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Subject:
From:
David Sulman and Anne Altshuler <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 22 May 2007 22:12:48 -0500
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>
Kris asked:


> Date:    Mon, 21 May 2007 11:44:07 -0700
> From:    Kris Rogers <[log in to unmask]>
> Subject: EP vs direct breastfeeding and chuckle for the day
>
>>  Since we've been on the topic of exclusive pumping, I was  
>> interested in hearing what you might say to a mom who is asking if  
>> there is a diffierence between direct nursing and just giving her  
>> own milk in a bottle.  What sort of advantages besides less work  
>> involved does the baby and mom receive by direct breastfeeding  
>> that they would miss if the baby just received EBM in a bottle?
>


Some things moms might not have thought about:

Breast milk from the breast is instantly ready, at just the right  
temperature to feed, comfort and soothe a needy child.  No rushing to  
get it ready.  The act of breastfeeding generally soothes and relaxes  
mom as well.  It gives mom a chance to sit down and cuddle up and let  
go of the other demands on her time and attention for just a bit.   
And think of the delightful games nursing mothers and babies play all  
over the world - baby toying with mother's clothing or necklace,  
puttiing fingers on mother's mouth, playing peek-a-boo with her  
blouse, patting her breast (which my nurslings continued to do long  
after weaning), and that loving gaze at just the right distance from  
mother's face to baby's eyes, then eyelids growing heavy and finally  
closing in satisfied sleep.  The baby is more likely to hear mother's  
heart beat as well.

When a baby feeds at the breast, gazing up at mother's face, it is  
beneficial to eye muscle and facial muscle development on both  
sides.  When bottle-feeding, mothers tend to use their dominant hand  
and not switch sides.  So when I talk with mothers who will be  
feeding by bottle, I suggest they switch sides as would be done in  
breastfeeding.  Also, issues related to jaw and dental development,  
risks of dental decay more likely with bottles and milk pooling  
against the teeth.

Others have already mentioned the specificity of the milk directly  
from the breast to protect from germs in the environment at the time  
(wouldn't happen with milk frozen and used some weeks later) and to  
change over the course of the feeding to meet the needs of the baby's  
appetite.  Earlier discussions mentioned possible differences in  
satiation and appetite control, reducing the risks of later obesity.

I don't know if a mother feeding expressed breast milk by bottle  
reaps the benefits of the Lactational Amenorrhea Method of child  
spacing, or what effect there is on breast cancer and other long term  
illness rates for the mothers who pump and exclusively bottle feed.   
I don't think it has been studied.  People usually pump and bottle  
feed many fewer times a day and also less often at night than if  
feeding at the breast.  So hormonal differences may occur between the  
two methods.

Some mothers are exclusively pumping and bottle feeding for issues  
like a baby with cleft palate or their own history of past sexual  
abuse making direct breastfeeding a difficult experience for them,  
and I agree we need to support them wholeheartedly.  But what saddens  
me is those who pump and bottle feed because our society has given  
the message that breastfeeding is disgusting or embarrassing and must  
be hidden.  We need to help all mothers who would like to breastfeed  
directly feel welcomed and supported in doing so.

Sorry, I'm a bit behind in reading Lactnet, so these points may have  
been covered.


Anne Altshuler, RN, MS, IBCLC, LLL leader Reserve
Madison, Wisconsin, USA
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