Did your mother breastfeed you? If you’re in your thirties, she probably did not. That’s because the 1960s and 1970s were a low point for breastfeeding in America. Few of our mothers were encouraged to do it and now, few of us are able to ask our mothers for help when the time comes to figure out how to feed our own babies. Times have changed, but experts say not fast enough.
For the last twenty years, medical studies have overwhelmingly demonstrated that breastfeeding is best for babies. The American Academy of Pediatrics (AAP) finds “strong evidence” that exclusive human milk feeding of infants decreases “the incidence and/or severity of a wide range of infectious diseases,” and that in the U.S., “postnatal infant mortality rates are reduced by 21 percent in breastfed infants.” Breastfeeding is also credited by the Academy with lowering the risks of sudden infant death syndrome, obesity, asthma, and leukemia.
And it’s not just good for babies. Studies also indicate that mothers benefit from nursing with decreased postpartum bleeding, earlier return to pre-pregnancy weight, decreased risk of breast and ovarian cancer, and decreased risk of osteoporosis after menopause. The AAP, American College of Obstetricians and Gynecologists (ACOG), World Health Organization (WHO), and United Nations Children’s Fund all recommend exclusive breastfeeding for the first six months of life (obviously allowing necessary medicines or individually-prescribed vitamins or minerals).
So Why Are So Few Women Breastfeeding?
It’s not because there isn’t help available. Wendy Haldeman MN, RN, is a certified lactation consultant who credits Dr. C Everett Koop, President Reagan’s Surgeon General, with creating the field of lactation consulting when he mandated hospital maternity units provide new mothers with trained specialists to help them start breastfeeding.
Yet, despite the official support from the medical establishment, breastfeeding is still not as commonly practiced in the U.S. as doctors and public health experts would like it to be.
According to the Centers for Disease Control and Prevention (CDC), in 2003, 70.9 percent of mothers did some breastfeeding in the hospital, but of that group, only 36.2 percent were still breastfeeding when their babies were six months old and a mere 17.2 percent were still breastfeeding when their children reached twelve months. Rates of exclusive breastfeeding trailed those rates substantially.
So, how can we help more women breastfeed longer? Haldeman, who is also co-owner of The Pump Station (www.pumpstation.com) a Santa Monica, California store for breastfeeding supplies, support groups, and one-on-one consultation services, recommends that women educate themselves and their partners about breastfeeding before their babies are even born. She says that parents-to-be learn a lot from being around moms who are nursing, as “it’s a great way to experience it and hear concerns.” And she says if a mother is on the fence, she should at least try it in the hospital. “Even colostrum in the hospital benefits the baby,” Haldeman explains. (Colostrum is what is secreted from the breasts in the first few days after birth—it provides high levels of anti-oxidants.)
Women are likely to encounter a few difficulties along the way and Haldeman encourages women to get help quickly from either physicians or lactation consultants. In the first week, she says, the most common problems are sore nipples and engorgement. These can be prevented with proper help in the hospital after birth by nurses, as well as any lactation consultants on staff. Engorgement can be relieved with heat and ice (editor’s note, a frozen bag of peas works wonders!), and “a good nursing baby is the best defense,” Haldeman reiterates.
A variety of nipple creams can also help tremendously for sore nipples and these can be found in the grocery store baby aisle. You can network with your lactation consultant and other moms for recommendations.
One of the biggest problems with breastfeeding is getting the baby to latch correctly. If the baby is not latching, get help immediately while in the hospital. A lactation consultant can sit with a new mother and teach her how to hold the baby and position the mouth correctly. It makes an amazing difference.
After a mom tackles engorgement, sore nipples and latching, a few weeks later, she can be plagued with worry about whether her baby is gaining enough weight. According to Haldeman, this is sometimes a problem of unrealistic expectations. “All we ask of a breastfed baby is to regain birth weight at two weeks. Some babies take three.” She says some parents, and even pediatricians, expect babies to gain faster and that this in not necessary.
“We are a country of formula-fed people,” Haldeman says, and “because we are big and healthy there is a fundamental distrust that a breast can feed a baby.”
Going back to Work
Asked how women can continue to nurse when they go back to work, Haldeman says that support groups for working, nursing moms help to keep women motivated and to share strategies and concerns. “Don’t rule it out ‘till you try it,” she urges. “You can always wean if it doesn’t work out.” The lactation expert recommends women start pumping a month in advance of their return date, putting away about four ounces of breast milk a day, to build up a good supply before they have to leave the baby regularly. She also suggests that mothers prepare for pumping at work by making sure that they have a private place to nurse, a refrigerator for storing the milk while there, and a spare blouse in case of leaking. Many moms and Haldeman highly recommend “hands-free bras” that can hold the parts of the electric pump, allowing you to do something else while you are pumping. (For more tips when going back to work, see: “Back to Work: Strategies to Pump from the Office.”)
Nursing is a choice, Haldeman admits, and “it isn’t for everyone.” But for those who want to try—reach out to experts, educate yourself, and get support either from friends or a formal support group. Luckily, lactation consultants can be found in most cities and in many hospitals. To locate one, visit La Leche League’s  site that lists lactation consultants and health care providers.
Moms today have so much more support than moms did just a generation ago, so don’t be shy to ask for help—especially when your baby’s health, and your own, will benefit!