Written by: Phindile Le Bris Sithole-Spong
Breastfeeding has long since been the gold standard of baby and infant nutrition. But what happens when that gold standard starts to affect those it hopes to help in a negative way? As a mother myself, I never really fully understood the complexities of breastfeeding until I myself was faced with the question of whether to breastfeed or not (another story for another day). Which is why when I was thinking up our next interview. It seemed only normal to speak to my good friend and infant nutritional expert and researcher at Oxford University Dr Rihlat Said Mohamed.
Not only because of her vast expertise. But also because breastfeeding has been a ling standing conversation between us. Way before anyone of our friends had children we would sit around and listen to Dr Said Mohamed talk about not only her research on breastmilk but also on vaginal versus c-section. And since then she has been my go to when it comes to getting as much information as possible for my little one. Not only because I trust her opinion. But also because she has years of experience and research to back it all up.
Phindile Sithole-Spong: Hi Rihlat. I know you have a very busy schedule so thanks first and foremost for taking the time to answer these questions. In the interest of time, I want to just jump straight into it and ask you about your research. In your work as a researcher and infant health is breastfeeding and lactation important and why?
Dr Rihlat Said Mohamed: Breastfeeding is one of the most effective ways to ensure child health and survival. Breastmilk is the ideal food for infants. It is safe, clean and contains antibodies which help protect against many common childhood illnesses. Breastfed children perform better on intelligence tests, are less likely to be overweight or obese and less prone to diabetes later in life.
PSS: There are many opinions about this from advertisers to campaigns that tell us that formula is as good as breastmilk, but know from our discussions this is not entirely true because they are different. What are the major differences between breastmilk and formula?
RSM: Firstly, it is important to know that inappropriate marketing of breastmilk substitutes, such as formula, continues to undermine efforts to improve breastfeeding rates. Formula can never be exactly the same as breastmilk. Every woman's situation is unique, and she should have the freedom to make an informed choice for the optimal feeding practice that suits her needs and that of her baby.
Did you know: The composition of breastmilk changes often within a day from ‘creamy' to more ‘watery'. Even when a baby is sick the breastmilk contains specific antibodies that help the baby recover.
Formula is created in a lab, and in most cases, is commercially altered cow's milk. Formula does not contain antibodies found in breast milk. There are substances added to formula to help protect babies from illness. But these are not as easily absorbed as breastmilk. And do not offer the same kind of protection. Furthermore higher concentrations of vitamins and minerals in formula make it more difficult to digest.
Breastmilk is always available, always the right temperature and always free. Breast milk requires no preparation. Formula must be prepared following specific guidelines to ensure it is sterile and the baby doesn't get sick. Bottles must always be thoroughly cleaned, and sanitized, and clean water used. Different brands and different types of formula can lead to confusion, and mistakes in preparation.
PSS: I know that for many of us, when we think about breastfeeding. We only think about the positive effects for the baby. But as I've learnt from you and my own research, there are some positive effects for mothers too. Can you share some of the positive aspects of breastfeeding for the mother?
RSM: Women who breastfeed have a reduced risk of breast and ovarian cancers. They are also more likely to lose some of the additional weight gained during pregnancy.
PSS: As you know I breastfed my daughter for 9 months before making the big switch to formula. In part because she started going to a nanny and it was just easier. But now my supply has all but run out as she is now purely drinking formula. And I would like to go back to feeding her half breastmilk and half formula. What are some basic tips to remember when wanting to up your supply or reintroduce breastfeeding?
RSM: If you are struggling to reintroduce breastfeeding, consider seeing a lactation consultant or a discussing it with your community healthcare worker or healthcare professional as they would be able to help you more specifically and to your exact needs.
PSS: Almost two years ago I moved to France with my husband and gave birth to our daughter there. One thing that struck me whilst there was how differently breastfeeding is viewed in France (and from my understanding in Europe too) versus in South Africa and Africa. Why do you think breastfeeding is viewed differently in Europe than to South Africa?
RSM: The breast has different meanings in different cultures. Western societies are prone to sexualizing the breast and as such, exposing the breast to feed an infant can be perceived as socially inappropriate. Some women in high-income countries may feel that the sacrifice of their freedom, their careers and being reduced to a breastfeeding ‘machine' may contribute to different perceptions. Covering while feeding, seclusion from social settings, and not having work and public environments that are facilitators to breastfeeding may add to this sense of alienation in western societies.
PSS: Lastly, we know that for some women, breastfeeding is not so much a choice as they cannot produce milk. In which case formula is introduced pretty early on. Are there ways of getting the effects of breast feeding without breastfeeding?
RSM: No. But that does not mean that women who can't, or don't want to breastfeed, can't have a healthy infant or healthy feeding practices. It is best to refer to your pediatrician for more insights and advice.