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. 

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When a baby is born, his/her ideal food is breast milk and breast milk only. Most of us know this fact but we do not entirely understand the vitality behind it. After randomly asking my two older sisters who both have two children if they understand the importance of breastfeeding the baby for at least six months, they showed an understanding of the benefits but the “exclusivity” part to them did not seem to uphold much significance. The same happened after I extended my conversations about exclusive breastfeeding with my female friends and other close relatives.

What is meant by “exclusive” breastfeeding?

Exclusive breastfeeding is a process of feeding the baby only breast milk without giving him/her any other food, or water for at least six months from the first hour he/she is born. The world health organization noted that, although many people know that breastfeeding is the most effective way to provide the baby with overall health benefits and a high survival rate, Not everyone follows the recommendations of exclusive breastfeeding. Statistics show that “nearly 2 out of 3 infants” are still not exclusively breastfed for the recommended period of six months.

Why is it important to exclusively breastfeed?

In the first six months, it is not necessary to give the baby any other food because the mother’s breast milk is enough. It provides the baby with all the needed nutrients for the baby’s organ development and is also rich in antibodies to help protect the baby from getting sick or acquiring infections.

In the first few days after birth, the baby is still fragile and prone to infections due to an underdeveloped and weak immune system. However, the mother’s milk (especially colostrum milk) is all he/she needs to survive all that. Colostrum is defined as a yellowish fluid that the mother (and other female mammals) first produces after giving birth before the mature milk comes out. This fluid is rich in nutrients, antibodies and provides the baby with immunity, growth, and other developmental benefits needed by the newborn.

Benefits of exclusive breastfeeding

It is cost-effective

Breast milk is readily available whenever the baby needs it. You do not have to buy it or spend time preparing it.

It provides ideal nutrition for the baby

With breast milk, you do not have to worry about sterility because the milk is already sterile and free from any possible contamination. You also do not need to worry about the quantity and quality of the nutrients.

It protects the baby against allergies and infections

Breast milk helps protect from allergies and infections that can cause diarrhea, constipation, ear infection, respiratory infections (such as pneumonia and asthma). Research shows that breast milk also reduces the risk of Sudden Infant Death Syndrome by an estimation of 50%. Sudden Infant Death Syndrome is explained by the mayo clinic as an “unexplained death, usually during sleep, of a seemingly healthy baby less than a year old.”

It enhances the mother-child bond

Studies also show that the physical closeness of the mother and baby while breastfeeding helps the baby feel secure and facilitates the mother-to-child bond easily. The same goes for the mother, the physical and emotional connection they get while breastfeeding is unique and has a wide variety of benefits.

Provide long-term health benefits for the mother

Although it is not to a greater extent, breastfeeding may reduce the risk of cancer such as breast, ovarian and uterine cancer later in life. Similarly, it can lessen the chances of suffering from common chronic illnesses such as diabetes mellitus type 2 (for both mother and baby), high blood pressure, high cholesterol, osteoporosis and obesity.

It can work as a natural contraceptive

How does it work? When the mother breastfeeds the baby exclusively for six months as per recommendation, the body naturally stops ovulating. That means there is no release of an egg for fertilization and therefore no pregnancy.

• This method may not be viable for every mother. However, if you are considering trying out this method, consult your doctor or pharmacist first for advice. You may need to consider other methods of contraception as a back-up.

Breastfeeding also promotes a healthy weight for the baby and may help the mother to lose weight accumulated during pregnancy.

Endnote

This article is not to despise other ways of feeding the baby such as using formula milk. But to highlight the importance and benefits of exclusive breastfeeding. If you are a maternal parent to the baby and can breastfeed, it is advisable to consider it over other methods for both short-term and long-term benefits for you and the baby. For mothers with concerns such as HIV/AIDS patients, there are also ways you can successfully breastfeed your baby without putting them at risk of mother-to-child transmission.

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