Breastfeeding: All about it

For a process as old as humanity itself, breastfeeding gets a lot of media attention. 

I've read many articles and arguments over the years, and decided to spend some time looking into the matter. Not that I need to worry about it, having no children myself. But maybe someday, who knows. 

And it has to do with two of my most favorite topics, money and food. How so? you may ask. Well, breastfeeding saves you money because your body naturally makes it. It is free food for several months for this little critter you just popped out of your body. And food, because that's what breast milk is.

Also I'm just insatiably curious. I read this article on Yahoo, and it stirred something in me. 

Why does the entire world think their opinions are needed, welcome, or necessary about what a woman does with her own body? I've always been of the opinion that what I do is my business and what you do is yours. 

I object to smoking in public because I hate the smell of smoke, it makes me gag and cough, and actively damages my health. If you want to smoke in your own house or car or whatever, that's your life decision. If you dress like a hooker or wear your pants down to your ankles, yes I will silently judge you. But you aren't actively harming me or stopping me from living my life, so I have nothing to say to you about it.

It is the same with breastfeeding. I've seen women in public and private doing so, both with and without covers. I'm more comfortable if they use a cover, sure. I feel super awkward if a lady's breast is all hanging out, but that doesn't mean I have to look at it. Look away, or go somewhere else. If she doesn't feel the need to cover up, that's her choice.

Anyways, time to get down off my soap box and look at some facts.

How it works

"Breastfeeding" is exactly that, the act of feeding an infant with milk produced by a female human breast. This production of milk is lactation, and is a natural anatomical event which begins after giving birth. Newborns only minutes old already have a suckling reflex which enables them to latch on to a breast, suck, and swallow milk. Surprisingly, Wikipedia has a very complete and thorough page all about breastfeeding.

Photo from SMAHCP

Common recommendations are that babies be breast fed within an hour of birth, exclusively breastfed for the first six months, then supplemented with age-appropriate foods until age two or "as long as is mutually desired by the mother and baby" (American Academy of Pediatrics).

During pregnancy and after giving birth, the woman's hormonal endocrine system drives milk production in the milk duct system of the breasts. Progesterone, estrogen, prolactin, oxytocin, and others all influence development and production of milk. The milk ejection process, known as let-down, is triggered by oxytocin in response to the baby's suckling. It can also become a conditioned response, as in beginning at the cry of the baby.

The milk is made from the nutrients in the mother's body and bloodstream, and consists of just the right balance of fat, sugar, protein, and water for the baby. How much milk is produced can change depending on the age of the child, how often they nurse, and how much they consume per nursing session.
 

From the Wikipedia page: Formula (left) next to breast milk (right)

Many years ago, and in some poor countries today, your only option is to breastfeed. With the invention of formula, this freed mothers to allow others to feed their child if for some reason they could not. A third option has been even more recently made available through the widespread use of pumps. This combines the benefit of using your own milk with the convenience of having stores whenever the baby is hungry and using a bottle. The choice is personal, and unique to each mother's situation. 

Women who are nursing or pumping need to be careful of what they eat, as you can pass on toxins, mercury, and alcohol through breast milk. Alcohol-containing breastmilk has been shown to have a detrimental effect on motor development. Additionally, excess caffeine in breastmilk can cause irritability and restlessness in infants, so keep it under three cups of coffee (or 300 mg) per day.

Health/cognitive effects

Chronic non-communicable diseases (NCD) such as heart disease, respiratory diseases, and diabetes, are a growing concern in the developed and developing worlds. These diseases have a complex interaction of causes from genetics to gender, age and ethnicity, to environmental factors and lifestyle choices.

The major risk factors of chronic NCDs include smoking, hyperlipidemia (high lipids in the blood), hypertension (high blood pressure), hyperglycemia (high levels of sugar in the blood), obesity, and a sedentary lifestyle. A review titled "The protective effects of breastfeeding on chronic non-communicable diseases in adulthood: A review of evidence" looks at the current body of literature researching the effects of breastfeeding on NCDs. There is a growing body of evidence which suggests that breastfeeding has protective roles for the infant against obesity, hypertension, dyslipidemia, and type II diabetes mellitus during adulthood. 

Mother's milk has been a staple of child rearing for decades, maybe millennia. Its nutritional content and makeup has been adapted to feed a newborn infant into a strong, healthy toddler. It also contains antibodies from the environment of the mother, and thus the baby, helping the baby's immune system develop. There are numerous physical, emotional, psychological and health benefits for mothers too.

In addition to its short-term benefits, encouraging breastfeeding can have long-term beneficial health effects at individual and population levels. 

The Agency for Healthcare Research and Quality stated in their review Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries, that "A history of breastfeeding is associated with a reduced risk of many diseases in infants and mothers from developed countries."

For baby

According to the American Academy of Pediatrics, research shows that breast feeding provides advantages with regard to general health, growth, and development for the baby. Infants who are not breastfed are at a significantly increased risk for a large number of acute and chronic diseases including:

• lower respiratory infection
• ear infections
• bacteremia
• bacterial meningitis
• botulism
• urinary tract infection
• necrotizing enterocolitis
• weak jaw and jaw muscles

There are numerous studies that show a possible protective effect of breast milk feeding against sudden infant death syndrome, insulin-dependent diabetes mellitus, Crohn's disease, ulcerative colitis, lymphoma, allergic diseases, digestive diseases, and a possible enhancement of cognitive development. However, the association between breastfeeding and 'intelligence' is not clear.

Regardless, it is hard to argue that breastfeeding will in any way harm your baby's health. In fact, the vast majority of mothers plan on breastfeeding, but various health, behavioral, or social factors get in the way and prevent them or cause them to stop early.

For mom

Breastfeeding can have numerous benefits for mom, in physical, mental, and financial terms. Benefits for the mother include: 

• Assists in post-baby weight loss (breastfeeding uses up about 500 calories a day)
• Uterine shrinkage (apparently that's a good thing?)
• Decreased risk of breast cancer, ovarian cancer, and endometrial cancer (if you nurse a female child, it also decreases her lifetime risk of breast cancer! that's pretty flippin cool)
• Decreased rates of depression 
• Decreased risk of osteoporosis
• Bonding experience for both mother and baby
• Less expensive than formula
• Lactational amenorrhea - delays return of fertility by suppressing ovulation, however is not 100% guaranteed, so please don't use this as the only form of birth control if you don't want another little on to follow on this one's heels

Breast milk was developed over millennia of evolution, and as such is perfectly suited to its job of feeding infants during their first few months and years of life. Studies have shown that the caloric intake of breastfeeding and non-breastfeeding mothers was not very different, therefore breastfeeding is a cost-effective way of feeding an infant, providing nourishment for a child at a small cost to the mother.  Breastfeeding soon after giving birth increases the mother's oxytocin levels, making her uterus contract more quickly and reducing bleeding. And of course it bonds baby and mom closer together at every meal.

If you cannot or choose not to directly breast feed but still want to give your baby your milk, you can use a breast pump to express the milk and store it. Milk can be stored in special freezer bags (6-12 months) or in bottles in the refrigerator (6-8 days). This frees the mother to return to work or other daytime duties, enables other partners or caregivers to feed the child, and still offers all the benefits of using natural milk. Research suggests that the antioxidant activity in expressed breast milk decreases over time but it still remains at higher levels than in infant formula.
 

Any drawbacks?

Sometimes, due to drug use, infections, mastitis, or other health problems, a woman cannot use natural breast milk. There are still options available. If you want your child to still receive human breast milk, there are breast milk banks where kindly new mothers can donate excess breast milk. The milk will not be tailored to your baby, but will still be nutritionally superior to formula. See the Human Milk Banking Association of North America website for a bank near you. Or elsewhere in the world, a quick Google search should find some.

The process of weaning a baby can also be somewhat traumatic for both mother and child. Many mothers dread the loss of the bonding experience with their child. Weaning is the process of introducing other foods and reducing the frequency of milk, until the child is no longer receiving any breast milk. Most mammals stop producing the enzyme lactase, which breaks down the lactose in milk. This can lead to lactose intolerance. The frequency of lactose intolerance rises over time, and varies among human populations.

It is also unconfirmed that breastfeeding causes any type of permanent disfigurement or 'sag'. This is more correlated with age, weight, lifestyle, and other factors.
 

Controversy 

The whole concept of to breastfeed or not seems to have a long-running polarizing effect. Again, I am not a mom, and have no intensely strong opinion either way. I think we are all free to make our own choices, and should respect each other as women and human beings in the choices each other makes. 

However, it seems moms on both sides of the fence take issue with the other side. Both choices are beset with the notion of being "right" or "good", while the other choice is wrong and hurts the child, mother, or both. 

This is silly. As women we are genetically and evolutionarily programmed to keep an offspring alive. And this is really the key. NO ONE is perfect. Everyone messes up sometimes. Everyone sucks sometimes. And that's okay. RenegadeMothering gets it.

The controversial TIME magazine cover "Are you MOM enough?"

The upsetting part though, is that society has developed a super-negative view of breastfeeding, especially in public. Women get stares, glares, and sometimes even asked to leave places, all for trying to provide food to their hungry babies. Yet no one objects to a lady on a park bench with a bottle.

Negative perception of breastfeeding in has led women to feel discomfort when breastfeeding in public. Wikipedia says: "Even though many women are educated about the health benefits of breastfeeding, less than 25% choose to breastfeed their children". 

A major driver of this is the over-sexualization of breasts. As they say, sex sells. And we like to sell lots of stuff. Therefore, we see lots of breasts in ads, on billboards, in magazines, on TV, on the subway... Every day we are bombarded with images of sexualized women and men trying to make us buy things. Thus, the thought of someone bearing one of those in pubic touches a nerve because people do not like to associate feeding an infant with sexual pleasure.

Societal judgment along with limitations as to when and where you can breastfeed in public leads some women to give up much sooner than they would have otherwise, which could have negative health effects for the baby later on in life. Shame should not be used as a tool to advocate breastfeeding, rather women should be able to individually define what a good mother is. 

As a society, we need to move towards providing women with education on the benefits of breastfeeding, as well as problem solving skills for women who may find it difficult.

More great blogs and websites to check out: 

• http://www.kidspot.com.au/why-im-glad-i-was-told-to-stop-breastfeeding-in-public/
• http://healthfoundationsbirthcenter.com/2013/11/19/15-cool-facts-about-breastfeeding/
• http://thegothicmommy.wordpress.com/2012/12/02/pressure-to-breastfeed/
• http://www.who.int/features/factfiles/breastfeeding/en/
• http://www.unicef.org/mozambique/media_9256.html

References - made using EasyBib (the world's best auto-citation site!)

Kelishadi, Roya, and Sanam Farajian. "The Protective Effects of Breastfeeding on Chronic Non-communicable Diseases in Adulthood: A Review of Evidence." Advanced Biomedical Research 3.1 (2014): 3. Print.

Much, Daniela, Andreas Beyerlein, Michaela Rothbauer, Sandra Hummel, and Anette-G. Ziegler. "Beneficial Effects of Breastfeeding in Women with Gestational Diabetes Mellitus." Molecular Metabolism 3.3 (2014): 284-92. Print.

Slusser, W. "Breastfeeding and Maternal and Infant Health Outcomes In Developed Countries." AAP Grand Rounds 18.2 (2007): 15-16. Print.

World Health Organization. "10 Facts on Breastfeeding." WHO. N.p., Feb. 2014. Web.