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Alternatives For Women Unable To Breastfeed

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Many in the medical community favor breastfeeding for the physical benefits it offers both mother and child. But not every woman can do so. In this KERA Health Checkup, Kathy Chaney, a nurse and lactation consultant at Baylor University Medical Center, talks about alternatives for women who can’t or should not breastfeed.

Kathy Chaney: Moms who’ve had breast surgery are at risk of not producing enough breast milk, whether they’ve had an augmentation or a reduction. Moms who have certain diseases – HIV, for one, is not as contraindicated in breastfeeding. Some moms do not have, or some women do not have, a lot of ductile tissue and therefore do not produce the milk. But that’s usually about one to two percent of the population of the world.

Then moms who are very sick, have lost a lot of blood after surgery or after delivery, they’re at risk for having a low remote supply.

Baker: When a woman can’t breastfeed, what then are her alternatives?

Chaney: Well there’s a lot of alternatives that she can do. If it’s that mom would like to put the baby to breast, say for an adoption, or she’s had a breast reduction and she wants to breastfeed but she’s really concerned that there won’t be a milk supply, there are devices that we can use that allow the moms to breastfeed and supplement at the same time.

Baker: For instance?

Chaney: There’s a supplemental nurses system, it’s a tube that leads down to the nipple, and the moms can actually latch the babies on and they’re supplemented with formula. Or they can also use pasteurized donor breast milk, which can be purchased with a prescription from their pediatrician, from the North Texas Mothers Milk Bank.

Baker: And as I understand it, the milk that goes into the bank comes from fully screened, healthy mothers who breastfeed, and its processed, tested for bacteria as I understand it, and it’s frozen until it’s ordered by a physician, which was interesting to hear that there were milk-sharing agreements or arrangements available there.

Chaney: There are. The pasteurized donor milk is optimal. When you look at how or what the American Academy of Pediatrics says about how infants should be fed, the very first thing it says is mom’s own milk. If mom’s own milk is not available, or if it’s a contraindication to breastfeeding, like I said with HIV, obviously street drugs – there are some medical conditions also, that moms are on medication that are contraindicated with breastfeeding, then the next choice is donor milk. Then after that, it would be the formulas they could use.

Baker: Is there a preference for commercial or homemade version or formula?

We would always want to be sure it’s a safe formulation for the baby. There are a lot of things the FDA require about making a specific formula. It has to be safe, it has to have nutrients and protein. If you do the homemade little concoctions, some of the nutritional needs may not be met and that could cause a growth deficit for the infant.

Baker: Do you ever find that women feel guilty for not being able to breastfeed?

Chaney: I think, yes, but I like to say it this way: I think in today’s world, we put a lot of pressure on parents to be perfect. Our parents weren’t perfect. There were trial and errors. So moms who don’t succeed at breastfeeding, I really encourage them to try again. It’s so stressful today being a full-time mom. And a mom who didn’t succeed at breastfeeding and then she looks back on it three months later and she goes, “You know I should have worked at that a little bit harder.” At least she tried. There are some moms who don’t even try.

The more we empower women and the more that we educate women starting when they’re pregnant, the more successful they are.

Baker: The pros of breastfeeding – why do some advocate that?

Chaney: It’s not some. It’s becoming more and more because there’s so much more research about the use of breast milk and the benefits for both the mom and the baby. There’s the American Academy of Pediatrics that recommends exclusive breastfeeding for the first six months.

The U.S. Surgeon General and U.S. Department of health have recognized that when women exclusively breastfeed for six months it saves $13 billion a year in health care costs. It also saves an employer costs because moms who are breastfeeding and providing milk for their baby while at work tend to miss work less often than those who are formula feeding your babies.

Baker: Physical benefits of it – why are these organizations and others advocating breastfeeding?

Chaney: The benefits for the baby are numerous. They have appropriate weight gain; babies that are formula-fed tend to gain weight a a higher, faster rate, which is what is leading to the obesity rate in the US today. Babies whop are breastfed tend to be sick less often, less ear infections, less GI, diarrhea disorders. They have less problems with reflux and also with SIDS, it’s a protective factor against SIDS, or Sudden Infant Death Syndrome.

Baker: Is there a particular reason for all of that?

Chaney: It’s the way that the breast milk is designed. Breast milk has many components to it. All the different components have a lot of different factors. They work differently. One component of breast milk is oligosaccharide. It’s an antiviral it’s an antibacterial, it helps to rupture bacterial cells.

So all of these components work together to provide immune support to the infant. And it has long-term memory cells that can trigger later in life when there’s Crohn’s disease that they could be a potential for. The longer a mom breastfeeds, the less incidences of diabetes. Especially if there’s a family history of Type 1, it’s very important that they continue to breastfeed.

Baker: Is the social view of breastfeeding in tune with the medical community’s view of it?

Chaney: Yes and no. More people are breastfeeding, and some women come in and they are like, “We’re gonna breastfeed, and things are going to go well.” And you know, it’s a learning process. And physicians are very supportive of breastfeeding. However there are still many physicians out there who are not as educated on how to support the mom to help her succeed at breastfeeding. Pediatricians are becoming more and more supportive of breastfeeding and even having board-certified lactation consultants in their office to help moms after discharge get the breastfeeding help that they need.

Baker: In researching this topic, over and over it seemed to come up, this opinion of many women that they felt as if they were being expected to breastfeed, as opposed to just following their own choice to do so or not do so.

Chaney: Hopefully that doesn’t happen, especially in our hospital. One of the things they found through evidence and research and the big push by the U.S. Surgeon General, has been just providing breastfeeding education. A lot of moms don’t understand that breastfeeding is not only important for the baby, but it’s important for them. Sometimes women think, “Breastfeeding is going to hurt, it’s going to take up too much of my time.” And just with some good general breastfeeding education, they can make a more educated decision.

Our goal is not to force women into breastfeeding. The World Health Organization, which offers the baby-friendly hospital designation, which means these hospitals provide optimal breastfeeding care. It’s not about forcing the moms, it’s about providing the education for them. So the more we empower the mothers, the more they can make an educated decision. There are some individuals that will push and push and push  about the breastfeeding but I learned a long time ago if you meet the mom where she is, you can have a lot better outcomes with it.

Kathy Chaney is a nurse and lactation consultant at Baylor University Medical Center.

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