The health benefits of breastfeeding are well-documented but there's a lot of practical information many women don't know. Joanna Egan reports.
1) Breastfeeding rates are low
To encourage optimal growth, development and health in infants, the World Health Organization (WHO) recommends mothers exclusively breastfeed their babies for their first six months and then suggests they introduce solid foods but continue regular breastfeeding until babies are about two years old. The Australian Dietary Guidelines (ADG) also promote exclusive breastfeeding for the first six months and then encourage mothers to continue regular breastfeeding until their babies are at least 12 months of age.
Despite these recommendations, only 35 per cent of all babies worldwide are breastfed for longer than three months. This figure is slightly higher in Australia, at 56 per cent, but our national breastfeeding rates drop rapidly in the first six months after childbirth. About 92 per cent of all Australian babies are breastfed at birth. By one week of age, this drops to 80 per cent, and then to 71 per cent by one month. By four months, only about 46 per cent of Australian infants are fully breastfed and by five months this drops to 28 per cent. At six months, which is the time when WHO and the ADG recommend mothers start introducing solid foods, only 14 per cent of mothers are still exclusively breastfeeding.
Establishing a breastfeeding routine can take time and many mothers feel disheartened and are likely to discontinue breastfeeding if they experience difficulties early on. Other barriers to successful breastfeeding include physical challenges such as nipple discomfort, soreness or cracking, mastitis, thrush and white nipples. Environmental and social factors, such as difficulty experienced while breastfeeding in public and the timeframe in which mothers return to the workforce, also play a role in discouraging continued breastfeeding.
2) Breastfeeding women require about 20 per cent more kilojoules
On average, breastfeeding mothers require about 2000 kilojoules per day more than non-lactating adult women however this varies depending on the amount of milk they are producing and their level of physical activity.
During pregnancy, women are expected and encouraged to gain a healthy amount of weight. While breastfeeding, mothers should avoid following weight-loss diets because breastfeeding naturally allows for gradual weight loss after childbirth by converting fat stores to energy for lactation. Instead, women should eat regular nutritious meals and snacks to help meet their additional energy requirements. They should eat a varied diet that includes the following:
- Protein, which encourages cell growth and repair. It is found in meat, fish, poultry, eggs, dairy products, legumes, nuts and seeds.
- Calcium, found in dairy products and calcium-fortified soymilk. If a breastfeeding woman's diet lacks calcium, her body will draw it from her bones to meet her additional calcium needs. This increases her risk of developing osteoporosis later in life.
- Iron, found in red meat, chicken, fish, legumes, nuts, dried fruit, green leafy vegetables and wholegrain breads and cereals. During pregnancy a woman's iron stores deplete. They need to be built up again after childbirth.
- Folate, which is a B vitamin the baby needs for healthy growth and development. It is found in green leafy vegetables, wholegrains, nuts, avocado and yeast extract (Vegemite).
- Iodine, which allows the thyroid hormone to be produced. It is found in seafood, milk, vegetables and iodised salt.
- Zinc, which assists growth and development. It is found in meat, wholegrain cereals, milk, seafood, legumes and nuts.
- Vitamin A, found in milk, cheese, eggs, fatty fish, yellow-orange fruits and vegetables, and dark green vegetables. It helps provide resistance to infections.
- Vitamin B6, found in muscle and organ meat, poultry, fish, wholegrains, brussel sprouts, green peas and beans. It is important for the metabolism of protein and the formation of red blood cells.
3) Even if a woman avoids dairy products, her breast milk contains lactose
Some of the foods breastfeeding mothers eat or drink (such as alcohol, caffeine and rich or spicy foods) can pass into their breast milk and affect their infants. Many women believe that because this occurs, they can reduce the amount of lactose in their breast milk by eliminating dairy products from their diets. However, lactose is the principal sugar, or carbohydrate, in human milk (breast milk contains about seven per cent lactose) and women cannot influence the lactose content of their milk by modifying their diet.
Lactose intolerance occurs when a person has difficulty or is unable to digest milk sugars because they do not make sufficient amounts of lactase, an enzyme produced in the gut lining that breaks down lactose. It is a rare genetic condition that causes bloating, gas, abdominal pain and diarrhoea. Babies who suffer from it become dehydrated and cannot gain weight from birth. They require medical attention and must follow a special diet.
Mothers commonly confuse other allergies, in particular an allergy to cow's milk protein, with lactose intolerance. This is because an allergy can upset the baby's gut lining and even though the baby may normally produce enough lactase, the allergy can temporarily wipe out or reduce the amount in their gut. This means the lactose in the mother's breast milk cannot be broken down and the baby suffers the symptoms of lactose intolerance. When the food that upsets the gut lining is removed from the mother's diet, the baby's gut heals and the symptoms should stop.
4) One in five breastfeeding women develops mastitis
Mastitis is an inflammation of the breast tissue caused by a blocked milk duct or by bacteria passing into the breast through a cracked nipple. Symptoms include a breast that is sore, red, swollen, hard or hot. Women may also experience a high temperature and develop flu-like symptoms. About 20 per cent of breastfeeding women in Australia develop mastitis, most frequently within the first six weeks after childbirth, however the condition can occur at any time.
Milk from a breast affected by mastitis is safe for the baby and one of the most important treatments for the condition is continued breastfeeding, which can help to clear blockages. However, if a woman experiences a high temperature or flu-like symptoms, she should consult her doctor as an infection has developed and she may require antibiotics.
Last updated: June 2012
© Women's Health Queensland Wide Inc. This article was written by Joanna Egan and reviewed by the Women's Health Queensland Wide editorial committee. It was published in Health Journey Issue 2 2012.