BREASTMILK - NATURE'S PERFECT GIFT

How breast feeding benefits your baby ?

* A complete food

Breastfeeding provides all the nutrients in the right quantities, in a form that is easily digestable to meet your baby's needs.

* Protects against infection

Anti - infective substances in breast milk protect against diarrhoea, respiratory illness and other infections, including those that a mother may have while breastfeeding.

* Prevents allergies

Decreases the risk of your baby developing asthma, eczema and other allergies.

* Promotes bonding

Provides emotional security and increases the bonds between mother and child.

* Makes smarter babies

Contributes to higher intelligence.

* Lowers risk of diseases in adulthood

Decreases the risk of diabetes, heart disease, certain cancers in adults.

How breastfeeding benefits you ?

* Decrease risk of breast and ovarian cancer

* Delays ovulation - helps postpone the next pregnancy

* Contracts the uterus, prevents excessive bleeding

* Uses up energy and helps you to regain your figure faster

* Convenient - requires no sterilized bottles, hot water, artificial milk. Breast milk is available immediately.

* Saves money - on milk, on illness & on hospitalisation.

The production and release of milk is dependent on two hormones. Various factors can increase or decrease these hormones and hence the milk production :

The production and releases of milk is dependent on two hormones. Various factors can increase or decreases these hormones.

FROM THE WARMTH OF THE WOMB TO THE COMFORT OF THE BREAST

The fetus spends nine months in the quiet, warm and secure comfort of your womb. After birth a baby needs the same warmth and security which can be made possible by placing the baby skin-to-skin on your chest, and drapping a warm towel or sheet over you. Close to your familiarn heartbeats and in close proximity in your breast, the baby can feed if hungry. In this first hour, the baby is most alert, look around and willing to suckle at the breast.

It is vital that your baby leaves the labour room with you and spends the first few days of life close you.

The first milk is thick and yellow, and is called colostrum. It is extremely important for the baby, as it has many protective substances and vitamins which your baby needs.

In these first few days, some babies may demand frequent feeds, others sleep for long hours. Babies also need to be fed day and night on demand. This pattern of feeding and closeness to you offers the baby security and protection.

ART AND TECHNIQUE OF BREASTFEEDING

Breastfeeding is natural and most mothers take to it without any problems. There are as many ways to breastfeed as there are mothers and babies, and you will develop your own style to suit your baby. However, some mothers and babies need help. Just as a baby learns to walk, he stumbles, sometimes falls, but with practice and time, walking becomes effortless, the same is true of breastfeeding.

There are certain steps that will help you breastfeed with ease. It may take time, sometimes days, to master these techniques, but preseverance pays dividends in the glowing health of your baby.

Mother's Position

Step 1 : Find a comfortable position for yourself. You may lie down, sit on a chair, on the bed or on the floor to feed your baby. Most important is that you must feel comfortable and your back must be supported.

Step 2: Hold your baby in your arm so that her head and neck rests in the bend of your elbow, the back along your forearm and the buttocks in your hand. If you are feeding baby on the right breast, your right arm should be used to cradle your baby.

Step 3: Turn the baby's entire body towards yours so that the baby's tummy touches your tummy. The baby's head and neck should be supported

Step 4: Raise the baby to the level of your breast so that the baby's mouth can easily reach the nipple and areola. This could be made possible by putting a pillow below your arm or raising your thigh, if you are sitting crossed-legged on the floor. Make sure that the baby is not excessively clothed so that the baby can be brought really close to you. Sometimes, you may need to tuck your baby's arm away so that it does not come in the way. You may use your free hand to hold your breast or to fondle your baby is well attached.

Step 5: When the nipple touches, the baby's lips or the cheek, your baby's mouth will reflexibly open to draw the nipple and part of the areola in to form a teat. This is known as "attachment to the breast". The lactiferous sinuses which are the storehouses of milk are situated beneath the areola. To effectively suckle milk from the breast, both the nipple and areola should go into the baby's mouth. Proper attachment is the key to successful breastfeeding. Improper attachment is responsible for most of the problems related to breastfeeding like sore nipple, congested breast and inadequate milk supply.

Signs of a good attachment :

* Baby's mouth is wide open.

* Chin touches the breast.

* Nipple and most of the areola are inside baby's mouth.

* Lower lip is turned outwards.

* You feel no pain while breastfeeding

How can ensure your baby gets a good attachment ?

Some babies need help to get properly attached :

* Hold your baby close to you so that baby's mouth is at the level of your breast.

* Support the breast such that your fingers are below the areola & your thumb above it, so as to fully expose the areola.

* Wait till your baby's mouth is wide open.

* Direct nipple and areola into the baby's mouth by bringing baby closer to your breast by moving the arm supporting the baby towards you.

* Do not lean forward and do not push your breast towards your baby.

Make sure the baby suckles at the areola and not just the nipple. If the baby's mouth is not opened wide enough and the lower lip is turned inwards, use the index finger of the hand supporting the breast to press the baby's chin firmly down while you pull the baby onto the breast.

Important : Remember, if your baby is not properly attached, you will get pain while breastfeeding. In that case, interrupt the feed by pulling down baby's jaw to release the nipple. Get baby to latch again.

Other positions : Mothers who may not be comfortable using the cradle position can try these positions :

Modified cradle : If you are feeding your baby on the left breast, use your right arm and hand to support baby. The baby's head should be in the palm of your right hand, with your right forearm supporting the back and buttocks. Your left hand is then free to hold the breast or fondle baby. If your baby is small or prematurely born, you may find it useful to feed in a modified cradle position.

Clutch hold or football position : If you are feeding baby on the right breast, hold your baby's head in the palm of your right hand. Tuck your baby's body below your right arm, & support it with your forearm. If you have twins, you can feed both simultaneously with this method.

Side lying position : Lie down on your side. Baby should lie facing you. Baby's mouth should be in line with the nipple & areola; & baby's tummy should be touching your tummy. Use your forearm and hand to bring the baby close to you. This position is helpful if you have had an episiotomy or caesarean section.

Indications for good position :

* Mother must be comfortable

* Back must be supported

* Baby should be held close, tummy touches, mother's tummy

* Head and neck of baby should be in straight line

* Baby's mouth should be close to the mother's nipple and areola.

PROBLEMS & SOLUTIONS

Congested breast occurs most often in the first few days if your baby does not feed frequently.

Symptoms : Breasts become hard, red and painful

Causes/Reasons : Milk production is more than baby's needs

- Delayed feeding
- Infrequent feeding
- Poor attachment

Treatment :

A congested breast can be painful. Warm packs applied locally and a pain reliever like paracetamol prior to expression would be useful.

Prevention        *     Early feeds
                            *     Frequent feeds
                            *     Corret attachment to the breast

Sore nipple : The most common cause of a sore nipple is poor attachment to the breast. If the baby sucks only at the nipple instead of both nipple and areola, the baby does not get milk and therefore sucks forcefully, damaging the delicate skin of the nipple.

Symptoms
* Pain while feeding.
* Sometimes, there are cracks on the nipple.
* Rarely, it may bleed.

Causes
* Incorrect attachment of the baby to the breast
* Frequent washing of the nipple with soap and water
* Pulling the baby off the breast when feeding
* Fungal infection of the nipple.

Treatment
The solution is correct attachment to the breast - baby must suckle at the nipple and areola.

Even if the nipple is sore or cracked, if baby is properly attached, you will feel no pain. Interrupt the feed and get baby to relatch till you experience no pain.
* Use loose clothing to allow the cracks to heal

* Apply the last few drops of milk at the end of the feed to the nipple. The 'hind milk' contains fats and anti-infective substances that will help in the healing process.

* If your baby has white patches in the mouth called thrush, it suggests a fungal infection. Antifungal solutions should then be applied to the baby's mouth & your nipple.

Prevention
* Make sure that baby is properly attached to the breast at each feed.

* The breast and nipple do not need to be cleaned before each feed.

Inverted/Retracted nipple

Some nipples are small, others flat and a few inverted. A baby has no problem feeding at a flat or small nipple. In case your nipples are flat or inverted, you can hold the nipple between the thumb and the index finger, and it can be easily pulled out. On the other hand, in case of a retracted nipple, the nipple goes dipper into the brast which makes difficult.

 Treatment

* A simple method is to roll the nipple between your fingers and try to pull it forward before feeding

* Syringe method - Take a 10cc plastic syringe. Take off the piston. After cutting the barrel half a centimeter from the nozzle, insert the piston form the cut end of the barrel. Place the other opening of the barrel around the nipple of the breast and withdraw the piston gently. The nipple will slowly protrude into the barrel. After 30-60 seconds, push tje piston back gently to release the hold of the syringe on the nipple. Repeat this procedure 5-8 times before each breastfeed.

* As soon as some part of the nipple becomes prominent, hold the nipple and areola in your hand so as to form  a teat and put your baby to the breast.

* Do not use this method for expression of milk, even if a few drops of milk flow into the syringe. Do not use        nipple shields. They are not effective and may infact be harmful.

EXPRESSING, STORING AND FEEDING BREASTMILK

It is useful for all mothers to know how to express & store your milk. You may need to express milk in the following situations :

* To maintain milk production if your baby is premature or sick and cannot breastfeed for some time.

* If you want to go out of the house for sometime, when your baby is still on exclusive breastfeeds, you can express enough milk for a feed. A family member can feed it to your baby while you are away.

* When you plan to return to work you can express milk a few days in advance and store it. You can also express milk every day before you leave for work or at your place of work.

* To relieve breast problems like engorgement.

* If you wish to donate milk to a " Mothers Milk Bank".