Exclusive Breast-Feeding Not the Norm in U.S.

FRIDAY Nov. 11, 2011 -- When something's been scientifically proven as good for the body -- nourishing, boosting disease-fighting ability and more -- you might think Americans would clamor to adopt it, especially when the bodies it helps are babies'.

But you'd be wrong, health experts bemoan -- at least when it comes to breast-feeding.

A large number of mothers in the United States, they say, do not breast-feed their babies.

Nearly three out of four mothers start breast-feeding while still in the hospital, but by the time their baby is 6 months old, just 43 percent are still breast-feeding, said Dr. Richard Schanler, a neonatologist and pediatrician in Manhasset, N.Y., and chairman of the American Academy of Pediatrics' breast-feeding section. Fewer than one of four mothers in the United States breast-feeds till their child's first birthday.

And those numbers represent only women who do any breast-feeding, said Schanler and Dr. Laura Viehmann, a pediatrician in Pawtucket, R.I. Just 33 percent of mothers exclusively breast-feed to 3 months of age, Schanler said, and only 14 percent to 6 months.

The American Academy of Pediatrics recommends breast-feeding for a year, and as long as baby and mother desire after that, Schanler said. Once a baby reaches 6 months old, the mother can start adding in complimentary foods.

But until then, exclusive breast-feeding has the backing of medical research. "The physical benefits of breast-feeding are improved with exclusive breast-feeding for six months," Viehmann said.

So why don't more mothers breast-feed? Breast-feeding can be difficult to learn, for both mother and child. And American society, according to Schanler and Viehmann, doesn't provide the sort of support needed to promote the practice.

Breast milk contains a rich amount of nutrients, hormones and antibodies, a wondrous combination that acts in concert to promote good health in vulnerable newborns.

Health benefits that babies gain from breast-feeding, according to Schanler, Viehmann and the U.S. Department of Health and Human Services, include:

  • Protection against infections of the ear and respiratory system.
  • Protection against diseases of the digestive and intestinal tract that cause vomiting or diarrhea.
  • Reduced risk for sudden infant death syndrome (SIDS).
  • Reduced likelihood that the child will develop such chronic diseases as diabetes, asthma and obesity later in life.
  • Enhanced brain development.
  • Decreased risk for leukemia, lymphoma and other cancers.

These protections have been found unique to breast milk. Baby formula manufacturers have been unable to replicate the chemical makeup of breast milk, Schanler explained, and thus have not been able to create a product that provides the same health benefits.

"It's not so easy to just say we'll take one component out and put it in a substitute milk," Schanler said. "It's really the interaction of all these factors together that produce these protective effects."

Studies have shown that most successful breast-feeding begins within an hour of birth, Viehmann said. Unfortunately, that's the time when many hospitals tend to whisk the child away while the mother recovers.

"The hospital system is not supportive of keeping the mother and the baby together and unseparated," she added. "They like to take the babies away to weigh them and dry them."

Hospital care also can hamper breast-feeding by not giving mother and child enough uninterrupted time together, Viehmann said. Newborns often need to nurse every 60 to 90 minutes for a good portion of the day, but new moms in a hospital are constantly pestered by nurses, doctors, administrators, loved ones and well-wishers.

"So then they're tired," she said. "They're supposed to sleep when the baby sleeps. If they can't rest, they can't attend to the baby when the baby is ready."

Another stumbling block for some is that breast-feeding is not easy. Though it's often described as a natural process, both mother and newborn need to learn how to work together for feeding.

"It takes two or three weeks for moms and babies to really get to know each other, and how the whole system works," Viehmann said. "Even with a mom who's breast-fed other babies, she can have a newborn who is different and responds differently."

During this learning period, babies can become very fussy. If mothers aren't provided solid moral support, they can lose their confidence and abandon breast-feeding, she noted.

"Mothers are very anxious," Viehmann said. "If anyone suggests that maybe they would be harming the baby by refusing to give a bottle, it throws them off. Mothers can be influenced by the expectations of other people who do not understand this baby is going to be fussy."

Bigger obstacles await once mother and child have left the hospital, Schanler said. Pumping breast milk for a child's later use is a difficult task, and many women just don't have the time and determination.

"We need to have a very motivated mother to pump and store milk so she can have milk to feed her baby when she goes back to work," Schanler said. "I give a lot of credit to women who continue to supply milk to their babies after they've gone back to work."

Working mothers need 15 minutes twice a day at the job to pump their breast milk, he said. They need a private place to pump, and they need a refrigerator to store the milk.

"It sounds pretty simple, but all of our industries are not on this page yet," Schanler said, noting that only one of four U.S. worksites provides such help for breast-feeding mothers.

And then there's the attitude issue, as Viehmann pointed out.

"The United States is not supportive of breast-feeding on many, many levels," she said. "We have a culture where breasts are seen as something for sex, not for food."

More information

The American Congress of Obstetricians and Gynecologists has more on breast-feeding.

A companion article describes an Iowa woman's approach to overcoming breast-feeding obstacles.

Posted: November 2011


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