A to Z about breastfeeding

August is world breastfeeding week and Kenya joined in the celebrations. There were medical camps in Nairobi, just to encourage mothers to breastfeed. This is one of the best campaigns ever for the little angels. This took me back to my own experiences — good and bad.

No one had warned me how hard it would be. As a doctor, I had read about it, taught it and had practicals on dummies on it as a student but none of that made it easier for me. I was back to the basics as any mother and instincts only took me so far. I needed a lot of support. Armed with all the knowledge and best attitude ever, I charged on courageously.

What did I know? I knew that breast milk is best for baby. That I should do it exclusively for six months if possible, that is, without adding water or pumpkins to the diet, just breast milk for breakfast, lunch and supper. If baby needed porridge, I drink the porridge and give her the breast milk thereof; nothing goes directly to baby mouth but breast milk.

Breast milk has so many goodies that scientists are yet to work out all the benefits yet. It has just the right combination of vitamins, minerals, fats, carbohydrates proteins and everything that baby needs for the first six months in the right form ready to be digested by baby’s brand new gut and absorbed and used by her brand new body. It has immune boosters, anti-infection fighters and anti-cancer agents — all in one. Breastfeeding has been shown to improve both the Intelligence Quotient (IQ) and Emotional Intelligence (EI) of a baby. That is the best head-start anyone would want.

In fact, some of its advantages are just due to its priceless convenience. It is free, portable and on the tap, will never expire , always comes in the right temperature, has no hygiene contamination issues and no baby has complained of being allergic to mum’s milk. Some mothers swear that the baby poo smells better when breastfed than when bottle-fed and the young ones hardly ever get constipated.

New regimens advise that babies should be breastfed on demand or every three hours, whichever comes first. If the baby is crying and she is not wet or just angry, then she needs breast milk. But if it is an inconsolable cry, then check if she is ill. Short snacks every hour or so not only make the mother tired but may not be giving the baby all the required nutrients. In the first week, a mother produces colostrum, a yellow fluid full of the best nutrients, immune fighters and everything a brand new baby needs. Then breast milk settles in. In the first few minutes of breastfeeding, the baby gets foremilk, which is full of fluids and rather refreshing. Then middle milk comes next and this is thicker than foremilk and richer in proteins and carbohydrates. Lastly is hind milk, the thickest and with essential fats and vitamins. Thus, ideally a baby should breastfeed for 20 to 30 minutes each feed to not only get satisfied, but also to harvest all the possible advantages.

Good knowledge is good but not enough; it has to be accompanied by good attitude. Breastfeeding may be natural but it still needs determination. Some mothers need lots of encouragement just to start breastfeeding. Others, once they start grappling with sore nipples, engorgement and milk let down may be discouraged, yet still in other settings breastfeeding may not be fashionable. All these mothers have worthwhile concerns but with little training and help, most of these can be overcome.

The most common complaint mothers have is the supply issue. For some reason, most mothers feel that their milk is not enough for their babies and get tempted to add porridge or milk. Do not unless expressly advised to do so by a doctor. In any case, these are not the best weaning foods. Generally, the more one breastfeeds, the more milk they produce.

So, feed and feed and feed and more will come. Expressing milk after baby is full also lies to your bosoms that more milk is needed; so they produce more. This is a trick many mothers have learnt and love to share. A calm and reassured mind helps produce more milk. Just have loving thoughts about the baby and see how the milk pours. Do not fret and be anxious, this is counterproductive. Eat a balanced diet. This is not the time to worry about low fat products and losing weight, just feed and embrace the fact that you are your baby’s only best and favourite lunchbox.

In fact, most mothers ask for extra food, especially early in the morning. Go ahead! Certain foods are known to increase milk production — malt products (Milo, Bournvita, Horlicks, etc.), fenugreek tea, raspberry leaf tree, thistle tea and oat porridge. Locally available foods that are praised include leafy vegetables, (saga, managu, mrenda, etc.). The trick generally is to increase the amount of warm fluid intake in the form of herbal teas and soups. Avoid tea, caffeine, and alcohol for this short period.The size of your breast does not affect the amount of milk you produce.

Exhaustion is also inevitable. Babies seem to love feeding in the night. Try to sleep with the baby and see how much rest you can sneak into your life .Maternity leave is not the time to be the Chief Executive Officer of your house. It is baby time. A well-rested happy mother is a successful breast feeder.

Cracked and sore nipples, what a pain! The first few weeks of feeding my angel were hell and I had started dreading every hungry cry. These are mostly caused by poor attachment of the baby’s mouth to the nipples. Ideally, they should attach to the whole areola and not just the nipples. Massaging your nipples with breast milk after every feed, briefly exposing them to sunlight, wearing a fitting bra when not feeding and just resting the affected breast for a day proved very beneficial tips.

Oh! The most miraculous natural remedy I experienced was applying cabbage or lettuce leaves on the sore area; it really works. Naturopathists say kales, cabbage and salad leaves help in wounds. The secret chemical is unknown.

Bosoms can be painfully full, known as engorgement. This happens as breasts try to adjust to the right amount for your baby. Do not worry; it will come to pass. Temporary relief: feed baby. Others include warm massages or applying cabbage milk. Caution should be taken when using cabbage as too much has been shown to reduce milk supply.

Breast ducts can be blocked and get infected (Mastitis). One needs an antibiotic and painkillers if this happens. Care should be taken that it does not complicate into to an abscess that shall need to be surgically drained. Sometimes they can be infected with thrush and fungi that may also infect baby mouth. The doctor will prescribe proper drugs for this.

People with inverted nipples may have harder time than most mothers but with proper support and training, even they can successfully breastfeed.

Apparently, the flavour of breast milk may change with the food one eats, and baby may or may not enjoy this. That is temporary and I think something exciting to experience.

Putting on a fitting bra when not nursing actually helps reduce how far your breast will sag at the end of that period. This is good news for fashion conscious people. It also helps reduce abrasions, sore nipples and breast engorgement. I had to go back to work after six months. However, most working women in our country go back after four months, leaving a child who would still benefit from exclusive breast milk. How do we reach a compromise? Expressing milk with a pump helps a lot. Pumps may be manual or electric. The collected milk is put in dated bottles and stored.

Milk can be stored in a deep freezer for six months, in a normal freezer for three months and in the fridge for six days. It can be left at room temperature for six to eight hours. Once thawed to room temperature, it can be used within four hours. Once thawed from freezer to fridge, it can be used within a day. Never refreeze the milk. It is not good to use the microwave as this reduces the immunological and nutrient value. Baby can be fed using a bottle or by cup and spoon. Of significance is hygiene.

In as much as breastfeeding is lovely, not everyone is advised to feed their child that way. Certain illness and medications may cause one to opt for another method. Discuss with your healthcare giver if you are concerned about any health issues you have that may affect your baby.

Unfortunately, however much both mother and baby may enjoy breastfeeding, it has to come to an end. It is advised that if child and mother can continue for two years, the better. You can imagine my horror when my baby stopped voluntarily at one year. But one cannot force the baby. One can only make sure that he or she has graduated to healthy wholesome foods.

Some mothers choose to stop suddenly, others gradually. Whichever you opt for is fine. If you choose the latter, be prepared to tackle engorgement issues and let down, but even these are manageable if you follow the above tips.
To all mums who have chosen this option, I wishing you all the success!

END: BL 44/ 38-39