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School of Medicine
Breastfeeding 101: Q&A with Lactation Expert Nadine Rosenblum
If you are a mom-to-be, you’re probably busy planning for the arrival of your baby. When it comes to feeding your baby, research has widely shown the advantages of breastfeeding for both baby — providing baby with balanced nutrition and reducing baby’s risk of developing asthma, diabetes and other conditions — and mother — aiding in postpartum recovery and lowering her risk for developing certain cancers, among other benefits. Many hospitals, including Johns Hopkins, are reworking their infant care models to be more “baby-friendly”— that is, encouraging mother-baby bonding through skin-to-skin contact and breastfeeding — based on this research.
To help explain the benefits of breastfeeding, Nadine Rosenblum, perinatal lactation program coordinator at The Johns Hopkins Hospital, answers some commonly asked questions about breast milk, common struggles women face and what resources women can tap into to increase their likelihood of nursing success. “There are still so many misconceptions about breastfeeding and a general lack of support,” says Rosenblum, “that many women discontinue breastfeeding or add formula when they don’t necessarily need to.”
What makes breast milk so effective?
During pregnancy, a baby’s immune system readies itself for that unique food source his or her mom produces: breast milk. “It’s what a baby’s body expects to eat, consume and utilize most effectively,” says Rosenblum.
And breast milk isn’t a homogenous substance. Hundreds of nutrients have already been identified in breast milk, and researchers are still discovering more. The exact combination of these nutrients is dynamic. The composition of nutrients changes based on a baby’s unique needs on a daily basis, at every meal and every stage of life. If it’s hot outside, the milk will have a higher water content to keep a baby hydrated. If a baby is in a growth spurt, breast milk will have more protein and fat. This specialized diet fuels a baby’s developmental growth and helps lay the foundation for a baby’s immune system. As Rosenblum puts it, “You can’t manufacture what mom makes new for baby every day.”
The bottom line? “Babies who are fed only breast milk for their first six months of life are the healthiest,” says Rosenblum. The American Academy of Pediatrics suggests women continue breastfeeding, with the addition of complimentary (solid) foods starting at 6 months, for at least 12 months. Other organizations, such as the World Health Organization, recommend women continue nursing, with the addition of solid foods after 6 months, until the child is 2 years of age for the best health outcomes.
What are the advantages of breastfeeding for babies?
There are a wide range of benefits for babies who drink breast milk. Babies who breastfeed are less likely to develop:
- Upper & lower respiratory diseases
- Digestive diseases such as acute diarrhea, long term Crohn’s disease and colitis
- Diabetes types 1 and 2
- Childhood leukemia
Additionally, babies who drink breast milk are also at reduced risk for sudden infant death syndrome (SIDS) and are less likely to be overweight or obese.
How do moms benefit from nursing?
Nursing not only benefits a baby — nursing also promotes immediate and future wellness and good health in breastfeeding moms.
Nursing right after delivery helps improve postpartum recovery by bolstering many natural processes, including:
- Expelling the placenta
- Slowing postpartum bleeding (and thus decreasing the likelihood of postpartum hemorrhage)
- Reducing the size of the uterus (to revert to pre-pregnancy size and shape)
- Burning calories (to lose the weight gained during pregnancy)
Beyond physical benefits, breastfeeding may also promote good mental health, as nursing has been linked to lower incidences of postpartum depression in new mothers.
Breastfeeding also helps with longer term health outcomes. Women who breastfeed have lower rates of developing:
- Certain cancers including breast cancer, ovarian cancer and endometrial cancer
- Heart disease/high blood pressure
What are common breastfeeding struggles moms face?
According to Rosenblum, it is normal for women to feel many anxieties around breastfeeding, at all stages and experience levels.
Women who have not yet breastfed are often concerned they may not make enough milk to sustain their baby. They may also worry about experiencing discomfort or pain when breastfeeding.
Moms new to breastfeeding are commonly uncertain about whether their eating habits are ideal for milk production or how any medications, drugs or alcohol may interact with the milk. They may also fret over not seemingly connecting with their baby when nursing, and be concerned their baby is not getting enough milk.
Working, nursing moms can be apprehensive about managing the transition from home to work and what that disruption might mean for their breastfeeding process.
What is Rosenblum’s main suggestion? Women should seek out help from lactation experts and other support groups in their communities to help ease many of these concerns and empower them in their breastfeeding journey.
What are some tips for successful breastfeeding?
- Keep baby with you. “It’s easier to learn about your baby when the baby is with you,” Rosenblum says. Essentially, the more time you spend with your baby, the easier it becomes to distinguish the many different needs of the baby and ensure good nursing.
- Get the right information from experts. Don’t get overwhelmed with internet resources and friends, says Rosenblum. Lactation experts can direct women to good information and provide hands-on help at the hospital. If women aren’t able to meet at the hospital, nurses are also available to answer questions over the phone or by email.
- Go to a prenatal breastfeeding class. These classes cover the benefits of breastfeeding, basics of milk supply, how to maintain milk when mom and baby are apart, how to understand baby behavior and gauge when a baby is well-fed, and positions for a good latch. Classes are often interactive and include a variety of teaching methods such as videos and baby models to accommodate all kinds of learners.
- Find a local support group. Many hospitals, including Johns Hopkins, coordinate support groups for breastfeeding women, where mothers can share stories, learn from each other’s experiences and practice breastfeeding in a group setting. There are also many other organizations that are dedicated to helping women successfully breastfeed. Rosenblum suggests women find a group that they feel most comfortable with.