The Great Breastfeeding Debate

savvyhealth: What should women consider when deciding whether to breastfeed or not?

Huotari: It's always important for a woman to make an informed decision. If she takes the trouble to learn about breastfeeding, she's almost certain to do it. It is in the best interest of the baby. Every year we put out a fact sheet with articles about breastfeeding and they come from all over the world. One article about the benefits of breast milk and asthma came from New Zealand, another about pneumonia came from Brazil.

SH: Why is breast milk so good?

Huotari: The hormones in breast milk help to mature an infant's gut. If the baby is exclusively breastfed, the baby's gut will resist many different kinds of bacteria and viruses. A lot of people are examining the components of breast milk and we still don’t know exactly what they are.

SH: What are the differences between milk straight from the breast and expressed milk?

Huotari: None really. The only change is that it might not be mom giving it to the baby. The other problem might be the bottles. The World Health Organization doesn't recommend bottles at all, especially in developing countries, because bottles are difficult to clean and sterilize. In these countries, experts recommend that people give their babies milk from cups. Even premature babies. They lap it up like a kitten.

SH: What are some reasons a woman might not want to breastfeed?

Huotari: Sometimes, if a woman has been sexually abused, she may find it difficult to let a baby nurse. In these situations, therapy and counseling might be good to help her over a hump. There are very few women who have a physical reason to be unable to breastfeed. One of these might be insufficient glandular tissue, but a woman probably would suspect that she had a problem ahead of time.

If a woman had breast reduction surgery and the surgeon had to remove the nipple, the nerve endings would have been cut. In this case, when the breast fills up with milk, the nipple won't be notified to release the milk. That might be a problem.

SH: More and more women are deciding to breastfeed, why?

Huotari: One reason is because of all the new research that shows how good it is for babies' brain development. Also, last week, there was an article in the Chicago Sun-Times about contaminants found in formula. People don't want to give babies artificial food in the first place, and then this. You know that breast milk will always be right — the right temperature, the right components, nothing's going to be left out.

In the past, the increase in the number of women who were breastfeeding was among affluent, well-educated women. In the last two years, however, rates of minority mothers choosing to breastfeed have been increasing rapidly. Part of this is because the federally funded WIC program(Women, Infants and Children) is allowing a budget to promote breastfeeding in their clinics.

SH: What are some risks associated with breastfeeding?

Huotari: Unfortunately some women have lost their jobs because they wanted to pump milk or have their babies brought to them to feed during breaks at work. The government is working to remedy that.

Some employers have been quite successful in providing a room for women to go in and pump milk, wash their hands and go back to work. Some even have a lactation consultant on call. This creates loyalty from employee to employer. There have been studies showing that women are less likely to leave or change jobs if this is the case. Plus, if the babies are healthier, the moms don't need to take off as much time to bring babies to the doctor or to stay at home with sick babies. The cost for insurance companies and HMOs show that breastfed babies have far fewer doctor or hospital visits.

SH: What are some problems a woman might encounter when breastfeeding?

Huotari: It is important to latch the baby on correctly in the beginning. You just touch the nipple to the baby's lower lip and the baby will respond by opening wide, like a yawn, and then you just pull him/her right onto the nipple. It works the best in the quiet alert period right after the baby's born. It was a big mistake in hospitals up until a few years ago; they used to take the baby away from mom to put drops in his/her eyes and other things. That really interfered with the bonding that needed to go on.

SH: What should women eat while breastfeeding to provide the most nutritious milk?

Huotari: It's best to avoid gassy foods. If certain foods like broccoli or onions give a mom gas, they should be avoided. It's important that the mother eat a good diet including whole grains, fruit and vegetables. A mother doesn't have to eat meat while breastfeeding; vegetarians can provide excellent breast milk.

• Attached at the Hip: Parenting by the Book(s)