Three out of four new moms try breast-feeding over the bottle, but most of them have quit by the time the baby reaches six months, a new study shows.
Breast or bottle? (Francesco Tonelli for The New York Times)A report from Brigham Young University shows only 36 percent of babies are breast-fed through six months. The American Academy of Pediatrics recommends breast-feeding through the first year.
The data are based on a weighted sample of more than 60,000 children, collected from national immunization surveys compiled by the Centers for Disease Control and Prevention. Although the data are focused on childhood immunization rates, questions also were asked about breast-feeding, giving the researchers a representative sample of nursing patterns in the United States.
The researchers found that children who were most likely to be breast-fed for more than six months typically had mothers with higher levels of education and income. Married women and those who lived in Western states were also more likely to breast-feed. Hispanic women and women born in other countries were also more likely to breast-feed.
Returning to work, being a smoker or living in the Northeast decreased the likelihood of long-term breast-feeding. Notably, low-income women who participated in the subsidized Women, Infants and Children program, which provides food, milk and formula to mothers and young children, were also more likely to stop breast-feeding sooner.
“Breast-feeding promotion programs encourage women to start but don’t provide the support to continue,” said Renata Forste, in a press release. Dr. Forste is co-author of the report, published in the August issue of the Journal of Human Lactation.
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Are there any studies looking at whether there are any positive or negative effects to feeding a combination of breast milk and formula? Many moms I know who returned to work, myself included, breast feed as much as possible and supplement with formula. Also, is there any benefit or harm to breast feeding once or twice a day after your child is a year old?
FROM TPP — Perhaps a pediatrician can comment or I can find someone to answer you more specifically. The goal recommended by AAP is exclusive breast feeding for the first six months, which is why so many women go through the inconvenience of pumping during those first six months. Exclusive breast feeding during that time has been linked with all kinds of health benefits, including fewer ear infections, respiratory infections, lower risk of childhood obesity, allergies, asthma and SIDS. But remember these are lower risks. It doesn’t mean your baby won’t be healthy if you choose not to breastfeed. Unfortunately I’m not sure anyone has really studied what you’re talking about — a combination of breast milk and formula. The data I’ve seen have compared just breast feeding to just formula, although intuitively I would think that some level of breast feeding, even if it means sometimes supplementing formula, is good for your baby and certainly better than giving up on breast feeding altogether. Finally, the reason to continue breast feeding after one year is because it works for you and the baby. Many moms continue to do this long after 12 months but that’ because it works for them. Many women choose not to continue and it’s a valid decision and one supported by the AAP.
— JesI can tell you why breast feeding drops off before 6 months: Women have to work! As I type, I’m hooked up to a beast pump in my nice office with a locking door. It would not be possible for me to breastfeed if I didn’t have these small perks.
— S. HoffmanAs a prosecutor, I’ve had to make some sacrifices to continue to breastfeed my daughter. For example, I can’t ake any cases to trial because I can’t be away from my office for an entire day. Luckily, I have a supportive work environment.
I don’t know what one of my secritaries would do if she wanted to breastfeed. They are all stuck in cubicle land.
One of the best thing about breastfeeding has been that I’ve dicovered this blog. I check in at least once every day since I have some time on my one free hand.
This study shows just how powerful the Baby-formula lobbyists are in the U.S. Melissa Bartick who is chair of the Massachusetts Breastfeeding Coalition wrote a letter about the benefits of breastfeeding and the conflicts of interests pertaining to the American Academy of Pediatrics in the Journal of Pediatrics. Dr. Kattwinkel, Chairperson of the SIDS Task Force, dismisses her completely. You can read her letter and Dr. Kattwinkels response below. Dr. Raphael Pelayo also questions the safety of diminishing slow wave sleep by pacifiers during the first year of life. He questions whether not allowing infants to have delta sleep during the first year of life is actually safe? Dr. Kattwinkel dismisses him too. We have been seeing numerous developmental delays since Dr. Kattwinkel and his task force started the Back to Sleep campaign in 1992. Do people think that less awake tummy time is really the root cause or is it possible that a generation of infants not getting Slow Wave Sleep (Delta Sleep) during the first year of life is also a possible cause. Also, fully-paid materniy leave should be for 18 months..
Pediatrics 2006;117;992-993
Melissa Bartick
Bed Sharing With Unimpaired Parents Is Not an Important Risk for Sudden Infant Death Syndrome: To the Editor
Pediatrics 2006;117;994-996
— TomJohn Kattwinkel, Fern R. Hauck, Rachel Y. Moon, Michael Malloy and Marian Wallinger
Bed Sharing With Unimpaired Parents Is Not an Important Risk for Sudden Infant Death Syndrome: In Reply
Breast-feeding falls under the “health” category which is now a luxury only for the rich. We’re at war now, and fighting terrorism calls for sacrifices from people of all low sectors of our society. Put down that kid, get back to work, and don’t even think about unionizing.
— osisbsI am a pediatrician and was able to breastfeed both my children until they were 1+ years old. I have a private office where I could pump and very supportive colleagues. My husband brought my kids in to work so I could nurse them when I was on call or working late.
— SSSI think without my support system it would have been very hard- I try to do my bit to help other women by having staff and others use my office to pump.
In response to the first question,I agree with TPP, most of the time breast with bottle supplementation is ok. However, the less you nurse/ pump, the less milk you produce. Then you need supplement more with formula.
Perhaps the prosecutor - and other women with the privileges and perks she cites - ought to stand up for the secretaries and others who don’t have those perks. Rather than wondering what those in cubicle land would do, she might ask those women what they do, and what the workplace as a whole could do to support them. There must be some space that could be used periodically by any woman needing to pump, and advocating for that would be a nice way for the poster, or anyone else (male or female!) to support working mothers.
(For the record, way back when I was born in the late 60s, my mother got the flu and was unable to breastfeed. A bottle-fed baby from the start, I had no substantial childhood health problems, nor anything as an adult that could be traced to not being breastfed. I never felt myself lacking in IQ points, despite being reared on formula. All of this is anecdotal, of course - I offer it only to reassure the mothers who for whatever reason aren’t exclusively breastfeeding. (I certainly have enough IQ points to wonder why the online link for this article is about women “quitting” and the headline is about moms “giving up” - language that implies women are culpable for somehow harming their kids by not breastfeeding).
— Lois#1, it is easier and less of an effort for a baby to suck on the bottle than on the nipple, so often babies that are offered both go for the bottle.
#2, why not put in a good word for any secretary who would want to breastfeed? Let her use your office for pumping. Just as a show of solidarity between working mothers. Plus she will worship you. They all will.
I hate it when people wag their finger at the US and tell how much better everything is in Europe, but here we actually could learn from the best practices of other countries. Lactating mothers should be at home breastfeeding their babies instead of the pump, with near-full pay and without fear of being fired or demoted. Now THAT’S what I call believing in family values. Without all that, it’s too much to expect that mothers heroically carry on breastfeeding their babies for a full year, regardless of all the obstacles.
— SusannaI am a nursing mother.
I nursed my 1st child to 16 months and am presently nursing my 8-month-old. Because I work, and can’t pump a lot, I supplement with formula: my daughter gets one formula bottle a day and the rest of the time, including before work in the morning, mama’s milk.
I believe it’s true that most women don’t get the support they need to continue to nurse past infancy. Support has to start at home (for instance, my husband entertains our toddler whenever I need a quiet few minutes to nurse our baby) and must extend to the workplace and community. Surely our homes, workplaces, and communities might do a better job supporting nursing mothers.
But equally, I think a lot of women just quit because it’s “too hard.” They don’t think beyond the one year of sacrifice! Nursing shouldn’t be seen as a choice equal to formula feeding. Bottle feeding is far, far inferior, and any mother who chooses not to nurse for anything *other than* medical reasons is (a) fooling herself and (b) doing her child a grave disservice.
I’m ashamed of those women.
I’ve seen this myself, many times. These mothers need to STEP UP TO THE PLATE.
Formula is NOT equal to breastmilk!
— TIWI think I know part of the answer to this one, and part of it is there is a lot of myth out there.
For example, the ‘breast feeding purists’ claim that you can either breast feed or do formula, you can’t mix them. I have heard all kinds of claims, like that babies get confused, etc, but that is crap. And this isn’t just from ‘lay people’, my wife when our son was born was told by the pediatric nurses that if we chose to give our son formula (my wife’s milk supply wasn’t coming, and the poor kid was hungry as hell by that point) the baby wouldn’t be able to breast feed. Since then I have been told by experts that that is a crock of bullcrap, along with kids less then 6 months old smiling is gas.
I suspect that the real problem here is misinformation and also dogmatism. Is breast feeding better then formula? Probably, but maybe some is better then none?
— wdefWhen mothers are given at least one half-hour every four hours for pumping at work, along with a comfortable and private space to do so; when lactation consultants are part of regular post-natal care for mothers instead of a special perk the first two days in the hospital; and when daycares are close enough to mothers for women to visit and feed instead of having to pump during the day, mothers are more likely to sustain breastfeeding. In the U.S., unfortunately, these working conditions are restricted mostly to upper-middle and upper-class mothers. It’s workplaces’ breastfeeding support, not breastfeeding promotion programs, that come up short. Want more mothers to keep breastfeeding? Then come up with these resources as well as good, pithy comebacks for the single co-workers who continually complain about the “breaks” these new mothers get. Any woman who’s ever pumped knows that breastfeeding and pumping are work!
— habeasI like how this article mentions “give up”, as if to say you are a failure if you do this. Don’t Moms get enough of a guilt trip as it is? For those Moms that are able to do this for any length of time, I applaud them. For those that don’t, I’m sure they’re doing the best they can.
— LAMRinTXS Hoffman, Number 2, you have too good a sense of humor to be a prosecutor, or maybe I watch too much Law & Order. “Too much time on (your) one free hand,” indeed…LOL
Seriously, though, there are so many structural impediments to breast feeding among women without office doors that closed that somebody ought to be making this a campaign. Not having an office probably correlates with not having any more than 10 or 15 minute breaks twice a day; not having a refrigerator to store it once it’s pumped; certainly not having the money to buy an efficient electric pump; and not having the networking skills to call up a La Leche League counselor to figure out how to get back on track when slowing milk production scares the bejeezus out of you.
These are my observations as a grandmother, whose daughter is still breastfeeding her 18-month old…
— Fasaha TraylorI am disappointed to admit but I am now part of this demographic. Despite my original intentions of nursing my 5 month old for a full year, and my maternity leave ending in 3 short weeks, I just finished weaning her. The guilt I felt/still feel is overwhelming but at the same time it is liberating. I know that breast milk is best for my daughter but knew that weaning now was the best option for our family. Despite living in a breast feeding friendly state (California) and working for an employer that is also supportive of nursing moms, the practicalities of my job would just make pumping during the day problematic. Not only that, but after not having my body be my own for 9 months of pregnancy and then another 5 months after that, I was ready to reclaim myself, so to speak. Graned, some out there may flame my choice and call me selfish but I think that taking care of myself is just as important as taking care of my daughter. Do I miss the nursing? Yes and no. Most certainly at night prior to her bedtime but do I miss being the one who always gets up in the middle of the night to feed? Heck no. It’s a chore I gladly trade off with my husband now.
— RosieAmen to S. Hoffman’s comment above about the luxury of having an office with a locking door. Although I went back to work after eight weeks of leave, I was able to breastfeed my son for a year, never using formula. There’s no question that the relative flexibility and privacy allowed by my work as a lawyer afforded me the ability to make that choice. Of course there’s a correlation between longer terms of breastfeeding and higher incomes/education levels; those are the women with the types of jobs that allow them to breastfeed. Until more employers begin providing private rooms and scheduled breaks for lactating mothers - and recognizing that this is a public health issue as well as an employee “perk” - there will continue to be an imbalance. This doesn’t even touch on the cost savings of breastfeeding rather than buying expensive formula.
— AmandaSo will WIC offer a waiver for a discounted or free breast pump in lieu of the formula? A decent and quick breast pump can cost hundreds of dollars — maybe even just good financing would be a start (since over the long term, breastfeeding would be cheaper than formula).
The baby formula lobby is strong; we were at a very pro-breast feeding hospital, and we go the free formula branded diaper bag like everyone else.
Part of it is though, is the effort by hospitals and doctors not to make mother’s who can’t produce enough milk to a) be sure that their infant is receiving enough nutrients and b) not feel like a failure of a mother because they can’t make enough (and there are plenty of reasons to feel like you are doing everything wrong in those first months… years?!)
Working moms without offices are not accommodated at most offices or workplaces. We need federally mandated maternity/paternity leave (so people can have the time to figure out how to work all this out), and the ability to have a private pumping room and sufficient time.
— DIn 30 years, the conventional wisdom on this subject has gone from from “breast feeding is disgusting” to “bottle feeding is child abuse”. Is breast feeding better than bottle feeding - of course. For most first-world Americans, is breast feeding so much better than bottle feeding that women should be bullied into it despite the logistical problems it poses - probably not. On the scale of all the things parents can do wrong in raising their children, bottle feeding doesn’t even come close to being #1.
For the record, I breast fed my children when it was considered disgusting.
— clareBreastfeeding is clearly best, for mother and baby, and new mothers who want to breastfeed need lots of help and support from their families, LaLeche League, and classic books like THE WOMANLY ART OF BREASTFEEDING.
— bethCompanies that make baby formula only care about the billions of dollars they will make if they can con new mothers into giving up breastfeeding too easily. Breastfeeding is natural; formula is unnatural, and sorely lacking in what babies really need.
I’ve been reading lists of infant formula ingredients. What a nightmare! Corn syrup, other sugars, vegetable oil, MSG, all rebranded into various names. I can see how women feel they have no choice given job structures, but I’m shocked about these ingredient lists. And we’re surprised when the kids grow up obese and unhealthy?
I was formula-fed in the late 1970s, but haven’t yet been able to find what the average formula’s ingredient list was back then. Anyone know any sources for this information?
Debs
— DebsFood Is Love
I breastfed both my children for the first year, because I could stay home it was very convenient. I think I am unusual in being able to afford do this and not necessary representative in wanting to. My children who never even saw a baby bottle have allergies and asthma, too.
— Petra NormanI wish we could just lay off on all this breastfeeding propaganda until a substantial number of women can have the sort of lifestyle that supports breast feeding. For instance I think the stress on the mother of pumping milk in a toilet stall while working full-time is much more detrimental to an infant that formula. We should be supporting mothers, not adding more pressures with unreasonable expectations. 36 percent is amazing considering what we expect from new mothers in this country. Is the benefit of breast milk really so pronounced that it justifies adding another burden to women who are already in a very vulnerable state? I don’t think so.
I think the all-or-nothing approach of breast-feeding versus formula hurts more than helps. I supplemented my breast-feeding with formula for all four of my kids, against the recommendation of everyone. Breast-feeding proponents will chastise you for this, and even the title of this article, “Most Moms Give Up..” indicates failure, when it just goes onto say that women are giving up EXCLUSIVE breast-feeding, not breast-feeding altogether.
— JenniferI agree with the person that asked about the research done on using both breast milk and formula. Perhaps even some breast milk provides all the same health benefits, and surely supplementing with formula allows mothers a bit more freedom to continue partial breast-feeding for longer.
But too often mothers are encouraged to choose one over the other, and that’s when breast-feeding loses out.
I think that after you have a baby, a woman realizes how difficult it really is to breastfeed in our society. Breastfeeding is hard enough, and requires a big (and I mean big) commitment on the mother’s and her support system’s part. But when you combine it with women working, and trying to juggle everything else on their plate, i think it is easy to see why women give up on breastfeeding. I think women do not have enough of a support system in place in our society to really be successful in breastfeeding. Unless of course, they quit their job and stay at home full time during the first year of the baby’s life and have family and friends to help with caregiving of other children and other domestic jobs (and not to mention have a bread-winner that can really deliver). But, women get the short end of the stick here because we are taught from an early age in our society that working is the way to be a productive member of society (having children and all the contributions of the domestic sphere are not valued)…then, when women are ambitious in their career goals…they are told by society that, they must make a choice…either have a great career or take time off from your job to have kids…this as you all know, can be certain death for a career….staying home may just mean giving up a fast-track to a successful career. Until societal attitudes change regarding child-rearing, women working, etc…breast-feeding is going to continue to take a back-seat.
— crescentgirlOf course higher-income moms are more likely to breastfeed for longer. It’s a delicious luxury to be able to sit quietly numerous times a day with your baby at your breast. So many cannot afford that: they are back at work or if not, have little support. No mother should be made to feel guilty for it. Yes, the formula lobby is powerful but the main culprit is the lack of support for a version of motherhood that would include the time (and that might mean time OFF) for moms to nurse their babies.
— EileenMy wife and I have a two month old. As with most articles on breastfeeding this one and the associated comments completely neglect to mention the extreme difficulty many women face with breastfeeding. Our baby could not latch on no matter how much time and effort my wife committed. Based on our conversations with other couples this is very common. We then moved to pumping but had to supplement with formula because of the amount of milk production. Pumping is tedious and painful and falls squarely into the realm of things on which no should comment unless they have experienced it every 4 hours for 3 months. This includes all men.
No article on breastfeeding should be published that doesn’t include the fact that it is difficult and sometimes just doesn’t work. This would decrease the psychic pain to women who encounter difficulties and the physical plain to babies who are left hungry because their mothers have been brainwashed into thinking that bottle feeding is negligent parenting. And yes, this happens, trust me. Feed your baby the best way you can that doesn’t cause you to have a nervous breakdown.
— DatMelThis is truly a shame; not only because breast milk is better for the baby’s health, but because breast-feeding can be a pleasure shared between mother and child. We seem to have trashed that, replacing it with harried mothers attached to pumps in office rest-rooms. Twenty years ago, I was one, but I was able to quit my job and enjoy my motherhood. Breast-feeding is actually quite easy–much easier than buying and heating formula in bottles–but somehow, we have made it quite hard.
— VNSI gave up after less than a week, when I had no supply and my prematurely-born son needed to eat. I guess I should have stood on ceremony and let him starve to death rather than take formula?
— Jamie