miércoles, 17 de marzo de 2010

Madres que optan por la leche materna, pero no amamantar

[Mi agradecimiento a mi más fiel lectora Coqui por enviarme este link]

Mothers Who Opt for Breast Milk, Not Breast-Feeding

By Catherine Sharick

When Crystal Byrd's second child was born, the doctors urged her to place her baby to her breast. Byrd declined. She had already decided, months earlier, that she would not breast-feed. It was a lifestyle choice, says Byrd, 33, a stay-at-home mom in Cedar Creek Lake, Texas. "I'm a huge fan of breast milk, just not of nursing," she says.

Byrd says she tried breast-feeding her first child, who is now 12, and lasted nine weeks before giving up. "I just did not like it. I felt locked away. I was young and self-conscious, and everyone would leave the room when I breast-fed. I was lonely," Byrd says.

Her plan for Baby No. 2, born in 2003, was to pump milk and exclusively bottle-feed. The criticism came swiftly: lactation consultants warned that she would never be able to express enough milk. Doctors told her she would not bond with her baby. Her friends and family suggested that for all her trouble, she would be better off switching to formula. Byrd held firm.

By the time her baby daughter was 4 months old, Byrd had fed her exclusively with expressed breast milk and had stashed away enough milk in a deep freezer (she estimates she pumped an extra 3,500 oz.) to last until her child turned 1. After the birth of her third child, in 2009, she pumped for 8½ months, bottle-fed and, again, stored enough milk for a year. Byrd isn't the only mother choosing to breast-feed off the breast. Although there is no official tally of the number of women who pump exclusively, numerous conversations with mothers suggest that the practice is not uncommon and perhaps even growing. Their reasons for doing so are varied: some mothers say they dislike the feeling of a suckling baby. Others say it is painful or that the baby fails to latch on. Some want to avoid the uncomfortable possibility of having to breast-feed in public. For many, including Byrd, a key issue is time. "People think that since I am a stay-at-home mom, I should always have my baby attached to my breast," she says. "Well, sometimes I have other things to do." It takes her half the time to pump and bottle-feed as it would to breast-feed, because she can express milk from both breasts at the same time, rather than waiting for the baby to switch from one side to the other.

Pumping is a win-win proposition, say mothers: it gives them freedom while still ensuring their babies get that all-important breast milk. It can be scheduled around work and leisure. Women can drink alcohol, for instance, and "pump and dump," so they avoid giving their babies tainted milk. Further, pumping allows fathers and other caregivers equal time in feeding the baby.
Technology has helped fuel the trend. Medela, the Swiss breast-pump maker and industry leader, introduced its first electric-powered, vacuum-operated at-home breast pump in the U.S. in 1991. Five years later, the company launched the Pump in Style, a portable breast pump that comes in a fashionable bag that looks like a purse. Since then, Medela's sales of the item — not cheap at around $279 — have quadrupled. Pumping mothers can also purchase breast-milk storage bags, nipple shields and power adapters for the car so they can pump on the go. A hands-free pumping bra made by a company called Easy Expressions lets busy mothers pump while checking e-mail or even holding (if not feeding) their baby.

Wendy Williamson, a self-described type-A personality, breast-fed her son for only two days. She says the experience made her feel anxious and depressed because she couldn't tell how much milk he was drinking. She started pumping instead, and says it wasn't until she knew exactly how much her son was eating that she could relax and enjoy her new baby. Williamson continued to express milk for her son for more than a year, and donated 200 oz. to a local milk bank in Austin, Texas. "Some of us moms are a little neurotic, and the pump really works for us," Williamson says. "We can see what the baby eats, and it makes us feel so much better."

But lactation experts say mothers should allow themselves more than two days to adjust to breast-feeding. Often it takes much longer to overcome initial anxiety, discomfort or even pain, and researchers say the benefits of breast-feeding may be long-lasting. Studies have found, for instance, that breast-fed babies are more capable than bottle-fed infants at determining when they're full and that that difference may carry into childhood, with breast-fed children developing healthier eating behaviors, reducing their risk for obesity. Since breast-feeding mothers focus on the infant's cues for fullness and hunger, rather than on feeding schedules or ounce-notches on the bottle, they tend not to overfeed their children, studies suggest, which encourages both mother and child to tune in to internal cues for fullness.

And while doctors agree that breast-feeding is best for babies' health, other research indicates that it benefits mothers too. One large study, published in 2009 in the journal Obstetrics & Gynecology, found that women who never breast-fed were more likely than women who had to develop high blood pressure, diabetes, high cholesterol and heart disease years later, in menopause.

In an intriguing paper published in July in the journal Medical Hypotheses, Gordon Gallup, a professor of biopsychology at the University of Albany, posits another upside to sticking with the breast: a mother's decision not to breast-feed may unwittingly mimic child loss, evolutionarily speaking. Given that bottle-feeding technology did not exist for the last 99.9% of human evolutionary history, Gallup reasons, the likeliest reason a mother of yore would not have breast-fed is the death or loss of the child. He suggests that the consequences for the bottle-feeding modern-day mother could include an increased risk of postpartum depression and difficulty producing milk. [????????]

But pumping mothers may be protected, he says, since the pump simulates a baby's suck and stimulates the flow of milk. Still, since lactation has a lot to do with the mother's direct hormonal response to her child, for some women, Gallup says, pumps may not be as efficient as the real thing. "When you just have a relationship with a pump instead of with a baby, the milk supply can dwindle because the mother may not be secreting the hormone oxytocin that aids in a mother's milk letdown," he says. For those mothers, he suggests staying near their babies or looking at photos while expressing milk.

La Leche League, the world's most active breast-feeding support and advocacy group, insists that breast is best for mother and child. "We would encourage mothers to feed their babies from the breast to promote bonding," says Loretta McCallister, a spokeswoman for the organization. But she concedes that using expressed milk exclusively does not contradict La Leche League's core message: "Women who choose to pump are still providing breast milk for their babies, while doing what is best for their families," she says. "And that is much better than turning to formula."

That's about as much support as pumping mothers get, they say. When Byrd decided to stop breast-feeding her first child, she says doctors suggested formula as the only alternative and never once mentioned pumping. Private lactation consultants typically do not offer pumping as an alternative either, as their goal is to get the mother to breast-feed. Williamson was so frustrated by the lack of available information about pumping from her doctor and elsewhere that she created a website, Got Breast Pump!, in 2004, after having fed her second baby exclusively with expressed milk.

Williamson's site offers how-to's for scheduling pumping sessions and increasing milk supply and sells pumping-related products. In the past 10 years, online community boards for exclusively pumping mothers have popped up on iVillage.com and Yahoo!

That's why Melissa Brown, 31, a program coordinator who pumped milk for two children, first logged on to iVillage. "The iVillage board made me feel normal in what I was doing and gave me the confidence I needed to keep going and get on track," says Brown. In 2008, she became the community leader of iVillage's exclusively pumping board. She estimates that since then, she has helped hundreds of women get through the difficult early days of pumping.

Despite the general bias toward breast-feeding, mothers like Byrd say pumping was the only feeding option that made the first years of their newborns' lives manageable. "People need to understand that after breast-feeding from the breast and bottle-feeding with formula, there is a viable third option for feeding your infant — and that's exclusively pumping," Byrd says. "And all mothers should have a right to choose this option and receive the support and care they deserve from their doctors and families.

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