Fall 2001 Volume 5 Number 1

• Breast Milk: The Gold Standard
—Still the best nutrition for infants.

One of the most important decisions you will make while you are pregnant is how you will feed your baby. There are two obvious choices, breastfeeding or bottle-feeding. However, the reasons for your decision may not be quite as obvious. Many factors go into this decision:

Breastfeeding rates have fluctuated over the last 30 years. In the 1970s, 20 percent of women started breastfeeding their babies and this rate rose to a high of about 60 percent in the early 1980s. In the late 80s the rates dropped again and started rising again in the mid-90s to 60 percent of women nursing their babies at birth. And about 20 percent of mothers are still breastfeeding at 6 months after birth.

Here in the Twin Cities area, some lactation consultants feel the starting rate is closer to about 70 to 80 percent. We encourage more and more women to start breastfeeding their children in the hospital after delivery but the ultimate goal is to encourage breastfeeding beyond the early weeks.

The American Academy of Pediatrics came out with a paper in 1997 that states "human milk is the preferred feeding for all infants" and that "exclusive breastfeeding is ideal nutrition and sufficient to support optimal growth and development for approximately the first 6 months after birth." The recommendation also encourages women to breastfeed their babies for the first 12 months of life or longer if desired.

What are the benefits of breastfeeding for my baby?

• Nature's natural nutrition. Human milk is superior for infant feeding and is "species-specific." Human milk is made for human babies. A woman's breast milk changes over time to meet the nutritional needs of her infant.

Breast milk in the first weeks is different nutritionally than breast milk in the fourth month. Mothers who have premature babies make milk that meets the nutritional requirements specific for their premature baby. There is more and more evidence supporting the health benefits of breastfeeding for infants and children.

• Protection. Breastfeeding can decrease the incidence and severity of diarrheal illnesses, ear infections, meningitis, urinary tract infections and lower respiratory infections like RSV (respiratory syncytial virus). There are studies that show a possible protective effect of breastfeeding against SIDS, insulin dependent diabetes, Crohn's disease, ulcerative colitis and some allergies.

• It makes you smarter. New research is looking at the effect breastfeeding has on possible enhancement of cognitive development.

What are the benefits of breastfeeding for me?

There are also many personal and health benefits of breastfeeding for the women who breastfeed their babies:

• Economics. Breastfeeding is convenient and free. Formula is very expensive and can cost a family over $800-$1,000 a year.

• Health. Health benefits include less postpartum bleeding and more rapid return of the uterus to its pre-pregnancy size.

• Weight. There is generally an earlier return to pre-pregnant weight.

• Protection. There is also evidence that there is a decrease in breast cancer among pre-menopausal women and a decrease in osteoporosis in the postmenopausal period.

What can I do to ensure a successful breastfeeding experience?

We cannot guarantee that all women who want to breastfeed will be 100 percent successful. There are things you can do to educate and prepare yourself so that you will have all the information you need to get off to a good start.

First, attend a breastfeeding class before the birth of your baby. Most hospitals have prenatal breastfeeding classes that you can attend to get information on many aspects of breastfeeding. Having your partner attend with you can ensure that you have a knowledgeable support person to assist you in the early days post-discharge from the hospital.

You can also read books on breastfeeding. Books can give you information on the anatomy and physiology of breastfeeding, the benefits of breastfeeding, the mechanics of breastfeeding and offer trouble shooting guides to assist you when things are not going as you expected.

Besides your partner, surround yourself with others who can support you throughout your breastfeeding experience. Female family members or friends who have breastfed are excellent resources and support people.

Find community resources ahead of time that can assist you if you or your baby are having difficulty with breastfeeding. Local lactation clinics, the La Leche League, the hospital where you delivered your baby and your baby's primary health care provider are all excellent sources of information and practical help.

You may need to consult your health insurance company to find out what services are provided under your particular health insurance. Most services are not covered by insurance, however.

If you have any special health care needs or are on any medications for chronic illnesses, ask your health care provider how they may impact breastfeeding. The above resources also can answer questions like these. The key to ensuring a successful breast-feeding experience is to get help early on if you are experiencing any problems!

How can Partners in Pediatrics help me in breastfeeding my baby?

Partners in Pediatrics has two Pediatric Nurse Practitioners, one of whom is a board certified lactation consultant, who have both personal and professional breastfeeding experience available to assist you. These health care providers are available most Mondays through Fridays from 8 a.m. to 5 p.m. to answer questions and help you determine if a personal lactation visit is necessary.

You can also make an appointment on your own if you feel one is necessary. The on-call provider can assist you with breast feeding issues that arise after regular office hours.

—Allison Goulson, CPNP, IBCLC
—Roxanna Plouff, CPNP