Breastfeeding

with John Goetz, M.D., Pediatrician, Advanced Healthcare

Posted: Jan. 1, 2004

With all the overwhelming decisions that face a new mother, it’s lucky that at least one is an easy choice – whether to bottle-feed or breastfeed your newborn. Breastfeeding has gone in and out of fashion over the years, but that was before the facts were in.

“The overwhelming evidence is that any breastfeeding is better than none, and nursing for the whole first year is ideal,” said Dr. John Goetz, a pediatrician with Advanced Healthcare.

John Goetz, M.D., Pediatrician, Advanced Healthcare "Whenever possible, breastfeeding is the best feeding choice for infants. And that's for the entire first year of life."

But, adds the doctor, that doesn’t mean you’re consigned to failure if you only breastfeed for a few weeks – or even not at all.

“If a mother has postpartum illness or a condition that makes nursing not advisable, it’s more important to take care of the mother’s health because infant formulas, while not ideal, are still very good,” he said.

Benefits for mom and child
Breastfeeding benefits both mother and baby. When a new mother breastfeeds immediately after giving birth, it stimulates the production of oxytocin, a hormone which causes the uterus to contract, stemming bleeding and hastening healing from the birth. The most immediate benefit to the baby is its mother’s immunities.

It’s also more convenient for the mother because there are no bottles to sterilize and wash, no worries about the purity of the water you’re using to mix formula, and no waste because there are no unused portions to throw away. There are also important health benefits for the baby.

“Infants have a poorly developed immune system in the first few months of life,” said Dr. Goetz, “and breast milk contains antibodies that help to protect the baby from infections.”

That includes infections that the mother might be dealing with while caring for her newborn. Dr. Goetz described the case of a mother who had a classic case of intestinal flu. Her body ached; she had a fever and nausea. The next day, her infant, who was less than a month old, developed a fever and was admitted to the hospital.

“The infant developed mild viral meningitis with mild diarrhea and a subsequent total body viral rash,” he said. “But the baby continued to breastfeed during the hospitalization and had a very mild illness considering the young age and the possibility for a much more serious illness. Breastfeeding likely played a role in moderating the infant’s illness.”

Nutrients in breast milk
Breastfed infants, said Dr. Goetz, have lower rates of hospital admissions, ear infections, diarrhea, rashes, allergies and other medical problems. They also absorb the nutrients in breast milk more easily than they do those in formula.

Iron, for example, is present at less than 1 mg per quart in breast milk, while formulas contain 15 mg per quart. But, said Dr. Goetz, the breast milk iron is absorbed more efficiently, while an infant on formula only absorbs a fraction of the iron contained in formula. “Iron is crucial to infant growth because of the dramatic growth of a baby during the first year,” he said. “Babies generally double their size and triple their weight during the first year, and that requires a lot of iron.”

One exception, he said, is Vitamin D. A quart of breast milk contains 25 units compared to 400 units in the same amount of formula. To compensate, breastfed infants should receive supplemental Vitamin D to assure a daily intake of 200 units.

Mother’s diet
When it comes to diet, the ideal scenario for breastfeeding mothers is to keep it balanced, and don’t overdo the alcohol. One glass of wine or one beer a day is acceptable.

Food can be trickier. Some babies react badly to coarse vegetables present in their mother’s diet, such as broccoli, cauliflower, onions, garlic and cabbage. Other foods to be careful about are tomatoes, chocolate, maple syrup and large quantities of citrus.

But, cautions Dr. Goetz, every baby is different. You might have one child who reacts badly to one type of food, and another baby who doesn’t even notice. He suggests trying a modest portion of any food you aren’t sure about.

“The baby will guide the mother, because if the baby gets fussy, she will often find a food that could have been the culprit,” he added.

When to wean
For first-time mothers who decide to breastfeed for the duration, either pumping milk after they go back to work or using formula when they’re not at home, the question of when and how to wean can be an issue.

“The baby gives you signals,” he said. “He or she will start to lose interest in breastfeeding, and it’s different for every baby.”

Sometimes it’s an interest in table food, sometimes the baby just can’t get the hang of nursing without biting down with his or her new teeth, sometimes the baby gets busy with other things.

And while the literature may state that breastfeeding is the best choice for the entire first year of life, it’s clear from the experience of at least one parent that babies are not up on the literature: “My own children all stopped at different ages,” Dr. Goetz said. “Some stopped before a year and some after a year, and those are the pediatrician’s children. It’s an individual thing.”

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