To Breastfeed or Not To Breastfeed?

In honor of World Breastfeeding Week, we wanted to share a previous post from a guest blogger, Allison:

 

Guest Blog: Breastfeeding versus Bottle-feeding
By Allison Brooks

Photo Credit: nettsu via Compfight cc

Moms may differ in their opinions and or choice to breastfeed or bottle-feed. I personally think it should be the woman’s right to choose. Breastfeeding and bottle-feeding both have pros and cons. We hear the many pros of breastfeeding such as less illness, possible greater intelligence of the child and so on. Many organizations including the Academy of Nutrition and Dietetics (formerly known as the American Dietetic Association) promote breast-feeding here in the USA and abroad. However, I question whether this is always appropriate especially if the mother is deficient in micronutrients, deficient in essentially fatty acids, malnourished, stressed, had multiple births in a short period of time or perhaps is not the right choice for the mother. I was breast fed for 3 months and choose to bottle feed my children.

Below, guest blogger Allison Brooks shares her point of view at an international level. Allison studies biomedicalization in Bolivia. Here she presents an example of biomedicalization on breastfeeding versus bottle-feeding in third world countries. Allison shared with me that she too was bottle-fed.  Feel free to comment and share your opinions as well. All are welcome.

Biomedicalization of BreastFeeding: What is healthy here, might not be healthy for all

Biomedicalization is a term used to describe the way in which natural life processes, human conditions and problems are defined and treated as medical conditions. Aging, childbirth and breastfeeding are good examples of normal life processes which have come under the authority of doctors. Biomedicalization may bring benefits, but there are also costs. Philosopher Ivan Illich was one of the first to use the term “medicalization,” which he argued actually caused an increase in social and medical problems as a result of medical intervention. One example is the drive by manufacturers of baby formulas to supplant breastfeeding with formula.

When a mother dies in childbirth or cannot breastfeed for some reason, infant formula may be the only choice. However, in the underdeveloped nations of the world, breastfeeding serves a number of critical purposes. Breastfeeding protects babies from infection, provides them with near-perfect nutrition and acts as a natural birth control for the breastfeeding mother. Breastfed babies are less likely to develop diarrhea, bacterial meningitis, ear infections and respiratory infections than infants who are fed formula. Breastfeeding also triggers beneficial hormone secretion in the mother, and the milk changes in amount and constituents to meet the needs of the individual infant.

The Nestle baby formula promotion of the 1970s urged mothers in less-developed countries to forgo breastfeeding in favor of formula, stressing convenience and nutrition. Nestle used strategies such as sending a new mother home with free samples; once the samples ran out, the child was habituated to formula and the mother’s milk had dried up, so the family had to buy formula.

Problems with this sort of infant nutrition quickly became apparent. Formula must be mixed with water and water in poor countries is often contaminated. Mothers could not read the instructions on water sterilization, or did not have the means to boil the water. Formula-fed babies were much more likely to die of diarrhea or pneumonia as a result of infections. Poor mothers would often mix inadequate amounts of formula for each feeding to make the expensive formula last longer, resulting in malnourished babies.

Nestlé’s marketing activities were considered so unethical that a boycott was launched by a group called the Infant Formula Action Coalition. In 1981 the World health assembly adopted Resolution WHA34.22, which bans the promotions of breast milk substitutes. Although Nestle agreed to accept the code, in 1988, formula companies were accused of repeating the unethical tactics and the boycott, which was still in force as of 2011, was launched. Other companies such as BordenSimilac and Wyeth have come under similar criticism for marketing methods that imply formula and breast milk are nutritionally equal. Most physicians and international organizations such as WHO and UNICEF recommend now breast milk exclusively for the first six months of life.

But the effects of biomedicalization do go way beyond the idea of breastfeeding. Pharmaceutical companies push new rules on societies regardless of their cultures, everyday. This is easy to see in America, because we are the only country that allows pharmaceutical companies to run ads and develop an image for people to follow. Without regards to the culture, the environment and so on, sometimes these “better” medications/therapies can actually be harmful for the people. With new drugs entering the system to promote beauty or health, or a better life-expectancy for cancer, traditional practices are be dropped by the wayside, and people and cultures are being negatively affected.

 

About Guest Blogger Allison Brooks:

Allison says “I was bottle-fed too, that’s why I say what is healthy to you might not be healthy to others (cultural relativism). Thats why I don’t push my beliefs onto people, I state what I know and allow you to do what you please, with no judgment.”

Allie went to the University of Mississippi. She earned her degree in biomedical anthropology and  is now studying in the field to finish an ethnography on the effects of biomedicalization on Bolivian cultures, but as it relates on other societies as well. She loves to guest blog on her time off to past time and spread the word. When she is not at her computer, Allie enjoys riding her  horse, Lilly and playing with her ducks, Alvin and Shirley.

One Mom's Story on Breastfeeding

In honor of World Breastfeeding Week, we wanted to share a post from a guest blogger, Rachel:

Breastfeeding May Be “Natural,” but That Doesn’t Make It Easy
By Rachel Lipson

Like so many other pregnant woman, I spent the months leading up to my son’s arrival planning, reading, decorating the nursery, and educating myself about childbirth, breastfeeding, and raising a newborn. I took classes, read books, talked to lots of moms and moms to be to get more tips. Everyone told me that breastfeeding would be difficult, but I couldn’t believe it would be difficult for me. I couldn’t imagine that a practice passed down over so many generations, a practice that nourished newborns since the beginning of time, could be all that challenging. The pain of unmedicated childbirth should have given me a clue that just because something has been done countless times before doesn’t mean it’s easy. I took breastfeeding classes, read books, talked to anyone who would give me tips, and prepared myself for any issue that could come up with nursing.

 

When my son came out last November, rooting and ready to latch, it still seemed like the most natural, carefree experience a mom and baby could share. How amazing that he came out knowing just what to do! Then he latched on and I was in excruciating pain! I was breathing through every suckle like it was another contraction. The nurse told me to toughen up (ironic since this was following a thirty-hour labor, an unmedicated birth, and two very severe post-partum hemorrhages that led to massive medical interventions and two blood transfusions). I had just been through quite a lot but was feeling stronger and more capable than ever. So, I persevered. The nurses at the hospital fancied themselves lactation consultants but dished out the worst advice. It turned out, following a visit to the pediatrician after we got home, that my son was tongue-tied. I thought that sounded like a figure of speech and not a diagnosis, but as it turned out, his tongue was too attached to the bottom of his mouth and that’s what caused the painful latch. We were referred to an ENT and had it corrected when Max was five days old. We were told he would cry for a moment and then nurse painlessly immediately after. He did only cry for a few moments, but when he tried to latch, he couldn’t figure out what to do with his tongue! After two visits with a lactation consultant, we were partially able to nurse with a nipple shield. Then, at the next doctor’s visit, it turned out Max was losing too much weight. We were advised to supplement with formula, but instead I supplemented with my own pumped milk in bottles after every feed.  Max’s latch was still incorrect, and it turned out he wasn’t efficiently nursing. I continued to nurse and pump and bottle feed…I was exhausted!

 

All of that pumping helped him to return to his birth weight but led to a massive oversupply of breast milk. Max would drink for a few moments and pop off screaming as milk squirted into his mouth. This was just getting harder and harder. I should say here that I’m the type of person who is extra motivated and somewhat of a perfectionist. It’s harder for me to give up than it is to persevere. Still, I thought about giving up, and when Max became colicky at three weeks old, I was ready to throw in the towel. I was exhausted, the latch problems were still there, and the nursing, pumping, and bottle-feeding took up way too much time and energy. That’s when things really got tricky. Max’s colic got worse and worse. He would cry and fuss from 7:00 p.m. or so until 2:00 a.m. every single night. My husband and I were losing our minds. The doctor suggested giving up dairy in my diet to see if it helped his colic. She gave us a can of hypoallergenic formula to try as well in case we wanted to see results even faster. Within just a few days, Max was a different baby. He no longer seemed to be in such intense discomfort, and the crying at night subsided. It turned out that Max had a milk protein intolerance. Problem solved!  But wait! A few days later, his reflux started. He was spitting up left and right and crying out in discomfort. The doctor suggested giving up soy as well. I gave up soy, and his reflux started to improve to some extent. The hypoallergenic formula made his reflux much worse. We tried multiple other hypoallergenic formulas (to supplement), and every single one made him absolutely miserable and unable to keep any food down.

 

From that moment on, I knew that all I had done to continue to breastfeed my son had been worth it. I had a child who couldn’t tolerate any food other than my breast milk (as long as it was milk and soy free). We had all sorts of other ups and downs, Reynaud’s phenomenon, mastitis, etc. I constantly wished I could stop, but I knew that this wasn’t an issue of what I felt was best for my son…there was nothing else for him to eat! What would we have done if I hadn’t kept it up all those weeks before? By six months, he was thriving and loving life. The reflux started to subside, and with the help of the amazing Brooke from Sleepy on Hudson, Max started sleeping through the night. I tried every hypoallergenic formula out there once again and found that there was one ready-to-feed version (one that had failed us miserably early on) that he was able to drink and keep down. When he was seven months old, he had given up nursing (his choice) for the most part and was exclusively bottle-fed (still mostly breast milk). I knew I had given him what he really needed…food and sustenance during a time when he couldn’t tolerate anything else. I was ready to eat dairy and soy again, ready to stop pumping 4–6 times a day, and completely weaned him by the time he was eight months old. Now he’s nine months old and as happy and healthy as can be.

 

Pregnancy was challenging at times, childbirth was excruciatingly painful beyond words, but breastfeeding was hands down the hardest thing I’d ever done in my life. It wasn’t always the amazing bonding experience I had envisioned, but I am grateful that I had the willpower and perseverance to stick with it when my son really needed me the most. I can’t believe I thought it would be easy! Of course, I’m sure it couldn’t be that hard the second time around…right?

 

About Guest Blogger Rachel Lipson:

Rachel Lipson is the founder and director of Blue Balloon Songwriting for Small People in Brooklyn, NY.

Breastmilk or Bust

Does the Rocking Chair Look Good Next to the Deep Freezer?
By Amanda Mellowspring, MS, RD, CEDRD, LD/N

Eat from the Earth Nutrition Counseling, LLC
www.eatfromtheearth.com

We all hear stories about “the crazy things” that mothers will do to care for and protect their children. I, along with many of you, also thought I was immune to such craziness despite my big heart…until I actually became a mom myself! Oh yes!

First, I will declare that “crazy” is not the right word for what I will share below, nor for most of the decisions we make as parents. While others may have their own views on our choices, the decisions that feel right in your family do not require approval from others. So, here’s a portion of my story…

In 2012, my husband and I welcomed a baby boy into our lives through adoption. What a powerful experience (which is an entirely separate story)!

As with any parents, our discussions had thoroughly covered a million topics on how we would care for this child. We reached out to only a few family and friends before his birth to avoid spreading the word in such a delicate situation (again another story altogether). One topic that arose as we spoke with another family that had recently adopted a child was feeding. Now, I certainly think most families have some discussion about feeding, so I don’t think being a dietitian really impacted me all that much. My friend shared with me the idea of breastmilk donation. I was immediately in LOVE and curiously asked a million questions about safety, quantity, storage, resources, and networks and then we were off! We eagerly met with pediatricians in our area to find a good fit before the big day and asked for their feelings about our decision to pursue breastmilk donation, at least as much as possible. We purchased a deep freezer for our milk storage & pre-purchased breastmilk bags to trade these amazing mommas who would offer us milk. We nervously contacted our local midwife to explain our situation and ask if she knew any mothers who may like to donate. Interestingly, this was the only thing, aside from one sweet handmade teddy bear that my husband made, that we allowed ourselves to do to prepare for his birth. Again, side story, adoption is amazing and amazingly scary. Everyone approaches this in their own right way.

The dietitian in me did step in the picture at times. We had an open adoption process, and knew that our birthmother was a beautiful gift in our life, but she also refused anything aside from soda and pizza throughout the pregnancy. Now I am not out to bash a good pizza and soda now and again, but talk about checking my work at the door! And, don’t worry I hold onto my own mom/RD guilt about not trying to induce lactation (yes, you can do this & yes, it is super cool), but there were a million reasons that it wasn’t possible in my life at that time. I have always been a strong advocate for breastfeeding, but prior to hearing about breastmilk donation, I had already adjusted my personal feelings about using formula as I had anticipated it to be my only reasonable option. Yes, formula is formulated to resemble breastmilk and provides adequate nutrition, and bonding really comes from love and not from boobs, so I was okaying myself with this. In learning more about milk donation, I also knew that I would most likely supplement with breastmilk donations and primarily feed formula and it would be fine, more than fine. I mean, how would I actually get enough breastmilk from other women to feed him only that!?! So, my dietitian part obviously loved the idea of the nutrition that breastmilk would provide, but I was most excited surprisingly about two other aspects of this endeavor – introducing milk would allow for flavor variation which would assist with food introduction and the development of his flavor palate & I would meet other moms! When you adopt, you don’t generally build the community that you may get from birthing classes etc, so meeting mommas was on my radar!

Beautifully and perfectly, our little guy was born on 9/12/12 and came home with us just a few days later. Over the next 9 months, I fully engaged in my “crazy” & my amazing husband went there with me! I linked up to every milk sharing network that I could find and began driving all over the state (& even other states when we travelled) to meet moms to trade breastmilk for milk bags and fresh foods from our garden. (The Friday evening car rides that took 3-4hrs round trip to pick up donations, the parking lot meetings at Babies R Us, & the coolers that constantly resided in the back of our car may be the “crazy” that I speak of!) Most of the moms didn’t want anything in trade (although milk bags are expensive and I would have bought a million of them if someone had wanted). Just the joy of knowing that they were offering a priceless gift satisfied these amazing women. (It is illegal to pay for breastmilk in the US just so you know, & I never met a mother that would have ever considered it either.) Amazingly, we were able to provide him with ONLY breastmilk from donation for 9 months – and talk about flavor profile with cultural influences from all over Latin America, Asia, Australia, France, & throughout the US! I will just take a moment here to say that the amount of breastmilk that a woman can produce is AMAZING! Seeing all of the milk that my son took in just by standing over a deep freezer packed, labeled, and organized always left me in awe (& usually tears again…a theme in motherhood I am pretty sure.) We pulled back from the search a bit as he started to eat more solids, because we knew that there were more new little ones out there that could benefit from this precious gift. Our little guy had never even had a diaper rash in this time period, so we wanted other babies to benefit from this nutritional gold mine too.

The idea of breastmilk donation dates back, way back, all the way back! Historically women have always been known to wet-nurse or nurse babies that were not their own. It’s just a love thing. But, even still, my protective mom self and my RD part considered what questions to ask women about their lifestyle, their diet, their health, etc. ‘To each her own’ on this topic, I say. I think everyone should be responsible for asking the questions that fit for them. We did not use formal hospital-based milk banks (which do exist) because those generally are reserved for sick children or children with special nutritional needs & there was not one in our area. For me, I can say that I have hugged every woman that provided for my child in this way & that, amongst a few questions here and there, felt right for me. Mind you, that almost all of these women came to me to offer to donate via midwives, other mommas, & friends. I went to their homes, met their babies, and even shared tears for babies that made the gift possible but didn’t live to see the gifts of their mothers in this way. Many women consider the birth children of their milky moms’ to be “milk brothers/sisters”. All of the sudden, I wasn’t just making momma connections; our family was literally growing with every milky mom we met! Thankfully, somewhere in the craziness of the adoption process and becoming a mother, I had the clarity to ask each woman to pose for a photo with our little one. In total, over 30 heart-touching, heart-wrenching photos of love and gratitude have compiled my little guy’s “Moms Book”. His book includes photos of his birthmother, several women (& a man) who were integral to his adoption, over 30 milky moms, & me. Quite a book. And, we are really loving picture books right now anyhow. We look at it together, and I suppose that one day he will ask why I always cry when we do.

What eating right means to this mom and RD…

What eating right means to this mom and RD…
By Laura Cipullo, RD CDE CEDRD CDN and Mom

 

The Academy of Nutrition and Dietetics recently asked RDs to explain what eating right means to them. So I asked my assistant, my interns and my student volunteers to describe what it means to each of them. They shared their definitions with me—and therefore with you—at www.EatingAndLivingModerately.com.

I really think my blogs—and even simply many of the titles of my blogs—paint a very accurate picture of what eating right means to me. But just in case you may have missed my continuing message, here’s a short synopsis:

One Size Does Not Fit All

I’ve learned that diets basically don’t work! And I learned this fact more than twenty years ago! Since then, via earning my RD credentials, attempting to balance my own state of wellness, and working with clients, I’ve definitively learned and absolutely believe that ONE SIZE DOES NOT FIT ALL! Every individual carries a different set of genes, brings a different mindset and lives in a different environment. So although I believe all foods can fit into a healthy lifestyle, how I educate my clients (and my children) depends a great deal upon their personal situations. The concept of eating right is truly unique to each person’s unique needs. We need to go back to defining diet as habitual nourishment, rather than a quick fix.

Mixed Meals with Internal Regulation

For me, eating right became much easier when I let go of perfecting my diet and made the decision to eat all foods. Yes…carbs, proteins and even fats! I began using internal regulation methods rather than external regulation methods such as calorie counting or using a scale to “weigh my health.” Eating “imperfectly” became my perfect! For example, this means that if I eat a cupcake with my boys or share a meal with a client even though I’m already full, I don’t think twice about it. Rather, I enjoy the taste while I’m eating and remain mindful of my overall lifestyle. Learning to eat meals mixed with all three macronutrients and snacks with two of the three was essential—and still remains my ideal means for structuring food intake throughout each day. Actually, many of the techniques I use to feed myself and my family as well as what I teach all of my clients are based on the knowledge I’ve gained as a diabetes educator. Eating in harmony with the endocrine system (insulin, blood sugar, mixed meals, rate of absorption and fullness, etc.) and empowering intelligent decision-making are integral to wellness.

Some Food From Boxes

But I also know that eating right must also be realistic! Being a mom of two and having a full-time career which requires my working out-of-my-home two nights each week means learning how to create— and quickly prepare—healthy meals with just a few basic ingredients. It means sometimes eating a Kale Caesar Salad with salmon, or pasta with fresh asparagus or just pizza. It means actually making my children’s meals—even if not totally from scratch. At the very least, what I prepare is much less processed than fast food or take-out. And it also means my family and I can choose to eat vegan chili for lunch with chocolate chip cookies for snack!

The 75/25 Approach

My personal eating behaviors reflect what I teach in my book HEALTHY HABITS: The Program plus Food Guide Index & Easy Recipes. Although I created this book to help parents and educators teach children how to feed and eat in healthy ways, my husband, my children and I all practice these lessons in our daily lives. As explained in HEALTHY HABITS, I employ the concept of consuming what I call “everyday” foods (nutrient dense and sustainable) the majority of the time  (in general about 75%) and “sometimes” foods (low nutrient dense and less likely to be earth friendly) the remainder of the time (about 25%). And I use a “hunger/fullness scale” to help determine my portion sizes.

 Eating a Variety of Real Food

As evidenced by massive, ongoing research, nutritional science is neither black nor white. We always hear what the latest study has found or is associated with; it may, in fact, be in extensive conflict with a study completed just a year previous. So I personally try to stay in the middle—what I like to refer to as the grey zone. If I’m not eating excessively of one food or nutrient, I genuinely feel this will help minimize my risk of developing disease—such as diabetes, heart disease or even cancer. Being in the grey zone also helps to keep me at ease mentally. The mind-body connection is an important part of eating and being healthy. The yin yang symbol of balance bearing the apple and the cupcake on the cover of HEALTHY HABITS truly summarizes my definition of health and healthy eating and therefore, eating right.

Focus on Behaviors

And one more thing, eating right does not get measured on a scale located in your bathroom or in your doctor’s office. Here’s what is truly measurable and absolutely remarkable: The behaviors we engage in on a daily basis and how these actions and interactions affect us as complete, unique individuals. For me, that means being a mom, a wife, a friend, and an RD who eats, moves, rests and, of course, laughs!

Have Some Fun

So while you’re trying to live a life with what you deem as eating right, be sure that flexibility, spontaneity and “ a light hearted” attitude accompany your food choices. Again, this is the grey zone rather than the extreme zone.