One of the first, and most important decisions a mother makes for her newborn is how she will feed him. When a mother chooses to breastfeed she is making a positive investment in her baby’s future. Breast milk is the perfect food and will give her infant a healthy start that will last a lifetime. In fact, breastfeeding protects the baby, benefits the mother, may make life a little easier, and is less expensive than baby formula.
But the decision to breastfeed is a very personal one and may be dependent upon some factors out of a woman’s control. The bottom line is that mothers deserve all the support they can get, regardless of how they choose to feed their babies. However, understanding the substantial benefits of breastfeeding, also being prepared for any difficulties and receiving support and resources can help a woman make the best, most informed decision about feeding her newborn.
Beginning with the Benefits
The American Academy of Pediatrics (AAP) has taken an aggressive stance in promoting and encouraging breastfeeding as best for babies and mothers. Well-Being spoke with Anita Henderson, M.D., Pediatrician, at The Pediatric Clinic, a division of Hattiesburg Clinic, about the benefits of breastfeeding for infants and their moms.
“Breastfeeding is beneficial in many ways,” says Dr. Henderson. “First, there is the significant nutritional value of mother’s milk. But breastfed babies also have fewer ear infections, and the incidence of asthma, diabetes and obesity is reduced, along with many other acute and chronic illnesses. Additionally, the rate of SIDS (sudden infant death syndrome) is reduced by a third in babies who are breastfed.”
Miraculously, mother’s milk actually changes as a baby grows, providing just the right amount of fat, sugar, water, and protein, with all of the nutrients and antibodies a baby needs for healthy growth. The AAP recommends exclusive breastfeeding for the first six months of life, followed by breastfeeding in combination with the introduction of baby foods until at least 1 year, and the continuation of breastfeeding for as long as is mutually desired by mom and baby.
“Moms who breastfeed their babies have lower rates of postpartum depression and lower rates of hypertension as well,” Dr. Henderson continues. “Some studies have even shown that moms who breastfeed for at least six months have lower rates of breast and ovarian cancer. Breastfeeding helps moms lose weight (particularly “belly fat”) and this also leads to lower maternal rates of type 2 diabetes and cardiovascular disease. So you can see that breastfeeding is a win-win situation for mom AND baby.”
What to Expect When You are Expecting to Breastfeed
“Breastfeeding is the most natural thing in the world.” “Mom’s and babies just take to breastfeeding by instinct.” “There’s no reason why every mother can’t breastfeed successfully.” All of these statements are meant to be encouraging and supportive, but for a new mother, they can sound like indictments, if initially everything doesn’t go smoothly. Expectant mothers, especially first-time mothers need to be informed not only about the benefits, but the challenges that can come for both mother and baby as both are growing accustomed to the process of breastfeeding.
Well-Being reached out to Jack D. Owens, M.D., who specializes in neonatal-perinatal medicine. He is affiliated with several central Mississippi hospitals and serves on the Mississippi Department of Public Health perinatal quality advisory board (MSPQC). Dr. Owens believes encouragement for breastfeeding should begin before birth with the expectant mother’s OB/GYN helping to prepare her mentally and emotionally for the experience.
“By the time a woman comes to the hospital to give birth, her mind is usually made up about whether or not she wants to breastfeed,” Dr. Owens notes. “That is where her doctor, public health information and the news media can make a difference by educating her in advance about what to expect.”
“It’s important for a woman to understand that initiating breastfeeding after birth is a process,” Dr. Owens continues. “During the first 2-3 days after birth, a primary function of nursing is not feeding, but stimulating lactation. So a mom should not be concerned during this time about how much milk her baby is getting, or if he or she is dehydrated. Knowing this in advance and being aware of what to expect can help prevent a mother from becoming stressed and wanting to give up breastfeeding before she has really gotten started. Mothers also need to know that feeding the baby on a strict schedule is a myth. Current recommendations are for mothers to be flexible in terms of frequency and duration of feeding. Infants may feed every 30 minutes to 3 hours, and for anywhere between 10 to 45 minutes.
The Hospital’s Role in Supporting Successful Breastfeeding
According to Dr. Owens Hospital policies can make a huge difference in the experience a mother has once the baby is delivered and she initiates breastfeeding.
“Hospitals should begin by using a set list of talking points about breastfeeding to ensure that new mothers are getting a consistent message from all staff members across all shifts,” Dr. Owens explains. “Babies should be allowed to room-in with the mother as much as possible. There are very few activities, which cannot be taken care of in the mother’s room, including initial assessments and examinations by health care providers. If problems with breastfeeding arise, the mother should have immediate access to a lactation specialist who can work with her during and after her hospital stay. Post-discharge follow-up appointments with the same medical team 48 hours after leaving hospital are also a positive way to see how mother and baby are doing and provide intervention if there are any jaundice issues or breastfeeding problems.”
For a copy of “Ten Steps to Successful Breastfeeding” (directed to healthcare organizations) developed by WHO/ UNISELF and published by the World Health Organization, visit http://www.wellbeingmag.com/2015/06/ten-steps-to-successful-breastfeeding/ .
Meeting the Challenges of Breastfeeding in the First Weeks of Life
Make no mistake, there are challenges associated with breastfeeding that can make the process stressful and frustrating if a mother doesn’t have a strong support system and access to resources to help her deal with them. Well-Being turned to Debi Fatherree, MSN, IBCLC (International board certified lactation consultant and Director of The Lactation Center and Education at Merit Health Woman’s Hospital for information about some of these challenges.
For most mothers the greatest fear is that their baby will not get enough breast milk to nourish them. Fatherree shared some simple guidelines moms can use to help reassure mothers about whether their milk supply is adequate.
“What goes in, comes out,” Fatherree explains. “So we teach mothers the minimum output to expect. On day one, one wet, one dirty diaper. On day two, two wet, two dirty. When volume milk comes in around days 3-5, we expect 6-8 wet diapers and a few dirty diapers. There actually are apps that can help mothers keep up with this.”
Mom’s nutrition is also very important for developing and maintaining an ample milk supply. A nursing mother should make sure she is getting enough protein and is staying well-hydrated. It may be necessary for her to continue prenatal vitamins to supplement the nutrients in her food.
Some potential problems with breastfeeding include: trouble latching on, sore nipples, inverted nipples, engorgement and breast infections. Mothers who have late pre-term babies, born at 34-36 weeks and those with multiple births may also have difficulty breastfeeding. For these mothers, NICU policies should be modified to allow them to have 24-hour access to their babies, unless a medical condition on the part of mother or baby prevents it.
When asked if she had any other advice for expectant or nursing mothers, Ms. Fatherree offered the following:
“Learn as much as you can about the breastfeeding process and how it works. Sign up for a breastfeeding class, find out where the IBCLS’s (International Board Certified Lactation Consultants) are in your area and contact them. Practice skin to skin contact with your new baby immediately after birth. Mothers and infants should be separated as little as possible after birth so that breastfeeding can be well established. Lastly, have family and spousal support. Enlist family members to cook, clean and run errands for you in the first few weeks so that you can concentrate on nursing your baby.”
Educating herself, choosing a doctor and hospital with breastfeeding-friendly policies, having a lactation specialist, and the support of family and friends can help a mother cope and keep her resolve to continue breastfeeding intact. The ultimate decision about whether a woman continues to breastfeed to six months and beyond is a complicated one. In the end she has to come to the decision that is best for herself, her family and her baby.
Anita Henderson, MD, Pediatrician, of The Pediatric Clinic, is affiliated with Forrest General Hospital, Hattiesburg. She received her Doctor of Medicine degree from the University of Mississippi Medical School and served her internship and residency in Pediatrics at Vanderbilt University. Dr. Henderson has been Board Certified in pediatrics for over 20 years, and her special areas of interest include breastfeeding, obesity prevention and treatment, and immunizations.
Jack Owens, MD, MPH, Neonatologist, of Newborn Associates, in Jackson, is affiliated with multiple hospitals in the area, including Merit Health Central and River Oaks. He received his medical degree from Emory University and completed his residency in pediatrics and fellowship in neonatal-perinatal medicine at the University of Alabama, Birmingham, where he also received a MPH in Perinatal Epidemiology. Dr. Owens is Board Certified in neonatal-perinatal and pediatric medicine.
Debi Fatherree BSN, MSN, IBCLC is an International Board Certified Lactation Consultant with Masters Degrees in Nursing and Health Care Administration. She has 28 years of experience as a maternity nurse, has been on staff at Woman’s Hospital since 1997, and in 2013 helped to opened the Hospital’s Lactation Center.
dig deeper: Check out the latest edition of what has been called the Bible of breastfeeding, The Womanly Art of Breast Feeding by the La Leche League International, Diane Wiessinger and Diana West. This classic bestselling guide has been retooled, refocused, and updated for today’s mothers and lifestyles.