Dr V.K. Ahuja MBBS, DCH, MD, FNNF, FIAP
Consultant Child Specialist
Breastfeeding is a natural and normal way to feed an infant and is critical for child health, survival, nutrition and development, maternal health and rather it should be referred to as the “Gold Standard” feeding. It protects the child health and development by reducing the infections like diarrhoea, Pneumonia, Sudden Infant Death Syndrome, allergies’, obesity and cancers. It protects maternal health by reducing postpartum bleeding (causing anaemia and sometimes death), contraception, lowers the risk of breast and ovarian cancers, diabetes mellitus, obesity, osteoporosis etc. Globally breastfeeding reduces the disease burden and saves the lives of the infants and it also reduces the disease burden of the mothers who breastfeed.
Breastfeeding could save the world $ 1 billion daily. Formula feeding should be discouraged as it interferes with maternal milk supply, increases the risk of engorgement, undermines maternal confidence and is associated with increased childhood acute and chronic diseases. The goal should be to create an enabling environment for optimal breastfeeding. Breastfeeding is eco-friendly and important for the health of our planet.
Breastfeeding is the only safety net against being born in poverty.
Early start of breastfeeding: Breastfeeding should be started within the first hour (Golden Hour) after birth in normal deliveries and even in case of C-section delivery with support from hospital staff as per recent joint guidelines from FOGSI and IAP on Early Initiation of breastfeeding in C- section deliveries. No pre-lacteal feeds should be given as they interfere with lactation. Why – because the newborn baby is wide awake and active and when put to breast sucks vigorously during the first 30 – 60 minutes and after this baby may go to sleep or is inactive. Baby is so active that if put on the tummy of the mother, the baby will crawl to the breast for feeding (Breast crawl). This can be utilized for good initiation of the breastfeeding. Immediate skin to skin contact has been shown to facilitate early initiation of exclusive and extended breastfeeding. It creates a strong bond between the mother and the baby. Early skin-to-skin contact should be the key strategy for good exclusive breastfeeding. Colostrum, the first yellowish secretion is the super food and it protects the baby from the infections.
Exclusive Breastfeeding: To avail of all the great benefits of breastfeeding both for the baby and mother, the baby should be exclusively breastfed for the first six months of life as the mother’s milk is sufficient to provide all the nutrients. Not even water should be given (except under medical advice for administering medicines. Teats and soothers also interfere with successful breastfeeding and should not be used.
Continued Breastfeeding: After six months of age mother’s milk is not sufficient to fulfill all the nutritional requirements, so the infant should be given homemade nutritious food from the family pot along with continued breastfeeding for two years or beyond. No juice should be given up to one year of age.
Common Breastfeeding Problems
First-time mother problems: though instinctively well equipped, they face initial difficulties due to anxiety, worry and lack of confidence.
Mechanical problems: Cleft lip, cleft palate, big tongue, thrush and non-coordinated suckling in premature infants, engorged breasts and retracted nipples.
Sore and cracked nipples: Don’t offer artificial feeding to avoid nipple confusion, practice correct latching and unlatching. In case of sore or cracked nipples apply your own milk as cream and not any other emollient. Avoid washing the nipples with soap.
Engorged Breasts: Some mothers develop engorgement of the breasts after the third day of delivery and the breasts become heavy, hard swollen and painful. This may lead to an abscess (pus) formation and resultant lactation failure if not treated in time. The mother must ensure emptying of the breasts by suckling the infant, expressing manually or with a breast pump. Night breastfeeds should be encouraged. Avoid Pre-lacteal feeds which are often the culprit.
Note that the whole body of the infant is close to you. His mouth and chin are close to the breast. Touch baby’s angle of mouth or lips with your breast and when the mouth is wide open quickly move the baby well on the breast. Much of the areola is not visible and the baby is relaxed and takes long deep sucks.
Can a mother breastfeed during Corona pandemic?
WHO and UNICEF encourage mothers to continue breastfeeding the baby with certain precautions ( frequently washing or sanitizing hands, social distancing and wearing the mask) even if she is a suspected or confirmed case of Corona-19 disease as the current evidence indicates that it is highly unlikely that breast milk can transmit disease.