While they are still pregnant, women worry about whether breastfeeding will cause pain — there should not be any, West said — and whether they will produce enough milk. Some need reassurance they can do it or crave tips that will help them. They wonder what it is supposed to be like.
After the birth, many women need advice to optimize production. "There are a lot of ways to increase milk production," said West, who said that's important to know because many women for different reasons struggle to produce enough. It helps to be able to consult lactation experts.
In an editorial in the same issue of JAMA Pediatrics as the study, Dr. Dimitri A. Christakis of Seattle Children's Research Institute questioned whether news that breastfeeding boosts intellect would provide an impetus for American moms to work harder to breastfeed successfully. Many have not responded to health benefits like fewer ear infections, which are not seen as life threatening. Intellect, though, is a long-term issue that could resonate more.
"It is possible that cognitive ability (and what it might lead to, namely, educational achievement, higher lifetime income, etc.) might be more powerful motivators for breastfeeding than reduced risk for otitis media and diarrhea and eczema," he wrote, noting it could kick off a positive cycle of lifelong benefits to both baby and society. Or the opposite could happen.
“It is clear that a vicious cycle can be created wherein lack of breast-feeding begets lower IQ, which begets lower socioeconomic status and thereby decreases the probability of breast-feeding the next generation and so on,” he wrote.
Christakis called for policy changes that would include insurance coverage of public health nurse visits and breast pumps, creation by employers of private places for women to pump milk when they are not with their babies and targeted efforts to destigmatize breastfeeding in public.
He ended with a plea: “Let’s allow our children’s cognitive function to be the force that tilts the scale, and let’s get on with it.”
The CDC said efforts to increase breastfeeding rates have been helped by an increase in hospitals that room mothers and babies together during maternity stays. Rooming in and skin-to-skin contact are important steps to helping mother and newborn get a good start on breastfeeding.
The World Health Organization feels so strongly about breastfeeding that it created recommendations called an "International Code of Marketing of Breast Milk Substitutes." This week, WHO announced that 37 countries, or about one-fifth of those that report to it, have passed laws that reflect the guidelines, which include banning advertising for breast-milk substitutes, not allowing free formula samples to be distributed through health services, andtio promon of advertising on the superiority of breastfeeding over substitutes.
The national Breastfeeding Report Card for 2013 said that among the states, Idaho leads the way, with 91.8 percent of new moms breastfeeding, followed by California, Oregon, Colorado and New Hampshire. At six months, the top three are the same, but Hawaii and New Hampshire round out the top five. At a year, Utah has crept ahead of Idaho, with 52.3 percent of mothers nursing, compared to Idaho's 45.5 percent. California, Hawaii and Vermont are the other leaders.
On the bottom, in Mississippi, only 50.5 percent of new moms nurse their babies for any length of time and less than 1 in 10 nurse for a full year. The report card said Alabama, Arkansas, Kentucky and Louisiana round out the worst five states for breastfeeding.
Not everyone can nurse successfully, including moms who adopted babies or those with certain medical challenges. Belfort and other experts say those moms can still enhance intellectual development in important ways like talking to, reading to and playing with baby.
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