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Thursday, August 7, 2014

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, diabetesceliac 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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