Breastfeeding: Part One

Hey Everyone!

For my last essay to receive my postpartum doula certificate I decided to write about breastfeeding. Everything from an introduction in the biology, to global trends, scientific findings, and popular opinions. Now I’m going to share it with you! The reason why it’s going to be in two parts is because this paper is seven pages long – single spaced. It might seem a little ranty if I give it all to you at once, even if that wasn’t my goal at all.

Enjoy!

Bottle versus Breast Controversy

We’ve all heard/ seen/ read about the (essentially) war that’s going on between people about breastfeeding versus bottle formula feeding. I figured that I’d collect some information from both sides and let you decide. Basically with all the information out there available for personal use, it’s difficult to determine which method is best to feed a newborn.

Human Biology and Anthropology

“Babies were born to breastfeed” This was an advertisement that ran for six months put out by the United States Ad Council to create a public health initiative. To break this down a little bit; before formula there was only one option for feeding a child: Breasts. We were biologically made to be fed from our mothers’ breasts and historically that’s how every mother-child relationship began. There was no such thing as “I don’t have enough milk”, “Breastmilk isn’t as good as formula”, or “Breastfeeding imposes too many demands on me”; a mother would just see to the needs of her baby and everything would turn out fine.

Let’s talk biology for a few minutes. In their book Breastfeeding Made Simple, Nancy Mohrbacher and Kathleen Kendall-Tackett researched many resources to put together a guide on how breastfeeding works. Within this book they describe seven ‘laws’ that pertain to breastfeeding that will let the process begin and thrive throughout a breastfeeding relationship. These laws include: (1) Babies are hardwired to breastfeed (2) Mother’s body is baby’s natural habitat (3) Better feel and flow happen in the comfort zone (4) More breastfeeding at first means more milk later (5) Every breastfeeding couple has its own rhythm (6) More milk our mean more milk made (7) Children wean naturally. I won’t go into too many details here but to sum up this three hundred page book: if a mother has seen another woman breastfeed, the newborn isn’t removed from mother at birth, and if the mother has family and cultural support then breastfeeding should be a relatively smooth process.

blue-iycf-recommendations-practices-global-numbers-1

Introduction/ Creation of Formula

Now, you may be thinking to yourself “if breastfeeding is the answer to all the problems then why was formula even created?” First off everyone must understand that health professionals have and intrinsic mistrust of nature and that they are trained to assume that everyone is sick unless proven otherwise. Within this frame of mind, it’s not too difficult to see where the idea that breastfeeding wasn’t the best. This method of training health professionals came about during the industrial revolution, when things that were difficult/ unreliable suddenly became available to the masses (i.e. heat, indoor plumbing) the field of science was also improving by leaps and bounds.

With everything changing so quickly the ‘old fashion’ way of doing things seemed out of place with the science-enamored generation. During this time, scientific mothering came into practice: parenting manuals that told not to ‘spoil’ a child with affection, keep them in a sterile environment, and keep them on a strict schedule (feeding, sleeping, toilet training). Formula feeding fit right in because you can see how much a baby is eating and it can be regulated no matter what the baby wants or needs. All of these were seen as ‘progress’ the issue was that the formula wasn’t regulated by any overseeing organization, mothers went to their pediatrician (a newly created field specialization) to buy the formula created for each individual baby. At this time who knew what they were feeding their child? Plus if they prepared it incorrectly or didn’t sanitize the bottle properly than they were causing more harm then good.

Nowadays formula ingredients are regulated by the FDA (in America) and are constantly developing new concoctions to get closer to their goal: Breast Milk. One problem deals with immunity: antigens can’t survive the canning process (they get cooked out). Recently creators have added  DHA (docosahexaenoic acid) and ARA (arachidonic acid) for healthy brain and eye development. Some have also added probiotics to support a healthy immune and digestive system. While it’s still not up to par with breast milk: at least you don’t have to worry about your formula restricting your baby’s nutrients or causing infection to the point of death.

Global Trends

Bottle feeding formula is seen as the ‘modern’ way to feed a newborn. When a woman immigrates from an underdeveloped country, where she’s only seen breastfeeding practiced, to a developed country she will often abandon breastfeeding for bottle feeding. Many women (from everywhere in the world) don’t understand or are unaware of the health consequences to them and their babies if they don’t breastfeed. They also don’t understand how influenced they are by advertisements and the culture around them. Quick history lesson: Formula companies used to hire women to dress up as nurses and offer free samples of their formulas, just enough to decrease their milk supply so that they were forced to supplement even if they couldn’t afford it. This unethical practice caused millions of deaths and led to the World Health Organization to create the International Code of Marketing of Breast-Milk Substitutes which limited how formula companies could market their products. The United States doesn’t adhere to these policies though some companies do.

Recently (23 May 2016) a study found that there is global infant and young child feeding (IYCF) transition towards diets higher in milk based formula is underway and is expected to continue apace. In 2008–2013 world total  milk based formula sales grew by 40.8 percent. The marketing of breastmilk substitutes negatively affects breastfeeding: global sales in 2014 of US $44·8 billion show the industry’s large, competitive claim on infant feeding. The observed increase in milk based formula sales raises serious concern for global child and maternal health, particularly in East Asia, sales volume per infant/child was positively associated with country income level although with wide variability between countries. It calls into question the efficacy of current regulatory regimes designed to protect and promote optimal global infant and young child feeding, as the observed changes have not been captured by existing global monitoring systems.

The formula supplementation has led to formula-only fed babies, which has started a trend where ‘My mother formula fed me so I’m going to formula feed my children”.  It also causes a loss in knowledge: mothers who haven’t seen breastfeeding don’t know how. They can’t ask their mothers, sisters, women family members, girl friends, anyone really because no one knows how to properly breast feed. Health professionals also don’t understand the biology behind breastfeeding because they aren’t thoroughly trained on how to maintain a breastfeeding relationship unless it’s a personal interest and they conduct their own research. Nor do health professionals normally care learn more about breastfeeding because formula companies can pay/ give free samples to them to promote formula. Much of the time the company that controls the office that the doctor is working for will receive free formula for their infants for however long the child wants it.

UNICEF-Regional-avg-exclusive-BF-1.png
Percentage of infants <0-5 months of age exclusively breastfed, 2015

To be continued…

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