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Column originally published Jun 26, 2007

Breastfeeding Is Very Important For Newborn Babies

Question: I am expecting our second baby in another month. I was able to nurse our son for six months, but it wasn’t easy at all. He had a very strong suck, and I had cracked nipples and a lot of pain. My sister put her daughter on the bottle right after birth, and she slept for several hours after each feeding, while my son nursed much more often. My sister is trying to convince me to use formula this time around. Please give me some advice whether I should even try to nurse, and whether I can do this half-and-half, give him the bottle and breast feed at the same time.

Answer:

It is unfortunate that your first experience of breast feeding was not as enjoyable as it could be.  However, there are plenty of reasons why you should still try to nurse your upcoming baby.

Let me begin by saying that numerous scientific research around the world, involving mothers and babies of all ethnic groups, have found that breast milk is the best for our babies, and there is nothing formula companies can make that will match it.  Breast milk is produced by all mammal species.  The breast milk of each species is adapted to its own babies.  Human breast milk is most suitable for our babies, with all the proper nutrients in the correct proportion that is best for their digestive system and for their growth and development.

In a similar way, breast milk from cows, goats, sheep, and all other mammals are best suited for their own babies.  Most of the formulas available on the market are produced from cows milk.  Each formula company has its own way of manufacturing to produce the formula on store shelves.  The nutritional requirements of these infant formulas were set by United States government many years ago, and they were based on scientific research at that time.  These formulas are generally safe for most babies, and provide adequate nutrition for the growth and development of our children.

However, formula companies have made changes to their formulas over the years, when scientific research found new ingredients in human milk (which has never changed) that were lacking in their formulas.  Their advertisement always says that their new formula is closer to human milk than their previous formulas, or those from other formula companies.  However, I can dare say that they will never be able to make a formula that is identical to human breast milk, unless they can completely change the genes of a cow to that of a human.

In general, bottle-fed babies are fed no more than every 3 to 4 hours, while nursing babies need feeding more frequently.  This is because formulas are not as easily digested as breast milk by the baby.  As a result, formulas tend to stay in a baby’s stomach for much longer time so that the baby feels full for longer, and therefore eats less often.  Breast milk is made for our babies and is easily digested, so it doesn’t stay in the stomach for too long.  As a result, breast-fed babies often need nursing more often than those on the bottle.

As a paediatrician who has worked in my specialty for over 30 years, I have seen many formula-fed babies with problems like vomiting, diarrhea, constipation, cramps, and severe cows milk allergy.  Some of them are very difficult to manage.  By the time these problems surface, there is no way for the mother to go back to breast feeding.  Decision on bottle feeding is almost a one-way street, it is very hard to turn back.

Breast milk not only provides the best nutrition, it also protects babies from serious infection by providing a special kind of immunoglobulin call IgA, which protects a baby’s intestinal tract from serious germs when they are most vulnerable.  In developing countries, the most common reason for young infants to get sick and die is diarrhea: babies who are being breast-fed are mostly protected.

Because breast feeding is the best way to nourish our babies, the Canadian Paediatric Society, the American Academy of Pediatrics (with many thousands of paediatricians as their members), as well as the World Health Organization, all recommend mothers to breast feed for two year, with the first six months strictly breastfeeding.  We understand that not every mother and baby can achieve that, but that should be the goal.  It may not be easy, as you have experienced, but it is the best.  Mothers need support in order to breast feed their babies.  That is where other family members, including the fathers, have to help to take care of all other family needs so that the mothers can concentrate on breast feeding, which is a task that no one else in the family can do.

There are only very few situations where a woman should not breast feed, and I won’t go into details of them here.  Many doctors advise nursing mothers to stop breast feeding when they are taking medications: this is not always true.  Although most medications pass into breast milk, the amount is usually extremely small and they often don’t affect these babies.  There are reference books detailing which medicine is safe or not for nursing mothers, and they are often available in obstetrics departments of many hospitals.  It would be wise to give them a call if there is any question.

If you want to nurse your baby, you cannot do half-and-half, at least not for the first few weeks.  This is because babies can get confused between the nipple of the bottle and your breasts.  In general, it is harder for a baby to get milk from your breast than from a bottle, she needs to suck harder on the breast.  Many babies, once they have taken to the bottle a few times, may refuse to nurse from the mother’s breasts again.  Furthermore, once your baby takes fair amount of milk from the bottle, your breasts will automatically produce less milk in response, and this may spell the end of breastfeeding.  This does not mean you cannot give your baby a bottle of formula from time to time, when breast feeding is difficult or inconvenient, although the more bottles you give, the more likelihood this will affect your breast feeding.  Some mothers do pump and store their breastmilk so that someone else can feed the baby.

Finally, you should give your baby Vitamin D supplement when you are breastfeeding.  This is because of our geographic location: many mothers are not getting enough exposure to sunlight, especially in winter months.  Sunlight helps our body to produce Vitamin D, which is important for calcium absorption as well as some other health benefits that scientists are still trying to determine.