Just why breast really is best.

Earlier this year I was asked to write a foreword for a book entitled “Born to Breastfeed” by Rowena Gray. I read the manuscript, was really impressed and so agreed. The book was published recently and I spoke at their launch event. The feedback has been mostly positive but what surprised me was the reaction from some media camps. It seems that just talking about breastfeeding divides women. It falls into that camp of ‘judgment’ and ‘mother guilt’ that inevitably accompanies anything to do with parenting and mothering in particular.

So right up front I want to make absolutely clear. This is not about judging anyone. As women we should always have each other’s back and be a support to one another. That’s the way any women worth her salt behaves. So if for whatever reason you are formula feeding your infant or did formula feed, this is not about shaming you. There are a myriad of reasons that drive a mother’s decision as to how to feed her baby. Sometimes it is a choice and other times it’s not. Each family has their own unique circumstance that drives the outcome.

What I am concerned about however is that in our fear of judging women, who formula feed, the conversation about exactly why ‘breast is best’ is being muted. Several media outlets have refused to run any breastfeeding stories and to me that is doing women and their babies a disservice. Regardless of the topic, my goal is always to give women all of the information available so that they are in a position to be able to make the best choice for them. Without the correct knowledge how can an informed decision be made?

Sadly this is exactly what is happening. Yes there are circumstances, be they medical or situational, where formula feeding might be best for a particular family. But where there is a choice, it’s a woman’s right to understand the full benefits that come with breastfeeding. They then need to have the support and guidance along the way to get the best outcome for them and their baby.

The WHO and our own NHMRC recommend exclusive breastfeeding to around 6 months, continuing breastfeeding while solids are introduced until 12 months, and longer if both mum and baby wish. Here in Australia we are falling far short of these recommendations. While we have fantastic rates of initiation of breastfeeding with 96% of women choosing to do so, this falls away rapidly such that by 3 months of age only 39% of babies are being exclusively breastfed, and by 5 months only 15%.

Why does this matter? Well the truth is that from a nutritional and health perspective, there is no contest between formula and breast milk. Breast milk wins hands down. It is a unique living substance that is impossible to replicate with formula. Formula companies do a sterling job of mimicking the nutritional aspects of breast milk as best they can and the result is a safe product that certainly meets the baby’s nutritional needs. However there are key differences and many aspects that just cannot be replicated.

Breast milk contains antibodies from the mum that help the baby to foster a good strong immune system. Breastfed babies have fewer infections as a result. The microflora that develops in a breastfed baby is also different to one who has been fed on formula. This impacts on immunity and gut health in infancy and beyond. While the composition of formula is standardised, at least within each stage specific formulation, breast milk changes within each feed and over time to tailor the nutrition to the individual baby. Isn’t that quite extraordinary?

One of the major composition differences between formula and breast milk has just been illuminated in research. Formula-fed babies have a higher risk of being overweight and being obese. The reason for this has been pin-pointed to the higher protein content of formula.

Protein is usually portrayed as the darling nutrient for weight control, with adults guzzling protein shakes by the bucket load as they leave the gym in an effort to lose weight. But in babies who are developing and growing at a rapid rate, too much protein actually makes them fatter.

Independent intervention studies from Europe, Chile and the USA have all seen the same results; that babies fed the usual higher protein formulas are fatter at 12 months and are still fatter by the time they are 6 years old compared to those who are breastfed. This greatly increases their risk of being overweight later in life. However babies fed a specially produced low protein formula (much closer to the protein levels in breast milk) were closer to the breast-fed babies in terms of body fatness. Unfortunately in Australia legislation has not caught up with this research and lower protein formulas are not allowed. Hopefully we will see this change.

So we know that there are long-term benefits to the child from breastfeeding, but there are also health benefits to the mother. Breastfeeding reduces the risk of breast and ovarian cancer, type 2 diabetes and osteoporosis later in life.

So why is it all so controversial? The reality is that for many women breastfeeding is a difficult and unpleasant journey, that ultimately causes her to give up. I breastfed my own two boys and was not one of those women who absolutely loved it. I can attest to many of those difficulties – mastitis, waking up in the middle of the night to a sleeping baby but swollen painful breasts, the terribly practical but very inelegant experience of using an electric breast pump – these are not pleasant memories. However I did get through them because I had advice and support.

This is what the Born to Breastfeed book is all about. Giving women that help, support and badly needed advice to allow them to continue to breastfeed because the reality is that most of us can. So let’s lift the lid on this conversation and allow the facts to be told. Allow women to receive the right information, good advice from the experts in the area and the support from their families, but also the public at large from changing attitudes, and avoid making this about ‘us and them’. Australian women and their babies can only benefit as a result.

What do you think about breastfeeding verse bottlefeeding?