When preparing to introduce a new baby into the world, one of the many decisions a mother makes is whether to breastfeed or formula feed their new child. Breastfeeding has known benefits for both mom and baby, but initiation rates are still below what the World Health Organization’s (WHO) goals are for the optimal health of babies globally. The continuance of breastfeeding past the 6th month rates are even lower than initiation rates.
In the U.S., 81% of new mothers initiate breastfeeding. Globally, only 38% of moms do. WHO has set goals to have this number at 81% across the world. In Oklahoma, the initiation rate is at 77%. At 6 months, only 22% of U.S. moms are continuing to breastfeed compared to 41% globally. In Oklahoma, 53% are still breastfeeding at 6 months. (2019). Fundamentals of Breastfeeding. WIC. Missouri Department of Health and Senior Services. Thereby, Oklahoma falls short of WHO’s goals for initiation and continuation of breastfeeding.
Why Is It Important To Breastfeed?
Benefits for Baby
Why are these numbers important? Studies show that breastfeed infants have significant reductions in childhood diseases: 50% reductions in ear infections, 42% reduction in atopic dermatitis, 64% reduction in GI infection, up to 71% less respiratory infections, 20% less asthma, 40% less type 2 diabetes, 19% less childhood cancers and a 36% reduction of SIDS deaths. All of these numbers result in less dollars spent on healthcare and less time working mothers have to take off.
Breast milk changes each day according to the needs of the baby. If mom is exposed to viruses or bacteria, she makes antibodies in her milk that protect baby against these sicknesses. It has been prove that mothers pass COVID antibodies onto babies who are breastfed. Hesel, S. (2021, November 10). New Study Finds Evidence of COVID Antibodies in Breast Milk of Vaccinated Mothers. https://www.urmc.rochester.edu/news/story/new-study-finds-evidence-of-covid-antibodies-in-breast-milk-of-vaccinated-mothers
Breastfeeding also increases fat content as baby grows. The fat content of milk supports brain and neuro growth essential for healthy babies. Breastfeed babies have lower rates of obesity as children. They learn to stop feeding when they are full and this lowers their chances of overeating as they mature.
There are other benefits of breastfeeding as well. Breastfeeding is convenient, with milk always available at the right temperature with no preparation. Breastfeeding exclusively until 6 months of age saves hundreds of dollars in formula costs, reduces the stress of finding a supply of formula, as well as decreases environmental burden of formula cans and bottles.
Benefits for Mom
Breastfeeding also has great benefits for mom. Women who breastfeed have 28% less chance of being diagnosed with breast cancer and 21% less chance of ovarian cancer.
Breastfeeding releases oxytocin, which is the hormone responsible for contractions of the uterus during and after birth. This reduces uterine bleeding after delivery. Oxytocin is also the hormone that creates feelings of love and bonding between mom and baby. Moms often feel sleepy and happy as they breastfeed due to this hormone being released.
Moms also return to pre-pregnancy weight more quickly if they breastfeed. Pre-pregnancy weight is often achieved within 3-6 months compared to 9 months with non-breastfeeding mothers.
Why Do Mothers Stop Breastfeeding Early?
Sixty percent of mothers do not breastfeed for as long as they intend to.How long a mother breastfeeds her baby (duration) is influenced by many factors including:
1. Issues with lactation and latching.
2. Concerns about infant nutrition and weight.
3. Mother’s concern about taking medications while breastfeeding.
4. Unsupportive work policies and lack of parental leave.
5. Cultural norms and lack of family support.
6. Unsupportive hospital practices and policies
Breastfeeding Disparities also exist:
1. Fewer non-Hispanic Black infants (73.7%) are ever breastfed compared with Asian infants (90%), non-Hispanic White infants (86.7%) and Hispanic infants (84.1%).
2. Infants eligible for and receiving the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are less likely to ever be breastfed (77.0%) than infants eligible, but not receiving WIC (82.1%), and infants ineligible for WIC (92.1%).
3. Younger mothers aged 20 to 29 years are less likely to ever breastfeed (82.4%) than mothers aged 30 years or older (85.2%).
What Is And Can Be Done To Encourage Breastfeeding?
The factors listed above show us the importance of prenatal breastfeeding education for the mom and increased education for medical providers in the hospital and pediatrician offices. Many hospitals across the U.S. are already achieving Baby friendly status, which encourages nurses on Labor and Delivery floors to be certified in lactation support, nursery nurses are encouraged to delay bottle feeding to allow for a breastfeeding relationship to be formed. Pacifier use is being discouraged until 1 month of age.
Workplaces are being encouraged to establish maternity leave, ensure breastfeeding moms have a room to pump and store milk in. Childcare providers are also being educated on how to store and reheat milk and allow moms to come and feed their babies on their lunch breaks.
Many mothers will be returning to work or school within the first few weeks of a baby’s life, so the importance of workplace accommodations for mother and baby are very important for the overall health of moms and babies.
Most moms can breastfeed and still take medications. They should always consult a physician before taking any medications.
Education about how to measure a baby’s success while breastfeeding is also crucial. Babies lose weight at birth and this is an expected outcome. At 2 weeks, babies should be back at birth weight. Moms should keep a feeding and diaper log.
Babies should be at the breast 8-10 times each day for the first few weeks of life. They should have 8-10 wet diapers and 2 dirty diapers after the first week of life. The baby should be satisfied between feedings, usually sleeping after each feed. It is always good to remember that babies should be feed on demand, not kept to a schedule. Anytime a baby displays hunger cues, they should be fed. Breast milk is a natural food, so it digests more quickly than formula and babies need to be fed more often at first.
Moms can use these tips to be assured their baby is getting enough milk and is growing well. If baby is not latching properly, staying on the breast well, not gaining weight by 2 weeks, appears listless or more jaundiced, then a mom should be evaluated by a lactation expert called a lactation consultant. They should also consult the child’s doctor.
If a baby is not meeting these goals, then a pediatrician may encourage supplementation. It is especially important for a mom to understand that breast milk is produced based on supply and demand. Each time baby is at breast, milk is produced. If supplementation occurs too much, then milk supply will diminish. Most moms in the U.S. use a combination of breast milk and formula to meet the needs of their babies. The continuance of breastfeeding will still give baby and mom all the benefits listed above, even if formula is used in combination.
How Can We Support Breastfeeding
There are several ways we can support breastfeeding. Allowing new moms to breastfeed within one hour after birth, provide education on how to breastfeed successfully, encourage mom to rest and get adequate nutrition while breastfeeding, educate dads and other support people on the benefits of breastfeeding so they can help maintain the breastfeeding relationship. Most importantly, a fed baby is a healthy baby and if the breastfeeding relationship is not going well, then mom needs extra encouragement that bottle feeding is still feeding and that a healthy baby is the goal.
We can work together to create a healthy culture of breastfeeding in our sphere of influence. Continued work is needed to combat our culture that does not always support breastfeeding. Cultural practices take time to change and change only comes with continued education and support of new moms.