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Breast feeding or lactation is the basic physiological, exquisitely natural function of the woman’s body, essentially meant to nurture the newborn. It’s as natural as the air in the atmosphere or the clouds in the sky. Yet many times mothers find it challenging to be able to breastfeed. The first week of August is observed as the Breast feeding week and keeping this in context and to be able to help mothers overcome the challenges of breast feeding, we bring forth this write up.
Breast feeding preparation begins during the prenatal period. Breast development is a process and it starts just before menarche ( appearance of the first menstruation ). It develops gradually and the final growth and maturation occur during the first pregnancy.The breast increases in size and there are structural and functional changes during the prenatal period to prepare it for lactation immediately after the birth of the baby.
The breasts increase in size. The nipples become pigmented and the area around it too becomes darkened and increases in size. Clear secretions are observed coming through the breasts after 12 weeks of pregnancy. Breasts feel heavy during pregnancy.
During the first few weeks of pregnancy, the breast feels heavy and a little painful. A good support inner ware preferably of cotton or hosiery should be used. The nipples may have encrustations and get dried up. They are to be cleaned and kept dried. Do not stimulate the nipples and breast unnecessarily and too often. If any lump, or depressed nipples or any abnormality is observed please contact the doctor. Clinical breast examination is an important component of your prenatal care and once during the course or at the first confirmation visit, your doctor will certainly do this check.
Breast feeding is initiated immediately after the baby’s birth. Be it at cesarean delivery or a vaginal delivery, immediate breast feeding is a normal practice. Immediate breast feeding helps baby to swallow the secretions in the chest and also to breathe well. It also helps immediate bonding. Immediate breast feeding helps to control bleeding from the mother’s womb and helps the lactation process to set in well.
When the baby suckles, there is a release of two types of hormones. One helps in preparation of milk in the breast and the other helps in releasing of this milk in response to suckling. Suckling acts as a stimulation for the hormonal pathway to set in.
When the baby suckles, it pulls the entire nipple and the surrounding areola in a forceful manner to an extent that the nipple touches the palate of the baby and a continuous process of suckling and milk let down starts.This is called as lactating. It is a sign of optimum breast feeding technique.The initial few days of birth are a learning phase. The baby has to learn and develop the strength in its cheek bones to be able to have longer lactating durations. This needs patience from the mother and understanding that the first few days the baby will need feeds more often and should not be made to cry for a long time. Excessive crying causes accumulation of air in the stomach and this reduces the capacity of the stomach and the baby sleeps off tired and full to wake up in a short while. Remember a content baby is a happy baby.
Weight gain, adequate urine, deep yellow colored non-foul smelling stools are a sign of adequate feeding. Cranky crying baby may not be getting adequate feeds. White milk solids in the baby stools signal excessive feeding.
Burping helps release the gas bubble in the stomach and thus prevents vomiting. This vomitus, if enters the wind pipe or the lungs, can cause aspiration and sometimes serious complications. Every feed, therefore, has to be followed by a burp assistance. Baby less than 4 months, who has not yet learnt to turn or flip on its tummy, needs this assistance. This can be done by holding the baby upright, rested against the bosom or on the bed with head side up and tummy down or on the lap.
Excessive vigorous feeding gradually helps the nipples to harden. Initially, there can be soreness. If the nipple is not kept clean, breast remains engorged and if the baby has oral thrush which is a fungal infection, there can be small abrasions on the nipple which is called as cracked nipple. The nipples should be kept dry, the breast should be emptied after feeds if they are filling and getting tightened or engorged and baby should be treated for the thrush. The demand supply cycle needs a while to set in and it’s important to care for breasts during this period. If this is not done, it can lead to conditions such as mastitis ( swollen and tender breasts ) and breast abscess ( collection of pus in the breast )
Food rich in healthy calories, proteins and nutrients should be taken. Breast milk has to be ample and nutritive. Avoid contents such as gram which can cause allergies to the baby. Fenugreek ( methi ) is an effective time tested galactagogue. Healthy, clean food, easy to digest should be taken. Plenty of water needs to be taken as breastfeeding causes perspiration. A glass each before and after every feed is a good practice to follow.
Patience and a positive attitude are extremely important. Comfortable positioning, understanding the baby and its cries and handling your own baby, can help mothers, to be able to lactate optimally. Aggressive efforts should be undertaken for breast feeding and shift to top feeds or supplementary feeds should be deferred as much as possible.
It is the naturally processed nutrition created for the baby with the right composition and replete with protective ingredients such as antibodies which help the baby to establish the functioning of its digestive system . While in the womb the baby was swallowing and realizing the fluid around it and was getting its food supply from the umbilical cord. After birth it has to now suckle, swallow, digest, assimilate and then excrete the food and this needs proper priming. This initial establishment of correct functioning of the alimentary canal needs breast milk as the initial meals. Breastfed babies are healthy, protected from infections and future lifestyle related metabolic diseases. Breastfeeding also protects the mothers form breast cancers. It helps in faster recovery of the mother to pre-pregnancy status and is convenient.
Friends, breastfeeding, therefore, is an important natural function of the body and should be undertaken with zeal and enthusiasm. Today many women are seen opting for bottle feeds or expressed breast milk feeds. Natural lactating helps in better bonding and assurance of security and emotional stability in the baby. It’s an art and a right of every mother and baby and therefore should be indulged into.
Dr. Girija Wagh, MD (Obstetrics & Gynaecology), FICOG, FICP, Diploma (Endoscopy, Infertility), Fellowship of Indian College of Ob-Gynec, Women health care specialist, Academician, Acclaimed Orator & Researcher, B. J. Medical 1990-1992, Topper University Of Pune 1992
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