Breast or Bottle?

Research shows unequivocally that breastfed babies are healthier and smarter, and that the longer babies are nursed, the healthier and smarter they are. That's because brain development, immune function and all aspects of the baby's physiology are designed to flourish when the baby is fed her natural food. Substitute food, no matter how well-designed, cannot exactly match what the human body creates.

But the benefits aren't just physical. Because the nursing mother experiences hormonal changes that influence how she perceives and relates to her infant, many experts feel that the mother who nurses bonds more strongly with her baby, resulting in a better relationship over time. 

If for some reason you can't breastfeed, don't panic. Babies who aren't fed breastmilk can of course still be emotionally and physically healthy. The most important emotional factor is the responsiveness of the parent to the infant. (See this article for more on how breastfeeding relates to Attachment Security.) And infant formula has made great advances in the past two decades in insuring that formula is closer to breast milk in its composition than it was previously.

But if you can manage it, breast is better.

 
"Ok, I'm convinced. How do I successfully breastfeed my baby?"

1. PLAN to nurse.

Not "If it works out." But "I will do this." And you almost certainly will. There are lots of times in history when infant formula wasn't available, as, for instance, in London during World War 2. Records show that every mom who gave birth during that time was able to breastfeed her baby successfully -- because there was no alternative.

2. Be Prepared.

The classic nursing hold is to cradle your baby's head in the crook of your arm, turn her whole body to face you so you're belly to belly, and move her to your breast so she can "latch on." That means she needs to be at the level of your breast, which means on a pillow, not on your lap. Many nursing moms say that a good nursing pillow, the kind with the circular cut-out for your belly, is hugely better than an ordinary pillow, which slides around and isn't necessarily the right height or firmness. You don't need most of what they sell for baby (I didn't use changing tables or cribs, for instance, or strollers in the early months), but a nursing pillow is a smart purchase.

3. Know Your Technique.

Good basic technique can tremendously lessen sore nipples, prevent clugged ducts and mastitis, and make the difference in whether breastfeeding works or not. A few helpful rules:

  • Be sure your baby opens his mouth wide and gets not only the nipple, but most of the aerola in. This stimulates the full milk let-down as well as preventing sore nipples. Can't get him to open wide enough? Trigger the "rooting reflex" by tickling his mouth or cheek with your nipple.
  • Be sure your baby is facing you so he doesn't have to turn his head to nurse.
  • Be sure your baby is at breast level so you don't have to hunch over. You can relax better, insuring better milk let-down, and you don't get a sore back and neck.
  • Don't know if he's in the correct position? His tongue should be slightly visible between his lower lip and your breast. If not, dis-engage him, tickle his cheek so he opens his mouth wide, and and let him latch on again.
  • To save your nipples, dis-engage by inserting your finger at the side of his mouth and breaking the suction so he pops off. (Usually he will fall asleep nursing and the breast will fall out of his slack mouth, that is also fine.)
  • Change holds and rotate the baby's position from feeding to feeding. This better drains the breasts and avoids clogged ducts, as well as protecting the nipples from soreness. For example, use the football hold (Baby's feet pointing behind you, hold his head in your hand) or try nursing lying down (prop yourself well with pillows, and if necessary put a folded blanket under baby so neither of you strains).
  • Be sure you drink LOTS of water. Just drink water constantly.
  • Change your bra daily so any leaked milk (even tiny amounts) doesn't cause a breast infection.
  • Wait to introduce a pacifier or bottle until nursing is well-established.

4. Get a good start.

We don't grow up watching moms and aunts nurse their babies, and it isn't second nature to us, so sometimes it isn't as easy to get started nursing as we expect. It's easy to get unbearably sore nipples in the very beginning, or for the baby to have a hard time latching on. And very occasionally, babies are born with a challenge, such as being tongue-tied, which requires a quick snip under their tongue by a doctor.

While you're pregnant, arrange lactation support for that first week. It's a good idea to call your local La Leche chapter in advance just to have a couple of breastfeeding consultants' names handy. Such an expert often makes all the difference in the world. It is absolutely not worth the anxiety of muddling through when one session with an expert can put you and your baby on track.

5. Cultivate family support.

Make sure your partner understands your reasons for choosing to breastfeed. A little education goes a long way to overcome prejudices. Most men, with their wife's encouragement, find breastfeeding a miraculous act, especially once they understand how important it is for their baby. Your partner's support will be critical to your success.

6. Pick a pediatrician who supports breastfeeding.

Virtually all new breastfeeders worry about whether their child is getting enough milk. Most pediatricians are nursing advocates. Get him or her to help you as much as possible.

7. Remind yourself of all the advantages to you.

No middle of the night fixing of bottles. No sterilizing of bottles. No formula expenses. No formula allergies. As much ice cream as you want to eat, while the pregnancy pounds melt away. Diminished chance of breast cancer later. A delay in how soon your period resumes. Pride in the amazing ability of your womanly body.

8. Find other Moms who are breastfeeding to hang out with

...through La Leche or other groups. It makes all the difference in the world.

9. Resist the impulse to supplement with formula.

If you want your baby to take a bottle, pump your milk and have your partner offer it in a bottle once nursing is well established. (Don't wait too long or your baby may turn up her nose at this fakery!) Remember that the answer to too little milk is always to increase the demand by more nursing and/or pumping. Supplementing with formula -- even in an attempt to be sure your baby gets enough -- ALWAYS decreases your milk supply. If your baby needs more food, feed her more often!

10. Take a six month maternity leave

...if at all possible. Then, when you return to work, your child will be ready to supplement his morning and evening feedings with solid food during the day.

11. Relax. Enjoy. And don't be in a hurry to wean.

Don’t worry, she won’t be nursing in high school.

"Well, since you brought it up, when should I plan to wean? When I go back to work?"

Many studies confirm that breast milk changes in nutritional value to remain appropriate for babies as they grow into toddlers, maintaining its many health benefits. The National Association of Pediatricians recommends breastfeeding at least until age one, preferably longer. The average age of weaning around the world is four years old. So you might want to plan to nurse for at least a year, maybe two or three. (I'm biased here, I nursed both my kids till they were three. And I was back at work, in both cases, well before they weaned, but not for the first six months.)

So why do most mothers bottlefeed or, at best, wean in the first year?

Cultural pressures certainly influence many women. If no one around you is nursing a baby, it may be hard to envision yourself nursing. If your own husband -- or even complete strangers -- begin to chastise you for nursing an eleven month old who is learning to walk, you will probably begin to feel uncomfortable nursing, especially if you don't have support to continue.

But for most mothers, even those convinced of the benefits of nursing for their child, going back to work means the beginning of the end of breastfeeding. Most maternity leaves in this country are disgracefully short, averaging 6 weeks at 2/3 pay compared to an average of a year at full pay in most European countries. Fully half of all American women are not entitled to ANY paid maternity leave!

"Well, I do have to go back to work. What can I do?"

Wait as long as you can, so breast-feeding is well-established. By six months, your baby can supplement with solid food while you're gone. Remember that any reduction in demand will reduce your supply, so nurse her as much as you can when you're together, and pump at work.

Breastfeeding 101: Getting Started »

Recommended Best Breastfeeding Books »

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