Baby Care: Glimpses from my book

Breastfeeding

BREASTFEEDING AND WEANING

Successful infant feeding requires cooperation between the mother and the baby, beginning with the first feed, and continuing throughout the child’s period of dependency. Promptly establishing comfortable, satisfying routines contributes greatly to your baby’s emotional well-being. Feeding times should be pleasurable to both mother and baby.

As soon as possible after birth, the baby should be put to the breast for feeding. This will enable her to acquire the needed energy to successfully transit to extra-uterine life, promote mother-infant bonding and decrease the risk of the infant getting a low-blood sugar, jaundice, low blood calcium levels and many other metabolic problems. It may be possible to make mistakes, and give the baby too much or too little milk. She may then vomit (too much) or become feverish (dehydration fever) (too little). Babies usually begin to breast feed within a few hours after birth, although some may start after 4-6 hours. After this, the baby may feed “on demand”, that is, whenever she is hungry. The interval between feeds may vary from one child to another and even in the same infant from time to time, and will depend on the time it takes for her stomach to empty after a feed. However, by the end of the first fortnight, your baby will have established a reasonable schedule of feeding. Feeds can be considered adequate if your baby stops losing weight by a week and regains her birth-weight by 10-12 days.

It should be remembered that babies cry for reasons other than hunger too, and on no account should the baby be fed everytime she cries. Nor should you immediately suspect either that the baby is ill, or that you are not having enough breast milk.

Too much clothing, gas, colic, soiled, wet or uncomfortable diapers and a hot or uncomfortable environment can all cause the baby to cry. Some may even cry to gain additional attention, while some may be actually sick.


Breastfeeding:

Everyone knows that breast milk is the best milk for the baby!
I shall enumerate its advantages here so that you may realise just how good it is for your baby.

1. It is the natural food for her. It is always available at the right temperature, and needs no preparation. It is fresh, free and has no contaminating germs which could produce attacks of diarrhea.
2. Cow’s milk often causes allergies, characterised by intestinal bleeding, diarrhea, spitting up, colic, or even wheezing or eczema. Infants fed breast milk have no such problems. They also suffer less from middle ear infections, pneumonia, meningitis and some other illnesses.
3. Human milk is full of antibodies against the disease causing germs. These antibodies protect your baby within the gut as well as in the body from an attack by many different kinds of bacteria and viruses. Besides antibodies, human milk has many other immunity boosting chemicals and hormones that protect the baby from an onslaught of diseases.
4. Milk from an adequately nourished mother will supply most essential vitamins and minerals, except, perhaps fluoride (in the West), and Vitamin D (after several months).
5. Breast feeding has tremendous psychological benefits for both, the baby, and the mother. The mother feels a sense of accomplishment at having nourished and nurtured her baby; the baby is provided with a close and comfortable relationship with her mother.
6. Breast-feeding hastens the healing of the womb; it is said to impart a sensually happy feeling to the mother; it also promotes a better shape to the bust of the mother in later life; it may actually protect against some types of cancer in the mother; and finally, it provides some protection against an unwanted pregnancy for a variable length of time, as long as the mother is nursing.

Establishing and Maintaining Milk Supply:

The most satisfactory way of maintaining adequate lactation is to feed the baby regularly to empty the breasts. During the initial days, although the mother may feel that she has less milk, she should continue to put the baby to her breast every time she cries, or at least every 2-3 hours, so that the baby stimulates the production of more milk.

Once the mother’s lactation is established, she will easily produce more milk than what the baby requires. Breastfeeding should begin as early as possible after birth, and preferably within the first few hours. The baby may be given to the mother whenever she cries, or at least every 2-3 hours. About 75% of the milk that has been taken by the baby in the previous feed gets replenished in the next two hours.

The first two weeks are crucial for the successful establishment of breast-feeding, and unnecessary supplementation of bottle-feeds, raising doubts about the adequacy of milk flow, giving “other” foods like honey etc. and cracks in the nipple or other breast-related problems can compromise the success of breast-feeding. Hence, please JUST PUT THE BABY TO THE BREAST. Do not do anything that can take her away from the mother’s breast.

Worry and unhappiness in the mother are the most potent dampeners of breast-milk flow. Fatigue, tenderness (pain) in the nipples, full, engorged breasts, tensions about the home, other children, husband, etc. can all create nursing problems.

The breasts should be washed once a day and the nipple area must be kept dry at all times. A comfortable brassiere, with support at the bottom, and absorbent pads under the cup to absorb leaking milk will allow the mother to stay comfortable and at peace.

The nursing mother should eat a well-balanced, varied diet that imparts health to her and to her baby. Her diet should be supplemented (if needed) with extra calcium, iron etc. in consultation with her obstetrician. She may find that the baby has gas or loose motions when she (that is the mother) eats tomatoes, onions, certain berries, spicy food or chocolates in excess. Before taking any drugs or going for any special X-rays, the mother should consult the doctor about whether breast feeds may be continued or withheld, at least temporarily.

She must completely stay away from alcohol, smoking, recreational or addictive drugs and sleeping pills.

Technique of Breastfeeding:

At the time of feeding, the baby should be hungry, dry, neither warm nor cold, and be held in a comfortable semi-sitting position. The mother should also be comfortable. The baby is held in the crook of the elbow of one hand, while the breast is supported by the other hand and the nipple is taken near the baby’s searching mouth. The baby’s lips should engage a considerable portion of the areola as well as the nipple.

You should realise that if the baby is hungry, she will energetically “root” for the nipple, and her sucks will be deep and accompanied by a slight thrusting action to enable the easy expulsion of milk. On the other hand, a baby that does not “root” for the breast, or does not suck vigorously is usually not hungry… unless she is sick. Usually, the baby gets the major part of her milk in the first few minutes after she begins to feed; almost 80-90% has been already ingested within the first 4 minutes. However, the baby should be permitted to suckle till she is satisfied. She should never be “pulled” away from the breast, for this may cause nipple cracks or tenderness. Waking a sleepy infant “to feed” is also usually inappropriate and unsuccessful.
At the end of the nursing, the baby should be held erect, either on the shoulder or mother’s lap for assistance in expelling swallowed air (burping). Her back may be gently rubbed or patted to aid the process. When the burping is completed, the baby must be laid in her cot on her back, or on her right side to aid the digestion process.

To know more about breast-feeding, see the bibliography at the end, or visit:
http://www.breastfeeding.com.

The next entry is about supplemental feeding, weaning and formula feeding.