More than two decades of research have established that breast milk is perfectly suited to nourish infants and protect them from illness. Breast-fed infants have lower rates of hospital admissions, ear infections, diarrhea, rashes, allergies, and other medical problems than bottle-fed babies.
The academy recommends that babies be breast-fed for six to 12 months. The only acceptable alternative to breast milk is infant formula. Solid foods can be introduced when the baby is 4 to 6 months old, but a baby should drink breast milk or formula, (not cow’s milk,) for a full year.
The primary benefit of breast milk is nutritional. Human milk contains just the right amount of fat, sugar, water, and protein for human digestion, brain development, and growth. Cow’s milk contains a different type of protein than breast milk. This is good for calves, but human infants can have difficulty digesting it. Bottle-fed infants tend to be fatter than breast-fed infants, but not necessarily healthier. Breastfed babies have fewer illnesses because human milk contains the mother’s antibodies which help fight off disease. A breastfed baby’s digestive tract contains large amounts of Lactobacillus bifidus, beneficial bacteria that prevent the growth of harmful organisms. Human milk straight from the breast is always sterile and never contaminated by polluted water or dirty bottles, unlike infant formula.
Human milk contains at least 100 ingredients not found in formula. No babies are allergic to their mother’s milk, although they may have a reaction to something the mother eats. If she eliminates it from her diet, the problem resolves itself. Many psychologists believe the nursing baby enjoys a sense of security from the warmth and presence of the mother, especially when there’s skin-to-skin contact during feeding. Parents of bottle-fed babies may be tempted to prop bottles in the baby’s mouth, with no human contact during feeding. But a nursing mother must cuddle her infant closely many times during the day. Nursing becomes more than a way to feed a baby; it’s a source of warmth and comfort.
Nursing is nature’s contraceptive–although not a very reliable one. Frequent nursing suppresses ovulation, making it less likely for a nursing mother to ovulate, menstruate, or get pregnant. There are no guarantees, however. Mothers who don’t want more children immediately should use contraception even while nursing. Hormone injections and implants are safe during nursing, as are all barrier methods of birth control. Birth control pills containing only progesterone are a popular method of birth control for nursing mothers.
Most common illnesses, such as colds, flu, skin infections, or diarrhea, cannot be passed through breast milk. In fact, if a mother has an illness, her breast milk will contain antibodies to it that will help protect her baby from those same illnesses. A few viruses can pass through breast milk, however. HIV, the virus that causes AIDS, is an example. Women who are HIV positive should not breastfeed.
Breast cancer is not passed through breast milk. Women who have had breast cancer can usually breastfeed from the unaffected breast. There is some concern that the hormones produced during pregnancy and lactation may trigger a recurrence of cancer, but so far this has not been proven. Studies have shown, however, that breastfeeding a child reduces a woman’s chance of developing breast cancer later.
Yes, saline breast implants usually do not interfere with a woman’s ability to nurse. However, if silicone implants leak, there is some concern that the silicone may harm the baby. Some small studies have suggested a link between breastfeeding with implants and later development of problems with the child’s esophagus. Further studies are needed in this area. But if a woman with implants wants to breastfeed, she should first discuss the potential benefits and risks with her child’s doctor.
For all its health benefits, breastfeeding does have some disadvantages. In the early weeks, it can be painful. A woman’s nipples may become sore or cracked. She may experience engorgement more than a bottle-feeding mother-when the breasts become so full of milk they’re hard and painful. Some nursing women also develop clogged milk ducts, which can lead to mastitis, a painful infection of the breast. While most nursing problems can be solved with home remedies, mastitis requires prompt medical care. Another possible disadvantage of nursing is that it affects a woman’s entire lifestyle. A nursing mother with a baby-in-tow must wear clothes that enable her to nurse anywhere. She should eat a balanced diet and she might need to avoid foods that irritate the baby. She also shouldn’t smoke, which can cause vomiting, diarrhea, and restlessness in the baby, as well as decreased milk production.
Women who plan to go back to work soon after birth will have to plan carefully if they want to breastfeed. If her job allows, a new mother can pump her breast milk several times during the day and refrigerate or freeze it for the baby to take in a bottle later. Some women alternate nursing at night and on weekends with daytime bottles of formula.
Most medications have not been tested in nursing women, so no one knows exactly how a given drug will affect a breastfed child. Very few problems have been reported; however, most over-the-counter and prescription drugs, taken in moderation and only when necessary, are considered safe. Even mothers who must take daily medication for conditions such as epilepsy, diabetes, or high blood pressure can usually breastfeed. They should first check with the child’s pediatrician. To minimize the baby’s exposure, the mother can take the drug just after nursing or before the child sleeps. In the January 1994 issue of Pediatrics, the American Academy of Pediatrics included the following lists.k by Harvey Karp. A classic book on baby-rearing, with valuable advice for calming a baby.
Some drugs can be taken by a nursing mother if she stops breastfeeding for a few days or weeks. She can pump her milk and discard it during this time to keep up her supply, while the baby drinks previously frozen milk or formula.
Radioactive drugs used for some diagnostic tests like Gallium-69, Iodine-125, Iodine-131, or Technetium-99m can be taken if the woman stops nursing temporarily.
Bromocriptine (Parlodel®): A drug for Parkinson’s disease, it also decreases a woman’s milk supply. Most chemotherapy drugs for cancer: since they kill cells in the mother’s body, they may harm the baby as well.
Ergotamine (for migraine headaches): Causes vomiting, diarrhea, and convulsions in infants. Lithium (for manic-depressive illness): Excreted in human milk.
Methotrexate (for arthritis): Can suppress the baby’s immune system.
Drugs of abuse: Some drugs, such as cocaine and PCP, can intoxicate the baby. Others, such as amphetamines, heroin and marijuana, can cause a variety of symptoms, including irritability, poor sleeping patterns, tremors, and vomiting. Babies become addicted to these drugs.
Tobacco smoke: Nursing mothers should avoid smoking. Nicotine can cause vomiting, diarrhea and restlessness for the baby, as well as decreased milk production for the mother. Maternal smoking or passive smoke may increase the risk of sudden infant death syndrome (SIDS) and may increase respiratory and ear infections.
According to the FDA, the following advice should help make breastfeeding a pleasant experience for the mother and baby.
Common causes for a decrease in milk supply:
It is normal for milk supply to be less in the late afternoon and evening when you are tired. Try to pump more in the morning when your supply is larger. Be aware that if you are sick (cold, flu) your milk supply will drop temporarily while your body is working to heal itself. Try to increase your resting time when you are home with the baby by nursing while lying down. Increase fluid intake to 8-10 glasses per day. If the color of your urine is not very pale yellow, increase your fluid intake. Drink malted milk (such as Ovaltine®) each day. Stop smoking. Increase frequency and duration of breastfeeding and pump about 10 minutes between feedings as often as you can. If pumping at work, add another pumping session if possible (preferable in the morning.) If the baby is eating solid foods, breastfeed the baby first, and then offer solids. Pump after feedings. Some oral contraceptives can affect milk supply-check with your provider about this. A variety of non-prescription herbal medications are available. These herbal medications are not approved by the U.S. Food & Drug Administration; contact your obstetrician or pediatrician. You may try fenugreek capsules.
IF NO CHANGE IN 7-10 DAYS, CONTACT THE LACTATION CONSULTANT AT THE HOSPITAL.
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