The American Academy of Pediatrics (AAP) recommends that babies feed exclusively on breast milk for six months, and continue to receive it alongside food for a year or more. But few mothers meet that goal.
It’s easy to feel guilty if you resort to formula. In New York City, the health department even urges hospitals to “restrict access to infant formula by hospital staff.” New mothers hear that breast milk may protect them against cancer and their children from developing a long list of ailments into adulthood.
The truth: breastfeeding is good for babies, but once they grow up, many of the advantages you’ve heard about are unproven, according to a 2013 overview of the evidence published by the World Health Organization.
The paper concluded that “small studies provided estimates that clearly overstated the benefits” of breastfeeding for protecting adults against high blood pressure. Breastfeeding “does not seem to protect against total cholesterol levels,” and the data is wanting for diabetes and obesity. The authors did find strong evidence that breastfeeding could boost performance on IQ tests — but only a bit.
A 2016 meta-analysis was more positive about the connection between breastfeeding and a lower chance of diabetes and obesity, but added that it does not protect children against allergies or asthma. Expressing milk does seem to help mothers avoid breast and ovarian cancer and diabetes.
Breast milk contains an ideal combination of proteins, fats, vitamins, and carbohydrates as well as antibodies, living cells, and enzymes. So it’s a good thing for your baby to get at least some of nature’s food.
But even in the first six months, you can have it both ways, bottle feeding your baby breastmilk or combining the breast with bottles that contain either expressed milk or formula. In fact, giving yourself breaks may keep your baby from getting breast milk longer. In the 2014 Breastfeeding Report Card, the latest available, the Centers for Disease Control and Prevention reported that about half of the babies born in 2011 were breastfeeding at six months, but only 19 percent exclusively so.
Some mothers feed their babies only breast milk for a year or more — but entirely from a bottle. If that sounds attractive — or if you need help maintaining a partial pumping routine — look for “exclusive pumping” support groups online.
There are many advantages to bottle feeding. For fathers and other family, the bonding bliss of feeding may be more powerful than simply holding the baby or changing a diaper. Parents who bottle feed may feel more bonded as well. Imagine sleeping through the night while your husband cradles your child and, the next evening, checks whether the bottles are full.
You’ll need to express milk for at least a month to keep up your milk flow. Some mothers successfully introduce bottle feeding after they get home; others wait two or three weeks to make sure the baby is feeding well. It’s best to start before the sixth week, some lactation experts say. When your moment comes, try a few different types of bottles to see if your baby has a preference. Start bottle feeding during the second feeding of the day. It may also help if you give the bottle to another person familiar to the baby, so your breasts aren’t immediately available.
You’re likely to have more milk in the mornings, so you might begin pumping right after the first feeding. You can rent a hospital-quality electric breast pump in many areas: check Medelabreastfeedingus.com. Rent or buy a double electric breast pump if you plan on feeding your baby almost entirely with breast milk. If not, a manual pump could do. Find a way to free up your hands while pumping: cutting slits into a sports bra and inserting the cups may work.
All that said, don’t beat yourself up if you opt for formula entirely. You might be working and have no time to breast pump. You might prefer to know exactly how much your baby is eating. You might want to drink wine without worrying about dousing your child’s brain in alcohol from your breast milk. The most common reasons for using a formula in the first six months are a combination of breastfeeding difficulties and conflicts with a job. That’s called life.
April 23, 2016
Janet O’Dell, RN