A Breastfeeding Fact Every Parent Should Know

I am reviewing Hale and Hartmann’s “Textbook of Human Lactation” for an upcoming exam and LOOK at this:

“Lactation probably evolved initially to protect the young against infection and subsequently took on a nutritional role.  However, infant formula is focused on nutrition rather than protection.  Therefore, it is not surprising that the mortality rate of formula-fed infants in the USA today is at least 21% higher than breastfed babies.”

Wow, did you all know that?


The Importance of Breastfeeding in the First Few Days

Okay, here is my second mini-rant of the day:  Colostrum and its benefits!

For those of you who are not as familiar with the early days of breastfeeding, this is what happens within the breasts:  Lactogenesis I occurs midway through pregnancy as estrogen causes the ductal system to grow and progesterone increases the size of lobes, lobules, and alveoli of the breast.  Most women have colostrum during pregnancy.  Lactogenesis II occurs with the sudden drop in progesterone after birth and the  mature human milk comes in within three to five days after giving birth.  There may be a mix of  colostrum/mature milk for up to two weeks post partum

Colostrum has many advantages.  At birth, the infant’s stomach is the size of a marble.  Colostrum is readily available in small amounts to match this.  Colostrum has a laxative effect and promotes the passage of meconium in the early days after birth.

Colostrum contains 60 components, 30 of which are exclusive to human milk.  Some of the most important components for the early days include:

  • Secretory IgA (sIgA), which paints the lining of the stomach and intestines.  This important immunoglobin protects the mucosal membranes in the body from germs, foreign proteins, and harmful invaders. Even as colostrum decreases and the volume of mature milk increases, there is still plenty of sIgA. A woman produces about 2.5 grams of IgA daily for her own use; a baby, who is less than 1/10th of the mother’s  size, receives .5 gram to one full gram while nursing.  Even past the first birthday, there are significant amounts of IgA in the milk and the concentrations of this immunoglobin increase during weaning. The presence of IgA stimulates the infant’s own gastrointestinal production of IgA.
  • High amounts of sodium, potassium, chloride and cholesterol
  • High in protein –three times higher than mature milk
  • Live cells in colostrum, which  survive in the baby’s GI tract and secrete growth factors, hormones and immune regulators.
  • White cells – there are as many live white cells in colostrum as there are in blood in the early weeks
  • Lactoferrin, the main protein in human milk.  Lactoferrin kills certain kinds of bacteria, viruses, fungi and tumor cells.
  • Oligosaccharides, which prevent bacteria from binding itself to surfaces in the respiratory tract.

Do keep in mind these benefits of exclusively breastfeeding your infant within the early days of life:

  • Helps mature milk come in earlier
  • Decreases severity of engorgement
  • Enhances milk supply
  • Helps uterus to involute
  • Bolsters mother’s confidence that she can be the sole provider for her infant
  • Gives mother plenty of practice
  • Prevents nipple confusion
  • Baby can practice at breast on small amounts of fluid before mature milk comes in
  • Colostrum’s supply of IgA coats the mucous membranes of the linings of the digestive tract, keeping harmful pathogens out and helping to activate the infant’s own immune system
  • Colostrum is high in protein, concentrated in volume,  and is easily digestible
  • Colostrum acts as a laxative and minimizes risk of jaundice
  • Assists with bonding and attachment

There are times when supplementation is necessary after birth but please do understand the risks of supplementing with artificial infant milk.  Even one bottle of artificial infant milk can sensitize a newborn to cow’s milk protein.  Formula changes the gut flora by breaking down the mucosal barrier colostrum provides and allows pathogens and allergens to enter. 

So, please have an open dialogue with your health care team if they are advocating supplementation for your healthy, full-term newborn.   Know what levels of bilirubin and blood glucose your baby has, and how breastfeeding can help.  Understand how to nurse your baby with a good latch, and how nursing your baby at least nine to 12  times within a 24- hour period is more likely to lead to breastfeeding success and satisfactory outcomes.  Talk to your pediatrician before you give birth as to what scenarios they would advocate supplementation for and why.  If you are giving birth in a hospital, know your hospital’s policies regarding supplementation of term infants.

Hope this will help some of you out there.

Just a few thoughts from my little corner of the world.

Extended Breastfeeding: Breastfeeding Beyond A Year

Okay, here is my mini-rant of the day!  I have had three separate mothers come and talk to me about their pediatricians telling them that human milk has no nutritive value after the first year of an infant’s life!  I cannot believe these pediatricians are in practice, I really can’t.  This is such misinformation to be spreading, and while these particular mothers were educated enough to know this isn’t true, what about the mothers who do not know the facts, hear this, and prematurely wean their child based on this information? 

So, let’s talk about the facts.  If you want to breastfeed your child beyond a year, here are some facts about the advantages of extended nursing.

First of all, many organizations around the world recommend nursing beyond a year:

  • The World Health Organization recommends nursing for a minimum of two years.
  • The United Nations Children’s Fund also recommends a minimum of two years.
  • The American Academy of Pediatrics recommends nursing for at least a year and for as long after that as is “mutually desirable”.
  • And the best organization, the organization of motherhood,  has this to say :  the estimated median age of weaning throughout the world is between three to five YEARS.

Why Breastfeed Beyond a Year?

  • At one year of age, a baby’s immune system is functioning only at 60 percent of the adult levels. A child’s immune system is not fully functioning at adult levels until six years of age. Nursing toddlers grow better and have better resistance to infection.
  • In particular, secretory IgA, an immunoglobin, appears to remain low for the first 18 months of a child’s life, so breastfeeding is an important source of this immunoglobin.  Breastmilk contains IgA, IgG and IgM to augment a child’s immune system until it is functioning at optimal levels.  Human milk still contains nutrients, growth hormone factors and immunoglobins after the infant is one year of age.
  • From the wonderful site www.kellymom.com:  “Human milk expressed by mothers who have been lactating for >1 year has significantly increased fat and energy contents, compared with milk expressed by women who have been lactating for shorter periods. During prolonged lactation, the fat energy contribution of breast milk to the infant diet might be significant.”
    — Mandel 2005
  • Also from www.kellymom.com:  “Breast milk continues to provide substantial amounts of key nutrients well beyond the first year of life, especially protein, fat, and most vitamins.”
    — Dewey 2001
  • In the second year (12-23 months), 448 mL of breastmilk provides:
    • 29% of energy requirements
    • 43% of protein requirements
    • 36% of calcium requirements
    • 75% of vitamin A requirements
    • 76% of folate requirements
    • 94% of vitamin B12 requirements
    • 60% of vitamin C requirements

    — Dewey 2001

  • Studies done in rural Bangladesh have shown that [human milk] continues to be an important source of vitamin A in the second and third year of life.
    — Persson 1998
  • Better skin.
  • There is no easier way to comfort a sick child.  A sick child will almost always nurse, even if they are not eating.
  • Nursing may help improve the dental arch
  • Comfort nursing can be a fundamental part and advantage of nursing a toddler.
  • Enjoyment of  the connection and closeness with your child!  Closeness and loving attachment are very important for all babies, children and teens, but the turbulent toddler years provide a special opportunity for love and reassurance that nursing can provide.
  • Norma Jean Bumgarner writes in the LLLI book “Mothering Your Nursing Toddler” :  “Some children are very shy and tend to withdraw from close interaction with people, even mother.  The shy child who is still nursing has a ready-made assertive behavior – asking to nurse-  that can help him learn how to get his other needs met, too.  Other children are so active that nursing is the only quiet, calm time in their busy waking hours.”

The Myths Surrounding Extended Nursing:

  • If a child can ask to nurse, there is something wrong with doing so.”

THE FACT:  If we biologically compare human mammals to other mammals, the natural weaning age would be somewhere between 2.5 years and 7 years.  Please see this article by Katherine Dettwyler here: http://www.kathydettwyler.org/detwean.html.  This article will clear up many of the biological comparisons for you regarding the physiological age of weaning.

  • Once a child no longer needs mother’s milk solely for nutritional purposes, there is no sense in breastfeeding.”   or “Your child should be drinking whole milk now instead of human milk.”

THE FACT:  While human milk does not provide all the nutrients a nursing child may need, see the truth regarding the child’s immune system in the above section and the benefits human milk provides. 

Norma Jean Bumgarner does write in her book, “If your child eats very little besides your milk and is anywhere past his first birthday, you should make a point of offering foods that are rich in minerals.  The little bit he eats should not be cheese or other dairy products that contribute nothing beyond what he is already getting from your milk.  His food should be mineral-rich and easy for people his age to eat, foods like tender meat, eggs, raisins, dried apricots, and foods made with wheat germ, including whole-grain breads……..Except for making iron-rich food attractive to your child his second or third year, it is usually best to trust your child’s preference for nursing or for eating.”

If you are concerned regarding Vitamin D and extended nursing in your toddler, please see this link from La Leche League International: http://www.llli.org/Release/vitamind.html  and here: http://www.llli.org/NB/NBJulAug04p124.html

  • Your child would eat more solid food if you would just wean him.”

THE FACT:  Norma Jean Bumgarner writes in “Mothering Your Nursing Toddler”:  “Children in the second and third years are notorious for eating nothing, or so it seems to mother….[Nursing] should be more a comfort than a worry that a child has a regular source of nutritious food through nursing.”

  • After a certain point, the nursing relationship is more for the mother than the child.” (This is especially said regarding 4, 5 year olds who still nurse)

THE FACT:  Uh, any mother who has nursed a child in this age range can tell you it is not for the mother….The child still wants to nurse, and the child is the other person within this relationship.  How would your child react if you tried to stop now?   As a parent you weigh your child’s need for nursing, connection and closeness to you with your own feelings and needs and come up with a plan that hopefully works for the both of you.  Look at your child and see what happy confidence is there from extended nursing, and go from there.

  • Extended nursing will spoil a child.”

THE FACT:  Just based upon historical accounts of nursing children all over the world, we know the most treasured, precious children were nursed the longest so they would not be afflicted with the diseases that sometimes accompanied weaning; so I guess in that sense extended nursing does spoil your child (because preventing illness and death is obviously spoiling, LOL).

ANOTHER THOUGHT:  Children come into this world without inhibitions about their bodies or other people’s bodies. Extended nursing gives them an opportunity as they grow to learn boundaries of when nursing is accepted and when it is not.  Nursing often provides the first opportunities to practice gentle discipline and set boundaries while guiding and teaching your child.

  • A toddler who is still nursing is too dependent on his or her mother.”

THE FACT:  See the comment above.  People who are critical of breastfeeding often say things such as that.  Above all, realize it is not other people’s  business and in fact, you do not have to mention your child is still nursing if you do not want to!  Talk to people who will support you and be encouraging!

A toddler or even early preschooler is still a very young child.  This child would be dependent upon you whether you were still nursing them or not!

  • If you weaned your child, your child would not be (insert behavior here)”

THE FACT:  It is interesting how whatever behavior comes up, this is due to and completely caused by  breastfeeding whereas bottle feeding is never mentioned as a cause of behavior.  Funny how the world works, ain’t it??

  • Comfort nursing encourages the toddler to turn to food for comfort

THE FACT:  The composition and quality of human milk (along with the quantity) changes throughout a twenty four hour period and within a feeding.  Many times toddlers nurse for comfort for only a few minutes and are off and running again; they are not sitting down to the eight-course nursing buffet the way a one-month-old does!

Handling Pressure to Wean

If a one year old is still not walking, chances are a pediatrician will reassure mother that the unfolding of this skill will happen in time and not to worry. Weaning is also a biological function and yet we think nothing of encouraging a child to wean. Weaning in the United States often does not have the same dangers as it does in other parts of the world, but it still deserves thought and respect as an important rite of passage in a child’s life.

Just a few thoughts from my little corner of the world.