Sunday, July 29, 2012

Increasing Breastfeeding Rates

In the United States, only 14.8% of babies are exclusively breastfed at 6 months, according to the CDC's 2011 Breastfeeding Report Card. We have the lowest exclusive breastfeeding rate in the Western world. Why is this, and what can we do to improve these rates?

In my opinion, the U.S. exclusive breastfeeding rate is so low due to lack of breastfeeding education and normalization. In this country, many people still feel that breastfeeding is somehow sexual and abnormal, and public and extended breastfeeding are seen as extreme. Another issue stems from the aggressive and misleading advertising of breast milk substitutes.

Below is what I believe are some steps that can be taken to increase breastfeeding rates:

*The U.S. needs to sign on with the World Health Organization's International Code of Marketing of Breast-milk Substitutes. The code is the "international public health recommendation to regulate the marketing of breastmilk substitutes." The code mandates explanation of the risks of inappropriate feeding methods, the social implications and costs of breastmilk substitutes, prohibits samples of breastmilk substitutes and promotion of infant formulas by healthcare providers, etc. To view the code in its entirety, please view this PDF

* Normalization of breastfeeding and education about breastfeeding prior to pregnancy are vital. I personally feel that we really need to strive to normalize breastfeeding in our culture. This means nursing in public, nursing without a cover, and nursing with no shame! Breasts are not just sexual organs, they serve to feed our infants, no cover required. The more women see breastfeeding, the more normal it is and the more knowledgeable women will be when they give birth and breastfeed their own children. In many cultures, breastfeeding problems are extremely rare. This is because women are used to watching other women breastfeed and have learned the techniques via observation. I also believe it is important to teach the importance of breastfeeding when covering pregnancy and childbirth in middle and high school sexual education classes. This will aid in normalization of breastfeeding and help make more people aware of the many amazing things breastmilk does for the human body.

*Promotion of natural childbirth, leaving the baby whole and attachment theory. Although interventions can be necessary in certain circumstances, most women can have normal natural births with no complications. This is important because we know that interventions such as the epidural and ceserean sections both effect latching on after birth and can have long lasting negative effects on the nursing relationship. Leaving your baby whole, meaning not circumcising him/her, can be very beneficial to nursing relationships. Research has found that circumcision negatively effects breastfeeding and is associated with refusal to latch, which in turn can lead to decrease in milk supply. Attachment theory is also important. Encouraging immediate skin to skin contact after birth and immediate breastfeeding has far reaching benefits for mother and baby. Rooming and on demand feeding are also invaluable. On demand feeding encourages proper milk supply, helps baby and mother establish a stable feeding relationship, and also helps any problems be recognized early on, therefore increasing chances of breastfeeding success.

*Experienced IBCLCs on staff at all hospitals. I unfortunately know how damaging it can be to have an inexperienced lactation counselor "help" you when you are having trouble nursing. I remember her trying to force my son onto my breast while he was screaming and crying and basically telling me I was doing it right. Had there been a good IBCLC on staff, we could have solved my son's latching problem in the hospital and spared me the pain of exclusively pumping and drying up prematurely. Sadly, my story is not rare, but this experience can be prevented! Having experienced IBCLCs on staff and available to women as needed is indispensable. Better yet, Medicaid should cover lactation consultants.

*Normalize donor milk and wet nursing. Before formula, if a woman could not nurse for whatever reason, her fellow women would help her out by nursing her baby. With modern day living, wet nursing isn't as easy, but it and donor milk should be encouraged. We do have some great organizations like Human Milk 4 Human Babies, Eats on Feets and Milkshare working hard to bring donor milk to mothers around the globe, but there is still much to be done. We should encourage women who have oversupply or extra milk to donate their milk to babies in need. Every drop of breast milk a baby receives counts, and you could save a life!

*Finally, a better formula needs to be made. Realistically speaking, there are women who really truly cannot breastfeed for a variety of reasons. However rare they may be, they are out there, and until we make huge scientific leaps that will enable these mothers to nurse or until there are enough milk donors in the world to feed all the babies with mothers unable to nurse, a more nutritionally complete formula must be developed. Today's formula is still lacking in many ways. Synthetic vitamins and minerals and GM ingredients are very common. Formulas lack sufficient probiotics, human growth factors, white blood cells, antibodies, etc. We do need to make large leaps in the scientific sector, but I believe that at this moment in time there are plenty of ways we could improve infant formula like using whole food vitamins and minerals that are bioavailable, using organic ingredients, etc.

I truly feel that if we could make at least a few of these changes, we would see huge increases in exclusive breastfeeding rates!

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