Benefits of Breastfeeding

Breastfeeding Module – HUG 2121 This essay will explore various factors within breastfeeding, it will focus on the long and short term health benefits of breastfeeding, for both the mother and baby it will also discuss the reasons why women chose not to breastfeed, especially within the western society. Contributory factors such as social, psychological, cultural and political all contribute to the reasons women chose to breastfeed or not. WHO (2011), suggests that breast milk provides the necessary nutrients for up to the second half of the infants first year , and it also promotes sensory and cognitive development, and protection from infections and chronic illness. Breastfeeding has been also promoted by various studies and organisations and is said to be the healthiest and most effective way of feeding your baby, it not only increases bonding with the baby, but it also helps the mother to keep track of their babies health. Dykes (2002:98) The world health organisation(WHO) recommends that â€Å"mothers worldwide to exclusively breastfeed infants for the child's first six months in order to achieve optimal growth, development and health†. There are many advantages associated with breastfeeding your baby, such as low risk of child obesity, which in turn usually leads to type 2 diabetes  in later life and a low risk of acquiring other health problems such as eczema. Miller (1991:76). Breast milk also contains valuable antibodies from the mother that may help the baby resist infections, so this means the baby is not at a high risk of acquiring disease. There are various factors that influence the initiation and maintenance of breastfeeding, Earle (2002) recognises some of these factors, as the way the mother identifies herself, the fathers understanding on infant feeding, the personal factors involved and the sexualisation of breasts. The politics of breastfeeding is explained in detail by, Counihan (2008:467) stating that political obstacles include the â€Å"marketing practices of instant formula manufacturers†, and how such factors appear to have a positive impact on the choice women make in order to breastfeed or not. The article goes on to reflect breastfeeding rates in the UK; and the health benefits of breastfeeding for the mother as well as the infant. Despite attempts to reiterate to general public that ‘breast is best’, breastfeeding is still very much low in the western society (UNICEF, 2005). Protheroe et al (2003) discuss the issues behind this and explain the evidence that shows the health benefits of breastfeeding. Protheroe et al, (2003) also suggest that breastfeeding allows babies to have a better start in life than those who are formula fed. Due to both the short and long term health benefits associated with breastfeeding, Protheroe et al (2003) continues to argue that the main development of the infant is dependent on the nutrients breast milk provide. Breastmilk does not contain any extra ingredients that may cause the baby to have problems digesting it, so it is less strenuous for the baby. According to Allen and Hector (2005:42), they suggest that breastmilk is â€Å"uniquely engineered† for babies and that, it is biologically and naturally the correct way to feed babies. They also, argue that unlike formula milk breastfeeding has a vast number of health benefits for both mother and baby. Alexander et al. (2009:158) supports this claim and explains that breastfeeding provides a vast number of health benefits, â€Å"including protection against many acute and chronic diseases as well as advantages for general health, growth and development. UNICEF suggest that babies who are fed using breast milk substitutes have an increased risk of acquiring infections and diseases such as gastroenteritis, urinary tract infections, respiratory or chest infections, ear infections, and even childhood leukaemia and possibly sudden infant death syndrome, or cot death. Allen and Hector (2005:44) support this, and explain that breastfeeding â€Å"has been shown to be protective aga inst a large number of immediate and longer term health outcomes that are a significant burden on individuals, the health system and society. It is also suggested that babies who are breastfed are bound to have better neurological development. However, a study carried out by Holme et al (2010), aiming to establish the effect of breastfeeding on neurological development, does not support this study. They came to the conclusion that breastfeeding is not associated with intelligence quotient (IQ) and that â€Å"maternal and socio-economic characteristics† are particularly influential. Babies who are breastfed are also protected against diabetes mellitus. Whitney et al, ( 2010 ), breastfeeding is also associated with defending babies from long term ealth problems and disorders of the cardiovascular system as well as obesity, a very huge problem that most Western societies are finding difficult to control. Due to this factor alone, it is very important that breastfeeding is more w idely promoted and advised, with sufficient support systems for mothers who are breastfeeding or considering it. This will not only reduce the health issues associated with breastfeeding, but it will promote the health benefits involved. UNICEF (2011) suggests that there may be a link between breastfeeding and protection against multiple sclerosis, acute appendicitis and tonsillectomy. However, research within this area is still very limited, and nothing has been done to prove this may be true. Breastfeeding does not only benefit the health of the baby, but mothers who breastfeed have a reduced risk of multiple diseases and illnesses; such as, breast and ovarian cancer and osteoporosis. Breastfeeding also increases involution, whereby the mothers figure is most likely to return to normal, after pregnancy. Insel et al. (2009:538) support this, stating that breastfeeding stimulates uterine contractions, which aid in the uterus returning back to size. This is a very important factor to recognise especially for many mothers, due to the pressures associated with body image. If mothers are made aware of such benefits of breastfeeding, they may be more likely to breastfeed in order to promote the health and wellbeing of their baby and themselves, and maintain their figure. In addition breastfeeding means that mother and child are able to bond effectively; Insel et al. (2009:538) also state that if the baby is placed onto the breast instantly after delivery, these uterine contractions are able to control the level of blood lost in birth. Additionally by consuming a healthy diet, the mother is also able to understand and monitor any possible causes of any allergic reactions, infections or illnesses the baby develops. Lauwers and Swisher (2010:428) explain that exclusively breastfeeding, the breastmilk coats the baby’s intestinal tract with components in the breastmilk that ultimately prevent foreign proteins from entering the baby’s system and causing any allergic reactions. Pryor (2010:4) also suggests that the role of breastfeeding is very important especially if a mother and baby are bonding. This study showed that babies that interacted more with their mothers, stayed warmer, and cried less. It was also found that, although there were some difficulties to measure, if there was early skin-to-skin contact, there is still a very high possibility that breastfed babies were more likely to have a good early relationship with their mothers. A study conducted by Riodarn et al, (1998 ), shows that, breastfeeding rates within the United Kingdom (UK) are the lowest in both the developed world and Europe. Additionally the Infant Feeding Survey, from 2000 to 2005, found that the number of babies who were breastfed within the UK increased by 7 per cent and in both Scotland and Northern Ireland the initiation rates were raised by 8 per cent and only 7% in England and Wales. Although the statistics show a small rise in the number of breastfeeding mothers in the UK the number is still very low. Studies have found that most women, who do breastfeed, are usually from upper-class families whereas most economically disadvantaged women and teenagers continue to bottle feed their infants. Bryant et, al (1999:79). Efforts to improve breastfeeding initiation and duration among low income women have been tried however no success has been met. Therefore, it is important that an effort must be made to address the reasons for this problem and to identify breastfeeding promotion strategies that will overcome the barriers that are negatively influencing breastfeeding decisions in these particular populations. A lot of the women from low socio economic backgrounds, who chose not to breastfeed, is not because they just don’t care, but mostly because they live in an unsupportive or work in a non supportive environment. Other reasons why they do not breastfeed are that in low income women, their reasons not to breastfeed are closely related to social and cultural beliefs. Various studies have revealed that main issues that women from low income societies face, are that they are modest and embarrassed and the restrictions on their lifestyles, also play a huge role. Hartley,et al (1996:87). Other women however complained of physical discomfort and inconvenience. Some studies also found that some economically disadvantaged women feel a lack of confidence in their ability to produce an adequate quality or quantity of breast milk Marcus (2007). Living in a particular society usually influences many of your life choices, so if not breastfeeding is the cultural norm, for people living in these environments then chances of them breastfeeding is low. NICE, also suggests that in the UK alone most factors that also contribute to women overall not breastfeeding apart from the influence of society and culture, is the lack of continuity of care in the health services, clinical problems and the lack of preparation of health professionals and public in general to support breastfeeding effectively. Health care professionals also have a huge impact on women’s choices to breastfeed. The WHO and UNICEF launched the Baby Friendly Hospital Initiative in 1991, in order to provide information, support and assessment for health care workers in order to promote and encourage breastfeeding. This programme is very useful especially to new mothers because another reason why the rate of breastfeeding is low in the country is because; some women just don’t have enough information about it. This programme not only allows health professionals to encourage mothers on their own, but to also have the government to back up what they are saying. Arnez, et al (2004:67). Fletcher,et al(2000:98) however also suggests that whilst some women do have the information and are educated on all the reasons as to why breastfeeding is better, most women however usually just do what their, peers, parents or friends do. This suggestion is also supported By NICE, who also note that â€Å"a pregnant woman considering how to feed her baby may be influenced, positively or negatively, by the experiences of her friends and family, messages in the media, and the advice of her midwife and GP. Adequate advice is especially important for mothers because, although the choice is ultimately theirs, it is important for health professionals to know that they have given the mother as much information as possible and support in whatever decision they make. Riodarn, (2005:83) For the mothers who do chose to breastfeed, some of them end up discontinuing in many cases the reason being is that the mother’s report of ‘insufficient milk’ Ham lyn et al. (2002:54). This reason of not having enough milk may be influenced by the baby’s behaviour, the input of health professionals, the views of family and friends, and the mother’s own self-esteem, as well as clinical problems with feeding. If the mother feels as if she is not producing enough milk to feed her baby, then she can easily change to formula milk because, the stress of her thinking that the baby is starving would pressurise her to doing so Fletcher, et al (2000:43). It is especially important in situations such as these, that health professionals play a huge role in supporting the mother, because they are various reasons that can lead to such problems, so advice and a health knowledge would be needed. In most cases women tend to think this way because breast milk digests faster than formula milk, so the baby becomes hungry more often. So the support and advice from health professionals would help the mother to understand and not worry about this problem, Hartley et al (1996:31). It is very rare for anyone to suffer from not producing enough milk however, this is one of the main reasons why most women stop breastfeeding. Miller (1996:50) Suggests that it is especially women from low income backgrounds that usually use this as a reason to stop breastfeeding. However this can be argued that this excuse can be used by all women. A number of investigators suggest that this, is a condition that â€Å"spans a bio psychosocial continuum from a rare physiological situation to a condition embedded in psychological and social circumstances† Kumar, (2008:72). This method of encouragement was shown to have the greatest impact on women’s choice to breastfeed. The baby friendly initiative hospitals also support this and statistics show that these hospitals had increased their breastfeeding rates by more than 10% by comparing the year receiving Baby Friendly accreditation with four previous years, before they had the accreditation. In teenage mothers the need of support to initiate breastfeeding is prevalent, in most cases this is due to the vast influence young mothers get from the media, and the pressure from society. Appearance also plays a huge role in most women who decide to either breastfeed or not Scott, et al (1999:12). Most young mothers think that breastfeeding will make them socially unacceptable and make their breasts saggy. Most teenagers follow the media very closely and celebrity culture, so when they see or hear about certain things that their favourite celebrities have done they tend to follow in those footsteps. Teenagers are not the only population that the media influences in this particular area. In 2001 breastfeeding obtained a large amount of negative and controversial media coverage, when a woman was removed from a Delta Airlines flight because she refused to cover her child whilst she was breastfeeding (Marcus, 2007). Last  year,  famous  media  icon, Barbara Walters commented to millions of viewers, that â€Å"a breastfeeding woman made her feel uncomfortable while on a flight, Curran  (2006). Attitude such as this can influence women to not breastfeed, because they may start to feel embarrassed doing it. Although these are the most reasons why women do not breastfeed, other reasons may include sore nipples, or the pressure on going back to work. In some cases women chose not to breastfeed because they feel, the father of the baby would benefit from bottle feeding so that he too can get some sort of bonding with the baby during feeding, Curran (2006:12). Women often complain that their partners do not get to experience the same bond they do whilst feeding, Hollander (1995). Other health benefits said to be associated with breastfeeding are that minerals such as iron are present and lower in breast milk than in formula, so the minerals in breast milk are more likely to be completely absorbed by the baby Kumar, ( 2008:70 ). However In formula fed babies, the unabsorbed portions of minerals can change the balance of bacteria in the gut, which gives harmful bacteria a chance to grow, Foster (1995:45) this can often can cause constipation and lead to harder odorous stools than breastfed babies. In cases where women find that breastfeeding makes their nipples sore, it’s very important for health professionals to give them the relevant support and education on how to treat this problem. Most sore nipples can be helped by changing how the baby is attached to the mother’s breast, so talking to someone who has had specialist training in giving women support and information on baby feeding, would help. Midwives, health visitor or other specialist are also able  to help the mother, however it’s important for the mother to know that this information is readily available to them. The stigma attached to breastfeeding especially in the UK, has caused a lot of women to be cautious about it compared to other countries. The WHO statistics show that women in Asia and Africa are more comfortable breastfeeding compared to the Western Society. This information shows that although the women in England live in a country where healthcare and information is easily available to them compared to developing countries, their surroundings influence their decisions greatly. However women from other parts of the world such as Asia and Africa, do not particularly have media influences. Other reasons why Western countries have less women breastfeeding may be because, they have the formula milk easily available to them and it’s more convenient to their lifestyles. Formula feeding your baby especially in Western countries seems to be more ideal because of most work schedules and time off work given after the baby is born. In western culture a women’s breast is very closely associated with sex, so in most cases when a women is seen to be breastfeeding especially in public this is deemed as inappropriate Marcus, (2007). Most men also do not want to see their partner’s breastfeeding in public, because of the confusion over sexual role of the breast. If we compare this attitude to other countries, most women and men have strict rules on sex exposure and attitude. For example in Africa the majority of women that do have children are married and the number of teenage pregnancies is very low, so already the type of women that do get pregnant are usually young and married. Their culture on pregnancy, marriage and breastfeeding is also in most cases taught to them from a young age and it becomes a part of their culture. If the women’s grandmother and mother, both breastfed their babies they teach the daughter to do so, and because this is something that is taught growing up, it becomes the right choice for them. Having strong cultural beliefs has shown to have a huge impact on people particularly from this population, because they do not want to seem rebellious if they chose to do anything different from what they have been taught. Hollander, (1995) So in other words in most non Western countries the option to choose between formula milk and breastfeeding your baby is rarely given. In western culture however, because individuals tend to do their own thing and the choice for them to breastfeed or not is there this gives, the mother opportunity to weigh out her options on what suits her and baby. If her everyday life requires her to be busy perhaps finding the time to sit down, and relax and feed may seem impossible. Breastfed babies eat more often than bottle-fed babies because the fats and proteins in breast milk are more easily broken down than the fats and proteins in formula, so they are absorbed and used more quickly Kumar, (2002:90). This then means that the mother would have to breastfeed a lot more than she would with formula, so in a fast moving environment again this may not be ideal. In past years the facilities to actually breastfeed within the UK were very few, if women wanted to breastfeed their babies they were forced to either go and do it somewhere private or stay within their homes. It was only in 2010 that an equality act was carried out and passed to allow women to breastfeed anywhere, and to get public places and work places to facilitate this. In other cultures image concern is not as high as it is in the western culture so there are less cautious about it. Overall breastfeeding is a very important and extremely beneficial point to consider for all women and healthcare providers. BIBLIOGRAPHY Anderson, A. K. , Damio,  G. , Young, S. , Chapman,  D. , Perez-Escamilla,  R. (2005). A   Randomized  Trial  Assessing the  Efficacy  of Peer Counselling  on Exclusive  Breastfeeding   in  a  Predominantly  Latina  Low-Income  Community. Arch  Pediatrics  Adolescence   Medical,  15, 836-881. Arenz S, Ruckerl R, Koletzko B et al. 2004) Breastfeeding and childhood obesity: a systematic review. International Journal of Obesity. Bryant C, Coreil J, D’Angelo S, Bailey D, Lazarov M. (1992) A strategy for promoting breastfeeding among economically disadvantaged women and adolescents. NAACOGS Womens Health Nurs. 1992;3:723-730 Breastfeeding Among U. S. Children Born (1999),(2005), CDC National I mmunization Survey: 1999–2005. Centers for Disease Control and Prevention; Atlanta: 2005 Curran,  J. (2006). Online  Update:   â€Å"Nurse-ins†Ã‚  planned  over ejection  of breast-feeding  N. M   mother. Las  Cruces  Sun-News. http://lcsun- news. om/portlet/article/html/fragments/print_articlejsp? articleID=469 Counihan, C. (2008) Food and Culture: A Reader 2nd ed. New York: Routledge Dykes F. Western medicine and marketing: Construction of an inadequate milk syndrome in lactating women. Health Care Women Int. 2002;23:492–502. EU (2004) Promoting, protecting and supporting breastfeeding: an action plan for Europe. Luxembourg: European Commission, Directorate for Public Health and Risk Assessment Earle, S. (2002) ‘Factors affecting the initiation of breastfeeding: implications for breastfeeding promotion’ Health Promotion International 17 (3) 205-214 Foster K, Lader D, Cheesbrough S. , Infant feeding (1995), The Stationery Office, London 1997 Fletcher, D, Harris, H, The implementation of the HOT program at the Royal Women's Hospital Breastfeeding Review 2000, 8 (1): 19-23 Hamlyn B, Brooker S, Oleinikova K et al. Infant Feeding (2000). Department of Health, the Scottish Executive, the National Assembly for Wales and the Department of Health, Social Services and Public Safety in Northern Ireland. London: The Stationary Office, 2002 Houston MJ (1984) Home support for the breast feeding mother. In: MJ Houston, editors Maternal and infant health care. Edinburgh: Churchill Livingstone. Hartley B, O’Connor M. (1996)Evaluation of the â€Å"Best Start† breastfeedingeducation program. Arch Pediatr Adolesc Med. 150:868-871 Insel, P. , Turner, R. E. & Ross, D. (2009) Discovering Nutrition 3rd ed. Boston: Jones and Bartlett Publishers Inc. Lauwers, J. & Swisher, A. (2010) Counseling the Nursing Mother Boston: Jones and Bartlett Publishers Inc. Marcus, J. A. (2007,). Lactation  and the  law. Mothering (143), 48-57 Miller NH, Miller DJ, Chism M. Breastfeeding practices among resident physicians. Pediatrics 1996;98:434–437. Pryor, G. 2010) Nursing Mother, Working Mother: The essential guide to breastfeeding your baby before and after you return to work Sydney: Read How You Want Large Print Books Protheroe, L. , Dyson, L. , Renfew, M. J. , Bull, J. & Mulvihill, C. (2003) ‘The Effectiveness of Public Health Interventions to Promote the Initiation of Breastfeeding: Evidence Briefing’ National Health Service : Health Development Agency Kumar A, Kumar Rai A, Basu S, Dash D and Saran Singh J. Cord Blood and breast milk iron status in maternal anemia. Pediatrics. 2008: 121(3); e673-677. Accessed 5/29/2010. Kramer MS, Kakuma, R 2002. Optimal duration of exclusive breastfeeding. Cochrane Database of Systematic Reviews 2002, Issue 1. [Art. No. : CD003517. DOI: 10. 1002/14651858. CD003517] Riordan J. Breastfeeding and Human Lactation. 3rd. Jones and Bartlett Publishers; Sudbury, MA: 2005. Scott JA, Binns CW. (1999) Factors associated with the initiation and duration of breastfeeding: a review of the literature. Breastfeed Rev 1999; 7: 5–16. Scott JA, Shaker I, Reid M. Parental attitudes toward breastfeeding: their association with feeding outcome at hospital discharge. Birth 2004; 31: 125–31 UNICEF UK Baby Friendly Initiative. Baby Friendly hospitals show strong increase in breastfeeding rates. Baby Friendly News No. 6, July 2000. World Health Organization (2003) Global strategy for infant and young child feeding. In: Organization WH, ed. Geneva: World Health Organization. Whitney, E. , DeBruyne, L. K. , Pinna, K. & Rolfes, S. R. (2010) Nutrition for Health and Health Care Belmont, USA: Wadsworth World Health Organisation (2011) Breastfeeding http://www. who. int/child_adolescent_health/topics/prevention_care/child/nutrition/breastfeeding/en/index. html [accessed 7 May 2011] *