Exclusive Breastfeeding - What I've Learned

(Looks like she's got a comfortable chair. Photo credit: Marc van der Chijs)

For the first six months of an infant's life, the World Health Organization recommends exclusive breastfeeding. Exclusive breastfeeding means that the baby gets nothing but breastmilk. No water, no formula, no cow's milk, no tea. The WHO also recommends that babies be fed on demand, rather than on a schedule.

This makes perfect sense. Breastmilk is nutritionally perfect for infants. It provides all the hydration and nutrition that they need. Giving anything else is both redundant and dangerous. Water is unnecessary, and may be contaminated. It has no caloric value, and can take up space in an infant's stomach that is needed for calories and nutrients. If you give a young baby cow's milk, in a best case scenario it will make her intestines bleed because her system isn't able to cope with it. In a worst case scenario, then milk is insufficiently pasteurized and could transmit bacteria.

Feeding on demand also makes sense. An infant with a cold will need to nurse more often, and take less each time. An infant in the throes of a growth spurt may need to eat all the time. These things can happened before a parent even notices; sticking to an overly strict feeding schedule can leave a sick or growing child malnourished.

Exclusive breastfeeding for six months is the best possible option for the infant. It should be promoted. But, when I used to go around recommending exclusive breastfeeding, I had no idea how hard it is. We are asking a lot of women when we recommend it. Understanding that makes us better at talking about breastfeeding, nor worse. When we recommend exclusive breastfeeding and ignore the challenges involved, we just look clueless.

Here's the challenge: infants nurse a lot. In the first few weeks on my son's life, I nursed him so much that I started tracking my time spent on a spreadsheet. On one particularly memorable day, he nursed for 16 out of 24 hours. He was a scrawny little guy, and we had some trouble with attachment, but I was not an unusual case. I learned to eat my meals while nursing, read a book, type on my laptop. It was hard, but it was worth it. When people acted like it wasn't hard, I wanted to kick them.

Exclusive breastfeeding takes a lot of the mother's time. I had my husband and my mom to help. They cleaned the house, made the food, and did the grocery shopping. A woman whose family depends on her to earn money, manage the livestock, or tend a garden may not be able to breastfeed exclusively. Not because she doesn't want the hassle of exclusive breastfeeding, but because she is literally unable to do so without putting her other children at risk.