WORLD HEALTH

 

 

 

In the shortest answer, just two words: “Back off.”

 

It seems, reading between the lines, that your daughter may be asserting her independence, and direct pressure will tend to backfire. She will have to be allowed to make her own choices, and likely will be influenced more by her health care provider and support group over this issue than by your protestations.

 

Breastfeeding is a most important way of caring for the newborn. In places such as rural Africa this practice is so important that in some regions four out of five infants who are not breastfed do not survive past their first birthday. Infants fed a cow’s milk formula also face a small, but real, increased risk of developing type I diabetes, otitis media, gastrointestinal illness, as well as pneumonia and obesity as they grow older, even in Western society.

 

Mothers who don’t breastfeed also face increased health risks. These are not enormous risks, but they are statistically significant and may influence a woman to choose appropriately.

 

Mothers who do not breastfeed face a greater risk of diabetes themselves. High blood pressure is also seen more frequently in those women who have not breastfed. The risk here is about 10 percent higher than in those who breastfed for at least one year. It has been known for some time that the risk for breast cancer is reduced in mothers who breastfeed, as is the risk of ovarian cancer.

 

There is evidence beginning to accumulate that women who did not breastfeed have a higher incidence of the metabolic syndrome that is a predisposing condition to type II diabetes and heart attack.

 

Women in the U.S. Nurses’ Health Study who had never breastfed had a 1.3 increased relative risk of heart attack.

 

Why these differences should attend those who do and don’t breastfeed is not clear. It’s been suggested that breastfeeding helps lose the accumulated fat of pregnancy with positive benefits for the mother. Others have suggested that oxytocin released during breastfeeding slows the heart rate and lowers blood pressure, and that other hormonal adjustments may be beneficial.

 

Of course, some of these factors might relate to lifestyle choices made by nonbreastfeeding women. Women who choose to avoid breastfeeding tend to be less educated and of lower socioeconomic status. They are more likely, as a group, to have an increased number of smokers in their ranks. These factors could well explain some of the differences between the two groups of women.

 

It is very important that doctors and nurses promote breastfeeding and support mothers in making their decisions.

 

The prevalence of HIV infection in Africa, however, has led to serious questions about breastfeeding when a mother is infected; though the availability of highly active antiretroviral therapy has changed the situation enormously.

 

In the Western world lactation consultants have become available. These are usually nurses who have studied the nuances, problems, and possible difficulties a new mother may encounter with breastfeeding. They can advise, demonstrate, and generally facilitate in the process of breastfeeding.

 

In my experience, the relaxed, natural approach to breastfeeding seen in many developing countries would be a great advantage to our nervous and tense Western society.

 

In the case of your daughter, if she is receiving competent care, I am sure she will be advised of these factors to help her make a decision. 

 

Peter N. Landless, M.B., B.Ch., M.Med., F.C.P.(SA), F.A.C.C.,
is ICPA executive director and associate director of the General Conference Health Ministries Department.