Wednesday, October 15, 2008

Successful Breastfeeding.

I'm a little behind in blogging, but I've seen this posted a few times and think it is time to share my own thoughts especially after the post I wrote yesterday. In early October, Pediatrics published an article on the Effects of Maternity-Care Practices on Breastfeeding. The study's goal:
Our goal was to assess the impact of "Baby-Friendly" hospital practices and other maternity-care practices experienced by mothers on breastfeeding duration.
The analysis was based on the Infant Feeding Practices Study II, which surveyed just under 2000 women who initiated breastfeeding on the care they recieved and their breastfeeding success rate. The results are distrubing. Only 8.1% of women recieved care that met all six of the "Baby-Friendly" hospital practices (breastfeeding initiation within 1 hour of birth, giving only breast milk, rooming in, breastfeeding on demand, no pacifiers, fostering breastfeeding support groups) the analysis looked at. (The Baby Friendly Hospital initative actually lists ten practices, but the analysis presented looks only at six. ) The women who did not recieve care that met all six practices (almost 92% of those surveyed) were thirteen percent more likely to terminate breastfeeding early (defined as six weeks).
The results are especially disturbing when you look at the short and long-term benefits to baby and mother of breastfeeding and the positions/recommendations of medical groups. For example, the American Academy of Pediatrics (who published the results in their magazine Pediatrics) recommends breastfeeding EXCLUSIVELY (no solids, only breastmilk) for the first six months and that breastfeeding continue for at least 12 months (and thereafter as long as mutually desirable). The American Academy of Family Physicans positions paper says:
"If the child is younger than two years of age, the child is at increased risk of illness if weaned."
The World Health Organization:
As a global public health recommendation, infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health. Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to two years of age or beyond. Exclusive breastfeeding from birth is possible except for a few medical conditions, and unrestricted exclusive breastfeeding results in ample milk production.
I've written quite extensively on my ongoing breastfeeding experience, and come December, we'll reach two years. It is upsetting to me to watch my friends and family quit early because of the "medical" advice they receive from their doctor or pediatrician. I was livid when a friend's husband told me that breastmilk was no longer needed after one. I was equally livid after watching my friend give her soon to be one son a bottle of undiluted apple juice before nap time, because her ped said that their child should be weaned by one. The worst part-- it's the same ped that my son sees, yet he has always been supportive of my continued breastfeeding. Perhaps, due to my lactivism and constant questioning, he keeps his parenting opinions to himself. (Rightfully so, because sometimes I ask just to see what he will say rather than truly wanting his advice.)
Furthermore, until women are treated with respect when receiving medical care for themselves or their children, we need to be advocates. Doctors threaten women with removal of their child and calling child protective services in order to manipulate women in to following their care guidelines when they are using out of date information (i.e. forcing formula on a jaundice baby, etc). This practice needs to end NOW. Doctors need more ongoing education on breastfeeding and its benefits. They need to provide better service, or they need to back down.
More at:


Trannyhead said...

Well ... I'm not going to comment on the breastfeeding until 2 thing because I've got a different opinion than you have. And I have a different opinion as far as supplementing with formula goes ... because I didn't make enough milk to keep my enormous baby going. And he grew just fine. But I WILL say that my breastfeeding experience at the hospital where I delivered was AWFUL!!! AWFUL!!!

Among other issues, I was NOT able to breastfeed right after birth despite my SPECIFIC request to do so. And my lactation consultant was SO MEAN. I was struggling with 3rd and 4th degree tears thanks to delivering a 9 and a half lbs. baby THROUGH MY HOO-HA and she told me to stop the ice packs immediately despite my crippling pain. She said I needed to just "get used to the pain so that it would heal faster." Umm ... riiight.

Anyway, it was by tenacity and luck that I kept at breastfeeding. Now my kid is almost 15 months and we're still at it. But anyway, it was NOT because of help from anybody (except my poor husband) that got me there. It was definitely by my own volition!

Maria said...

Tranny-- only 3-5% of women are physically incapable of breastfeeding (not producing enough milk, breast issues). That leaves a large gap of women who are not breastfeeding. I cannot comment on your personal experience, but it is my opinion that most women supplement because they have gotten a poor start and doctors are quick to push formula. OK, so my opinion is similar to well documented publications and studies. LOL! None the less, I personally know women who have had multiple 10 pound plus births and exclusively nursed for the first six months, and I also know that there is a reason formula exists, but formula will never mimic 100% the benefits of breastmilk.

I'm sorry you received such crappy care, and the entire point of the analysis in Pediatrics, IMO, is that hospitals, doctors, medical professionals need to do better. The top indicators of if a woman will stick with nursing are the care/help she receives.

I'm not entirely sure what your thoughts are on nursing until two. That's where we are headed and not where I thought I'd be, but I am enjoying it and mostly committed to child lead weaning. Feel free to expand your own position... or wait for the two year mark and post to come. I'm fairly certain I've heard it all. ;)

Oh, and before I forget, congratulations on 15 months of nursing! That is absolutely amazing and beautiful!

Rachel said...

Well said. I think you hit the nail on the head with this: "until women are treated with respect when receiving medical care..." I'm not holding my breath.

Bethany said...

I guess I has an odd experience. I had great support in the hospital, he nursed soon after birth, roomed with us and nursed when ever he wanted (which was all the time-it was hard to have visitors!). My OB, ped, and all the nurses were very supportive, and I loved my LC. I also had support from my mom (i nursed until 15 mo when I told my mom "no more") and my husband (although his support came from the price of formula!!!).

I don't think I could have done it without support because BFing is hard in the beginning.

Maria said...

OK Bethany. I have to ask, because if I ever have to have a hospital birth, I want to go where you went! It's great you had a wonderful experience. You are probably one of the 8%. :) Also, I agree that support is key. My own success, I generally credit to my midwife and others who helped me in the early days.

Bethany said...

I delivered at SouthCrest! I am amazed by "home birth-ers" I couldn't do it, I am too much of a wienie...i needed that epidural. Besides Parker had a knot in his cord so it was probably best we were in a hospital!

Maria said...

Some of that must have been your doc. I've heard mixed things about Southcrest, but I still want YOUR experience if I ever have to birth in a hospital in the US. Well, minus the epi. ;)

Melissa said...

i have a friend who has a two week old and her doctor wanted her to give her jaundice baby formula. she told me this at octoberfest last weekend. :(

and when i found out that the st. francis nursery had given aislinn sugar water AND a pacifier i was LIVID! they did not even mention it to me!

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