Friday, February 4, 2011

A Dozen Days of Doula Scoop: Day 10

Breastfeeding: Just do it.

After wading the murky pond of labor options and the risks and benefits of various interventions during delivery, its refreshing to enter the crystal clear water of some definitive scientific evidence. Not to give away the punchline, but the verdict is in, and breastfeeding is better for babies. Period. Except in a few rare situations where the mother is HIV positive or has another body-fluid born virus, mothers who breastfeed their babies are conferring a hosts of benefits on their babies with none of the risks inherent in formula feeding and should absolutely breastfeed if they possibly can. A strong statement? Yes. However, scientific evaluation of breast milk versus formula has shown that breastmilk is a superior food for an infant which means, by default, that formula is an inferior food. Breastmilk is tailored to the specific needs of babies at every stage of development, from the colostrum babies get in the first couple of days of life (high in concentrated nutrients but easy to digest), to the milk produced for a breastfeeding toddler that has increased fat and energy contents and continues to deliver protective antibodies (read: less sickness). Formula delivers the same limited nutrients to babies at every stage of development. Breastmilk is chock full of dozens of kinds of beneficial bacteria that subsequently populate the baby's intestines, providing a barrier against infectious agents and potential allergens. Some formulas have one strain of beneficial bacteria that may or may not be viable by the time the baby ingests it. Breastmilk protects against allergies, formula often triggers them (trust me, you do not want this to happen!). Breastmilk is good, good, good stuff!

So why don't more American moms breastfeed their babies? I believe there are two primary problems: cultural stigma and lack of support. Add to that the way that formula is vigorously marketed while breastfeeding makes no one any money, and you have a recipe for babies not getting the perfect food. Somehow moms have gotten the message that breastfeeding is inconvenient, immodest and painful, and while it can be any of these three things, it doesn't have to be. Breastfeeding is, in my opinion, more convenient than bottle feeding. You don't have to worry about sterilizing twenty pieces of equipment (unless you're pumping, which does add a challenge, though not an insurmountable one), you don't have to test the temperature of the milk to make sure it doesn't burn your baby, and you don't have to pay for it (who doesn't love free stuff?). You don't have to stumble around in the middle of the night trying to find a clean bottle and fill it with formula when you can hardly get your eyes open. You just pick up your baby, uncover your breast, and doze while the baby nurses. You can sit in a glider with your feet propped up, recline on your bed, or lie on your side without worrying about a bottle not being held at the proper angle. And many breastfed babies don't even need to be burped since they don't swallow a lot of air while nursing. As for breastfeeding modestly, it is very possible. In most places, you can find a private corner where you can feed your baby without fear of exposure, but even if you have to nurse in the crowded waiting room of your pediatrician's office, you can throw a blanket over your shoulder and feed your baby while staying covered yourself. (My babies never did tolerate the blanket over the head, so I usually retreated to the car if I couldn't find another relatively private location.) Especially once your baby is older, their heads will cover the exposed part of your breast and you can tuck your shirt low enough to cover everything else. Finally, is nursing painful? For some women, it is, and continues to be painful. In most cases, the pain has a cause, i.e. the baby is latching poorly, or mom has a fungal infection of the nipple. For the first few days, breastfeeding is often uncomfortable as baby figures out how latch properly and the nipples adjust to vigorous sucking. This is a time when support from a lactation consultant or another woman who has breastfed a baby is critical. Without help and encouragement, many moms give up before breastfeeding gets easier, because they think it will be that hard the entire time they're breastfeeding. Some mom/baby pairs figure out the nursing dance pretty quickly, while others need a few weeks before it feels natural.

There are a few things you can do to facilitate an easy start to breastfeeding:
  • Give birth without pain medications if possible. These tend to make babies lethargic for a few days which makes it hard to get them interested in breastfeeding.
  • Forego IV fluids, as they can cause tissue swelling in the breast which makes it more difficult for little newborn mouths to latch on.
  • Get the baby skin to skin with mama as soon as she emerges. You may have to fight hospital policy to get your way on this one (they want to wash, weigh and measure, and do the newborn examination right away; if baby is breathing and healthy, these things can wait), but it's worth it because babies who spend the first hour or two of their life skin to skin with mama actually have the ability to find the nipple and latch themselves on without help. It doesn't get any easier than that!
  • Room in (keep your baby with you) instead of sending your baby to the nursery. This is not a guilt trip on you if you send your baby to the nursery while you nap for an hour or two! However, moms are able to be in tune with their babies' hunger cues (opening their mouth wide, sucking on fist, rooting around) when they are close. A busy nurse may not notice a baby's hunger cues until he's crying. This is a late sign of hunger for a newborn, and most babies need to be calmed before their mom can even try to feed them if they have been crying.
  • Take advantage of the lactation specialist before you leave the hospital. Especially if you're having breastfeeding difficulties, a lactation specialist has a wealth of information about getting babies latched on, pumping, and more. Seek help early if you feel things are not going well. Babies arrive with an energy reserve that allows them a few days to figure out this thing called eating, but it's important to get things moving before this energy reserve runs out.
  • Talk to other breastfeeding moms or your doula for encouragement. We all need to know other people have been there and made it through, especially when it comes to this demanding thing called parenting.
I know this entire post has been extremely pro-breastfeeding, and I wish every mom could breastfeed their baby, but I know that, in many cases, the desire to breastfeed is there, but for whatever reason, breastfeeding is not possible. Maybe because the mom has to go back to work and doesn't have much success with pumping or because she has breast infection after breast infection. Not being able to breastfeed when you really wanted to is a loss that you may need to grieve a little bit. That's okay. It's also okay to give yourself a free pass on the guilt. We all want to do more for our children than we ever possibly could. Despite the fact that most parents don't get around to half the things they want to do for their children, most of us turn out okay. Your children will too. If you love them and do your best as their parent, that is the most important thing. But if you can breastfeed your baby, persevere! The benefits are proven, and there is a sweet emotional bonding that takes place when you snuggle your baby to your breast.

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