Is the Bottle Really As Bad As the Bull?

Recent breastfeeding awareness campaigns—including one sponsored by the U.S. Department of Health and Human Services that compared formula feeding to riding a mechanical bull while pregnant—have triggered heated debate. Is formula feeding really detrimental to a baby’s health? Should—and can—everyone breastfeed? Cheryl Smith, R.N., IBCLC, lactation consultant in UAB Women’s and Infants Services, discusses the facts about breastfeeding.

“I don’t try to pressure people. I discuss the benefits of breast milk for babies and let them know we are here to help if they would like to try it—but if they don’t want to, it’s their choice. We’re not here to make anyone feel guilty.

“Two percent of people just can’t breastfeed—maybe because of an abnormality of the breast, or maybe because their milk supply is not adequate. And certain patients should not breastfeed, such as mothers who are HIV-positive or on drugs—although if a woman is on methadone and in a treatment program, she can breastfeed, because it also helps the baby to withdraw.

“For all other patients, the American Academy of Pediatrics suggests breastfeeding exclusively for the first six months, then continuing to breastfeed while introducing other foods for up to a year and thereafter as long as mom and baby want. Benefits include less diarrhea and a stronger immune system, which means a lower risk of infection, as well as a lower risk of childhood cancers; in fact, in the baby’s first days of life, the colostrum—the first milk—is like the baby’s first immunization shot.

“Breastfeeding is good for the mother, too. It helps the uterus contract back down to its prepregnancy size, and she can get back into those jeans quicker. She can burn an extra 500 calories a day. Breastfeeding also lowers the mother’s risk of ovarian cancer and premenopausal breast cancer.

“Sometimes I ask patients their concerns about breastfeeding. They may say that they have to go back to work or school, or they may think they have to breastfeed for a long time. I tell them that any amount of breast milk they give their baby is beneficial, and I give them the option of pumping their breast and putting the milk in a bottle. Returning to work or school can be a challenge. Some people tell me there’s nowhere at their job or school to pump. We need for more employers to establish lactation centers. All that’s really necessary is a room with a door, a plug for the pump, and preferably a sink close by.

“There is a myth that breastfeeding hurts. But if it hurts, you probably don’t have the baby positioned correctly. There may be a little discomfort with the first latch-on, but when the baby is actually nursing, it should not hurt. A lot of times people hear that it’s painful from others who tried to breastfeed and didn’t get the support they needed. One of the most important things for successful breastfeeding is for the mother to receive encouragement and to have someone to call when it’s not going right.”

— Rosalind S. Fournier