Everything you need to know about baby feeding

By Vanessa Grant on April 19, 2013
Shortly after having my son, I attended a postnatal class at the hospital where I gave birth. Although most of the women in my class were breastfeeding, many felt like they weren’t prepared for some of the challenges of nursing their children – despite having taken a prenatal class on the subject. While breastfeeding can be the most natural, wonderful experience for many mothers and babies, one baby plus one pair of boobs doesn’t always equal immediate success.

The World Health Organization and Health Canada both advise exclusive breastfeeding for at least six months. “I tell moms to aim to breastfeed for a year as long as they continue to find it satisfying and enjoyable,” says Dr. Morton Goldbach, pediatrician and assistant professor of pediatrics at the University of Toronto. Ultimately, he says that parents have to make their own decisions about what works for them.

Working through possible challenges may be worthwhile. As pediatrician, author and breastfeeding expert Dr. Jack Newman says, “every time a mother breastfeeds it’s as if silently, mother and baby say to each other ‘I love you’.”

When I talk about breastfeeding with other new moms, the sentiment is often the same: women tend to associate the ability to breastfeed with their womanhood, just as a man might associate his sperm count with his manhood. Those feelings alone are enough to start arguments, but add the overwhelming emotions of having a baby and the pressure to make all the right parenting decisions and it’s no wonder that breastfeeding is such a contentious issue. And it’s an issue that’s revisited time and again in the media.

One of the most controversial stories of 2012 was the article on attachment parenting that made the cover of Time magazine. Featuring a mother breastfeeding her three-year-old son with the headline “Are you mom enough?”, the image made just about everyone angry – including the cover girl, herself, who reportedly thought the photos made her look confrontational instead of warm and nurturing.

Last January, breastfeeding advocates were outraged when Facebook removed photos of a B.C. mom breastfeeding her daughters, calling the images sexually explicit. Since then Facebook has included a note on breastfeeding in its Warnings, explaining that photos of children actively nursing are acceptable but fully exposed breasts are not.

It was big news when superstar and People Magazine’s Most Beautiful Woman of 2012 Beyoncé was seen breastfeeding at a New York City restaurant.

More recently, a White House reporter intent on using a breast pump while at work was dismayed she had nowhere clean and comfortable to do so – despite the Obama administration’s new law that employers must provide a lactation space other than a bathroom. She wrote a story about it for Yahoo and received backlash from readers who thought she should just stay home with her baby. The subject of feeding can dominate your thoughts during Baby’s first year. Am I doing this right? Is my baby getting enough nutrition? When should I start solids? Our feeding guide will outline the basics, benefits and challenges.

Breastfeeding 101

How is breast milk made?

Females are born with milk ducts but they stay dormant – besides some growth during puberty – until pregnancy when the ducts grow and branch off, forming a network of channels and milkproducing alveoli. The hormone prolactin, which your body begins to make as soon as you deliver the placenta, stimulates the alveoli to collect proteins, sugars and fat and make breast milk.

One common breast milk misconception is that your milk doesn’t “come in” until a few days after baby is born. When your baby is born – and sometimes even during your third trimester – your body produces a protein-rich liquid called colostrum.

When your baby is a few days old, true breast milk is produced and flows into the breasts. Some women even feel a warm rush in their chest when it happens.

“In my opinion,” says Dr. Newman, “the most important reason to breastfeed is the special relationship that develops between the mother and the child. It is an intimate, physical and psychological relationship between two people who love each other.”

Common problems

In a perfect world, your tiny new baby latches onto your breast and it feels totally natural and meant to be. In reality, new mothers can expect to feel at least a little pain for the first few weeks. I was told to count to 10 when Baby first latched and if it still hurt after 10 seconds, the latch wasn’t correct.

The most common problems Dr. Newman sees are sore nipples, the baby not getting enough milk and babies who won’t latch. But none of these problems has to mean the end of breastfeeding. With a little determination and support from a doctor or lactation consultant, most problems can be overcome.

Certified lactation consultant Cindy Battaglia says that getting support early is important, as is finding a support person you click with. “It’s a very special relationship,” she says. Even more important, she says, is sticking with it, even when things aren’t going well. “Don’t quit on your worst day,” she advises.

Comedian Tina Fey found it challenging. As she writes in her memoir Bossypants, “Over the whir of the milking machine, I could almost hear my baby being lovingly cared for in the other room.” After seven weeks of pumping breast milk for her daughter who never latched correctly, she became depressed.

Without the right support from a doctor or lactation consultant, problems with breastfeeding can lead to exhaustion, says Dr. Goldbach. “A mother’s mental health and wellbeing are very important,” he says.

Bottlefeeding basics

Whether you’re formula feeding or using a breast pump to express breast milk, bottle-feeding has its share of benefits and challenges, too.

Formula is made with cow’s milk that is altered to simulate breast milk. Carbohydrate, protein and fat levels are made to match those of breast milk and vitamins and minerals are added. Like breast milk, formula provides all the nutrients needed until babies are six months old.

Benefits of bottle feeding

While some doctors may not see a point to expressing milk while breastfeeding exclusively, many moms find it hard to be attached to their baby 24/7 and want to have a date night with their partner or get a pedicure. And a short break from Baby may help a tired new mom feel refreshed. If you’re formula feeding, dad can share bottle duty, which may help you get some much-needed rest.

Sometimes formula fed babies sleep longer than breastfed babies. This is because formula takes longer to digest than breast milk. Keep in mind, this is only if Baby is waking from hunger. Your formula fed baby may still wake often for a cuddle.

Bonding with a bottle

Skin to skin contact is important for all babies, breastfed or not. And feeding time is perfect for some skin-to-skin bonding. So even if you’re using a bottle, undress your newborn and lift your shirt, then cozy up under a blanket.

Introducing solids

You may have heard the phrase “food before one is just for fun” but this isn’t entirely true. By between six and nine months of age, babies need iron from sources other than breast milk or formula. Most doctors suggest starting solids around six months when Baby starts to show an interest in your food.

Although some babies may do just fine on breast milk alone until nine months, according to the International Breastfeeding Centre, starting solids is an important developmental milestone. If started too late, your baby may have trouble adjusting and accepting solid foods.

Baby led weaning

Around six months old, little ones use their newly-honed skill of reaching and grabbing to, well, reach and grab everything that captures their fancy. It’s around this age (and often earlier) that babies also become fixated on food and watching you eat.

Baby led weaning encourages parents to skip traditional baby foods and purées and let babies chew on hunks of food either from parents’ plates or prepared specifically for baby. The term was coined by a health professional in the UK where weaning doesn’t mean removing breast milk, but adding solid foods to a baby’s diet.

The idea is that once babies have developed the skill of grabbing something and putting it in their mouth, they’re ready to gnaw or chew on solid or soft-cooked foods. Baby led weaning allows babies to show you when they’re ready – and, if you let them, to choose which foods they like best.

Whether you’re feeding your baby purées or solid pieces of food, your little one should be supervised and learning infant first aid and CPR is always a good idea.

Is nipple confusion a myth?

Ah, nipple confusion. When a baby begins to prefer a bottle or pacifier over the breast. Experts are divided on the issue, but Dr. Newman says it is more likely to happen in babies who haven’t mastered breastfeeding, when a mother has low milk supply or a slow flow from the breast. When this happens, he recommends using a lactation aid and avoiding the use of pacifiers.

You can also try products that have been designed to replicate actual breast action.

Share and share alike?

Women who can’t breastfeed for medical reasons, or perhaps because they’ve adopted an infant, may get breast milk from a milk bank. There is one milk bank in Vancouver and another coming to Toronto. Donors are screened for diseases and infections, and often milk is pasteurized before being given to a family in need.

But what about women whose milk supply is a little low or who have trouble pumping? There’s a growing trend among moms to share pumped milk on a casual basis. Have a friend with litres of milk in the freezer but you’re struggling to pump enough to go on a date with your husband? Friends are sharing their supplies.

Although Health Canada and the Canadian Paediatric Society advise against informal milk sharing, Dr. Newman recommends milk sharing if it’s needed. In order to ensure that the milk you give your baby is safe, Dr. Newman advises mothers to flash heat or pasteurize the milk before feeding it to Baby. This can be done at home with a liquid safe thermometer and a double boiler.

Vanessa is a Toronto-based editor and writer with a very hungry nine-month-old boy.

By Vanessa Grant| April 19, 2013

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