In this article, I aim to increase your understanding of breastfeeding to help you educate pre-natal mothers on the benefits of breastfeeding, how to do it, and the possible difficulties.

Breast feeding can be commenced during the first hour after birth. This makes the mother more confident to breast feed, the baby receives colostrum - first breast milk with protection against infection and disease, the baby’s digestion and bowels are stimulated,

and sucking difficulties can be avoided. If delivery is by a caesarean, breastfeeding can be commenced in the recovery room. Bottles and dummies should be avoided in the first few days because they reduce the ability of the baby to attach onto the breast which may result in breast engorgement, breast refusal, low weight gain, blocked milk ducts, and mastitis.

HOW TO BREAST FEED

Nurses at the hospital of birth can teach the baby how to latch onto the nipple. Hold the baby close with the baby turned towards the mother. Touch the baby’s mouth with the mother’s nipple, and the baby will take the nipple into its mouth. This should not hurt the mother if the baby is well attached

HOW OFTEN TO BREAST FEED

A baby may want frequent breast feeding, especially in the first 24 hours. Feeding the baby as much as they want can help establish good breast feeding patterns. It also ensures the baby receives colostrum, full milk production is stimulated, and the risk of breast engorgement is reduced. Breastfeeding may be necessary every 2-4 hours, which can vary depending on the baby and how hungry they are. Offer both breasts after each feed and allow the baby to finish one breast before offering the other. Let them detach themselves.

A breast pump can be used if the nipples become too sore, or if the nipple is too small and the baby can not suck the nipple. If a good sucking technique has not been developed yet, expelling the milk can be done and put into a cup or teaspoon

WHAT FOODS TO EAT

A good mother’s diet is essential during pregnancy to ensure the baby receives all the necessary nutrients. Extra snacks are needed because breast feeding does burn up a lot of energy. Ideal snacks include bread, milk, fruit, yogurt, nuts, avocado, cheese, and vegetables. The required daily nutrient requirements include water as a source of fluid, with a consumption of around 2.5 litres per day. Protein is needed because it is a major factor in breast milk. Sources include meat, fish, eggs, cheese, yogurt, nuts, and legumes.

Calcium is important because it is another major component of breast milk, so dairy products are recommended. Iron is necessary because breast feeding uses up your iron stores. Red meat, legumes, nuts, dried fruits, breads, and leafy vegetables are a good source of iron. Folate and vitamins demand are also increased during pregnancy. Folate is found in spinach, broccoli, cabbage, and brussel sprouts. Vitamin A and vitamin C are the most important vitamins required. Strict diets are not recommended because essential nutrients may not be supplied to the baby.

TIME TO STOP BREAST FEEDING

There is no particular time to stop breast feeding. A time can be decided by the mother and the baby. It is recommended by the World Health Organisation to breast feed for the first 6 months. Still, some mothers breast feed until the baby reaches up to four years of age. If you decide to stop breast feeding early, bottle feeding with infant formulas may be necessary for the first twelve months of age. If they start to bite when their incisors come through, feed when drowsy. Weaning the baby off breast feeding is important to avoid problems such as mastitis. Recommended to gradually replace breast feeds, one at a time over at least several days. Breasts can become tight, and uncomfortable, so express enough milk to remain comfortable. Wear a supportive bra, use a cold pack, or take paracetamol for any discomfort. Look for any lumps, and massage the breast when expressing to minimise the chance of mastitis

BENEFITS OF BREASTFEEDING

There are many benefits for both the mother and the baby in breastfeeding such as:

* It is the perfect food for the baby, provides the essential nutrition for a baby with changing needs.

* For the first six months, breast milk is the only food babies need

* Provides immunity with protection against common infections, middle ear infections, some childhood cancers, juvenile diabetes, and sudden infant death syndrome

* Mother loses weight (pregnancy can result in an increase in weight).

* Weight is lost because due to the extra energy the body must use to produce milk, with frequent interruptions during the night for feeding.

* Breastmilk is more digestible

* Contains essential amino acids such as taurine. (Not found in all milk formulas that you can buy)

fGood for eye development, and production of bile salts

* The mother’s uterus returns to its pre-pregnant size quicker.

* The return to fertility is delayed for a mother, which can provide some protection against ovarian cancer and osteoporosis

* Milk formulas can increase the risk of the baby becoming sensitive to cow’s milk protein

* Breast feeding for the first four months of a baby’s life can significantly reduce their chance of developing asthma and other allergies.

* Decreased risk of developing pre-menopausal breast cancer

* Possibly increases bone mineral density

POSSIBLE DIFFICULTIES OF BREASTFEEDING

The problems that can arise from breastfeeding includes:

* The longer you breastfeed, the more difficult it can be to stop

* The mother may not be comfortable

* The mother may not have the time to do it. eg. Working full time.

* The baby may want attachment to the nipple every few hours, even just for comfort

* Nipples can become tender over time: rash or even an infection of the nipple. Therefore, nipples require care and conditioning. eg. Lansinoh (wool fat). Apply over the whole area of sore skin every feed and as needed. It does not need to be removed before breastfeeding. It can also be applied before showering to prevent stinging from hot water and the drying effect of soaps. Avoid soaps and shampoos during showering. Avoid ointments, powders, and tinctures. You can even leave any milk on the nipple after feeding because it contains some anti-infective agents

* Mastitis. This is inflammation or infection of the breast, caused by a cracked nipple or a blocked nipple duct. Symptoms include shiver, fever, sore reddened or hard nipples or breasts. This can be caused by poor attachment of the baby to the nipple, engorgement in the breast due to missed feed, ill-fitted bra, a high saturated fat diet, or nipple creams which can damage the skin. Treatment includes massaging the nipple which can be beneficial to clear any nipple blockage. The baby must be attached correctly to the breast before feeding. Wearing of loose clothing, avoiding nipple cream and ointment use for a long period of time, washing hands before touching the breasts, and heating the sore area of the breast before feeding can relieve the pain. Paracetamol can be taken to help reduce any fever or pain. It is recommended to keep fluid levels up and get plenty of rest. If symptoms persist for longer than eight hours, visiting your doctor would be recommended, and antibiotics could be necessary.

* Some medications are contra-indicated in breast feeding, and may cause the baby to become restless, nauseous, or alter the suckling reflex.

* Lifestyle adjustments may be necessary: smoking and alcohol consumption

CONCLUSION

There are benefits and possible difficulties for breastfeeding, and the decision is the mother’s. Overall, breastfeeding would be recommended, because it has nutritional, emotional, physical, and practical benefits for the mother and the baby. If the mother requires more information, relevant people to contact include:

* Doctor

* Pharmacist

* Local Nursing Mothers Association

* Parent help line

* Local baby, child or infant health centre

* Tresillian Guide: How to stay sane in baby’s first year, Simon and Schuster, 1999

* Australian Breastfeeding Association: PH (03) 9885 0855