"No Nutritional Benefit?" A Breastfeeding Myth Debunked

Welcome to The Breastfeeding Cafe Carnival!

This post was written as part of The Breastfeeding Cafe's Carnival. For more info on the Breastfeeding Cafe, go to www.breastfeedingcafe.wordpress.com. For more info on the Carnival or if you want to participate, contact Claire at clindstrom2 {at} gmail {dot} com. Today's post is about child-led weaning. Please read the other blogs in today's carnival listed below and check back for more posts July 18th through the 31st! 

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 Lately I've been hearing women at my playgroup or in the church mother's lounge passing around the idea that that breastfeeding has "no nutritional benefit" after the first year. Women say this with the implication that the only reason to breastfeed your baby is because it feeds them. I have been responding that even though children at age one and beyond are able to eat table food and therefore do not "need" breastmilk, their immune systems benefit from breastfeeding and they get comfort from the nursing relationship.

But then I decided to do some research. And I found multiple sources of evidence that breastfeeding after the first year does, in fact, have nutritional benefits. And why wouldn't it? Breastmilk is nature's tailor-made food. It is not as if the milk that keeps babies healthy for their first year suddenly becomes diet coke after a year. The fat energy content of breastmilk actually increases with prolonged lactation. It probably changes in composition to meet the needs of the nursing child as she grows and begins to eat complimentary foods.

And even though one year olds can eat a balanced variety of table food, it doesn't mean that they will. Toddlers are notoriously picky eaters. That is why companies design drinks for them to "fill in the gaps" in their diet from the things they refuse to eat. Obviously, continued breastfeeding works the same way. One study of children in Kenya found that the more deficient the food diet of the child, the more nutrition the child got from breastfeeding. Nursing does not provide complete nutrition for toddlers, but it does complement the diet they eat.

When my daugher started solids (we did both finger foods and homemade purees) at 6 months, I followed the recommendations at kellymom. I offered solids about an hour after nursing, so she was never very hungry when she ate and never ate a lot. When she started eating table food around 12 months, she was still nursing a lot and not eating large amounts of food. I was glad that even if she didn't eat much food, I knew she was at least getting nutrition from breastmilk. I knew she was just not ready to wean. No one really seemed to be bothered by the fact that she was still nursing, but we didn't get out much at the time, so not a lot of people even knew. A few months later, after she and I both got sick and my milk supply suffered, she was nursing only to fall asleep. That decrease in nursing increased my fertility, and since we were "not preventing" pregnancy anymore at that point, I got pregnant with my son the following cycle.

At that point, either continuing or stopping wouldn't have affected either of our lives verey much. I knew that nursing throughout pregnancy and tandem nursing are options, but I chose to wean her a few weeks after I found out I was pregnant. We weaned slowly, over the course of about 3 weeks so that my milk would decrease slowly and avoid the risk of mastitis. She learned to fall asleep with snuggles instead of nursing, and it was so gradual, that I didn't even realize when it was the "last time" for her to nurse. I can't imagine mother-guided weaning going more smoothly.

I am grateful that I chose to not to automatically wean at an arbitrary age, like one year. I feel that the choice to wean when we did was the best choice for us, and everyone has to make the best choice for them. People aren't making informed choices if they are basing them on inaccurate information, like the myth that breastfeeding after a year has "no nutiritonal benefit. 

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 Here are more posts by the Breastfeeding Cafe Carnival participants! Check back because more will be added throughout the day.

• Sylko @ Chaotic Mama—Breastfeeding Carnival: Child-led Weaning


• Shary Lopez @ Mama Fish—On How We Concluded Our Breastfeeding Relationship...


• BoobiesNBabies @ Num In Mind—She Will Let me Know


• Claire @ The Adventures of Lactating Girl—Facing It As It Comes


• Lexi @ Life As A Mommy—She's Done When SHE'S Done


• Timbra @ Bosoms & Babes—Where she leads


• Charity @ Imperfect Happiness—Child-led Weaning Breastfeeding Cafe Carnival Post


• Natasha @ naturalurbanmama—Mutual Weaning - My New Terminology


• Renee @ Just the 5 of us!—Weaning


• Brittany @ Birth Unplugged—No Nutritional Benefit Breastfeeding


• Kimberly @ Monkey Tales Mama Thoughts—End of Nursing


• And of course the guest poster on the Breastfeeding Cafe’s Blog today is Marilee Poulson—The Normal Course of Breastfeeding

How Midwifery Care Can Reduce Racial Disparities In Birth Outcomes

At the request of Courtroom Mama posting at The Unnecessarean, I watched the documentary Crisis in the Crib: Saving Our Nations Babies. I think the film does a great job of raising awareness on the issue of racial disparities in birth outcomes and infant mortality in the United States. It really got me thinking about what factors contribute to this disparity. I think it is a very complex problem, and it can be difficult to pinpoint all of the causes. Poor nutrition, lack of exercise, and lack of access to care are all factors, but they don't explain why there is still a disparity for babies of college educated black women. The film suggests higher stress levels and the lack of presence of a supportive partner as possible additional factors that could influence middle class populations. There are also some life-course factors.

As I was considering these factors and trying to decide what to write this blog post about, I remembered this video from last year's The Big Push for Midwives Issue Briefing for members of Congress showing Jennie Joseph, LM, CPM talking about her birth center, The Birth Place, in Orlando, Florida.

It's pretty clear that The Birth Place has drastically fewer racial disparities than her area's average. She attributes the difference to their care being more accessible to the uninsured, but I think that is only part of the story. I believe that the obstetric model of care, which is the norm in the U.S., is failing black women. Here are some components of the midwifery model that I believe may better meet their needs:

• Focus on Preventing Complications with Healthy Lifestyle - While obstetric practices generally focus mostly on screening for pathology, midwifery care includes extensive counseling on nutrition and exercise during pregnancy. This approach integrates prevention of problems.

• Individualized Care - Midwives strive to make their care specific to the needs of individual women instead of providing one-size-fits-all care that may be more suited to one race than another.

• Holistic Treatment - Midwifery care treats the whole woman, not just her body. Prenatal care that is only a medical check up is a missed opportunity to resolve other issues that could contribute to disparities, including social and emotional stresses in the woman's life.

• Longer Prenatal Visits - The average length of a midwife visit is significantly longer than one with a physician. This allows more time to focus on these issues and develop a trusting caregiver/client relationship.
  

• Relaxation Practice - Birth centers do not offer epidurals, so midwives at a birth center would encourage women to prepare for a natural birth. In fact, State of Florida Law requires that birth centers counsel their clients to receive appropriate childbirth education. This preparation usually involves relaxation practice, which can be helpful for dealing with stress.

• Empowering Education - Midwifery supports women in being educated and involved in decisions about their care instead of letting the birth professional make most of the choices for them. This can help them learn to take responsibility for themselves and their babies, both during and after the childbearing cycle.

I believe that the caring, sensitive, woman-centered model of midwifery care may be exactly what is needed to reverse the terrible trends we see in maternity care today and make great bounds in resolving the disparity we see between races in maternity care in the U.S.