” It is the wrong word.

Try this on: You have been crippled in a serious accident. Your physicians and physical therapists explain that learning to walk again would involve months of extremely painful and difficult work with no guarantee of success. They help you adjust to life in a wheelchair, and support you through the difficulties that result. Twenty years later, when your legs have withered beyond all hope, you meet someone whose accident matched your own. “It was difficult,” she says. “It was three months of sheer hell. But I’ve been walking every since.” Would you feel guilty?

Women to whom I posed this scenario told me they would feel angry, betrayed, cheated. They would wish they could do it over with better information. They would feel regret for opportunities lost. Some of the women said they would feel guilty for not having sought out more opinions, for not having persevered in the absence of information and support. But gender-engendered guilt aside, we do not feel guilty about having been deprived of a pleasure. The mother who does not breastfeed impairs her own health, increases the difficulty and expense of infant and child rearing, and dismisses one of life’s most delightful relationships. She has lost something basic to her own well-being. What image of the satisfactions of breastfeeding do we convey when we use the word “guilt”?

Let’s rephrase, using the words women themselves gave me: “We don’t want to make bottlefeeding mothers feel angry. We don’t want to make them feel betrayed. We don’t want to make them feel cheated.” Peel back the layered implications of “we don’t want to make them feel guilty,” and you will find a system trying to cover its own tracks. It is not trying to protect her. It is trying to protect itself. Let’s level with mothers, support them when breastfeeding doesn’t work, and help them move beyond this inaccurate and ineffective word.

Pros and cons, advantages and disadvantages. Breastfeeding is a straight-forward health issue, not one of two equivalent choices. “One disadvantage of not smoking is that you are more likely to find secondhand smoke annoying. One advantage of smoking is that it can contribute to weight loss.” The real issue is differential morbidity and mortality. The rest–whether we are talking about tobacco or commercial baby milks–is just smoke.

One maternity center uses a “balanced” approach on an “infant feeding preference card” (5) that lists odorless stools and a return of the uterus to its normal size on the five lines of breastfeeding advantages. (Does this mean the bottlefeeding mother’s uterus never returns to normal?) Leaking breasts and an inability to see how much the baby is getting are included on the four lines of disadvantages. A formula-feeding advantage is that some mothers find it “less inhibiting and embarrassing.” The maternity facility reported good acceptance by the pediatric medical staff and no marked change in the rates of breastfeeding or bottlefeeding. That is not surprising. The information is not substantially different from the “balanced” lists that the artificial milk salesmen have peddled for years. It is probably an even better sales pitch because it now carries very clear hospital endorsement. “Fully informed,” the mother now feels confident making a life-long health decision based on relative diaper smells and the amount of skin that shows during feedings.

Why do the commercial baby milk companies offer pro and con lists that acknowledge some of their product’s shortcomings? Because any “balanced” approach that is presented in a heavily biased culture automatically supports the bias. If A and B are nearly equivalent, and if more than 90% of mothers ultimately choose B, as mothers in the United States do (according to an unpublished 1992 Mothers’ Survey by Ross Laboratories that indicated fewer than 10% of U.S. mothers nursing at a year), it makes sense to follow the majority. If there were an important difference, surely the health profession would make a point of staying out of the decision-making process. It is the parents’ choice to make. True. But deliberately stepping out of the process implies that the “balanced” list was accurate. In a recent issue of Parenting magazine, a pediatrician comments, “When I first visit a new mother in the hospital, I ask, ‘Are you breastfeeding or bottlefeeding?’ If she says she is going to bottlefeed, I nod and move on to my next questions. Supporting new parents means supporting them in whatever choices they make; you don’t march in postpartum and tell someone she’s making a terrible mistake, depriving herself and her child.” (6)

Yet if a woman announced to her doctor, midway through a routine physical examination, that she took up smoking a few days earlier, the physician would make sure she understood the hazards, reasoning that now was the easiest time for her to change her mind. It is hypocritical and irresponsible to take a clear position on smoking and “let parents decide” about breastfeeding without first making sure of their information base. Life choices are always the individual’s to make. That does not mean his or her information sources should be mute, nor that the parents who opt for bottlefeeding should be denied information that might prompt a different decision with a subsequent child.

Breastfeeding. Most other mammals never even see their own milk, and I doubt that any other mammalian mother deliberately “feeds” her young by basing her nursing intervals on what she infers the baby’s hunger level to be. Nursing quiets her young and no doubt feels good. We are the only mammal that consciously uses nursing to transfer calories…and we’re the only mammal that has chronic trouble making that transfer.

Women may say they “breastfed” for three months, but they usually say they “nursed” for three years. Easy, long-term breastfeeding involves forgetting about the “breast” and the “feeding” (and the duration, and the interval, and the transmission of the right nutrients in the right amounts, and the difference between nutritive and non-nutritive suckling needs, all of which form the focus of artificial milk pamphlets) and focusing instead on the relationship. Let’s all tell mothers that we hope they won’t “breastfeed”–that the real joys and satisfactions of the experience begin when they stop “breastfeeding” and start mothering at the breast.

All of us within the profession want breastfeeding to be our biological reference point. We want it to be the cultural norm; we want human milk to be made available to all human babies, regardless of other circumstances. A vital first step toward achieving those goals is within immediate reach of every one of us. All we have to do is…watch our language.

If you found this article of interest, you may desire to ensure you regularly receive your own copy of the Journal of Human Lactation(JHL). Taking out membership in the International Lactation Consultant Association(ILCA)includes the benefit of four issues of the JHL a year. See www.ilca.org for how to join.

Reprinted from the Journal of Human Lactation, Vol. 12, No. 1, 1996

References: 1. Olds D. L., Henderson, C. R. Tatelbaum, R.: Intellectual impairment in children of women who smoke cigarettes during pregnancy. Pediatrics 1994; 93:221-27.2. Lucas, A., Morley, R., Cole, T.J., Lister, G., Leeson-Payne, C.: Breast milk and subsequent intelligence quotient in children born preterm. Lancet 1992; 339 (8788): 261-64. 3. Fruedenheim, J.L., Graham, S., Laughlin, R., Vena, J.E., Bandera, E., et al: Exposure to breastmilk in infancy and the risk of breast cancer. Epidemiology 1994, 5:324-30. 4. UNICEF, WHO, UNESCO: Facts for Life: A Communication Challenge. New York: UNICEF 1989; p. 20. 5. Bowles, B.B., Leache, J., Starr, S., Foster, M.: Infant feeding preferences card. J Hum Lact 1993; 9: 256-58. 6. Klass, P.: Decent exposure. Parenting (May) 1994; 98-104. to kayhh’s Breastfeeding page

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I came across this article and thought it was very interesting in what is all takes to formula feed compared to breastfeeding. I was also surprised to learn that formula fed babies consume 30,000 more calories than breastfed babies by the time they are 8 months old. The article says this is a factor contributing to childhood obesity. Never force a baby to finish a bottle — no matter the substance. Babies stop eating when they are full and naturally do not overeat (if we could only carry this trait with us to adulthood). This is even true as they enter toddlerhood. A child’s stomach is only as big as their sweet little fist. 

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Great article showing the benefits of breastfeeding. 

Illawarra Mercury
22 February 2008 - 5:00AM 
 
Breastfeeding benefit no baby talk
By KATELIN McINERNEY  
 
More women than ever are aware of the benefits of breastfeeding their children, but few are aware of the dangers associated with ceasing breastfeeding too early in a child’s life.

University of Wollongong doctoral student Nina Berry has warned many women do not receive enough information about the risks associated with weaning infants too early.

“The ‘breast is best’ message is a mantra women all over the world can recite now,” she said.

“To say that ‘breast is best’ is to suggest that what breastfeeding offers is a handful of optional bonuses and that formula-fed infants are the normal standard for comparison.

“But it may have obscured the well-established risks associated with early weaning from breastfeeding and while most people accept that breastfed babies are healthier, they do not understand that this means that formula-fed babies are likely to be sicker.”

Ms Berry, from the University’s Centre for Health Initiatives, co-authored a report on her findings with Dr Karleen Gribble from the University of Western Sydney.

She said women needed to be better informed of the health risks by health professionals.

The World Health Organization recommends children be breastfed for up to two years and should not be given any food or drink other than breast milk for their first six months.

My Comments: New and expecting mothers need to be better educated on this topic. I know it is a “hot” topic, but there really is no debate when it comes to breast vs. bottle. Formula is not and will never be even close to breastmilk. Anyone who says different is simply uneducated on the topic. There is way too much evidence to back this up. Not that formula is bad, it just is not breastmilk.

I do understand not all women can breastfeed their child and I am sensitive to that. Some have certain illnesses must take medication that could cross the milk and harm an infant. Obviously in such cases the health of the mother is more important than her breastfeeding her child and posing additional risk (in the past this is where a wet nurse would come in). 

However if you do have a medical condition that requires medication and you really want to breastfeed, please do not take your specialists word for it that the medicine you are taking puts your child at risk. Google the medication and its safety while nursing. Get your hands on Dr. Thomas Hale’s book Medications and Mother’s Milk. He is a doctor who has done extensive research on many types of drugs and how it affects nursing moms and their babies. Many specialists are too quick to say certain drugs are not safe, when in fact they are, or there may be effective and safer alternatives available.

I have a friend who had to be on medication for a blood cot that formed in her leg soon after her daughter’s birth. The doctor at the hospital said she would not be able to nurse her newborn — she was heartbroken as she really wanted to breastfeed. After consulting with a good lactation consultant and other doctors, she discovered the medication was in fact safe. She immediately started pumping and sending milk home from the hospital for her newborn daughter.

Of course, in some instances, there may not be a safe alternative leaving a mother who does want to breastfeed no choice but to offer formula. Your pediatrician can help you find the best formula for your baby. Be aware that a new study shows DHA / ARA in infant formula may be harmful. This study does not say all formula is harmful, but many babies have had bad reactions to formulas with DHA / ARA. So if you choose to formula feed or you need to supplement while still breastfeeding, you may want to consider those that do not contain DHA / ARA.

In the US, human breast milk banks are hard to find, but are an option for those who cannot medically breastfeed. You must have a prescription from your pediatrician and it is quite expensive if you can even get access to it.

Educate yourself to make the best decision for your family. It is not hard to breastfeed and be successful at it – find a good support system, a pro-breastfeeding pediatrician and don’t listen to people who are not educated about breastfeeding. Surprisingly, many in the medical field are not educated about breastfeeding, sadly this includes many pediatricians (fortunately, mine is not one of them) and even the nurses at the OB’s office (I have been a victim here).

Before I got pregnant, I figured I’d “try” breastfeeding (after all it is free!). Once I started to read and learn more about it, I questioned why more people didn’t try to breastfeed being there were so many benefits (and it was free!). Then I realized it is lack of education, and I personally fell into this trap. I do not want to offend friends or anyone, so I sometimes bite my tongue when someone says something about breastfeeding that is simply not true, I probably should not do this everytime. It’s hard to find a balance when you want to clarify and but not offend. Every situation is unique of course, and many who know the benefits will still choose to formula feed even if they can breastfeed. 

Breastfeeding is beautiful and a perfect way to bond with your new baby. Breastfeeding experiences differ from mom to mom, so don’t be afraid if you hear about bad experiences. Mine has been great and going strong now for 23 months. If you choose to breastfeed, my best advice is give things 6-8 weeks to establish a rhythm with your baby. It does not hurt and it is perfectly natural.

Some other facts:
UNICEF and the WHO recommends breastfeeding exclusively for the first 6 months of life (no water, juice or other foods) and offer complementary foods thereafter until at least age 2. The American Academy of Pediatrics also agrees and supports breastfeeding for as long as mutually desired by the mother and child.

UNICEF says “Research shows that exclusive breastfeeding for the first six months – with continued breastfeeding for the first year – could save 1.3 million lives every year,” says Miriam Labbok, UNICEF Senior Advisor on Infant and Young Child Feeding.

“This is well over 3,000 lives each and every day. And if breastfeeding is continued alongside appropriate complementary feeding until at least age two – we could be saving 5,500 additional lives each and every day of every year.”

Resources to learn more about breastfeeding and its benefits to mother and baby:

kellymom.com

Mothering from the heart: Benefits for Mom and Baby

Keep Kids Healthy

UNICEF

WHO

La Leche Leauge

Dr. Sears

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