The Benefits to the Mother Are Related to the Breastfeeding of Infants - Literature review Example

Lactation – the ability to produce, secret, and eject milk – is one of the most defining features of the mammal species. The mammary glands are organs that produce milk for the nourishment of the young. Medical experts agree that breastfeeding or consumption of human breast milk is by far the most nutritional/ beneficial form of feeding for newborn human babies. In regards to infant nutrition, the World Health Organization (WHO) states: As a global public health recommendation, infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health. Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to two years of age or beyond (WHO - p. 7). The mother’s bloodstream and bodily stores primarily constitute its nutrient content which is relatively stable. Proteins, carbohydrates, fats and oils, minerals, vitamins, and water are vital nutrients the human body must have in order to function properly. 448 milliliters of human milk provides a baby 12 to 24 months of age with the following minimum daily requirements: energy-29%, folate-76%, protein-43%, vitamin B12-94%, Calcium-36%, vitamin C-60% and vitamin A-75% (Picciano). Breast milk contains these essentials and a vast array of other nutrients, vitamins, and minerals which include: Macronutrients, Manganese, Vitamin B12 & B6, Vitamins A, C, D, & K, Full antibody repertoire, Memory T cells, Antioxidants, Iron, Riboflavin, Thiamin, Magnesium, Phosphorus, Potassium, Chromium, Copper, Fluoride, Iodine Lactoferrin, and Insulin (Hamosh, 70-75). For the baby, breastfeeding provides superior nutrition, promotes higher intelligence and contains immune building /boosting nutrients such as lactoferrin and immuno-globulin which counteract microorganisms as well. Long term health benefits include less chance/reduced risk of acquiring life threatening diseases (diabetes, infections, allergies, obesity, SIDS, etc.). Breastfeeding is holistically (physiological and psychological) beneficial for the infant. Does this hold true for the mother? Based on the aforementioned nutrients breast milk contains, it could be equated to precious gold in food form. If the benefits are paramount for the baby’s health, then stands to reason it would have to be equally beneficially if not more so for the provider – the mother. WHO further proposes that breastfeeding “is also an integral part of the reproductive process with important implications for the health of mothers (WHO – p. 7).” Numerous studies and supportive literature certainly contends that breastfeeding is by far beneficial for the mother as well. Specializing in breastfeeding education and promotion, Dr. Alicia Dermer is a Clinical Associate Professor in the Department of Family Medicine at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School (New Brunswick, NJ). She has published several articles/reviews on breastfeeding among them “Breastfeeding and Women’s Health (1998)” and “A Well-Kept Secret - Breastfeeding's Benefits to Mothers (2001).” Dr. Dermer explicitly details the benefits to the mother and most importantly argues that information regarding these benefits have seemingly been deliberately kept from the mothers thereby contributing to “a worldwide decline in breastfeeding (Dermer, 1998-p.427).” Dermer purports that a mother’s uniformed choice to breastfed is primarily based on the health benefits to the baby not to herself. She states: The emphasis many health care workers place on the infant health benefits during prenatal teachings reinforces. By comparing breast milk to formula rather than comparing the process of breastfeeding to bottle feeding, both medical literature and parent education literature minimize the importance of breastfeeding to the health the mother (1998, p.427). Very few people are unaware of the benefits of breastfeeding for babies, but the many benefits to the mother are often overlooked or even unknown. From the effect of oxytocin on the uterus to the warm emotional gains, breastfeeding gives a mother many reasons to be pleased with her choice…One of the best-kept secrets about breastfeeding is that it's as healthy for mothers as for babies. Not only does lactation continue the natural physiologic process begun with conception and pregnancy, but it provides many short and long-term health benefits. These issues are rarely emphasized in prenatal counseling by health care professionals and all but ignored in popular parenting literature (Dermer, 2001- p.124). Studies supporting such benefits are numerous but the results are conflicting due “to inconsistency in the definition of breastfeeding.” Such discrepancy has made it difficult to compare the results thereby minimizing the relevance “of effects dependent on exclusive or prolonged lactation (Dermer, p. 428).” Prolactin and oxytocin are mammalian hormones primarily known for their role in female reproduction and maternal behaviors (bonding, etc.). A pituitary hormone, prolactin stimulates and maintains milk secretion. Released from the pituitary gland as well and functioning as a neurotransmitter agent in the brain, large amounts of oxytocin are released after expansion of the cervix and vagina during labor. Oxytocin’s role is two fold Dermer contends for it “not only signals the breasts to release milk to the baby (this is known as the milk ejection reflex, or "let-down"), but simultaneously produces contractions in the uterus. The resulting contractions prevent postpartum hemorrhage and promote uterine involution - the return to a nonpregnant state (Dermer, p. 124).” Mothers who do not breast feed “receive synthetic oxytocin at birth through an intravenous line” after their babies are born. This leaves them at a higher risk of experiencing postpartum hemorrhage. Dermer goes on to say: “Unlike bottle-feeding mothers, who typically get their periods back within six to eight weeks, breastfeeding mothers can often stay amenorrheic for several months. This condition has the important benefit of conserving iron in the mother's body and often provides natural spacing of pregnancies…. As for fertility, the lactational amenorrhea method (LAM) is a well-documented contraceptive method, with 98 to 99 percent prevention of pregnancy in the first six months. The natural child-spacing achieved through LAM ensures the optimal survival of each child, and the physical recovery of the mother between pregnancies.” (Dermer, p. 125) Although a blessing with many benefits, childbirth takes a tremendous toll on a woman’s body and even more so when the births are not evenly spaced. Adequate spacing between births allows time for a woman to heal physically as well mentally/emotionally. The vast amount of evidence detailing the risks of using oral contraceptives (the pill) and various alternatives (topical patch, vaginal ring, intrauterine delivery, etc.) is enormous and readily more provable than supportive research/evidence. Dermer suggests that breastfeeding and its resultant, LAM/natural postpartum infertility, is the safest form of birth control while at the same time ensures “optimal survival” of the children and the mother. Aside from being cost effective, women who breastfed have a reduced risk of acquiring debilitating/life threatening diseases such heart disease, endometrial and ovarian cancer, breast cancer, and osteoporoses. Diabetic mothers requires less insulin when they breast feed and greater chance of bone re-mineralization takes places with those who breast feed longer than eight months. Others benefits include weight loss, stabilization of maternal endometriosis and insulin levels of mothers with polycystic ovary syndrome as well as reduced risk of postpartum bleeding. As previously mentioned the hormones oxytocin and prolactin regulate maternal behavior, in particular promotes and strengthens bonding between mother and child. In addition to the (endocrine) effects of breastfeeding that may promote maternal care giving behavior and bond formation, non-nutritive aspects of breastfeeding may promote infant attachment. Breastfeeding allows the mother to know what her infant is doing through direct sensory feedback, potentially promoting attachment through better attunement of mother–infant feeding interactions… In addition to potentially fostering maternal sensitivity and mother–infant attunement, breastfeeding has been shown to positively affect maternal emotion (Jansen, p. 510) Dermer concurs with the above mentioned benefits and advocates breastfeeding’s long term as well short advantages for the mother. It is now becoming clear that breastfeeding provides mothers with more than just short-term benefits in the early period after birth. A number of studies have shown other potential health advantages that mothers can enjoy through breastfeeding. These include optimal metabolic profiles (weight loss), reduced risk of various cancers, and psychological benefits (Dermer, 125). Reproductive cancers such as ovarian and uterine cancers rank high among non breastfeeding mothers due to high level estrogen exposure and repeated ovulatory cycles precipitated by not breastfeeding. As far as breast cancer, the risk is reduced because breastfeeding, a “normal physiologic function of the breast,” aids in naturally suppressing ovulation and estrogen levels which are leading causes of breast cancer. Dermer cites that bone diseases such as rheumatoid arthritis “was worse” among women who did not breastfeed. Her final analysis concerning physical health benefits is –“Breastfeeding reduces risk factors for three of the most serious diseases for women-female cancers, heart disease, and osteoporosis-without any significant health risks (Dermer, p. 126).” Breastfeeding fosters a “unique” bond between mother and child that “bottle-feeding mothers have to work hard to replicate.” A matter of definition or power to define, Dermer views breastfeeding as a life altering/transforming experience that empowers the mother rather than represses her as perceived and promoted by many popular women/feminist groups (Dermer, p. 430). Dermer cites numerous studies in her articles to substantiate her findings/arguments. She interestingly and forthrightly deduces that “there have been no other studies showing any detrimental health effects to women from breastfeeding.” Dermer concludes in “Well-kept Secret” with the question – Why don’t more people know how good breastfeeding is? Based on the aforementioned statement, a more glaring question would be - why would a woman, especially if there are “no detrimental health effects” associated with it and the benefits are obvious, not choose to breast feed? Dermer argues that health care professionals must first and foremost acquire proper/correct information concerning “psychosocial and cultural context of infant feeding decision (Dermer, p. 430). This could also explain what appears to be willful lack of proper dissemination of information – they don’t know. In the second article, Dermer’s use of words such as “well-kept secret,” “unaware,” “overlooked” “rarely emphasized,” “ignored” and “fail to” implies negligence. How do you measure the peace of mind of having a healthy baby who is developing optimally? Where do you factor in the financial burden of formula prices and increased medical costs? Public health agencies advocate for breastfeeding because of its well-documented health advantages to babies, but they fail to convey to individual mothers and families the potential emotional impact of this very crucial infant-feeding decision. In Western society, the decision about breast or bottle is still seen very much as a personal choice based on convenience…. Many mothers are not being told how good breastfeeding is for their health. Whether out of ignorance or due to the influence of the artificial baby milk industry, many health care providers fail to inform mothers of the facts. It's time for this well-kept secret to come out (Dermer, p.127). If mothers knew the benefits to themselves they would be less likely to feel uncomfortable, guilty, influenced by the notion that their “baby will do just as well on formula (Dermer, p. 127).” A convenient and uninformed choice without full and proper knowledge of the benefit/advantage of the choice diminishes the choice’s significance of the choice and effect. Could this explain why the benefits to the mother are a “well-kept secret”? Most importantly, could “the influence of the artificial baby industry” be at the core? A “well kept secret” usually means that certain knowledge/ information does not go beyond the parameters of a certain group for a specific reason. In “Breastfeeding and Women’s Health, “ Dermer contends that two significant factors influence the mother’s choice and one of two is “the wide spread acceptance of artificial feeding as virtually equivalent to breastfeeding (Dermer, p. 427).” Dermer only alludes to infant formula twice in “Well-Kept Secret” and in doing so makes clear her position without directly saying it – it does not equate to breast milk. Infant formula or artificially humanized milk is an artificial substitute for human breast milk. They come in the form of ready to feed powder and liquid concentrate. Infant formula is marketed according to segmented age groups – up to 6 months, 6-12 months, and from 12 months on. Cow or soy milk as well as whey protein is the basis for most modern infant formulas. The United States is the world’s foremost supplier of infant formula. Breast milk develops and adapts according to the developing system of the baby and has “bioactive factors” which protect as well as promote the infant’s health – a unique quality (Hamosh, p. 69).” Infant formula contains similar nutrients found in breast milk, but they are altered. Although superior to animal milk, infant formula does not have this unique quality thereby making it an imperfect approximation. WHO states that “Only under exceptional circumstances can a mother's milk be considered as unsuitable for her infant (WHO, p. 10).” Careless preparation of the formula puts the infant at a greater risk of malnutrition and infection. “Inappropriate feeding practices –sub-optimal or no breastfeeding and inadequate complementary feeding – remain the greatest threat to child health and survival globally (Innocenti, p. 1).” Melamine contamination has been associated with infant formula as well. Nitrogen based, melamine combined with formaldehyde produces a durable thermosetting plastic known as melamine resin which can be found in formica, fabrics, glues, house ware cleaning supplies, and flame retardants. With strong evidence and organizational support, breastfeeding by far supersedes infant formula which is restrictive and regulatory. International standards/regulations for infant formula are conducted by the Codex Alimentarius Commision, the International Code of Marketing of Breast-milk Substitutes and the International Baby Food Network (IBFN). Established by WHO in 1981, the International Code works in conjunction with other WHO resolutions regarding food safety. An ardent advocate for breastfeeding the International Code “forbids virtually all forms of advertisements and marketing methods for breast milk substitutes to the general public, especially advertisements claiming health benefits from the substitutes (Code).” The International Code does not have legal jurisdiction therefore; it relies on organizations such as IBFN to fully im-plement and enforce its resolutions/tenets. In Australia, organizations such as The Dieticians Association of Australia (DAA) ardently support breastfeeding. A leader in nutrition with over 3000 members, DAA advocates “better” food, health, nutrition, and living for all. Their 2007 publication, “Inquiry into Breastfeeding” contains recommendations and a vast amount of information promoting the tenets of breastfeeding, maternal/infant health, and alternative feeding monitoring (DAA). The DAA states: The health benefits of breastfeeding are extensive. They reach beyond solely the infant. Breastfeeding promotes maternal health, and the benefits last beyond the duration of lactation and affect a wide range of health outcomes covering infant and maternal physical, psychological, and emotional health…… Increasing rates of breastfeeding will potentially affect the health of Australians in the short and long term (DAA, p. 2 & 4). The human body is a phenomenal creation known for its sustenance and regenerative ability. Human milk/breastfeeding substantiates this fact and its vital role must always remain at the forefront. “Breastfeeding is a unique biological heritage shared by women everywhere. The hormones of breastfeeding aid in the adjustment to mothering, in conservation of energy, and in subsequent nutrient recovery. Because the physiologic processes of breastfeeding are a normal part of the maturation of the female body it is not surprising that breastfeeding seems to have the attributes of a preventive health measure for women: Breastfeeding is beneficial for women’s health (Labbok, p. 143).” Dr. Dermer, the World Health Organization, the Dieticians Association of Australia, and a host of other experts seem to be in accord with this premise and are helping to diminish the secretive facade shrouding the benefits to the mother. With the best of intentions, infant formula - an imitation - can never equate to the real thing – breastfeeding and breast milk. In long run - infant, mother and society as a whole benefit from breastfeeding. Any unnecessary factors discouraging or impeding breastfeeding and its vital role would be a disservice to humanity and the planet - a well-kept secret that certainly should not be. Bibliography Dermer, Alicia MD, IBCLC. “A Well-Kept – Breastfeeding’s Benefits to Mothers.” New Beginnings: Vol. 18, No. 4: July/August 2001, p. 124-127. Dermer, Alicia MD, IBCLC. “Breast feeding and Women’s Health.” Journal of Women’s Health. Vol. 7, No. 4:1998, p. 427-433. Hamosh, Margit, PhD. “Bioactive Factors in Human Milk.” Pediatric Clinic of North America, Vol. 48, No. 1: February 2001, p. 69-86. “Infant and Young Child Nutrition: Global strategy for infant and young child feeding.” Secretariat, World Health Organization (24 November 2001-PDF). World Health Organization. WHO Executive Board 109th Session provisional agenda item 3.8 (EB109/12). “Inquiry into Breastfeeding.” The Dieticians Association of Australia: February 2007, p. 1-11. Jansen, Jarno, Carolina de Weerth, and J. Marianne Riksen-Walraven. “Breastfeeding and the mother-infant relationship – A Review.” Department of Developmental Psychology, Behavioral Science Institute: Nijmengin, the Netherlands. Developmental Review 28 (9 July 2008), p. 503-521. Labbok, Miriam H. MD, MPH, IBCLC. “Evidence of Breastfeeding on the Mother.” Pediatric Clinic of North America, Vol. 48, No. 1: February 2001, p. 143-158. “On Infant and Young Child Feeding.” Innocenti Declaration 2005: 22 November 2005. Florence, Italy. Picciano, M. "Nutrient composition of human milk". Pediatric Clinic of North America. Vol. 48 No. 1: 2001, p. 53–67. The International Code of Marketing of Breast-milk Substitutes: http://www.who.int/nutrition/ publications/code_english.pdf Read More