Breast-feeding The advantages of breastfeeding are...

Breast-feeding

The advantages of breastfeeding are universally T known. Though breastfeeding establishes naturally for mother and baby, knowing what to expect and how to deal with setbacks can ease the mutual adjustment. Here are the FAQS (frequently asked questions) which we encounter in the breastfeeding class.

"Doctor, when should I first feed the baby?"

You should give the child your breast the moment the Doctor gives the baby to you in the labour room after the cord is cut and after checking if the baby's air and food passages are clear. 'Colostrum' , the first feed, is a thick yellowish secretion. It is nature's start- up pack for the baby. It is very rich in proteins, minerals, and vitamins. It also has, [most importantly] disease resistant antibodies. One should never let this Elixir of Life go to waste. Even after a caesarean section, breast-feed the baby as soon as the anesthesia wears off by having an attendant holding the baby to the breast. Breast

Tips for successful feeding sessions

Painful breast-feeding experiences like cracked nipples, and mastitis or inflammation of the breast can be prevented by adopting a proper feeding position.

When suckling, the baby should hold the areola in its mouth and not just the nipple. After feeding do not abruptly remove the baby from the breast if you have a sore nipple. Slowly insert your little finger in

the baby's mouth, open it, and then gently remove the breast. This prevents injury to the nipples. After the feed, there is some residual milk in the breast with a rich fat content. Squeeze the breast slightly and apply this milk to the nipples. Avoid repeated washing of the nipples with soap. In this way you can prevent chapped nipples. From the seventh month of pregnancy, slowly massage the nipples with oil, this will raise them and further gentle stretching will prevent retracted nipples. Wearing nursing pads and nursing bras will make feeding easier.

Oxytocin let down reflex - While feeding the baby from one breast, the opposite breast often leaks milk. This is called the 'let down reflex' and is normal. Very often, even the thought or sight of your or another baby causes the breasts to secrete milk. At this time, nursing pads worn inside the bra absorb the milk and prevent embarrassment, when away from home.

"How can one know if the mother's milk is sufficient for the baby?"

When a baby is given only breast-feed, [not even extra water] and if the baby urinates 6 or more times in a day, (except for the first 4-5 days after birth, when the water content in the milk is lower) is active, sleeps after a feed and puts on adequate weight, then the milk is sufficient. Adequate weight gain is defined as 500 gms. to 1 Kg. per month. There are some notions that if the baby has passed greenish stools then it is not getting a full feed. This is incorrect if the baby urinates 6 or more times in a day.

A baby's cry does not always imply that it is hungry. It is the baby's way to attract attention, to ensure that someone holds it. It could be because the baby enjoys suckling or even that the baby is bored. Thumb or fingers or fist sucking is not always a sign of hunger. Frequent or infrequent suckling or soft breasts do not always mean that the child is not feeding properly. Usually a baby puts on 1 kg weight every month. If your baby is healthy, active and puts on 500 gms weight every month, it should not bother you. Some mothers unduly worry that their babies are not growing as per the growth chart. They should not worry, as the charts only give trends and each baby is an individual.

Babies generally sleep after a feed but again each baby is unique and wakefulness is nothing to be worried about.

Herbs enhancing milk supply

There are many home remedies which act as Galactogogues [increase flow of milk] like Shatavari, [Asparagus racemosus] Ashwa-gandha, [Withania somniferra] Jyesthi-madh, [Liquorice] Nagarmotha, Haleev, Dinka (gum), Sounth, [Dried Ginger] Methi, [Fenugreek] etc. Above all the very act of suckling, the 'touch', and the flood of maternal emotions are the best galactogogues.

While breastfeeding, how to sit, how to hold and position the child?

Hold the baby in the crook of your arm, with the baby's upturned face towards you. Ensure that the baby's mouth and chin are near the nipple. The baby should hold the areola and the nipple inside its mouth, with its lips curled out. The baby's chin should rest on your chest. To facilitate this, in the beginning, the mother should slightly raise the nipple and insert it in the baby's mouth, with the upper areola just covered by the lips. If the nipples are sore, a thin nipple shield can be worn. The baby will feel the urge to suckle and will start sucking strongly and will swallow properly. It will look calm and contented. This method reduces pain in the nipple, which some mothers feel. While breastfeeding the baby, always feed the baby from one breast at a time and only when it empties out, then you should switch the baby to the other breast. At the next feed, reverse the order of the sides. A simple way to remember this is to wear a bangle in the arm on the side you are feeding from last. It is a fallacy to believe that the right breast has food and the left breast has water. The sooner this is dispelled the better or else favouring one will result in engorgement and hardening of the other breast. Not only are these situations painful but also can lead to further complications.

Breast-feeding is such a wonderful experience that it defies description. The emotional state after the baby has fed and is contently sleeping in your arms is beyond words.

Remedy For Breast Engorgement

If the breasts feel full even after the baby has fed well, then lightly apply some oil and gently squeeze out the excess milk. Even if this squeezing out is painful, bear with it. If the breasts remain engorged it could lead to abscess or mastitis, sometimes requiring an operation. Warm water fomentation of the back before removing excess milk helps a lot. If there are lumps that you can feel then take some crushed ice and lay it on gauze strips on the painful breast. Local application of Nagarmotha and Warul Matti (mud pack) pack for about 1/2 an hour is very useful at such times. From the third to the tenth day the milk secretion is excessive and enough for even 2-3 babies, but from the 10th day onwards this settles down. This is also a part of nature's design. From now on breast engorgement complaints reduce. This excess milk is provided by nature just in case there are twins, who also can be completely breast fed.

"Doctor, what happens when I go back to work?

I know that Mother's milk is the best feed for the newborn. I want to regularly breast-feed my baby. My problem is, that three months down the line I will resume my job. My mother-in-law insists that I switch to bottle-feeding while I want to continue breast milk. Doctor, can you advise?"

There is a definite remedy to this oft-voiced problem. The remedy gives the best of both worlds: the benefit of breast milk and the convenience of holding the job.

How to extract your own milk, for the baby, prior to leaving for office

In the morning, when the breasts are full, you should collect your own milk. Take a steel container having a 3-4" size mouth with a lid. Boil it to disinfect it. Wash your hands and your breasts properly. Now slowly squeeze the areola and the nipple evenly and from all sides, with thumb and index finger. The expelled milk is to be collected in the steel container. All round pressure ensures that the entire breast is emptied. Repeat this with the other breast. Cap the container tightly. The milk is now ready for feeding. This milk lasts for upto 8 hrs at room temperature and 24 hrs if refrigerated. To feed the baby remove some quantity from the container into a bowl. If it has been refrigerated, then keep the bowl in a deep dish with some warm water. This will warm the milk enough and now the baby can be fed using a spoon. After the feed, burp the child by holding up the baby on your shoulder.

You can ask your mother or mother-in-law to give this milk, when you are away; which she will be glad to do. Initially she might find it a bit difficult to spoon-feed the baby and might think that bottle- feeding is easier. This little problem soon settles down. For, once you start bottle-feeding, the baby may not be willing to make the effort of sucking at the breast. Furthermore bottle-feeding is known to cause digestive problems in the child and there are numerous problems of bottle hygiene and sterility.

Breast Pump

Breast pumps help in expressing milk which can be stored and fed to the baby later on. When expression by hand is painful or difficult, breast pumps provide a good option. The different types of pumps are

1) Manually operated pumps by which a suction is created by hand, which sometimes can be a little tiring.

2) Battery operated or electrical pumps, which are easier to operate but are noisy.

These pumps are fitted to sterile feeding bottles in which the milk is collected and can be fed to the baby.

1) Battery operated pump

The method of expressing the milk with the pump is given in the photograph. Hold the pump parallel to your body and make a strong seal with the sealing ring. In a manual pump, you have to press the handle, in a battery operated pump this work is done automatically and a suction is created.