May 14, 2010

Hormonal birth control: widely used, widely misunderstood

I thought I would address hormonal birth control first, since it is so widely used. It is not only used for the prevention of pregnancy, but is also frequently prescribed by physicians for the treatment of painful menses, regulation of cycle length, and perimenopausal physiological issues.

The most common reason for discontinuing the use of hormonal birth control is the uncomfortable side effects. These can include, but are not limited to: nausea, vomiting, bloating, constipation, breast swelling/tenderness, weight gain, mood swings, depression, vaginal infections, high blood pressure, bone density loss, and enlarged ovarian follicles. In many cases, the decrease in libido alone is enough to contribute to the effectiveness rate of hormones!

When my husband and I got engaged, I ran straight to the doctor to get a prescription for birth control. We didn't want to have to mess with condoms or other barrier methods, and we wanted a very effective form of birth control, as we planned to wait at least a year after our marriage before attempting to conceive. One of the side effects that I dealt with early in our marriage was painful intercourse. There was about one week a month where sex was completely pain-free, and one week where it was excruciatingly painful, and the other two weeks had some level of pain in between these two extremes. But more about my personal story later.

(Quick note: when referring to birth control methods, "typical use" refers to the fact that most women do not use birth control correctly 100% of the time. It refers to the likelihood that the average woman using the method will avoid pregnancy. "Perfect use" assumes that the user will use the method absolutely correctly every single time.)

"The pill" is the most commonly used hormonal method of family planning. A pack of pills usually contains 21 active pills followed by 7 "sugar pills" (placebos). The week when the placebo pills are taken is when the "menses" occurs. I put that in quotation marks because it is not really menses at all, but withdrawal bleeding from lack of hormones. There are other combinations of pill packages, including Yaz 28 and Loestrin 24 Fe that include 24 active pills and 4 inactives. Also newly on the market are Seasonale (77 active pills, 7 inactive), Seasonique (77 active pills, 7 low-dose ethinyl estradiol pills), and Lybrel (365 active pills, with no inactive pills). Perfect use: 99.7% effective. Typical use: 92% effective.

The birth control patch is another method. (OrthoEvra is the most common.) It is a 4 inch square patch that is applied to the stomach, buttocks, arm, shoulder, or torso. The patch is changed once a week for three weeks, and no patch is applied the final week of the month. Perfect use: 99.7% effective. Typical use: 92% effective.

The vaginal ring is an increasingly popular prescription, under the name NuvaRing. It is a clear ring that is held in place by the vaginal muscles. It is inserted for three weeks, then removed for a week, and a new one is inserted. (That would be the annoying commercial with the three girls sitting around the TV having the most unrealistic conversation in the world.) Perfect use: 99.7% effective. Typical use: 92% effective.

The mini-pill is becoming increasingly popular among breastfeeding women, since it only contains progestin, and no estrogen to be passed to the nursing child. They contain 28 pills which are all considered to be active. Perfect use: 99.7% effective. Typical use: 92% effective.

Finally, we have the birth control shot; the most commonly known is DepoProvera. It is an intramuscular injection which is received every 11-13 weeks. It has been in the news in recent times for causing loss of bone density when used long-term, and also should be discontinued about a year before pregnancy is desired, because the hormones can take up to 10 months to leave the body. (It should be duly noted that ANY form of hormonal birth control takes at least 3 months to fully leave the bloodstream, and thus should be discontinued about that length of time before trying to conceive.) Perfect use: 99.7% effective. Typical use: 97% effective.

Another personal note of disclosure: It took approximately 7 months for my cycles to straighten out after I ceased the use of hormonal birth control. Thankfully we weren't trying to get pregnant at the time, but it does cause many issues for many women. It can take months or even years for their fertility to return.)

Hormonal birth control prevents pregnancy by two means: first, it prevents ovulation so that no eggs are released, and thus pregnancy does not result. The second method (the "back-up" method, if you will) is to make the uterus an inhospitable environment for a fertilized egg to implant, in case of the first means failing. The main objection that many women have to hormonal family planning is just that: if life begins at conception, then they do not want to take the chance of preventing life from being able to implant and grow properly. (I do take this view: although I stopped the use of hormones due to undesirable side effects, I later learned of this second method of preventing pregnancy, which made me extremely uncomfortable. It was the side effects that made me stop its use, and the method of action that keeps me from returning to it.)

Hopefully this has provided some thought-provoking material, regardless of what readers choose to do with the information. I hope that regardless of the final decision of my readers, that they are well-informed and intentional about their family planning choices.

May 2, 2010

Family planning methods

Birth control and family planning is something I definitely wanted to address on my blog, because I feel it's something that is woefully misunderstood by many woman out there. Many women (myself included) have begun to use hormonal birth control without fully understanding the effect that it has on their bodies or the mechanisms that it uses to prevent pregnancy. My goal in these posts is that women become better informed about the options that are available to them, and that no matter the decision they make in the end, that they are informed about the risks and benefits. This is a part of my goal of intentional living: to truly stop and think about my decisions before jumping into them.


Family planning methods can be broken down into six basic categories: natural, hormonal, barrier, permanent, emergent, and abstinence. We will be discussing these in depth in the near future, but for now, a quick summary:

Abstinence is, of course, the only method that is 100% foolproof, but most of us find it less than acceptable as a means of birth control!

Barrier methods are any non-hormonal device that is used to avoid pregnancy or the spread of sexually-transmitted diseases. These include the male condom, female condom, spermicides (foams, jellies, films, tablets, and suppositories), sponges, cervical caps, and diaphragms.

Hormonal methods include birth control pills, the "mini-pill," birth control injections, vaginal rings, transdermal patches, intrauterine devices, and implants.

Emergent methods describe the "morning after" pills.

Permanent methods are the sterilization implant, and tubal ligation or vasectomy.

Finally, natural methods can include any combination of NFP (natural family planning) methods, including the fertility awareness method (FAM), cycle beads, the rhythm method, standard days method, two-day method, Creighton model system, Billings method, and basal body temperature (BBT) method.

May 1, 2010

Lesser known advantages to breastfeeding

ProMoM's Leslie Burby has compiled a list of 101 reasons to breastfeed your baby. While many are common knowledge, there are also reasons listed here that I wasn't aware of. Some reasons may be more influential on one mother, while others may convince another woman. References can be found at http://www.promom.org/101/.

1 - The American Academy of Pediatrics recommends breastfeeding. According to the AAP, human milk is species-specific, and all substitute food preparations differ markedly from it, making human milk uniquely superior for infant feeding. Exclusive breastfeeding is the reference or normative model against which all alternative feeding methods must be measured with regard to growth, health, development, and all other short- and long-term outcomes. In addition, human milk-fed premature infants receive significant benefits with respect to host protection and improved developmental outcomes compared with formula-fed premature infants. Pediatricians and parents should be aware that exclusive breastfeeding is sufficient to support optimal growth and development for approximately the first 6 months of life and provides continuing protection against diarrhea and respiratory tract infection. Breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child.

2 - The American Dietetic Association promotes breastfeeding. The ADA also believes that the bonding that occurs during breastfeeding makes it a special choice. The ADA actively promotes breastfeeding, stating that it is the position of the American Dietetic Association that broad-based efforts are needed to break the barriers to breastfeeding initiation and duration. Exclusive breastfeeding for 6 months and breastfeeding with complementary foods for at least 12 months is the ideal feeding pattern for infants. Increases in initiation and duration are needed to realize the health, nutritional, immunological, psychological, economical, and environmental benefits of breastfeeding.

3 - Breast milk is more digestible than formula. In recent years nutritionists have voiced concern about overly high levels of protein in the American diet. Since cow's milk contains about twice as much protein as human milk, formula-fed babies usually receive more protein than they need (much of it in the form of the less digestible casein). The stools of formula-fed babies are so bulky because the babies cannot absorb so much protein, and excrete the excess in their stool, whereas breastfed babies absorb virtually 100% of the protein in human milk.

4 - Not breastfeeding increases mother's risk of breast cancer. Many studies have shown that women who breastfeed have lower risks of developing breast cancer. Recently, data from 47 studies in 30 countries was re-examined. The study group concluded that the incidence of breast cancer in developed countries could be reduced by more than half if women had the number of births and lifetime duration of breastfeeding that have been common in developing countries until recently. According to the analysis, breastfeeding could account for almost two-thirds of this estimated reduction in breast cancer incidence.

5 - Baby's suckling helps shrink a mother's uterus after childbirth. The uterus of a non-breastfeeding mother will never shrink back to its pre-pregnant size. It will always remain slightly enlarged. Nursing will help you to regain your figure more quickly, since the process of lactation causes the uterus (which has increased during pregnancy to about 20 times its normal size) to shrink more quickly to its pre-pregnancy size.

6 - Formula feeding increases baby girls' risk of developing breast cancer later in life. Women who were formula-fed as infants have higher rates of breast cancer as adults. For both premenopausal and postmenopausal breast cancer, women who were breastfed as children, even if only for a short time, had a 25% lower risk of developing breast cancer than women who were bottle-fed as infants.

7 - Formula feeding is associated with lower I.Q. Human breast milk enhances brain development and improves cognitive development in ways that formula cannot. One study has found that the average I.Q. of 7 and 8 year old children who had been breastfed as babies was 10 points higher than their bottle-fed peers. All of the children involved had been born prematurely and tube fed the human milk, indicated that the milk itself, not the act of breastfeeding, caused this difference in I.Q. level. Another study to support this statement was done in New Zealand. Here an 18 year longitudinal study of over 1,000 children found that those who were breastfed as infants had both higher intelligence and greater academic achievement than children who were formula fed.

8 - Breast milk is always ready and comes in a nicer package than formula does. Need we say more?

9 - Breast milk helps pass meconium. Babies are born with a sticky tar-like substance called meconium in their intestines. Colostrum, or early milk, is uniquely designed to help move this substance through the infant's body.

10 - Breast milk contains immunities to diseases and aids in the development of baby's immune system. Formula provides neither of these benefits. Breastfed babies have fewer illnesses because human milk transfers to the infant a mother''s antibodies to disease. About 80% of the cells in breast milk are macrophages, cells that kill bacteria, fungi, and viruses. Breastfed babies are protected in varying degrees from a number of illnesses including pneumonia, botulism, bronchitis, staphylococcal infections, influenza, ear infections, and German measles. Furthermore, mothers produce antibodies to whatever disease is present in their environment, making their milk custom-designed to fight diseases their babies are exposed to as well.

11 - Breastfeeding satisfies baby's emotional needs and increases bonding between mother and baby. All babies need to be held. There is no more comforting feeling for an infant of any age than being held close and cuddled while breastfeeding. In fact, studies have shown that premature babies are more likely to die if they are not held or stroked. Breastfeeding stimulates the release of the hormone oxytocin in the mother's body. It is now well established that oxytocin, as well as stimulating uterine contractions and milk ejection, promotes the development of maternal behavior and also bonding between mother and offspring.

12 - Breast milk provides perfect infant nutrition. Human milk is uniquely superior for infant feeding and is species-specific; all substitute feeding options differ markedly from it. The breastfed infant is the reference or normative model against which all alternative feeding methods must be measured with regard to growth, health, development, and all other short- and long-term benefits.

13 - Not breastfeeding increases mother's risk of developing ovarian cancer. Based on the research, breastfeeding for a total of 12 to 24 months can reduce your risk of ovarian cancer by about one-third.

14 - Nursing helps mom lose weight after baby is born. Breastfeeding requires an average of 500 extra calories per day and breastfeeding mothers who eat a normal diet lose the extra weight they gained during pregnancy faster than moms who choose to bottle-feed. In one study, mothers who breastfed exclusively or partially had significantly larger reductions in hip circumference and were less above their pre-pregnancy weights at 1 month postpartum than mothers who fed formula exclusively.Other studies have also shown that women who were overweight when they began their pregnancies can safely get closer to their ideal weight by breastfeeding in conjunction with a moderate exercise program.

15 - Pre-term milk is specially designed for premature infants. Milk produced by women who deliver prematurely differs from that produced after a full-term pregnancy. Specifically, during the first month after parturition, pre-term milk maintains a composition similar to that of colostrum.

16 - The World Health Organization and UNICEF recommend it. Breastfeeding is an unequaled way of providing ideal food for the healthy growth and development of infants; it is also an integral part of the reproductive process with important implications for the health of mothers. As a global public health recommendation, infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development, and health. Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to two years of age or beyond. Exclusive breastfeeding from birth is possible except for a few medical conditions, and unrestricted exclusive breastfeeding results in ample milk production.

17 - Breastfeeding protects against Crohn's disease (intestinal disorder). Crohn's disease is a chronic intestinal disorder. It is a form of inflammatory bowel disease that causes inflammation extending into the deeper layers of the intestinal wall. It is difficult to treat, but several studies have shown that breastfeeding may help babies avoid developing the disease in later life.

18 - Formula feeding increases risk of children developing diabetes. There are many studies linking development of insulin dependent type 1 diabetes (formerly referred to as "juvenile diabetes") to lack of breastfeeding. The results of a study from Finland suggest that the introduction of dairy products at an early age, and high milk consumption during childhood increase the level of cow's milk antibodies in the children's systems. This factor is associated with an increased risk of insulin dependent diabetes. Now a new study has indicated that breastfeeding in infancy may help reduce the risk of type 2 diabetes. This sort of diabetes was formerly referred to as "adult onset" diabetes, but has been mysteriously occurring in more and more youngsters.

19 - Breastfeeding baby helps decrease insulin requirements in diabetic mothers. Reduction in insulin dose postpartum was significantly greater in those who were breastfeeding than those who were bottle-feeding.

20 - Breastfeeding may help stabilize progress of maternal endometriosis. Endometriosis is a disease in which the endometrial tissue in a woman's body begins to form in places other than her uterus, such as her ovaries, fallopian tubes, and the outer surface of the uterus. This tissue continues to function like uterine tissue would in the uterus, and sheds once a month during the woman's menstrual cycle. Since there is no vaginal outlet for this blood and tissue, painful complications, including sterility, may result. There is much clinical research showing that pregnancy temporarily stops the progress of this disease. Many women say that the disease also seems to be alleviated by breastfeeding. It certainly makes sense that the delay in the return of a woman's menstrual cycle would be desirable in preventing the endometriosis from starting up again. Some women even claim a permanent cure.

21 - Baby's suckling helps prevent post-partum hemorrhage in mother. Nursing her baby causes the mother's body to release oxytocin, which stimulates contractions which help shrink the uterus back to pre-pregnancy size while expelling the placenta. These contractions also shut off the maternal blood vessels that formerly fed the baby and discourage excessive bleeding. Women who choose not to breastfeed must be given synthetic oxytocin to insure against hemorrhaging.

22 - Not breastfeeding increases mother's risk of developing endometrial cancer. A World Health Organization study has shown that the longer a woman breastfeeds, the less likely she is to get endometrial cancer.

23 - Formula feeding increases chances of baby developing allergies. Breastfed babies have fewer allergies than artificially fed babies. This is especially important if your family has a history of allergies. Many babies are allergic to cow's milk formulas. Some babies are even allergic to soy formulas. Breastfeeding protects against other allergies, such as atopic eczema, food allergies, and respiratory allergies.

24 - Breast milk lowers risk of baby developing asthma. A number of studies have linked lack of breastfeeding to asthma. According to one study, six year old children were more likely to have asthma if they had not been exclusively breastfed for at least 4 months.

25 - Formula feeding increases baby's risk of otitis media (ear infections). Research has shown that ear infections are up to 3-4 times more prevalent in formula-fed infants.

26 - Formula feeding may increase risk of sudden infant death syndrome (SIDS). Sadly, as of now, researchers have not yet discovered any one factor to account for SIDS. However, there are a number of studies showing a possible link between lack of breastfeeding and SIDS. A Swedish study has found that babies who were breastfed exclusively for less than 8 weeks had a 3-5 times greater risk of dying from SIDS than babies who were breastfed exclusively for four months.

27 - Breastfeeding protects baby against diarrheal infections. Numerous studies have shown that diarrheal infections are much more common in formula-fed babies. This is true throughout the world, despite a misconception that only people living in areas with contaminated water need be concerned with this issue. Such infections are more likely to be fatal in developing nations, but all formula-fed infants are at greater risk than their breastfed peers.

28 - Breastfeeding protects baby against bacterial meningitis. Meningitis is an infection which causes the inflammation of the membrane covering the brain and spinal cord. It can be caused by a type of bacteria called Haemophilus influenzae type B (HiB). Breastfeeding is protective against infections caused by this bacteria, and the meningitis which may result.

29 - Breastfeeding protects baby against respiratory infections. Breastfeeding effectively protects nurslings from many life-threatening respiratory infections including those caused by rotaviruses. Studies have shown breastfed babies are less than half as likely to be hospitalized with pneumonia or bronchiolitis, and have one-fifth the number of lower respiratory tract infections compared to formula-fed infants. According to a recent meta-analysis of studies from developed countries, the risk of severe respiratory tract illness resulting in hospitalization is more than tripled among infants who are not breastfed, compared with those who are exclusively breastfed for four months.

30 - Formula fed babies have a higher risk of developing certain childhood cancers. In a study done by researchers at the University of Minnesota, it was found that babies who were breastfed for at least one month had a 21% less chance of getting leukemia than formula fed babies. The risk was 30% less for children breastfed for 6 months.

31 - Breastfeeding decreases chances of developing rheumatoid arthritis. Recent results from a Swedish study indicate that breastfed babies were less likely to develop rheumatoid arthritis as adults. An earlier University of North Carolina/Duke University study had indicated that breastfed children were only 40% as likely to develop juvenile rheumatoid arthritis.

32 - Breastfeeding decreases child's chances of contracting Hodgkins disease. Hodgkins disease is a type of lymphoma, or cancer of the lymph system. It can develop in children, although it is less likely to do so in children who were breastfed as infants.

33 - Breastfeeding protects baby against some vision defects. In a study in Bangladesh, breastfeeding was a protective factor for night-blindness among preschool-aged children in both rural and urban areas. Breastmilk is generally the main, if not the only source, of vitamin A during a child's first 24 months of life (or for the duration of breastfeeding).

34 - Breastfeeding decreases chances of osteoporosis. According to many studies, both breastfeeding mothers and their children will be less at risk for development of this disease. One study found that the odds that a woman with osteoporosis did not breastfeed her baby was 4 times higher than for a control woman. In another study, Dr. Alan Lucas, MRC Childhood Nutrition Research Center of London, found that 8-year-olds who were formula fed rather than breastfed as infants, had less developed bone mineralization than those fed breastmilk. Bone mineral density decreases during lactation, but after weaning showed higher bone mineral density than those who did not breastfeed.

35 - Breast milk aids in proper intestinal development. The gastrointestinal system of a newborn baby is not yet mature. It is still permeable, allowing bacteria, viruses and toxins to pass through. The intestinal permeability decreases more slowly in formula fed babies. According to Dr. Jack Newman, "Certain hormones in milk (such as cortisol) and smaller proteins (including epidermal growth factor, nerve growth factor, insulin-like growth factor and somatomedin C) act to close up the leaky mucosal lining of the newborn, making it relatively impermeable to unwanted pathogens and other potentially harmful agents. Indeed, animal studies have demonstrated that postnatal development of the intestine occurs faster in animals fed their mother's milk. And animals that receive colostrum, containing the highest concentrations of epidermal growth factor, mature even more rapidly."

36 - Cow's milk is an intestinal irritant. According to Dr. William Sears, cow's milk should not be given as a beverage to infants under one year of age. Cow's milk can irritate the lining of your infant's intestines, causing tiny losses of iron. This can contribute to iron-deficiency anemia.

37 - Formula-fed babies are more at risk for obesity in later life. A study of 32,200 Scottish 3-year-old children found that the incidence of obesity was significantly lower among those who had been breastfed, after adjusting for socioeconomic status, birth weight, and gender. Another study, this one of Czech children, found that the even older children (6-14) who had been breastfed were less at risk for overweight/obesity. Additionally, a German study found that 4.5% of formula children are obese, while only 0.8% of breastfed children have this condition.

38 - Breastfed babies have less chance of cardiopulmonary distress while feeding. Bottle-fed babies are at increased risk of cardiopulmonary disturbances, including prolonged airway closure and obstructed respiratory breaths due to repeated swallowing. According to one study, infants can experience oxygen saturation below 90% when bottle feeding. Nine of 50 healthy term infants in one study experienced bradycardia during bottle feeding. Six of these episodes were preceded by apnea, three showed hypopnea (marked reduction in ventilation) and one had certral apnea (no respiratory efforts).

39 - Breastfed babies have less chance of developing ulcerative colitis. Ulcerative colitis is a chronic inflammatory bowel disease that causes ulceration and inflammation of the inner lining of the colon and rectum. A number of studies have shown that breastfed babies are less likely to develop this disease.

40 - Breast milk protects against Haeomophilus influenzae B bacteria. Haemophilus influenzae type B is a bacteira which can grow in the respiratory tract with no symptoms, but may spread into the throat, ears or blood and cause grave illness. Breastfed babies are much less vulnerable to such an overgrowth. Interestingly, a 1999 Swedish study found that even 5-10 years later, children who had been breastfed were much less likely to contract H. influenzae B.

41 - Breastfed babies require shorter pre- and post-surgical fasting. Breastfeeding may continue until three hours before arrival time at the hospital in healthy children having elective surgery.

42 - Breastfeeding results in less sick days for parents. Since breastfed babies are statistically healthier than their formula fed peers, the parents of breastfed babies spend less time out of work taking care of sick children.

43 - Breastfeeding enhances vaccine effectiveness. Breastfed infants showed better serum and secretory responses to oral and parenteral vaccines than those formula fed.

44 - Breastfed babies have less chance of developing necrotizing enterocolitis. This disease occurs most commonly in premature or sick newborns. In NEC the lining of the intestinal wall dies and sloughs off. Premature infants fed their own mother's milk or banked human milk are one-sixth to one-tenth as likely to develop NEC. One Australian study has estimated that 83% of NEC cases may be attributed to lack of breastfeeding.

45 - Breastfeeding contributes to optimal child-spacing. First of all, please know that it is certainly possible to get pregnant while you are still breastfeeding. However, many breastfeeding women do not ovulate for the first 6 months or so following the birth of a new baby. This is true only for those who are exclusively breastfeeding (no supplements or solid food), and have not yet gotten their periods back following childbirth. Night nursing encourages longer amenorrhea (periodlessness). If you really don't want to get pregnant again, use some back up birth control even if you haven't gotten your period again. Unless you are carefully following a natural family planning program, you will have no way of knowing when your first ovulation will occur, and by the time you figure it out, you may be expecting! Still, generally speaking, breastfeeding contributes to optimum child spacing.

46 - Breastfeeding is easier than using formula. After the initial start-up period, breastfeeding is very easy. All you have to do is raise your shirt and let the little one latch on. No shopping for formula, bottles, and other supplies. No mixing, heating, refrigerating, and cleaning up of formula. If you sleep with your baby, or sleep the baby next to your bed, you can forget about all the disturbing nighttime rituals associated with formula use. All you have to do is roll over, let the baby latch on, and go back to sleep!

47 - Breastmilk is free. Any way you look at it, you'll spend a lot more if you choose to formula feed. The added calories a nursing mother must take in are a negligible expense, and nursing clothes are optional. If you need to pump, excellent pumps are available for between $50 and $225. A good pump can be used for more than one child, so they are really an investment. Do be sure to buy a pump manufactured by a company specializing in their manufacture. Beware of pumps made by formula companies. Many women report these pumps to be inefficient at best, and painful at worst.

48 - Formula is expensive. It presently costs upward of $1,200 dollars per year to formula feed an infant in the United States. If you factor in the added medical cost you are statistically likely to incur, that brings the cost up to around $2,500 per year. If your baby happens to require a hypo-allergenic formula, you will have to pay considerably more.

49 - Formula costs the government (and taxpayers) millions of dollars. The U.S. government spends more than $2,665,715 a year to provide formula for the children of non-breastfeeding mothers participating in WIC supplemental food program. Of course, this doesn't take into consideration the additional costs of caring for those infants who are statistically much more likely to get sick. According to the American Academy of Pediatrics, higher breastfeeding rates could reduce U.S. health care costs by $3.6 billion per year.

50 - Breastfed babies require fewer doctor visits. Since breastfed babies are statistically healthier, they see the doctor less often.

51 - Breastmilk always has the right proportions of fat, carbohydrates and protein. Formula companies are constantly adjusting these proportions looking for the best composition. The reality is that a mother's milk composition changes from feeding to feeding depending on the needs of her child. No formula can do that! According to the American Dietetic Association, "Human milk provides optimal nutrition to the infant with its dynamic composition and the appropriate balance of nutrients provided in easily digestible and bioavailable forms."

52 - Breast milk acts like a natural tranquilizer for baby. Mother's milk contains chemicals that seem to work like "knock-out drops" for tired babies. Even if baby doesn't fall asleep, he/she will certainly calm down and become more agreeable. If you choose to breastfeed into toddlerhood, you may find that the "terrible twos" never materialize.

53 - Breastfeeding acts like a natural tranquilizer for mom. Nursing mothers often joke about falling asleep on the job. The sleep-inducing qualities of a nursing baby are remarkable. In fact, some new mothers have to be careful to hold a nursing baby in such a way that they will not drop the child when they inevitably nod off. Nursing in bed is a great solution. Even pumping at work can be a great way to calm down and get refocused during a stressful day. All this relaxation is caused by the hormone oxytocin, which is released each time a mother breastfeeds. It decreases blood pressure and calms the mother. Interestingly, one study found that there were far fewer incidences of domestic violence and sexual abuse in breastfeeding families.

54 - Breastmilk tastes better than formula. Human breastmilk is sweet and light. Formula is pasty and bland. Which would you rather eat?

55 - Breastfed babies are healthier overall. Kaiser Permanente, one of the largest HMOs in the U.S. has conducted research to determine the value of the company lactation support program. This research found that breastfed babies had many health advantages over formula-fed babies, including better overall health.

56 - Breastfed babies are less likely to die before their third birthday. Not only are breastfed babies less likely to contract life-threatening diseases, they are better able to combat any illnesses that may develop.

57 - Breastmilk is always the right temperature. Severe burns to babies' mouths have occurred due to improper heating of artificial milks. Even when it's done correctly, it's never fun to warm a bottle for a fussing baby.

58 - Breastfeeding mothers spend less time and money on doctors' visits. In 1995 the Kaiser Permanente Health Maintenance Organization in North Carolina found that formula fed babies averaged over $1400 more per year in additional health care costs than breastfed infants.

59 - Fewer waste packaging products. No wrappers, canisters, disposable bottles, etc. If every child in America were bottle fed, almost 86,000 tons of tin would be needed to produce 550 million cans for one year's worth of formula. If every mother in Great Britain breastfed, 3000 tons of paper (used for formula labels) would be saved in a year. But formula is not the only problem. Bottles and nipples require plastic, glass, rubber, and silicon; production of these materials can be resource-intensive and often leads to end-products that are not-recyclable. All these products use natural resources, cause pollution in their manufacture and distribution and create trash in their packaging, promotion, and disposal.

60 - No bottles to tote, unless you're pumping and transporting the milk for later. Even then, there are fewer bottles to deal with.

61 - Breastfeeding may lower the risk of developing high cholesterol. A recent British study found that breastfeeding seems to be associated with lower levels of damaging cholesterol in adulthood. The authors concluded that breastfeeding may have long-term benefits for cardiovascular health.

62 - No need to refrigerate. Of course, breastmilk stays fresh because it's made on demand. Even pumped breast milk keeps for a long time outside of the fridge. Check out the guidelines for storing breast milk at http://www.medela.com/.

63 - Cow's milk is designed for baby cows, while human milk is designed for human babies. Human milk contains completely different proportions of protein, fat, and carbohydrates. Cow's milk is designed to help put on weight quickly, grow amazingly fast, and develop only as much brain power as a cow needs. After all, a calf is able to stand and walk on the day it is born. The natural hormones in cow's milk are geared towards cows, not humans. The fact that human beings can even partially digest the milk of another species is sort of amazing when you stop to think about it. Human milk is designed for baby humans. It's designed to build brains, and to foster gradual physical growth.

64 - Breastmilk aids in the proper development of a baby's gastrointestinal tract. The cells of the mature intestinal lining are tightly packed together so that potential allergens cannot seep through into the bloodstream. But in the early months, the lining of a baby's immature intestines is more like a sieve, allowing potential allergens to get through, which sets the infant up for allergies and infections. Breastmilk contains a special protein called immunoglobulin A (IgA), which acts like a protective sealant in the digestive tract. Breastmilk also contains a special substance called epidermal growth factor (EGF), which promotes the growth of the cells lining baby's intestines as well as other surface cells, such as the cells of the skin.

65 - Breastmilk provides natural pain relief for baby. Breastmilk actually contains chemicals that supress pain (endorphins). Aside from this, the comfort a baby derives from being held close and suckling is remarkable. Many a bruise or scrape has been soothed away almost instantly by a few moments of nursing. If you choose to have your child vaccinated, it is a good idea to nurse immediately after he/she receives a vaccination. This soothes the hurt, as well as enhancing the vaccine's effectiveness.

66 - Human milk is the perfect food for a sick infant. When a formula fed baby gets a gastrointestinal ailment, they are usually put on an artificial electrolyte solution because formula is too hard for them to digest. Breastmilk, however, is easily digested, and soothing to the intestines, so there is no need for artificial and expensive electrolyte solutions. If a baby gets a respiratory illness, formula may cause even more mucus. In contrast, breastmilk contains antibodies to these ailments, as well as being highly digestible and not contributing to excess mucus formation.

67 - A breastfeeding mom gets more sleep. Especially if she sleeps with baby, but even if she doesn't, there are no bottles to prepare and warm, and less time comforting a crying baby suffering from gas and allergies.

68 - Babies that nurse are happier at night. A baby that gets its nighttime needs met quickly is more likely to get right back to sleep than a baby who has to wait for a bottle while crying and swallowing air.

69 - More sleep for dad. Again, even if he helps with baby burping, diapering, and baby toting, there are no bottles to deal with. Also, breastfed babies tend to need much less burping after the first few months.

70 - Less equipment to maintain and store. Those bottles, measuring devices, sterilizing equipment, and other gadgets take up shelf space, and they all require cleaning.

71 - Less equipment to buy, unless you pump. Even if you do have to buy a pump and the basic bottle kit, the savings in cost of formula and additional medical attention make breastfeeding financially well-worth trying.

72 - Breastmilk has never been recalled due to manufacturing problems. Formula has been, sometimes after causing injury or death. There were 22 "significant" recalls of formula, including 7 potentially life-threatening situations.

73 - Fresh breastmilk is never contaminated with bacteria. In fact, it has antibacterial properties.

74 - No need to worry about which brand is better. Each artificial breastmilk formula is different from all its competitors, but none of them come close to duplicating the real thing. It can be very stressful for formula feeding mothers to try to determine which brand is the best of the lot. No matter which formula is used, it is increasingly apparent that infant formula can never duplicate human milk. Human milk contains living cells, hormones, active enzymes, immunoglobulins, and compounds with unique structures that cannot be replicated in infant formula.

75 - No need to worry about adding contaminated water. Even in regions of the world where bacterial contamination is not an issue, water can contain dangerous elements like arsenic, lead, and aluminum. These contaminants can become concentrated if water is boiled to sterilize it before being added to formula.

76 - Breastfed babies get fewer stomach infections. According to a study of 17,046 mother and infant pairs in Belarus, breastfed infants had a significant reduction in risk of gastrointestinal infection.

77 - Breastfeeding facilitates proper dental and jaw development. Nursing is good for a baby's tooth and jaw development. Babies drinking from the human breast have to use as much as 60 times more energy to get food than do those drinking from a bottle. Obviously, a nursing baby's jaws are receiving much more exercise as she pulls her mother's milk into her mouth. Apparently, this constant gentle pulling assists the growth of well-formed jaws and straight, healthy teeth. Among breastfed infants, the longer the duration of nursing, the less chance of dental malocclusion.

78 - Breastfed babies have less tooth decay. Breastmilk contains bacteria-fighting cells that may help kill the bacteria that cause tooth decay. Furthermore, bottle fed babies are at increased risk for baby bottle caries, a destructive condition when occurs when a baby is put to bed with a bottle containing formula, milk, juice or other fluids high in carbohydrates. Extensive dental repair may be required at a cost of thousands of dollars.

79 - Less money spent on corrective orthodontia. The longer you breastfeed, the more likely the baby's teeth will come in properly. If the teeth come in straight, there's no need to fix them.

80 - Better speech development. Tongue-thrust problems often develop among bottle-fed babies as they try to slow down the flow of milk coming from an artificial nipple. This can lead to speech problems later on. Early weaning may lead to the interruption of proper oral motor development provoking alterations to the posture and strength of the speech organs and harming the functions of chewing, swallowing, breathing, and articulation of speech sounds. The lack of physiological sucking on the breast may interfere with the oral motor development, possibly causing malocclusion, oral respiration and oral motor disorders.

81 - Less chance of baby getting eczema. A number of studies have indicated that breastfed babies are less likely to develop eczema.

82 - Breastfed babies have great skin. You don't have to refer to the many studies showing that breastfed babies have less eczema and fewer rashes. Check out the skin of a breastfed baby and see what you think.

83 - Less spit-up. Breastfed newborns demonstrate gastroesophageal reflex episodes of significantly shorter duration than formula fed newborns.

84 - Breastfeeding is better for premature infants. A recent Israeli study confirmed that the more breastmilk premature babies receive, the more responsive they are. Infants receiving substantial amounts of breastmilk showed better neurobehavioral profiles - in particular, motor maturity. These infants were also more alert during social interactions, and their mothers provided more affectionate touch. In addition to its nutritional value, breastmilk may be related to improved maternal mood and interactive behaviors, thereby indirectly contributing to development in premature infants.

85 - Breastmilk contains no genetically-engineered materials. Most consumers are completely unaware of how much genetically-engineered food they are consuming because the U.S. government does not require this food to be labeled as such. Genetic ID, a company in Fairfield, IA, tested four soy-based baby formulas for genetically-engineered ingredients. All four, Carnation Alsoy, Similac Neocare, Isomil, and Enfamil Prosobee, tested positive.

86 - Breastmilk contains no synthetic growth hormones. Since many cows in the U.S. are now routinely ingesting synthetic growth hormones to artificially increase their milk production, it stands to reason that these hormones are also getting into the U.S. formulas.

87 - Lack of breastfeeding is associated with multiple sclerosis later in life. Although thought to be multifactorial in origin, and without a clearly defined etiology, lack of breastfeeding does appear to be associated with an increased incidence of multiple sclerosis.

88 - Less chance of inguinal hernia. The inguinal canal brings down the spermatic cord and certain vessels to the groin area. A hernia is a defect in the opening where these things pass from the abdomen to the groin because the canal opening gets too big or tears off. The hernia allows abdominal contents to get down into the groin area. Breastfeeding is protective against inguinal hernias. For unknown reasons, breastfed babies experience significantly fewer of them. Human milk contains gonadotropin-releasing hormone, which may affect the development of a baby boy's testicles.

89 - Better cognitive development for low birth weight babies. In 771 low birth weight infants, babies whose mothers chose to provide breastmilk had an 8 point advantage in mean Bayley's mental development index over infants of mothers choosing not to do so.

90 - Better social development. The psychomotor and social development of breastfed babies clearly differs from that of bottle fed ones and leads at the age of 12 months to significant advantages of the psychomotor and social capabilities.

91 - Decreased risk of baby developing urinary tract infections. Breastfed babies have fewer urinary tract infections than their bottle fed peers. According to one study, infants who were exclusively bottle fed were more than five times as likely to develop urinary tract infections compared with those that were breastfed.

92 - Suckling optimizes hand-eye coordination. It isn't completely clear why, but breastfed infants are able to see and manipulate objects quicker than their formula fed counterparts. This is one of the many benefits of breastfeeding that are still being explored.

93 - Breastfeeding protects mothers against anemia (iron deficiency). Since many exclusively breastfeeding mothers do not begin to menstruate for a year or longer, their iron stores are not depleted by monthly bleeding during this time.

94 - Breastfeeding mothers spend less money on menstrual supplies. Many breastfeeding moms do not begin to menstruate again until 14 or more months after giving birth. That means for 14 months, many nursing moms don't have to buy tampons, sanitary napkins, and cramp relief medication! Multiply this by the four million U.S. births each year to see that over one billion sanitary products annually could be kept out of our nation's landfills and sewers. To compound the scenario, because breastmilk is absorbed by babies more efficiently, breastfed babies excrete less and thus require fewer diaper changes than formula fed babies.

95 - Breastfeeding is a self-confidence booster for mom. There is nothing more amazing than looking at a plump six-month-old baby and knowing that the only nutrition this happy little creature has received has come from your own body.

96 - Breastmilk may help combat eye infections. Breastmilk contains natural antibiotic qualities, and many mothers swear that a squirt in the irritated eye of their baby has cleared up the problem in short order.

97 - Breastfeeding may lower blood pressure in childhood. A 2004 study of 4763 British children showed that 7.5 years later, those who were breastfed as infants had lower blood pressure compared with those who were never breastfed. In another new study from the U.K., a small but important reduction in adult diastolic blood pressure is associated with having been breastfed as an infant.

98 - No worry about latest ingredient discovered to be missing from formula. There is no formula that can duplicate human milk because, as the FDA recognized in a recent statement, the exact chemical makeup of breastmilk is still unknown. Formula fed infants depend on products which can be quite different from each other, but which are continually being found deficient in essential nutrients. These nutrients are then added, usually after damage has occurred in infants or overwhelming market pressure forces the issue.

99 - Much nicer diaper changes. The bowel movements of breastfed babies smell mild and inoffensive. The same cannot be said about those of formula fed babies. Try changing a few formula fed babies if you are uncertain about wanting to try breastfeeding!

100 - Breastfed babies smell fantastic. No scientific study needed here. There is something almost magical about the scent of your own breastfed baby, whether you're the mother or father involved. Try it, you'll like it!

101 - It's what breasts were designed for!