Choices: How Will You Feed Your Baby?

by Pregnancy.org Staff

baby mouthing a rattleOne of the most challenging choices new parents face is how to feed rheir baby in those first months of life. No doubt you have already received enthusiastic advice from friends and family members who favor one feeding method over the other.

While this decision is entirely up to you and your partner, it is wise to get as much information as possible before you decide. Whatever method you choose, it should be based on a good understanding of infant nutritional and emotional needs and an honest assessment your own situation.

Breastfeeding is a gift mothers have given their babies since the beginning of time. It is only in this century that bottle-feeding has become a viable option for mothers, as pre-prepared formulas and specially-designed bottles have become commonly available. The result is a cultural trend toward bottle-feeding that reached its peek in the 1970s, creating a culture that was irrationally intolerant of breastfeeding. As the children of the 1970's begin to have children of their own, a major effort is underway to help them make informed decisions about the health and nurturing of their babies, even as we inform the culture to make it more supportive of nursing mothers. While bottle-feeding is an adequate source of nutrition, modern medical research has concluded that breastfeeding is vastly healthier for both mother and child.

Since breastfeeding benefits both mother and child, both medical and popular opinions favor it. Nature designed human milk to perfectly meet the needs of growing babies, and the extent of nutritional and autoimmune benefits are only just now being discovered.

The emotional benefits of breast feeding cannot be fully measured. Breast feeding also provides the most intimate way a mother can care for her child and initiates a very special and loving relationship. It is no accident that a newborn baby's eyes, which cannot focus on objects far away or near, can perfectly see his mother's face when she is ten inches from him -- the approximate distance between them when he is at the breast. Breastfeeding is a built-in time of love and attention that nurtures both mother and child. If you're beginning to think now about whether or not you'll breast feed your baby, here are some facts you need to know:

• The American Academy of Pediatrics has stated that breastmilk is the best food for infants throughout the first year of life.

• Your milk is the only food the baby needs for the first 5 to 6 months of life.

• Mother's milk is really the "perfect food". Once your breast milk supply is established, and as long as you eat well and drink plenty of fluids, this nourishment is always available.

• Moreover, breastmilk has the right amounts of all the necessary nutrients to help your baby grow.

• Mother's milk is designed to be easily digestible by a baby's immature digestive system.

• Breastmilk contains substances that may help protect babies against illness. The colostrum, a yellowish fluid that is the first milk to come from the breast, contains antibodies and other protective substances. Several studies have shown that babies who nurse have less colic and diarrhea, fewer colds and ear infections.

• Mother's milk helps to protect the baby early in life from developing allergies.

• Nursing is convenient. Your milk is always clean, at the right temperature, and ready to serve when your baby is hungry.

• Nursing is more economical, allowing you to forgo the cost of formula and bottles.

Breastfeeding has benefits for the mother, too. Not only do you have the personal satisfaction of knowing that your body continues to nourish and nurture your baby, you'll find it may help your body return to its pre-pregnancy size sooner. Sucking releases hormones that contract the uterus, helping to return it more quickly to its normal size. Also, because stores of fat that accumulated during pregnancy are used for milk production, the mother who breast feeds usually returns to her normal weight more quickly. For more benefits, read How Breastfeeding Benefits Add Up.

Many nursing mothers find breast feeding gratifying because they feel they are giving part of themselves to their baby. While breast feeding, you and your baby are in constant skin contact, and your baby responds to the smell of you and your milk. Like other aspects of parenting, however, there are some sacrifices involved. Because the food you eat becomes the milk that nourishes your baby, your personal nutritional choices are as important now as when you were pregnant. Some babies have reactions to dairy products or leafy green vegetables, and some may even have acid reflux (link to the coolest newborn reflux article ever written) which would require some changes to your diet. These changes, however, are generally minor and not always needed.

Attitudes About Breastfeeding

As we learn more about the incredible health benefits of breast feeding, the cultural trend favoring bottle-feeding is reversing. Breast feeding has never been more supported or nurtured, and there has never been a better time to be a breast feeding mother. You'll find organizations (such as the La Leche League) ready to help and you'll find other breast feeding mothers (past and present) eager to support you in your decision. If you are concerned, for example, about how you will manage breast feeding in social settings, the advice of these women can be very beneficial. As they'll tell you, tastefully, no nursing mother ever need expose herself in a way that is uncomfortable to herself or others. Options like specially-designed clothing and neat tricks the pros use to be discreet make modest breast feeding completely possible. Read Nursing Discreetly for tips on nursing in public.

The most important factor to remember, however, is that breast feeding is a very natural function of mothering. Your infant's healthy development is far more important than a stranger's uninformed opinion. Many mothers before you have paved the way to make this incredible gift of mothering socially acceptable. Your commitment to breast feeding will make it even easier for generations to come.

Ability to Breastfeed

Almost every woman can produce milk after her baby is born, and almost every woman can breastfeed successfully. Counter-intuitive as it seems, no woman is born knowing how to breast feed. Mother Nature gives you the ability to nurse, but not the "know-how", and it involves study, learning, patience, and practice.

Unfortunately, few new mothers of this generation have had the chance to learn about breast feeding by watching other women nurse. With today's families scattered across the country, grandmothers and aunts are no longer available to teach new mothers how to breast feed. Hospitals and mother's groups know how important nursing is and have filled this gap by training professional peer counselors and lactation consultants to help you. Your obstetrician's office, midwife or Labor and Delivery Department should be able to connect you to local lactation professionals who teach classes, refer you to reading materials, and even make hospital or home visits to assist you.

The amount of milk you can produce for your baby and or his/her ability to nurse does not depend on the size or shape of your breasts or nipples. Breast size is determined by the amount of fatty tissue surrounding the milk glands, not by the size of the glands themselves. Breastmilk production follows the laws of supply and demand, the more a baby nurses, the more milk the mother makes. Regardless of the size of her breasts or her baby, a breastfeeding mother almost always can produce enough milk for her newborn baby.

One factor that may require some special preparation before delivery are those women who have very flat or inverted (turned in) nipples. The baby may have difficulty attaching properly to the breast. This condition can be modified while you're pregnant by wearing special nipple shields inside your bra and by performing exercises.

Previous Problems With Breastfeeding

Many women who have had difficulties breast feeding in the past conclude that they are simply unable to do it. This is often not the case. Talk with your lactation consultant, other women who have nursed, or childbirth educators about your experience and your concerns. Breast feeding involves learning and practice, and simple changes in technique may give you more positive results.

Special Health Problems

Your midwife or doctor can make specific recommendations or provide you with information regarding any special health problems you may have. If you are a diabetic, have a strong family history of breast cancer, or if you have even had breast surgery, it still may be possible for you to breast feed. Discuss with your doctor/midwife what the specific recommendations might be for your individual situation.

A chronic illness or condition that requires medications may present a problem for breast feeding. The drugs may pass into the breast milk and be harmful to the baby. A lactation consultant can determine if you should breast feed and what the risks, if any, might be. She will take into consideration such factors as half life of the medicine, route of absorption and affect on the baby. Check with your physician to see if temporarily modifying your drug intake, or even supplementing with herbals, could provide you even a few weeks of breastfeeding.

The Working Mother and Breast Feeding

Returning to work after the baby is born doesn't have to mean weaning your baby from breast milk. Many mothers combine working and breast feeding quite successfully.

There are several different ways of collecting and storing your breast milk for your caregiver to give your baby. Hand expression, though time consuming, is by far the most "portable." Hand pumps offer the advantage of small size as well as portability. The third and best alternative for a mother returning to work full time is an electric pump. Electric pumps provide fast and efficient emptying of the breast while simulating the actual force of a baby's suck -- which helps to maintain your supply. Care should be taken to select a quality pump that allows adequate suction without damaging the delicate breast tissue. You can rent hospital-grade electric breast pumps.

At least a week or two before you return to work, start practicing your routines around a "typical workday" Introduce your baby to bottle feedings (using breastmilk) so that the baby can learn to suck from a bottle nipple instead of a breast. If you're planning on supplementing with formula during the workday, start the baby on this new feeding (following the schedule you would use if at work) while you are still at home.

Get a tentative schedule in mind before you go back to work. Then be prepared to make adjustments as you and your baby develop your new routine.

The following is a schedule that many mothers find convenient:

• Nurse early in the morning, upon awakening.

• Nurse just before leaving for work.

• Express breastmilk by hand or by pump two or three times during the workday. You may store the milk in a refrigerator at work and then use it for the next day's feedings. Some electric pumps also come with coolers.

• If you don't think you will be able to express milk while at work, you can begin to slow down your milk production. Start a few weeks in advance of your return to work to replace one feeding every few days with a bottle of formula until you've weaned your baby for the feedings for which you'll be away. You still can nurse in the morning, in the evening, and thorough the night. Although with fewer than 6-8 feedings per day, you may have supply issues.

• If you are storing breastmilk, have your baby's caregiver give your baby one or two bottle feedings of stored milk or formula during the day.

• Nurse right after picking the baby up from the caregiver, or arriving home.

• Nurse at least once or twice more during the evening.

On days off, some mothers nurse at all feedings. Others follow their workday routine. Since nursing mothers need to drink additional fluids to produce an adequate supply of milk, keep a non-caffeinated beverage at hand throughout your workday. And remember to drink a large glass of water or other liquid each time you sit down to nurse or pump. You also need to eat nutritious foods. Keep a supply of healthful snacks in your desk and car. Even if you don't lose all the weight you gained during your pregnancy right away, don't pick this time to go on a drastic weight reduction diet. You may want to splurge on some new nursing/working outfits or borrow some clothes to wear until you're back to your pre-pregnancy size.

Working mothers may find that they require more sleep at night. Try to go to bed early at night or work in a nap before dinner if possible. Getting extra sleep on your days off may also help you to feel more rested.

Stress is the biggest enemy of breastfeeding. It can interrupt the production of milk and complicate nursing sessions. Therefore, it's important to take extra time to relax once you return to work.

Other Facts About Breastfeeding

Breastfeeding has no influence on when you can resume sexual relations after deliver. The common problem of vaginal discomfort during sexual intercourse may last longer if you're breast feeding, but can be helped by over-the-counter products to provide vaginal lubrication.

If you want to avoid pregnancy while you're breastfeeding, you will need to use some form of contraception. Although ovulation and menstruation often may not occur during this time and your risk of pregnancy is decreased, breastfeeding should not be viewed as a method of birth control. Read more about Breastfeeding and Birth Control.

Bottle-Feeding

If you are one of the 1-2 per 100 women who can't produce sufficient breastmilk for their babies or if your baby has a congenital birth defect such as PKU and is unable to have a diet of only breastmilk; or if you determine that nursing is not for you then you'll want to use commercially prepared infant formulas as an alternative to breast milk. These formulas are made from cow's milk or soy protein. Note: before formulas were widely-available, it was common for babies to be fed whole cow's milk. This is not a nutritionally acceptable choice. Whole cow's milk does not contain enough nutrients to ensure growth and brain development. Most specifically, whole cow's milk does not contain enough iron, a critical building block of your baby's brain.

Formulas give babies most of the nutrients they need. However, formulas do not include the protective properties of breast milk. Even so, many mothers find that bottle feeding is the method which fits their needs and lifestyle better. Some working mothers prefer to formula feed. One advantage of bottle feeding is that fathers and other family members can participate in the joy of feeding a newborn without the mother's having to express milk. The modern parent has vast consumer choices when it comes to formula: it can be purchased ready-to-feed, concentrated liquid, and powdered in bulk cans. The concentrated and powder forms that need to be diluted are generally less expensive than ready-to-feed formulas. Many parents choose to have their preferred formula on hand in a variety of forms: individually packaged servings for on the go, concentrated liquid in cans for long trips, and stashes of powdered for home bottle-preparation.

Bottle-feeding has some disadvantages:

• It is expensive: You'll want lots of bottles and nipples so you can pre-prepare them while you wash others. Formula is quite expensive in any form, and you'll be running your dishwasher (or filling your sink) much more frequently.

• Most formulas contain cow's milk, which may produce digestive upsets and aggravate allergies. If you or your partner have a family history of problems with or allergies to milk, there are several soy based formulas on the market as an alternative.

• You must use care when preparing and storing the formulas in order to control the growth of germs that cause diarrhea and stomach infections. It is an absolute necessity to sterilize bottles and nipples, which takes extra time and hassle but ensures that no milk bacteria lingers to sicken your baby.

Making the Right Decision

Even though health care professionals favor breast feeding as the optimal nutritional choice for babies, the decision to breast or bottle feed is still yours. Each couple must balance the data and decide what is best for them and their lifestyle.

The prospect of nursing is intimidating for most first-time mothers, and with good reason. This is one of the great challenges of motherhood -- and like the rest of motherhood's great challenges, the payoff is simply awesome.

As challenging as breastfeeding is, formula feeding is not without its difficulties. You may start formula feeding and two or three weeks later discover that you really don't like washing the bottles or buying formula or having to prepare a bottle in the night. You might find yourself wondering how it would feel to breastfeed. It is extremely difficult to reverse the decision not to breastfeed, but not impossible. Read about relactation.

It is, however, perfectly possible to start out breastfeeding and then switch to bottle. Furthermore, those first few feedings of colostrum are absolutely invaluable and cannot be manufactured artificially. So, if you don't have any strong feelings against nursing your baby, give it a try. Set reasonable goals: "I'll learn to nurse in the hospital, and I'll make sure the baby gets colostrum;" "I'll nurse throughout my maternity leave;" "I'll nurse to the six-month mark so the baby gets the maximum immune benefit." It is not uncommon for mothers to set such goals for themselves and discover that they love breastfeeding and sticking with it is no longer the challenge -- the challenge is letting their babies wean!

Remember a "yes" or "no" decision isn't necessary. After you've established a dependable milk supply, you can choose to breast feed some of the time and supplement with infant formula other times. If you later decide you prefer to breast feed all the time, there are techniques you can use to increase your milk supply.

The most important thing to remember is that the feeding time is an opportunity to nurture your baby in body and spirit and that whatever method you choose should be an enjoyable one for both of you. Remember that your face is precious to your baby, and that you smiling down on her while she fills her tummy is just about the best feeling she'll ever know. Don't let the challenges of feeding a newborn get in the way of the incredible experience of doing it.

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