Published Apr 1, 2010 10:00 AM
The vast majority of new moms intend to nurse, but only about half leave the hospital exclusively breastfeeding, despite mounting evidence that doing so offers enormous benefits for both mother and child. Why is there such a gap between intentions and outcomes? Wendy Slusser, M.D., director of the UCLA Breastfeeding Resource Program, offers some keys to breastfeeding success.
When it comes to natural nutrition, nothing is more organic than mother's milk. Breast milk provides infants with nutrients and antibodies that can prevent a host of diseases and infections, reduces the risk of allergies, and significantly decreases the likelihood of pediatric obesity and childhood leukemia. And baby isn't the only one who benefits: Breastfeeding also reduces the mother's risk of breast and ovarian cancers and obesity and enhances maternal bonding, releasing hormones that promote relaxation and elevate mood.
So why are so many new moms not doing it as long as doctors recommend?
Feed Your Mind
Want to find a hospital where breastfeeding is encouraged? In California, rates by hospital for breastfeeding at time of discharge can be found at the state Department of Public Health website. And find out more by visiting the UCLA Breastfeeding Resource site.
The American Academy of Pediatrics encourages exclusive breastfeeding (i.e., no formula or solid food) for the first six months of a baby's life, then continued nursing as a supplement to solid food for the first year or beyond. In California, 87 percent start out intending to nurse, according to a 2008 study by the California WIC Association and UC Davis Human Lactation Center. But of those, only about half are exclusively breastfeeding when they leave the hospital, and after six months, only about 40 percent are still nursing.
This gap is driven to a large extent by the failure of many hospitals to implement practices known to promote breastfeeding, says Dr. Wendy Slusser, director of the UCLA Breastfeeding Resource Program. "There is a window of opportunity in the first week or two of the baby's life to establish a successful breastfeeding outcome," she explains. "If the hospital has the right policies in place, there is much more potential for that to occur." And more barriers may loom ahead if there is a lack of support at home or, more commonly, at work. Women and their spouses who want to ensure that they meet their breastfeeding goals need to be proactive, Slusser suggests, from educating themselves in advance to advocating for their needs in the health-care and work settings. Here are her keys to breastfeeding success:
1. Plan Ahead
During the pregnancy, identify people who can provide support, as well as resources where services can be obtained, often for little or no cost. When considering where to deliver, look for hospitals with the highest rates of new mothers who are exclusively breastfeeding at the time of discharge.
2. Don't Delay
Many hospitals separate infants and mothers after Cesarean sections for as long as five hours, even though there is almost never a medical reason to do so. Bringing the newborn to the mother's breast within the first hour after delivery serves multiple purposes. The colostrum produced in that post-delivery feeding is high in antibodies and has a cathartic effect that can reduce the baby's risk of jaundice. The first feed also serves as a powerful early bonding moment for mom and baby at a time when the infant tends to be alert. By about the fourth hour after the delivery the little one is often conked out, making the initial and subsequent feedings more challenging.
"It's like an elaborate waltz after the birth — you miss a step, you can trip," Slusser explains.
3. Don't Mix and Match
Supplementing breast milk with formula, water or later on, food, can reduce a new mother's milk production, diluting nursing's benefits and rendering it more difficult to sustain breastfeeding over the recommended length of time. Too often, hospitals introduce formula as an early supplement for no medical purpose. Slusser views formula the same way she views antibiotics — to be used only when the new mom isn't producing an adequate milk supply (and even then, there are breast-milk banks that can be employed).
"The physiology of breastfeeding is such that the more milk you remove, the more milk you make, and there is a limited time period to establish a robust milk supply," she notes. And if the baby is unable to suckle immediately or the mother and baby are separated, the new mom should pump to express milk.
4. Get Help
Breastfeeding is a natural act, but knowing how to do it isn't. Many women have trouble getting started; others grimace through painful experiences, assuming it's supposed to feel that way, before ultimately giving up. But it's not supposed to be painful.
The best hospitals for breastfeeding ensure that experts are available to provide education and support for new mothers, with appropriate follow-up after discharge from the hospital.
"The key is to establish proper mechanics early," says Slusser. "If women haven't been around others who breastfeed, they need to be taught."
5. Seek Support on the Job
Returning to work, many women find poor accommodations for expressing breast milk — the pumping necessary to maintain a supply — and end up stopping before they had planned. Others assume they won't receive support and simply wean their child before resuming their job.
California, like many other states, requires workplaces to have a designated room where lactating mothers can pump privately. But in practice, Slusser notes, few comply. Educating and enlisting the support of employers and coworkers can be critically important.
6. Seek Support at Home
Slusser has found that fathers are the largest influence in determining whether and how long their spouses nurse, but many are in the dark about breast milk's nutritional benefits. "I see this as a great opportunity, and always try to engage the fathers as much as possible," she says.
As in the hospital and the workplace, bringing all family members aboard when it comes to breastfeeding goals can ensure that baby and family reap the many rewards of a food that is both super and, lest we forget, free.