Breast, bottle, whatever: How You Feed is a shame-free series on how babies eat.
Since then, the narrative around breastfeeding has shifted — most say for the better. New mothers face immense pressure from medical professionals to breastfeed exclusively, but what happens when that pressure turns into guilt and shame when nursing doesn't work out as well as you'd hoped?
On the opposite side of the spectrum, moms also face guilt and shame surrounding extended breastfeeding — continuing to nurse past their child's first birthday. They're inundated with questions like, "Aren't they a little old to be nursing?" and "When are you going to finally wean?"
Dr. Maria Wright, in Sacramento, Calif., says, "Breastfeeding provides a source of profound comfort and security [for a child], providing a foundation for a healthy future." But Wright also points out there are plenty of things to consider before extending breastfeeding or weaning before it's recommended.
How breast milk's nutrition changes over time
The American Academy of Pediatrics (AAP) and World Health Organization (WHO) officially recommend . During this time, breast milk provides a "complete source of nutrition" for a child. After 6 months of age, babies can continue nursing while other sources of nutrition are introduced, including iron-rich foods like pureed meats and certain oats, barley and rice cereals.
"There are many benefits to breastmilk," Wright tells Yahoo Life. "Besides being easily digestible, it strengthens the immune system, prevents illness and reduces obesity risk."
Earlier breast milk contains different levels of nutrients than breast milk produced later, according to Wright, which is why babies should start nursing within hours of birth.
"In the first stage, you have the colostrum, which contains a higher amount of protein and high concentrations of other important microbes that bolster a child's immune system and growth," she says. "As milk volume increases, sodium concentration and the ratio of sodium to potassium decreases. The mature breast milk is rich in fat and higher in calories to help babies grow."
Wright says that as time goes on, the nutrients in breast milk continue to benefit a child, though the benefits might lessen. "Although exclusive breastfeeding may be protective against certain infections requiring hospitalization during the first 12 months of life, this isn't necessarily the case after their first year."
When nursing doesn't go as planned
Before Jaclyn Lauer's son was born, she'd always planned to breastfeed. "It never occurred to me that I wouldn't be able to exclusively breastfeed my baby," she says.
But immediately, Lauer ran into problems. Between difficulties with latching and manual pumping and a few hospital stays with her son for jaundice, a lactation consultant told her that supplementing with formula would be the only way for the issues to resolve and her son to be healthy. "He spent three days in the NICU under the bili lights drinking formula while I cried and tried to learn how to use the electric pump," she says.
After trying a breastfeeding support group, pushing formula from a syringe while her son tried to latch, many different positions and recipes for various lactation-producing baked goods, the lactation consultant sat Lauer down to deliver the news: "She said exclusive breastfeeding might not work for me and that was OK. It was perfectly fine to feed my son formula. The kindness was helpful during a time when I felt extremely alone."
Over the next four months, Lauer continued trying to pump, lucky if she could get an ounce per day. "I usually fed that ounce to my son before his bedtime bottle of formula," she says. "I was exhausted physically, emotionally and mentally. I was trying to force my body to do something it clearly could not do. Talking to my friends about it helped me cope with the guilt I felt for stopping."
If it ain't broke, why fix it?
Hillary Landers gave birth to her twin girls while her husband was stationed in Colorado. She'd planned on breastfeeding as her "plan A," but understood the potential issues that could lead to formula feeding.
"I had a can of formula at the house, but I don't think we used more than two or three bottles," she says. "I was cautious of their weight because they were five weeks premature, so they were feeding every three hours on the dot, around the clock." Because her girls were so tiny, Landers knew there would be latch issues, so she was willing to give them formula if needed.
Having twins is challenging enough, but . "Some twin moms choose to feed one at a time, but I went with tandem feeding, which meant a bigger nursing pillow and a lot of pillows set up in the corner of the couch where I set up to nurse them at the same time." Landers also kept a log of feeding, which baby was on which side and for how long, and included the number of wet diapers to make sure they were getting enough nutrition.
And they were. "I had a large demand with twins," she says. In the beginning, her lactation consultant suggested letting them eat fully and then pump afterward, past the point where no milk was coming out. That would send the signal to my body to make more milk. It definitely worked." Landers was able to exclusively breastfeed for six months, and ended up with over 150 ounces of milk in her freezer.
While she and her husband started baby-led weaning around 6 months, Landers decided to continue nursing, even past the one-year mark. "I felt like it still worked with our routine," she says. "But by that point, they were basically only nursing in the morning and before bed, and maybe a snack here or there." Landers continued nursing both of her daughters until they were 14 months old. Her pediatrician encouraged her to continue for as long as she wanted.
When to wean
Whether nursing is going well but no longer fits your schedule, maternity leave is over and availability for nursing and pumping is limited or breastfeeding just wasn't right for you and your baby, deciding when to wean and how to do it can be a challenge.
Wright suggests taking into account lots of factors when deciding when to stop breastfeeding. "The AAP supports breastfeeding beyond the first year for as long as mom and baby desire," she says. "When you're ready to wean, consider whether you and baby are ready, your personal desire to continue, the need to be away from home if you are going back to work or a new pregnancy."
Landers started giving her daughters a bottle of almond milk in a training cup when she was ready to stop nursing. "They didn't seem to be too upset, though there was a bit of confusion when they would ask for milk and a cup was presented to them instead of a breast," she says.
When Lauer went back to work and enrolled her son in daycare, it seemed like the right time to wean completely. "I still feel sad sometimes that I didn't get the breastfeeding experience I envisioned when I was pregnant. It was much harder on me than it was on him," she says. "He's three now, and there's no difference between him and his friends who were breastfeed. Sometimes we just need to cut ourselves some slack."
Landers suggests enlisting the help of your partner to help you decide when to continue and when to taper off. "Talk to your partner while you're still pregnant if you want to breastfeed," she says. "When things were really tough in the beginning — and they were — he was supportive and reminded me how much I wanted to do it."
Now a doctor of pharmacy in Orlando, Fla,. Landers also points out that stress hormones like cortisol have a negative effect on milk production. "Calm patience is key, but fed is best" she says. "If you've given it your best shot, the best thing you can do as their mother is to get them fed any way you can."
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