Dr. Sarah Whitehead, Obstetrician and Mom, Talks about Breast and Bottle Feeding

New Mother holding newborn in nurseryFew of our expectant moms have missed the message that breastfeeding has many benefits. But, while we continue educating expectant and new mothers about how good it is for baby, we don’t want to overwhelm them with the idea that breastfeeding—because it is natural—should always be easy to do. Some well-meaning breastfeeding advocates cite higher breastfeeding rates in third-world countries. Such statistics suggest that successful breastfeeding happens naturally in cultures where breastfeeding is the norm, and it happens despite inadequate healthcare and education for women.

Many suppose that, in developing countries like Botswana where I grew up, every woman breastfeeds her babies for over a year and it’s easy. Well that’s just not true. Historically, a woman in Botswana would take a year away from working with the family agriculture/cow rearing in the village and just breastfeed on demand. Her mother, grandmother, and/or aunts would take care of other household things so she could focus on her baby. However, the AIDS epidemic, with 1/5 adults living with HIV, has left many widows and families where the mother is forced to be the main source of income, the breadwinner. Although breastfeeding studies in Botswana show that as high as 96% of women breastfed after birth and were planning to continue (in 1996), actual rates were far lower. Common reasons women expressed for not reaching their goal were the need to return to work or school and an insufficient supply of breast milk (not much different than their American sisters). The truth of the matter is, breastfeeding can present challenges no matter where you live. As a community, we should take care not to shame moms about their choices, but rather, to support them in whatever they choose to do.

So, what is our message to the expectant mothers we care for in our practice? Of course, breast milk is the ideal nutrition for your newborn. But there are certainly circumstances where another choice is a necessary and better option for an individual mother. Most of you will consider breastfeeding. I wholeheartedly recommend beginning breastfeeding in the hospital even if you don’t think it will be your long-term choice. It will help your uterus return to its non-pregnant state more quickly. Your baby will get some immune protection from even the first fluids the breast produces.  And our lactation consultants have lots of great tips. But, if you come to a point where this is no longer meeting your needs or your baby’s, we want to support you there as well. Here are a few thoughts from a fellow working mom (me).

  • Do review the information we provide in your Birth Planning sessions about the advantages of breastfeeding and why we encourage it. Your RN will help you sort through myths and facts.
  • Try to avoid pressure from friends, family, and even healthcare staff with extreme opinions either way about what’s “best” for you.
  • Don’t become obsessed with research on the subject. (infant health and survival, intelligence and school success, childhood illnesses, etc.). Research has not yet provided a set of undisputed facts about these issues. In a country like ours, where clean water and good healthcare are available, full-term babies generally do very well with breast or bottle.
  • Follow YOUR PEDIATRICIAN’S guidelines about keeping your baby adequately fed AND HYDRATED (getting enough fluid), especially in the first few days of life. Concerns about adequate fluid should be answered by your pediatrician.
  • If you request supplementary feedings for your baby while in the hospital, you have the option to request formula or human donor milk. Safe human donor milk is generally not available outside the hospital. The American Academy of Pediatrics strongly cautions against using breast milk purchased on the Internet or from sources other than a regulated milk bank.
  • About pacifiers—research on this subject is very conflicted! We recommend that this is a personal choice, or one that you can discuss with your pediatrician. Comfort and rest for mother and baby are important!
  • Let us know promptly if you are experiencing problems with breastfeeding. Such as fever, severe engorgement of the breast (usually felt as hard, painful breast lumps), redness, cracked or bleeding nipples. Also inform us, if within the course of your medical care, you feel that your wishes have not been respected.

A final thought, I encourage you to view this early decision in perspective with many more you will make for your child’s well-being. Nutrition is an important part of what you provide for your newborn. But, as parents ourselves, we know it’s only a part of the big job ahead!