April 30, 2005
Overcoming Breast-Feeding’s High Hurdles
Pediatric group urges employers and hospitals to support breast-feeding
HealthDay News -- Marianne C. Stook, mother of 1-year old Annie and 4-year-old Heidi, was determined to give her children the benefits of breast-feeding.
But as a working mother who travels a lot, she often encountered obstacles that demanded raw determination and a dash of levity on her part.
For instance, while on an advertising shoot in New York City with an all-male crowd, Stook asked whether there might be a place she could go to pump breast milk. Indeed there was -- a curtained-off area, hardly the private, sound-muffling nook most women would deem acceptable.
So, what did she do? "I pumped behind the curtain. I knew there weren't any other options so I stuck with my goal despite the awkward interactions before and after."
As vice president of marketing services at a Connecticut firm that helps companies provide work/life services to their employees, Stook was fortunate to have had the benefit of lactation consultants and high quality pumps to help her reach her breast-feeding goals. Without such support, she might have given up.
Studies show that breast-feeding provides the best balance of nutrition for babies and provides all sorts of protective health benefits. It also helps the mother lose weight after her baby is born.
Despite its many advantages, breast-feeding remains a challenge for women in the United States, with rates of initiation and duration trailing optimal levels. In 2001, 70 percent of mothers initiated breast-feeding, 33 percent were still breast-feeding their infants at six months and 18 percent were doing so at one year, according to government data cited by the American Academy of Pediatrics (AAP).
Rates of exclusive breast-feeding -- no water, juice, formula or baby food -- were much lower. At six months, only 17 percent of women were breast-feeding their infants without any kind of supplementation.
Yet that is exactly the goal the nation's pediatricians have set for mothers and their infants. Based on mounting research supporting the value of human milk, the AAP in February issued a revised policy recommending exclusive breast-feeding for approximately the first six months of a baby's life. Mothers should continue breast-feeding for at least the first year. And beyond that, the group endorses breast-feeding for as long as mutually desired by mother and child.
"We're learning more and more about the importance of exclusivity," explained Dr. Jane A. Morton, a member of the AAP Section on Breast-feeding, which issued the policy update. Exclusive breast-feeding in the first six months seems to provide protection against the incidence of allergic symptoms in children, for example, and it can protect against infections, not only as nursing infants but later in life, she noted.
Other studies have indicate that breast-feeding can decrease the incidence and severity of conditions such as diarrhea, ear infections and bacterial meningitis. And some research suggests breast-feeding may even protect against sudden infant death syndrome (SIDS), diabetes and asthma, according to the AAP.
By introducing formula or solid food earlier than six months, "you start diluting some of the benefits down," said Morton, director of breast-feeding medicine at Stanford University Medical Center in Palo Alto, Calif.
For women who must return to work before their infants are 6 months old, the AAP policy may present a significant challenge, experts acknowledge.
"It's a very high bar," Stook agreed. "It requires an extra level of commitment on behalf of these women, and without having a supportive environment you can only put up with so many bumps on the road before you give up."
Stook hit one of those bumps herself when she was breast-feeding her first daughter. Despite hopes of nursing longer, she was forced to wean at six months when her milk production decreased as a result of being on a decongestant. Her doctor hadn't realized the drug could have that side effect.
"I was tremendously upset that I couldn't make it longer," she said.
Recognizing the barriers that exist from Day 1, the AAP offers specific ways pediatricians and hospitals can encourage and support breast-feeding. It recommends delaying weighing, measuring and bathing a newborn, for example, until the first feeding is complete. That feeding should take place within the first hour of birth, the group says.
"If you think of puppies and kittens, you would never think of taking one of the puppies away from its mother in the first few hours and washing it off," Morton said. "But we've been doing that for years with humans."
Another way to preserve the mother-child bond and promote breast-feeding is by keeping the newborn in the mother's hospital room at all times and feeding on demand, Morton added. Carting baby away to the nursery sends the wrong message that "there's something that we can do better than you," she said.
Once new mothers return to the workplace, the biggest issue is keeping up their milk production, Morton said. A woman may need to pump every four to five hours to keep up her supply.
That's where things can get dicey. Only 21 percent of human resource managers say their companies offer a lactation program or a designated area for pumping, according to the Society for Human Resource Management's 2004 benefits survey.
More important than a room, though, is a supportive corporate culture and supervisor, said Stook, who managed to breast-feed her youngest for a year. It can be difficult for a mother if her job does not allow sufficient time to pump or if her co-workers view her absences as an extra perk.
Mothers have to be really committed to conquer all sorts of physical and social barriers, she said.
"If you have a sense of humor," she added, "that goes a long way."
For answers to your questions about breast-feeding, visit La Leche League International.