Breast Feeding

Breast Feeding

Although most breastfeeding mothers choose to stop at some point in the baby’s first year of life, others continue for longer, sometimes in to toddler and school age. Prolonged breast feeding beyond 2 years old is controversial in the western world but it is strongly advocated by some women’s groups who feel it should be the child’s choice when to stop. No matter how long a woman decides to breast feed, it is a personal choice and there are benefits for the child immediately and for the years ahead. There is no evidence to suggest that prolonged breastfeeding into childhood is harmful to the child’s physical or psychological wellbeing, provided they are happy and comfortable continuing to do so. Some mother’s are made to feel uncomfortable by family or friends who think it is strange to breastfeed an older baby or toddler. These women often decide to breastfeed in private for the sake of an easier life, but in reality it is no one’s business but theirs. After all, in a different time in history or place in the world, breastfeeding an older child would be entirely acceptable.

In addition to the nutritional benefits previously mentioned, the advantages of breastfeeding are numerous both for the child and mother. Breastfed babies immune systems are boosted and they gain extra protection from antibodies, other proteins and immune cells in human milk. This is particularly important in the first 3-4 months of life as the baby’s own defences are just developing. They are less likely to get stomach upsets, diarrhoeal illness, ear and respiratory infections. Babies who are breastfed for at least 3-4 months are less likely to develop eczema, asthma and allergies, including food allergies. Breastfed babies are less likely to be obese as children and as adults, and children and adults who were breastfed as babies are less likely to suffer from diabetes, high blood pressure and have other risk factors for heart disease. Breast-fed babies have faster motor and mental-skills development with higher IQ scores compared to formula fed babies.

Breastfeeding helps a mother form an intimate bond with her baby and helps to nurture children. It can be a very relaxing and rewarding experience for both mother and baby. It is more convenient and is cheaper than formula feeding as it is free and milk is always available wherever you go. Breast milk is produced on demand and there are no leftovers to deal with. There is no milk preparation needed, no heating (it is the perfect temperature), and there is no worry about cleaning and sterilizing bottles and teats or storing formula.

Breast fed babies have less smelly diapers and vomit. Breast milk is easily digested so breastfed babies are unlikely to get constipated and have less colic than formula fed babies.

There are several health advantages for a woman who breastfeeds. If she exclusively breastfeeds her baby in the first six months (i.e. no solids, formula, water or pacifiers), breastfeeding can provide effective contraception.  Breastfeeding women tend to lose weight more quickly and achieve their pre-pregnancy weight. In the longer term, breastfeeding can reduce pre-menopausal breast cancer by 22% and postmenopausal breast cancers are also reduced. There is also a 20-25% risk reduction for ovarian cancer in women who breastfed for at least two months for every birth. Osteoporosis is also less common in women who have breastfed.

There are very few medical reasons why a woman should not breastfeed. These might include being on certain medications for a long-term condition or if there are concerns about transmission of severe maternal infection such as HIV or hepatitis. Drug therapy during pregnancy and birth, planned caesarean sections and safe replacement feeding (no breastfeeding) can reduce HIV transmission from mother to child to less than 2%.

If breastfeeding is to be a successful and enjoyable experience, a mother should receive adequate information and support. Just because breastfeeding is “natural”, does not mean that it is easy or comes naturally to every mother. Successful breastfeeding takes determination, patience and persistence. Women may experience problems with positioning and latching the baby to the breast. Help and advice can be sought from midwives, experienced mothers, paediatricians and obstetricians, breastfeeding counsellors and groups such as La Leche League. There are a lot of forms of information and support groups accessible on the World Wide Web.

Sore nipples are a common problem in the early stages of breastfeeding. Measures to prevent this include proper positioning and latching on, exposing the nipples to air as much as possible, or using dome-shaped breast shells, use of specific ointments which do not need to be washed off, avoidance of repeated washing of the nipples, and alternating feeds from each breast.

Occasionally fungal infection (due to candida albicans) can cause sore nipples. This can cause knife-like pain that continues throughout the feed and may have a sudden unexplained onset when feeding has previously been painless. This may require treatment.

Some women may experience symptoms of mastitis (blocked and inflamed milk duct) whilst breastfeeding. A hardened, red, tender area of the breast is noticeable, sometimes associated with a short feverish episode. Often continuing to feed with the affected breast, warm compresses plus oral fluids and paracetamol are enough for the mastitis to resolve. If, despite these measures, the symptoms continue, a doctor should be consulted as very occasionally antibiotics are needed.

Women are more likely to be happier breastfeeding and do so for longer if they have a supportive partner. It is not uncommon for male partners of breastfeeding mothers to feel left out. He may feel that he’ll have a harder time bonding and developing a relationship with his child or may have a sense of inadequacy, thinking that nothing he does for his child could ever compete with his partner’s breasts. He might feel resentment towards the baby who has “come between” him and his partner or that, because a woman can breastfeed, they somehow possess the knowledge and skills that make them naturally better parents.
There are several things a male partner can do to take an active role in the care of the new baby and promote bonding. Spending time alone together, going out for walks, cuddling, changing diapers, putting the baby to sleep, bathing or sometimes even reading on a chair whilst allowing the baby to sleep on your chest are great relationship builders for fathers. Women can express breast milk, usually once breastfeeding is established, through a pump or manually. This gives father’s the opportunity to feed the baby. Fathers should keep in mind that women may be less interested in sex than in the pre-baby days. Lactating women produce fewer ovarian hormones so may have lower libido and less vaginal lubrication. Intercourse may be uncomfortable or even painful. If the mood does arise, a good water based lubricant may make the moment more enjoyable for both partners.

All in all, the benefits of breastfeeding are great to both mothers and babies. The decision to breast feed is a personal one and each woman should make her mind up after receiving adequate information on its benefits. This simple act protects children’s health and saves lives in communities around the world as well as reducing maternal mortality.

Dr. Leon Dupuch, BSc., M.B.B.S., Dip. RCOG/RCR, MRCOG, CCT(UK)

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