There are two kinds of mothers in this world: those who love to breastfeed and those who don't.
I fall squarely into the first category. I breastfed both my children for a year each and loved every minute of it.
I loved the convenience of not having to stumble around in the dark in the middle of the night, warming up bottles. And most of all, I loved the intimacy.
I have a close friend who is the polar opposite. She hated the very idea of a child suckling from its mother's breast, even when she was the mother and the child was her own.
She did try very hard to overcome her natural antipathy. And she did breastfeed each of her three children for those vital first few days after birth, when mother's milk is full of colostrum, the thick yellow substance that is full of antibodies, providing much-needed protection for infants from many common diseases.
It would be an understatement to say she did not enjoy breastfeeding, but not because she didn't want to "ruin" her beautiful figure, or because she feared shapeless, sagging breasts pulled down to the waist by voracious infants.
She simply found it physically unpleasant. This did not mean that she was "not a natural mother" or that she loved her babies any less than I loved mine. On the contrary, she was as besotted a mother as I was, and bonded just as quickly with her infants.
On reflection, I'd say she's probably proved to have been the much better mother overall. Certainly she has been calmer, more centred, much less neurotic and generally more balanced and intuitive in her approach to negotiating the challenges strewn in the path of new mothers, especially those who work outside the home.
Clearly, breastfeeding is not for everyone, though there's no denying that when it comes to the best food for newborn babies, breast is usually it. And mothers who are physically able to breastfeed should be encouraged to do so, unless there's a serious medical reason why they should not, as for example with HIV positive mothers. However, even that is no longer written in stone.
The Aids conference in Durban threw up controversy around the issue, following a ground-breaking study by the University of Natal Medical School, published in the prestigious British medical journal, The Lancet.
The research team led by Dr Anna Coutsoudis, of the medical school's department of paediatrics and child health, showed that exclusive breastfeeding for three months - absolutely no other liquids at all, no water, no juice, baby teas, rooibos tea, traditional use of laxatives or muti - did not carry any additional risk of mother-to-child transmission of HIV.
In fact, the study suggested that exclusive breastfeeding prevented the introduction of contaminants or allergens that could damage the gut barrier and allow easier access of the HI virus. Coutsoudis has since presented unpublished material showing that the findings apply to exclusive breastfeeding for six months as well.
The researchers called for a recommendation that "HIV-infected women who choose to breastfeed, or who have no other choice but breastfeeding, should be encouraged and actively supported to breastfeed exclusively".
Of course, breastfeeding exclusively for six months is not confined to mothers with a serious health problem.
The La Leche League (LLL) International, a non-profit organisation that offers breastfeeding education and encouragement through mother-to- mother support groups, phone help and extensive interaction with doctors and healthcare providers, recommends this for all mothers as the optimum way to feed a newborn baby.
There is a vast body of scientific research on the benefits of breastfeeding, thanks to the constituents of the milk.
When the mother is healthy, her milk is a living, biological fluid, with immune-boosting properties, and all the right nutrients, in the right proportions for a growing baby. The lactoferrin in breastmilk, for example, allows for optimal absorption of iron and protects the stomach and intestines from harmful bacteria.
Environmental groups and media reports continue to play up issues of environmental contaminants in mother's milk. However, research shows that this is an issue only in situations of toxic spills or occupational exposure to hazardously high levels of toxins.
A League press statement points out that a lesser-known and less publicised issue is the presence of phyto-oestrogens (plant hormones) in soy milk formulas. As well, cows are exposed to environmental toxins, and artificial milks are certainly not necessarily "pure" either.
The League says that rather than calling for women to avoid breastfeeding, we need to "continue to clean up the environment to safeguard everyone's health".
And while breast is demonstrably best for babies, there is also research to show that breastfeeding actively benefits the mother's health: information from the Nutrition Information Centre of the University of Stellenbosch (Nicus), says that recent studies show that women who breastfeed enjoy decreased risks of breast and ovarian cancer. Breastfeeding causes contractions that help the mother's uterus to return to its normal size sooner than if she does not breastfeed.
It helps women to more easily lose weight they may have gained during pregnancy.
And it acts as a form of contraception by suppressing menstruation, though not one to be relied on too heavily. I have more than a few friends who did rely on it, and have unplanned children to show for it.
Breastfeeding is not always a breeze, even for mothers who are passionately committed.
Problems of insufficient milk flow, engorged (swollen) breasts, and cracked and bleeding nipples are very real for many women, says South African La Leche League co-ordinator, Jane Maarsdorp. "But they can all be solved," she says.
- The La Leche League publishes The Womanly Art of Breastfeeding, a comprehensive handbook on breastfeeding and parenting. For more information, contact (031) 309-1801.
- The Nutrition Information Centre of the University of Stellenbosch can be contacted at (021) 933-1408.
Its social and economic benefits
August 1 marked the 10th anniversary of the signing of the international Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding which was adopted in 1990 by 32 governments and 10 United Nations Agencies. South Africa is not a signatory to the declaration, but is a signatory to the UN Convention of the Rights of the Child which supports breastfeeding. Benefits include:
* Families who breastfeed save money: Breast milk is free; the cost of baby formula for the first six months averages between R700 and R1 000, excluding the cost of bottles, detergents and preparation utensils. Breastfed children are less prone to middle-ear infections, pneumonia and gastroenteritis than bottle-fed infants, leading to savings on health-care costs and related time lost to care for sick children.
r Fathers benefit: They can see their wives developing a healthy responsibility towards the baby; they benefit from the economic impact on the family budget of not having to buy expensive formula foods; and they have less smelly nappies to deal with - the stools of breastfed babies do not smell as dreadful as formula-fed infants.
r Communities reap the benefits: Research shows less absenteeism from work among breastfeeding families. Resources used to feed those in need can be stretched further when mothers give their babies their own milk rather than costly artificial substitutes.
r The environment benefits: Breastfeeding uses none of the tin, paper, plastic or energy necessary for preparing, packaging and transporting artificial baby milks, cutting down on pollution and garbage disposal problems. Research also shows an increase in naturally spaced pregnancies among women who breastfeed exclusively.