Breast feeding is an emotional subject. It is linked to the basic events of life and its difficult not to be touched by it in some way.
The merits of breast feeding are widely recognized. Jargons like “Breast is best” and “Breast feed is the Baby’s right” are being used to promote the un ageing practice of breast feeding amongst all mothers rich or poor, urban or rural.
Our grandmothers and great, great grandmothers managed to breast feed and our counterparts in traditional rural societies still do so. Today’s mothers have to rediscover this knowledge with our help.
The modern ‘era’ of artificial feeding dates back to the beginning of the century. There was this woman’s desire to be relieved of the “chore” of breast feeding and also equally importantly another key factor was the woman’s rapid loss of confidence in the ability to do so.
Old customs are abandoned. The extended family is replaced by small nuclear families, feeding bottles and powders are readily available and many poor women change to bottle feeding encouraged by the example of the elite. We need to get back to nature again. So here are a few facts about breast feeding and Baby child care some suggested ways of successful breast feeding:
1. The baby must be put to the breast within the first few minutes of birth in a normal delivery and in the first few hours after birth after an operative delivery.
2. No pre lacteal feeds like honey, water or ‘ghutti’ need to be offered
3. Sucking in the first few days is essential. Although only a little milk is produced, sucking helps the milk to “come in” and helps to prepare the baby’s digestive system by removing meconeum (the first greenish black stool a baby passes).
4. The small amount of milk produced is usually enough for the baby’s needs. Supplementary feeds are not required.
5. Sucking makes the mother’s womb contract and therefor helps stop uterine bleeding.
6. The ability to breast feed does not depend upon breast or nipple size.
7. The quality of milk will always be good – even if the mother’s diet is poor – her milk is the best for the baby.
8. Bottle feeding is dangerous expect in situations where conditions are very, very hygienic.
The first Milk – “Colostrum” is good for the baby. Its not harmful despite its bright yellow color. It has properties which protect the baby against infections and allergies. The baby needs to suck colostrum to “let in” regular milk. Full milk production may take 2 to 12 days, sometimes longer. During these early days the baby and the breast are not yet in balance and there may therefore be too little or too much milk – as the amount is not regulated by demand. So painful congestion of breasts may occur specially if babies are fed by the clock!
Supply According to Demand: The breasts produce milk for one special baby according to its needs and demands. The milk producing factor – “Prolactin” enables the breast to do so. When a baby sucks the nerve endings in the nipple are stimulated which in turn relay to the anterior pituitary in the base of the brain to release prolactin in the blood. The blood carries prolactin to the breast where it acts directly on milk secreting cells. So more the baby sucks, more milk is secreted. The simplest, oldest and most natural way to increase is to make the baby suck more often. The milk ejection reflex acts on both breasts simultaneously and may cause a pricking sensation, while some mothers complain of “leaking” while the baby is feeding on the other breast.
The Mother’s Pyschological State: The mothers psychological state is very important for the milk ejection reflex. A happy, relaxed mother who thinks happily or lovingly for the baby, coos and sings to him, caresses him with abandon, the milk starts to flow “uninhibitedly”! In a tense, irritated, tired, anxious mother, the milk simply ‘dries up’!
The Baby’s Reflexes: If you touch one side of the cheeks of a new born baby, it turns its head to that side. If it feels anything touching the lips, the baby opens its mouth and tries to find the nipple to suck. So one must stroke the cheek with the nipple and it will turn eagerly to find it.
Sucking: The baby is “latched in” correctly when the nipple is far into the baby’s mouth. Mother should offer the whole breast and not just the nipple. Sucking in a wrong position may cause breast engorgement, sore nipples or too little milk or refusal to suck. The baby should take the nipple and much of the areola into the mouth while sucking.
The Volume of Milk Produced: It depends on how much the baby sucks. If a breast is seldom sucked, little milk is produced. If sucking is strong and vigorous, more ‘prolactin’ and therefore, more milk is produced. Majority of women produce enough milk to completely satisfy the needs of an infant between 3 to 9 months.
Frequency & Duration of Feeds: Fifty percent of the feed from each breast is taken in the first two minutes and 80-90 % is taken by four minutes. The average duration of a feed in traditionally breast feeding societies is 13 minutes. Obviously, there are individual differences in babies as well as mothers. Some mothers give their milk more easily than others. Some babies suck vigorously take what they need in few minutes, while others linger on, enjoying every minute at the breast, making the feed last a half hour or more! Frequency is purely on demand. In the first day or two, they may want only 2, 3, or 4 feeds a day. From the third day onwards, the pattern changes and the baby may want to be fed 10-20 times a day. There is nothing unusual or wrong about this. From the second week onwards, they may begin to demand less and settle into some kind of a routine.
Clean the Nipples: Normal washing and bathing and personal hygiene is all that is necessary. It is not necessary to wash or clean the nipples before a feed.Sore
Sore Breasts: Some swelling or engorgement is normal from the third to seventh day after delivery when the milk “comes in”. Frequent sucking may help reduce engorgement.
Positioning During the Feed: The mother must be relaxed, the mother and baby must both be comfortable. The breasts should be allowed to fall towards the baby. The mother should hold the baby close enough to her breast for its chin to touch her breast all the time. Make sure that the baby’s breathing is not obstructed in any way. It matters not whether she sits or lies down and feels – whats important is comfort.
Other common problems encountered in the first few moths of breast feeding include milk drying up: Breast milk never really dries up. If one worries about whether jt js enough for the baby, whether the quality is good enough, is it too thin, can I or canI not breast feed, milk will dry up because it will soon be supplemented by a bottle and less stimulation leads to less production. “You cannot lose your milk but you can dry it away”, said Elizabeth Helsing, the famous author of “Breast Feeding in Practice”. The baby cries too much, suckles all the time, is angry and cranky, is colicky, there’s too little milk are many other questions that worry young mothers.
The main prerequisite for successful breast feeding is confidence that one can do it. In traditional societies, older women give younger ones the confidence through their own experiences. It is necessary for mothers to know that there are solutions to most breast feeding problems – a positive attitude is all that is needed.
To know more do write us into – info@drpromillabutani or get in touch with Dr Promilla Butani Pediatrician in South Delhi at +919811051270.