Critical Thinking and Writing Assignment - Breastfeeding IS Best

The American Academy of Pediatrics, American Medical Association, American Dietetic Association, and the World Health Organization all recommend breastfeeding newborns through their first year of life or longer because of the health benefits available to both mother and child. However, in a study conducted by the Center for Disease Control of more than 27,000 participants across the United States, only 20% of mothers nurse their children for 12 months (CDC web). While any amount of breastfeeding is better than none at all, many women in the United States switch to formula at three months, generally not long after the time when working women return to their jobs from maternity leave. With so many benefits of breastfeeding to both mother and child, the number of children who are breastfed until the age of one should be significantly higher.

BREASTMILK BEST FOR BABY
Breastfeeding not only provides the best nutrients for a growing baby, but it has other long term benefits such as providing immunities, protecting against health problems, and in recent studies, cultivating higher IQs. Breastfed babies are healthier overall and the longer they are breastfed, the more benefits they receive. According to the La Leche League web site, infants who are breastfed for four months are protected from frequent middle ear infections for three years, bouts of diarrhea for seven or more years, and Haemophilus influenza, type b for ten years. Imagine what those numbers would be if the infant were breastfed longer.
Breast milk protects against other infections as well. Because of the transfer of the mother’s antibodies through breast milk, babies are protected from viruses, sometimes even when the mother is carrying it. Rebecca Williams writes for the FDA Consumer Magazine and states that breast milk can protect from illnesses such as “pneumonia, botulism, bronchitis, staphylococcal infections, influenza, ear infections, and German measles” (Williams). Studies also suggest that breast milk protects against bacterial meningitis, urinary tract infections, and respiratory infections.
The most important aspect of infant nutrition is the ability of the newborn’s digestive system to be able to take in the good and excrete the bad. In M.S. Eiger’s The Complete Book of Breastfeeding, he states that infant formula contains so much protein that it cannot be fully absorbed while breast milk proteins are generally completely absorbed by the baby (Eiger 23). The proteins found in breast milk help to develop the baby’s immature digestive track and keeps infection out – proteins that are not replicated in formula (What is Colostrum? LLL Web Site). Another intestinal benefit was reported by the Journal of American Medical Association. In a study of breastfeeding and infections, it was determined that breastfed infants had less gastro-intestinal infections than formula fed babies in the first year of life (Kramer et al, 413-420).
Because of the position and motion required to suckle on a human nipple versus a silicone one, “breastfed babies are less prone to orthodontic problems than those raised on a bottle” (Eisenberg 4). The child’s teeth will more likely come in straighter as well as help with proper speech development. Bottle rot, a condition occurring when a child is left with a bottle in his or her mouth while sleeping, is unheard of in exclusively breastfed children not only because most breastfed babies received fewer bottles, but also because breast milk contains bacteria inhibitors that protect the enamel of the child’s tooth.
Amy Spangler, author of Breastfeeding: A Parent’s Guide, says that human milk lowers the risk of developing allergies, asthma, colic, diaper rash, reflux, and eczema. It also reduces the chance of developing chronic bowel diseases, diabetes, leukemia, and lymphoma. Breastfed babies are less likely to die from Sudden Infant Death Syndrome or other illness related mortalities.
Other possible benefits include lower cholesterol as an adult, less chance of becoming obese, and now studies are finding a link between breastfed babies and cognitive development. Published in the Journal of American Medical Association, a study compared breastfed children who in their adulthood scored higher on IQ tests than those who were not breastfed. “Duration of breastfeeding was associated with significantly higher scores on the Verbal, Performance, and Full Scale Wechsler Adult Intelligence Scale IQs” (Mortensen 287). In a test using the Bayley’s Mental Developmental index, breastfed participants scored on average eight to ten points higher than formula fed children. Many people question whether this because of the chemical makeup of breast milk, the bonding experience of nursing, the likelihood that a mother who chooses to nurse also spends more time with her children, or because children who are breastfed generally come from better socio-economic backgrounds and have more educational resources available to them.
Regardless, the bonding experience provided by breastfeeding plays an important role in infant development as well. Breastfeeding cannot be carried out without some sort of skin-on-skin contact. In an article presented by Fit Pregnancy magazine, Kimberly Pfaff tells readers that “kangaroo care,” or skin-on-skin contact, is advantageous to premature babies. “Proven benefits to the baby include a more stable heartbeat, breathing and body temperature regulation and longer periods of sleep” (Pfaff 76). Kangaroo care, as well as breastfeeding, soothes newly born babies, babies with colic, and children receiving shots.
Probably the best reason to breastfeed pre-term and full-term babies alike is the fact that breast milk is designed for each stage of baby’s life. The authors of What to Expect the First Year bring to light some highly significant information: “Unlike formula, the composition of breast milk changes constantly to meet a baby’s ever-changing needs: it’s different in the morning than it is in the late afternoon; different at one month than it is at seven; different for a premature baby than for a term baby” (Eisenberg 3). It is simply the perfect nutrition for a human baby.

BREASTMILK BEST FOR MOTHER
Breastfeeding also provides health incentives to the mother. These include lowering the risks of developing diabetes, breast and ovarian cancer, osteoporosis, postpartum hemorrhaging, and menstrual anemia. In a study reported by the Journal of American Medical Association, it was found that “longer duration of breastfeeding was associated with reduced incidence of type 2 diabetes in… young and middle-aged women” by helping stabilize glucose levels (Stuebe 2601-2610). Breastfeeding also lowers maternal and child blood pressure because of the release of oxytocin.
Producing breast milk helps the mother return to her pre-pregnancy size faster. Early nursing stimulates uterine contractions which helps the uterus to shrink faster. Most pregnant women gain, on average, 25 to 55 pounds. A few days after delivering her baby, a mother will have lost almost half of the weight she had gained during her entire pregnancy. But there will still be unwanted pounds to lose. “Milk production requires 500-1000 calories a day” (Spangler 17). In my own experience, I have lost almost 30 pounds in three months since my baby was born and I eat twice what I was eating when I was pregnant.
If instant weight loss isn’t enough, breastfeeding is convenient, inexpensive, and easier at night. There is no preparation, it costs less to feed a nursing mother than buy formula for a bottle-fed baby, and night time feedings are quick and without fuss. Dads can appreciate that, too.

INFANT FORMULA NOT SECOND BEST
Formula falls short on providing the same advantages and cow’s milk should not be introduced into a baby’s diet until the age of one or later. Commonsense would dictate that a newborn calf should drink the milk of the mother cow, a newborn kitten the milk of the mother cat, and so on. Therefore, why would a newborn human drink anything other than the milk of his or her mother? The female breasts are designed specifically for the purpose of nursing a baby. Though formula makers do recognize that breastfeeding is best for babies, these companies lead consumers to believe that an iron-fortified formula is the next best choice (Similac, 14). The World Health Organization, an authority on international public health, thinks otherwise: “The second choice is the mother's own milk expressed and given to the infant in some way [bottle or cup]. The third choice is the milk of another human mother. The fourth and last choice is artificial baby milk” (Granju). Formula may be the next best choice after breast milk, but only by default.
Infant formulas are composed of cow’s milk or soy – neither of which are designed for a newborn human. They do not provide the same nutrition as breast milk and there have been recent concerns about infant formula causing long term health problems. Studies are in the works that are exploring a possible link between the use of cow’s milk formula and type I diabetes, obesity, and Parkinson’s disease.
Soy formula has not been studied long enough to know whether it is truly safe for use in infants, yet according to Better Nutrition magazine, “almost 25 percent of formula-fed American babies get soy formula” (“Soy and Baby” 14). Julia Barrett reports in an article featured in Environmental Health Perspectives, that The University of Illinois at Urbana-Champaign has recently performed studies that have shown that soy formula has the ability to make changes in the cells of the intestines, “with unknown effects for infants fed soy formula” (Barrett, A302). There are also ongoing studies to determine if administering high levels of phytoestrogens (found in soy) prior to the onset of puberty could lead to cancer. With so many questions about the safety of soy formula, it is astounding that almost 20 million babies consume it each year (Barrett, A302).
While some formulas attempt to mimic breast milk in its design by adding DHA docosahexaenoic acid (DHA) and arachidonic acid (ARA), two essential fatty acids that are supposedly responsible for aiding brain development, formulas simply cannot emulate breast milk’s complexity. The FDA explains that formula is not a perfect match for breast milk “because the exact chemical makeup of breast milk is still unknown” (Williams and Stehlin). Breast milk contains properties that formula manufacturers may never be able to imitate. Not to mention, each mother’s breast milk composition varies from day to day to meet the changing needs of her baby - formula can’t yet do that.
Formula lacks the antibodies found in breast milk, which could be why so many formula fed babies experience repeated ear infections. “When compared with exclusively breastfed infants, infants who were exclusively formula-fed had a 70% increase in their risk of developing an ear infection” (Otitis Media).
Another serious concern is the possibility of formula contamination. According to the Breastfeeding Sourcebook, “enterobacter sakazakii is a frequent contaminant in powdered formula and can cause sepsis and meningitis in newborns” (Colson, 14).[JMW1]
Aside from the health concerns that formula poses, formula has other downsides. It takes much longer to prepare a bottle of formula for a potentially screaming, hungry baby than it takes to simply provide a breast. Most formula must be mixed in advance and is often wasted when the baby doesn’t finish an entire bottle.
Formula feeding costs on average about $1500 per year with premixed and hypoallergenic formulas costing substantially more. Add lost wages, increased health care costs, and gas for repeated doctor’s visits due to an increased need to care for childhood illnesses, allergies, and infections, and the cost to formula feed becomes much higher. Breastfeeding is surely a more economical and healthy source of nutrition for a baby.

WHY BREASTFEEDING CAN BE DIFFICULT
If breastfeeding is superior to formula then why do so many mothers switch to formula before baby’s first birthday? The bottom line: if it was easy, every mother would do it. It is not that mothers do not care enough about their child or are not willing to make a simple sacrifice; breastfeeding does have its difficulties. These I have learned from my own experience.
Sleep, sensation, and separation are the major concerns. In the first few weeks, a breastfed baby may need to eat every one to three hours around the clock. As a mother of three children, I clearly remember feeling like I spent my entire day, and night, nursing, changing diapers, trying to catch up on sleep, and nursing again, and again, and again. Formula fed babies are able to go longer between feedings because “cow’s milk is more difficult to digest than breast milk, and the large rubbery curds stay in the baby’s stomach longer” which make baby feel full for up to several hours (Eisenberg 6). I suspect that the less frequent feedings contribute to a slower metabolism and are one of the causes of obesity in formula fed children.
Even though nighttime bottle preparation takes more effort than nighttime nursing, less time is spent feeding a formula fed baby. A nursing mother may have to awaken, at least partially, three or four times a night while a bottle feeding mother may wake up once or twice. Still, it is much less disruptive to put a child to breast than it is to prepare and warm a bottle of formula, especially when the baby wakes up screaming because he or she wants to eat right now!
Accompanying the quick weight loss in nursing mothers (because of the extra calories burned in producing milk), is fatigue. Frequent nursing is consuming, especially just days after delivery. Proper nutrition, hydration, and rest are very important for a breastfeeding mom.
While it is pretty painless to pump and store milk so a nursing mother can have time away from her baby, it is painful to go too long without emptying her breasts every few hours. Engorgement, a condition that occurs normally when a mother’s milk first comes in and when a mother is not able to empty her breasts regularly, is very painful and can lead to other problems. A woman’s milk “let down” reflex is determined by how frequently her baby nurses. This reflex often happens involuntarily. If milk becomes backed up, engorgement can occur which could lead to a clogged milk duct. These painful lumps can then become infected causing an infection called Mastitis. From first hand, recent experience, I can tell you that Mastitis produces severe, flu-like symptoms: high fever, chills, sweats, achiness, dizziness, and fatigue as well as painful, red, swollen lumps. A doctor once told me it is one of the fastest spreading infections in the female body. Fortunately, with proper care, these are easy to avoid.
When milk is not backed up, it is flowing, or leaking, or spraying. The wetness is annoying, especially at night, and too much milk can cause the baby to choke and swallow too much air. These are generally early issues that become less of a problem as breastfeeding progresses and as milk production slows down.
Some mothers may experience nipple pain from a baby’s latch. Because of improper latch-on positioning or, less often, because the baby may have a dome-shaped mouth, a nursing mother can develop sores, cracks, and initial latch-on nipple pain (Huggins 21). In the case of improper latch, the baby can easily be repositioned. If the problem is caused by the shape of the baby’s mouth, there is little that can be done, however, the nipples generally toughen up in about two weeks and the pain becomes gradually decreased.
Probably the most common reason for women to cease breastfeeding before 12 months is her return to work. Breastfeeding in public is not illegal, but very few states provide laws to protect it. Employers are required to provide a clean, comfortable, private space for woman to express milk in. They also must allow enough break time to do so. I think many women are afraid to ask their employers for these things because breastfeeding is so personal. In order to keep the milk supply in check with the baby’s demand, a working mother may have to pump three or four times during the work day. That doesn’t leave much time to get work done.

CONCLUSION – BREASTFEEDING IS WORTHWHILE
While breastfeeding may have minor inconveniences, it is truly worthwhile. Providing short and long term health benefits, increased cognitive skills, and a better alternative to formula, breast milk should be the only milk substance ingested by children from ages zero to 12 months. If all childbearing women were aware of everything breastfeeding can do for themselves and their children, I believe the number of babies who are breastfed for one year or longer would dramatically increase. Hardly a sacrifice, breastfeeding is natural, beautiful, and a great way to create an everlasting bond with one’s own child.



WORKS CITED

Barrett, Julia R. “Sour News for Soy Formula?” Environmental Health Perspectives. May 2005: A302.

Colson, Jenni Lynn, Ed. Breastfeeding Sourcebook. Detroit: Omnigraphics, Inc., 2002.

Department of Health and Human Services Center for Disease Control and Prevention. Breastfeeding: Data and Statistics: Breastfeeding Practices — Results from the 2005 National Immunization Survey. 2005. 26 November 2006. http://www.cdc.gov/breastfeeding/data/NIS_data/data_2005.htm

Eiger, M.D., M. S. The Complete Book of Breastfeeding. New York: Workman Publishing Company Inc., 1999.

Eisenberg, Arlene, Heidi E. Murkoff, and Sandee E. Hathaway, B.S.N. What to Expect The First Year. New York: Workman Publishing Company, Inc., 1989

Granju, Katie Allison. “What Every Parent Should Know About Infant Formula.” Breastfeeding.com The Reading Room 1998. 28 November 2006 http://www.breastfeeding.com/reading_room/what_should_know_formula.html

Huggins, R.N., M.S., Kathleen. Nursing: The First Two Months. The Harvard Common Press, 2000. [place of publication unknown]

Kramer, Micheal S. et al. “Promotion of Breastfeeding Intervention Trial (PROBIT): A Randomized Trial in the Republic of Belarus.” JAMA. Jan. 2001: 413-420.

Mortensen, Erik L. et al. “The Association Between Duration of Breastfeeding and Adult Intelligence.” JAMA. May 2002: 287.

Otitis Media (Middle Ear Infection). 2006. La Leche League International. 30 Nov. 2006. http://www.lalecheleague.org/cbi/Otitis.html

Pfaff, Kimberly. “Tips for Parents of Preemies.” Fit Pregnancy. Jun/Jul 2006: 76.

Similac /Abbott Laboratories. Feeding Reference Guide. USA: Abbott Laboratories, 2006.

Spangler, R.N., M.N., I.B.C.L.C., Amy. Breastfeeding: A Parent’s Guide. USA: Amy Katharine Spangler, R.N., M.N., I.B.C.L.C., 1995 [Self-published]

Stuebe, Alison M. et al. “Duration of Lactation and Incidence of Type 2 Diabetes.” JAMA. Nov 2005: 2601-2610.

“Soy and Baby.” Better Nutrition. Mar. 2005: 14.

What is Colostrum?. 2006. La Leche League International. 30 Nov. 2006. http://www.lalecheleague.org/FAQ/colostrum.html

Williams, Rebecca D. “Breast-feeding Best Bet for Babies.” FDA Consumer. Oct. 1995. http://www.fda.gov/fdac/895_toc.html

Williams, Rebecca D. and Isadora Stehlin. U.S. Food and Drug Administration. Breast Milk or Formula: Making the Right Choice for Your Baby. September 1998. 28 November 2006. http://www.fda.gov/fdac/reprints/breastfed.html

[JMW1]Preparation, Lack of Antibodies, Expense, gastro-intestinal, does not compare to breast milk, http://kidshealth.org/parent/nutrition_fit/nutrition/breast_bottle_feeding.html

Outcomes of Breastfeeding versus Formula Feeding
http://www.lalecheleague.org/cbi/Biospec.htm