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Breast-feeding: Perseverance brings results

Reproduced from www.oregonlive.com
10/06/02
PATRICK O'NEILL - THE OREGONIAN

It’s not news that mother’s milk is the best for baby, but that is certainly the reason new moms give for their decision to breast-feed.

Few speak about the new research that has shown that breast-feeding can protect against a wide variety of cancers as well as osteoporosis, infections, obesity and even depression.

No one mentions the landmark study published in July in The Lancet medical journal that found that the more children a woman has and the longer she nurses them, the less chance she has of developing breast cancer.

Women simply answer in chorus: It’s the best thing for my baby.

More and more, research shows it’s good for mom, too.

Despite all this good news, nursing doesn't necessarily come easily to everyone. Problems with Starting Out Right, producing enough milk and feeling comfortable are common physical concerns. At times, career demands and social stigmas play against nursing, leaving new moms to abandon their desires and this good news altogether.

Success, experts say, starts with early commitment -- which means you need to start thinking about it even before you become pregnant.

"The commitment to breast-feeding occurs before pregnancy," says Margi Munson, an international board-certified lactation consultant and coordinator of lactation services for Legacy Health System. "The more you are really planning on breast-feeding, the more likely you are to succeed."

She has found that women who say they're going to "try" to breast-feed are the least likely to succeed because they seem to lack a positive attitude.

"So much of breast-feeding is psychological anyway," she says. "Breast-feeding is 90 percent in your brain and the other 10 percent is on your chest."

Munson says 85 percent to 90 percent of new mothers in the Legacy system start breast-feeding in the hospital.

Figures on breast-feeding are sketchy, but Munson guesses that 30 percent to 60 percent of Legacy mothers are still breast-feeding their infants six months later.

A 1998 survey by Abbott Laboratories found that 64 percent of women nationwide begin breast-feeding. The national figure tapered off to 29 percent by six months and 16 percent by one year, the length of time the American Academy of Pediatrics recommends that mothers breast-feed.

"We feel like we struggle keeping women on track," Munson says, adding that breast-feeding is far more popular with women on the West Coast than in the East.

A learned skill At Legacy hospitals moms and babies are encouraged to breast-feed within the first hour of life, something Jennifer Merrill had planned to do when Sophie was born. Sophie, however, had other thoughts, leaving new mom and little daughter in a frustrated state for a couple of weeks.

Merrill, a recent graduate from Oregon Health & Science University, knew the benefits of breast milk and was discouraged when Sophie didn't immediately nurse.

"It was hard at the beginning," Merrill, 32, says. "I was scared." Sophie wasn't eating enough and lost weight, so Merrill sought out advice from Legacy. The "incredibly helpful" advice she received put her and Sophie back on track. "A lot of people say, 'Oh, you'll know, the baby will know' how to nurse, and we didn't," says Merrill, who remembers wondering why as a mother and a nurse she couldn't make it work. "If I didn't have the help (of the lactation services), the pediatrician would have put her on formula. With Margi’s support, I was able to say this is what I’m going to do," says Merrill, who lives with husband Anthony in Southeast Portland. "As long as we saw increments in her weight gain, I was encouraged to keep going."

Third time’s a charm Shannon Kirk’s desire to get breast milk to her first baby met with different hurdles. Colin, who is now 5, was born prematurely at 32 weeks.

Colin was not strong enough to eat on his own and was in the neonatal intensive care unit at Legacy Emanuel Hospital & Health Center for three weeks. During that time Kirk, 34, pumped her milk for Colin until he learned to latch on and nurse on his own.

When her daughter came along two years later, also prematurely, at 31 weeks, Kirk maintained her desire to nurse, but little Caitlin was born with pneumonia, and her lungs were not developed. "I pumped for two straight months," Kirk says, adding that Munson was her biggest supporter.

No one had told Kirk that it was uncommon for preemies to latch on to nursing, and it took Caitlin a long time to get it. "It was devastating for me," Kirk says. "It was something I wanted to do so badly. . . . It’s important for them to have my milk." Kirk says she and Caitlin "muddled through," and two weeks past her full-term date, "Caitlin got it."

The support Kirk, who lives in Happy Valley with her husband, Troy, received from Munson is the kind that’s vital to successful nursing for many new moms.

Kirk was thrilled with the immediate bond she had with her third child, Ryan. Although Kirk spent 13 weeks on bed rest, it paid off when she carried Ryan to term and was able to hold him and nurse him nearly immediately. "Nursing is an amazing relationship with your child," Kirk says.

Kirk, who isn't working outside the home now, did return to work after the birth of her first child, Colin, and is passionate about employers making it easy for women to continue to nurse.

"It’s the best thing for the baby," Kirk says

Balancing nursing, work Merrill, who returns to work in February, hopes to continue nursing Sophie for a year. "I'll be working in a hospital, which is supportive of breast-feeding."

The best way to tune in your commitment is to surround yourself with friends and relatives who support your decision to breast-feed.

"Any mom who has an opportunity to breast-feed at work or at day care is going to have a higher rate of success -- whatever their goal," Munson says.

Lee Wyatt’s goal was to get her milk to her daughter.

Wyatt’s third child, Gehrig, was born 10 months ago with an undiagnosed neuromuscular condition. "There is some disconnect in her brain from what her brain wants to do and what her body is able to do," says Wyatt, an attorney who lives with her husband, Pete Baur, daughter Gretel, 5, and son Gustav, 2 1/2, in Corbett. Gehrig is unable to take food by mouth, so Wyatt pumped her "Mom’s milk," as she calls it, and fed it to Gehrig through a gastrointestinal tube. "Mom’s milk is brain food," Wyatt, 37, says.

Gehrig is showing improvements in both motor and brain function, something "we had no hope for" when Wyatt left the hospital after Gehrig’s birth. "Where she is today is part miracle, part mother’s milk and part physical therapy," Wyatt says.

Moms benefit from nursing Breast-feeding may also be "brain food" for the mom, according to Dr. Elizabeth Mezzacappa, assistant clinical professor of medical psychology in psychiatry at Columbia University College of Physicians & Surgeons and a breast-feeding researcher.

Mezzacappa says there’s a deep connection between breast-feeding and activity in the brain, which helps explain why nursing women suffer less depression than their bottle-feeding counterparts.

"My analysis of data indicated that women who breast-fed were half as likely to have a high depression score shortly after the baby’s birth than mothers who bottle-feed," she says.

Research shows that cells in the brains of rats actually change their structure when the animals begin lactating. The cells in question, called oxytocin neurons, are in areas of the brain that control emotions. Researchers are only beginning to understand the depth of the connection between the brain and the act of breast-feeding. That connection is an evolutionary certainty, Mezzacappa says, because feeding infant mammals is essential to their survival.

Carol Houtari, manager of La Leche League’s Center for Breast-Feeding Information, says medical schools don't stress the importance of breast-feeding. As a result, doctors don't give their patients enough guidance in that area.

"Women need to understand from their obstetricians how important breast-feeding is," she says.

That information is essential to overcoming the embarrassment some women feel about nursing in public. "In our country breasts are considered to be sexual objects," she says. "Even if women use a pump at work, they're embarrassed because people hear the pump."

Kirk finds nothing to be embarrassed about.

"I’ve been to two home Ducks games with 57,000 fans," Kirk says about nursing in public. "I don't care. This is what we do. It’s so healthy."

Patrick O'Neill; 503-221-8233;
poneill@news.oregonian.com

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