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“A growing body of research suggests early feeding habits influence diet and health later in life.” That’s according to Pediatrics (The Official Journal of the American Academy of Pediatrics). The research finds that food preferences begin during infancy and toddlerhood and that first foods play an important role in laying the foundation for healthy eating habits. 

So, how can parents help nurture the foundation for healthy eating habits?

Here are some AAP recommendations:

• First 6 months: exclusive breastfeeding
• After 6 months: consumption of appropriate complementary foods
• Offering water and non-flavored whole milk or 2% milk as beverages for children ages 1-2 years
• Eating at least three meals a week together as a family 

Let's talk about breastfeeding. Let me start off by saying, BRAVO! Bravo to ALL mothers reading this. Whether you use breast milk or formula, we know that each parent loves and cares for their child deeply. Motherhood is the most rewarding and, at times, challenging role in the world - so KUDOS to each and every Mom out there. You are doing great! KUDOS to Dads too - parenting is teamwork no matter how you slice it! Today I am simply going to discuss the benefits of breastfeeding and how, we as physicians, partners, employers and fellow moms, could do a better job of providing support to new moms who want to try it.

Prior to having my own children, as a young resident physician, counseling new moms on breastfeeding seemed so easy. Here are the benefits, here are some various holds and here is the schedule. Ok, checklist of “anticipatory guidance” complete. And then I had children. WOW. There is no anticipatory guidance for this at 2 a.m. with a screaming newborn and a painful latch. When people ask me what my greatest accomplishment is, they are surprised when I say “breastfeeding twins.” Breastfeeding can be challenging and every mother should make a choice that is best for their situation. 

When I had my twins six years ago I had no idea what obstacles lay before me when it came to my determination to exclusively breastfeed them. Yes, I had to supplement with formula in the beginning … there was the post-feed pumping and feelings of failure when they weren’t gaining weight. It was emotional, time-consuming and a ton of WORK. Was it worth it? It was for me. 

When inside your belly, your baby receives all the necessary nutrients through you. It is a mother’s well-developed immune system that serves as protection against infection. Then, baby enters the world. Your milk is your baby’s perfect food. Its composition changes over time to meet the demands of your baby at each stage. In addition, just like many other systems (neurologic, gastrointestinal, etc.), your baby’s immune system is not fully developed at birth. Mom’s antibodies bridge the gap. Breast milk serves as an infection-fighting, natural medicine - able to pass mom’s antibodies to a newborn and help boost immunity to fight infection. Wow. Our bodies do that!

In 2012 the AAP went as far as to say, “infant nutrition should be considered a public health issue and not only a lifestyle choice.” While it’s easy to recommend as a physician, it’s not so easy to do as a mother. I can understand and appreciate both views. I’m a practical person. Breastfeeding has sustained our species since the beginning. That makes sense. However, lack of sleep combined with the varying physical and emotional changes that occur post-baby take all rational thoughts and throw them out of the window. When I was encountering my own challenges as a new mom, hearing the words “You can do this" and "I’m here for you” helped me tremendously. With those moments of encouragement and support from family members and friends - we did it. 

I’ve watched as a mother struggling with breastfeeding has either been encouraged to persevere or discouraged enough to give up. It’s not easy. You think it should be. It’s what our bodies are designed to do. But, any mother who breastfed will likely tell you, it’s no walk in the park. Engorgement, clogged ducts, bleeding, mastitis, baby losing too much weight - there are so many challenges. I encourage moms to give it six weeks. Those first several weeks can be brutal. But, there’s this magical moment for many moms around that six-week mark where everything seems to jive. And once you're past that hump, the mode often feels like autopilot rather than emergency landing.

Returning to work and pumping is a whole separate beast. Do what you can and what your mental health allows. Employers and lawmakers should continue to improve current practices. But, for now there are some protections in place. Federal law requires employers to provide reasonable break time for an employee to express breast milk for her nursing child for one year after the child's birth. Employers are also required to provide a place, other than a bathroom, that is shielded from view and free from intrusion from coworkers and the public, which may be used by an employee to express breast milk. The World Health Organization and the International Labor Organization recommend that lawmakers ensure 4 months paid maternity leave! A new study from UNICEF shows that when compared to 40 other developed countries, the U.S. came in last in terms of paid leave available to mothers and fathers. WOW. 

So, what is clear to me is that our medical community agrees that breastfeeding is important. The AAP continues to support the unequivocal evidence that breastfeeding protects against a variety of diseases and conditions in the infant and also has maternal health benefits. 

However, a mother needs a village to breastfeed one child. In many areas of the world - that’s what happens. Generations and communities come together to care for a new mom in those early months. Mothers are able to stay back from work to recover. In India, mothers and mothers-in-law often stay with a new mom after birth. The notion is that a mother needs to rest to recuperate from the rigors of giving birth. She is fed a nourishing herbal-based diet (fenugreek leaves are used and go figure - it’s an herb that can help with milk supply), drawn warm baths to help the muscles and ligaments relax after all of that stretching and encouraged to sleep after each nursing session while grandma takes care of baby, including daily infant massage.

I realize that this level of support isn’t an option for everyone. I also realize that policies in place often serve as a roadblock for working moms. But, the point is that mothers also need care. At minimum, it’s important to know that grabbing moments for rest and self-care is crucial; advocating for yourself at work; seeking resources that are available to you to help with breastfeeding. The better you feel, the better version of yourself you can be for that beautiful baby. 

As a pediatrician, it is my responsibility to offer encouragement and sound advice when it comes to those early and what can be grueling months. A new mom is so vulnerable during those times and therefore, it’s our job to support her. I am here for you. It’s hard. But, I believe you can do it! Enlist support from your doctor, partner, employer, lactation consultant, family, and friends to help you through those initial stages.

Visit healthychildren.org for more information - it is my number one resource that I refer parents to as it is powered by the AAP. 

Until next time … remember, Moms - you ROCK. 

With love and Ahimsa,

Manasa 

 References:

*Pediatrics (Trends in Food and Beverage Consumption Among Infants and Toddlers: 2005–2012) *https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Stick-with-Breastfeeding-Its-Worth-It.aspx  To learn more about Ahimsa or related articles, please see Our Story and  Hello World! Meet Manasa, Founder of Ahimsa, the world's first and only colorful stainless steel dinnerware for kids