Lactation consultant discusses myths, benefits of breastfeeding

Last year, the United States Breastfeeding Committee declared August National Breastfeeding Month. The Ledger-Enquirer recently asked Debi Miller, a registered nurse, certified lactation consultant and operations coordinator of perinatal education at Columbus Regional Healthcare System, to discuss the misconceptions, benefits and sometimes controversy that surrounds breastfeeding.

This interview has been edited for length and clarity.

What are some common misconceptions about breastfeeding?

Many women have heard that breastfeeding is painful. It should not be painful. Some do experience tenderness the first few days or so but if it hurts, you need to see a lactation specialist so the baby's position at the breast and latch onto the breast can be evaluated. It is usually something very simple that can be fixed for more comfortable nursing.

Some women have heard that breastfeeding ties you down. Actually, young babies are pretty portable and you don't have to worry about carrying bottles and formula and have to worry about how to keep it cold. As baby gets older and goes longer between feedings, it is easy to schedule necessary trips around that. Also, some women find having a breast pump to be an important part of their breastfeeding experience.

I have heard women (and their partners) are worried about nursing in public. This is very much a cultural issue but nursing is the normal way to feed a baby. There is nothing "sexual" about feeding your child. In the state of Georgia you have the legal right to breastfeed your baby/child anywhere that you have the legal right to be. You cannot be asked to leave a public area if you are breastfeeding. There are many attractive nursing cover-ups if you are shy but you can breastfeed discreetly by dressing in layers.

Some men are concerned that they will not bond with their baby if they don't feed their baby. There are so many other ways to interact with your child. I encourage dads to help mom get baby positioned for feedings, change baby's diaper before feedings, bring baby to her before night time feedings, become the bath expert, (etc). A father has a unique and special relationship he can develop with his child.

Why is breastfeeding healthier for mom and baby than formula?

Human milk is specially designed for human babies! The components are uniquely designed by your body for your baby. Each mammal makes milk for their species containing what that species needs. Human milk contains antibodies to make a strong immune system and components to develop brain cells. Formula is a mixture of chemicals and alteration of cow's milk or soy to make it possible for infant consumption. It will never be as perfect a food for babies as his own mother's milk.

Breastfed babies have less stomach upsets, constipation, diarrheal illness, ear infections. The World Health Organization says: "Adults who were breastfed as babies often have lower blood pressure and lower cholesterol, as well as lower rates of overweight, obesity and type-2 diabetes. There is evidence that people who were breastfed perform better in intelligence tests." Mothers who have breastfed have a lower risk of peri-menopausal breast cancer and that protection increases the longer she breastfeeds.

Is there ever a time when formula would be recommended over breast milk?

Very rare instances. For example, if the baby has a metabolic disease called galactocemia he/she may have to be on a special formula; if mother is using drugs such as cocaine; if mother requires cancer chemotherapy or radiation treatment she many need to review her treatment program with her pediatrician and lactation specialist to see if some breastfeeding is possible. In the developed world, mothers who are HIV positive are encouraged not to breastfeed but recent research may change that recommendation in the future. If you are concerned about your individual circumstances, you can ask your baby's doctor or a lactation consultant.

What are some common issues that new mothers face when first nursing their newborns?

Most issues can be overcome with support and encouragement. Common things in the early days are: sleepy babies, sore nipples, poor latch and engorgement. These can be overcome by finding a supportive birth team and hospital to give birth in, educate yourself by attending classes about breastfeeding, having the least amount of drugs and medical intervention in your birth so baby and you are ready to feed immediately after birth, breastfeed early and frequently, keep baby with you during your hospital stay and hold baby close to your skin frequently, do not give formula, bottles or pacifiers for the first 5 weeks unless there is a medical reason to do so, attend nursing mom's support groups for encouragement and give you and your baby time to learn this special skill.

What kind of support does Columbus Regional offer nursing mothers?

We offer prenatal breastfeeding classes twice a month, lactation support and assistance in the hospital by our trained staff as well as by our International Board Certified Lactation Consultants (IBCLC) and our Certified Lactation Counselors (CLC). We offer a twice weekly Nursing Mom's Support Group at the Columbus Regional Lactation Center & Boutique and we host the LaLeche League at our North Columbus classroom monthly.

Our Nursing Mom's Groups have become so popular that we are planning to start a third weekly group next month. All breastfeeding mothers are seen in the hospital at least once during their stay by our lactation staff and have the availability to see an IBCLC as an outpatient if they or their pediatrician feel that breastfeeding may need some additional help. In our Boutique we offer a variety of breastfeeding supplies, breast pumps, nursing bras, camisoles, gowns, nursing pillows and swaddle blankets. Our goal is to support the nursing mom and baby achieve their breastfeeding goals.

Breastfeeding has been the center of some controversy in the news this year -- first, when the May issue of Time magazine featured a mother breastfeeding her 3-year-old, and again when New York's Mayor Bloomberg announced his "Latch on NYC" plan, which promotes breastfeeding and makes it more difficult for new moms to get formula in the hospital. What are your thoughts on the duration of time children should be breastfed and the role hospitals should play in the breastfeeding-vs-formula debate?

The average age of weaning internationally is between the 3rd and 4th birthday. This is not the cultural norm in the United States but it certainly is a biological norm for human infants/children. In February 2012, The American Academy of Pediatrics "reaffirms its recommendation of exclusive breastfeeding for about the first six months of a baby's life, followed by breastfeeding in combination with the introduction of complementary foods until at least 12 months of age, and continuation of breastfeeding for as long as mutually desired by mother and baby." That about says it all. The Time Magazine cover was done for shock value in the manner in which the picture was taken and displayed. The age to wean your child is certainly a personal decision for each family. Mother's should be able to have the support to breastfeed for as long as she and her baby want to.

Hospitals should support and encourage breastfeeding as it is a huge health benefit for both mother and infant. I don't believe that Mayor Bloomberg's proposition makes it more difficult to get formula for those babies who need it for medical reasons. It just treats formula as the substitute that it is for mother's own milk. An informed and educated mother still is able to choose how to feed her child. That is a decision that no one else can make for you.

This story was originally published August 21, 2012 at 12:00 AM with the headline "Lactation consultant discusses myths, benefits of breastfeeding."