Breastfeeding: What do the guidelines really say?

When you’re pregnant, it seems like everyone has an opinion or wants to give you advice. For example: what you should eat when you’re pregnant, how you should choose your baby’s name, and how to handle labor pains are just some of the popular topics people like to weigh in on. Another such topic is breastfeeding. Everyone seems to have an opinion and it can be confusing to know who to believe, or what the evidence is about breastfeeding.

At Diana Health, we want you to have information you need so that you can make an informed decision that works well for you, your body, your health, your baby, and your lifestyle. Once you’ve read this basic information, we encourage you to seek out other reputable sources for information on breastfeeding, such as websites, lactation consultants, blogs, and your own Certified Nurse Midwife or OB/GYN  who can help you decide the best path forward for you and your baby.

What Does the Evidence Say?

The American College of Obstetricians and Gynecologists recommends that women exclusively breastfeed their baby until they are at least 6 months old. They also suggest that women continue to breastfeed their baby until they are at least one year old, even as additional foods are introduced into the baby’s diet. Exclusive breastfeeding for the first six months of life is also recommended by the American Academy of Pediatrics. 

Why do the guidelines encourage breastfeeding?

Benefits for Baby

According to the Centers for Disease Control and the American Academy of Pediatrics, breastfeeding is associated with and/or linked with:

• Fewer respiratory tract infections
• Less asthma
• Less type 1 diabetes
• Fewer gastrointestinal infections (diarrhea/vomiting)
• Fewer ear infections
• Decreased obesity
• Lower sudden infant death syndrome risk
• Decreased necrotizing enterocolitis for babies who are preterm

Benefits for Mom

Breastfeeding, especially for longer periods of time, is associated with a decreased risk of  a mom getting:

• Breast cancer 
• Ovarian cancer
• High blood pressure (hypertension)
• Type 2 diabetes

What if you struggle with breastfeeding and need an alternative?

According to the Centers for Disease Control, although 83% of babies in the U.S. are ever breastfed, only 25% of infants are still exclusively breastfed at 6 months. 

Why don’t more moms breastfeed exclusively until their baby is at least 6 months old?

Although breastfeeding exclusively for at least the first 6 months is recommended by leading health organizations, we know this often does not happen. One study showed that 45% of U.S. moms reported undesired, early weaning. About ⅔rds of all women weaned earlier than they had initially intended. The reasons are varied but some common obstacles include:

• Challenges returning to work and pumping (not having a place to pump in private, store milk, or support from management)
• Schedule or time constraints
• Illness in mom and/or baby
• Lack of support when having challenges with breastfeeding
• Problems with the baby latching on, painful nipples, or other breastfeeding challenges
• Lack of policies that support breastfeeding families

According to Joan Younger Meek, MD, RD, IBCLC, and lead author of the AAP Section on Breastfeeding, “Not everyone can breastfeed or continue breastfeeding for as long as desired for various reasons, including workplace barriers. Families deserve non judgemental support, information and help to guide them in feeding their infant.” We at Diana Health couldn’t agree more.

Not every woman is able to breastfeed their baby or may need to stop breastfeeding earlier than intended. If you aren’t able to breastfeed your baby, you may feel anxious or worried that your baby will not be healthy or that your baby will experience harm. The reality is that breastfeeding doesn’t work for everyone. If you choose not to or are unable to breastfeed, we do not want you to feel shame or guilt. We are here to support you with information and evidence, while also holding space for you to choose what is right for you and your family, each step of the way. 

The Realities of the Risks

Although the risk of some health conditions are higher for babies who are not breastfed and for moms who do not breastfeed, there are also many babies and moms who are very healthy and have never breastfed or been breastfed. Breastfeeding simply impacts the risk of certain conditions – it does not predict or completely eliminate certain conditions. We know that some babies who are breastfed have many infections and there are babies who are not breastfed who never have an infection. There are risks and benefits of many decisions that we make for ourselves and our babies. We are here to support you through whatever you choose. 

Breastfeeding Support & Formula Resources

If you are interested in learning more about breastfeeding or need additional support with breastfeeding, talk to your Diana Health Care Team or your healthcare provider to get resources and potentially connect with a lactation consultant. They have experience with helping moms who are struggling with breastfeeding. We even offer a Lactation 101: Building Breastfeeding Confidence class that can help prepare you with the basics of breastfeeding.

In the United States, we are fortunate to have the WIC program (Women, Infant, and Children services), which provides affordable access to infant formula. Should you prefer to feed your baby using breast milk, you can also find a local milk bank here.

Whether or not you breastfeed your baby, you will want to stay well connected with your baby’s healthcare provider so that they can help guide you as you nourish your baby in whatever way is best for you and your family.  At Diana Health, we are here for you and your baby, every step of the way.