Breastfeeding

Breastfeeding2

I have to admit that I was in two minds about writing this article, as it has become such a controversial topic. But isn’t it sad that we live in a society where that is the case? I mean we’re talking about BREASTFEEDING… it’s such a natural thing; why does that have to be controversial? Sadly, in Western societies it is becoming an avoided and very sensitive subject, and there is a war being created between mothers that breastfeed and mothers that don’t. Before I continue on this subject, I want to make it very clear that this article is NOT written to shame mothers that don’t breastfeed, or to say that those that do are in any way superior or better.

I decided to write this article because I feel it is very important for us to start talking openly about the topic and questioning why it has become such a sensitive one. I think it is important for us to have an open dialogue in order to educate ourselves, change the attitude towards breastfeeding and give new mothers the correct facts and support in order to allow them to make an informed decision; rather than one that is influenced by the system we live in, our mainstream media, the lack of information and support, and our fear of discussing the topic.


Benefits of Breastfeeding

There are no “benefits” to breastfeeding. Breastfeeding is the biological norm. Rather there are risks involved when not breastfeeding – The Milk Meg.

No matter how much formula milk has advanced and improved, it cannot be denied that it is still a man made product, which is impossible to ever have the same benefits as a mother’s natural milk. There are constantly claims by our mainstream media that formula milk is now ‘as good as breast milk’. However, when looking closer at these so called ‘studies’, it becomes apparent that they are often produced by the formula companies (or others that benefit from them) who are making enormous amounts of profit from selling formula. There is no scientific evidence to say that formula milk provides all of the same benefits as breast milk; and many aspects of these studies are manipulated or incorrectly defined in order to get these intended and biased results. If you are interested in looking into this further there is a great article written on this topic here by The Milk Meg.

One would assume that a product made to be consumed by a new born baby has been made carefully to ensure that it is healthy for the baby. Unfortunately this is not the case. If you study the ingredients of formula milk, it is actually shockingly unhealthy. The first few ingredients found in mainstream formula brands, like Similac are Corn Syrup Solids (GMO), Soy Protein (GMO), and Sugar (this is added, processed sugar. Not natural glucose that our bodies and cells require. They are not created equal). It goes on to list a slew of other ingredients I would never give myself, much less my baby. Amongst them are casein (milk protein), choline chloride (first isolated from ox bile, an ammonium salt often used in pet and livestock feed), and synthetic vitamins – Earthbasedmom. In comparison, the ingredients and nutrition in breastmilk are absolutely irreplaceable. There is a fascinating poster here comparing these ingredients, alongside another brilliant article by The Milk Meg. Additionally, there is also a table with the comparison of breastmilk and formula milk here by Dr Sears.

According to the UK’s National Health Service (NHS), Breastfeeding has long-term benefits for your baby, lasting right into adulthood. Any amount of breast milk has a positive effect. The longer you breastfeed, the longer the protection lasts and the greater the benefits. Breastfeeding reduces your baby’s risk of: infections, diarrhoea and vomiting, sudden infant death syndrome (SIDS), childhood leukaemia, type 2 diabetes, obesity and cardiovascular disease in adulthood. Giving nothing but breast milk is recommended for about the first six months (26 weeks) of your baby’s life. After that, giving your baby breast milk alongside family foods for as long as you and your baby want will help them grow and develop healthily. Breast milk adapts as your baby grows to meet your baby’s changing needs. Moreover, breastfeeding and making breast milk also has health benefits for you [the mother]. The more you breastfeed, the greater the benefits. Breastfeeding lowers your risk of: breast cancer, ovarian cancer, osteoporosis (weak bones), cardiovascular disease and obesity – NHS.

One thing that I find fascinating is how a mother’s milk adapts to their own baby, providing a tailor made milk which no formula product could ever replace. One of the benefits of breast milk is that each mother provides custom-designed milk to protect her infant. When a baby is exposed to a new germ, mother’s body manufactures antibodies to that germ. These antibodies show up in her milk and are passed along to her baby… When mother comes down with a bug, the best thing she can do for her baby is to keep breastfeeding – Dr Sears. On this subject, there is an incredibly moving video here by Human Milk.

Another amazing benefit of breastfeeding is brain development. There have been numerous scientific studies and research which confirm that breastfed babies have higher IQ and increased white matter in the brain. A study by Brown University looked at brain images from MRI scans of infants. The study showed that extra growth was most pronounced in parts of the brain associated with language, emotional function, and cognition… and that the exclusively breastfed group had the fastest growth in myelinated white matter of the three groups (exclusively breastfed, combination fed and formula fed), with the increase in white matter volume becoming substantial by age 2 – Kevin Stacey.

Breast milk also contains Oxytocin, which is a hormone that relaxes the mother and baby. There are many benefits to Oxytocin. It provides healing and pain relief, creates a strong bond and attachment between mother and baby, reduces stress, anxiety and depression, aids digestion, prevents obesity, solidifies relationships, improves social skills, triggers protective instincts, induces sleep, and fosters generosity – Maureen Salamon, Live Science. When a baby is breastfed on demand at the first sign of feeding cues (including throughout the night – see my Cosleeping article for ways to make this easier and less tiring for the parents) and Oxytocin is released, it reduces cortisol levels and reduces the need for the baby to cry. It is such a natural thing for babies to want to be constantly held and breastfed by the mother, whether it is for hunger, comfort, security, closeness or warmth, etc. There is a great saying by The Milk Meg for whenever a baby is unsettled or unhappy and you’re not sure if it is because of hunger or something else, which is…‘if in doubt whip it out!’. In so many parts of the world babies are constantly on the breast day and night and it is something that is not even questioned or made a big deal of, as it is so normal; yet in Western societies we often second guess ourselves. I strongly believe that this is one of the reasons why babies cry more in some Western societies and we believe that that is normal. There is a great article, Why African Babies Don’t Cry by Claire Niala – The Natural Child Project; and another article in the Guardian British Babies Cry the Most, Danish Babies the Least. Why?

Moreover, breastfeeding doesn’t cost anything for parents as they avoid constantly paying for formula milk, bottles, etc. It is also much easier for the parents as they don’t have to sterilise and prepare the bottles; the mother can simply put the baby on her breast, especially during the night, making it is less disturbing to everyone’s sleep.

Other benefits to breastfeeding can be seen in this fantastic image here by The Alpha Parent, and in the article ‘101 Reasons to Breastfeed Your Child’ by Leslie Burby – The Natural Child Project.

According to UNICEF, Breastfeeding is a natural ‘safety net’ against the worst effects of poverty … Exclusive breastfeeding goes a long way toward cancelling out the health difference between being born into poverty and being born into affluence … It is almost as if breastfeeding takes the infant out of poverty for those first few months in order to give the child a fairer start in life and compensate for the injustice of the world into which it was born – James P. Grant, UNICEF. Anything that can have that much of a health difference on humanity is surely undoubtedly the better choice.


Myths About Breastfeeding

With the sale of formula milk becoming so popular and profitable, and the lack of knowledge and understanding, there are many misconceptions and myths floating around about breastfeeding. This is another reason while I feel that it is very important to have an open dialogue about the subject. Mothers should be getting the correct information before making such a vital decision for their baby.

One example of this is mothers thinking that they are not producing enough milk. Health Visitors too easily suggest that they need to supplement with formula. In order to increase a mother’s supply the baby needs to be encouraged to feed more to stimulate and increase the production of milk. If a mother is supplementing with formula the baby ends up feeding less from her, which in turn ends up affecting her milk supply.  It is therefore a vicious circle. Instead of blaming low weight gain (or no weight gain) on breastfeeding it would be much more helpful to do the following: assess how a woman is feeding (is she feeding on a schedule which can affect her supply); is she trying to stretch out her baby’s feeds; is she timing how long her baby breastfeeds for, is her baby falling asleep very quickly at the breast due to prematurity or a medical condition; does her baby have tongue or lip tie which can affect milk transfer and therefore the mother’s milk supply…  let’s focus on getting her good support while looking into all of the various possibilities, not just blaming weight issues on the simple fact that she is breastfeeding. The other important factor is SOME BABIES ARE TINY! Some babies will gain slowly. Look at the WHOLE picture. Is your baby developing normally? Are they continuing to stay on the same percentile even if it is on the low end of the scale? Is your baby meeting all of the developmental milestones? Is your baby generally content and happy? Does your baby have at least 5-6 wet nappies per day and 2-3 poops per day? If yes then great! – The Milk Meg. Many mothers have expressed that they were not even told that the milk does not come in for the first few days and that the mother initially produces colostrum; which has made them panic that they are not producing enough milk. Furthermore, babies are born with a fat reserve and the amount that they need can vary (and thus should not be measured with a one size fits all rule).

Another common misconception evolves around the idea that mothers should not be breastfeeding on demand, or that they are overfeeding. It is actually impossible to over feed a breastfeeding baby, as their body tells them when they have had enough; however it IS possible to over feed a formula fed baby. Breastfeeding a baby on demand is the healthiest way; a mother should always follow the baby’s cues. Mothers are also told that they are spoiling their baby by feeding on demand and that their babies should not be waking up several times a night to feed (which is biologically incorrect information and something else that is pushed on parents for their own convenience and benefit). Dr. James J. McKenna, Director of the Mother-Baby Behavioural Sleep Laboratory at the University of Notre Dame and member of La Leche League International’s Health Advisory Council, has stated in previous discussions about night waking that he wonders if parental expectations have been determined by social ideologies and social ‘wish lists’, which have little to do with who babies are biologically… Infant waking can be related to breathing patterns. Sleep apnoea (a temporary inability to breathe) can induce protective awakenings and infants who spend more time in deeper sleep do not arouse so easily in order to prevent a life-threatening apnoea. Dr. Mckenna adds that it is known that babies that die of Sudden Infant Death Syndrome (SIDS) likely had some kind of arousal deficiency (did not arouse sufficiently well enough) – La Leche League. Moreover, Babies cannot be spoilt with love, attachment and on demand feeding. In fact the more a parent responds to their baby by learning their cues instead of waiting for them to cry, the stronger their attachment will be. The stronger the attachment is during the early years, the more likely that they will be secure and independent as adults. Babies’ stomachs are also very tiny, they get full quickly and need feeding often. Some babies will cluster feed, which is also very common and normal behaviour; and does NOT mean that the mother is not producing enough milk.

There are also many myths that push the idea that breastfeeding should not be done after a certain age. One of these is dentists giving misinformation about breastfeeding causing cavities (see article here by Kellymom, which debunks this myth with scientific evidence). Another one is statements about breastfeeding not being nutritionally beneficial after a certain age, and that it is ‘just for comfort’. This is not true. Although comfort is a big part of breastfeeding, there are still nutritional benefits for breastfed toddlers. The World Health Organisation recommends that babies are breastfed until they are two years old and beyond. Breastfeeding older children might be uncommon – but that doesn’t make it wrong… Many non-Western societies have a median breastfeeding duration of around three years and some longer than that. Studies comparing when non-human primates stop breastfeeding suggest it is around the time of the first permanent teeth – that’s around five to six years old in human children… A pint of breastmilk during the second year and beyond will provide 94% of the vitamin B12, 75% of the vitamin A and 60% of the vitamin C recommended intake. For free… Extended breastfeeding may not be our cultural norm, but this does not stop it being the biological norm. – Amy Brown – Swansea University, The Conversation. Furthermore, 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 and 60% of vitamin C requirements (Dewey 2001)… as well as mothers also benefiting for various reasons from extended breastfeeding. – Kellymom.


The Statistics

British women have the lowest breastfeeding rates in the world because they are put under pressure to “get their lives back” after having children, according to a leading public health academic. Swansea University professor Amy Brown said breastfeeding can become “overwhelming” for new mothers, who have to deal with social pressure to continue with the lives they led before giving birth. According to a study published in the Lancet in January 2016, only one in 200 British women (0.5 per cent) are still breastfeeding a year after becoming mothers. The figure is 23 per cent in Germany and 27 per cent in the United States. Dr Brown said: “Is the reason for the low figures because of physical problems? No. There are only 2 per cent of women in the UK who are unable to breastfeed because of a physical problem or because of medication that they are on…  Despite more than 90 per cent of mothers in the UK wanting to breastfeed, more than half (of babies) have had some formula by the end of their first week – The Telegraph.

According to The Lancet, 2016 the countries with the highest rates of breastfeeding after 12 months are: Senegal (99.4%), The Gambia (98.7%), Malawi (98.3%), Guinea-Bissau (97.8%), Ethiopia (97.3%); and the countries with the lowest rates after 12 months are: UK (0.5%), Saudi Arabia (2%), Denmark (3%), Greece (6%), Canada and France (9%).


History of Breastfeeding and Formula Milk

In the 1800s the rubber nipple, bottle and formula milk (as an emergency substitute to breast milk) were invented. Prior to the invention of formula, wet nursing (where another woman breastfeeds a child that is not her own – from as early as 2000BC) was very common for those children who were unable to get milk from their mothers (such as orphans). In the Renaissance period wet nursing remained the best alternative for infants whose mother could not breastfeed… During the same time period, societal class tended to dictate breastfeeding practices. It was unusual for aristocratic women to breastfeed because the practice was considered unfashionable and because the women worried it would ruin their figures. Breastfeeding also prevented many women from wearing the socially acceptable clothing of the time and it interfered with social activities such as playing cards and attending theatre performances. The wives of merchants, lawyers, and doctors also did not breastfeed because it was less expensive to employ a wet nurse than it was to hire a woman to run their husband’s business or take care of the household in their place… From the end of the 18th century through the 19th century, the practice of wet nursing shifted away from wealthy families to labouring, lower-income families. With the onset of the Industrial Revolution, entire families relocated from rural to more urban areas. The increased cost of living and poor wages forced many women to seek employment and contribute financially to their family, which made it virtually impossible for many mothers to breastfeed and attend to their children – Emily E. Stevens et al., The Journal of Perinatal Education.

In 1865 chemist Justus von Liebig developed the first liquid and powdered formula milk. The success of this commercial formula gave rise to competitors. The fact that mothers were being forced to work and that formula milk was becoming commercialised both worked hand in hand to create huge profits and make the capitalist system more successful. As formula milk was becoming such a profitable business, there was a lot of time and money being put into advancing it. Formula milk went from being used only as an emergency substitute, to being the chosen method of feeding babies right from the onset.

In 2015 the global formula industry alone was worth around $50 billion (£31 billion). Money spent on formula and related products brings vast profit in to supermarkets and other retailers. On the other hand there’s very little money to be made out of breastfeeding. To some, a successfully breastfeeding mum represents lost income… even during Breastfeeding Week  retail giant Babies R Us took to Facebook with this message for their 27,000 followers: “We know this week is National Breastfeeding Week but we also know that there are lots of parents out there that bottle feed. Whatever your circumstances, we cannot recommend the Tommee Tippee Perfect Prep Machine enough.” – The Telegraph. After public outcries in response to this, Babies R Us then decided to advertise covers for breastfeeding mums, adding to the attitude that they should be covering up or that they are doing something shameful.

Nowadays, with the mainstream media being one of the biggest influences on Western societies, advertisements of formula milk, bottles, etc. are becoming more and more common on the television, in newspapers and magazines, on billboards in the streets and on leaflets being handed out everywhere. Women are encouraged to choose formula milk for their own convenience and so that they can quickly adapt back to their old lives; to get back their pre-pregnancy weight and figure, to start drinking alcohol again, to go out and socialise, and to go back to work as soon as possible. More and more myths about breastfeeding are spreading. Slogans such as ‘fed is best’ are being widely thrown about with the scaremongering of ‘babies starving due to breastfeeding mothers not being able to produce enough milk’.

There is this idea that breastfeeding mothers are somehow superior and are shaming formula feeding mothers just for mentioning the word breastfeeding. This has also led to increased sensitivity in parents (with professionals being told to word things carefully and to not put pressure on women). As a result there is no longer an open dialogue on the subject… which ultimately works only in favour of the formula industry and not the mother and baby.

The sexualisation of breasts has also added to the notion that breastfeeding (especially in public) is wrong. Isn’t it sad that society is accepting of the fact that there are sexualised and provocative images of breasts everywhere, but seeing a woman feed her baby (which is why breasts even exist) creates a stir! Many men are also demanding that their wives and partners don’t breastfeed; and the argument that ‘men also need to bond with the baby and be involved in the feeding process’ is being pushed on parents. All of this has contributed to the normalisation of formula milk.


The Struggle and Lack of Support

Unfortunately, as breastfeeding has become more uncommon in Western societies, it is no longer something that comes as naturally to first time mothers as it should or used to, or a subject that all women are knowledgeable on. In the past, if a mother was experiencing any difficulties with breastfeeding she would get the necessary support and advice from experienced women in the family/village, and worst case scenario a wet nurse would be found. The experience and knowledge was always passed down from the women in the family, and the support would be there for mothers struggling to breastfeed. In the UK, women were required to stay in hospital for the first ten days, so any issues were more likely to be resolved before they were sent home.

Nowadays, as long as there aren’t any complications, women are often sent home within the same day. There is a lack of immediate support and knowledge for breastfeeding mothers. The NHS does not employ lactation consultants in hospitals (which is the most crucial time that a mother needs support), there is only a breastfeeding specialist (who cannot always provide the same level of advice and help as a LC), and midwives/health visitors do not have enough training to support breastfeeding. Lactation consultants in the community are also scarce and it takes time to arrange an appointment with them. Support groups only run once a week and breastfeeding peer supporters work voluntarily. It is also up to the mother herself to go out and seek help from these groups, which can be daunting for first time parents. There have also been additional cuts to services in hospitals and in the community, with not enough staff being hired and health professionals being stretched too thin.

Yes I cannot deny that formula milk has saved lives and having that option can be vital for a baby, however, I do believe that it should only be used in an emergency, as intended (where a wet nurse or donation of milk is not accessible first). There should be support and encouragement to continue breastfeeding in combination with the formula (and working on eventually cutting out the formula). Formula is instead being suggested too quickly as an alternative and not enough support is given to mothers to continue breastfeeding. It is being used to generate profit and for convenience, rather than as a necessity.


My Own Experience

When my son was born, I assumed that breastfeeding would be easy and that it would come naturally to me. Sadly this was not the case; as it is not for many women. After spending several days in the hospital asking for help from midwives and a breastfeeding specialist (as he was struggling to latch on), I was made to feel like it is normal and that he will eventually learn. I was even told by the breastfeeding specialist that my son was just ‘being lazy’. Now that I have more knowledge and understanding I know that a baby CANNOT be lazy. If a baby is struggling to latch on then there are other issues. In the meantime my baby was not feeding as frequently as he should have been; he was diagnosed with jaundice and I was told that I needed to feed him more regularly. At no point during my pregnancy (despite having regular midwife visits and an antenatal class) or even after the birth, did anyone tell or show me HOW to breastfeed. There was no information given on what to expect, how often to feed or what to look out for if the baby isn’t feeding enough; so I just assumed it would all come naturally. I left the hospital feeling completely overwhelmed.

A week later I started to experience severe pain in my nipples whenever he was latching on, during feeds and even in between feeds. The pain was so bad that I sat crying whenever he would feed. I struggled with the pain for several months because there was not enough support. I was told by professionals (midwives, health visitors and doctors) not to be hard on myself if I wanted to switch to formula, rather than the time being taken to identify the cause of the pain. They observed me feeding my baby and tried different positions; and when there was no improvement I was told that they had no other suggestions to offer me. I then saw a doctor who misdiagnosed me with Raynaud’s syndrome and prescribed medication that I did not need, which I took for several weeks.

After becoming frustrated at the lack of support and no improvement, I decided to do my own research. I came across a story on one of the parenting forums online of a baby that had posterior tongue tie which was only diagnosed after seeing a lactation consultant twice. As a last attempt I went along to a breastfeeding support group that had a lactation consultant. After I asked whether it could be posterior tongue tie, a breastfeeding counsellor checked my baby’s mouth and said that she suspects it could be. I was then referred to see a specialist at the hospital where it was confirmed and my son’s tongue tie was cut.

I cannot stress enough how valuable these support groups are, and that I only wish I had gone there from the beginning. Unfortunately, with both the lack of funding and the fear of being too pushy about breastfeeding, these groups are not advertised and encouraged enough. This I suspect is due to the sensitivity that has formed around the subject and the fear of offending parents on their choices. People often believe that it is not good to put expectations and pressures on mothers to breastfeed. While I agree with this to a certain extent, as long as the immediate help is there, any problems are solved without delay and mothers are not made to feel bad if they can’t do it, then having these expectations is not necessarily a bad thing. Having expectations that are in the best interest of babies, rather than for our own convenience or to sustain the system we live in, would help us to be more educated, developed and advanced as a society.  In the current system however, it has become the complete opposite, with women not getting the necessary support and formula being suggested too quickly.


Useful Links and Support 

https://kellymom.com/category/bf/ – A website developed to provide evidence-based information by a mother of three and an International Board Certified Lactation Consultant (IBCLC).

https://themilkmeg.com/ – Experienced IBCLC, blogger, author and speaker.

http://www.lalecheleague.org/ – An international website (you can select your country for specific information and contacts) offering breastfeeding support, encouragement, information and education.

https://www.breastfeedingnetwork.org.uk/ – An independent source of support and information for breastfeeding mothers.
They also have a breastfeeding helpline: https://www.breastfeedingnetwork.org.uk/contact-us/helplines/
and an email address to ask for information about using specific medication while breastfeeding: druginformation@breastfeedingnetwork.org.uk

https://abm.me.uk/breastfeeding-support-groups/ – To find your local breastfeeding support group in the UK, just enter your postcode on this page or contact your local children’s centre.

http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/breastfeeding-help-support.aspx – NHS website with links and helplines for breastfeeding support.

 

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