Is Breast Really Best? The struggles of breastfeeding women

Breastfeeding is super hard for a lot of families.  While it is touted as the best and most natural way to feed your baby, it doesn’t come easily or naturally for many people. Not to mention that many of us were raised on formula, and we turned out just fine.  As long as you are feeding your baby, you are doing your job as a parent. All TRUE statements. So why do we care so much about breastfeeding?

Firstly, we just need to say that, as neonatal nurses and mothers, we APPRECIATE formula.  We value it the same way we value C-sections, as a safety net for when nature breaks down.  We are so grateful that science has provided a safe, alternative way to nourish babies that is accessible and affordable.  Formula, like C-sections, has saved the day for many babies who might have otherwise died because of various complications.  But, also like C-sections, it is being overly relied-on in western culture, which has some very important drawbacks for mothers and babies.

We felt that it could be helpful to write about some of the challenges and benefits of breastfeeding in the same post, because we find it useful to be reminded of why breastfeeding is worth the blood, sweat and tears that it often requires.

Photo Credit to Jasmine McGowen and Lowe Photography

Photo Credit to Jasmine McGowen and Lowe Photography

Challenge 1:  Waiting for milk to come in.

In my case, it took 5 days for my milk to come in. 5!! whole days of feeling like I was starving my baby.  He was getting colostrum, but it felt like only drops worth. Those 5 days were some of the most stressful of my life.  My baby lost too much weight, was teetering on edge of dehydration, and was ravenous.  No one was sleeping, my nipples were raw and cracking. Ultimately, I ended up supplementing with formula for 24hrs, on top of nursing around the clock, because I didn’t want to mess around with dehydration. It was ROUGH and I wanted to quit.  I am sure that many breastfeeding moms could tell a similar story.

Benefit 1: Colostrum is liquid GOLD. 

The first milk that mothers produce is like thick honey, and so rich in nutrients.  Not only is it very high in protein and carbohydrates, it is full of antibodies and white blood cells that help protect your fresh newborn from the onslaught of bacteria and viruses that they face on their first days outside the womb.  It also acts as a mild laxative, helping your baby to clear out that thick tarry poop and aiding in the prevention of jaundice.  Colostrum is the perfect first food to prime a baby’s digestive system and helps create the ideal balance of microbes in the gut, something that has lifelong implications.  

We trust women’s bodies to provide everything needed to magically build babies from scratch in the womb, and when those babies are born, we should be trusting breastmilk to continue that magical process of growing our babies, only on the outside.  Labs can’t even come close to replicating the biology of a mother’s womb, and so it’s not surprising that they have a hard time replicating the incredibly complex and evolving biology of breastmilk; alive with enzymes, hormones, stem cells, and beneficial bacteria.

Those first weeks of breastfeeding can be brutal, but the getting to give your baby COLOSTRUM, and eventually, breastmilk, helps make it worth it.

Challenge 2: Getting the latch right!

Wince..unlatch.. re-position.. try again.. baby screaming.. crying mom.. try again… wince, bite tongue, unlatch… try again.  Wash, rinse, repeat…

Sleepy babies, tongue ties, flat nipples, overactive letdowns, cracked & bleeding nipples, engorgement, pumping, nipple shields.. and so many other challenges can be part of the breastfeeding journey for mothers and newborns.  It’s very hard and a far cry from glamorous.

Benefit 2:  Less Risk of Postpartum Depression

In large scale studies, it has been found that successfully breastfeeding mothers have a lower risk of developing postpartum depression.  It is not clear if it’s due to the hormones released when breastfeeding (oxytocin – love hormone) or if it’s that breastfeeding mothers have an easier time bonding with their babies.. or a combination.  What is clear is that breastfeeding has important mental health benefits for mothers, even if it can be super HARD in the beginning.

Challenge 3:  Medical Challenges

Breastfeeding is largely baby controlled, not parent controlled. Mothers must accept far more uncertainty and variation when breastfeeding than when bottle feeding.  Dealing with complications like jaundice, poor weight gain, reflux, allergies and colic can be extra hard for breastfeeding families, because its hard to control the composition of breastmilk, and measure and control how much and when a breastfeeding baby eats.  Breastfeeding mothers also have their own medical complication to deal with, like engorgement, thrush, mastitis and cracked, bleeding nipples.

Benefit 3:  Health Benefits

There is an astounding amount of robust evidence detailing the incredible health benefits of breastmilk.  They can not be overstated.  Get ready, the list is long…

A person who was breastfed as a baby has a significantly DECREASED RISK of developing/contracting: Ear infections, Respiratory infections, Allergies, Cold/Flu/Gastro viruses, Diarrhea, SIDS, Celiac Disease, Inflammatory Bowel Diseases, Leukemia, Lymphoma, Diabetes, Asthma and Obesity.

Toddlers who were breastfed have 20-30% more white brain matter, and a higher IQ throughout life. In a British study, 16yr old’s who were breastfed as babies had higher exams grades than their formula fed peers, and a Brazilian study found people who had been breastfed for at least a year earned a higher income in their 30s.  Breastfeeding also appears to have a positive impact on a child’s emotional intelligence and stress management later in life. Funnily, they have straighter teeth and better eyesight too!

Women who breastfeed have a lower lifetime risk of breast, ovarian and uterine cancer as well as lower risk for heart disease, diabetes, depression, osteoporosis, and fractures.  Amazingly, breastfeeding can even improve the mother’s IQ!

To sum up, we are not trying to pretend that breastfeeding is always wonderful and romantic.  But is one of the most powerful things you will ever do for your child, and it should not be dismissed lightly. 

All that said, we support formula feeding if it is necessary or if it is your choice as a parent, we just want it to be an informed choice.  A fed baby and a sane mother trumps everything, and that is also supported in the scientific literature.

REFERENCES

1 Moberg KU et al. Oxytocin effects in mothers and infants during breastfeeding. Infant. 2013;9(6):201-206.

2 Sobhy SI, Mohame NA. The effect of early initiation of breast feeding on the amount of vaginal blood loss during the fourth stage of labor. J Egypt Public Health Assoc. 2004;79(1-2):1-12.

3 Labbok MH. Effects of breastfeeding on the mother. Pediatr Clin North Am. 2001;48(1):143-158.

4 Stuebe AM et al. Association between maternal mood and oxytocin response to breastfeeding. J Womens Health (Larchmt). 2013;22(4):352-361.

5 Uvnas-Moberg K, Petersson M. Oxytocin, a mediator of anti-stress, well-being, social interaction, growth and healing. Z Psychosom Med Psychother. 2005;51(1):57-80.

6 Peters SAE et al. Breastfeeding and the risk of maternal cardiovascular disease: a prospective study of 300 000 Chinese women. J Am Heart Assoc. 2017;6(6):pii:e006081.

7 Victora CG et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-490.

8 Li DP et al. Breastfeeding and ovarian cancer risk: a systematic review and meta-analysis of 40 epidemiological studies. Asian Pac J Cancer Prev. 2014;15(12):4829-4837.

9 Jordan SJ et al. Breastfeeding and endometrial cancer risk: an analysis from the Epidemiology of Endometrial Cancer Consortium. Obstet Gynecol. 2017;129(6):1059-1067.

10 Vekemans M. Postpartum contraception: the lactational amenorrhea method. Eur J Contracept Reprod Health Care. 1997;2(2):105-111.

11 Brown EJ et al. Contraception update: oral contraception. FP Essent. 2017;462:11-19.

12 Trussell J. Contraceptive failure in the United States. 2011;83(5):397-404.

13 Brown A, Harries V. Infant sleep and night feeding patterns during later infancy: association with breastfeeding frequency, daytime complementary food intake, and infant weight. Breastfeed Med. 2015;10(5):246-252.

14 Uvnäs-Moberg K. Neuroendocrinology of the mother-child interaction. Trends Endocrinol Metab. 1996;7(4):126-131.

15 Kendall-Tackett K et al. The effect of feeding method on sleep duration, Maternal well-being, and postpartum depression. Clin Lact. 2011;2(2):22-26.

16 Doan T et al. Breast-feeding increases sleep duration of new parentsJ Perinat Neonatal Nurs. 2007;21(3):200-206.

17 Britton JR et al. Breastfeeding, sensitivity, and attachment. Pediatrics. 2006;118(5):e1436-1443.

18 Dewey KG. Energy and protein requirements during lactation: Annu Rev Nutr. 1997;17:19-36.

19 U.S. Department of Health & Human Services [Internet]. The Surgeon General’s call to action to support breastfeeding – Factsheet; 2011 Jan 20 [cited 2017 Feb]

20 Howie PW et al. Protective effect of breast feeding against infection. BMJ. 1990;300(6716):11-16.

21 Cohen R et al. Comparison of maternal absenteeism and infant illness rates among breast-feeding and formula-feeding women in two corporations. Am J Health Promot. 1995 Nov-Dec;10(2):148-53.

22 Wiklund PK et al. Lactation is associated with greater maternal bone size and bone strength later in life. Osteoporosis International. 2012;23(7):1939-1945.

23 Kinsley CH, Lambert KG. The maternal brain. Sci Am. 2006;294(1):72-79.