What to expect when you're expecting (131 page)

It’s custom-made.
Tailored to meet the nutritional needs of human infants, breast milk contains at least 100 ingredients that aren’t found in cow’s milk and that can’t be precisely replicated in commercial formulas. The protein in breast milk is mostly lactalbumin, which is more nutritious and digestible than the major protein component of cow’s milk, caseinogen, which is what formula is made from. The amount of fat in the two milks is similar, but the fat in mother’s milk is more easily broken down and used by a baby. Infants also have an easier time absorbing the important micronutrients in breast milk than in cow’s milk.

It’s safe
. You can be sure that the milk served up directly from your breast isn’t improperly prepared, contaminated, tampered with, or spoiled. It never gets pulled from the shelves or overstays its sell-by date.

It’s a tummy soother
. Nursed babies are almost never constipated, thanks to the easier digestibility of breast milk. They also rarely have diarrhea, since breast milk seems both to destroy some diarrhea-causing organisms and to encourage the growth of beneficial flora in the digestive tract, which further discourage digestive upset. On a purely aesthetic note, the bowel movements of a breastfed baby are sweeter smelling (at least until solids are introduced). They’re also less apt to cause diaper rash.

It’s a fat flattener.
Not only is breastfeeding less likely to cause overweight infants, but having been nursed for at least six months (or better, at least a year) appears to be related to lower rates of obesity later in life. It may also be linked to lower cholesterol readings in adulthood.

It’s a brain booster.
Breastfeeding appears to slightly increase a child’s IQ. This may be related not only to the brain-building fatty acids (DHA) it contains, but to the closeness and mother-baby interaction that is built into breastfeeding, which naturally fosters intellectual development.

It keeps allergies on hold
. Virtually no baby is allergic to breast milk (though once in a while an infant can have an allergic reaction to a certain food or foods in mom’s diet, including cow’s milk). On the other hand, beta-lactoglobulin, a substance contained in cow’s milk, can trigger an allergic response, with a variety of possible symptoms ranging from mild to severe. Soy milk formulas, which are often substituted when an infant is allergic to cow’s milk, stray even further in composition from what nature intended and can also cause an allergic reaction. Studies show, too, that breastfed infants are less likely to get childhood asthma than those babies fed formula.

It’s an infection preventer.
Breastfed babies are less subject not only to diarrhea but to infections of all kinds—including UTIs and ear infections. In fact, a number of studies suggest that a very wide range of diseases may be somewhat lower in breastfed children, including bacterial meningitis, SIDS, diabetes, some childhood cancers, Crohn’s disease, and other chronic digestive diseases. Protection is partially provided by the transfer of immune factors in breast milk and in the premilk substance, colostrum.

It builds stronger mouths.
Because nursing at the breast requires more effort than sucking on a bottle, breastfeeding may encourage optimum development of jaws, teeth, and palate. Also, recent studies show that babies who are breastfed are less likely to get cavities later on in childhood than those who are not.

It expands the taste buds early on
. Want to raise an adventurous eater? Start at the breast. Developing those little taste buds on breast milk, which takes on the flavor of whatever you’ve been eating, may acclimate a baby early on to a world of flavors. Researchers have found that nursed babies are less likely to be timid in their tastes than their formula-fed peers once they graduate to the high chair—which means they may be more likely to open wide to that spoonful of yams (or that forkful of curried chicken) later on.

Breastfeeding offers a pile of perks for Mom, too:

Convenience.
Breastfeeding requires no advance planning, packing, or equipment; it’s always available (at the park, on an airplane, in the middle of the night), at just the right temperature. When you’re nursing, you can pack up the baby and hit the road without having to pack up and lug around bottles, nipples, cleaning supplies, and so on; your breasts will always come along for the ride (you can’t forget to pack them). You can also skip 2 a.m. trips to the kitchen for a formula refill; late-night feedings require nothing more complicated than an easy-access nightie and a cozy, sleepy snuggle with your little one. When you and baby aren’t together (if you work outside the home, for instance), milk can be expressed in advance and stored in the freezer for bottle-feedings as needed.

Economy.
Breast milk is free, and so is its delivery system.

Speedy recovery.
When baby sucks on your breasts, it triggers the release of the hormone oxytocin, which helps speed the shrinking of the uterus back to its prepregnant size and may decrease the flow of lochia (postpartum vaginal bleeding), which means less blood loss. Nursing also enforces rest periods for you—particularly important, as you’ll discover, during the first six postpartum weeks.

Speedy return to prepregnancy shape.
And speaking of shrinking, all those extra calories your baby is draining out of you means that even though you’ll
be adding more calories to your diet to make milk, you won’t be piling on the pounds—and you might start seeing that waistline of yours sooner.

Prepping for Breastfeeding

Luckily, nature has worked out all the details, so there’s not much you’ll need to do to get ready for breastfeeding while you’re still expecting (other than read up as much as you can). Some lactation experts recommend that during the last months of pregnancy you skip the soap on your nipples and areolas—just rinse with water, instead (it’s not like they get that dirty, anyway). Soap tends to dry the nipples, which may lead to cracking and soreness early in breastfeeding. If your breasts are dry or itchy, a mild cream or lotion may feel soothing, but avoid getting it on the nipple or areola. If your nipples are dry, you can apply a lanolin-based cream such as Lansinoh.

The no-prep-necessary rule applies even to women with small or flat nipples. Flat nipples don’t need to be prepped for nursing with breast shells, hand manipulation, or a manual breast pump during pregnancy. Not only are these prepping techniques often less effective than no treatment, but they can do more harm than good. The shells, besides being embarrassingly conspicuous, can cause sweating and rashes. Hand manipulation and pumping can stimulate contractions and, occasionally, even trigger breast infection.

One possible exception: You may want to think about planning ahead if your nipples are inverted (in other words, they retract when you squeeze the areola), which can make nursing a little trickier. Breast shells may help draw nipples out, but you probably won’t want to use them frequently, for the reasons above. Ask your practitioner for the name of a lactation consultant who may be able to advise you, or contact your local La Leche League.

Period postponement
. Your period will be slower to return, and who could complain about that? But unless you want your children very closely spaced—or enjoy surprises—you should
not
rely on breastfeeding as your only form of contraception. Most mothers who exclusively breastfeed—and whose babies are not sucking often on pacifiers—are probably protected for a few postpartum months. But they can begin menstruating as early as four months after giving birth and may be fertile before that first period.

Bone building
. Nursing can improve mineralization in your bones after weaning and may reduce the risk of hip fracture after menopause, assuming you’re taking in enough calcium to fill your needs and milk-making requirements.

Health benefits
. Feeding your baby via the breast can reduce your risk of some cancers down the road. Women who breastfeed have a lower risk of developing ovarian cancer and breast cancer. Nursing also seems to reduce your risk of developing type 2 diabetes.

The biggest and best bonus
. Breastfeeding brings you and your baby together, skin to skin, eye to eye, at least six to eight times a day. The emotional gratification, the intimacy, the sharing of love and pleasure, can not only be very fulfilling and make for a strong mother-child relationship, but it may also enhance your baby’s brain development. (A note to mothers
of twins: All the advantages of breastfeeding are doubled for you. See
page 447
for tips on tandem breastfeeding.)

The Breast: Sexual or Practical?

Or can it be both? If you think about it, having two or even more roles in life is not unusual—even roles that are very different, that require different skill sets and different attitudes (lover and mother, for example). You can look at the different roles of the breast—one sexual and one practical—in the same way: Each is important; neither is mutually exclusive. You can have one and the other, too (and in fact, breastfeeding makes lots of women—and their partners—feel especially sensuous). In deciding whether or not to breastfeed, keep this in mind.

For more information on breastfeeding, contact your local La Leche League, (800) La Leche (525-3243), or visit
LLLUSA.org
.

Maybe you’ve decided that breastfeeding definitely isn’t for you. Or maybe there’s a reason you won’t be able to breastfeed, at least not exclusively. Don’t feel guilty about choosing the bottle over the breast (or even combining the two; see
page 336
). Here are some of the pros of bottle-feeding:

More shared responsibility.
Bottle-feeding allows dad to share the feeding responsibilities and its bonding benefits more easily. (Although the father of a breastfed baby can derive the same benefits, assuming his baby will take a bottle at all, by feeding a bottle of expressed mother’s milk, as well as by taking charge of other baby-care activities, such as bathing, changing, and rocking.)

More freedom
. Bottle-feeding doesn’t tie a mom down to her baby. She’s able to work outside the home without worrying about pumping and storing milk. She can travel a few days without the baby, even sleep through the night, because someone else can feed her baby. (Of course, these options are also open to breastfeeding moms who express milk or supplement with formula.)

Potentially, more romance
. Bottle-feeding doesn’t interfere with a couple’s sex life (except when baby wakes up for a feeding at the wrong time). Breastfeeding can, to some extent. First, because lactation hormones can keep the vagina relatively dry (though vaginal lubricants can remedy the problem); and second, because leaky breasts during lovemaking can be a cold shower for some couples. For bottle-feeding couples, the breasts can play their strictly sensual role rather than their utilitarian one.

Fewer limitations on your diet
. Bottle-feeding doesn’t cramp your eating style. You can eat all the spicy foods and cabbage you want (though many babies don’t object to these tastes in breast milk, and some actually lap them up), you can have a daily glass of wine or a cocktail without factoring in the next feeding, and you don’t have to worry about as many nutritional requirements.

No public displays
. If you’re uncomfortable about the possibility of nursing in public, breastfeeding may be hard to imagine. That hangup, though, is often quickly hung up; many women who opt to try breastfeeding soon find it becomes
second nature (and easy to accomplish discreetly), even in the most public places.

Less stress.
Some women worry that they’re too impatient or tense by nature to breastfeed. Given a try, you may find, however, that nursing is actually very relaxing: a stress-buster, not a stress-inducer (at least once it’s well established).

For more and more women today, the choice is clear. Some know they’ll opt for breast over bottle long before they even decide to become pregnant. Others, who never gave it much thought before pregnancy, choose breastfeeding once they’ve read up on its many benefits. Some women teeter on the brink of indecision right through pregnancy and even delivery. A few women, convinced that nursing isn’t for them, still can’t shake the nagging feeling that they ought to do it anyway.

Undecided? Here’s a suggestion: Try it—you may like it. You can always quit if you don’t, but at least you will have cleared up those nagging doubts. Best of all, you and your baby will have reaped some of the most important benefits of breastfeeding, if only for a brief time.

Nursing After Breast Surgery

Many women who have had breast reductions are able to breastfeed, though most don’t produce enough milk to nurse exclusively. Whether you will be able to breastfeed your baby—and how much you’ll need to supplement your milk supply with formula—will depend at least in part on how the procedure was performed. Check with your surgeon. If care was taken to preserve milk ducts and nerve pathways, chances are good that you’ll be able to produce at least some milk. (The same applies if you had breast surgery because of breast cancer or because of fibrocystic breasts.)

If your surgeon is reassuring, increase your chances of success by reading up on breastfeeding and working with a lactation consultant who is familiar with the challenges of nursing after a breast reduction. Closely monitoring your baby’s intake (by keeping an eye on growth and the number of dirty and wet diapers) will be especially important. If you don’t end up making enough milk, supplement with bottles of formula (do the combo). Also consider using a nursing supplementation system, which allows you to breastfeed and supplement with formula at the same time and can encourage milk production while ensuring that your baby gets enough to eat. Remember, any amount of breastfeeding—even if it doesn’t turn out to be baby’s only or even primary source of nutrition—is beneficial. Visit bfar.org for more information on breastfeeding after reduction.