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Vegan Babies and Toddlers
Physicians Issue New Prescription: Most Moms Should Breastfeed for at Least a Year
by Mary Ann Romans
Originally appeared in MetroKids Magazine.
From pediatric offices to television, the message that breastmilk is best for babies has been promoted throughout America. Even formula companies are legally bound to put a disclaimer on their product. Nancy E. Wight, MD, IBCLL, FABM, FAAP, and president of the Academy of Breast Feeding Medicine, among her many credits, says "We've been talking about the benefits of breastfeeding, but we should be talking about the risks of not breastfeeding,"
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The American Academy of Pediatrics (AAP) is doing just that with its release of new guidelines on breastfeeding that strongly recommend feeding babies human milk and human milk only as the standard care for infants. Formula is suggested only in extreme cases where the mother has health issues such as HIV, is taking strong medications such as chemotherapy, or in the event the baby has a rare gastronomic disease that requires special feeding.
"The American Academy of Pediatrics for many years has supported breast feeding," Jane Morton, MD. Morton, who is a spokesperson for the AAP, a clinical professor of pediatrics at Stanford University and the Director of Breastfeeding Medicine at Stanford University, says. She talks about the thorough research that promoted the new guidelines. "It is extremely well researched. There are 216 very current references."
"What we are now seeing are many things to bring [the importance of breastfeeding] to our attention. There is amazing work neonatologists are doing. Preterm babies act as a magnifier for how beneficial human milk is for all babies. The protection [of breastmilk] in many instances is life saving. It is the gold standard for nutrition. There are benefits for years and years later for these babies, well off into adulthood. We are seeing in IQs an eight-point advantage." Morton is referring to an IQ jump specifically in premature infants. "Babies were born to be breastfed."
Diane Spatz, Ph.D., RN, a clinical nurse specialist/lactation consultant for the Newborn Infant Center at the Childrens Hospital of Pennsylvania, couldn't agree more with Morton. "Clinically, [breastfeeding] makes a huge difference in our babies," she says. Spatz is happy to see the new guidelines. "The literature is really clear. We know about the risks [of not breastfeeding] based on 25 plus years of research."
"We absolutely were thrilled when we saw the new statement," Kathy Lebbing, BS, IBCLC, RLC, the manager for Breastfeeding Information at La Leche League International, says. "The annual healthcare costs saved by breastfeeding are stated at 3.6 billion a year."
Among the new recommendations is one for exclusive breastfeeding for approximately six months, with support for at least the first year and then beyond as long as it is mutually desired by mother and child. "The Academy is very clear," Morton says. "Exclusive breastfeeding for the first six months and continued breastfeeding until at least the first birthday."
"The statement reinforces that it is natural to breastfeed for one year." Lebbing says. "There is no evidence of psychological damage with extended breastfeeding. That is exciting to see." The term extended breastfeeding can indicate breastfeeding past the first year or two. It's definition has never been clearly defined.
"If we can get women exclusively breastfeeding for six months, we would be in good shape," Spatz says. "We think of it as dose dependent. The more the baby gets, the more benefit there is. If they can make it a year, that is wonderful. The AAP statement also confirms that there is no limit to breastfeeding into the third year of life."
The AAP guidelines also list obstacles to breastfeeding, many of which are issues with physician and hospital care. The new guidelines state "Obstacles to initiation and continuation of breastfeeding include insufficient prenatal education about breastfeeding; disruptive hospital policies and practices; inappropriate interruption of breastfeeding; early hospital discharge in some populations; lack of timely routine follow-up care and postpartum home health visits..."
"We're the biggest problem and the ones who guide the care," Wight says, talking about physicians. She hopes that with the new guidelines, physicians will be "making management decisions based on science." Wight is proactive in creating and supporting physician education about the importance of breastfeeding. "We're trying various venues," she says. "Conferences, getting online, using protocols, reaching out to residents and medical students."
"All healthcare providers need good education," Spatz says. Through the Childrens Hospital, residents receive training about breastfeeding in both their first and second year. There are also educational programs in place for nurses and other support staff. "Our focus has been on education."
The AAP is also conducting many educational sessions for physicians. "What is really needed is a stronger front line," Morton says. "Doctors need the attitude 'I feel responsible for making you succeed.'"
Lebbing agrees on the significance of a good medical support system for a breastfeeding mother. "Breastfeeding is like baking a chocolate cake. It's super easy, but if you don't know what chocolate is or where the store is, it can be tough," she says. "It is the biggest dinner party you'll ever have; you want to prepare."
The new breastfeeding guidelines can be reviewed at the AAP website
Breastfeeding FAQs
As seen on the La Leche League International website (www.llli.org). Reprinted with permission.
Here are four of the most frequently asked questions, according to La Leche League International.
How do I know my baby's getting enough milk?
Once the milk comes in, the theory of "what-goes-in-one-end-comes-out-the-other" works: 4-6 wet disposable diapers (6-8 cloth) and 3-4 bowel movements in 24 hours usually indicate the baby is getting an adequate volume of your milk.
Can I breastfeed without exposing myself?
Absolutely! Besides special clothing available expressly for discreet nursing, wearing a two-piece outfit and pulling the shirt up from the waist works well. Drape a burp cloth or receiving blanket over your shoulder for greater coverage! Practice nursing in front of a mirror until you are comfortable that nothing shows that shouldn't!
Can I breastfeed if I'm not large breasted?
Yes! Size has nothing to do with milk production. Changes in the breast during early pregnancy make it possible for the breasts to make milk.
What about the baby's father? Won't he feel left out if he can't feed the baby?
There are lots of things dads can do with a baby besides feeding him. Bathing provides lots of skin-to-skin contact and fun, too! Sitting by you while you nurse the baby and rubbing between your shoulder blades usually gives the baby a milk mustache! Listen for the rapid swallowing! Rocking, holding, cuddling and playing with the baby will make dad feel a part of the action.
Mary Ann Romans is the author of numerous parenting, health and nutrition articles. She resides near Philadelphia with her husband and two children.
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