Tuesday, August 16, 2016

The advantages of breastfeeding

As promised before, I'll try to explain why I love breast feeding so much and why I find it such an obvious choice to make.

Raising a child is quite an emotional thing. Apart from some rare exceptions who need mental help, all mothers want to do the best for their little one and they try to take the right choices based on the information they have at a particular moment, on the support they get from their environment, on the energy levels they have, ... For that reason it is quite tricky to make statements on any educational topic as it is easily mistaken for judging other mothers, finger pointing, mommy wars, ... while in fact you can't judge someone else until you are in their shoes.
I've seen on several other blogs that heated debates flared up on pro-breastfeeding posts. Therefore I do want to clarify that this post is my personal opinion/experience that I want to share. It hopefully serves as extra information to anyone who might be interested. However this information might not show the complete picture that defines someone else's choice to (have) breastfe(a)d or not. So with this starting disclaimer I want to clarify that my enthusiasm on breastfeeding does not necessarily cast judgement on people making different choices.


Breast milk is the best nutrition for your child. 
I guess we all know that. All medical staff will tell you so; media articles -especially in weeks like the past breastfeeding week- will tell you etc. I believe that you can get a lot of pressure as a new mom to breastfeed, so much that there's sometimes talk of a "breastfeeding mafia".
It probably comes across as such pressure because we still don't realise yet how good the nutrition is exactly fit for our children. It's cast as a "they shall do this because its best" statement without much more explanation. We often hear that formula is almost as good as breast milk...by which we are basically saying that formula is still inferior to breast milk, if we would assume breast milk is the standard normal thing to do from a biological point of view. While formula is definitely good and qualitative and strictly controlled, it cannot imitate entirely the qualities of breast milk yet.

While formula is based on cow's milk qualities, destined for calves that need to grow muscles quickly (too many proteins!), human breast milk has delicate bacteria and complex sugars that are fit for human babies that are more fragile at birth, that need different energy levels and different brain development (and hence sugar peaks) and different levels of fat than calves.

A baby is born with sterile intestines, so without any of the bacteria it needs to digest food. The first bacteria that enter the baby determine the further development of the bacteria it needs for digestion and the level of immunity for specific diseases. Formula cannot provide the exact mix yet to influence the development of the intestines in the same way.  (sources here and here). The development of the intestines and its unique intestinal flora, is also why it is utterly important to feed exclusive on breast milk (exclusive = without starting any solid foods) long enough.  The recommendation from the World Health Organisation (followed by Kind en Gezin) is to feed exclusively 6 months. The maturity of the baby's intestines is not before 6 months.  (sources here and here). In the past it was recommended to start with solid foods earlier if you were bottle feeding a child as there was a lack of vitamines in the formula. Nowadays, even bottle fed children would benefit from waiting until 6 months to start with solid foods.

On top of that breast milk evolves with your child's needs: the first days you produce colostrum, the bright yellow vanilla milk that packs your child the first days with a immunity and protein boost. Then you evolve to more greasy milk with less proteins to provide more energy.  The milk production continues to evolve with the needs of the baby eg will be a bit less concentrated on hot days so it is a better thirst quencher without the risk that the baby "overeats" itself. (so no need to give an infant water on hot days!!). It's so brilliant how it is well adapted to an infant's needs.



Breast milk helps your child's immunity
I guess I touched upon this indirectly with the above paragraph. This is often contradicted by people stating that their formula fed child has never been ill while the breastfed child of the neighbour's has been frequently ill.  You can't much argue individual cases, but research shows clearly that on average a breastfed child is less frequently ill or less seriously ill. It's better digestible than formula and decreases the chance of allergies.

During the first year, the doctor's proclaimed that they had not seen Kabouter very often yet when I had to see them anyway.  I have experienced that Kabouter is more frequently ill since he stopped feeding but once again, a sample of 1 is not very scientific.  Beertje seems to suffer continuously from colds already as an infant but I blame being the second child (with a brother bringing home the viruses from school). So far so good, he has not had any other illness.


Breastfeeding creates a strong bond with  your child and vice versa

Let us be clear: you don't need to breastfeed to bond with your child. If not, I'd really pity all the dads. There's nothing so sweet as to nap with a sleeping baby on your belly, to carry an infant cheek to cheek, to cuddle, to laugh with your child and drown into its eyes, etc...
But I do enjoy the physical touch while feeding...feeling the baby belly to belly, his face buried onto your chest.  When feeding with a bottle, the closeness isn't as intense as obviously you need some distance from the baby's face to be free in order to be able to hold the bottle. So breastfeeding would help fulfill the emotional need of a child to get touched but obviously it isn't the only way to do so.

But nature helps a breastfeeding mom and child to bond a little extra by releasing oxytocine hormone with every feeding session. Oxytocine is nicknamed the love hormone or the hugging hormone, which is e.g. also released during sex. It links social (physical) interactions with feelings of pleasure, relaxation, openness, romance and bonding.  No wonder I fall in love with my 2 little boys ;).


Fall asleep after night feedings

Breastfeeding is often blamed for sleepless nights. Since breast milk is more easily digestible for the baby than formula, there is a statically higher chance that the baby wakes up more easily for a feeding at night. And that's good for newborns by the way and should not be attempted to be countered. Their brain development benefits from regular boosts in their sugar levels every x hours. And mom's have more prolactine hormone at night which boosts their milk production all together.

That being said... as a parent, night feedings are not easy to handle. I might console myself each night with the knowledge that night feedings are good for my child, I'd rather sleep through the night. Don't we all love our sleep? Don't we all wish to sleep more?

So while I don't fight night feedings but try to keep them as manageable as possible by using a co-sleeper etc, nature once again helps the breast feeding moms through the release of oxytocine.  That hormone helps both mom and baby relax and fall asleep faster again after feeding. It's true that I never lay awake after a feeding (on the contrary, I'm often already asleep again, while Beertje is still drinking). I've also heard that the sleep cycles of baby and mother get aligned so I'm never getting woken up from a deep sleep.
I do experience that I am often tired, but I function (even back at work) despite Beertje drinking 2-4 times a night.  But if Kabouter wakes me up on rare occasions once or twice for eg mosquito's in his room or because he's thirsty, I'm a wreck the next day. And last year when I was not breastfeeding, I experienced now and then "laying awake" which is now not happening anymore.

This week I read an article that some research would show breastfed or formula fed children would wake up just as much statistically: there is no causal link to their feeding. But they found that breastfed children were fed more often at night...probably as it is such a good soother for both mom and child.

No bottles, always available at right temperature

Breastfeeding is just so easy to do! It is totally hassle free: you do not need to carry bottles and formula powder around, find water, find a bottle warmer. You do not risk running out of formula when the stores are closed, ...

You can simply go to places with your child without calculating the time you'll be gone to pack up the right amount of logistics: delays, change of plans... you always have everywhere the food your child needs right at hand. The first weeks the feeding sessions might take up a lot of time and you might need to give more attention to the "right position" etc, but the baby will become more efficient and faster in drinking and it'll become a quick routine.

The first 2 years of Kabouter we made a record number of city trips and we took him twice across the ocean.  When he was eating solids, it was not always as easy to find the right type of food at the right time but there was always an acceptable alternative if needed.

So easy!!! I could not imagine it doing differently.  Sometimes I hear mothers claim that they do not wish to breastfeed because they want to be free. Gosh, really, it's breastfeeding that sets you free! I truly pity those that need to carry bottles around and need to wash-up all the time.  This was a huge motivator for me to continue feeding Kabouter as we always had a next trip ligned up and I really didn't want to carry bottles around in my suitcase.

(The fact that if you start working again and you pump milk to provide bottles to the baby in daycare during your absence is really only a sort of status quo with formula when it comes to washing up some bottles, right? Ok, that's not true: transporting fresh milk does require some logistics that can be a hassle. But to make up for that, you get to take extra breaks at work ;) )


It's free! (and ecologic)

It's such an obvious advantage but not often mentioned. But it's quite huge if you would add it all up! Unless you go nuts on fancy breastfeeding outfits, truckloads of pads etc, breastfeeding is free and ecologic. Why would you pay a lot of money for a surrogate that processes another mammal's milk in order to approach the qualities of your own milk production, which you produce automatically for free after giving birth? It doesn't make sense to me.

Yet unfortunately enough the breastfeeding rates are significantly lower among poorer families.

By the way, breastfeeding is also more ecologic because the mother's fertility and the menstruation cycle that comes with it is postponed.  So you save out on the processing and packaging of formula milk, the transporting etc but also on the hygienic products for women.  (The delayed fertility cycle might be a disadvantage for mothers that want to get pregnant again right away on the other hand.)


Less chance to get breast cancer

While al the above advantages focus on the process of feeding the baby itself, the next ones simply focus on advantages for the mother. Those are often forgotten or unknown but I find them huge.
Don't we all know someone who suffers/suffered from breast cancer? The % of women who have to deal with this disease sooner or later in their lives is frightening high. If you were given a puzzle piece that might reduce your risk for this disease, wouldn't you grab it right away?

So if I tell you that breastfeeding longer than 6 months, reduces progressively your risk with each month you continue to feed any of your children, wouldn't you consider doing so just for this reason even if breast milk wouldn't be significantly better for your child than formula? Even if you thought that feeding would be a bigger hassle than bottle feeding after all...wouldn't you give it a try as a sort of insurance for your own health? Well hell yeah, I sure do!!! Since the cells in your breasts get assigned and specialized in milk production they have less probability to become malign if I understand it well enough. There is only a significant statistic difference after 6 months. As the number of "long term" feeding mom's is so low in Belgium, we leave this advantage usually unmentioned in our information sessions.  (quote from my hospital)

I just read last week that this effect would not only count for the feeding mom but also for baby girls that are getting fed? Wow, not heard that before but if that would be true, that would be a magnificent gift you can give to your daughter too, no?
(source: Freudenheim, J. et al. 1994 'Exposure to breast milk in infancy and the risk of breast cancer'. Epidemiology 5:324-331)

Mother recovers faster after birth
These facts are less motivating for me (as I can't compare what it would be like without it), but a breastfeeding mother recovers faster after birth.  The uterus shrinks much much faster, which reduces the post natal bleedings etc.  I remember that the midwives came to push my belly at least once a day to check the size of my uterus and they always seemed impressed and pleased by the result.  "It's your breast feeding why it goes so well".   ...Yeah, probably so, I do not consciously feel and track the size of my uterus but if you say so.

Less chance to become obese (mother & child) and diabetic
The weight loss on the other hand does motivate a lot of women. Breast feeding makes it easier to return to pre-natal weight. Unless you start to eat for 2, the feeding would use a 500kcal per day. In the first months I am often very hungry though, so it feels like a good excuse to snack a lot. Even so, while eating whatever I want, I've gone -6kg prenatal weight with Kabouter (most of the weight loss at 6-9 months after birth) while I had lost all my kilos with Beertje already within the first 6 weeks after birth. I had never dared to hope this before I got the first time pregnant. I sort of assumed that giving birth to children gave you some kilo's that remained to stick around.

The weight loss reduces the probability from becoming diabetic. Due to the fact I got pregnancy diabetic with Beertje, I was struck with the number of doctor's that have asked me earnestly whether I'd breastfeed. They stressed out my higher future risk of becoming diabetic type II and seemed genuinely relieved I proclaimed to be willing to breastfeed for a longer time.   "Good, if not we'd have given you a lot of pressure to change your mind" one specialist stated. So I belief it's more than just the weight loss, but I don't know why it's so good for me.

Breast feeding also reduces the risk for your child to become obese (and hence have a higher risk for diabetes).

(sources: Davies, H.A., 'Insulin Requirements of Diabetic Women who Breast Feed.' British Medical Journal, 1989 / 
von Kries, R et al, 'Breastfeeding and obesity: cross sectional study.' BMJ 1999; 319:147-150 (July 17) )

Less chance for osteoporose
Maybe one day I'll be glad for this, but at this moment I'm not very pre-occupied with this topic

Less chance for dental problems
I'm also not very pre-occupied with this but breast milk would cause less dental issues with children than formula.   I mention it as it's often misunderstood. Since the teat of a bottle is a source of bacteria, a lot of dentists oppose to night feedings (after brushing your teeth) without distinguishing formula feeding or breast feeding.  While breast milk contains a lot of complex sugars, it also contains anti-bacteria and you don't need bottles and teats if you can provide the real thing.

But then again...as soon as children are teething, they also start with solid foods and the sources for dental problems increase as well. So I don't think breastfeeding or not will cause a huge change in the dental health of a child as it's part of a bigger picture of dental hygiene.


Higher IQ for breast fed children
I've listed this advantage as last as it's quite a controversial one. There's been quite a lot of researches that have found a statistic difference in the IQ of breastfed children versus formula fed children.  yet the controversy is the question whether this is also a causal link.

It's a fact that there's a higher rate of breast feeding with higher educated parents, so the question is whether there isn't an educational bias in the IQ research.  One Brasilian study published last summer would take that bias into account and still show show a statistic difference, but this probably needs more research.  It's also uncertain whether the effect would remain at a later age.

So it's a controversial claim, but a very interesting topic.


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