Breastfeeding is one of those things like smoking cessation or exercise that we are constantly told that we “should” do, and feel guilty if we don’t.

And yet, despite media attention, unqualified endorsement from the American Pediatric Association and every other healthcare organization, encouragement from your midwife, obstetrician, and mother (unless you have a really old mother who had her babies back in the 1950s), and an instinctive feeling that it is the right thing to do, not enough mothers are breastfeeding. Why is this?

Let’s face it, breastfeeding has its drawbacks.  No milk at first or just a trickle, then the next day huge, tender breasts and bright red, sore nipples (where did those things come from?).  It is messy, it is impossible to know if the baby has got enough or too much – it’s a hassle.  You are told that you will need a pump, which is expensive and time-consuming to maintain.  You will need special clothing and bras, and you will have to forego candlelight dinners out with your partner to try to get that romance going again.  If you do dare to go out, you will worry about the baby starving and you will realize at the worst possible moment that you have two highly visible wet patches on the front of the new, larger dress you just bought.  At least, all that is what your friends who tried and gave up, or never tried at all, will tell you.  And that is how you will feel when, three days out from childbirth, home alone (or with too many cooing baby admirers), with an adorable little baby who seems to be hungry all the time; with the worst sleep deprivation you’ve ever experienced; and with an overload of advice from the nurse, the lactation consultant, your friends and, yes, your mother, you think about the benefits, not of breastfeeding, but of formula!  Yes, formula, that rich, creamy liquid that comes in a calibrated bottle with a sterile nipple (one that doesn’t feel like it’s being chewed on every time the baby latches), that calms the baby the moment you put it in its mouth, and that puts the baby to sleep just as the last few drops are emptied from the bottle.  (Why do babies seem to know what to do with a bottle right away, but have a learning curve with a breast?)  Oh, and let’s not forget, formula can be given by your mother-in-law at 3 am while you are sleeping. It seems so simple, and what harm can it do?

So let’s go over the benefits of breastfeeding once again, or, rather, the risks and harms of not breastfeeding  – they make the effort truly worthwhile for most moms, and they last a lifetime for baby and mom as well.  And those drawbacks I listed?  They can be eliminated or minimized if you have some help at the get-go (moments after the baby emerges from the womb or as soon as possible), from someone you trust to show you the right way to get started.

Best for Baby: Colostrum, or the first breast milk, is “liquid gold” for the baby in the first few days following birth – even more so if the baby is premature or has other health issues.  It is super-rich in nutrient and antibodies, so even the small amount the baby gets at each feeding is sufficient to protect against infections and other disease – and to nourish the baby.  Don’t worry that the amount seems so small – so is the baby’s stomach at this point – about the size of a hazelnut!  (To see the newborn’s tummy and to get more information about breastfeeding, go to http://www.womenshealth.gov/breastfeeding/learning-to-breastfeed/index.html#i.)  Remember:

COLOSTRUM = LIQUID GOLD FOR NEWBORNS.

Over the first week after birth, breast milk changes to meet your baby’s needs – it becomes thinner (looks like skim milk) but still provides the right nutrition for the baby at this stage.  It contains antibodies, probiotics, and hormones that fight diseases like diarrhea and ear infections in infants.  It can also protect against serious diseases like necrotizing enterocolitis (a serious disease of the GI tract in premature babies), asthma, bronchitis and pneumonia, obesity, and Type 2 diabetes.  The intestinal tract of a totally breastfed baby has different, more appropriate and beneficial flora than the tract of a formula-fed baby.

Some research shows that breastfeeding can also reduce the risk of Type 1 diabetes, childhood leukemia, and atopic dermatitis (a type of skin rash) in babies. Breastfeeding has also been shown to lower the risk of SIDS (sudden infant death syndrome).

Best for Mom: Despite the learning curve with breastfeeding, which is steeper for first-time moms and for some moms more than others, it is ultimately easier, more convenient, and cheaper. Have you checked the price of formula?  It is definitely liquid gold for the formula companies.

FORMULA = LIQUID GOLD FOR INDUSTRY.

Breastfeeding is also good for your health – it lowers your risk for Type 2 diabetes, breast cancer, ovarian cancer, and postpartum depression. How good is that?  But most moms who breastfeed will agree that the biggest plus is the extra close relationship they develop with their baby – extra one-on-one time together, extra skin-to-skin contact – and that dreamy, cozy, loved and loving feeling that is brought on by the release of the love hormone, oxytocin, during breastfeeding.

New research is showing all the time that there may be many more benefits to breastfeeding for both mom and baby – after all, this is how the babies of all mammals have been fed for thousands of years – this is why we are called mammals!  It is crazy to think that “formula,” invented in a lab in the last century, can top the natural milk, adapted specifically to the needs of each and every baby, that nature has given us.

Best for Society: According to the Office on Women’s Health, USDHH, “recent research shows that if 90 percent of families breastfed exclusively for 6 months, nearly 1,000 deaths among infants could be prevented. The United States would also save $13 billion per year — medical care costs are lower for fully breastfed infants than never-breastfed infants. Breastfed infants typically need fewer sick care visits, prescriptions, and hospitalizations.”  Since breastfed babies don’t get sick as often, their moms miss less work and are more productive.  Finally, think about the difference in impact on the environment without all that trash from formula bottles and nipples, cans, and supplies.

The internet is full of excellent sources of information on breastfeeding – how to do it, how to handle problems and emergencies if they arise, how long is optimal, how and when to introduce other foods, how to wean the baby when it is finally time to do it.  The Office on Women’s Health, USDHH website has a great list of resources at the end of their article on breastfeeding.  Many of these are online or can be checked out from your local public library.  It pays to have a positive attitude, and this is easier when you have a support system of family and friends who understand why breast is better and who are willing to help you to do it right.  Let them do the laundry, wash the dishes, run some errands – so you can snuggle up in your favorite corner with your baby, get connected, and let that rush of well-being take you over as your baby fills up on the only food that is really right for him or her.

The good news is that breastfeeding is increasing – more moms are breastfeeding for longer.  According to a news release from the CDC in July 2013, “Breastfeeding rates have continued to rise over the past decade….  The percent of babies breastfeeding at six months increased from 35 percent in 2000 to 49 percent in 2010.  The percent of babies breastfeeding at 12 months also increased from 16 percent to 27 percent during that same time period. The data show that babies who started breastfeeding increased from 71 percent in 2000 to 77 percent in 2010.”

I want to say a word or two (maybe more) about breast pumps and lactation consultants.  Like cesarean birth in those instances where it is necessary, the availability of a good lactation nurse and an electric breast pump can be a game-changer for a mom who, despite her best efforts and the best advice she can find from books, family, and friends, cannot make enough milk to keep her baby’s diapers poopy and wet (the best way to determine if the baby is getting enough to eat), or cannot keep her own milk ducts from clogging or her own nipples from cracking and bleeding.  These problems should not occur if the baby is nursed frequently, held correctly, and allowed to do what comes naturally – but sometimes they do.  Of course, there are special cases – moms with premature babies, twins or triplets, babies with cleft lip or palate, babies who don’t gain weight despite appearing to take enough milk – that may require the assistance of a professional lactation consultant as well as a pediatrician, and the use of an electric breast pump, which can cost up to $500 and, we are told, should not be re-used by future babies. I consider relying on professional advice or on a commercial breast pump for most moms, unless something is going very wrong, to be the medicalization of breastfeeding.  The hospitals and the companies who make the pumps benefit from over-use of these services, not the mother or the baby.  Is a natural, beautiful human function being taken over by the “breastfeeding-industrial complex”?  Just a thought.