ONE OF THE BABY B’s that greatly influences the physiology of mother-infant attachment is breastfeeding. This should not be a surprise, since breastfeeding is an attachment tool that is “built in,” or part of mother and baby’s biology. It is also the prime example of the mutual giving at the heart of attachment parenting, since both babies and mothers benefit from breastfeeding.
Even though bottle-feeding mothers can feel as close to their babies as breastfeeding mothers do, breastfeeding does make attachment parenting easier. Here’s how:
It gives you a hormonal head start. Every time a mother gives her baby her milk, baby gives something back to mother by stimulating the production of her lactation hormones. The hormones associated with breastfeeding, namely prolactin and oxytocin, do more than cause the mother’s body to produce and release milk. They also help the mother get connected to her baby. Think of these hormonal helpers as attachment hormones.
Levels of these attachment hormones are highest in the first ten days of breastfeeding, just when mothers need all the hormonal help they can get in learning to care for their babies. Besides signaling the body to make milk, prolactin acts as an antistress hormone, helping mothers stay calm while dealing with the challenges of a new baby. Oxytocin causes the milk-making cells to release milk, and it also makes a woman feel content and peaceful. Both of these hormones are released in response to the baby’s sucking, making breastfeeding a natural tranquilizer.
These hormonal perks are a mother’s reward for nursing her baby, and the sense of relaxation that mothers come to associate with breastfeeding makes them want to be with their babies even more. Because of this biochemical boost, breastfeeding is particularly helpful for the mother who is slow to feel connected to her baby after birth. Repeated nursing sessions not only give her lots of hands-on time with her baby, they also generate good feelings within the mother when she is with her baby. Breastfeeding thus jump-starts the mother-infant attachment.
TEN HEALTH BENEFITS OF BREASTFEEDING
Thousands of research studies over the years have shown that breastfeeding is best. Here are just a few of the health benefits enjoyed by breastfeeding babies and mothers:
1. Breastfed babies see better. Studies show that visual acuity is better in breastfed babies because of the “smart fats” it contains. Breast milk contains the type of fats needed to build better nerve tissue in the eyes and the brain.
2. Breastfed babies hear better. There are more middle-ear infections among formula-fed infants, and these can contribute to hearing problems. Even temporary hearing impairment can affect a child’s language development.
3. Breastfed infants have better smiles. Because breastfeeding improves jaw alignment and the development of facial muscles, children who were breastfed experience fewer orthodontic problems.
4. Breastfed babies breathe better. Breastfed babies have fewer and less severe upper-respiratory infections, asthma, and nasal allergies.
5. Breast milk is easier for babies to digest. Because human breast milk is designed specifically for human infants, it is easier to digest than formula. Human milk empties more quickly from the stomach, which makes it less likely that breastfed babies will have problems with gastroesophageal reflux (GER), the regurgitation of stomach acids into the lower esophagus. GER is a common, though hidden, cause of colic and painful night waking.
6. Breast milk protects immature intestines.Breast milk contains immune substances that act like a protective paint, coating the digestive tract to keep germs from entering the bloodstream. This friendlier environment means that breastfed babies have less trouble with intestinal infections and diarrhea. Breastfed babies are also less likely to develop food allergies, because they are protected from exposure to foreign proteins that inflame the intestinal lining.
7. Breastfed babies have healthier skin. They are less likely to experience the allergic, rough, dry, sandpaperlike rashes found in some formula-fed babies. Breastfeeding is especially important if there is a family history of eczema or skin allergies.
8. Breastfed babies are less likely to become obese adults. Breastfeeding teaches healthy eating habits right from the start. Infants learn to match their intake to their appetite, without anyone prodding them to finish the last ½ ounce. Breastfed babies tend to be leaner (just the right amount of fat for their body weight) than their formula-fed friends, and leanness is an important contributor to overall health.
9. Breastfed babies are protected from many diseases. Breastfeeding is associated with a lower incidence of virtually every kind of infectious disease, including bacterial meningitis, urinary tract infection, and infant botulism. Children who were breastfed are less likely to develop juvenile-onset diabetes, Crohn’s disease, and childhood cancer. Rates of Sudden Infant Death Syndrome (SIDS) are also lower among breastfed babies.
10. Breastfeeding makes Mommy healthier. At least one study has shown that breastfeeding mothers have a lower incidence of postpartum depression. Other studies have shown that breastfeeding reduces the risk of breast, uterine, and ovarian cancers. It is also associated with a lower incidence of osteoporosis. Many women also find that breastfeeding helps them to lose weight postpartum.
Studies comparing mothers who breastfeed with those who don’t have shown that breastfeeding mothers have lower levels of stress hormones. Research has also shown that breastfeeding mothers tend to be more tolerant of life’s stresses. In other words, what breastfeeding does for the mother tends to balance the otherwise tiring effects of high-maintenance baby care. This may explain why mothers who are breastfeeding and practicing attachment parenting often say that their lives are made easier—not more difficult—by their parenting choices. While attachment parenting may look like a lot of work, mothers often describe this parenting style as more relaxed.
ATTACHMENT TIP
Working and Breastfeeding
The hormonal perks of breastfeeding are particularly helpful for mothers who work outside the home. Breastfeeding helps you unwind from a busy day’s work and reconnect with your baby, especially after a tense day.
I’m a busy person, and I tend to get overly committed and have a hard time setting priorities. Breastfeeding forces me to take time out, relax, enjoy my baby, and put less important obligations on hold. Breastfeeding makes me realize that other things can wait. Those frequent nursings are special times that will pass all too soon. My baby has this special need only once in her life, and only once in my life do I have the privilege of meeting it.
SCIENCE SAYS:
Enjoy your hormonal helpers.
How do you keep your hormone levels high? Studies show that the more a mother and baby nurse, the higher the mother’s prolactin levels. Prolactin has a short biological half-life of approximately half an hour. This means that prolactin levels drop by 50 percent only half an hour after a feeding. Oxytocin has a half-life of only a few minutes. These biochemical facts suggest to scientists that mothers and babies are designed to breastfeed frequently. The more frequently a baby feeds, the better the mother’s milk supply and the greater the hormonal benefits.
It helps you become an expert on your baby. Breastfeeding is an exercise in baby reading. Successful breastfeeding depends on learning to read your baby’s cues, which means you have to spend a lot of time paying attention to your baby, not to the clock. Baby gives a cue, and it’s up to you to figure out what is an appropriate response. If his mouth is opening and closing and he’s searching for the nipple, you offer your breast. If he’s whimpering and you’re not sure what’s wrong, you try walking with him or patting his back. If that doesn’t calm him, you try a new position, or perhaps you try nursing. With each new cue-response session, you become a more intuitive cue reader, and baby becomes a more accurate cue giver. You seem to “just know” what baby wants, and baby’s cues become more organized because he’s learning to understand his own needs as well.
Breastfeeding gives you lots of practice at reading your baby’s cues because breastfed babies nurse eight to twelve times a day, and those feedings are not evenly spaced throughout the day and night. Baby may sleep for three or four hours in the middle of the day, have a feeding, play for a while, and then want to nurse every twenty minutes during the dinner hour. You learn to be flexible, to recognize and respond to your baby’s body language. You learn that sometimes she needs to nurse vigorously and fill her tummy, and other times she needs some leisurely sucking and a few sips of milk to calm her. A veteran breastfeeding mother once told us, “I can tell my baby’s moods by the way she behaves at the breast.”
Breastfeeding as a tool for helping mothers get to know their babies is especially useful for mothers who may not feel they have any intuition. Learning to read your baby’s cues is a mental exercise that will build your confidence in your own intuition. At first you may feel as if you have no way of knowing whether your baby is hungry, upset, or something else, but the more you respond, the better you get at responding. You feel good about yourself as a mother, and you also become convinced that your baby can be trusted to tell you what he needs.
Sometimes I have to give my baby a bottle. While she bottlefeeds she can look anywhere. When she breastfeeds, she looks at me.
It helps you develop empathy. As a parent, you need to develop the ability to get behind the eyes of your child and see things from his viewpoint. Learning to tell when your baby wants to breastfeed is a good first step toward developing empathy. Following your baby’s cues for feeding gets you in the habit of looking at life through your child’s eyes.
As a psychotherapist, I have noticed that breastfeeding mothers are better able to empathize with their children.
It builds healthier babies and healthier mothers. Everything about mothering is easier when both baby and mother are healthy, and research shows that breastfed babies have significantly fewer health problems than formula-fed babies. Every organ and every system in a baby’s body works better when that baby is fed human milk. Consider breastfeeding like immunizing your baby with periodic booster shots throughout the day. Your milk, like your blood, is a living substance full of infection fighters. In the Koran, mothers’ milk is called white blood. A drop of breast milk contains around one million infection-fighting white blood cells. Your baby’s own immune system is weakest during the first six months, a time when the antibody-rich mother’s milk fills in this gap, until baby’s immune system matures toward the end of the first year. Problems with allergies are also less likely when babies are breastfed. The incidence of nearly every kind of disease is less in breastfed babies.
The mutual sensitivity that we described above in connection with baby’s and mother’s cues and responses exists on a physical level as well. Mother’s body responds to the baby’s need for protection from germs in the environment. Mother’s body also adjusts the nutritional content of the milk to suit baby’s growing and changing needs.
At this point, you may be agreeing with us about the importance of breastfeeding but wondering if breastfeeding will work for you. Friends and relatives may have shared their stories of sore nipples or insufficient milk, or maybe you already have experienced problems with breastfeeding. We know from our thirty years in counseling breastfeeding mothers in our pediatrics practice and from Martha’s eighteen years of breastfeeding our eight children that breastfeeding has its challenges as well as its rewards. The key to successful breastfeeding is believing that you can do it. We have found that the mothers who truly enjoy the breastfeeding relationship are the ones who take the time to learn about breastfeeding and who look for support. Here are some tips and resources for getting your breastfeeding relationship with your baby off to a good start:
NATURAL CHILD SPACING:
THE RULES OF THE GAME
The same hormone that makes milk, prolactin, also suppresses ovulation. Most mothers who breastfeed exclusively find that their periods do not return until sometime around or after baby’s first birthday. Although the system is not foolproof, this prolonged period of infertility means that they can naturally space their children two or more years apart. For prolonged infertility to work, you must breastfeed according to these rules: You must practice frequent, unrestricted breastfeeding throughout the day and night (prolactin has the highest response to breastfeeding between 1 A.M. and 6 A.M.). You must also avoid the use of supplemental bottles and pacifiers and delay introducing solid foods until the second half of the baby’s first year.
BOTTLE-FEEDING FOR ATTACHMENT
Can a bottle-feeding mother experience the same closeness with her baby as a breastfeeding mother does? We believe she can, though it will require more conscious effort, since the bottle-feeding mother doesn’t get the biochemical boost that comes with breastfeeding. Remember, nursing means caring for and nourishing, whether by breast or bottle. The breast is the original model for infant feeding, but it is possible to bottle-feed in a way that follows the breastfeeding blueprint.
Feed according to baby’s cues. Feeding is more than delivering nutrition. It is a time for social learning, and babies need lots of daily lessons in the cue-response pattern, in which the baby gives a signal and his mother figures out that he’s hungry and offers food. Bottle-feeding mothers may be tempted to put their baby on a three-to-four-hour feeding schedule. Because formula takes longer to digest than human milk, it is easier to get a formula-fed baby on a schedule and to feed that baby less frequently. This is not how breastfed babies are fed. Feed your baby as frequently as you would if you were breastfeeding: eight to twelve times a day for newborns and younger babies. Small, frequent feedings are not only good for mother-infant attachment, they’re also easier on baby’s immature digestive system.
Forget the fear of spoiling. Becoming sensitive to her baby’s cries is a bit easier for a breastfeeding mother. Since the baby’s cry will often stimulate her milk-ejection reflex, she has a strong biological motivation for picking up her baby and offering the breast. The baby can then decide whether he needs to fill his tummy, suck for comfort, or take just a few sips of milk to ease into sleep. When a baby is bottle-fed, Mom has to think more about her responses: “Is baby hungry? Should I go to the kitchen for a bottle? Or does he just need to suck—where’s the pacifier? Maybe his tummy is too full and he needs to burp.” Faced with many possible solutions to baby’s cry, a formula-feeding mother may take longer to come up with the right response. If baby keeps crying, she may have to tune him out while she prepares a bottle or deals with the intestinal discomforts formula may cause or the extra burping bottle-feeding babies may need. Tuning him out keeps her from getting to know her baby better, and it can make the baby trainers’ advice to let baby cry it out more acceptable. We find that a bottle-feeding mother has to work harder to respond consistently and sensitively to her baby’s cries and to overcome worries about spoiling the baby.
Hold your baby during bottle-feedings like you would at the breast. Besides giving your infant the bottle, give her your eyes, your voice, and your touch. Give your baby the warmth of skin-to-skin contact, like she would experience were she breastfeeding. Wear short sleeves and open your shirt during feedings. Hold the bottle alongside your breast, as though it were coming from your body. Don’t distract your baby from sucking, but do watch for pauses in your baby’s feeding rhythm; these are opportunities to smile or talk. Give lots of eye-to-eye contact. You want your baby to feel that the bottle is part of you.
Avoid bottle propping. Like breastfeeding, bottle-feeding should be a social interaction—with a human being at both ends of the bottle. You want your baby to know that a person, not a thing, is feeding him. Propping a bottle is not safe, since baby could choke on the formula. Also, falling asleep with a bottle allows sugary formula to pool against the teeth, causing tooth decay.
Practice the other Baby B’s of attachment parenting, especially babywearing. Your relationship with your baby is about much more than just the way he is fed. The best way to get connected to your baby is to spend lots of time with him—bonding in the first days after birth, bedding close to him, being responsive to his cries. Babywearing is a very practical way to get to know your baby and build the attachment. With baby cuddled close to your body, you’ll nurture the feeling of harmony that helps attached parents relax and enjoy their child.
Don’t beat up on yourself. Above all, don’t worry that you will somehow be less of a mother or less attached to your baby because you have chosen to bottle-feed or because breastfeeding did not work out for you. Breastfeeding is just a part of the whole attachment-parenting package, and the ways in which breastfeeding builds the mother-infant attachment have more to do with behavior—which you can duplicate—than with physiology. Don’t let anyone make you feel guilty about not breastfeeding. It’s your choice to make, whatever your reasons. Your commitment to mothering your baby will shine through in many other ways.
A veteran AP mom hung this little note on her baby’s bassinet in her hospital room: “Because I don’t want my baby to develop bad sucking habits, please do not give him any bottles or pacifiers. Thank you.” She wasn’t taking any chances!
I thought breastfeeding would just come naturally, but I soon learned that there is a definite technique to successful breastfeeding In the first couple of weeks, Cheyenne had trouble latching on and sucking properly. My nipples were sore and bloody, which only made me dread every feeding. We were both frustrated, and my confidence as a new mother was completely shot. Only after we hired a lactation consultant to train Cheyenne how to suck and latch on properly did breastfeeding become an enjoyable experience.
SCIENCE SAYS:
Cache or Carry? A Biological Clue to AP
The nutritional content of the milk made by each species of mammal contains clues to the way the young of that species are cared for. Some animal parents leave their young for long periods while they are away hunting. These mammals are called intermittent-contact species. The milk of these mammals is high in fat and calories so that the babies need to feed only a couple of times a day. Human milk, on the other hand, is relatively low in fat and calories, which indicates that nature intended human infants to be fed frequently. Human infants are therefore called a constant-contact species. Humans’ closest genetic relatives in the animal world are the primates, and these mothers carry their babies constantly and feed them throughout the day. Anthropologists dub these two parenting styles “cache” (meaning infants are left alone for long periods) and “carry” (infants are kept in arms and nursed frequently).
The first two weeks of motherhood were anything but perfect. My daughter and I were having so much trouble breastfeeding I didn’t know how to latch her on properly, and she didn’t know how to suck properly. My nipples were cracked and bleeding, and breastfeeding was not enjoyable. The best money we ever spent was on having a lactation specialist come to our home. She found that my daughter was sucking my nipple in the front of her mouth rather than drawing it to the back of her mouth. She trained her how to suck in the back of her mouth using her index finger. She advised me that I might have to occasionally retrain her with my index finger. That was the beginning of a beautiful breastfeeding relationship. I had never realized what an art breastfeeding is. I can honestly say that if I hadn’t had training from an experienced lactation specialist who reassured me I could breastfeed and then helped me to be succesful at it, both my daughter and I would have been robbed of something very special.
♦ ♦ ♦
Despite an unmedicated birth, lots of early bonding time, and many attempts to get my firstborn son to breastfeed, he had a great deal of difficulty latching on to the breast. He lost a lot of weight, and we ended up giving him bottles of formula. In fact, for a day or two he was exclusively formula-fed because I was so exhausted and so discouraged. But still I wanted to breastfeed, so I began the job of teaching him to nurse at the breast, using an SNS (a supplemental nutrition system that delivers milk through a tube while baby learns to suck on the mother’s nipple correctly). This was an uphill struggle, and I’m sure many people wondered why I was putting myself through this. I often wondered myself.
Then one afternoon my sister came to visit, bringing her four-and-a-half-month-old chubby breastfed son. We sat and talked, and she started to nurse her baby. He sucked for a while, then pulled off the breast, reached for her face, and gave her a big smile. I thought to myself, “I want that. That’s why I’m working so hard at breastfeeding now.” I realized that the struggle to get breastfeeding to work for us wasn’t about how my baby was being fed today, or how he would be fed tomorrow. It was about this whole first year (and, as it turned out, well beyond the first year). If I gave up now, I wouldn’t have that later. So I persevered, and before long, I had my own real breastfeeding baby—with the smiles, the cuddliness, the simplicity of breastfeeding. It was well worth the effort.
I have heard many an expectant mother say, “I’m not going to be one of those women with a two-year-old who pulls at her blouse and asks to nurse.” I’m happy to report that many of these same mothers later go on to nurse toddlers. As the saying goes, “Don’t knock it till you’ve tried it.” Long-term nursing is the one feature about attachment parenting that really stands out as different from the way most women in Western culture mother their children. Yet ideas about weaning are beginning to change. Here’s why:
What the experts say. In 1990 then–surgeon general Dr. Antonia Novello wrote, “It’s the lucky baby, I feel, who continues to nurse until he’s two.” If you look at the recommendations of the American Academy of Pediatrics’ Committee on Nutrition over the years, you’ll find growing support for extended nursing. In this committee’s 1997 statement on breastfeeding, they recommended that breastfeeding continue “for at least twelve months, and thereafter for as long as mutually desired.” The World Health Organization recommends breastfeeding for at least two years. So if uninformed friends raise their eyebrows and say, “What! You’re still nursing!” just tell them that you are following the advice of experts.
What mothers say. The real experts on nursing into toddlerhood are the mothers who do it. Their reasons for continuing to nurse these walking, talking little persons are often very practical: “Nursing heals boo-boos”; “It’s the only time I ever get to sit down”; or “I don’t know how I’d get her to sleep at night if it weren’t for nursing.” Mothers also find that nursing helps to soothe a child who is beginning to stretch his boundaries but who is often frustrated by the things he can’t do. Breastfeeding helps a mother and toddler reconnect on days when they find themselves in constant conflict. For many mothers, the reason they continue to nurse is that they simply can’t imagine weaning: “Nursing means so much to my daughter. How could I refuse to give her something that is so important to her emotional well-being?”
SCIENCE SAYS:
Health Benefits of Long-Term Breastfeeding
In recent years a flurry of studies have all come to the same conclusion: the longer mothers breastfeed, the greater the health benefits to their babies and themselves. Studies correlating the duration of breastfeeding with intellectual development conclude that the longer infants are breastfed, the greater their intellectual advantage. And in a recent study from China, mothers who breastfed for two years had at least a 50 percent lower risk of developing breast cancer.
It’s fun. How charming it is to hear toddlers talk about their nursing relationship. Your toddler will have his own way and his own vocabulary for letting you know that he needs to nurse. Choose your family’s term for breastfeeding carefully—be sure it’s something that’s okay to say out loud at the mall or during church. Most mothers prefer, for example, nana over booby. Terms of endearment we hear include nummies, milkies, nee, and nur. Few things can make a mother feel more special than having her toddler snuggle up to her expecting to nurse.
SCIENCE SAYS:
Breastfed babies have higher IQs.
Breastfeeding is smart! Because breast milk contains brain-building nutrients, namely the omega-3 fats DHA (docosahexanoeic acid) and AA (arachidonic acid), that are not in formula, breastfed infants tend to be smarter. Recent scientific studies comparing breastfed and formula-fed infants have shown that breastfed babies enjoy as much as a 10-point higher IQ. And the more frequently and longer babies are breastfed, the greater this intellectual advantage.
Long-term breastfeeding builds beautiful memories. Many children who nurse past the age of two can remember when they get older being at their mother’s breast. These are moments to treasure—for both of you.
Feed on schedule is a dangerous dictum passed along by the baby trainers, parenting advisers who advocate crying it out and other ways of letting babies know that parents, not infants, are in control. But babies pay a high price for this ill-conceived approach to feeding. Only a baby knows when he needs to eat. (You don’t let other people tell you when you’re hungry, do you?) The body is programmed to satisfy hunger with feeding. When parents ignore their baby’s hunger signals and watch the clock instead, their baby learns that her hunger signals are unreliable. This is not a healthy feeding habit for a child to learn. Baby even may stop asking to be fed, and her growth and weight gain will suffer along with the baby’s relationship with her parents. (For a story of a scheduled baby who failed to thrive, see page 122.)
Besides affecting infant growth, feeding schedules can keep breastfeeding mothers from making enough milk for their babies. Milk production works on the principle of demand and supply. The more milk baby takes from the breast, the more milk the breasts make. When you space feedings farther apart, milk production slows down. Another interesting fact about human milk production is that the fat level in milk is higher when the time in between feedings is shorter. Frequent feedings allow babies to receive more high-fat milk—the kind with lots of calories for growth.
Studies of infant growth and maternal milk production have shown that babies who are allowed to breastfeed on cue have a remarkable ability to decide for themselves how much milk they need to grow. Mothers’ bodies respond by producing the milk their baby needs. Schedules get in the way of this finely tuned system. They also get in the way of parents and babies learning to trust one another.
ATTACHMENT TIP
Avoid Scheduling Feedings
Watch your baby, not the clock.