Whether to breastfeed or formula feed is one of a new mother's earliest and most important decisions. The final choice is always a personal one and not necessarily easy to make.
What should help make your decision easier, however, is knowing that evidence continues to mount suggesting that breast milk as the exclusive source of nutrition for the first six months of life (with continued breastfeeding through the first year of life after the introduction of solid foods) provides substantial benefits to both baby and mother. In fact, the American Academy of Pediatrics (AAP) revised its policy statement regarding breastfeeding in 1997, recommending breast milk as the "preferred feeding for all infants, including premature and sick newborns." If you're still undecided, here's some "food for thought":
Breastfeeding Enhances the Emotional Bond
Breastfeeding right after delivery establishes a powerful emotional bond between mother and baby. The stronger the emotional bond between baby and mother, the more likely the mother will be sensitive and responsive to her baby's behavior. Hundreds of studies show that such a bond helps babies to develop a trusting relationship with mother and to adapt to life outside the womb.
Breastfeeding May Aid Brain Development
Breastmilk is thought to provide the optimal fat source for the development of nerve cells in the brain. Although the differences are small and reasons have not been clearly established, several studies have consistently shown that breastfed babies as a group perform better on standardized tests compared to babies who were not breastfed.
Breastfed Babies Are Healthier
Breastmilk helps build up a baby's immune system. Breastfed babies are far less likely to have ear infections and other respiratory infections. They are also less likely to have a number of other serious conditions throughout life, including:
- blood infections
- meningitis (a potentially life-threatening infection of the brain)
- urinary-tract infections
- intestinal disorders such as diarrhea
- chronic diseases, including diabetes
- allergic conditions such as eczema, asthma and some food allergies
Premature babies, whose immune systems are relatively undeveloped, may especially benefit from breastfeeding.
Moms Benefit, Too
Research has shown that mothers who nurse their infants as recommended by the AAP are less likely to develop premenopausal breast cancer and ovarian cancer, as well as osteoporosis, compared to women who do not breastfeed. Breastfeeding helps with weight loss after pregnancy, when mothers breastfeed exclusively for six months or longer. Mothers who breastfeed longer than six months report greater happiness and emotional security. Because their babies are healthier, working mothers are absent less often from work, are more productive, have reduced health care expenses and report that they experience less stress.
Coping with Obstacles
Anticipating possible problems will help get you and your baby off to a better beginning. For starters, know your hospital's policy regarding breastfeeding and the availability of resources for breastfeeding. Here are some important questions to ask:
- Can your baby room with you or does she have to stay in a group nursery? Research has shown that infants who room with their mothers have less incidence of jaundice and breastfeed more often and for a longer duration.
- Does the hospital assume that it is okay to offer formula to all babies regardless of the mother's wishes? Make sure your hospital knows whether or not you want to breastfeed exclusively.
- What resources can your ob-gyn's office or pediatrician's office provide? Will a lactation consultant be on hand? Will someone be available to answer questions by telephone?
The AAP and other experts recommend doing the following to help you and your baby ease into a successful breastfeeding relationship:
- Begin breastfeeding your baby as soon as possible after birth, preferably within the first hour, when the baby is most alert and eager to suckle. Breastfeeding in the first hours not only allows you to begin bonding with your baby right away, but also helps to release the hormone oxytocin in your body, which helps the uterus to release the placenta.
- Ask that such procedures as vigorous suctioning of the baby's mouth -- which can result in the baby experiencing painful swallowing and therefore interfere with breastfeeding -- be avoided. Also, ask that certain procedures, such as shots and getting blood drawn, not conflict with your baby's eating schedule. Having a traumatic experience just before breastfeeding can negatively affect your baby's breastfeeding experience.
- Breastfeed on demand, whenever your baby shows signs of hunger, preferably before she starts crying. An exception to this is during your baby's first week, when to feed her you will often have to wake her; newborns must feed at least eight to 12 times in 24 hours. Otherwise, during the first months of life do not restrict feeding or put your baby on a set schedule.
- Monitor your baby's diaper output to know whether you're feeding him frequently enough. Babies should have up to six wet diapers per day by day 3 of life, according to Dr. Wendy Slusser, director of the Breastfeeding Resource Program at the University of California at Los Angeles School of Public Health. Put a piece of paper towel in the diaper to be sure the diaper gets wet -- it's hard to determine this with the hyper-absorbent diapers made these days. Your baby should have one bowel movement on day 1 of life; two on day 2; and three or more bowel movements on day 3 of life. Bowel movements should be getting yellow and seedy by day 3.
- Slusser also recommends that you learn from the hospital staff what swallowing during breastfeeding sounds like, so that you can gage whether your baby is actually feeding or just sucking.
- If you are discharged from the hospital before 48 hours after delivery, see a doctor or nurse practitioner within two to four days so that he or she can address any problems you might be having.
- Use lanolin and breast shields if you develop sore nipples. A recent study from the Archives of Pediatric and Adolescent Medicine reported that breastfeeding moms with sore nipples healed more quickly when they used lanolin and breast shields as opposed to absorbent bandages.
Finally, don't hesitate to ask for help from family and friends during this exciting but exhausting time in your life.