Naomi Baumslag, MD and Dia L. Michels
Do you need breasts to breastfeed?
Humans
do, but some mammals do not. The Australian Echidna and Duck-Billed Platypus produce
breastmilk in spite of the fact that they have no breasts or nipples. The mammary glands
rest underneath the mother's chest; the young suck milk from pores in the chest wall,
skimming milk off of the skin and hairs (it should be called chest-feeding). Whale mothers
have breasts and nipples, but baby whales cannot move their lips and so cannot suckle.
When it is feeding time, the mother ejects her milk (which is the consistency of sour
cream), the baby then drinks it out of the water.
Is
breastmilk " green"?
Yes.
Breastmilk is produced and delivered to the consumer without any pollution, unnecessary
packaging or waste. Most of the focus on the environmental effect of newborns is
concentrated on the debate between cloth vs. disposable diapers, but the environmental
consequences of formula feeding have far greater impact. It would require 135 million
lactating cows occupying 43% of the surface of India just to substitute for the breastmilk
produced by the women of India. If every child in America were fed on artificial foods,
almost 86,000 tons of tin would be needed to produce 550 million cans of formula to meet
the need. Large amounts of water, fuel, paper, glass, plastic, and rubber are required in
the production, shipping, and preparation of formula. Additionally, formula feeding
produces significant amounts of solid waste. Substituting cow's milk for breastmilk is
costly, causes waste, and uses valuable resources.
How
long should you breastfeed?
All
evidence points to the benefits of continuing to nurse for at least one year. For
optional health and nutrition, breastfeeding should be done exclusively for six months
(breastmilk only), then continued as a complementary food as solids are introduce. Both
WHO and UNICEF agree with the 1990 Innocenti Declaration that recommends breastfeeding
continue (with appropriate complementary foods starting at six months) for up to two years
of age or beyond. In some cultures, children are breastfed until they are three or four
years old. The American Academy of Pediatrics (AAP) recommends nursing for one year.
However, in the US, nearly half of the women who initiate breastfeeding quit before the
baby is 3 months old. The attitudes of health workers and the prevailing societal
perceptions of breastfeeding are significant factors in determining how long humans
breastfeed. Length of nursing for mammals varies considerably. The Hoooded Seal nurses the
shortest amount of time, the baby seal is given breastmilk for only 4 days (the milk is
almost pure fat enabling the baby to double its weight during this time). Orangutans nurse
their babies longest- fully six years in the wild. The most important factor in
determining how long animals nurse is the onset of, or preparation for, another pregnancy.
One of the most important factors determining how long humans nurse is the limited time at
home before returning to work after childbirth.
Is
breastfeeding that important?
The
United States like to think of itself as a world leader. Yet, America has one of the
lowest breastfeeding rates in the world with very low rates of initiation and extremely
low rates of exclusive breastfeeding. This contributes to the high amount of infant
hospitalization and mortality in the US. Breastfeeding significantly reduced diarrhea (a
leading cause of infant death) and lowers the risk of sudden infant death syndrome (SIDS).
Breastfed babies are protected against bacterial meningitis, have lower rate of pneumonia,
allergies, ear infections, asthma, gastrointestinal illness, inflammatory illness juvenile
diabetes, childhood lymphoma, and learning and behavioral difficulties. One study has
shown that premature breastfed babies had higher IQs than artificially-fed babies.
Breastfed babies also have lower rates of dental decay and obesity and are less likely to
develop heart disease in adulthood.
Can
you get pregnant when you're breastfeeding?
Breastfeeding
is nature's contraceptive -- the more you nurse, the less likely you will become pregnant.
Continued lactation is a powerful method of suppressing ovulation. Breastfeeding
exclusively, feeding through the night, and feeding-on-demand increase natural
infertility. In societies that practice frequent and prolonged breastfeeding
around-the-clock, where no other forms of contraception are used, children are born about
four years apart. Even though breastfeeding can be an effective method for limiting
conception, it should not be relied upon as individual hormonal levels determine the
length of natural infertility for each woman. Contraceptive measures should be started by
mothers who wish to prevent pregnancy if they are supplementing with formula, when menses
resumes, or when the child is 6 months old.
What
ever happened to wet nurses?
Wet
nursing has been around as long as there have been babies. Until technology (such as
refrigeration, glass and rubber processing ) and milk surpluses launched the mass
production of artificial baby foods, wet nursing was the only viable alternative to the
mother breastfeeding. Throughout the Middle Ages in France, all French royal children were
suckled by hired women (and several wet nurses were kept in reserve for emergencies). Wet
nursing provided a tremendous employment opportunity -- providing status, safety, and
financial security to uneducated women. Suspicions that syphilis and tuberculosis were
transmitted through the milk (they aren't) helped to speed the decline of wet nursing. One
legendary wet nurse was Judith Waterford who in 1831, on her 81st birthday, could still
produce breastmilk. In her prime, she unfailing produced two quarts of breastmilk a day.
Wet nursing is out of fashion, but still occurs in developing countries when an infant is
orphaned.
Is
breastfeeding just for the baby?
Most
people know that breastfeeding is best for the infant, but they are unaware that
breastfeeding has life-saving benefits for the mother -- both in the short and long term.
Not only does breastfeeding help contract the uterus, shed the pregnancy pounds, and help
the new mom feel relaxed and happy, but women who have breastfed have lower rates of
breast cancer, uterine cancer, urinary tract infections, and osteoporosis.
Do
you need big breasts to breastfeed?
Breastfeeding
is one of the most efficient supply and demand mechanisms in the world. The more a
baby sucks, the more milk is produced. Yet still, there is a persistent myth that milk
supply is determined by breast size. Small-breasted women from every corner of the planet
almost uniformly declare they could not produce enough milk for a child, in spite of the
fact that the size of the breasts has nothing to do with either the quality or the
quantity of breastmilk. Large breasts contain more fatty tissue, not more breast ducts,
than small breasts. It is frequency of sucking and the ability of the mother to eject milk
through the let-down reflex that is critical to successful breastfeeding.
Do
you have to have a baby to breastfeed?
t
is commonly believed that lactation only occurs following conception an birth, but this
not necessarily so. Certain species such as elephants and foxes lactate and suckle
young without ever giving birth. For humans, continued suckling over a period of time is
the only requirement to stimulate milk production -- pregnancy is not necessary. Many
women who have breastfed can begin again by simply initiating sucking (with either a baby
or a pump). Women who have never given birth, but wish to breastfeed can do so by having
their nipples sucked on frequently with either a pump or a child nursing with a Lact-Aid
(a device that feeds formula through a small tube attached to the nipple providing the
infant with calories and the mother with the sucking necessary to establish milk
production).
Why
is formula so expensive?
Baby
formula is expensive. Families who feed formula exclusively spend $75 or more per month,
per child, on formula. Three companies (Abbott Laboratories, American Home Products
and Bristol Myers) have dominated the US infant formula business for more that 20 years.
Infant formula sales are astoundingly profitable, comprising, for example, up to 50% of
the total profits of Abbott Labs, an enormous pharmaceutical concern. It has been
calculated that for every wholesale dollar Abbott charges for formula, production and
delivery costs are only 16 cents. The largest purchaser of formula in the US is the
Federal Government, for its WIC (Woman, Infants and Children) program. From 1979 to 1989,
the price of formula shot up 155% while the price of cow's milk (its basic ingredient)
increased only 36%. Formula revenues are often directed towards providing free samples to
new moms or underwriting meals and parties at pediatricians' conventions. They also go to
line numerous pockets: the formula makers have provided the American Academy of Pediatrics
with a generous $8,000,000. The chief executives at Bristol Myers and Abbott Labs (the two
largest formula-producing companies) earned whopping 1992 salaries of $12,788,000 and
$4,213,000, respectively. It has been estimated that if every WIC participant today
decided to breastfeed, the direct savings in US tax dollars would be over $500 million.
Federal antitrust charges against the three companies have recently been settled resulting
in total expected payments and fines of over $230 million, but this is not expected to
result in lower prices of formula at the check-out counter.
Isn't
formula always available in this day & age?
Jennifer
Stolpa knows the miracle of breastfeeding. Stranded for 8 days in Nevada by a winter
storm that buried the region, Jennifer's son Clayton is a thriving child today only
because she chose to breastfeed. After spending five nights in their snow-bound truck,
James left his wife and five month old son in a cave while he sought help. Jennifer melted
show in her mouth, held Clayton snugly, and nursed him throughout the ordeal. The family
survived with little more than frostbite and weight loss. Experts agree that breastfeeding
saved Clayton's life. Heidi Lunn also knows the wonders of breastfeeding. Her Florida
house was destroyed in Hurricane Andrew. She was nursing her three-month old baby when the
storm hit. Living near the eye of the storm, her neighborhood and all the surrounding
communities were destroyed. "We were trapped," Heidi recalls, "we had no
water for a week, no fuel, debris covered everything. We couldn't have bought formula then
had we wanted to. Thank God I was breastfeeding!" Most people don't expect to have a
disaster befall them. But acts of war, environmental accidents, and natural disasters are
part of life. Floods, earthquakes, hurricanes, and ice storms can bring life as we know it
to a halt. Breastfeeding mothers in Kuwait, Somalia, and Bosnia know the importance of
their food supply, as do all the women who have raised children on breastmilk in
concentration camps, refugee camps, and during periods of famine. No one hopes to find
themselves in a desperate situation, but knowing you can take care of your child when an
emergency hits can help you and your infant survive.
UNICEF estimates that 1.5 million babies die each year worldwide
--- because they are not breastfed....
There is no cheaper or more effective way of improving maternal and infant health and
lowering fertility than the promotion of breastfeeding...
Naomi Baumslag and Dia L. Michels. All rights reserved, may not be reproduced, in
whole or in part, without permission. Excerpted from Milk, Money & Madness: The
Culture and Politics of Breastfeeding (Bergin & Garvey), 1995.
About the Authors
Naomi Baumslag, M.D., M.P.H., is Clinical Professor of
Pediatrics at Georgetown University Medical School in Washington D.C., and president of
the Women's International Public Health Network in Bethesda, MD. She has served as
an advisor to USAID, UNICEF, WHO, PAHO, and the governments of many developing countries
as well as the Health Council of the La Leche League International (LLLI) and the World
Alliance of Breastfeeding Associations (WABA). The author of more than 100 articles
and eight books, Dr. Baumslag lectures widely both nationally and internationally.
Dia L. Michels is a science writer whose articles and essays
have appeared in newspapers and magazines around the world. Her commitment to
breastfeeding has come both from her research and from her experience nursing her own
children over the past six years. This is the second book she has written with Dr.
Baumslag. A Woman's Guide to Yeast Infections was published in 1992.
Dia L. Michels
P.O. Box 15348
Washington, DC 20003-0348
202-546-2356-fax
DiaMichels@aol.com
Breastfeeding.com would like to express our thanks to Dia and Naomi for allowing their
fine article to be reprinted here.
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