World Breastfeeding Week: Mother knows breast

The month of August is marked by several significant events: the Illinois State Fair, kids returning to school and, of course, World Breastfeeding Week, celebrated Aug. 1-7 every year worldwide! In honor of one of the breast, er, best weeks of the year, we spoke with SIU School of Medicine certified lactation counselor Melissa Nicol, RD, to answer the most frequently asked questions about breastfeeding.  

What are the benefits of breastfeeding?
Breastfeeding has numerous benefits for mother and baby. Some of the benefits breast milk provides to babies include: antibodies to provide protection against common illnesses, ease in digestion, an increase in cognitive development in children through school age, a reduced risk for developing type 1 diabetes, less chance of developing some allergic diseases and a lower risk of sudden infant death syndrome during the first year of life. Studies also show that overweight and obesity are less common among children who were breastfed.

Some benefits to mother include: a reduced risk for breast and cervical cancer, cardiovascular disease and other health conditions; emotional benefit in bonding with child and aid in weight loss postpartum. Breastfeeding is also much cheaper and takes less preparation than bottle-feeding.

What are the drawbacks to formula feeding?
Drawbacks include the high cost of formula, lack of antibodies in formula to fight off infection and preparation time— bottles of formula cannot be made more than 24 hours in advance. Also, no formula can exactly duplicate the ideal composition of breast milk.

For how long do you recommend women should breastfeed?
According to the World Health Organization and the American Academy of Pediatrics (AAP), an infant should be exclusively breastfed for the first six months. After the first six months, the infant should be provided with complementary foods in addition to breast milk at least until the child reaches one year of age.

If women choose to breastfeed, is any additional nutrition necessary for the baby or mother?
A typical woman who is breastfeeding will need an additional 500 calories per day. Some women may be encouraged to continue a prenatal vitamin while breastfeeding. This should be discussed with the patient’s doctor. Overall, there are no specific foods that you should consume or avoid while nursing.

Suggested breastfeeding needs:

FOOD GROUP                     # OF SERVINGS

Milk/milk products                 3-4

Meat/meat substitutes           2-3

Grains                                    6-12

Fruits/vegetables                   5-7

Fats, oils, sweets                   limited amounts

What can women do to promote successful breastfeeding?
If able, women should breastfeed within an hour after delivery. Also, nurse on demand and not by time, that is, when the baby shows signs of hunger rather than every 2-3 hours since last nursing session). Avoid pacifiers until nursing is well established, and use skin to skin contact with infant.

What if breastfeeding isn't going well? Could it be an anatomically-related issue? Or do some babies just not want to breastfeed?
A few women may be unable to build a full milk supply due to anatomical issues or health conditions. If a mother is having difficulty with breastfeeding, she should contact a certified lactation counselor (CLC) to help guide her in the right direction. A common myth is that the size of the breast determines whether a mother will be successful with breastfeeding.

Can women combine breastfeeding and formula-feeding?
Generally this practice is not recommended. The more you nurse, the more your body will produce milk. Milk supply for breastfeeding is based on supply and demand. If you give a baby formula, your body will not be signaled to make more milk for the infant. If a mother is struggling with adequate supply, I would encourage her to try skin to skin contact with the infant, nurse often and frequently, stay hydrated, sleep when you can and don’t stress. The mother may benefit from meeting with the CLC just to ensure that the latch is correct and establish how much milk the infant is getting.

However, combination feeding rather than solely formula feeding is better than no breast milk at all.

I’ve heard that if a woman wants to breastfeed but is unable to, it can be a very emotional experience. What advice would you give to those women?
I would encourage these women to talk about her feelings and not try to deal with this alone. Just like delivery, sometimes things do not work out how they were planned. Do not blame yourself. Some women even need to allow time to mourn their inability to breastfeed.

Are there cases where breastfeeding isn't the best option for the baby?
Yes, some medications used to treat HIV treatment, anxiety, radiation therapy, chemotherapy, etc. can be passed through breast milk. In these cases, a mother should not breastfed her child. In addition, mothers who have HIV/AIDS or tuberculosis should not breastfeed. Simply reviewing a mother’s medication list with the physician can determine the safety of nursing while taking medication.

In addition, an infant is screened for galactosemia at birth. If a baby has this condition he/she cannot digest breast milk properly and cannot be breastfed.

What recommendations do you have for women who are breastfeeding their babies and preparing to return to work after childbirth?
Breastfeeding can be continued after returning to work. There are some options for the breastfeeding mother: the child can come to her work or moms can stop by the daycare if is nearby for nursing sessions or they can use the aid of a breast pump. The U.S. has multiple laws protecting a breastfeeding mother. An employer must provide a place other than a bathroom and provide a reasonable break time for employees to express milk.

Any final thoughts?

I encourage each and every expecting mother to conduct her own research on breastfeeding. Of course, every mother wants to provide what is best for baby. Be prepared ahead of time with breastfeeding basics and resources. Many local CLC are available to aid in any issues with latch or supply.

To schedule an appointment with a certified lactation counselor at SIU Medicine, call 545-8000.