By Sharon Palma RNC IBCLC, lactation consultation in the neonatal intensive care unit at Helen DeVos Children's Hospital in Grand Rapids, MI

Yet another study on yet more benefits of breastfeeding. The study comes from researchers in Switzerland and the United Kingdom and was published online ahead of print publication in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine. The researchers analyzed data from a nested sample of 1,458 children born between 1993 and 1997 in the UK whose lung function was measured at age 12. They found that breastfeeding four to six months was associated with greater forced expiratory volume 50 (FEV50) in all children (P=0.48), even more in those breastfed for more than six months (P=0.41).

However, the greatest improvement came in the children of mothers with asthma, with those breastfed four to six months demonstrating FEV50 increases of 0.375 L/sec (P=0.15) and those breastfed longer than six months improvements of 0.468 L/sec (P-0.99) compared to children who were not breastfed.

These were also the only children to demonstrate significant improvements in forced vital capacity (FVC) or forced expiratory volume at 1 second (FEV1). Even adjusting for respiratory infections in infancy and asthma and atopy in early childhood did not change the results.

These are particularly interesting findings given other work suggesting that breastfeeding might actually be harmful in children of women with asthma.¹

So, in addition to sharing this news with the mothers in your practice, particularly those with asthma, what more can you do?

The most important thing is to provide support. Emotional and educational. If your practice doesn’t have a lactation consultant on site, refer them out. Even the Women, Infants, and Children (WIC) nutritional program offers support through trained peer counselors in breastfeeding.

It is so easy for women to become discouraged about breastfeeding, particularly when formula is so readily available. Thus, it is important that they have realistic expectations from the beginning.

For instance, many women turn to formula because they think their infant isn’t getting enough milk. Remind them that frequent nursing is normal. Breast milk is digested more quickly than formula and a sudden surge in nursing frequency is the baby’s way of increasing your supply during a growth spurt.

Also remind them that babies cry for other reasons besides hunger.

Also ask mom how many wet diapers baby has, a clear sign that he/she is getting enough nutrition.

Many women (and some doctors) worry that breastfed babies don’t grow as fast as formula-fed babies. While it is true that breastfed babies may initially track lower on the growth chart, they eventually catch up.

If women try to quit nursing or cut back because the father wants to be “more involved,” remind them of the multitude of ways dad can be involved, including playing with baby, bathing baby, and, every woman’s favorite, changing baby’s diaper.

And if they want to stop nursing because they’re tired of getting up in the middle of the night to nurse, and someone told them that formula or, even worse, formula thickened with cereal, will help baby sleep through the night, remind them that infants are not supposed to sleep through the night.

So let’s review. Key messages you can provide:

• Babies are hard wired to breastfeed, so you can do this. And if you need it, help is available.
• There is nothing wrong with you; baby is most likely getting enough milk.
• There are plenty of ways for dad to be involved beyond giving bottles.
• Babies are supposed to wake up in the night for nursing.

And then tell them about this study—and the hundreds of other studies—that show breastfeeding is best.

Sharon Palma, RNC, IBCLC, is a lactation consultant in the neonatal intensive care unit at Helen DeVos Children's Hospital in Grand Rapids, MI

1. Guilbert TW, Stern DA, Morgan WJ, Martinez FD, Wright AL. Effect of breastfeeding on lung function in childhood and modulation by maternal asthma and atopy. Am J Respir Crit Care Med 2007;176:843-848.