The following article was authored by Dr. Rosemary Shy, a pediatrician at Children’s Hospital of Michigan. Dr. Shy is also a fellow of the Academy of Breastfeeding Medicine, the breastfeeding coordinator for the Michigan chapter of the American Academy of Pediatrics and the co-chair for the Michigan Breastfeeding Network, the state coalition for breastfeeding. A HUGE thanks to Dr. Shy for putting together this illuminating article for Tiny Green Mom.
Why Breastfeeding is Important
By Dr. Rosemary Shy
Why breastfeed? Breastfeeding is nature’s intended way to feed our infants. It is healthy, inexpensive safe, protects landfills and protects babies against risks of infection and autoimmune disease. Breast milk is always fresh, a perfect temperature, and ready when a baby wants it.
So why doesn’t every mother breastfeed?
Maybe they don’t know how different it is to feed their baby human protein, instead of cow protein, or if baby doesn’t tolerate the formula they may have grossly bloody stools;
or know that their body makes the immunity for their babies until the babies mature enough to protect their own bodies;
or know that the fat in their milk helps the babies’ brains mature. Fat is added to cow milk in formula to try to imitate breast milk, but studies show higher IQs for breastfed babies;
or that components in breast milk help the gut and immune system mature more quickly, and may help protect from some autoimmune diseases.
Human milk is a living, active entity which changes with a baby’s age and even with the time of feed.
Human milk has low iron that is highly absorbed and has another chemical which binds iron. This means the gut milieu is low in iron which make little available for viruses like RSV, Rotavirus and bacteria like E-coli, which need iron to grow .his low iron helps to protect the infant from these invaders. It also coats the gut with immunoglobulin A which keeps pathogens from attaching to the gut and causing diarrhea.
Getting off to a good start helps. Holding the baby skin to skin just after birth increases the likelihood of success. Skin to skin is having baby next to skin directly such as putting the infant on mother’s chest immediately after birth.
Some mothers are afraid that they will have pain or have had pain. Pain is not part of good breastfeeding. If there is pain the mother needs to get some help. Something is definitely wrong.
Breastfeeding is a learned experience so it may take a few tries to get it right.
Pain most often means that there is some positioning problem even if the baby seems to be latching and eating. Sometimes pain is caused by infection in or poor emptying of mother’s breast. If baby falls asleep before a full feed, they are probably not getting a good flow of milk. If the milk is not flowing then baby will stop eating.
Some common problems experienced:
1) Positioning problems:
When a baby falls asleep quickly at the breast then wakes soon to feed again they are probably not getting enough milk. A common positioning problem is leaning forward to the baby for latching and then sitting back when relaxed. This relaxation pulls the mother away from the baby, which allows the baby to have their chest and abdomen move away from the mother with the abdomen/chest facing out with the baby’s head turned. In this position the baby cannot latch properly and the milk flow slows or stops. To prevent this, the mother needs to make sure that baby is chest to chest with mother, with baby’s chest /abdomen always turned toward the mother.
Another problem in position is holding the baby’s head in a neutral or slightly forward position. The baby tries to position itself leading with the chin, with the head slightly back; if the mother holds the head forward, the baby then has its nose against the breast, and the nipple tips to the roof of the baby’s mouth. The nipple can then be traumatized by rubbing and latch is not good. This may cause pain and slow flow.
2) Near term babies, that is babies born between 35 and 38 weeks gestation, may have more difficulties with feeding:
This group of babies may be slower at learning to breastfeed, may fatigue easier, are more susceptible to get jaundice because of this bit of prematurity, and may have more difficulty latching onto the breast. If the babies are small, they may take less milk than the mothers make.
If the infant is falling asleep before being full, is jaundiced, or is not gaining well, one can use compression to get more milk to the baby and remind them to keep feeding. This works as well as bottle feeding if your milk supply is good. There is a good video and discussion of this technique on Dr. Jack Newman’s website, www.drjacknewman.com. If the infants are small the mother may make more milk than they need so they may only use one breast initially. Don’t switch breasts until the first empties (the breast should feel softer, less tense and less full); pump the other breast if necessary until baby grows big enough to need the milk in both breasts. The mother should try to avoid letting the breast get engorged. If the breasts get engorged, the baby may have difficulty latching, and the mother may have pain. The mother should empty the breast either by hand expression or pump.
There are many sites that are useful for a breastfeeding mother. To name a few, our state of Michigan breastfeeding coalition has a website, www.mibfnetwork.org, with many links to other useful websites. Dr. Newman has handouts and videos on his website, www.drjacknewman.com, and the Academy of Breastfeeding medicine has information to use with your physician and hospital nurses. The American Academy of Pediatrics has information on its site.
Breastfeeding should be enjoyable for both mother and baby. Problems should be addressed early and fixed. Many problems are worsened by not addressing them early.