To breastfeed or not to breastfeed?
Continuing the theme of guilt that mothers feel about not meeting society’s expectations or not doing well enough, another controversial motherhood-related topic that tends to attract clashing views and opinions is that of breastfeeding.
In simple terms, breastfeeding is a biological mechanism that all mammals, including human beings, developed through the natural evolution process as a way to keep their young nourished, healthy and protected.
Many people believe that mothers should breastfeed their babies in order to ensure that the infant enjoys optimal health, with some advocating that mothers should exclusively breastfeed their babies, instead of using infant formula milk.
The scientific benefits of breastfeeding
According to WHO (World Health Organization), breastfeeding is one of the most effective ways to ensure a child’s health and survival. The American Academy of Pediatrics (AAP) as well as the American College of Obstetricians and Gynecologists recommend that mothers breastfeed their newborn infant exclusively for at least the first 6 months.
Breast milk is an ideal source of food for infants. It contains nutrients, vitamins, minerals and other important elements that work to fulfill the nutritional needs of infants, It’s what a human child needs to develop and thrive, particularly during the early stages of life. Moreover, the nutrients contained in human milk changes throughout the day and throughout the course of lactation. Through it, the mother passes on her antibodies to the child, thus helping protect him or her against different illnesses.
Breast milk has many positive effects on both mother and child, as observed among societies living in both developed and developing countries. Interestingly, data tells us that breastfeeding can save lives in countries with poor hygienic conditions (Anatoulitou, 2012).
The benefits of breast milk have been thoroughly studied and include the following (Anatoulitou, 2012):
● It helps prevent infections and lowers the severity of illnesses.
● Studies suggest decreased rates of SIDS (sudden infant death syndrome) in the first year of life.
● It offers immune protection (lowering the chances of suffering allergies, asthma, atopic dermatitis, eczema…).
● It appears that breastfeeding can reduce the risk of obesity, with a 15%-30% reduction of obesity rates in adolescence and adulthood amongst individuals who were breastfed during their infancy and childhood.
● Evidence shows that breastfeeding may be associated with a small advantage in cognitive development that persists into adulthood.
● It also holds many benefits for mothers: decreased postpartum bleeding, decreased blood loss during periods, decreased risk of breast and to a certain extent, ovarian cancer.
● Breastfeeding may play a role in preventing postpartum depression, as studies have shown that mothers who do not breastfeed or who wean off early are more prone to suffering from this psychological condition.
Why choose not to?
The practice of breastfeeding not only strengthens the bonds between mother and child, but also has many benefits, as described above. Knowing this, it is easy to ask: why would anybody choose not to breastfeed? There are many possible answers to this question.
Firstly, although breastfeeding is a natural biological mechanism, not all mothers may be able to adopt this practice at first. New mothers in particular may experience difficulties getting their baby to latch, or they may produce insufficient milk, resulting in the baby not getting enough food. if the mother has a condition like mastitis (an inflammation of breast tissue that sometimes involves an infection), this may make it difficult for her to lactate.
While these may seem like trivial issues, they can actually turn breastfeeding into a painful experience for the mother, both physically and emotionally. A mother who has been trying for a while, whose child has difficulty latching and won’t stop crying because it’s not getting enough food, whose breasts hurt, may ultimately give up and decide to use formula instead.
Moreover, while human milk provides the most complete form of nutrition for infants, there are certain exceptions where breastfeeding could cause harm. For example, a mother who is infected with a virus like tuberculosis or herpes may risk transmitting harmful infections to her child if she chooses to breastfeed. Likewise, an infant with an inborn metabolic illness like galactosemia (the inability to digest galactose) may be adversely affected if the mother chooses to breastfeed exclusively, since the child would not be able to obtain full nutrients from the breast milk.
Besides maternal illness and infant metabolic diseases, there are many other possibilities that make breastfeeding a less favourable option for mothers. Some mothers may choose not to breastfeed their babies, but instead use formula milk, or reducing the frequency of breastfeeding by combining their breastmilk with formula milk. Some mothers, especially those who juggle work and different responsibilities, may choose to pump their milk beforehand and store it so that the baby can be bottle-fed by a caretaker.
In such cases, mothers may be criticized for not placing the “best interest” of their child first. But is this really a fair judgement? While breastfeeding is beneficial for the mother and baby in many ways, this is not always the case, if the mother is stressed out, suffering and unhealthy as a consequence.
In this modern day and age, with the availability of different kinds of infant formula milk to satisfy a baby’s basic needs, a mother should be free to choose the option that suits herself and her baby best. In fact, formula milk has proven to be a healthy alternative that can bring children to grow healthy, happy and well nourished. Knowing this, there is no reason why a mother should be made to feel guilty for choosing to use formula milk, if that will make her thrive. After all, beneficial as breastmilk is, is it worth it if it comes at the expense of her mental or physical health?
As a society, we should strive to help mothers explore what works best for them and their child. Resources should also be provided to help them make informed choices on whether or not to breastfeed, and guidance on how breastfeed (if that’s what they wish to do) in the healthiest way possible. But if for some reason they choose to go the other way, then as a community, we should support the choice that they have made, instead of turning the issue into “moral blackmail”.
Remember: a happy, healthy mother often means a happy, healthy baby.
Anatolitou, F. (2012). Human milk benefits and breastfeeding. Journal of Pediatric and Neonatal Individualized Medicine, 1(1),11-18. doi: 10.7363/010113
Maternal mental health issues are significant challenges that may affect women before and during pregnancy, and after childbirth. Studies have shown that better awareness, and timely assistance, can help increase the chances of full recovery for mothers affected by these conditions.
SOLS Health is currently conducting research into how existing identification and treatment services may be improved for women affected by postpartum depression in Selangor. If you are a woman of childbearing age residing in Selangor, please do take some time to share your thoughts with us by filling up a short survey at one of the links below. It will only take less than 10 minutes, and your insights would contribute to improving the quality of services, and access to care for mothers affected by these conditions.
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