Are you pregnant and trying to decide whether breastfeeding is right for you and your baby? You have probably heard all the ways that breastfeeding can benefit your newborn, but breastfeeding provides substantial benefits to the mother as well. This week I talked to Patricia Ellis RN, MA, IBCLC of Bridgewater/Somerville NJ about the health benefits to mothers who breastfeed. Q: Please tell me about yourself and your interest in breastfeeding. A: My interest in breastfeeding began before my first pregnancy, in 1980. I began attending La Leche League meetings to learn about breastfeeding during my pregnancy, and continued to attend for support and information as the baby grew (he's now 21!), and I eventually applied to become a certified Leader, counseling moms and leading the monthly topics at meetings. I was a LLLI Leader for five years, had one more child, and nursed for a total of five years. I lived in Shannon, Ireland for one year and through LLLI contacts there, organized a new group. Breastfeeding was a beautiful experience for me and my sons, in spite of engorgement, sore nipples, and mastitis--even La Leche members get them! However, since that time, much new information has become available and many problems are now more preventable or minimized, especially with the advent of Lactation Consulting as an outgrowth of LLLI. Subsequently I completed nursing school in 1996 and as I tried to decide which way to go with my degree, maternal and child health became my focus. Lactation Consulting came about as a field that extended the role of the volunteer leader to a person who had additional specialized training and met specific prerequisites in order to sit for the International Board of Lactation Consultant Examiners annual exam. I became Board Certified in 1999. I have been employed by two hospitals on a part-time basis, and am currently, in addition to my private lactation practice, employed full-time at the hospital with the most births per year in New Jersey as a Lactation Consultant. It is challenging and rewarding work, and I feel honored to be a part of the special process that occurs following childbirth. Q: What are the health benefits to mothers who breastfeed? A: Health benefits to mothers who breastfeed are many, including reduced risk of some cancers, reduced risk of osteoporosis, faster return of the uterus to its prepregnant state, steady weight loss based on use of fat deposits laid down during pregnancy for early milk production, slower return of menses which can aid in natural child spacing, and a psychological sense of confidence as the mother provides completed nourishment for her baby. Q: How does breastfeeding reduce the risk of cancer? A: To quote Dr. Jack Newman, MD, FRCPC, a Canadian pediatrician regarding the protective factors against cancers conferred by breastfeeding, "There are various theories, but the most common is that women who breastfeed, especially for more than a token few weeks or months, have a different hormonal milieu than women who do not. It is also thought that a woman who has never had children is also at risk for ovarian cancer. In fact, this is the explanation for breast cancer and endometrial cancer as well. It was always well-known that nuns had much higher rates of these cancers than other women. If we go back to hunter- gatherer societies, sterile menstrual periods are very uncommon. Women in these societies are pregnant or breastfeeding almost continuously from menarche to menopause. This is thought to be the norm for our species and modern society has completely turned this around." In regard to breast cancer, the risk declines in inverse proportion to the duration of breastfeeding. Also, the mother's age at first full-term pregnancy exerts the strongest influence on reducing the risk; if lactation occurs in early reproductive life, the effect is greatest (Riordan, 1999). I spoke to Alicia Dermer, MD who also agreed and indicated that the low estrogen level during breastfeeding may be the protective factor. The degree of protection is dose-related; that is, the degree of reduced risk is directly related to the duration of breastfeeding "A 60 percent reduction in the risk of ovarian cancer was found among women who had breastfed as compared with nulliparous women." as stated by A Patrick Schneider II, MD, MPH in the New England Journal of Medicine, 1987. Q: How does breastfeeding reduce the risk of osteoporosis? A: Osteoporosis is prevented by the fact that mineral bone density has a rebound effect following weaning; that is, while calcium is used during lactation, when the mother ceases to lactate, the body actually increases former bone density, thus protecting against later bone loss. Q: What effect does the milk-producing hormone, prolactin, have on the mother? Prolactin is called the "mothering hormone" because it "physiologically produces in the mother an intensification of her 'motherliness,' the pleasurable care of her child. Psychologically, this intensification serves further to consolidate the symbiotic bond between herself and her child" (Montagu, 1971). In addition, prolactin has a relaxing effect, causing the breastfeeding woman to feel calm, even euphoric, during the feeding. Q: How does breastfeeding increase the amount of energy available to new mothers? A: Breastfeeding is actually less time-consuming than bottle-feeding, resulting in more time to rest and recuperate. Preparation of bottles, buying formula, cleaning bottles, heating bottles, getting up out of bed to prepare for a feeding, all take more energy for the mother. The amount of time spent feeding is roughly the same. In addition, a breastfeeding mom can easily pick up her baby by her side and nurse in bed, allowing both to doze on and off during the night. Thus, energy saved is energy not drained. Q: Is there anything else you would like to add? As I began to answer your questions regarding breastfeeding, it occurred to me that both moms and dads often ask me, "If this is so natural, why is it so hard?" They are often disappointed that babies do not always latch well, suck eagerly, or wake up on schedule, not to mention sore nipples and sleepless nights. I usually respond that breastfeeding is very natural, but not automatic; rather, it is a learned process that develops between mother and baby as they learn to know each other, and learn better ways of obtaining milk through some basic techniques and education. In years past, women passed on this knowledge to each other and new mothers were used to seeing babies at the breast of their friends and family. When formula became popular in the 1940's, the trend toward bottles increased and breastfeeding was no longer a familiar experience to be shared. As breastfeeding has increased at times, mothers do not have the advantage of previous generations' wisdom and knowledge. We are building that now. Therefore, organizations such as La Leche League International, people such as Lactation Consultants, and trained nurses are replacing the family as the nurturers of the mother and the teachers of breastfeeding today. Finally, in the words of Anne Morrow Lindbergh, "In the sheltered simplicity of the first days after a baby is born, one sees again the magical closed circle, the miraculous sense of two people existing only for each other, the tranquil sky reflected on the face of the mother nursing her child." -- Gift from the Sea.