Breastfeeding Facts- Benefits, guidelines, FAQ’s

Breastfeeding is not a choice but a responsibility for mothers. Lets find out why?

Breastfeeding is amazing in so many ways. From the intense bond it can help you form with your baby in the first hours after birth, to the benefits it has on your baby’s health even into adulthood, there’s a reason breast milk is called “liquid gold.”

Amazing benefits of breastfeeding:

What is so great about breastmilk? Why the hype? 

  • The World Health Organization also recommends that mothers initiate breastfeeding within one hour of birth and thereafter exclusive breastfeeding up to 6 months of age with continued breastfeeding along with appropriate complementary foods up to 2 years of age or beyond.
  • Globally only 40% of infants under the age of 6 months are exclusively breastfed.
  • Colostrum (your first milk) contains special proteins that coat your baby’s intestinal tract to protect from harmful bacteria right from the start.
  • It gives infants all the nutrients they need for healthy development and contains antibodies that help protect infants from common childhood diseases such as diarrhea and pneumonia, the two primary causes of child death worldwide.
  • Babies who are breastfed are less likely to be obese or overweight later in life. They are less likely to have type II diabetes and perform better in intelligence tests.
  • Premature babies fed more breast milk in the first 28 days of life have better brain development by the time their original birth date arrives and see benefits to IQ and memory skills later in childhood.
  • Breastfeeding burns between 500-600 calories a day. This is equivalent to 1 hour of high-intensity training. That means some moms might end up losing weight without any additional exercise
  • Mothers who breastfeed have a lower risk of developing breast cancer, ovarian cancer, heart disease, stroke, type-2 diabetes, and postpartum depression. And, the longer a woman breastfeeds in her lifetime, the more protection she receives
  • The hormones released when you breastfeed help your uterus shrink back to its pre-pregnancy size
  • Breast milk has been used to treat burns, eye infections, diaper rash, and to reduce infection and promote healing.
  • Breastmilk is a known superfood. In certain countries, bodybuilders have been known to consume it for more benefit.
  • The benefits of breastfeeding have been recognized for centuries. In fact wet nursing is one of the oldest female professions.
  • A New York City restaurant sells cheese made out of breast milk. The chef says the flavor depends on what the mother eats
  • A woman’s right breast generally produces more milk than the left.

Breast milk is not always white. It can be blue, green, yellow (ahem- gold!), pink, or orange depending on what you eat or drink. Don’t worry, it’s OK for the baby.

The amount of breast milk you are able to produce has nothing to do with your breast size. A mom with small breasts can have just as much (or more!) milk-making tissue as a mom with large breasts

Next, Lets address some breast feeding FAQ’s:

When does breast care start in pregnancy?
The third trimester is a good time to start thinking about breastfeeding. Ideally, the mother should discuss this with her gynecologist and get in touch with a lactation specialist. The lactation specialist will conduct a thorough breast examination and advice as per the individual need of the mother. Another issue of vital importance is the use of correct size bras. This can get a little cumbersome and expensive as moms keep changing sizes. But even so, is extremely important. It helps support the breasts to prevent back pain and can even reduce the occurrence of stretch marks.

How can a mother prepare herself for breastfeeding and adequate milk supply during pregnancy?
As I mentioned earlier, the mother should have a candid discussion with her gynecologist and a Lactation specialist. She should air out all her doubts and issues. The biggest thing that a mother can equip herself with is knowledge. Breastfeeding is a natural process; however, it doesn’t always come naturally to everyone. I think if one is mentally prepared for the journey ahead, it makes things a lot easier and even enjoyable. One needs to take each day as it comes and not hesitate to ask for help when required. The sooner one starts breastfeeding the baby post-delivery, the smoother the entire journey of lactation is. It doesn’t matter whether the mother has had a natural birth or C-Section, she should ideally start breastfeeding in the delivery room or operation theatre itself. (add your 2 penny bits like you always encourage your patients to do so) It’s always better to plan ahead with the concerned doctors. The mother to be should ideally go in for a lactation counseling session, where she will go through a thorough breast examination. Sometimes mothers have flat, inverted nipples, or have gone through breast surgeries in the past. In such cases, they may be asked to conduct certain breast exercises and invest in a few products so that they are better prepared for the journey ahead.

Do smaller breasts mean lesser milk?

This is probably the biggest myth I’ve ever come across. I have met several women with small breasts who are able to produce ample milk for their babies and even have some left over to store. On the other hand some women with big breasts are unable to satiate the hunger of their children. Breast size is completely irrelevant when it comes to breastfeeding. It is the triggering of hormones within the mother’s body which determine how much milk is produced. These hormones are triggered by childbirth, and by nipple stimulation. In other words milk supply is dependent on the amount the mother nurses the baby. Therefore the more the mother feeds, the more milk she produces. Ofcourse there are exceptional cases of mothers having insufficient glandular tissue and other medical conditions, who are unable to generate enough breastmilk. But these are extremely rare cases and again can be dealt with by doctors and lactation consultants.

Does breast milk always have to be white?
The funny thing about breast milk is that it never has the same colour, consistency or composition. It keeps changing. Immediately post birth mothers produce colostrum, which is a clear thick yellowish liquid. It gradually turns into transitional milk as it takes on a more whitish appearance and finally mature milk. Then we have foremilk, which is more watery in consistency and hindmilk which is thicker and whiter. That apart the colour of the breastmilk keeps changing depending on the mother’s diet. Sometimes it turns greenish, other times bluish, sometimes even orange. If the mother is experiencing cracked or bleeding nipples, some blood may get mixed up in the breast milk and give it a pinkish or brownish colour. It’s almost always completely safe to continue nursing the baby despite the change in colour. However if there is a drastic change, it’s always advisable to take a medical opinion. Also the mother should always take her gynaecologist’s advise before having any medicine while breastfeeding.

Why is breastfeeding counseling recommended in the Indian setting?
Breastfeeding counseling
is a compulsory practice in western countries. I think India needs it all the more. India’s social make up is very family oriented. And with family comes it’s cultures, norms and traditions which is awesome but at the same time it can cause a lot of pressure and stress to the new mom. Moms somehow are expected to know how to breastfeed the second they give birth. And the breastfeeding journey is supposed to be a smooth hiccup free journey. If not, there are several people to judge and give unsolicited advice. The advice given is not always scientific. Mothers need to be equipped to make educated and informed decisions about breastfeeding. They need to understand that it is okay to have issues and problems and that they have professionals in the field who they can reach out to. 

When should mothers ideally start breastfeeding?
Ideally mothers should start feeding the minute they give birth. I know that you encourage mothers to breastfeed at the table immediately post delivery, even after C Sections. Latching is instinctive and the sooner the baby is made to latch on, the smoother the entire journey promises to be. In my experience 75% of breastfeeding related problems are because of a poor latch. Babies are very alert 1 hour post birth and if at this time a latch is established, it really does influence the days to come. It also gives the mother a lot of confidence to feed. And post that they should feed as much and as often as they can.

How often does one need to breastfeed?
New moms often complain that they feel like cows, constantly suckling their young ones. Ideally it should be like that. One should feed as much and as often she wants and as much as the baby wants to nurse. It’s very difficult to put a timeline on this as babies are also individuals and different babies have different needs. So if a baby asks for milk every 2 hours it’s considered normal, and if it wants to be fed 20 minutes after a feed, that too is considered normal. One should just not go beyond a 2-2.5 hour window for a new born. If a baby continues sleeping beyond 2.5 to 3 hours, the mother should ideally wake the baby up for a feed, as over sleeping is not always a positive sign.

How long does the mother need to nurse the baby in each feed?
Again this differs from baby to baby. And even the same baby may not have a fixed time frame. It can take anywhere from 5 to 45 minutes to fill a baby’s tummy. Ideally a mother should feed the baby till the baby is full. Many mothers that I’ve come across have been worried about their baby bringing up milk and are scared to overfeed their little ones. Babies are not like adults, they will not drink a drop beyond their requirement. Therefore it’s impossible to overfeed a breastfeeding infant. Mothers can therefore freely feed in an uninhibited manner.

Is there any particular breastfeeding position that is correct?
What is comfortable for you and the baby is the correct position. There are absolutely no hard and fast rules. The only thing you need to remember is to support the baby’s head and neck. Also avoid bending down or straining your arms as you don’t want any pains and aches. Breastfeeding is not a onetime thing, it is a long journey, so comfort of the baby and mother are of equal importance. Having said that, we often teach mothers different positions, sometimes due to latch issues or some other problem or simply because the new mother is overwhelmed or in pain. If she is confident enough to hold and feed the baby on her own, I feel nothing like following a mother’s instinct.

What kind of a diet does one need to follow for breastfeeding?
This is a huge point of contention in a society like ours. Every culture comes with it’s own sets of dos and don’ts. In fact even every family. I once met a mother who was very distressed as she was made to have only sabudana and milk for all meals for 6 weeks! Mothers should ideally follow a balanced and nutrient rich diet consisting of varieties from all food groups. At a time like this when we are facing a global pandemic in the form of COVID 19, breastfeeding mothers must ensure they take in plenty of sources of vitamin C. The ‘Indian Jaapa’ forbid mothers from having citric fruits like lemon and oranges and legumes like rajma. This is because it is considered to be heavy on the stomache and to prevent the baby from developing gas. Logically speaking there’s no point avoiding certain foods with the fear that your baby may be sensitive or allergic to it, as you may be depriving it of vital nutrients. A method of trial and error should be adopted. Where you can eliminate foods that you feel make your baby fussy or gassy. There are also certain foods that do help in increasing milk supply. By all means, mothers can include them in their diet. For example, the traditional panjiri, gondh laddoos, have been made through generations for new mothers to promote lactation. Simple foods such as jeera, mangoes, chicken soup, gur, oats, rice. Mothers need not force themselves to eat something which they don’t enjoy or they are allergic or not supposed to have as per the doctor’s orders. Follow the doctor’s orders, eat well, and stay hydrated.

Can you please reinforce your views on this never-ending debate on bottle-feeding vs spoon-feeding What are the most common issues?
If the mother plans to breastfeed
her baby it’s best to avoid the bottle. Babies almost always develop a preference towards the bottle and the entire breastfeeding cycle is disturbed and it ultimately results in a lower milk supply for the mother. Spoon feeding may sound cumbersome, but it’s really not. It is a bit challenging initially, but once you get the hang of it after a few sessions its quite simple.
The only advantage of bottle feeding is convenience really. There is no advantage for the baby. Bottle feeding puts the baby at risk of diarrhea and other infections incase of even the slightest lax in sterilization. It can also cause ear infections. Breast or spoon-feeding results in the better jaw and dental development as compared to bottle feeding.

Can mothers who haven’t given birth breastfeed their adopted or surrogate babies?

This is again something which You and I have dealt with in the past. We have successfully dealt with a case of surrogacy where the non-birth mother was successfully able to breastfeed her twins. This requires planning and a coordinated effort between the Doctor, Lactation consultant and the mother.

Milk supply can be induced through a combination of hormone therapy and stimulation. Milk may or may not be enough to fill the tummy of the little one. There are also devices which help to provide the baby with supplemental feeds while being attached to the breast so a dual purpose of feeding the baby and nipple stimulation happens at the same time

How do I know my baby is getting enough milk?

Every baby has a different appetite; therefore the amount of milk that it is consuming is generally not a factor. One needs to see if the baby is gaining weight, if he/she appears generally alert and settled and is passing urine a minimum of 6-8 times in 24 hours. If the pee count is any lesser and the baby appears cranky or too sleepy and lethargic all the time, the paediatrician should immediately be contacted as it is showing signs of dehydration.
Too much sleep is also not a good sign. It is not normal for newborn babies to sleep through the night. If they don’t get up themselves they should be woken up for feeds after a maximum of a 3 hour gap.

Should a mother continue nursing if she is unwell? 

Absolutely! During any ordinary illness, a mother must continue feeding her baby. The mother’s body manufactures antibodies to fight infections which get transmitted to the baby via breast milk, which actually gives additional immunity and health benefits to the young one. The mother must remind her doctor that she is breastfeeding so that he can prescribe medicines accordingly. In the case of extreme or major illnesses where the infection enters the blood stream, the mother may need to stop breastfeeding. This however happens rarely and in cases where the mother needs to be hospitalized. Nonetheless it’s always good to keep your doctor and lactation consultant in the loop so that there are no questions or doubts.

Why do mothers stop breastfeeding early?
The primary cause of stopping breastfeeding early is misinformation. Since breastfeeding consulting is relatively new in Kolkata, there are very few doctors like yourself who offer lactation counselling at the patient’s bedside. So when mothers are faced with any challenge during this time, they don’t know what to do and the immediate reflex is to introduce the bottle which starts a vicious cycle.

Latching issues are very very common. Establishing a correct latch forms the foundation of a healthy breastfeeding relationship. And an incorrect latch is equally distressing. It can result in non nutritive feeding sessions, plugged milk ducts, mastitis, cracked and bleeding nipples to name a few. Mostly this incorrect latch goes undetected. If addressed by a professional, the latch can quite easily be corrected through minor tweaks in the feeding process.

Unsupportive work place
Working mothers who have an exhaustible number of maternity leaves can find it very stressful especially if they are keen to exclusively breastfeed their infant. Having a supportive work place can be a huge blessing, where the mother is able to bring her baby to work or work from home etc. Of course depending of the nature of the mother’s job, it’s always not feasible to do so. Even so, with a little bit of planning and support she can easily manage. In such cases, a breast pump works very well. She can carry her pump to work along with an ice case to store the expressed milk, she can regularly pump and store in the bag. When home she can directly breastfeed her baby and the expressed milk can be used the following day to feed the baby when the mother is at work.

Cultural norms and or lack of family support
They say it takes a community to raise a child. This community can act as a boon and even a bane. Sometimes mothers get so pressurized by cultural norms and traditions and expectations that they are more stressed than happy about becoming mothers. This is really not healthy. The immediate family, especially the husband needs to step in and protect the mother from unnecessary comments and any kind of negativity. Motherhood itself is an overwhelming period especially for the new mom. She’s not just anxious about taking care of her baby but also she herself need to heal. Plus there is the hormonal aspect of things which makes her all the more susceptible to mood swings and also postpartum depression..

Also read:  Postpartum Depression – real life experiences and candid discussion 

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