Director-at-Large,
Breastfeeding Coalition of Ventura County
Literature is replete with scientific evidence on the benefit of the most natural process of a mother breast feeding her baby
Exclusive breast feeding in the first six months of life can cut down under-five child mortality by
13-15%
There could not be more compelling reasons for breastfeeding
1. The American Academy of Pediatrics recommends it
2. Breastfeeding promotes bonding between mother and baby
3. Breastfeeding satisfies baby's emotional needs
4. Breast milk provides perfect infant nutrition
5. Not breastfeeding increases mother's risk of breast cancer
6. Formula feeding increases baby girls' risk of developing breast cancer in later life
7. Formula Feeding is associated with lower I.Q.
8. Breast milk is always ready and comes in a nicer package than formula does
9. Breast milk helps pass meconium
10. Breast milk contains immunities to diseases and aids in the development of baby's immune system.
11. Breast milk is more digestible than formula
12. Suckling helps shrink mother's uterus after childbirth
13. Suckling helps prevent post-partum hemorrhage
14. Nursing helps mom lose weight after baby is born
15. Pre-term milk is specially designed for premature infants
16. The World Health Organization and UNICEF recommend it
17. Breastfeeding protects against Crohn's disease
18. Formula feeding increases risk of baby developing type I (juvenile, insulin-dependent) diabetes.
19. Breastfeeding decreases insulin requirements for breastfeeding mothers
20. Breastfeeding stabilizes progress of maternal endometriosis
21. Not breastfeeding increases mother's risk of developing ovarian cancer
22. Not breastfeeding increases mother's risk of developing endometrial cancer
23. Formula feeding increases chances of baby developing allergies
24. Breast milk lowers risk of baby developing asthma
25. Formula feeding increases baby's risk of otitis media (ear infections)
26. Formula feeding may increase risk of sudden infant death syndrome (S.I.D.S.)
27. Breastfeeding protects baby against diarrheal infections
28. Breastfeeding protects baby against bacterial meningitis
29. Breastfeeding protects baby against respiratory infections
30. Formula fed babies have a higher risk of developing certain childhood lymphomas
31. Breastfeeding decreases chances of juvenile rheumatoid arthritis
32. Breastfeeding decreases child's chances of contracting Hodgkins disease
33. Breastfeeding protects baby against vision defects
34. Breastfeeding decreases chances of maternal osteoporosis in later life
35. Breast milk is an intestinal soother
36. Cows milk is an intestinal irritant
37. Formula-fed babies are more at risk for obesity in later life
38. Breastfed babies have less chance of cardiopulmonary distress while feeding
39. Breastfed babies have less chance of developing ulcerative colitis
40. Breast milk protects against Haemophilus Influenzae B disease
41. Breastfed babies require shorter pre and post-surgical fasting
42. Breastfeeding results in less sick days for parents
43. Breastfeeding enhances vaccine effectiveness
44. Breastfed babies have less chance of developing necrotizing enterocolitis
45. Breastfeeding is a natural contraceptive
46. Breastfeeding is easier than using formula
47. Breast milk is free
48. Formula is expensive
49. Formula costs the government (and taxpayers) millions of dollars
50. Breast milk is always the right temperature
51. Breast milk always has the right proportions of fat, carbohydrates and protein
52. Breast milk acts like a natural tranquilizer for baby
53. Breastfeeding acts like a natural tranquilizer for mom
54. Breast milk tastes better than formula
55. Breastfed babies are healthier over-all
56. Breastfed babies are less likely to die before their third birthday
57. Breastfed babies require fewer doctor visits
58. Breastfeeding mothers spend less time and money on doctor visits
59. Fewer waste packaging products
60. No bottles to tote
61. Less cow induced global greenhouse gasses
62. No need to refrigerate
63. Cows milk is designed for baby cows
64. Human milk is designed for baby humans
65. Natural pain relief for baby
66. Perfect food for sick baby
67. More sleep for mom
68. More sleep for baby
69. More sleep for dad
70. Less equipment to maintain and store
71. Less equipment to buy
72. Breast milk has never been recalled
73. Fresh breast milk is never contaminated with bacteria
74. No need to worry about which brand is better
75. No need to worry about adding contaminated water
76. Breastfeeding helps reduce cruelty to farm animals
77. Facilitates proper dental and jaw development
78. Breastfed babies get fewer cavities
79. Less money spent on corrective orthodontia
80. Better speech development
81. Less chance of baby getting eczema
82. Breastfed babies have great skin
83. Less gastrointestinal reflux (Spit-up)
84. Easier to clean spit-up stains
85. Breast milk contains no genetically engineered materials
86. Contains no synthetic growth hormones
87. Lack of breastfeeding associated with multiple sclerosis
88. Less chance of inguinal hernia
89. Better cognitive development
90. Better social development
91. Decreased risk of baby developing urinary tract infections
92. Suckling optimizes hand-to-eye coordination
93. Protects mothers against anemia (iron deficiency)
94. Less money spent on menstrual supplies
95. Self confidence booster for mom
96. Breast milk is good for combatting eye infections
97. Breast milk is a good natural antibiotic for wounds
98. No worry about latest ingredient discovered to be missing from formula
99. Much nicer diaper changes
100. Breastfed babies smell fantastic
101. It's what breasts were designed for!
"Human milk is the preferred feeding for all infants, including premature and sick newborns... It is recommended that breastfeeding continue for at least the first 12 months, and thereafter for as long as mutually desired.”
"Human milk is uniquely superior for infant feeding and is species-specific; all substitute feeding options differ markedly from it. The breastfed infant is the reference or normative model against which all alternative feeding methods must be measured with regard to growth, health, development, and all other short and long-term benefits.”
“Unbeknownst to most health professionals, a revolution is taking place in the way U.S. infants are being fed human milk. The possible benefits or harms resulting from exclusive pumping merit careful study.”
- American Journal of Public Health
Why is this happening?
Widespread availability and inexpense, convenience, lack of education, pumping is started too early, formula is introduced, no evidence to the contrary
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“To follow her doctor’s orders, a woman who returns to work 12 weeks after childbirth has to find a way to feed her baby her own milk for another nine month. The nation suffers, in short, from a Human Milk Gap. There are three ways to bridge that gap: longer maternity leaves, on-site infant childcare, and pumps. Much effort has been spent implementing option No. 3, the cheap way out.” - Lepore, New Yorker , 2009
“Your baby still gets almost all the benefits of breastfeeding”
“no learning curve”
“no sore nipples”
“you know exactly how much your baby is eating”
“you can eliminate hunger as a cause for crying / fussiness”
“easier to get your baby on a schedule”
“The lactation consultant wanted me to breastfeed then pump after each feed and that was just too much work. That was the key reason I decided to pump exclusively.”
“I hope to exclusively breastfeed for my 12-week maternity leave. But, obviously, when I go back to work I will be pumping and breastfeeding. I’m not looking forward to having to pump at work, but I guess I have no choice.”
Baby Food. January 2009 New Yorker. Jill Lepore. http://www.newyorker.com/magazine/2009/01/19/ba by-food
The Case Against Breast Feeding. April 2009.
Hanna Rosin. http://www.theatlantic.com/magazine/archive/2009/0
4/the-case-against-breast-feeding/307311/
Ban the Breast Pump by Judith Warner. New York
Times Opinion Page. April 2009. http://opinionator.blogs.nytimes.com/2009/04/02/why
-i-dumped-the-pump/?_r=0
“I wish I could breastfeed directly, but my baby was too freaked out when he could not latch on properly. I am glad I pump though because apparently my milk supply is not that much. I could not imagine my baby getting so frustrated everyday cause I don’t have much milk. With pumping, he gets to drink without freaking out and I just supplement with formula when I don’t have enough.”
“My baby bruised my nipples so bad the LC suggested pumping until I healed, but I never went back to breastfeeding.”
“I just prefer breastfeeding but if you encounter problems, then pumping will be a good solution.
Knowing that pumping doesn’t have that much of a disadvantage over breastfeeding.”
“Breastfeeding is definitely easier, but your LO can still get all the benefits of breastmilk if you are pumping.”
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Refrigeration reduces ascorbic acid concentrations and reduces antioxidant activity.
Freezing breaks down immunological cells and lipids
(but doesn’t affect antibodies).
Milk changes according to a baby’s needs: with age, through the day, and over course of feeding session.
Most women cannot pump as often as they can nurse directly
Most women cannot pump the same quantity of milk as they can feed directly (pump vs baby)
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Mothers stop BF 73% within first 6 weeks (self-report):
Baby self-weans (47%)
In another study of undesired weaning, at least two of the following three problems occurred in the majority of women: Breast pain, low milk supply, latch problems
Breast-milk didn’t satisfy baby / supply went down (22-44%)
Baby began to bite (32%)
Fatigue (23%)
Inconvenience (22%)
Why do moms not have enough supply?
Infrequency of feeding or pumping
Likelihood to pump long term (needs to be studied)
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“… Surprising that only a few studies have actually tested this hypothesis in humans, and even fewer have found significant results. Here, we review the small literature on the impact of breastfeeding on the mother– child bond. Briefly, however, we found no studies with evidence that breastfed infants are more securely attached to their mothers than formula-fed infants.”
Jennifer Hahn-Holbrook, Breastfeeding an Maternal Mental and Physical Health, 2013
Infection rates are higher in baby
Coughing and wheezing episodes (well documented)
Ear Infections (Position and dynamics of suck/swallow/breathe cycle is different in bottle-fed babies)
Contamination (Bacterial counts are higher)
Mastitis is higher in some EP’ing mothers
Longer intervals, poor milk drainage, poor duct rotation, tight fitting bras / purses
“Baby Backwash” – visualized on US
Theory of Dr Kakulas, well published in Clinical and
Translational Immunology because of moms “leukocyte blast” to baby, even when she does not have evidence of illness.
Risk of bottle-feeding for rapid weight gain during the first year of life . Arch Pediatr Adolesc Med. Li R. 2012
Sophisticated study. 4 intervals of weight, 3 proportions of milk feedings by bottle vs breast
Infants fed formula by bottle only had largest monthly weight gain
Breastfed-only had lowest monthly gain.
Breast and formula: gained 45 gms per month more
Bottle only (whether human milk or formula!) gained 89 gms more per month
What we know
Before BF, oxytocin is released in mom to aid in milk ejection
Mothers separated from their infants before a feeding session do not show this pre-feeding oxytocin release. So, it appears that infant cues drive this.
Tactile stimulation received from the nipple, OXY & PRL are released
Sucking promotes sleep, soothing, relieves pain
Breast vs. bottled human milk? We don’t know. Many of these studies don’t even describe how the suckling was performed (breast or bottle).
The basic research on rats describes “lactating rats”, but it doesn’t say if they used a tiny rat breast pump.
What we don’t know
Could that be a Pavlovian behavioral response?
Even if the oxytocin release happens because of baby, not pump, does that really cause a difference in the bonding?
How do we measure bonding?
Number of hours of sleep
Directly breastfed babies as well as their mothers and fathers sleep longest
Some early studies and expert opinions
(James McKenna, PhD) suggest co-sleeping actually increases the number of hours of sleep as well
Parents sleep least when combining bottle and breast / “los dos cosas”
In between: bottle-fed only babies
Quality of sleep?
Every 10% increase in the proportion of bottle-feedings
( regardless of the bottle contents ) was associated with a
4.1% increase in monthly weight gain.
Human milk (by any method) vs formula was associated with an insignificant increase
Direct breastfeeding results in a distinctly different growth pattern compared to providing human milk by bottle. Bottle-feeding may be a risk factor for more rapid infant weight gain, regardless of the contents.
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Primary responsibility lies with OBSTETRICIAN /
FAMILY DOCTOR (prenatal care provider)!
BF decision is made in 1 st . Stress DIRECT!
Encouragement and education from HCP results in increased BF initiation and duration.
Consistency in message and longer relationship with a provider increase likelihood for action / change (ie. Quitting smoking, weight loss)
Needs to be mentioned at MOST prenatal visits.
By the time they get to the pediatrician, it may be too late.
Newborns have no OP, and the epiglottis and soft palate overlap with the tongue anterior to the airway. This allows for newborns to simultaneously suckle milk and breathe.
18 months of age, they resemble an adult human. This gives them the ability to vocalize and make complex sounds, but begins to inhibit their ability to suckle and breathe at the same time.
Breast-feeding encourages the proper development of the swallowing action of the tongue; promotes good teeth alignment and proper shaping of the hard palate.
Studies have shown that bottle-feeding and pacifiers encourage the formation of a high palate and narrow arch, good predictors of OSA.
Broad palates and wide, U-shaped, uncrowded dental arches do not predispose to OSA.
Prevention of OSA: direct breast-feeding, limit pacifiers, and control finger habits.
When “breastfeeding is fully established” (4 weeks)
High suck need in order to demand more production
“He is placing an order for 3 to 5 days from now. If you place him on the breast 5 minutes after he is done eating and there really is no colostrum or milk, your body is getting the signal that you need to make more! If you use a pacifier, your body doesn’t learn that. The same is true for formula.”
Colostrum gets replaced quickly, so they absolutely can nurse every 45 minutes. Falling asleep in between is okay!
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“ … nature has designed the provision that infants be fed upon their mother ’ s milk. They find their food and mother at the same time. It ’ s a complete nourishment for them both for their body and soul.
”
Rabindranath Tagore,
Nobel Prize for
Literature 1913
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