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Breast-Feeding Best Bet for Babies
About Dr Hina Ayesha
New parents want to give their babies the very best. When it comes to
nutrition, the best first food for babies is breast milk.
More than two decades of research have established that breast milk is perfectly
suited to nourish infants and protect them from illness. Breast-fed infants have
lower rates of hospital admissions, ear infections, diarrhea, rashes, allergies,
and other medical problems than bottle-fed babies.
According to the American Academy of Paediatrics,
"There are 4,000 species of mammals, and they all make a different milk.
Human milk is made for human infants and it meets all their specific nutrient
needs,"
The academy recommends that babies be breast-fed for six to 12 months. The only
acceptable alternative to breast milk is infant formula. Solid foods can be
introduced when the baby is 4 to 6 months old, but a baby should drink breast
milk or formula, not cow's milk, for a full year.
"There aren't any rules about when to stop breast-feeding," says
Lawrence. "As long as the baby is eating age-appropriate solid foods, a
mother may nurse a couple of years if she wishes. A baby needs breast milk for
the first year of life, and then as long as desired after that."
In 1993, 55.9 percent of American mothers breast-fed their babies in the
hospital. Only 19 percent were still breast-feeding when their babies were 6
months old. Government and private health experts are working to raise those
numbers.
The U.S. Food and Drug Administration is conducting a study on infant feeding
practices as part of its ongoing goal to improve nutrition in the United States.
The study is looking at how long mothers breast-feed and how they introduce
formula or other foods.
Health experts say increased breast-feeding rates would save consumers money,
spent both on infant formula and in health-care dollars. It could save lives as
well.
"We've known for years that the death rates in Third World countries are
lower among breast-fed babies," says Lawrence.
"Breast-fed babies are healthier and have fewer infections than formula-fed
babies."
Human Milk for Human Infants
* Nutrition
The primary benefit of breast milk is nutritional. Human milk contains just the
right amount of fatty acids, lactose, water, and amino acids for human
digestion, brain development, and growth.
Cow's milk contains a different type of protein than breast milk. This is good
for calves, but human infants can have difficulty digesting it. Bottle-fed
infants tend to be fatter than breast-fed infants, but not necessarily
healthier.
* Protection against diseases:
Breast-fed babies have fewer illnesses because human milk transfers to the
infant a mother's antibodies to disease. About 80 percent of the cells in breast
milk are macrophages, cells that kill bacteria, fungi and viruses. Breast-fed
babies are protected, in varying degrees, from a number of illnesses, including
pneumonia, botulism, bronchitis, staphylococcal infections, influenza, ear
infections, and German measles. Furthermore, mothers produce antibodies to
whatever disease is present in their environment, making their milk
custom-designed to fight the diseases their babies are exposed to as well.
A breast-fed baby's digestive tract contains large amounts of Lactobacillus
bifidus, beneficial bacteria that prevent the growth of harmful organisms. Human
milk straight from the breast is always sterile, never contaminated by polluted
water or dirty bottles, which can also lead to diarrhea in the infant.
* Prevents allergies:
Human milk contains at least 100 ingredients not found in formula. No babies are
allergic to their mother's milk, although they may have a reaction to something
the mother eats. If she eliminates it from her diet, the problem resolves
itself.
* Jaw development:
Sucking at the breast promotes good jaw development as well. It's harder work to
get milk out of a breast than a bottle, and the exercise strengthens the jaws
and encourages the growth of straight, healthy teeth. The baby at the breast
also can control the flow of milk by sucking and stopping. With a bottle, the
baby must constantly suck or react to the pressure of the nipple placed in the
mouth.
* Psychological benefits:
Nursing may have psychological benefits for the infant as well, creating an
early attachment between mother and child. At birth, infants see only 12 to 15
inches, the distance between a nursing baby and its mother's face. Studies have
found that infants as young as 1 week prefer the smell of their own mother's
milk. When nursing pads soaked with breast milk are placed in their cribs, they
turn their faces toward the one that smells familiar.
Many psychologists believe the nursing baby enjoys a sense of security from the
warmth and presence of the mother, especially when there's skin-to-skin contact
during feeding. Parents of bottle-fed babies may be tempted to prop bottles in
the baby's mouth, with no human contact during feeding. But a nursing mother
must cuddle her infant closely many times during the day.
Nursing becomes more than a way to feed a baby; it's a source of warmth and
comfort.
Benefits to Mothers
* Less work
Breast-feeding is good for new mothers as well as for their babies. There are no
bottles to sterilize and no formula to buy, measure and mix. It may be easier
for a nursing mother to lose the pounds of pregnancy as well, since nursing uses
up extra calories. Lactation also stimulates the uterus to contract back to its
original size.
* More rest:
A nursing mother is forced to get needed rest. She must sit down, put her feet
up,and relax every few hours to nurse. Nursing at night is easy as well. No one
has to stumble to the refrigerator for a bottle and warm it while the baby
cries. If she's lying down, a mother can doze while she nurses.
* Contraception:
Nursing is also nature's contraceptive--although not a very reliable one.
Frequent nursing suppresses ovulation, making it less likely for a nursing
mother to menstruate, ovulate, or get pregnant. There are no guarantees,
however. Mothers who don't want more children right away should use
contraception even while nursing. Hormone injections and implants are safe
during nursing, as are all barrier methods of birth control. The labeling on
birth control pills says if possible another form of contraception should be
used until the baby is weaned.
* Economy:
Breast-feeding is economical also. Even though a nursing mother works up a big
appetite and consumes extra calories, the extra food for her is less expensive
than buying formula for the baby. Nursing saves money while providing the best
nourishment possible.
When Formula's Necessary
There are very few medical reasons why a mother shouldn't breast-feed.
Most common illnesses, such as colds, flu, skin infections, or diarrhea, cannot
be passed through breast milk. In fact, if a mother has an illness, her breast
milk will contain antibodies to it that will help protect her baby from those
same illnesses.
A few viruses can pass through breast milk, however. HIV, the virus that causes
AIDS, is one of them. Women who are HIV positive should not breast-feed.
A few other illnesses--such as herpes, hepatitis, and beta streptococcus
infections--can also be transmitted through breast milk.
But that doesn't always mean a mother with those diseases shouldn't breast-feed,
Lawrence says.
"Each case must be evaluated on an individual basis with the woman's
doctor," she says.
Breast cancer is not passed through breast milk. Women who have had breast
cancer can usually breast-feed from the unaffected breast. There is some concern
that the hormones produced during pregnancy and lactation may trigger a
recurrence of cancer, but so far this has not been proven. Studies have shown,
however, that breast-feeding a child reduces a woman's chance of developing
breast cancer later.
Silicone breast implants usually do not interfere with a woman's ability to
nurse, but if the implants leak, there is some concern that the silicone may
harm the baby. Some small studies have suggested a link between breast-feeding
with implants and later development of problems with the child's esophagus.
Further studies are needed in this area. But if a woman with implants wants to
breast-feed, she should first discuss the potential benefits and risks with her
child's doctor.
Possible Problems
For all its health benefits, breast-feeding does have some disadvantages. In the
early weeks, it can be painful. A woman's nipples may become sore or cracked.
She may experience engorgement more than a bottle-feeding mother, when the
breasts become so full of milk they're hard and painful. Some nursing women also
develop clogged milk ducts, which can lead to mastitis, a painful infection of
the breast. While most nursing problems can be solved with home remedies,
mastitis requires prompt medical care (see accompanying article).
Another possible disadvantage of nursing is that it affects a woman's entire
lifestyle. A nursing mother with baby-in-tow must wear clothes that enable her
to nurse anywhere, or she'll have to find a private place to undress. She should
eat a balanced diet and she might need to avoid foods that irritate the baby.
She also shouldn't smoke, which can cause vomiting, diarrhea and restlessness in
the baby, as well as decreased milk production.
Women who plan to go back to work soon after birth will have to plan carefully
if they want to breast-feed. If her job allows, a new mother can pump her breast
milk several times during the day and refrigerate or freeze it for the baby to
take in a bottle later. Or, some women alternate nursing at night and on
weekends with daytime bottles of formula.
In either case, a nursing mother is physically tied to her baby more than a
bottle-feeding mother. The baby needs her for nourishment, and she needs to
nurse regularly to avoid getting uncomfortably full breasts. But instead of
feeling it's a chore, nursing mothers often cite this close relationship as one
of the greatest joys of nursing. Besides, nursing mothers can get away between
feedings if they need a break.
Finally, some women just don't feel comfortable with the idea of nursing. They
don't want to handle their breasts, or they want to think of them as sexual, not
functional. They may be concerned about modesty and the possibility of having to
nurse in public. They may want a break from child care to let someone else feed
the baby, especially in the wee hours of the morning.
If a woman is unsure whether she wants to nurse, she can try it for a few weeks
and switch if she doesn't like it. It's very difficult to switch to
breast-feeding after bottle-feeding is begun.
If she plans to breast-feed, a new mother should learn as much as possible about
it before the baby is born. Obstetricians, pediatricians, childbirth
instructors, nurses, and midwives can all offer information about nursing. But
perhaps the best ongoing support for a nursing mother is someone who has
successfully nursed a baby.
La Leche League, a national support organization for nursing mothers, has
chapters in many cities that meet regularly to discuss breast-feeding problems
and offer support.
"We encourage mothers to come to La Leche League before their babies are
born," says Mary Lofton, a league spokeswoman. "On-the-job training is
hard to do. It's so important to learn how to breast-feed beforehand to avoid
problems."
Most La Leche League chapters allow women to come to a few meetings without
charge. League leaders offer advice by phone as well. To find a convenient La
Leche League chapter, call (1-800) LA-LECHE.
Tips for Breast-Feeding Success
It's helpful for a woman who wants to breast-feed to learn as much about it as
possible before delivery, while she is not exhausted from caring for an infant
around-the-clock. The following tips can help foster successful nursing:
Get an early start: Nursing should begin within an hour after
delivery if possible, when an infant is awake and the sucking instinct is
strong. Even though the mother won't be producing milk yet, her breasts contain
colostrum, a thin fluid that contains antibodies to disease.
Proper positioning: The baby's mouth should be wide open, with the
nipple as far back into his or her mouth as possible. This minimizes soreness
for the mother. A nurse, midwife, or other knowledgeable person can help her
find a comfortable nursing position.
Nurse on demand: Newborns need to nurse frequently, at least every
two hours, and not on any strict schedule. This will stimulate the mother's
breasts to produce plenty of milk. Later, the baby can settle into a more
predictable routine. But because breast milk is more easily digested than
formula, breast-fed babies often eat more frequently than bottle-fed babies.
No supplements: Nursing babies don't need sugar water or formula
supplements. These may interfere with their appetite for nursing, which can lead
to a diminished milk supply. The more the baby nurses, the more milk the mother
will produce.
Avoid artificial nipples: It's best to wait a week or two before
introducing a pacifier, so that the baby doesn't get confused. Artificial
nipples require a different sucking action than real ones. Sucking at a bottle
could also confuse some babies in the early days. They, too, are learning how to
breast-feed.
Air dry: In the early postpartum period or until her nipples toughen,
the mother should air dry them after each nursing to prevent them from cracking,
which can lead to infection. If her nipples do crack, the mother can coat them
with breast milk or other natural moisturizers to help them heal. Vitamin E oil
and lanolin are commonly used, although some babies may have allergic reactions
to them. Proper positioning at the breast can help prevent sore nipples. If the
mother's very sore, the baby may not have the nipple far enough back in his or
her mouth.
Watch for infection: Symptoms of breast infection include fever and
painful lumps and redness in the breast. These require immediate medical
attention.
Expect engorgement: A new mother usually produces lots of milk,
making her breasts big, hard and painful for a few days. To relieve this
engorgement, she should feed the baby frequently and on demand until her body
adjusts and produces only what the baby needs. In the meantime, the mother can
take over-the-counter pain relievers, apply warm, wet compresses to her breasts,
and take warm baths to relieve the pain.
Eat right, get rest: To produce plenty of good milk, the nursing
mother needs a balanced diet that includes 500 extra calories a day and six to
eight glasses of fluid. She should also rest as much as possible to prevent
breast infections, which are aggravated by fatigue.
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