When should we decide about breastfeeding?

It is a good idea to meet with the baby's doctor prior to the birth in order for all to get to know each other in a controlled, non-rushed, quiet environment. This is a perfect opportunity to discuss your concerns and wishes about feeding your baby. One important reason to have the decision to breastfeed made before the delivery is that it can be very difficult or even impossible to start using formula and then later try to switch to breastfeeding. This is because the ability of the breasts to produce milk diminishes soon after childbirth without the stimulation of breastfeeding.

Why is the choice so important?

During your baby's first year of life, he/she will more than triple his/her total body weight, and the vast majority of this weight gain will come from the milk that they drink. According to the American Academy of Pediatrics, human milk is the preferred feeding for all infants. This includes premature and sick newborns, with rare exceptions. Of course, breast milk would appear to be the most ideal food for your newborn. It is the food least likely to cause allergic reactions, it is inexpensive, it is readily available at any hour of the day or night; babies accept the taste readily; and the immunity factors in breast milk can help the baby fight off some infections.

Although breast milk is the ideal food for human infants, because of medical or other reasons, some women opt for formula feeding. Infant formulas have been developed to artificially duplicate human milk, although no formulas have been developed that are an exact replacement for human milk.

What are the advantages and disadvantages of breastfeeding?

The nutritional advantages of breast milk are certainly numerous. The amino acids in breast milk, the building blocks of proteins, are well balanced for the human baby, as are the sugars (primarily lactose) and fats. The baby's intestinal tract is best aided in its digestion by the vitamins, enzymes, and minerals found in breast milk. Breast milk also contains infection-fighting antibodies from the mother, and breast-fed babies are believed to be at a reduced risk for many acute and chronic infections early in life. The cholesterol content is also high in human milk and very low in formulas. Cholesterol promotes brain growth and provides the building blocks of hormones, vitamin D, and intestinal bile.

Breast milk is also the least expensive way to feed an infant. However, the mother must maintain good nutrition and continue taking any vitamin/mineral supplements her doctor recommended during the pregnancy.

Formula-fed babies also have the risk of developing an allergy to a particular formula. When a baby develops an allergy to formula, he or she may have symptoms that include irritability, crying after feedings, nausea, vomiting, diarrhea, or a skin rash.

Nursing helps most women lose weight (though not fluid) after delivery, as 500 calories or more are used by breastfeeding each day.

The only disadvantages for the baby in breastfeeding occur when things are not going well, for example, if there's an inadequate supply of breast milk or an inefficient suck reflex in the baby. However, it is unusual for a mother not to produce enough milk for her baby unless she is not breastfeeding correctly or frequently enough. The disadvantages that most commonly arise involve the rest of the family. Siblings and dad often feel "left out" of baby care since mom is the only one who can do the nursing. However, other family members can be involved in helping with different aspects of the baby's care, and this gives them a valuable feeling of importance and allows mom a chance to rest.

Breast-fed babies eat more often than formula-fed babies since breast milk is more quickly digested and leaves the stomach empty more frequently. This puts a little more stress on the mother because of the potential necessity for more frequent feedings. If the mother develops certain medical conditions, whether or not to continue breastfeeding may need to be reassessed. These conditions should always be discussed with the doctor. However, it is rare that breastfeeding would need to be discontinued completely. In any interaction, the mother's doctor and/or pharmacist should be informed that she is breastfeeding. Some medicines should be avoided during breastfeeding. Numerous other medications have not yet been adequately studied in the context of breastfeeding and the possible effects on the baby. If a breastfeeding mother is required to take a medication which has not been fully studied, she may want to consider discussing this matter with her doctor.