Here, Dr Fiona MacRae, Women’s Health & Hormone Specialist at The Marion Gluck Clinic, provides an expert view on pregnancy, breastfeeding and hormones
Breastfeeding is the natural way to provide nourishment for a newborn’s first three months. “Breast is best” is the mantra, but best for who? Is the evidence in support of the pro-breastfeeding movement valid? Why is the UK having one of Europe’s lowest rates?
The best source of nutrition for newborn babies
For newborn babies, human milk is the best source of nutrition. Breast milk should be consumed exclusively for six months, with complimentary breastfeeding for 12 months. This recommendation is supported by several medical and professional organizations, including the World Health Organization (WHO), Royal College of Paediatric and Child Health(RCPCH), and Public Health England [PHE].
Breast milk is rich in macronutrients, minerals, water and has immunomodulatory and anti-inflammatory properties. This protects infants from infections like gastroenteritis and diarrhoea.
Breastfed infants are less likely to experience sudden infant death, asthma attacks, allergies or dental malocclusion.
Breast milk is high in digestive enzymes, such as protease. These enzymes aid infant digestion. Close skin-to-skin contact has neurobehavioural benefits, as well as analgesic and pain relief effects.
There are several attractive benefits for new mums and evidence-based health advantages. The rise in oxytocin is linked to breastfeeding. One function of this hormone is to contract the uterus, and reduce post-partum bleeding. The contraceptive benefit of breastfeeding is due to the circulating high levels of prolactin. This inhibits gonadotrophin production and ovulation. It is crucial for post-pregnancy weight reduction. While breast milk production burns more calories, high levels of oxytocin stimulate fat burning.
Breastfeeding promotes the mobilization and metabolism visceral fat, which reduces the risk of developing type 2 diabetes. Lactation also improves insulin sensitivity and glucose tolerance. It is known that it decreases the stress hormone cortisol’s production and release. This decrease in stress persists throughout the breastfeeding period. The bonding between mother & baby is enhanced by Oxytocin, which triggers positive emotions. Breastfeeding mothers have long-term advantages. There is evidence to support a reduced risk of developing breast, ovarian or endometrial carcinoma.
It is essential to ensure lactation with a well-balanced diet that includes lean protein and oily fish as well as complex carbohydrates. Calcium and other essential nutrients are provided by adequate dairy intake. You can fortify milk with vitamin D. Some groups recommend that mothers who are on a restricted diet such as vegans take vitamin B during lactation. Your overall calorie intake may need a boost. Both mother and baby should pay close attention to maternal nutrition during lactation.
Economics aside from the obvious savings for breastfeeding mothers’ finances, the NHS could be benefitted by breastfeeding. This would reduce GP visits and hospital admissions.
How much do UK women breastfeed?
Nearly three quarters (75%) of UK mothers choose to breastfeed after their child is born. However around 40% stop breastfeeding within six to 8 weeks. PHE conducted a survey to discover if mothers are worried that their babies may not be getting enough nutrients, or if they are under- or overfeeding them. While pressure may be applied by relatives to give formula, it only hinders milk production.
You may also feel more uncomfortable when you breastfeed in public because of societal attitudes. PHE polled 63% women who said they would be embarrassed to breastfeed before strangers. Particularly low rates of breastfeeding are seen among young mothers from lower socio-economic backgrounds. Given the above benefits, it is clear that this disparity will lead to an increase in health inequalities. This is a PHE concern.
Key messages for health professionals
RCPCH outlines key messages for health professionals stating that “all child health professionals have a responsibility to be aware of specialist advice and local services to support breastfeeding, in order to signpost mothers effectively”. (1) It is notable that the WHO now bans infant formula promotion and providing free samples of formula to new mothers. While some mothers may not be able to or choose not breastfeed, this should be respected. However, the WHO has now banned the promotion of infant formula and providing free samples of formula to new mothers. Breastfeeding is encouraged by the medical profession because it offers many health and wealth benefits. It is often necessary to provide encouragement and support for young mothers. Babies are smart little beings that can fulfill their own needs provided they have a supportive environment. We have seen that many mothers opt to breastfeed first, then move to formula. This is where a compassionate health visitor’s timely support could be crucial.
You may also need hormonal support. As many as 75% of new mothers suffer from post-partum depressive symptoms (PPD) after having their progesterone fall. Breastfeeding mothers have a lower rate of PPD and a decreased chance of breastfeeding. The feel-good hormone progesterone can be transdermally applied to select women to reduce PPD. It is safe and natural, and will leave moms feeling happier and better equipped to care for their babies.
1. https://www.rcpch.ac.uk/resources/breastfeeding-uk-position-statement#key-messages-for-health-professionals
