Monday, August 3, 2009

Breastfeeding - A moral decision?


At 8 1/2 months pregnant with my second child, I am in the last stretch of preparations before our little guy's arrival. With this being my second pregnancy, I am thankful that there are not as many critical decisions for me to make -- What car seat? What stroller? What nursery theme? The list goes on and on, especially for new parents. However, I believe one of the most important decisions a parent makes regarding a new baby relates to how to feed the baby. Human breast milk or human milk substitute (aka, formula)? As a Registered Dietitian and someone who is well aware of the multitude of benefits of breastfeeding for both baby and mom, the decision was easy for me. Yes, yes, yes -- breast is the best!

Yes, you got that right. I am quite gung ho for breastfeeding. At the same time, I also realize that making the decision is not a moral issue -- at least it shouldn't be. You are not a good parent if you do and a bad parent if you don't! However, to me, it is a health issue and I realize that for many parents the decision is not so easy. I can understand why as there are still so many sociocultural and environmental factors that seem to easily persuade parents to choose formula over breastfeeding. Let's first take a look at our environment. I see the plethora of very persuasive marketing by the formula industry to moms-to-be and new moms. During the first pregnancy, I was inundated with a new fantastic coupon deal for formula at nearly every OB visit, diaper bags provided by several formula companies, free samples, and even materials provided by the formula companies that would appear to support breastfeeding (i.e., ice packs for storage, etc.) -- don't even get me started on this. It is influences such as these that seem to easily sway parents to choose formula over breastfeeding or to simply give up on breastfeeding altogether. In terms of sociocultural influences, I believe that there are very subtle ways in which sociocultural factors can influence a woman's choice to breastfeed. I was reading a new book to my daughter the other day called "I'm a Big Sister". I noticed something in the story that others might not. The story presents a situation in which the big sister gets to help bottle feed the baby. Now, the reader can fill in the blanks and assume that the bottle is filled with formula or breast milk. It did not say. However, I just found this scenario interesting as I believe that our minds can be influenced in the most subtle ways when it comes to nutrition. Why not have the father and the little girl assist the mother while she's nursing the new baby rather than insinuating that in order for father and big sister to help s/he must participate in bottle feeding? Another example...the other day I was presented several questions from a reporter for a local university newspaper. One of the questions posed was "What can a parent feed a child who's allergic to cow's milk and soy?" Initially, I thought about how I'd actually like to educate and encourage the parent to feed a new baby breast milk first and foremost -- before any formula.

I get it...the decision is not easy, initiating the process is not always easy, and there are a lot of factors still working against the successful lactation experience. However, I will tell you, the rewards are well worth it. As a public health professional and advocate, I'm feeling a personal duty to spend the next few blogs writing about the what, why, and how of this very important issue in the hopes that if you're a parent-to-be, a new parent, or someone who knows someone about to make this important decision, you'll strengthen your decision for breastfeeding or at least consider this option more strongly. So, let's start with the what.

What is the recommendation regarding breastfeeding?
  • The American Academy of Pediatrics, American Dietetic Association, and U.S. Department of Health and Human Services recommends exclusive breastfeeding during the first six months of life (with some exceptions that you will find here). These organizations also suggest continuing breastfeeding along with appropriate introduction of solid foods for at least the first year of life.
  • The World Health Organization recommends breastfeeding through at least the first two years of life with the proper addition of complementary foods.
  • The national Healthy People 2010 goals include objectives targeting breastfeeding rates in the U.S. 1) Increase the rate of mothers initiating breastfeeding in the early postpartum period to 75%. 2) Increase the rate of mothers continuing breastfeeding to at least six months to 50%. and 3) Increase the rate of mothers continuing breastfeeding to at least one year to 25%.
Stay tuned for the why's of breastfeeding. How will it benefit baby?

4 comments:

Samantha said...[Reply to comment]

Awesome - I couldn't have said it better myself! And I can't wait to read the follow-up posts.

Oh, and I had no clue that the WHO reccomended to two years!

BBC said...[Reply to comment]

I am all for breastfeeding and plan to with my 2nd just as I did my first. I do, however, know I will not do it for 2 years, it is just not for me when a child reaches that age. I think many mothers feel the same -- a bit uncomfortable with nursing toddlers. Curious your thoughts on this? Does the discomfort come from the fact that this is not a typical choice? Did you nurse your daughter until 2?

Michelle Loy, MPH, MS, RD said...[Reply to comment]

BBC - Thanks for the comment. Personally, I believe it is up to mom and baby on how long to breastfeed though I do believe that choosing to breastfeed during the first year of life is best for the health benefits. I listed the breastfeeding recommendations from a few different sources, hence the difference in recommendations. The WHO recommends up to two years and beyond while U.S.-based organizations recommend up to the minimum of one year and beyond (based on mom and baby). We have to look at the population WHO targets with their recommendations -- They target populations in countries other than just the U.S. where there are other prevalent health problems to consider for which extended breastfeeding can be helpful. I do believe that the discomfort that many women in our country face is due to the sociocultural norms here. Breastfeeding is becoming more socially acceptable; however, I do feel that we have a long way to go. In many other countries, breastfeeding beyond the age of 1 is the cultural norm. However, in the U.S. we still have a long way to go to even get more mothers to choose breastfeeding up to the 1 year goal. Personally, I chose to breastfeed through 12 months. That was my personal goal and also a natural timeline during which my daughter also began to wean herself. Thanks again for the comment and reading my blog!

Nicole Candy said...[Reply to comment]

I breastfed my elder son as i was a WAHM at that time, but now relying on Ameda Ultra
breast pump as I do not work at home mom anymore, I need to make sure my kid is getting the breast milk needed, breast pump is really helping me a lot.

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