The Truth About Breastfeeding

New parents face a whole new world of challenges and decisions. The choice to breastfeed or not is a big one.

Breastfeeding has benefits for both the mother and the baby. Nursing can be very rewarding and can be a wonderful bonding experience. But it isn’t always an easy task and isn’t the only option to give your baby everything they need. The societal pressure to nurse your baby and to do it “the right way” can make you feel like a failure if breastfeeding isn’t coming easily for you and your child.

Anna Katerina Sfakianaki, M.D., a maternal and fetal medicine specialist with the University of Miami Health System, addresses misconceptions and shares advice for new parents.

True or False?

Breastmilk is better than formula.
True.

Breastfed babies tend to have lower rates of respiratory infections, allergies, and other illnesses. Infants fed breastmilk exclusively have reduced risks of asthma, obesity, Type 1 diabetes, severe lower respiratory disease, ear infections, sudden infant death syndrome, gastrointestinal infections, and necrotizing enterocolitis for preterm babies.

“However, bottle-feeding breastmilk offers many of the same benefits for babies. There aren’t big studies to prove there’s a difference in populations like ours,” says Dr. Sfakianaki.

New mothers also benefit from regularly expressing their breastmilk. Research shows that breastfeeding or pumping can help lower a mother’s risk of high blood pressure, Type 2 diabetes, ovarian cancer, and breast cancer.

“This should reassure moms who want more freedom to express/pump their milk when they have time,” Dr. Sfakianaki says. “The medical community is largely in agreement that it is the breastmilk itself that is best for babies, not necessarily the way the breastmilk gets into the baby.”

Breastfeeding is natural, so it should come naturally.

False.

Breastfeeding comes naturally for many women. However, for some, it isn’t the easiest thing to do. “Breastfeeding is not a passive thing that just happens for all new moms,” Dr. Sfakianaki says. “It’s a natural process; it’s why we have breasts. But it can take more commitment and effort than you’d expect.”

If breastfeeding is going to be successful, “nursing your baby has to be your full-time job for the first two to four weeks. That means avoiding formula, responding to your baby’s cues, and making sustained skin-to-skin and eye contact while nursing.”

Keep trying, but know that your child will be okay, even if breastfeeding doesn’t work out. You can effectively bond with your child if you pump, and you and your partner can bottle-feed breastmilk or formula. You can also seek help from a lactation consultant.

Nursing will exclude your partner from the experience of feeding and bonding with your baby.

False.

You can establish the intimacy and benefits of breastfeeding while bottle-feeding. “Cuddling, eye contact, skin to skin prolonged and repeated contact, reading the baby’s cues, and feeding them when they need to be fed. All of this can be achieved with a bottle,” Dr. Sfakianaki says.

Partners (non-birthing parents), fathers, and grandparents can also participate in the bonding experience by practicing skin-to-skin contact while bottle-feeding.

Breastfeeding helps new mothers lose pregnancy weight.

Possibly.

“This is hard to prove because there isn’t enough evidence-based research and statistics,” Dr. Sfakianaki says. We do know that lactating/breastfeeding mothers need to increase their daily caloric intake by 300 to 400 extra calories. Breastfeeding may help you burn off some of these extra calories.

“Anecdotally, many breastfeeding mothers tell me they are eating all the time while also losing their pregnancy weight,” she says. Of course, your activity level and diet significantly affect your after-birth weight loss.

If you don’t breastfeed your baby, it will be hard to bond with them.

The data is mixed on this.

“Some studies suggest that breastfeeding moms have a higher level of bonding, but other studies show the opposite,” says Dr. Sfakianaki. “I don’t want to add undue stress for mothers who aren’t nursing. If all of the other beneficial elements of breastfeeding are taking place, there should not be a difference with bottle-feeding.”

Breastfeeding will tie you down.

False.

When feeding your baby directly from your breast, you don’t need a breast pump and a private place to pump, a cooler/fridge to store your breast milk, and a way to warm it. You don’t need sterile water and supplies to make the formula. Plus, the cost of formula for the baby’s first year is $1000 to $2000 per year.

“Once breastfeeding is working for you and your baby, you can conveniently breastfeed anywhere, anytime — like on an airplane,” Dr. Sfakianaki says. In addition, you and your partner can supplement your nursing by bottle-feeding with your breastmilk or formula when needed.

Breastfeeding hurts.

Sometimes true.

Many women report discomfort with breastfeeding and milk let-down. It may give you sore nipples or lead to blocked ducts or a breast infection, all of which can be overcome with persistence or professional help. “However, real pain from breastfeeding may be caused by a problem with technique,” Dr. Sfakianaki says.

To make breastfeeding work for you and your child, you can speak with your OB or a lactation consultant (a medical professional who helps women overcome issues with breastfeeding).

The following changes may also help establish a more comfortable way to nurse your baby:

• Stay hydrated.
• After feeding your baby, rub some breastmilk on your nipples and allow it to air dry. Lanolin is also helpful.
• Wear nipple shields while feeding to protect sore or cracked nipples.
• Avoid using drying or irritating soaps on your areolas and nipples.
• If the pain is caused by a blocked duct, consult with your obstetrician. Try applying a warm compress or massage your breasts in a warm shower to encourage milk flow.

Once you start breastfeeding, you must commit to it for years.

False.

The American Academy of Pediatrics recommends that the baby’s diet for the first four to six months be exclusively breast milk. In the days immediately after giving birth, your breastmilk includes nutrient-rich colostrum for your baby. Colostrum can help your baby pass their first bowel movement and prevent jaundice. After four to six months, you can introduce some solid foods and continue to breastfeed as long as desired. Many women continue until the child is two to three years old.

“Beyond that, some mothers continue to breastfeed for non-nutritive reasons,” Dr. Sfakianaki says. “In these cases, most of the baby’s nutrition is coming from whole foods. But lactating parents may choose to continue breastfeeding toddlers ages two to three years old in an effort to support the child’s immune response and to soothe and bond with the baby.”

Dana Kantrowitz is a contributing writer for UMiami Health News.

Tags: breastfeeding, Dr. Anna Sfakianaki, infant nutrition, milk for babies