REBECCA B. SINGSON, M.D, FPOGS

In a third world country such as the Philippines where more than 50% of the population live below poverty line (defined in terms of a least-cost consumption basket of food that provides 2,016 calories and 50 grams of protein per day and of nonfood items consumed by families in the lowest quintile of the population) it is so disheartening, not to mention shocking to know that the minimum wage earner spends 26% of his wage buying formula milk when breast milk can guarantee less malnutrition, less diarrheal and upper respiratory infections for the neonate translating to less hospitalizations and best of all is available at no cost at all.

DID YOU KNOW?

Breastmilk is such a dynamic fluid that it is absurd to think that any brand of formula milk can even come close to it. The main proteins in milk are casein and whey (the more digestible between the two). The proportion of whey to casein differs in colostrum, in mature milk and in late lactation. The composition of breastmilk also varies during the time of the day and during the feeding. The hind milk (in the latter part of breastfeeding) has a much higher fat content than milk produced during the beginning portion of the feeding.(1) In fact, if your baby was premature, your breastmilk has a composition appropriate for premature babies. Furthermore, the odor and/or taste of breastmilk may change depending on the mother’s diet. Food preferences in adulthood are apparently developed in infancy so breastfeeding may actually help infants get used to different tastes and help prevent them from being picky eaters when they grow up.(2) How can any artificial milk formula duplicate these properties?

So dynamic and perfect is breastmilk as your baby’s food that you don’t need for any formula, glucose water, water, pacifier, teas, juices or vitamins during the first six months. Human milk has over 300 ingredients, including interferon, white blood cells, antibacterial and antiviral agents, while formula has only 40 ingredients. Breastmilk favors the growth of beneficial bacteria so breast-fed infants have a level of lactobacillus that is typically 10 times greater than that of formula-fed infants. This is the reason why they are better protected against diarrheal diseases. Because of the protective antibodies, your baby will have a much lower incidence of pneumonia and urinary tract infection if fed with breastmilk. In fact, adding formula milk in the first three months of life has been proven to triple the baby’s risk of getting admitted in the hospital for pneumonia (3). Furthermore, infants fed formulas of intact cow’s milk or soy protein compared with breast milk have a higher incidence of atopic dermatitis and wheezing illnesses in early childhood.(4)

BREASTFEEDING PROTECTS AGAINST CANCER

Did you know that breastmilk goes even so far as protecting the child from cancer before the age of 15? The risk of artificially fed children was 1-8 times that of long-term breastfed children. (5)  And if that’s not reason enough for you, breastfeed for your own sake because breastfeeding confers some protection to you against uterine cancer (6), ovarian cancer(7) and breast cancer if you breastfeed for at least 2 years (but some benefit is already seen even if you only breastfed for 6 months). A study by Yale University researchers showed that women who breastfed for two years or longer reduced their risk of breast cancer by 50 percent (8).

LOCAL RESEARCH

In Baguio General Hospital & Medical Center (BGHMC), research shows that when they shifted over in 1975 from a practice of separating the mother and infant immediately after birth to a policy of immediate rooming in and breastfeeding, within two year time, breastfeeding increased from 40% to 92%. This simple practice also brought a dramatic reduction of mortality and morbidity because by 1977, the incidence of diarrhea droped from 27.5 to 1.5 per 1000 newborns and the mortality rate from diarrhea dropped from 8 per 1000 babies to none at all!(9)

KILLING THE INSTINCT TO BREASTFEED

Living in a civilized society has also killed our human instinct to breastfeed. Women are embarrassed to breastfeed in public and people are likewise uncomfortable to see a woman breastfeeding in public. Hospitals whisk out the baby to the nursery soon after birth separating the mother and baby. Although the Dept. of Health has implemented the Baby Friendly Initiative among hospitals to mandate rooming in immediately after birth, patients are made to sign waivers, oftentimes, without even explaining to them that the document they are signing is a consent NOT to room in the baby to actually allow milk formula to be given to their babies. In fact, soon after birth, the pediatrician is already discussing with the Mom what milk formula she would prefer to give the baby!! Family support is so hard to find since the now Mom’s own mother will discourage her from breastfeeding with words like “Bakit magpapakahirap ka pa eh may bote naman!” Many of our common practices with babies end up driving a wedge between Mommy and baby and keeps them separated. We create a separate Nursery room in the house for baby to stay in with her crib. We use a stroller to transport the baby instead of carrying her on a harness or sling like tribal societies do so the baby can sleep and breastfeed at will.

LACTATION SUPPORT

It is important that women feel supported during breastfeeding since many insecurities about her motherhood abilities surface when the going gets rough. Breastfeeding can cause a lot of distress to a Mom when her baby continues to cry despite giving her breast. Babies cry for many other reasons than hunger but Moms usually misinterpret this to mean, “I don’t have enough milk. My baby is starving.” The mere anxiety will interrupt the release of hormones that cause the letdown reflex of breastmilk thereby, decreasing the milk supply. In fact, research in Sweden has shown that every second mother experienced transient lactation crises on at least one occasion (the crisis group). The crises were mostly caused by emotional disturbances in the mothers (e.g. anxiety, stress and discomfort), or by the infant’s refusal to suckle, by unmotivated crying, or by illness. Within the crisis group no significant difference was found between the infants’ intake of breast milk during the crises compared with control measurements one week later. Nor had the crises any immediate impact on the growth of the infants. (10)

Research has shown that lactation counseling improves the rate of breastfeeding of women. (11)

The key to successful breastfeeding is the right preparation prior and during pregnancy, constant hydration and supplementation to sustain it, and when the going gets rough, seeking help from lactation therapists or other more experienced fellow breastfeeders.