Digestive Topics : Breastfeeding
Breastfeeding is a great choice! It provides many benefits to the baby and the mother by way of improved health, development and most importantly, a strong bond. Download the GIKids Breastfeeding Fact Sheet to learn more about the benefits of breastfeeding and to learn about breastfeeding babies with colic, allergies and reflux.
What is breastfeeding?
Breastfeeding is the natural way of feeding a baby. Human milk is the perfect baby food. It meets the specific needs of a human baby and is nearly nutritionally complete. The main shortcoming is that breast fed babies need to be supplemented with 400 IU of vitamin D starting at 2 weeks of age to improve growth and bone heatlh. Breastfeeding significantly reduces the risks of diseases for mother and child. A breastfed baby is less likely than a formula fed baby to develop:
- Ear Infections/Allergies
- Respiratory problems
Researchers have found that infants breastfed for seven to nine months had higher IQ’s as adults, than those breastfed for less than seven months. Breastfeeding is associated with better adult cholesterol levels and studies indicate that breastfeeding also helps prevent insulin dependent diabetes, another risk factor in developing heart disease. It is also one factor that reduces the risk of childhood obesity. The longer a woman breastfeeds, the more protected she is against breast cancer.
How often should a breastfed baby nurse?
The American Academy of Pediatrics (AAP) recommends that babies start to nurse within the first hours of life, with frequent nursing of somewhere between 8-12 times per day during the first month. The baby should have at least 6 wet diapers per day. The bowel movements (BMs) of a totally breastfed baby usually appear liquidy and golden yellow in color. Some mothers believe that they should wait for their breasts to “fill up” between feedings in order to have enough milk for their babies (scheduled feedings). However, this is not based on any scientific evidence. Infants, particularly breastfed infants, do best when allowed to feed as they indicate their needs. This is called “cue” or “on demand” feeding. The AAP recommends that babies should be allowed to set their own routine, rather than being placed on a predetermined schedule.
Colic, allergy and breastfeeding
Exclusively breastfed infants may develop signs and symptoms of intolerance, such as colic, crying and excessive fussiness. It is important to determine whether the child is receiving adequate amounts of breast milk and therefore adequate calories. Mothers can offer the breast more often and see if the infant is hungry. Sometimes changing the way the baby is nursed at the breast may be helpful in improving fussiness and a lactation consultant may be helpful. Often maternal elimination diets are not helpful.
Breast milk colitis (also called protein-induced colitis) is a form of food allergy where a generally healthy breast fed infant presents with liquid stools associated with streaks of blood. Less commonly an infant may present with poor weight gain due to inflammation of the small intestine. Food allergies associated with breastfed infants are usually due to substances from the food ingested by the mother and passed into breast milk, rather than the breast milk itself. If an elimination diet is necessary, cow’s milk should be the first food eliminated. Most infants will respond to removal of cow’s milk from the mother’s diet. It is not necessary to eliminate multiple foods from the mother’s diet as a first line of therapy. Should the infant have ongoing symptoms following the elimination diet, then a doctor may consider the use of a specialized formula where the protein in the formula has been broken down. Most infants will outgrow the problem by about 6 to 18 months.
The breastfed baby with regurgitation
Regurgitation is the back-up of stomach contents into the esophagus. It is a normal process in infants, does not effect growth and development, nor do the infants need acid-blocking medication since milk acts as a natural antacid. Sometimes overactive let-down (from over-supply of milk or a too forceful flow of milk from mother’s breast) or over-eating can increase infant spitting-up. Breastfeeding, however, should continue even when the baby has regurgitation.
These babies may do best by nursing on only one breast at each feeding session. When breastfeeding a baby with regurgitation, it is important to remember basic breast-feeding management is the key.
- Position the baby so that gravity can help keep the milk from coming back up
- Baby may prefer being upright
- Use an over-the-shoulder baby sling, or front carrier, to position the baby at breast level, and nurse while standing or walking
- Nurse lying down (“side by side”), with baby elevated on mom’s arm
- Try feeding in a recliner, in a rocker with feet raised, or resting back on pillows
- Position baby tummy to tummy with mom, with baby facing toward the breast
While limited research has been done on breastfeeding and formula feeding for babies with regurgitation, it has been shown that breastfed babies with regurgitation have less severe problems at night. Some mothers have found the following tips helpful:
- Hand express milk to get it flowing before putting baby to breast
- Vary positions while nursing
- Nurse while baby is sleepy
- Eliminate distractions, walk while nursing
- Skin-to skin contact
In most cases, with time and further growth and development the baby’s regurgitation will improve and resolve.
Breastfeeding is a great choice! Breastfeeding provides many benefits to the baby and the mother by way of improved health, development, and most importantly, a strong bond.
For Additional Information
IMPORTANT REMINDER: This information from the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) is intended only to provide general information and not as a definitive basis for diagnosis or treatment in any particular case. It is very important that you consult your doctor about your specific condition.