Nutrition and its Effect on the Mother’s and Baby’s Health

Kaleigh Huber, Mackenzie Kravec, Alexa Lynch, Ashley McKee and Caylee Michaels

04/07/2021

NURS 3749: Nursing Research

Dr. Valerie O’Dell

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Abstract

The purpose of this research was to look at how the mother and baby are affected by the source

of nutrition. The two main sources of nutrition involve breastfeeding and formula feeding. The

correlation between physical, psychological, and emotional factors along with the bonding of the

mother and baby were explored. This research was drawn from thirteen quantitative and

qualitative studies and the Maternity & Women’s Health Care 12th edition textbook. The research

shows that there was significant evidence supporting breastfeeding in the postpartum period that

led to positive impacts on the mother and baby’s health. The postpartum period is referred to as

the time immediately after childbirth until the mother’s body returns to a non-pregnant state.

Furthermore, there was no significant evidence that formula feeding is necessarily bad for the

baby’s health. However, it was found that there are more negative effects on formula feeding

than there are on breastfeeding. Overall, the research shows that in terms of the best source of

nutrition for the baby, breastfeeding positively impacted not only the baby’s health but also the

mother’s more than formula feeding.

Nutrition and its Effect on the Mother’s and Baby’s Health

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As the number of childbirths are on the rise due to the Covid-19 pandemic, mothers have

to make the decision of how the baby will receive its nutritional intake. The nutrition sources that

are explored are breastfeeding and formula feeding. With that being said, breastfeeding had

positive impacts on not only the baby’s health but also the mothers unlike formula feeding. Many

studies have been conducted to emphasize the fact that breastfeeding is more beneficial than

formula feeding in the physical, psychological, and emotional aspects of health along with

bonding. This presents an issue for not only the postpartum mothers but also the nursing

profession. The reasoning for this is because the registered nurses provide teaching for the

patients and some of the mothers are unable to physically breast feed due to anatomical reasons

or they simply do not want to. Therefore, the following research question was addressed: In the

postpartum period, how does breastfeeding versus formula feeding affect the health of the

mother and the baby during the first year?

Literature Review

Introduction

With the aim of addressing this issue in the postpartum mothers, information was

acquired via A-Z research databases, specifically Elsevier ScienceDirect, NCBI and MEDLINE

in addition to the Maternity & Women’s Health Care 12th edition textbook. Comprehensive data

was collected and reviewed from fourteen sources regarding how the mother and baby are

affected by the source of nutrition. Physical, psychological, and emotional aspects of health

along with mom-baby bonding will be discussed.

Physical Aspects
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There are many components that contribute to the physical aspects of health, one being

the nutrients found in breast milk. Breast milk contains proteins, fats, vitamins, and

carbohydrates. The different types of proteins include whey protein and casein which are both

essential for quick and easy digestion and can also help protect against infection. Meanwhile, fats

are utilized for brain, retina, and nervous system development. Furthermore, breast milk contains

vitamins such as A, D, E, and K. Vitamin A is important for immune system, reproduction and

normal vision while helping the heart, lungs, and kidneys work properly. Vitamin D is used to

help with bone growth and calcium absorption from bone while vitamin E protects against skin

cancer and promotes wound healing. Also, vitamin K is necessary for blood coagulation and is

produced by intestinal bacteria. Lastly, the primary carbohydrate that makes up breast milk is

lactose which fights to decrease a large number of unhealthy bacteria in the stomach (Ballard &

Morrow, 2013).

Additionally, there are many benefits associated with breastfeeding for the mother and

the infant that contribute to their physical health. For instance, benefits for the baby include a

reduced risk for the following: otitis media, obesity, type 2 diabetes mellitus, asthma, sudden

infant death syndrome, and necrotizing enterocolitis in preterm infants. On the other hand,

mothers also benefit from breastfeeding in the way that they have a reduced risk for developing

hypertension, ovarian and breast cancer, and type 2 diabetes mellitus (Lowdermilk et al., 2020).

Therefore, breastfeeding is considered to be the clinical gold standard for nutritional intake, with

breast milk meeting the health needs of a growing baby (Petersen, 2021).

Specifically, obesity is one of the leading concerns in childhood and breastfeeding infants

reduces this risk. Breast milk is considered a protective factor for obesity in childhood shaping

gene, neuroendocrine, lifestyle, and environment interactions (Marseglia et al., 2014). This is
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significant because the infant’s intake of breast milk influences the physical development of the

baby. Mothers who breastfed their infants for a longer period of time decreased the risk of their

children becoming overweight. The reasoning for this is because breast milk promotes self-

regulation in infants and contains a lower protein content. Also, studies have shown that

microbiota in the baby’s gastrointestinal tract play a role in the chances of the infant becoming

overweight (Forbes et al., 2018).

Psychological Aspects

While the physical aspects of breast milk contribute immensely to the health of the baby,

there are also a lot of psychological aspects. It’s very important that newborns feel a bond with

their mother. There are studies that show that babies who are breastfed develop more of a secure

attachment to their mother which in turn reduces any negative temperament that could develop

later in life (Lui et al., 2013). Having a secure attachment at this stage of life can improve sleep

quality as well for the child. If a baby does not feel secure or safe with the mother this could

affect the quality of sleep and even the efficiency of feedings. Bonding plays a major role in the

psychological development of the baby and contributes to positive growth between the mother

and baby’s relationship. According to Lui et al. (2013), “Breastfeeding may enhance the mother-

infant bonding process via active talking, eye contact, and skin-to-skin touch” (p. 9). When a

baby has that skin-to-skin contact with their mother especially when being fed, it can

significantly increase the baby’s sense of safety and security.

Health benefits from breastfeeding are not just limited to the baby; the mother also

receives an abundance of positive psychological effects from the feedings as well as the one-on-

one bonding time with her newborn. According to Liu et al. (2013), “The production of prolactin

and oxytocin during breastfeeding is associated with lower levels of maternal stress and
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enhanced bonding” (p. 1). The bonding between a mother and baby is crucial especially within

the first year of life. Within the making of breast milk, oxytocin and prolactin are produced from

the mother, which in turn lowers stress naturally. It has also been found that breastfeeding relates

to a significant decrease in anxiety and depression in new mothers. (Ystrom, 2012). Since

breastfeeding enhances bonding as well as aids in the decrease of stress, this can also help reduce

any anxiety or depression the mother is feeling during the postpartum period.

There are many positive psychological aspects that breastfed babies develop later in their

life. Studies show that people who are breastfed experience a lot of psychological advancements

including improved memory retention, greater language skills, and intelligence (Krol &

Grossman, 2018). This has been proven to develop with a person as they get older but there have

also been studies that showed “the initiation of breastfeeding immediately after birth has also

been argued to play a role in reducing the risk for cognitive impairment among children” (Krol &

Grossman, 2018, p. 2). This study shows that breastfeeding can significantly affect a newborn’s

life later on and aid in cognitive health.

Emotional Aspects

In addition to the psychological aspects, emotional factors also play a major role in the

breastfeeding process. As specified in the text, many women who are breastfeeding feel a sense

of empowerment while having the ability to provide for their infant’s nutritional intake

(Lowdermilk et al., 2020). This shows that mothers have a positive attitude towards

breastfeeding, resulting in adequate nutrition for the baby. Additionally, research shows that

breastfeeding significantly reduces stress in mothers along with facilitating a positive affect

(Krol & Grossmann, 2018). This emphasizes the fact that when mothers breastfeed, they

tend to experience positive emotions while being under little to no stress.

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One of the most common diagnosis after childbirth up until two weeks postpartum is

termed postpartum or baby blues. If this lasts longer than two weeks than it is referred to as

postpartum depression. According to Vieira et al. (2018), “postpartum depression can be

characterized by irritability, anhedonia, anxiety, persistent discouragement, guilt, among other

symptoms” (p. 2). Studies have shown that early cessation of breastfeeding puts the mother at

risk for postpartum depression (Ystrom, 2012). Therefore, mothers taking the initiative to breast

feed as soon as the infant is delivered up to one year of age helps build the mother-baby bond,

improving maternal sensitivity and reducing postpartum depression (Lie et al., 2013).

Another dimension that has to do with not only the emotional aspect of health but also the

mom-baby bond includes the hormones secreted throughout pregnancy. Moreover, the

hormones, oxytocin and prolactin, play an important role in mother-infant bonding, and this has

been shown to decrease emotional and behavioral problems in children (Liu et al., 2013).

Oxytocin is released during the breastfeeding process which allows for the mom and baby to

learn each other’s scent. On the other hand, Prolactin stimulates the mother’s milk production. In

summary, these two hormones are often referred to as the “mothering hormones” simply because

of the affect they have on the postpartum mother’s emotions and physical state (Lowdermilk et

al., 2020).

Mom-Baby Bonding

When it comes to mother and baby attachment, breastfeeding provides a sense of security

and bond overall. One of the studies showed that early interactions between the mother and baby

with breastfeeding resulted in a positive feeding experience. The mother developed a greater

sensitivity and was more responsive to the infant’s needs (Liu et al., 2013). This shows when the

bonding is initiated early on, it is a more positive outcome with breastfeeding. In addition, this
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demonstrates how the mother is being more attentive to the baby. As time goes on, it is found

that there have been positive interactions between the mom and baby through social, verbal, and

nonverbal responses which facilitates security of the mom-baby attachment (Lowdermilk et al.,

2020). According to Linde et al. (2019), “Secure attached mothers initiated breastfeeding more

often and preferred breast- over bottle-feeding than insecure attached mothers” (para. 4). This is

significant due to the fact that all mothers should want a secure attachment to their infant. With

this attachment, it allows the baby to trust and communicate their feelings with their mother

which connects them on a high level.

With mother and baby bonding comes facilitating and inhibiting behaviors which affect

parental and infant attachment. Some of the facilitating infant behaviors that affect parental

attachment include smiles, grasp reflex, anticipatory approach behaviors towards feedings such

as sucking well and feeding easily, and eye-to-eye contact. Meanwhile, there are also some red

flags when it comes to infant behaviors such as crying for hours, bland facial expression, resists

holding and cuddling by crying, and ignores parents. Outside from behaviors affecting parental

attachment, there are also some facilitating parental behaviors that affect infant attachment which

include: claims baby as family member, smiles at baby, expresses pride, and talks, coos or sings

to infant. On the other hand, some inhibiting parental behaviors include turning away from

infant, avoiding infant, expressing disappointment, and not incorporating infant into life

(Lowdermilk et al., 2020). To sum this up, both the mother and the infant have behaviors that

will affect the security of attachment.

Formula Feeding

When choosing to formula feed, the most common type is commercial formula which
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includes cow’s milk-based formula, protein hydrolysate formula, and soy protein based-formula.

Out of those three, cow’s milk-based formula is the one most widely used due to its resemblance

of nutritional intake to that of human milk. In addition, the protein hydrolysate formula is a

predigested formula that is lactose free. This specific formula contains proteins that are broken

down into smaller particles that facilitate easier digestion. Last but not least, soy protein-based

formula is free of cow-milk based proteins and lactose therefore sucrose, corn syrup solids, or

maltodextrin is added to meet the caloric content needed for the baby (Lowdermilk et al., 2020).

Although breastfeeding has many positives, sometimes mothers have no choice but to

formula feed their babies due to various factors. Examples of this include inadequate milk

supply, anxiety about not producing enough milk, sore nipples, inverted nipples, and delay in

production of milk (McCarthy, 2020). Mothers are unable to provide adequate breast milk for the

baby for reasons such as insufficient granular tissue, pregnancy-induced hypertension, poorly

controlled diabetes, and premature birth (LaFleur, 2020). Aside from milk production being a

problem, many mothers also experience issues with latching due to anatomical reasons which

both have an end result of formula feeding.

To further discuss latching, some babies are physically not able to latch onto their mother

due to many reasons. Studies have shown that the majority of babies who have the inability to

latch is caused from the anatomic make up of the breasts such as the mother having flat, small, or

inverted nipples along with breast engorgement. Also, the babies can have an inability to latch

from being too eager and sucking on their tongue instead of the breast. Lastly, mothers often

have doubt regarding the baby and if it is latching the correct way or receiving enough milk

which prolongs and interrupts the breastfeeding process ending in latching problems with the

baby (Feenstra et al., 2018).

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Not only do mothers choose formula feeding due to the inabilities to breastfeed, but also

because they see it as more beneficial to themselves. Many parents feel that formula feeding is

more convenient since they could feed their baby a bottle at any time and do not have to pump

their breast milk. By avoiding pumping, this allows for the mother to have extra time with the

baby along with less pain and soreness of the nipples. In addition, this can help include the

significant other in the feeding process which allows others to bond with the baby outside from

just the mother. Mothers also benefit from formula feeding their baby because they are able to

consume whatever they want and not worry about what harm it will cause to the baby (Gavin,

2018).

Not only do mothers see formula feeding as beneficial for themselves, but also for their

baby. One positive attribute includes the fact that formula fed infants do not need to be fed as

often as breastfed infants, due to the formula being less digestible (Gavin, 2018). This allows for

less feeding occurrences and more free time to build a bond between the baby and family

members. Another benefit seen from formula fed infants is being able to measure their intake

from every feeding (Gavin, 2018). This is significant because the mother is able to know exactly

how much the baby is consuming and is not left wondering if he/she has adequate intake.

Aside from the positives, there are also negative aspects to formula feeding a baby. For

some, clean water may not always be accessible in the home which poses a risk for health

problems in the baby. If the incorrect amount of water is added to formulas that require the

mixture of water, it can lead to nutritional deficiencies or dehydration (Thoms, 2017). Also,

formula cannot match the intricacy of breast milk. Due to this, formula does not include the

antibodies that are found in breast milk. Therefore, it is harder for formula to supply a baby with

protection against infection and other illnesses. In addition, formula can be very expensive. The
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least expensive type is powdered formula and the most expensive is the ready-to-feed formula.

During the first year, the cost is estimated to be close to $1,500 (Gavin, 2018). To summarize,

the cost of formula plays a big role in deciding whether to breastfeed or formula feed.

Conclusion

When addressing how the source of nutrition effects the mother’s and baby’s health,

research shows that breastfeeding has many more benefits that far outweigh the risks when

compared to those of formula feeding. Studies show that there is an increase in mother-baby

attachment and a decrease in risks of health problems for both the mother and the baby when it

comes to breastfeeding. There was little information found about the disadvantages of

breastfeeding that actually are concerning to the mother and baby. Also, there is evidence

indicating the formula feeding still gives satisfactory nutrition to the baby although it does pose a

risk for health-related issues in the future. When it comes to nutritional intake for the child, its

solely the mother’s decision whether to breastfeed or formula feed having in mind the pros and

cons of each source.

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