ALSO BY INA MAY GASKIN Ina May’s Guide to Childbirth Spiritual Midwifery To all those who work to raise the status of breastfeeding as a gift for future generations C ONTENTS Introduction: Breast Is Best 1 How Breastfeeding Works, and How It Relates to Mothering 2 Preparing for Nursing 3 How Birth Practices Affect Breastfeeding 4 Getting Started: The Basics 5 Your Baby’s Needs—and Yours—During the First Week 6 Problem-Solving During the First Week 7 Sleeping Arrangements 8 If You Have a Job Outside Your Home 9 The First Three Months 10 As Your Baby Gets Older 11 Nursing Twins … and More 12 When Babies Get Sick or Need Hospitalization 13 Weaning 14 Shared Nursing, Wet-Nursing, and Forgotten Lore 15 Nipplephobia: What It Is and Why We Should Eradicate It 16 Creating a Breastfeeding Culture Acknowledgments Appendix A Appendix B Appendix C Resources Notes Image Credits and Permissions Author Bio I : B I B NTRODUCTION REAST S EST regnancy can be a time of great wonder and excitement as you P prepare for the birth of your baby. One of the great blessings of pregnancy is that your body and nature take complete care of the nourishment of your little one during his time inside your body (as long as you eat well). Who could design a machine that could reproduce and nourish its offspring so beautifully as this? You don’t even have to think about how to do it! One decision that does merit a conscious choice on your part is the first food that will nurture your baby once he is born. Will it continue to come from you or will you buy it from the shelves of a grocery store? Does it matter? You probably wouldn’t have picked up this book if you didn’t already have some idea of the benefits of breastfeeding and the possible undesirable consequences of feeding artificial milks to babies as a first choice. Even so, you may be surprised to find out how much your decision matters. Assuming that pediatricians are the accepted medical experts on the needs and health of babies and young children, let’s start with what their professional organization has to say on the subject of infant feeding. The American Academy of Pediatrics issued its first policy statement in support of breastfeeding in 1977, and in 1997 it followed up with a much stronger statement. In 2005 the AAP found it necessary to replace its 1997 policy statement with a newer version, because so many important recent studies corroborated 1 what common sense had always recognized—that breast is best. Excerpts from the American Academy of Pediatrics’ Policy Statement on Breastfeeding and the Use of Human Milk Human milk is the preferred feeding for all infants, including premature and sick newborns, with rare exceptions. When direct breastfeeding is not possible, expressed human milk, fortified when necessary for the premature infant, should be provided. Breastfeeding should begin as soon as possible after birth, usually within the first hour. Except under special circumstances, the newborn infant should remain with the mother throughout the recovery period. Procedures that may interfere with breastfeeding or traumatize the infant should be avoided or minimized. Newborns should be nursed whenever they show signs of hunger, such as increased alertness or activity, mouthing, or rooting. Crying is a late indicator of hunger. Appropriate initiation of breastfeeding is facilitated by continuous rooming-in. No supplements (water, glucose water, formula, and so forth) should be given to breastfeeding newborns unless a medical indication exists. Exclusive breastfeeding is ideal nutrition and sufficient to support optimal growth and development for approximately the first six months after birth. Now let’s turn to another health authority, the World Health Organization (WHO). The WHO ranks the safety of milks in the following way: first, the baby’s mother’s milk taken directly by the baby from the mother’s breast; second, the baby’s mother’s milk taken from a bottle; third, the milk of another mother; and last, bottle-feeding of artificial milk formulas. Please note that the WHO does not say that artificial milk formulas shouldn’t be consumed but that it is better for the baby if they are used only as a last resort. Here is a very practical reason to begin nursing your baby. When you choose to feed your baby this way, you are preserving your ability to have a choice about your feeding method. You can always stop breastfeeding and switch to artificial feeding later. What is there to lose? On the other hand, if you begin with artificial feeding and then find that your baby is allergic to several different products (which happens sometimes), it can be quite difficult to switch back to breastfeeding. Artificial Milks Don’t Measure Up to Human Milk for Babies It should not come as any surprise that the most desirable milk for a human baby is human milk. It is the most complete and perfect food for babies, just as camel milk is best for baby camels and cow’s milk is best for calves. Breast milk even tastes better to young humans than other milks do. I’ve met many adults who were breastfed until the age of four or five who can recall the taste of their mother’s milk, and each remembers it as incredibly delicious. Do you know anyone who buys infant formula because it is so delicious or who even has fond memories of it? I don’t.