HELPING THE MOTHER TO BREASTFEED

It’s always a first chance for any new mother who is full of anxiety for the new one coming to their family. Baby being the most precious and sensitive gift for a mother and to the family it demands a great care from the mother herself, the father and the supporting family. It’s all about the united effort of all the members within the family which decides upon the healthy outcome of any child’s future in terms of health, education, and emotional/ social development.

The first and foremost care starts right from the day when a mother conceives her baby within her womb, then giving birth to her child and reviving a life with hers, then feeding her child with her milk which is the first and the most important nutritional diet for any baby.

So being blessed with such a blissful act she always carries a tension to fulfill her responsibility with the best of her capability, knowledge and ability.

So here are some of the important questions that most of the mother’s have in their mind when they are blessed with this responsibility.

1.    When is the right time to start breast feeding?

     

All the mother should be well prepared to breast feed their baby, right from her antenatal visit. Breast feeding should be started within half an hour of normal delivery and 3-4 hours of caesarean section or as soon as mother is comfortable. Prelacteal feed with honey water, grape water, sugar water or any other liquid should be strictly avoided.

2. How can one initiate breast feeding and what is the proper way of breast feeding?

    

All the mother should be well prepared, encouraged and educated to breast feed their child after birth, right from her antenatal visit. Any problem related to her breast and nipple should be sorted out and she should be emotionally supported. She should be happy and taking proper nutritious diet, with extra calorie to meet the demands of her new born baby. Mothers first milk 

( Colostrum- rich in protein and immunoglobulin’s),thick yellowish milk is very important for the baby so it should not be thrown and should be feed to baby.

Rooming in- keeping baby and mother together, Bedding in- keeping baby and mother in the same bed close to each other, Mothering in- keeping baby on the mother’s abdomen, Kangaroo mother care for the pre term baby- keeping baby on the mothers abdomen or close to her chest, are some of the important factors that play a important role in mother and a baby bonding and helps in proper lactation as well.While breast feeding both the mother and the baby should be relaxed, in comfortable position and in an appropriate room temperature.

Preferably mother should breast feed the child in the sitting posture with her back supported and baby held in a semi-sitting position with the face held close to the mother’s breast by one arm and hand  while the other hand supports the breast making the nipple  easily accessible to the infant’s mouth without obstructing the nasal breathing. The infant’s lips should engage considerable areola as well as nipple. This would be the best way to feed your baby and you share the bond as baby sucks.

3. How often and how long one should breast feed their baby?

There is no hard and strict rule for timings regarding breast feeding. It can be a demand feeding (as when ever your baby feels hungry). Roughly it could be every 2-3 hourly. No extra water, other liquid or food is required till 6 months of age.

The infant should empty at least one breast at each feeding and it may take 15 – 20 minutes approximately per feeding. Most of the baby’s tend to sleep while feeding so it’s necessary to wake them by rubbing their back, ear lobule, behind the ear, or by tickling/patting them on their sole to feed them properly.  

4. How do we know that the breast milk is sufficient for the baby?

Mother’s milk is sufficient for the baby till 6 months of life provided mother is healthy and producing good amount of milk. The most important thing to be noticed for adequate feeding is:

The weight gain by 20-30 gms per day

Baby will pass urine frequently, almost 6-10 times a day

Baby may pass 1- 6 liquid stools per day

Baby will sleep 2-3 hrs post feed.

5. Quite often we think that breast milk is not sufficient for the baby because they keep crying most of the time in spite of being feed properly, Why?

Remember it’s not only the hunger which can make your baby cry, if your baby cries even after you breast feed properly then it means there may be some other factor troubling your baby, so please check out - if baby diaper is wet because of stool or urine, if baby cloth is too tight or cold, if some other child is troubling your baby unintentionally, or some other factors in her/his lying vicinity. Is it to sleep? or if it’s due to other  illness (i.e. nasal blockage, vomiting, cold, fever etc).Check the environment temperature if it’s too hot /cold. Your baby may need your warmth and attention at times too.

6. What is burping and why is it important after breast feeding?

    

Baby tends to take in lots of air during feeding/sucking, which leads to abdominal distension, colic’s, regurgitation. So to avoid all this, mother has to burp her child by putting the child on the left shoulder, head supported with mother’s left hand and then with the right arm support the buttocks and gently pat on the baby’s back with the right hand. Slowly air will escape from the baby’s mouth and baby will feel comfortable. It has to be done after every feeding and it may take 10-15 minutes for a baby to burp.

   

7. What other food or liquid should be give to the baby in addition to the breast milk?

   

Well no other form of food or liquid is required for the baby till 6 months of age. It’s only mother milk and mother’s milk. Mother’s milk is the best feed for the baby as it provides the best of the nutrition required for the baby growth and development. While sucking breast milk baby gets fore milk initially which satisfy the thirst of the baby and further sucking provides the hind milk that satisfy the hunger and the nutritional demand of the baby. So no other supplemental feed should be given other then breast milk in normal situation.

8. Till what age baby should receive breast feeding?

  

Start breast feeding right from the birth. Add on with supplemental feeds in form of weaning from 6 months of age and continue it with family pot feed till 2 years of age.

As well said breast milk is for brain growth and cow’s milk is for body growth so continue breast feeding till 2 years of age.

9. If you are a working mother how can you continue breast feeding your baby?

   

Well in that case feed your baby when you are at home and for the time when you are in office you can express the breast milk and keep it store in a steel container in a refrigerator in the middle compartment till 24 hrs. And it can be used  as palada feed, or a spoon feed with proper sterilization. Don’t heat the milk directly on the heater rather warm it up by keeping the container in the hot water vessel.

10. Can we bottle feed our baby?

No. It’s not accepted, as there is an increased chance of gastrointestinal infection in form of diarrhea. Baby may develop nipple confusion once you put him on breast feed again as sucking milk from the bottle is comparatively easy then sucking from breast directly. And as when mother put their baby for breast feeding it acts as a stimulant to the mother and helps her for better milk production and gives an emotional, physical and mental support both to the mother and a baby. And human milk is uniquely adapted to the infant’s need. But in case of working mother you can use it provided you maintain a proper hygiene and sterilization of the bottle. 

11. Do we need to give some vitamin supplement in addition to the breast milk?

   

Absolutely no for all the term healthy babies in normal cases as breast milk is rich in all the required nutrition, vitamins, minerals, enzymes, immunoglobulin’s, antibodies which is required for the baby growth and development.  Breast milk is the best gift that any mother can give to her baby for their better and healthy life as it provides unique nutritional, immunological and psychological benefits.But yes additional vitamin supplements may be required for the preterm babies, and babies less than 2 kg at birth, or any high risk babies.

  

 12. What are the contraindications of breast feeding?

For mother : HIV infection, Active Hepatitis B infection, Active Tuberculosis, Typhoid fever, Breast cancer, Malaria ,Septicemia, CMV, Rubella infection, Herpes simplex virus infection.

For baby: Galactosemia

But it’s always better to consult your regular doctor before you plan to stop/hold breast feeding your baby.

13. What food should mother avoid till she is breastfeeding her baby?

Mother should strictly avoid fish that are high in mercury (canned fish, Tuna), alcohol, Caffeine present in coffee (not more then 2-3 cups per day), chemical bisphenol  A- present in canned foods. She should also avoid eating too much of spicy/oily and  unhealthy/ junk foods which puts her at risk of getting ill and subsequently decreasing her milk production  because of her illness. She should be encouraged to eat healthy and nutritious food with increase fluid intake.

 

14.What are the benefits of Breastfeeding?

Benefits for the babies are: Breastfeeding is a complete nutrition that is easy for the baby to digest. Breast milk has just the right amount of fat, sugar, water, and protein that is needed for a baby's growth and development and also helps in improved cognitive development. Breast milk contains several anti-infective factors, immunoprotective components i.e. secretory IgA antibodies which provide early protection from infection and thus lower the risk of infant morbidity and mortality. It also helps in the jaw development/ strengthening of the baby; because breastfeeding is more difficult. It also decreases the risk of SIDS in infants and allergies, diabetes, celiac disease, obesity in later adulthood.

 While the benefits in mother from breastfeeding are: helps in uterine shrinkage, decreases risk of breast cancer, depression, and osteoporosis. It is also a bonding experience for both mother and baby and can be less expensive than formula.

 

15. What are the various positions of breastfeeding and perfecting the partnership with the baby?

The tips of “4P ” for perfecting the partnership between the mother and the baby is required for the successful  breast feeding : i.e. Positioning, Practice, Patience, Persistence

The various position while breast feeding are:

Cradle position

Cross Cradle position

Straddle position

Football holding position (especially for the Cesarean mother’s)

Lying down position

Side Lying position

For watching the video for the above position look at the web site below:

http://www.parents.com

http://www.parenting.com

http://www.babycenter.com

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An Article Published in Healthy Life Magazine in Issue March 2014

                          

MOTHER KNOWS BEST

NURTURE WITH CARE

A mother certainly has greater responsibility in raising a child;therefore,it is important that she has knowledge of some essential do`s and don'ts.

Parenting is an art to be learned through experience based on our own upbringing, opportunities to look after siblings and rekindling and reshaping innate parenting instincts during adolescence and early adulthood through sharing and counseling.Both the parents (mother and father) play an important role for the better growth and development of a child but yet mother play a supreme role right from the day she conceives till she gives birth.After delivery,the mother and baby remain together 24 hours a day.Therefore , she is in the best position to provide warmth,nutrition, and good nursing care for the baby.Here are some things to keep in mind:

• For better nourishment and growth of your baby start breastfeeding after birth and continue exclusive breast feeding till 5-6 months of age.
• Keep in the mind that your baby should pass urine and stool every day.
• Consult your doctor immediately if your baby develops jaundice.
• The baby may be massaged with oil and bathed after 15-30 minutes of doing so.
• Poor hygiene is responsible for most diseases,so keep yours and your baby`s body and clothes clean.
• Putting oil in the nose and ears.and kajal/surma in the eyes is harmful.

Keep yourself update with some danger signs of  some common childhood illness (i.e. acute    respiratory illness and diarrhea) especially below 5 years of age.Early recognition and management is very important.Here are some of the danger signs:

Danger signs of diarrhea

• Inability to drink/feed/suck
• Decrease in urine output
• Absent tears, dry tongue and mouth.
• Increase irritability, lethargy
• Sunken eyes
• Depressed anterior fontanelle
• Weight loss of more then 10% of body weight

Danger signs in acute respiratory infection

• Fast breathing, restlessness
• Chest in drawing, (kokha hanne)
• Inability to drink/feed
• Bluish discoloration of lips and skin
• Noisy breathing
• Inability to rest properly

Here are some more important things to keep in mind for new mothers:

• Visit a baby clinic for growth monitoring and Vaccination.Milestones are the phases in the growth and development in all domains (social, motor, language-social)  that any child grows through from a small dependent kid to an independent individual. A lot will happen in your baby’s during  first 12 months of life before you know it that your tiny, "helpless" newborn baby will be a person in his own right, able to move around and communicate.Hence monitoring your child for the age appropriate growth and development is very important.

• Vaccination is the process of Immunizing which protects children’s (and adults) against harmful infections before they come into contact with the infection in the community. But some parents are anxious about the side effects of vaccination so to let you know that still the benefit of protection against the disease by a vaccination far outweighs the very small risks of vaccination. This is to inform all the parents that there are certain other important vaccines that are available apart from those that are supplied by the government of Nepal. These newer vaccines are very useful to prevent your child from harmful diseases like: Mumps, Rubella, Influenza, Pneumonia, Chickenpox, Meningitis, Hepatitis A and B, Yellow fever, Rabies, Diarrhoea, Japanese Encephalitis, Typhoid.You should also remember that booster doses important in immunization.

• Start weaning around 5- 6 months of age and introduce one item at a time like, slowly keep on adding newer food every week as per the child tolerance, slowly increase calorie and dense feed till you start feeding him from the family pot at the age of 1.6 - 2 years. Continue breastfeeding  preferably till 2 years of life.

• Ensure a balanced diet that includes all the various food items, vitamins and nutrients.

• In case of any abnormality seen in growth, development or behavior or if there is any family history of major illness or disease then consult your pediatrician doctor in time.

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HAZARDS OF CANNED & FROZEN FOOD IN CHILDREN

Q1 .Can children be fed with frozen and canned foods? At what age is it okay for them to eat such items?

Answer:
Yes children can be given frozen or canned foods at times but not on a regular basis, provided you take a special precaution while handling those food like rinse all cans before opening them to avoid the food contamination because it has dust on outside when you purchase it from the supermarket and using of clean and sterile cutter or knife to open the lid of the container. It is important to check the expiry dates before you use them and make sure that the canned foods are used immediately after opening and avoid reusing the leftovers. Since it’s convenient, portable, and ready to eat it becomes a food of choice especially for working mother and while travelling.

 It can be given after the age of 7-8 years provided the nutritional labeling meets the child nutritional demand. While eating a frozen meal serve it with a salad or a side of fruits or vegetables so as to overcome the nutritional and vitamin deficiency associated with frozen meals.

Q2 .How healthy is it for children to consume frozen or canned food?

Answer:
With above mentioned precautions we can still feed our child with these kinds of foods. There are studies which say that even a frozen food is as nutritious as the fresh ones but then it depends upon the way in which these foods are processed and preserved along with some additional nutritional benefits. Sad to say, almost any meal that’s easy and convenient is probably highly processed.  Even though the processed, packaged foods have almost completely taken over the diet of most of the children and teenagers of today’s  world but still these foods are not as nutritious as fresh meal we prepare. They lack many essential nutrients, vitamins and minerals which are lost during the process. So it’s always a choice to encourage them to eat a healthier and freshly prepared food rather than a canned or frozen food.

Q3. If a majority of their diet consists of canned and frozen foods, what are the possible health risks?

Answer:
These type of food items are called Processed foods i.e (soft drinks, cheese crackers, cookies, chips, cakes, candies, instant meals, etc.) which  are  canned, frozen, dehydrated or hydrogenated for safety, a longer shelf life and convenience.

Some of the important hazards of these processed food are as below:

a.  *  Processed food have less nutritive value

Even though the Processed foods are neatly packaged in a box, bag, can or jar with a list of ingredients on the label, these food are very much  detriment to your health and not just because the food is basically nutrition less but due to the high temperatures and pressures required during processing which all affect the amount of nutrients the food delivers to you by up to 20-fold.

Commercial food is usually blanched before it is frozen. In this process, plant foods are cooked with hot water or steam for a short period of time. This decreases the water-soluble nutrients by 10-50%.

Vitamin stability is affected by heat light, air, and pH. Foods that are going to be canned are cooked at high temperatures and usually for a longer period of time. Fewer nutrients are lost when cooking at high heat for a short period of time. Vitamin B2 is more sensitive to light and  Vitamins A, E and beta-carotene are susceptible to destruction by air.

Canned fruits and veggies typically have added sugar or salt, and sometimes preservatives and colors, too. Draining or rinsing off this salty water also lose the water-soluble vitamins and minerals (vitamin C, B vitamins, potassium), which have leeched into the salty water. In general, vitamins E, C, B1, folate, and retinol are the most delicate and likely to be lost through cooking, processing or simply the passage of time.

The amount of time canned foods spend on the shelf also affects their nutritional value. For example, the vitamin C content can decrease another 20% over the course of a year.

Salmon,  which is typically cooked before being put in the can and then cooked again during canning, loses some of its carotenoids during pre-canning cooking, and another 15-35% during the actual canning.  Fish that are not canned with their bones, like tuna, lose about half their calcium due to canning.

b.    * Processed foods contains dangerous additives and chemicals

    However, packaged food (i.e soft drinks, meat, fast food, snacks, biscuits cakes, candies, creams) contains preservatives and additives (i.e artificial flavoring sugar, food colors, sodium nitrate, monosodium glutamate, trans-fat) designed to increase the longevity of the food items, maintain their taste and protect them from harmful germs while sealed inside the container  but  they have a side effect of decreasing the nutritional value of food products along with some common problems like: Allergies-rashes, hypersensitivity reaction, atopic dermatitis, infantile colic, Diarrhea, Constipation, Indigestion, Obesity, Diabetes, heart disease.

c.    *  Canned food are responsible for certain metal poisoning:

Almost all brands of canned food, contain the endocrine disruptor bisphenol A, better known as BPA in  the can lining.  BPA is a byproduct of the chemicals used to prevent can corrosion is known to cause causes massive hormone disruption with the serious problem of early puberty, ADHD, obesity, Type 2 diabetes, etc in human being.

Several other metallic containers used to can food at home or market may cause this metal toxicity like: copper, zinc, tin.

d.    These food are also responsible for certain food borne illness:

Botulism - seen with commercial food sealed in plastic pouches, home /canned foods, fruits, and vegetables, bottled honey, canned and fermented fish.

Q4. How can parents encourage children to eat healthy since they are fussy eaters?

Answer:

A healthy diet can confer wonderful benefits to your children. They will be happier, healthier, even more beautiful, and filled with energy and good spirits. With simple games and educational activities, you can have fun sharing with your children the delights of foods that taste good and are good for them.

              The best way to help your child discover the Joys of Eating Healthy Foods is by educating  and inspiring them so that you can transform these foods from the ones your children have to eat to the ones they want to eat. 

Here are some of the tips to help you inspire your children to eat healthy foods.

Educate your children about the world's healthiest foods!

Teach your children why certain foods are good for them. We can probably all remember our parents telling us that eating healthy would help us to grow up big and strong, yet many did not tell us of the benefits we would experience while still being a child. Since kids are very "now-focused," explaining how eating healthy foods will help them feel good, look great, give them the kind of long-lasting energy that will make them stars in their school's sports program, and help them to learn and think clearly. Depending upon their age, explain to them the specific benefits they will notice and appreciate, Tell them how a complete spectrum of vitamins and minerals will increase their concentration and ability to learn and do well in their school work.

Introduce a New Fruit, Vegetable or Grain Every Week
Most young children are fascinated by new things, and the colors, shapes, textures and tastes of different foods are no exception. And since foods have a rich history of tradition and heritage that kids can enjoy, learning about and eating new foods can be a lot of fun -- and it's easy to do.

Make Grocery-Shopping Fun for Your Little Ones

Take your kids with you to the market and make it an educational and participative experience for them. If you purchase food items from bulk bins, let your children help you scoop them into the bags. If they are old enough to read, ask them to read the labels, trying to determine by looking at the ingredients which foods are the most healthy.

Visit a Local Farm, and  Involve Your Children With Growing Foods Themselves

Nature, living things and the process of how things work captivate children. Children love to be productive and creative, and accomplish something on their own. You can help them create their own mini-"farm", kitchen garden by simply growing a pot or two of herbs or sprouting some seeds or grains. Once your child has experienced the miracle of a tender green shoot emerging from the soil you have watered together, he or she will understand through personal experience that food is a miraculous gift from the earth--not from a factory.

Let Your Children "Help" You Cook

All children can participate in cooking. Design their involvement depending upon their age. Small children can help measure and mix ingredients. Older children can cut and cook food and choose new recipes to try. Involving your children in the cooking process will award them with a sense of achievement, pride in eating what they helped to prepare, and cooking skills that they can rely on as adults.

Buy or Make Special Decorative Tiffin box for School Meals and Snacks

Packing the foods your children take to school in bright and decorative containers can help them feel special and loved. Let them select containers they like at the store or decorate any of the new, inexpensive reusable containers with favorite stickers. A healthy meal is a present for your child's body; a gift wrapping adds to the fun.

Thus, by helping your children to develop healthy eating habits, you will be providing them with a great gift - one that will benefit their health throughout their lives.

5. Anything else that you would want to inform our readers?

Answer:
The World's Healthiest Foods provide numerous benefits for everyone, especially in children. Since our children's bodies are in a state of growth and development, they need a constant supply of all nutritional building blocks - protein, essential fats, complex carbohydrates, and a full complement of vitamins, minerals and phytonutrients -- to support healthy growth. Because of their smaller size and still developing immune and detoxification systems, reducing the exposure of our very young children to potentially harmful chemicals may play a significant role in promoting a healthy future for them.

But still in case, you prefer a canned or frozen food please follow the tips as given below:

1. Avoid buying canned goods that are bulging, dented or leaking. Throw away any cans in your pantry showing these signs.
2. Store canned goods in a cool, dry place, not above the oven or under the sink.
3. Rinse all cans before opening them.
4. Use canned goods by the date on the can
5. At the grocery store, select frozen foods from the back of the freezer case; items in the back usually remain the coldest and most frozen.
6. At home, keep frozen foods tightly wrapped and store them in the freezer at zero degrees Fahrenheit or below.
7. Don't buy hanging dried or cured meat if the package is open.
8. Reheat pre-cooked foods such as stuffed chicken breasts and pre-roasted chickenbefore serving. Eat them on the day of purchase.
9. When eating a frozen meal, serve it with a salad or a side of fruits or vegetables to meet your daily nutritional requirements
10. Processed foods are often stripped of nutrients designed by nature to protect your heart, such as soluble fiber, antioxidants, and “good” fats. Combine that with additives, and you have a recipe for disaster.

Thus prefer the World's Healthiest Foods above the canned or frozen food. These include fresh vegetables and fruits (organically grown whenever possible), which contain an array of vitamins, minerals and other health-promoting phytonutrients; as well as whole grains and legumes, which provide healthy fibers, proteins, minerals, and fats. These healthy foods will help your children feel better, think better and live better.

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