Monday, July 11, 2011

Two years!

It was two years ago that I first began nursing my daughter.

Last month my little sweetie turned two years old. Yes, she is now two years old and we are still breastfeeding. A lot. She really likes to nurse.

Now, to many of the people I hang out with, this is totally normal. However, I realize that for most of the people in the US this may seem weird. My minimum breastfeeding goal has always been two years, though I fell a few months short with both of my boys. Why at least two years? Why would you still be breastfeeding a toddler? Can’t she have “regular” milk now? Doesn’t she have a full set of teeth and eat solid food?

Most people are simply unaware of the huge list of benefits of continuing to breastfeed full term. One of my favorite collection of research based information on this is at Breastfeeding Past Infancy: Fact Sheet

While it may seem “weird” to many in our culture, scientific research by Katherine A. Dettwyler, PhD shows that 2.5 to 7.0 years of nursing is what our children have been designed to expect (Dettwyler 1995).
In short:
Weird = Some person’s opinion
Normal = Science
So, if science says it is normal to be nursing a two year old, then why is it so often considered "weird"? Dr. Karan Epstein-Gilboa points out in her book, Interaction and Relationships in Breastfeeding Families, "In western environments, non-nursing or, at most, short term nursing are the norm. Behaviors veering from the normal status are therefore considered abnormal."

Some people may read this and think about how much breastfeeding is promoted as "best" and be mislead to think that we live in a breastfeeding culture. When you consider the fact that in the US approximately 11% of babies are still nursing at 12 months old, knowing that the American Academy of Pediatrics suggests baby is nursed a MINIMUM of 12 months, you can see that we are a culture in which bottle feeding and short term breastfeeding are the norm. The vast majority of children in the US are not nursing on their first birthday. Not normal is abnormal by default.

Until recently, nursing into toddler/preschool ages was often labeled "Extended Breastfeeding". The reality is that there is nothing "extended" about it. It is the physiological norm for human children. Breastfeeding beyond infancy is not extended, simply "full term". Many babies are born before 40 weeks gestation. Do we consider a baby who stayed in utero until 40 weeks "extended gestation"? No, it is normal. It is full term. Same thing with breastfeeding a toddler.

Full term breastfeeding has been in the mainstream media lately with Mayim Bialik being vocal about breastfeeding her toddlers, and child-led weaning. You can find may articles by her and interviews with her with titles like: I Breastfeed My Toddler. Got A Problem With It?

Don't even get me started on people who claim that a mother who nurses beyond infancy does it to meet her own needs, not the needs of the child.

Why at least two years?

There are literally dozens of reasons. Here are just a couple:
  • The American Academy of Family Physicians recommends that breastfeeding continue throughout the first year of life and that "As recommended by the WHO, breastfeeding should ideally continue beyond infancy, but this is not the cultural norm in the United States and requires ongoing support and encouragement. It has been estimated that a natural weaning age for humans is between two and seven years. Family physicians should be knowledgeable regarding the ongoing benefits to the child of extended breastfeeding, including continued immune protection, better social adjustment, and having a sustainable food source in times of emergency. The longer women breastfeed, the greater the decrease in their risk of breast cancer." They also note that "If the child is younger than two years of age, the child is at increased risk of illness if weaned." (AAFP 2008)
  • Nursing toddlers between the ages of 16 and 30 months have been found to have fewer illnesses and illnesses of shorter duration than their non-nursing peers (Gulick 1986).
  • "Breast milk continues to provide substantial amounts of key nutrients well beyond the first year of life, especially protein, fat, and most vitamins."
    -- Dewey 2001

Can’t she have “regular” milk now?

I think it is a funny thing in our culture that “regular milk”, or cows milk, is considered such an important part of our diet. There is an entire nutrition category based on a SINGLE food source: cows milk. Every other “group” has multiple sources of nutrition: Grains (rice, wheat, oats, corn etc.), proteins (meat, fish, eggs, legumes etc.), vegetable, fruits, you get the idea. The reality is that although the Diary Council would like you to think otherwise, NO ONE needs to consume any dairy products to be healthy (and many of us would probably be much healthier without them!). Some good info at Cows Milk? and Is Cow's Milk Necessary For Toddlers?

Yes, she can and does drink cows milk, as that is a food that our family keeps in the house. But, the best nutrition she gets is from species-specific milk made by her mama.

Doesn’t she have a full set of teeth and eat solid food?

Yes. She actually got all of her teeth rather early. She is a great eater and powers down lots of food. She loves fruit and chicken enchiladas.

Baby teeth are also sometimes referred to as: "milk teeth". If you look at it, the common time for kids to start losing their “milk teeth” around 5-7 years, coincides with the later age of natural weaning.

Isn't she nursing just for comfort?

Sometimes, yes. I think it is perfectly acceptable to comfort my child, and breastfeeding is sometimes the way to do it. Remember, it is not only about the milk.

I’m glad we are still nursing. I was really glad last weekend when we ended up in the ER after a fall. She didn’t need any pain meds, she was happy and comfortable sitting on my lap and nursing when she wanted.

Last week when we had a 4 hour layover at 6am in a strange airport, it was great to be able to nurse her and watch her relax and fall fast asleep.

Some people may be wondering how long we will continue to nurse. Ainsley is pretty much the boss on that one. She will let me know when she no longer needs it.


Want to read more about full term breastfeeding?

Six Misconceptions About 'Extended' Breastfeeding

Is breastfeeding a six year old ok? Er where do you live?

Breastfeeding Beyond Infancy: Radio Documentary

Breastfeeding My Jump-Roping Hula Hooper

To Wean or Not to Wean: Who Says When Is Enough
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Tuesday, June 7, 2011

My struggles and triumphs with breastfeeding!

I have another great, inspirational story about breastfeeding success! This article, by mom Christina Adams, is both inspirational and informative. She was able to successfully breastfeed with hypoplastic breasts and following breast surgery:

I had struggled with breast feeding my son, Vance. When he was born we lived in Japan and there wasn't a support system there at all. When I was struggling with supply issues, the hospital staff handed me an SNS (supplemental nursing system) and a case of pre-made formula and basically told me "Good luck". No one knew how to work the SNS and I was too nervous to try it. After 3 months of wondering why breast feeding wasn't working and having to supplement with bottles of formula, Vance developed a nipple preference and refused to nurse anymore. That was the end of that...

When I became pregnant with Harper, I decided that no matter what, she was going to be breast fed for at least one year, come hell or high water! I read everything I could get my hands on. I became very active in the Breastfeeding moms forum. I got in touch with La Leche League. That's when I realized that my supply issues were the result of something I had done to my breasts 8 years ago.

When I was going through puberty and developing breast tissue, something went amiss. Only one breast developed glandular tissue. As a result, my left breast was a size D and my right was tubular and only about an A cup. (This is often referred to as Insufficient Glandular Tissue, or Tubular Hypoplastic Breasts)As a teenager I was mortified by my "defect" and used a mastectomy prosthetic to mask the difference under clothes. When I was 20 years old (and about to be dropped from my dad's insurance) we found out that because my defect was considered a "chromosomal abnormality", his insurance would pay for reconstructive surgery! We went to all the referral appointments and the plastic surgeon that was covered did the surgery on May 30, 2001. He did a reduction on the left side and then put implants in both, so that they would both have that full, augmented look. They were still uneven, but looked a little better in a bra than they had before.

I went to the BFAR (breastfeeding after reduction) website and saw that a device called a "Lact-aid" was very highly recommended as an at breast supplementer. Then, in the breastfeeding forum, one of the moms recommended it as well. (Lact-aid is different than an SNS mainly in the way the milk come out of the tube. With an SNS, the baby doesn't have to work to get the milk out because gravity pulls it down. With a Lact-aid the baby has to suck and pull the milk up [like a straw] so it gives breasts more stimulation). I ordered the Starter Set that day! Domperidome was also mentioned numerous times to help up supply. Adoptive mothers had used it to get a supply going so they could breast feed their babies, even though they had not birthed them. I ordered a 3 month supply of that, too!

When Harper was born (an accidental homebirth!) on the way to the hospital, the EMT asked my if I wanted to nurse her. So there I was, strapped to a gurney, headed to a hospital, nursing Harper for the first time in front of a large, strange man that had just seen me in all my glory! I knew right then that everything with Harper was going to be different than it was with Vance!

She was 8lbs 6oz and just beautiful. I didn't let her out of my sight. She nursed and slept and nursed the entire time we were in the hospital! When we went home a couple days later she was down to 7lbs 11 oz (within normal range for loss). 3 days later when we went back in for a follow-up, she was 7lbs 12oz! My milk had come in that previous night and I was hopeful that i would be able to make enough milk for her without having to take the domperidome or use the Lact-aid. I made an appointment to see the lactation consultant in one weeks time. At that visit, Harper was still 7lbs 12oz. I was heart broken that my around the clock nursing and 64+oz of water a day just wasn't enough. The LC showed me how to use the Lact-aid and gave me a can of formula to use in it. I started taking the domperidome that day. I also started taking 12 fenugreek a day as well.

Because I knew that my breasts needed constant stimulation in order to send the signal to my brain to make more milk, I only gave her 2oz at a time in the Lact-aid, and only after she had nursed both sides without it. I watched her diaper count to make sure she was getting enough. She averaged about 12oz of formula or pumped milk a day and nursed 12-14 times in a 24 hour period. Her diaper count was always 6+, so I knew that she was getting enough. Slowly (and I mean s l o w l y!) we were able to wean off the Lact-aid. She was 5 months old. I had stopped taking domperidome about 2 months before then, but I was still taking fenugreek daily.

We battled thrush twice. Dane, Vance and I had Swine Flu in August. I know that she didn't get it because of the antibodies I was giving her through my milk. I had abdominal surgery when she was 8 months old. Because of the surgery, I had to stop taking the fenugreek. I was terrified that it would cause a dip in my supply, but to my surprise, I did fine without it. When Harper was 7 months old, I went back to school full time. I can't pump enough to send her with only "mommy milk" so she has been getting about 6oz of formula a day for the last 5 months. On the weekends, she only nurses. We stared giving her solid foods when she was about 6 1/2 months old and she is a food-aholic! She loves to eat pasta with red sauce and whole cuts of steamed broccoli.

She still nurses 4-5 times a day and I see no end in sight. I will nurse her for as long as she wants to. I love coming home at the end of a long day and cuddling with her on the sofa, while Vance sits on my opposite knee and we all read a book together. It makes the stress of Algebra and Western Civilization melt away, and at the same time it melts my heart. Vance is an amazing big brother. He is patient and loving towards her. Whenever she is upset and crying he'll tell me "Booboo needs nurse, mommy". I love them both so much!

I am so proud of my accomplishment and I know that I did everything I could to give her the very best! She is my angel-girl and I love her so much!

Resources

Diary of Lactation Failure
Hypoplasia/Insufficient Glandular Tissue

Tuesday, May 10, 2011

Nursing Against All Odds

I'm honored to share the story of Tami Caudill and her determination to breastfeed her daughter, against all odds:

My son who is now 3 was breastfed for 7 months, then was given pumped milk until 13 months. I thought I had challenges with him! Yeah, not so much. I had mastitis, oversupply ( which I liked) he was tongue tied and had a highly arched palate which caused my nipples to be hamburger for a month until the frenulum stretched and he matured/grew and the high palate wasn't an issue. At 7 months, after returning to work, he refused to nurse anymore. It was like he was mad at me.

When my daughter was born I decided I would try harder and that she would actually nurse for 18 months.

A few days after going home I had what I thought were symptoms of a UTI (nope) and mastitis (nope) and numbness tingling and weakness in hands and feet that got worse - higher. I had trouble walking and and was looking like a cow with mad cow disease. I went into ER and they said I was fine and that it was post partum depression and go home. That night I was falling and couldn't stand from sitting and couldn't go up stairs. I called clinic and a very smart receptionist squeezed me in for an MRI and to see my doctor. MRI showed no MS (woot woot!). Dr. examined me and thought that I had Guillain-Barre syndrome. He transferred me to an ICU that could infuse the IVIg I needed. During all of this I had my baby with me and was breastfeeding. I even brought her with to the ICU and she could stay with me. (We later determined that IVIg is not safe for breastfeeding infants and I would have to pump and dump while on it.*)

About 5 hours later the paralysis had reached my chest and I was not able to breath - the vent was started and Cambria went home with family. I was ventilated and paralyzed from the eyes down, but I insisted on being pumped every 2 hours (nurses or family had to do it since I was unable to hold them) during the day and every 4 hours at night.



After a week of treatment I came off the vent, but within 8 hours I developed preeclampsia (didn't know it at the time) at 3 weeks post partum. I went blind from swelling on my brain and shortly thereafter had eclamptic seizures and a mild stroke. I was medicated with things designed to make me forget things during this time and put back on the vent, but even through that I was asking to be pumped. I was in tremendous pain - makes natural labor look like a hang nail, would have taken that willingly and smiled about it - partially paralyzed needing to pump and dump for 4 weeks while on IVIg, doing intensive inpatient rehab for weeks and I still was determined that I would breastfeed when I got home - never even questioned that it would work.

By 5 weeks in my daughter (and son) could visit and when she did I breastfed her.



When I could have her at home 3 weeks later we never skipped a beat and she breastfed perfectly - cluster fed a lot at first, but that was no biggie.



She is now 13 months and still breast feeding. She only got formula for 10 days, because other moms found people to donate milk** to her when I was dumping. I literally nearly died twice in those 7 weeks (doctors didn't even leave my bedside for 2 days each time I was vented, and if you know doctors you know that's a HUGE deal) but I never gave up on breastfeeding my baby!

Editor's Notes:
* It is important to note that most medications and treatments are compatible with breastfeeding and it is very rare that a mother will need to "pump and dump". Many mothers are incorrectly told they cannot breastfeed on a medication when it is actually very safe. My review of the literature does not find an IVIg that is not compatible with breastfeeding, though it is possible there are some that are not. A reliable source to determine if breastfeeding is safe with an particular medication or treatment is InfantRisk Center
**There are risks involved in informal milk sharing and mothers are encouraged to research the risks and benefits before using donor milk. A good resource is Should Milk Sharing Among Mothers Be Encouraged?

Sunday, April 10, 2011

Adoptive Breastfeeding: What are the Benefits?

How important is adoptive breastfeeding? Does it really make a big difference?

From personal experience I can tell you that adoptive breastfeeding is HARD! It is probably one of the hardest things I've ever done. The steps and the physical action of doing it isn't difficult. It is hard in a different way. It is hard to see the results early on. It is time consuming and tedious. It is double the time and effort of breastfeeding and formula/bottle feeding combined. It is so much effort and you are constantly wondering, "Is it really 'worth' it?" or "Is this really going to matter in the long run?"
Knowing the positive impacts at the "end of the tunnel" can make all of the extra effort in the beginning worth it.

When I first held my new baby, who had spent her first 17 days as "Baby Girl Doe" in the NICU, I knew that I needed to breastfeed her.



That is over 17 days of being swaddled in a bassinet. Cozy, fed, and taken care of. She was held, in fact the nurses doted on her. But, she was never held skin to skin on her mother's warm chest.



The reality is that ALL adoptions involve a loss for the child. Even a newborn infant who is placed right into the loving arms of his/her adoptive parents is being separated from the only mother they know.

Adoption universally involves loss. Babies recognize their mothers at birth and at delivery healthy babies placed on the abdomen of their mother will crawl up onto her chest and, locating the nipple via its familiar smell, will attach to her breast and suckle. Newborn infants desire to remain with their mother and if removed from skin-to-skin contact with her will give a specific "separation distress cry/call" as an appeal for reunion. Maternal separation is stressful for infants, and all adopted children have experienced the loss of their birth mother (Gribble, 2006).

There is very little research on breastfeeding and adoption, but the little bit that there is suggests it is beneficial to both mother and child. I believe that this is because breastfeeding isn't just a feeding method, it is a relationship. It's not about the milk, it is about your connection with your child. With the current popularity of informal breast milk donations it would probably not be too difficult for adoptive parents to find human milk for their baby, but that does not provide the skin to skin contact and physical relationship that breastfeeding ensures.

breastfeeding is more than just the provision of nutrition; the act of suckling at the breast has an impact on both child and mother (Gribble, 2006)


Breastfeeding naturally puts you in skin to skin contact with your baby which is important to baby’s development and in forming attachments between mother and child. When you are bottle-feeding, you must find additional time each day to hold your baby skin-to-skin. Some benefits of skin-to-skin contact for your baby are better organization of reflexes, stable temperature, and regulated heart rate. Some benefits for you include increased milk production, easier breastfeeding, and better oxytocin release (Moore, Anderson & Bergman 2009). 

Research has shown breastfeeding to have positive psychological effects for mothers as well. One study compared mothers breastfeeding and bottle-feeding: The researchers found a correlation between positive mood and reduced stress after a breastfeeding session when compared to a bottle feeding session. The researchers suggested that the higher levels of the hormone oxytocin released by breastfeeding contributed to the decrease in negative mood (Buckley & Charles 2006). Bonding is important aspect in adoption, and the hormones released during breastfeeding can facilitate that process.


The World Health Organization (WHO) suggests that all children be breastfed by their mothers, and if that is not possible the baby should be fed the expressed milk from their mother, or nursed by or fed the milk from another mother. The last choice for feeding an infant, according to the WHO is an artificial breast milk substitute, or, formula. WHO recommends exclusive breastfeeding for at least the first 4 and if possible the first 6 months of an infants life, and continued breastfeeding with adequate complementary food for up to two yeas of age or more. So, it is not just infants who need to be breastfed, but toddlers as well.  

The International Breastfeeding Journal has a research article titled:

Mental health, attachment and breastfeeding: implications for adopted children and their mothers by Karleen D Gribble, 2006:

What are the benefits? Some of the benefits mentions in this article include:
  • Breastfeeding calms and provides analgesia to infants, as evidenced in reduced heart and metabolic rates and a reduced ability to perceive pain during suckling
  • breastfeeding involves maternal skin-to-skin contact, which stabilises blood glucose levels, body temperature and respiration rates
  • breastfeeding involves intimate social interaction between mother and child, which may result in the release of the anti-stress hormone oxytocin
  • Oxytocin is released (in the mother) from the hypothalamus in response to skin-to-skin contact and suckling at the breast
  • The hormone prolactin is released from the pituitary in response to nipple stimulation, such as that occurring during suckling...and is thought to act on the central nervous system to promote maternal behaviour
  • The increased responsiveness of breastfeeding women to their infants is perhaps a result of the hormonal influences already described, but it may also be related to the physical closeness of breastfeeding. Breastfeeding requires frequent close physical contact between mother and child and some research has found that breastfeeding women seek greater proximity to their babies . Breastfeeding involves infant-mother skin-to-skin contact which both increases a mother's desire to be with her baby and her sensitivity to her infant
Dusty Copeland wrote a very detailed article on the benefits of breastfeeding foster children. In her article, Foster Breastfeeding she answers the question, "Why should we have foster nursing moms?"

Breast milk is the normal food for babies. The World Health Organization and Unicef1 state that where it is not possible for the biological mother to breastfeed, the first alternative, if available, should be the use of human milk from other sources." Given the precarious physical and emotional health of some babies in foster care it is possible that breast milk/breastfeeding might assist many children (Gribble, 2006)  

I think the benefits to both mother and baby are worth the hard effort involved!


References


Buckley, K. & Charles, G. (2006) Benefits and challenges of transitioning preterm infants to at-breast feedings. International Breastfeeding Journal 1:13




Moore ER, Anderson GC, Bergman N. (2009) Early skin-to-skin contact for mothers and their healthy newborn infants Cochrane Summaries

Wednesday, February 23, 2011

Getting an Older Baby to Breastfeed

There are situations when a mother has an older baby, a baby beyond the newborn stage, who is not breastfeeding. It may be an adopted baby. It may be the case of a child who has weaned and the mother wants to get the baby breastfeeding again. Whatever the reason, there are ways to help transition an older baby, or even toddler, to the breast.

Kellymom.com has some good information on getting baby to the breast. She suggests that, especially with an older baby, you think about coaxing baby to the breast. These are just a few of her suggestions:

Your goal is to coax baby to the breast. Do not attempt to force your baby to breastfeed. Forcing baby to the breast does not work, stresses baby, and can result in baby forming an aversion to the breast. As baby gets better at nursing and is able to get more milk via nursing, he will grow to trust that breastfeeding works and will have more patience when latching.

  • Lots of skin-to-skin contact can help your baby nurse better and even gain weight faster. Keep your baby with you as much as possible, and give him lots of opportunities to nurse (even if you're not successful). Get skin-to-skin with him, first when he is sleepy, right after a bottle feed (or however you're supplementing). This way baby has the opportunity to sleep and wake up happily, skin to skin at mom's chest, and mom is right there to catch the earliest hunger cues. If baby moves toward the breast and then falls asleep before even mouthing the nipple, or after sucking twice, then these are positive baby steps, not failures.
  • Carry your baby close to you ... "Wear," carry, hold and cuddle your baby as much as possible; carry baby on your hip while doing other things, play with baby, and give baby lots of focused attention.
  • Sleep near your baby. If baby sleeps with you, you'll get more skin-to-skin contact, plus baby has more access to the breast... If baby is not in the same bed, have baby's bed beside your bed or in the same room so that you can catch early feeding cues, breastfeed easier at night, and get more sleep.
  • Nipple shields can be helpful at times for transitioning baby to the breast. Talk to your lactation consultant about using this tool.
  • Comfort nursing is often the first to come, followed by nutritive nursing. Offer the breast for comfort any time you see a chance- at the end of a feeding when baby is not hungry, when baby is going to sleep or just waking up, when baby is asleep, and whenever he needs to comfort suck If your baby is actively resisting nursing, then try encouraging comfort nursing after baby is comfortable with skin-to-skin contact. After baby is willing to nurse for comfort, you can then proceed to working on nursing for "meals" as well.

    You are working to seduce your baby back to breast. Again, coax, don't force!


    There are more things you can try:

    • Offer the breast when he is not hungry.
    • Try giving him most of his feeding by bottle and then switching over to the breast.This is known as the Finish at the Breast method.
    • You can change the way you bottle feed to help the transition. There are methods of bottle feeding that are more supportive of breastfeeding.



    SNS At Breast Supplementer

    If you have tried all of the suggestions above, without success, there is another approach you can try. I will describe steps in a method that is often used to teach older infants to breastfeed. How quickly you go through these steps will depend upon how your baby is responding. You will need an at breast supplementer to do this.


    Lact-Aid At Breast Supplementer

  • First, only mom feeds the baby (both solids and bottles). Baby is always held by mom when being fed.

  • Don’t allow baby to hold his own bottle. If baby is used to holding his own bottle you may need to gradually get him used to you holding it. Put a sock over it so that it looks more like a piece of clothing than a bottle.

  • When baby is comfortable with mom holding the bottle, and being held by mom while feeding, you are ready to try the at breast supplementer (abs). The first step is to thread the tube of the abs through the bottle nipple he usually takes, and feed him that way (you can use a tapestry needle to thread supplementer tube into the nipple, it only needs to stick out a little).

  • Next, move the bottle nipple over your own nipple. Once he is comfortable sucking on the nipple with the abs over your nipple you are ready to try and move him to your breast. Toward the end of the feeding try and switch him to your breast.

  • Once you get baby to latch on to the breast directly, you may try to feed at first with the abs (even if you have a good supply) as baby may like the faster flow he is used to getting from the bottle.You can eventually wean off of the abs (usually very quickly if you have a good supply).

Here is how one mother describes her progress:

From Child of My Heart
All the next day I bottle-fed him in the nursing position. He was content, but I found it so awkward. Breastfeeding leaves you with one hand free, and I'd never really realized that bottle-feeding takes two hands! The next day I began to work on the gradual transition to the breast. My first step was to thread the tiny tube of the nursing supplementer through the same type of bottle nipple he was used to. Then I placed the bottle nipple (without the collar) over my breast for the feeding. This way Joshua got used to being against my skin, while still sucking on his familiar bottle nipple. His formula now flowed from the supplementer rather than the bottle and to all outward appearances, he was breastfeeding.

Another mother describes their progress:

From We Are Breastfeeding
During the third week, I began put the tube of an at-breast supplementer next to the bottle nipple. I planned to put this tube next to my nipple while breastfeeding so he could get more milk at the breast. He needed to get used to that idea, so I pulled the tube through the bottle nipple with a needle, and then filled the supplementer bag with milk... ...At the end of the third week I put the bottle nipple closer to my breast and then right over my breast. Then I could move him toward me into a breastfeeding position. We were almost breastfeeding even though he had not yet latched on. He got milk from me while being held in my arms. He felt my skin next to his belly. He felt my breast against his cheek. He looked into my eyes. He smiled back at me.

Sunday, February 6, 2011

Milk Sharing: Good or Bad?

There is no question in my mind, and in most people's minds: Breastmilk is better for babies than formula. Human breastmilk is specifically designed to meet the needs of human infants. There is no changing that fact. As "good" as formula has become in the last 50 years, it still has only a fraction of the ingredients that are found in breastmilk, and none of the live cells and antibodies found in breastmilk.

Clearly I am a strong proponent of breastfeeding and feel that breastmilk is the best food for human infants. Milk sharing is big in the news right now. Even the mainstream media has picked up on the buzz about milk sharing websites such as Eats On Feets and Milk Share. So why am I feeling a little it uncomfortable about the huge rise in popularity of milk sharing?

I am not uncomfortable about the risks of milk sharing. I believe that, in most cases, the risks of formula are greater than the risks of donated milk. Nancy Mohrbacher has an excellent article on this: Should Milk Sharing Among Mothers Be Encouraged?

I'm not against moms sharing milk. In fact, have used donor milk (from friends) with two of my babies. I was forced to "pump and dump" for 48 hours due to a less than ideal choice on medication by an ER doctor when my son was only 2 1/2 months old and exclusively breastfed. I had some milk in the freezer, but it wasn't quite enough to make it through. Not wanting to compromise his virgin gut, I requested some milk from a couple of friends who were currently breastfeeding. My adopted baby was on formula while I was working to bring in a milk supply for her, and I gladly accepted some donations of milk from two friends to replace some of the formula.

In some of the stories I have read about moms who have used donor milk, I got the feeling that it was "okay" to "give up" on breastfeeding, because they would be able to get donor milk for their baby. Is donor milk the new "formula"? This is a concern with the explosion in milk sharing. My concern is that moms will give up too easily thinking that donor milk is "just as good". What have moms been told for years when breastfeeding got hard? "It's okay, formula is just fine." Will the new mantra become, "I'ts okay, he will still get breast milk, and that's just as good."?

Our culture seems to sing the praises of "breast milk" more than "breast feeding". Breastmilk IS the best food for babies, but it is not the best thing for babies, that is breastfeeding. When you look at the feeding recommendations from the World Health Organization (WHO) you will find that the first choice for infant feeding is breastfeeding. If that is not possible the choices are:
  • “The second choice is the mother's own milk expressed and given to the infant in some way.
  • The third choice is the milk of another human mother.
  • The fourth and last choice is artificial baby milk (infant formula)”

So, while donor milk is certainly better than formula, it is still pretty far down the list, just one above formula. With the wide availability of donor breastmilk, all we have is another widely available substitute for breastfeeding. While most infants will do just fine on commercial formula (you don't have to go far to hear "My baby was formula fed and he is fine!"), there are babies, who for a variety of reasons, really need human breastmilk in order to grow and thrive.

Breast milk feeding does NOT have the same benefits as breastfeeding, as I talked about in my post It's Not About the Milk. Even the milk itself is not as beneficial. For example, breast milk has the highest level of antibodies when baby takes it directly from the breast, and is second-best when it is freshly pumped. The mother's body actually responds to her baby’s saliva to make milk that is just right for him. If baby is exposed to something that he needs antibodies for, this is how the mother's body “learns” to make those antibodies for him. The longer the milk is stored, the more of these antibodies are deactivated. Freezing destroys even more antibodies. (Frozen milk still provides excellent nutrition and protection for your baby, just not as good as directly from the breast or freshly pumped.)

What is needed much more than another substitute is to help the mothers who want to breastfeed to be successful. The reality is, most of the mothers who "can't" breastfeed could be successful with the right information and support. The numbers just don't work out for moms who "need" to supplement. According to the Centers For Disease Control (CDC) as of 2007, only 33% of breastfed babies are breastfed exclusively, without supplements, at three months old. This is not hard to believe when you find out that, even though only a small percentage of newborn babies have a true medical need for supplements in the first few days, currently approximately 50% of newborns born in California are getting formula supplements in the first days of life in the hospital. Moms who want to breastfeed exclusively are being set up to fail.

This issue of milk sharing is of particular interest to me. As I said before, I have given two of my babies donated milk. I have also been in the situation of being handed a newborn baby when I had no milk of my own to give. As I struggled to induce lactation I came to a conclusion: Given the choice I would rather "breastfeed" my baby with formula, than bottle feed my baby with breastmilk. Why? Bottle feeding is a feeding method, breastfeeding is a relationship.

Bottom line, my biggest concern is that all of the hype about the benefits of milk sharing will draw the attention even closer to the "breast MILK" is best idea, and away from the "breast FEEDING" is best view.

What do you think?