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 breast feeding  challenging . 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. 

How does one prepare for breast feeding? 

Breast feeding preparation begins during the prenatal period. Breast development is a process and it starts just before menarche ( appearance of the first menstruation ). Breast develops gradually through the adolescence   and the final growth and maturation occurs 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. 

What are the common breast related symptoms during the prenatal( pregnancy) period? 

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. 

What should be the breast- care observed during the antenatal period?

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.

How and when is the breast feeding initiated? 

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.

What is the physiological mechanism behind breast feeding? 

When the baby suckles, there is a release of two types of hormones. One helps in preparation of milk in the breast( prolactin ) and the other helps in releasing of this milk(oxytocin) in response to suckling. Suckling acts as a stimulation for the hormonal pathway to set in.

What is lactating? 

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 muscles (buccinators) 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. 

How do I know that baby feeding is well? 

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. 

How do I burp the baby and why it is necessary? 

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. 

Why do women get cracked nipples? 

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 ) 

What should I eat when lactating?

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 traditional Indian 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 breasfeeding session is a good practice to follow. 

How can I effectively breast feed? 

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. 

Is it true that after the cesarean section the breastfeeding is not initiated as expected? 

The reason for doing the cesarean section decides the initiation of breastfeeding. cesareans are commonly performed for baby indications. thus if the baby is not very well at birth or is premature or growth-restricted, breastfeeding may be delayed. these babies need to be fed from the blood vessels or the mouth tube as their systems are not mature. If the baby is healthy breastfeeding is immediately encouraged. 

Mother can find the surgery or the delivery process tiring and painful and may find it difficult to handle the baby and this can cause a delay in breastfeeding initiation.

Doctor its been 14 days and my nipples are sore ………said TG my recently delivered PrimiP. What do I do?

It’s absolutely normal to experience such nipple soreness. It is due to repeated suckling and it gradually goes off. one can use some lubricants or gels . or the breastmilk itself is a good emollient. Keeping the nipples clean, using cotton underwear and proper support to the breasts are the solutions. sometimes baby can have a mouth infection which can cause such soreness 

My baby doesn’t seem to be satisfied and is constantly crying out for feeds ……once again TG 

 Breastfeeding is not only the source of nutrition but it also is a source of warmth and security for the baby .so you must focus when you are feeding the baby . its should feel comforted so cuddle it and it should feel secure so you can have your own ways of talking to your baby and don’t discuss something else or be on your mobiles or generally watch television while feeding your baby 

Why is breast feeding important? 

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 baby”s alimentary( digestive ) 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 from 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.

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