1. Breastfeeding is an important health issue.
Hundreds of medical studies have been done on the differing health
consequences of breastfeeding and formula-feeding.
The results are unanimous: every study shows significantly greater
instances of illness among artificially-fed babies, even where clean
water, adequate supplies of formula and modern medical care are
available. Some of these illnesses are minor and easily curable
and some of them are extremely rare regardless of feeding method.
Some of them are fairly common and fairly serious (gastroenteritis
and pneumonia, among them). And the impact appears to be life-long:
several studies have shown a significant influence on adult illness
rates (e.g., both pre-and post-menopausal breast cancer are 25%
less common among the population of adult women who were breastfed
as infants) . To see a small sample of the medical literature showing
that formula is an inferior substitute for human milk, click
I want to be absolutely clear that I am NOT saying that all, or
even most, formula-fed babies are sick. Nor am I saying that all
breastfed babies are healthy. The studies I am pointing to are epidemiological
in nature. When researchers look at different feeding methods among
populations and compare disease rates among them, they have consistently
found higher disease rates among the population that was fed substitutes
for human milk.
It is therefore worth investing some of your time and energy in
breastfeeding. Take some steps before your child is born to increase
your chances of success. Be prepared to take steps to solve problems
that arise. Make a committment to do whatever you can manage to
do to make breastfeeding work for you and your baby. If, despite
your best efforts, breastfeeding does not work out, you will at
least have the consolation of knowing that you did your best, and
that your baby probably got some of the benefits of the earliest
2. Breastfeeding is a learned art.
If you have grown up around breastfeeding women, you probably
know enough to breastfeed without expert help. Indeed, those other
breastfeeding women in your life are likely to be the best experts
you can turn to for help. However, if you have been raised in a
bottle-feeding culture (the U.S. and the U.K. being the most pervasive
in their bottle-feeding bias), you may never have even glimpsed
another woman breastfeeding.
If you mistakenly think that breastfeeding is simply instinctive,
you may not think it necessary to educate yourself about the process
and it will be harder for you to accept the help you may need to
get started. If, instead, you go into breastfeeding with the knowledge
that it must be learned and that you are not trained, you will be
able to arm yourself in advance with the knowledge you need to succeed,
and you will know when to accept expert help.
Because breastfeeding is a learned art that has been lost to the
majority of mothers in a bottle-feeding culture, all mothers should
be prepared to deal with some breastfeeding problems. This does
not mean obsessing over every horror story that you hear, but it
does mean being aware that problems can arise, and learning how
to find help if they do.
3. The best sources of information on breastfeeding.
La Leche League International,
the Nursing Mothers Council, the National Childbirth Trust (U.K)
and the Nursing Mothers
Association of Australia are the best sources of accurate and
helpful information about breastfeeding. If you can afford it, buy
a book, such as La Leche League's "Breastfeeding: Pure and
Simple" that covers all of the basics. You may also be able
to find helpful books in your local library or borrow them from
a local La Leche League group.
4. Many breastfeeding problems are caused by medical
Ideally, you should be able to choose health care providers that
are educated about and supportive of breastfeeding. But that is
not always possible. It is an unfortunate fact that, in addition
to educating yourself about breastfeeding, you may have to educate
your obstetrician, pediatrician, family practice doctor, midwife,
maternity floor nurses, etc., about breastfeeding. You must also
be prepared to fend off bad advice and unnecessary procedures that
may interfere with breastfeeding.
To avoid misunderstandings, it is advisable to set aside some time
in your preparation for childbirth to discuss breastfeeding with
your health care providers. Make it plain that you are committed
to breastfeeding your baby and that you want to remove all unnecessary
barriers to breastfeeding. One of the most important issues to discuss
is the avoidance of all artificial nipples in the first days of
life. Nipple preference (where a breastfeeding baby learns to prefer
an artificial nipple to his mother's) is a leading cause of breastfeeding
failure, yet routine bottles and pacifiers are still common in some
hospital nurseries. It can't hurt to ask your doctors and hospital
to sign a document promising not to use artificial nipples, and
make sure that document makes its way into your baby's chart. Then,
if supplementary feeds are necessary, they can be administered by
cup, spoon, dropper, syringe, or tube.
Some other important issues you might want to discuss with your
doctors are: what effects any labor medications may have on the
initiation of breastfeeding, whether cleaning and examination of
the baby can be postponed until after the baby has had her first
feed, whether rooming in with your baby can be arranged and, if
not, will the nursery staff bring your baby to you frequently enough
to get breastfeeding started, whether circumcision (if such is your
choice) can be postponed until after breastfeeding has been well-established,
whether there are trained lactation consultants on staff at the
hospital or pediatrician's office, and whether a family history
of allergies makes breastfeeding especially important for your baby.
You might also ask the doctor how she deals with a mother who is
concerned about the adequacy of her supply because her baby is nursing
every hour. If she responds that formula supplementation is the
first line of treatment for this concern, you will know for sure
that you are dealing with an ignorant doctor, and should not rely
upon her advice regarding breastfeeding. Frequent nursing may have
nothing to do with inadequate milk supply, and unnecessary supplementation
is the fastest road to the end of breastfeeding.
5. If it hurts, it is likely that something is
Breastfeeding is not supposed to hurt. While some women experience
discomfort in the first days of nursing, real pain is almost always
a sign that something is wrong. Some possible problems that can
cause pain and nipple damage: incorrect latch, incorrect positioning,
incorrect sucking, and yeast infection (thrush). These problems
can usually be solved, but only if you seek the right kind of help
soon enough. If you wait too long, the baby may be hard to re-train,
your nipples may be seriously injured, and the joy of breastfeeding
may be replaced with dread and misery. And if you seek help from
someone who doesn't really know much about breastfeeding, or who
doesn't take the time to watch you and your baby nursing, you may
be worse off than with no help at all.
The best kind of help is a personal visit with an International
Board Certified Lactation Consultant (IBCLC). The IBCLC is the
only internationally-recognized credential showing thorough training
and expertise in the diagnosis and treatment of nursing problems.
In a personal visit, a lactation consultant can examine your baby
and your breasts, observe you and your baby nursing to evaluate
latch and positioning, let the baby suck on her finger to evaluate
the baby's sucking behavior, listen for the sound of the baby swallowing,
talk to you and get a total picture of your nursing relationship.
She can then work with you to put together a treatment plan to solve
your breastfeeding problems.
Of course, like any health care professional, a lactation consultant
will expect to be paid. If that bothers you, try to remember that
the formula to feed a baby for the first year of its life will cost
about 15 times more than a visit with a lactation consultant. Not
to mention the risk you run of additional
medical expenses that may arise because of the greater risk
of illness in formula-fed babies.
6. Know the signs of dehydration.
The scariest risk of the early post-partum period with a breastfeeding
baby is the risk that the baby's fluid intake will be so low as
to cause dehydration. Here are the signs: (a) fewer than six very
wet diapers per day, (b) significant color or odor to the urine
(it should be clear and nearly odorless), (c) dry skin that doesn't
spring back immediately after being pinched, (d) sunken fontanel
(that's the soft spot at the top of the baby's head). If your baby
exhibits any of these symptoms, get immediate medical attention.
If you do have to supplement your baby's fluid intake, remember
that cup, spoon, syringe, dropper and tube feeding are all preferrable
to a bottle, and expressed breastmilk is preferable to any artificial
If the baby is not exhibiting the symptoms of dehydration, has
good color and can be heard swallowing after every couple of sucks,
it is unlikely that you are having problems with your supply of
milk, regardless of how frequently the baby is nursing. Supplementing
with formula because of unreasonable fears at this stage can cause
breastfeeding failure. The baby's reduced demand will lead to reduced
supply and further supplementation, in a downward spiral toward
the complete cessation of breastfeeding.
7. You will need support to breastfeed.
Support can come in many forms. The most important support for
many mothers comes from the baby's father: if he is fully supportive
of breastfeeding, it is much easier for the mother to find the strength
to breastfeed in a bottle-feeding culture. For some mothers, support
can be a relative, friend or neighbor who has breastfed, and who
acts as a positive model. For some, it is an organized support group,
such as La Leche League. For some, it is a lactation consultant
or other medical professional who provides expert help when difficulties
Without support, many mothers will quickly abandon any efforts
to breastfeed because it makes them feel even more isolated at a
time in their lives when the stresses of a new baby have already
8. Your breasts are functional and their function
is feeding babies.
While many of us have grown up believing that our breasts were
primarily sexual, the reality is that their
sexual function is a cultural construct. The biological reality
is that our breasts are for feeding babies. It helps to keep this
in mind as you prepare yourself for dealing with people who think
there is something indecent about feeding a baby with your breasts.
There is absolutely no reason why you should not feed your baby
wherever and whenever any bottle-feeding mother would feel comfortable
feeding her baby. If the bottle-feeders aren't forced to feed their
babies in the bathroom, neither should you.
To avoid unwanted attention, it is wise to learn how to nurse discreetly
and to wear clothing that permits easy access to your breasts without
disrobing. But try not to let the fact that you take those precautions
make you ashamed if someone detects what you are up to. Feeding
your baby is not an indecent act no matter where it occurs.
9. Human milk can be provided in mother's absence.
When mother and baby must be separated, expressing and storing
human milk is not only possible but relatively easy. With good hand
expression technique or a good quality pump, about fifteen minutes
of break time twice a day, and a place to express milk in privacy,
most mothers can provide all of their babies' need for milk even
if they are working full time. If this is your plan, you will need
some additional education and preparation regarding expressing and
storing your milk. Take a look at Breastfeeding
and Returning to Work for a start.
10. It is normal to breastfeed for two years or
Exclusive breastfeeding, in which the baby receives no nourishment
other than his or her mother's milk, usually lasts around six months.
Somewhere around the second half of the first year, most babies
are ready to start eating some other foods. But the transition to
a diet that is similar to that of an adult is meant to be gradual,
and human milk is a healthy part of a child's diet for some time
after the first solids are introduced.
by anthropologists and comparative biologists have revealed
that the probable natural weaning age (that is, the age at which
no more nursing occurs) of the human species is over 2 1/2 years.
There is no harm in permitting a child who wants to continue nursing
for two years or more to do so. In fact, it is quite common everywhere
in the world that bottle-feeding is not the cultural norm. The fact
that it is not unusual in our culture for a child of 3 to be drinking
milk from a bottle or using a pacifier is a clue that the need to
suck is a fundamental human need that does not disappear at six
months or one year of age.
Formerly part of
need to know about breastfeeding