Friday, September 14, 2012

Is Breastfeeding Normal?

"That's not normal!"

This was the response I heard from my stepson recently after he overheard his father and me talking about the issue of breastfeeding in public. I brought up the topic (surprise, surprise) after noting a mother nursing her toddler in a public setting that day. I was celebrating the scene, since it's so rare in our culture that women choose "extended breastfeeding" at all, let alone brave the public eye in doing so.

My stepson, who is eleven, was most certainly just mortified at hearing the word breast thrown around repeatedly more than anything else, but his statement startled me on a deeper level. "Can we PLEASE stop talking about breastfeeding? That's not NORMAL!!" he shouted again as he ran upstairs, red in the face.

But, isn't it? Isn't breastfeeding THE most normal way of feeding an infant?

breastfeeding, tulsa doula, breastfeeding education, breastfeeding is normal, honeybee mama

Is Breastfeeding Normal?

When I really think about it, I think we need to differentiate between what is common and what is normal. When we look at breastfeeding worldwide, statistics show only 51% of infants are exclusively breastfed at 4 months, and only 38% at 6 months. These numbers exist though The World Health Organization suggests that all infants be exclusively breastfed for the first 6 months of life, then they should receive complimentary foods (not formula) to accompany breastfeeding up to 2 years of life or beyond. So, it is evident that breastfeeding isn't necessarily common, though it is on the rise in the U.S. according to the CDC Breastfeeding Report Card.

Breastmilk is human milk for human children. Therefore, physiologically speaking, it is the normal way of feeding an infant. The components of breastmilk are perfectly composed to nourish human babies. There is no substitute that comes close to providing what each mother is capable of providing for her own child. Infant formulas in all forms are merely imitations and substitutes for human milk, derived from other animals and vegetable sources.

What's So Great About Breastmilk?

For one, breastmilk is completely unique. As much as science has studied the components of it, we still don't know everything that is in it or how to accurately imitate it. In addition, each mother-baby pair is completely unique. If you line up cups of expressed breastmilk from ten mothers, you will see ten different colors, thicknesses, smells and textures. This is because each mother produces exactly and precisely the very formula of human milk her specific baby needs.

What many people don't know is that as the baby nurses at the breast, she shares the germs and bacteria in her mouth with her mother. The mother's body is then able to adjust and create antibodies she and her baby both need to protect them from infections and illness. So, breastmilk changes from day to day, and from feeding to feeding to meet the needs of the baby. Not even breastmilk fed through a bottle can imitate this, though it is the second best alternative to nursing.

Also, have you ever watched how different babies look when they're feeding at the breast as opposed to a bottle? The jaw, lips, tongue and throat all move completely differently than they do when a baby drinks from a bottle. This is crucial in the development of the jaw and dental structure of infants. Children who never breastfeed are much more likely to require orthodontic care at some time in their life because of this deficiency.

Children who are breastfed have:
  • Fewer instances of ear infections
  • Fewer instances of asthma and eczema
  • Fewer gastrointestinal infections
  • Lower risk of respiratory tract diseases
  • Fewer instances of Type I and Type II Diabetes
  • Lower risk of Leukemia and other cancers, both in childhood and later in life
  • Lower risk of becoming overweight and obese
What Are the Risks of Formula Feeding?

As a doula, I am an advocate for parents having a choice about everything involved in the labor, birth and care of their children. This does not exclude the method of feeding their children. But as with every other choice, I believe it's imperative that parents have ALL the information about their choices before deciding on a plan of action.

Breastmilk and formula are too often presented on equal playing fields as an either/or choice. The method of feeding your baby is often seen as one of convenience or an emotional response. The truth is, baby formula and breastmilk are in no way equal choices. Infant formula was designed to be a substitute in cases where a child is unable to breastfeed for medical or other reasons. It's not even a second best option. First best is breastmilk fed from the breast of the baby's mother. Second best is pumped or expressed breastmilk from the baby's mother, fed through a tube, syringe or bottle. Third best is donated breastmilk from another woman. Only then, when all other options have been exhausted and there is no other way to nourish a baby should formula be considered.

The risk of formula feeding includes increased risk of the diseases and disorders described above, and more importantly the risk of death. There is a 21% reduction in infant deaths for babies that have ever breastfed (See Baby Bond for more information). Also, there are often formula recalls, formula contamination, improper preparation (did you know you're supposed to boil water and not allow it to drop below 70C before feeding?), unsanitary conditions and many other factors that make formula a risky choice.

Infants who are formula fed experience:
  • More diarrhea
  • More constipation
  • More colicky behavior
  • More acid reflux
  • Reduced cognitive development
  • Higher risk of Sudden Infant Death Syndrome or death from other causes
The Real Issue 

Before you misconstrue this blog post as saying that infant formula is poison, please read on.

The real issue here is not about presenting the benefits of breastfeeding. Most people know "breast is best" as much as they know smoking is bad.  The real issue is lack of breastfeeding support and knowledge. Since only about half of mothers breastfeed at all and many of those only the first few days or months, the number of knowledgeable women most mothers know is few. Who do women turn to in those first hours after birth when they are exhausted and know their baby needs to nurse but don't really know how to accomplish the task? How do they remain steadfast in their decision when baby seems tired or uninterested or can't get a good latch when the nursery nurses are so quick to offer infant formula as an alternative "just to make sure baby eats something?"

Moms who give their babies formula are NOT bad mothers. They are mothers who want the best for their babies. They may have all the information available and have made an educated choice to feed their baby with formula. They may have significant challenges in breastfeeding because of previous breast surgery, sexual trauma, stress, postpartum depression or many others. More often than not though, they are women who have been given little information or misinformation, or simply do not have enough resources and people around them to encourage them to keep trying until they get it right, or to problem solve when there are setbacks.

Breastfeeding IS normal, and it is far more common in our culture than we realize. Many women feel uncomfortable breastfeeding in public not because of their own discomfort with it, but because of others' discomfort. I hope more an more men and women can do more in our society to welcome breastfeeding mothers and remove the weirdness attached to something so very "normal."


Erin said...

I have a 6 month old and haven't been able to fully breastfeed him since he was 2 months old. At the time, he was starving because of several things going on with him and me. It breaks my heart to know what I couldn't give him.

I agree we need more breastfeeding support. I wish someone had told me how difficult it is or how one misstep can ruin it all. I wish someone had told me not to blindly trust nature because nature will screw you and not look back.

I envy the moms who get to BF in public. And although I know that a lot of people need to hear how normal and good breastfeeding is, it can also be really painful to hear how wonderful it is when it is completely out of reach for us.

Missy Rose said...

Congratulations, Erin! It wasn't completely out of reach for you! Two months is an incredible success, and the ability to supplement breastfeeding with other options after 2 months is still wonderful. Just two months of breastfeeding reduces your baby's risks of many childhood illnesses, reduces YOUR risk of breast cancer and greatly increases your baby's overall health and yours as well!

I'm sorry to hear of the pain you have experienced in having to lessen or stop breastfeeding, but I am thankful you have been able to access other resources to nourish your baby.

Thank you for what you said about "blindly" trusting nature. Yes, our bodies were designed to breastfeed, but you're right; just because something is natural, doesn't mean it comes naturally! Success in breastfeeding requires a tremendous amount of support and encouragement and knowledge.

ckueck said...

As someone who was Bradley educated before the birth of my first baby and having already finished a masters in speech pathology (which includes infant feeding and swallowing-normal and abnormal) I thought I had a pretty good handle on breastfeeding. And for the most part I did. But. I'm convinced nothing but experience could have educated and prepared me for the first six weeks of nursing my son. Had I not known all of the resources available, AND used them- we probably wouldn't have made it past six weeks. The support of my husband, mom, and sheer determination, and lots of prayer helped us make it through with most of the hair on my head still attached. And the second baby was easier, but still had some different challenges to overcome. I think you're right on with the fact that breastfeeding mommies need a lot of access to help and positive support, as well as tons of encouragement. It sounds so simple on paper. "Do you plan to breastfeed or bottlefeed?" No biggie, right?

Missy Rose said...

Agreed, Ckueck! Maybe my next post should be titled "Breastfeeding Hurdles are Normal!" I experienced a lot of hurdles myself. After the birth of my oldest son, I was unconscious for about 36 hours due to seizures and my son was wetnursed by a family member. When I was conscious again and tried to breastfeed, it was extremely difficult because of giganto boobs plus engorgement, plus a TINY baby and baby mouth. It was really hard. And before anyone thinks I'm a saint, I fed both my babies formula at one time or another. It happens, even for those of us who are well educated, but that's what it's there for. It's there for us when we NEED it. Let's pray that more and more knowledge and support is available for mothers who need it too!

ckueck said...

I agree. Both of my kiddos had formula at certain points, too. I think the thing that helped me the most was when someone acknowledged what I was going through was tough, and then offered suggestions and encouragement. And most importantly...didn't make me feel condemned by whatever choice I made. New mommies (and veterans) are going through some big changes, we need all the support we can get- no matter how much we know :)

Heather Valadez said...

Thanks for this post, Missy! I don't know if you saw my status the other day, but I expressed frustration about the general attitude toward breastfeeding in public. People seem to have no problem with women showing tons of breast when dressed revealingly, but scowl at a mommy showing a tiny bit while feeding her child. I make a point to affirm and thank women I see nursing in public, because I know how it feels when unsupportive people stare or look horrified. A very large chested woman wearing a very small tank top at the nail salon once commented, as I began nursing (WITH a cover, mind you), "I would die if I had to do that here!" I smiled and calmly replied, "It doesn't bother me. You're showing more breast than I am!" She didn't have a thing to say to that. :)

Missy Rose said...

Very good point Heather! Yes, yes, yes, that's exactly it. Men do not go red in the face when they see scantily dressed women. They whitsle, wink, comment to friends, and hand out cheesy one-liners. My stepson, in fact, has made a comment on a couple of occasions that a certain woman is "hot," and yet he's mortified to get on my computer to play a game and see "breastfeeding" in the search engine field. It should seriously be the other way around!

Anonymous said...

Great post, Missy! My breastfeeding experiences have run the gamut: my first two children were entirely breastfed with no problems. The next two were the opposite; I'd developed deep fissures in my nipples which would not heal, so #3 only nursed for 3 months, and #4 for 3 weeks. I was devastated at first, but they did fine on formula, and thank God for it! I was able to breastfeed the last two partially, supplementing with formula. My youngest nursed well beyond an "acceptable age" for weaning in American culture, but she was my last, so I wasn't in a hurry . . . nothing wrong with a little "nursy" to go to sleep!

Missy Rose said...

Thanks for your input Christine! Your last sentence made my boobs hurt. With Aidan we called it nursies too!

Rachel said...

I love the post Missy! When our third baby was born with Down syndrome and had to spend several weeks in the NICU, everyone I talked to told me how difficult it would be to get him to nurse. It was sort of like everyone except his doctor was saying "well, you can try, but 'these babies' usually aren't able to breastfeed." After an enormous amount of work he did get the hang of it. I feel like if I hadn't already breastfed 2 babies there is no way I would have had the strength to keep trying. No one, including the Lactation Specialist, expected us to succeed.
Now at 10 months he is still nursing strong and his oral development is right on par with typical children his age (he's able to hold his mouth closed, eat mostly table food, and has no tongue protrusion- which is pretty uncommon). Several healthcare professionals have commented on this and when I tell them that he has been exclusively breastfed they all agree that it has made an enormous difference!
Lots of babies that are born a little differently can benefit from breastfeeding even more than the typical child, but the support seems to go the opposite direction. Mamas in this situation are told that they probably won't succeed; they are forced to try and feed their baby every 3 hours at the nurses convenience; and worst of all they're told that their baby will come from the NICU faster in they'll just stop being so selfish and give that baby a bottle.
I have no idea how to implement change, but I think you are absolutely right that it begins with support!

Missy Rose said...

Wow, congratulations Rachel! What an amazing success story! You are absolutely right, premature babies, sick babies, babies with delays of any kind benefit even more from breastfeeding. Your caregivers' surprise at your son's development is testament to that. Thank your for your comment and sharing your story!


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