BREASTFEEDING AND ITS CHALLENGES

Breastfeeding and its benefits to both the mother and child are fairly known among the general population.The purpose of this article is more about those lesser known facts about lactation and its complications and the difficulties faced by the new mother in effective implementation of the same.

Why Breastfeeding?

Breast milk is recommended as the infant’s sole source of nutrition for the first 6 months of life.In addition to the fact that it takes care of all the nutritional needs of the baby,it also helps in increasing the bond between the mother and the baby.This indirectly promotes the baby’s initial stages of development as well.

However lactation-as every mother would be knowing-is not that simple and straightforward.So many internal and external factors come into play during the neonatal period.Some of these csn be extremely distressing for the mother and may in fact,adversely affect the quality of breastfeeding.

Benefits of Lactation

For the Baby

Breast milk is critical in compensating for developmental delays in immune function in the newborn.The antibodies in breastmilk,particularly IgA plays a significant role in this regard.The favorable gut microbiome from the milk has been found to be associated with decreasing incidences of asthma and obesity in the later years.breast milk contains hormones, neuropeptides and growth factors that may affect growth, development, and self-regulation of food intake, contributing to the differences observed between breastfed and formula-fed infants.Infants who are not breastfed, or who are breastfed for short periods or at low intensity, have a higher risk of infection and illness than those who are breastfed optimally.

For the Mother

In the immediate postpartum period,initiation of lactation aids in reducing the bleeding and involution of uterus while the continuation of breastfeeding confers long-term benefits such as reduction in weight,decreased incidence of reproductive cancers like breast and ovarian cancers,and risk of acquiring diabetes.Exclusive breastfeeding also serves as a natural birth control method for the first 6 months.


What are the challenges in Breastfeeding?

Having said all these,breastfeeding is not without its share of hurdles.Breastfeeding in the initial days are always a challenge to the mother and this is the time when she needs a lot of psychological support from her kith and kin.Unfortunately,it is where they are left wanting for.So what are the various challenges involved in lactation and how are we going to tackle them?

1. “She doesn’t have adequate milk!"

A very common issue almost all the mothers face would be this remark especially by the senior women in the families.Needless to say,this is one of the major reasons of psychological trauma to the new mother.Most often,this might be due to improper techniques but might also be due to the natural delay in initiation.Usually,this resolves over the next couple of days once the mother bonds to the baby and her comfort level is attained.

Perceived or actual low milk supply is a common reason for undesired weaning. A mother can rest assured if the average feeding frequency is 8–12 times per day,the baby has a steady weight gain by day four or day five,and 6–8 wet diapers occur on average per day.

2. “Give her something to increase milk production!”

A common practice seen is the advocation of 'natural' remedies to enhance milk production.Galactagogues(substances to increase milk production) should not be considered a first-line therapy because current research on the effectiveness of pharmaceutical and herbal galactagogues is relatively inconclusive and all substances have potential adverse effects.

3. “I have pain on attempting to feed!”

This is a fairly common concern of all lactating mothers.There are multiple factors responsible for the associated pain.A focused evaluation is required to distinguish the specific cause of pain and determine appropriate treatment.

What are the causes of breast pain in a lactating mother?

1.Cracked nipples.

A very common cause often due to injuries while feeding.The pain can range from mild to severe.If mild pain and there is no difficulty in infant’s ability to latch well to the breast,breastfeeding may be continued.


2.Inadequate feeding.

Breast engorgement due to inadequate feeding occurs as a result of milk accummulation.Mothers should be advised to alternate feeds from both breasts to prevent the occurence of this condition.They must also be taught regarding the importance of feeding in enirety at a time.Human milk consists of foremilk rich in water content which helps in alleviating the baby's thirst and hindmilk which is rich in nutrient content.Breast pumps can be made use of to express the breast milk in case of severe engorgement which can be stored in refrigerator upto 24 hours for later use.Breast pumps can be both manual and electric and any of it can be used as per convenience.


3.Mastitis and breast abscess.

Mastitis refers to the inflammation and infection of breast tissue which if untreated can lead onto abscess(pus collection).Nursing mothers are vulnerable to abscess in the first month due to inexperience and inadequate hygiene and towards weaning off when the baby’s teeth can cause nipple injury.

Every mother should understand the symptoms of mastitis and abscesses for early consultation and appropriate treatment;these include:

  • Redness and swelling over the breast

  • Severe pain and increased sensitivity to fabric

  • Fever and tiredness

Treatment

The physician would often order a Ultrasound to look for abscess formation.In the early stages,antibiotics and supportive measures are sufficient but in case of a formed abscess,aspiration or surgical drainage would be required.


4. “In which position should I feed my child?"

There are multiple positions any of which can be adopted as per one’s ease and comfort.Your doctor would be more than happy to inform you regarding the various options.Generally it is not that advisable to feed in the lying down position as there are increased chances for aspiration to lungs and ear infections in the baby.


5."Should I give water to my child in the first six months?"

No! Your child requires only breastmilk while being exclusively breastfed.There is no need to give water during this period.


Barriers faced in effective breastfeeding practices in our society

A topmost barrier in Exclusive BreastFeeding(EBF) is the belief that breastmilk alone is not sufficient in meeting the nutritional needs of babies-particularly advocated by the old generation.The breastmilk of an adequately nourished mother provides all the nutritional energy requirements for the first six months of an infants’ life, and continues to provide up to half the energy requirements during the second half of the first year, and about one-third during the child’s second year of life.


Nursing mothers are often culturally pressured to give water and artificial feeds to infants as reported in a recent survey by the participants.Public education on breastfeeding should be intensified so as to stimulate societal support for EBF practice.

It is still unfortunate to see that working women do not get ample support from both family and society when it comes to lactation.These include but not limited to inadequate facilities for breastfeeding at workplaces and getting frowned at for practising EBM(Expressed Breast Milk).

The other common stumbling blocks are emotional stress, lack of support from society and healthcare professionals and shyness when breastfeeding in public.


However it should be kept in mind that motherhood is not all about breastfeeding.Some mothers might need supplementation with formula feeds while some of them may have contraindications. It is important not to put undue pressure on her on these grounds.



Summarising...

Every year,August is considered as National Breastfeeding Month and the first week of August as the World Breastfeeding Week to encourage breastfeeding. Breastfeeding not only contributes to the overall development of the baby but also betters a woman's health after pregnancy,equipping her to return to a normal metabolic profile among other benefits.


As a society,let us ensure the mother and baby are at ease while they bond with each other!


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