Breastfeeding

The natural way to feed a newborn baby. Unless otherwise contraindicated, this is the best way to feed a baby for the first few months of its life.

Not only is breast milk nutritionally better (and cheaper) for the baby than any other baby food in the market but it also helps create a strong mother-child bond. There is also evidence to show that breastfed babies are less prone to gastroenteritis than bottle fed babies. This may be due to antibodies passing from the mother to the baby through the breast milk. The World Health Organization (WHO) has recommended that all babies be breastfed for the first 3 months of life. A recent study has suggested that breastfeeding for more than 4 months does not confer any additional advantage to the baby, so it might be a good idea to think about weaning then.

On the flip side, drugs have been known to pass through to babies through breast milk - therefore a mother addicted to heroin or alcohol (or any other drug of abuse) should not be breastfeeding her infant (and indeed should be a target of social services). Some viruses including HIV (causing AIDS) can also be passed on through breast milk so this is another known contraindication to breastfeeding.

A less known fact about breastfeeding is that it is a pretty good form of contraception. Breastfeeding on demand (the baby's demand, that is) alone is a proven contraceptive with a less than 10% failure rate for the first few months. This works because the prolactin levels that are induced by demand breastfeeding inhibit the normal ovulatory cycle. This should not be relied on as a sole form of contraception however, as most women in western society do not breastfeed their babies as often as they should and because they may well be fertile before their first period following childbirth.

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Western society seems to drift between approving and disapproving of breastfeeding in public. What is there to be ashamed about this when there are places such as topless beaches?

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Update - March 19th, 2001 - just for the record, between radlab0 and momomom's writeups below, I tend to agree with momomom.

And yes, IainB is correct, breastfeeding does reduce a woman's chance of getting breast cancer. Women who have an infant at a younger age and who breastfeed their infant have a lower risk of getting breast cancer. It has something to do with the fact that making use of the mammary glands for their actual intended purpose, lactation, is somehow better (in terms of cancer risk) than just letting them go through the 4 weekly menstrual cycle period of hormone cycling.

Breastfeeding also lowers the mother's susceptibility to breast cancer, and (statistically) increases the IQ of the child.

For maximum effectiveness, the baby should be breastfed for over a year.

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some links:
http://www.breastfeedingnetwork.org.uk/index.html
http://bmj.com/
search for breastfeeding + IQ
i had the link here before, but it was several hundered chars... :D

Breast milk is best... why would you not want to breast feed?? I am going to breast feed my kids (when I have kids) unless it's medically impossible or something like that. I have been in public places with other females, like myself, where there was a woman breast feeding. The females I was with criticized the woman for it. I think there was nothing wrong with it. I will concede that if I was in some situation where I was making people very uncomfortable, then I might not breast feed in that location.

From what I know and have been told, breast feeding creates a bond between mother and child... I think that is a very important part of motherhood. Babies that drink breast milk have an easier transition to solid foods than babies that drink formula. This makes sense since breast milk will change from day to day depending on how the mother changes (in her eating habits amoung other thing), whereas formula is always the same.

I do realize that breast feeding may create problems for the mother in most cases. I am willing to make this sacrifice for my children, though. Children are little pieces of their parents and should be treated as well as possible.

Women should be encouraged more (not just by their doctors, but by society in general) to breast feed their children. I have lived in and been to other countries where breast feeding a social norm and not a big deal at all. This is the way it should be.

To elaborate on alex.tan's excellent writeup, please never, never, never consume alcohol while breastfeeding. Drinking even a single alcoholic beverage within a few hours of a feeding can have profound effects on the feed and on the infant.

When a breastfeeding mother drinks alcohol, a small amount of that alcohol passes into the breast milk unmetabolized (This is true of many drugs, including but not limited to, caffeine, nicotine, and the THC in marijuana).¹ This means that when the baby next feeds, it will be feeding on alcohol-laced milk. Obviously, consuming a large amount of alcohol would result in a larger amount of alcohol making its way into the milk, a situation that would obviously cause problems. Research has shown that even the small amounts of alcohol in the breast milk resulting from a single serving of alcohol can have a marked effect on the infant.

• When a breastfeeding mother drinks alcohol, the amount of milk she produces is reduced.² Less milk means less sustenance available for the infant.
• The infant consumes significantly less of the milk produced if the feeding occurs within a few hours of alcohol consumption.³ The mother is often unable to tell that the infant did not get as much milk as it needed.
• After an infant has fed from an alcohol-tainted breast, it will sleep less--only about two-thirds of the normal time spent sleeping.⁴
• Years after exposure to alcohol in breast milk the child will have significantly altered responses to objects that smell like alcohol.⁵

Many breastfeeding manuals and OB/GYN doctors suggest that new mothers have a glass of wine to make let-down easier. These sources are disturbingly misinformed. From the literature I've come across, it seems reasonable to conclude that infants exposed to alcohol while breastfeeding are more likely to have problems with alcohol later in life. Be nice to babies, and pass this information along to new mothers.

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1. Breastfeeding and the use of recreational drugs--alcohol, caffeine, nicotine, and marijuana. Liston, J. (1998). Breastfeeding Review, 6(2), pp 27-30.
2. Short term effects of maternal alcohol consumption on lactational performance. Mennella, JA. (1998). Alcohol Clinical Experimental Research, 22(7), pp 1389-1392.
3. Infants' suckling responses to the flavor of alcohol in mothers' milk. Mennella, JA. (1997). Alcohol Clinical Experimental Research, 21(4) pp 581-585.
4. Effects of exposure to alcohol in mothers' milk on infant sleep. Mennella, JA., Gerrish, CJ. (1998). Pediatrics, 101(5), E2.
5. Infants' exploration of scented toys: effects of prior experiences. Mennella, JA., Beauchamp, GK. (1998). Chemical Senses, 23(1), pp 11-17.

This node is in response to subjective statements made in the node directly above. Radlab0 asks that a mother "please never, never, never consume alcohol while breastfeeding" and gives the opinion that even small amounts of alcohol may cause long term harm to the breastfed baby.

Breastfeeding is too important to be dismissed just because the mother lives a normal life. Breastfeeding is also inherently simple. When rules and more rules are imposed it becomes needlessly complex and something only an extraordinary woman can do. You don't have to be a saint to breastfeed.

Alex.tan correctly states (also above) that "a mother addicted to heroin or alcohol should not be breastfeeding her infant (and indeed should be a target of social services)". This is quite different from implying that a minute amount of alcohol in breastmilk will lead to the infant having long term problems with alcohol.

Don't take me wrong, mothers (and fathers) should not be drinking to excess or even on a regular basis. It is difficult to be a good parent and a drunk plus alcohol on a regular basis (2 drinks a day) has been shown to cause some gross motor developmental delays in one year olds. But again, this is not the same as implying that a single drink can cause harm. It is however true that drinking alcohol decreases the amount of milk a baby will recieve in the (short term) following feedings, probably by inhibiting the MER. A then hungry baby may fuss to feed more often thereby increasing milk because of the supply and demand regulation of breastmilk. Because of these conflicting pieces of information the folk lore advice to drink beer as a galactogogue is controversial. I'm just saying a breastfeeding mother can live a normal life. As much as new parents wish babies came with rule books, they just don't. Use common sense and moderation. Pay attention to your baby and if it acts hungry feed it. Don't be a lush, but you don't have to be a saint either.

Breastfeeding should be kept simple and sensible and not overly restricted by silliness. If you have an occasional drink it is best if you breastfeed first. By the time the baby next nurses the already minuscule amount of alcohol present in the milk will be further reduced.

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(note to Blue Dragon's node down stream a bit) Blocked ducts or plugged ducts can originate at the nipple tip causing a little bleb like you described. They can also originate further back in the ductal system and not show on the nipple tip.

If the block is caused by a nipple tip bleb your technique sometimes works but should be approached with caution and sterile technique. Deep hand expression, stretching of the pore and warm wet compresses are also known to help sometimes. Blebs often come back with alarming frequency. The milk that is expressed after opening the bleb is often thick and stringy. If infection or yeast or just inflamation sets in topical creams can be used to prevent reoccurance. One such cream is described on this site by the noted Canadian MD Jack Newman. See http://www.bflrc.com/newman/overheads/treatments%20for%20problems.html way down near the bottom.

If the block is further back in the breast the treatment would be different. Blocked ducts can lead to mastitis and mastitis can be "just" inflamatory (still really hurts and leads to loss of supply if not dealt with) or can be infectious. I agree that systemic antibiotics are overused when keeping the breast drained frequently and anti-inflamatory drugs would often be enough. One walks a fine line here, inadequately treated mastitis can lead to absesses but antibiotics can lead to yeast infections and resistant organisms. Jack also has some good recommendations on this. See http://www.bflrc.com/newman/breastfeeding/mastitis.htm

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Other nodes I've written with some breastfeeding content:

natural age of weaning / cleft palate / The medicalization of childbirth and pregnancy / premature baby / Poland Syndrome / male genital mutilation / breast pain mastalgia / supply and demand regulation of breastmilk / premature baby / formula / online information about breastfeeding for parents / Guide to Breastfeeding / afterbirth pain / moist heat therapy / beta-carotene / Breastfeeding the Newborn / Leche / lactation consultant / Feeding and Swallowing Disorders in Infancy: Assessment and Management / UNICEF / WABA / IBFAN / public breastfeeding / Medications and Mothers' Milk / Breastfeeding: Biocultural Perspectives / Apgar scale / Lactivist / attachment parenting / Breastfeeding Matters / La Leche League International / ear infection / nursing strike / Solomon / nipple piercing / milk / each one teach one / Sudden Infant Death Syndrome / fenugreek / lactogogue / Clinical Lactation: A Visual Guide / sub mucous cleft palate / The Breastfeeding Atlas / ankyloglossia / Tongue Tie From Confusion to Clarity A Guide to the Diagnosis and Treatment of Ankyloglossia / Current Issues in Clinical Lactation / peristalsis / BodyPerks / lactose intolerant / supplemenatal nursing system / at breast supplementer / How to Know a Health Professional is not Supportive of Breastfeeding / Lactnet (idea) / Breast Reduction (idea) / Clinical Therapy In Breastfeeding Patients (thing)

The Good Things About Breast Feeding

Nuzzling your face in a pair of breasts does your body good. Oh, but give your newborn a little room. Studies show that breast feeding can in fact make your child:

Leaner

In a University of Munich study of 9,357 children, those raised on formula were twice as likely to become obese. The added sugar in formula may cause infants to store more body fat, says Bethany M. Hayes, M.D., an obsetrician in Maine.

Smarter

In a review of 20 studies involving more than 20,000 children, those who were breastfed showed IQs that were 3 to 5 points higher than those who were not breastfed. The polyunsaturated fat in breast milk may help brain development, says James W. Anderson, M.D., of the University of Kentucky.

Healthier

An Australian study of 2,187 children under age 6 found that infants who were breastfed for the first 4 months were 25 percent less likely to suffer from asthma or allergies later in life. Unfortunately, they were still in Australia.

Those are only a few benefits to the child, but what of the mother? Well, during lactation, the uterus of the mother is stimulated to contract to its normal size. It will also be easier for the nursing mother to lose pounds, since breast feeding burns calories.

For those horny couples, nursing can act as a contraceptive, though not a very reliable one. Frequent nursing supresses ovulation, making the chances of mestration or getting pregant less likely. If you'd rather not take a chance, pretty much all barriers of birth control are safe during nursing, including hormone injections and birth control pills.

The Bad Things About Breast Feeding

Everything comes with a catch, especially breast feeding. During the first few weeks of nursing, the mother can be in pain due to sore and cracked nipples. She may also experience engorgement, where the breasts become hard and painful, due to being too full of milk.

Common disease, such as the cold, flu, skin infections and diarrhea, can be passed to the offspring through breast feeding. Viruses can also do this. Women who are HIV positive should not breast feed. If the woman carries any disease, such as herpes or hepatitis, it may be best not to breast feed, also. In cases like that, the mother should consult a doctor whether or not it would be ok to breast feed or not.

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Anyways, those are just some basic things about breast feeding. It really is the decision of the parents whether or not breast feeding will be an advantage to their child or not.

Unblocking Blocked Ducts.

One of the (painful) problems that may occur during breast feeding is a blocked duct. This is first noticeable when a section of the breast becomes very hard, hot and swollen despite successful nursing of the baby. On careful examination of the nipple a small white pin-prick sized lump (presumably a crystal of dried milk) can be seen blocking the exit to the duct. This needs to be carefully and gently removed with a pin, a bit like removing a splinter, so that the milk can be released. I can assure you that this doesn't hurt, unlike having a blocked duct which can be extremely painful!

The consequences of not unblocking the duct are pain and possible mastitis which can make the woman feel like she has a bad case of influenza. I know that in the UK doctors treat mastitis with antibiotics, as if it was an infection. Personally I believe that this is often unecessary - the symptoms of infection are usually due to an inflammatory response against the milk (which has leaked out into surrounding tissue because of the high pressure within the breast) and not to an invading micro-organism.