♀ Breast Feeding

Introduction To Breast Feeding

Midwives, health-visitors and doctors all highly recommend breast feeding for numerous reasons. Breast milk contains the perfect balance of nutrients for your baby, and also antibodies that will boost your baby's immune system providing a strong defence against infection. Breast stimulation by your baby immediately after delivery encourages your uterus to contract and hence reduces bleeding. Breast feeding enhances bonding with your baby. There are very few medical reasons why a mother shouldn't breast-feed.

Cow's milk and soya contain different sets of proteins to human milk. Most formula milks are derived from cow's milk which may be perfect for calves, but babies can have difficulty digesting it. Bottle fed infants tend to be fatter than breast-fed infants, but not necessarily healthier.

The volume of milk you produce for your baby is independent of the size of your breasts, as both small and large breasts contain virtually the same amount of mammary glands. Only the fatty tissue varies.< Colostrum is the first food available to breastfeeding newborns, and is tailor-made to meet the nutritional requirements. Breast feeding babies do not require the large volumes of fluid required by bottle fed babies during the first few days of life.

Infection

Breast milk may reduce the onset of late onset B streptococcal disease, a potentially lethal condition that rarely afflicts newborn babies.⁰⁴⁰¹

It has been suggested that the antibodies in breast milk would be neutralized by the acids in your baby's stomach. However, it has been shown that protective factors are present in higher concentrations in the stools of breast-fed infants than in stools from formula-fed infants.⁰²⁰¹

A breast-fed baby's digestive tract contains large amounts of Lactobacilli, which are beneficial bacteria that prevent the growth of harmful organisms. Human milk straight from the breast is always sterile and never contaminated by polluted water or dirty bottles which can lead to diarrhoea in the infant.

Breast-fed infants have a lower incidence of diarrhoea, respiratory disease, ⁰³⁰¹and otitis media (middle ear infection).^9901,0301

Diarrhoea claims a toll of 5 million children each year in the developing countries. The risk of dying from diarrhoea would be reduced 14-24 fold by universal breast feeding. ⁰³⁰¹

Predominantly breast feeding for at least six months and partial breast feeding for up to one year may reduce the prevalence and subsequent morbidity of respiratory illness and infection in infancy.0302 The American Academy of Pediatrics recommends that babies be breast-fed for six to 12 months. In the USA, almost two thirds of children had ever been breastfed and only 27.0% and 12.3%, at 6 and 12 months respectively, were receiving some breast milk.0303 In a study in Greece reported in 2007, breastfeeding initiation was reported by 96.1% of the participants but exclusive breastfeeding was initiated only in 19.1% and predominant breastfeeding in 7.2% of the cases.0505 On-going breast feeding continues to require encouragement.

Full breastfeeding lowers the potential chance for hospital admission as a result of infections among infants who are younger than 1 year within an industrialized country .^{0601,0701, 0702}

Breast milk reduces childhood asthma and skin problems such as eczema, ^0402,0501 childhood and adolescent obesity0502 and it seems to have a beneficial effect on blood pressure, lipid profile and possible insulin resistance/type-2 diabetes. ⁰⁷⁰¹

Breast feeding may protect against infection later on in childhood. There seems to be an association between a high breastfeeding rate in the population and a reduced incidence of HI meningitis 5 to 10 years later. ⁹⁹⁰²

Breast feeding reduces the prevalence of several chronic diseases . It has been estimated that in the population of the 596,122 babies born in England and Wales in 2002, the number of cases of asthma, obesity and coeliac disease that could have been prevented over 7-9 years if babies that had "no breast feeding" as a risk factor would have received breast milk were 33,100 for asthma, 13,639 for obesity and 2,655 for coeliac disease. ⁰⁷⁰³ The prevalence of childhood leukaemia is reduced in children who had been breast fed. ⁰⁶⁰²

Human milk is flavoured by the taste of the food that the mother has eaten and provides her baby with its first insight into the rich variety of culinary delights to come. Second, the infant's response to a particular flavour in milk may depend upon the recency and duration of previous exposures.

Breast-feeding has been significantly and positively associated with educational attainment achieved in childhood and even as far as age fifty.⁰²⁰² There is, however, conflicting evidence on the benefits of breast feeding with intelligence with some showing a positive relationship⁹⁸⁰¹ and others finding that a child's intelligence is unrelated to initial feeding method.⁰⁷⁰⁵

Advantages For The Mother

Natural feeding allows you and your baby to get closer - physically and emotionally. So while your child is feeding, the bond between you can grow stronger. Mothers who breast feed are less affected by stress. ^0001,0204

Despite popular belief, there is no compelling evidence that breastfeeding is effective in combating postpartum depression.

Breast milk is free so that you can save a lot of money not having to purchase formula and it is readily available. Women who breast feed return to their pre-pregnancy figure faster as they give calories to their babies. ⁰⁵⁰⁴

Breast feeding suppresses ovulation (egg release), reduces menstruation and the possibility of pregnancy, but there are no guarantees. Mothers who do not plan to conceive should use contraception even while nursing. The mini-pill is acceptable but the combined pill can suppress milk production.

Rheumatoid arthritis ⁰⁴⁰⁴ and hip fractures due to osteoporosis⁰⁵⁰⁴ after the menopause. are less common in those who have breast fed their babies.

Breast feeding reduces a mother?s risk of developing breast cancer 9201, 0403, 0504, 0701 and ovarian cancer .^0501,0504 Breast cancer risk decreases according to the total months of breast-feeding. Average duration of breast-feeding of 11-12 months reduces the risk of breast cancer by 54% compared with the duration of 1-4 months. ⁰⁷⁰⁴

Some medications contraindicate breast feeding. Always check with your health care provider. Most common illnesses, such as colds, flu, skin infections, or diarrhoea, cannot be passed through breast milk. Just a few viruses can pass through breast milk. Unfortunately, HIV, the virus that causes AIDS, is one of them. Women who are HIV positive should, therefore, not breast-feed.

Breast feeding can have some disadvantages. In the early weeks, it can be painful. A woman's nipples may become sore or cracked. She may experience engorgement more than a bottle feeding mother, when the breasts become so full of milk that they become hard and painful. Some nursing women also develop clogged milk ducts, which can lead to mastitis, a painful infection of the breast. While most nursing problems can be resolved with home remedies, mastitis requires prompt medical care.

A nursing mother is tied to her baby more than a bottle-feeding mother. The baby needs her for nourishment and she needs to nurse regularly to avoid uncomfortably full breasts.

Some women simply do not feel comfortable with the idea of nursing. They find the thought of handling their breasts to be unattractive, or they want to think of them solely as sexual, and not functional. They may be concerned about modesty and the possibility of having to nurse in public. They may want a break from child care to let someone else feed the baby, especially in the small hours of the morning.

If a woman is unsure whether she wishes to nurse, she can try it for a few weeks. It's very difficult to switch to breast-feeding after bottle-feeding is begun.

The decision to breast-feed is a personal one. Provide yourself with all the information you require and then come to a decision. Obstetricians, paediatricians, childbirth instructors, nurses, health visitors and midwives can all offer information about nursing. But perhaps the best ongoing support for a breast feeding mother is someone who has successfully nursed a baby, particularly her mother. Only you can decide if breastfeeding is right for you.

Technique

Breastfeeding can commence soon after the baby is born. The baby is usually awake at this time and will eagerly search for the breast.
First, the mother should make herself comfortable.
Then the baby should be laid close to the mother lying with its stomach facing its mother's stomach and with its head bent a little backwards. This way its nose is automatically free of the breast. Most babies are eager to suckle as soon as they feel the nipple against their cheek.
If the baby is not reacting or is too sleepy, the suckling reflex can be encouraged by gently stroking the baby's cheek and lips with the fingertips. The baby will then turn its head and search for the nipple with an open mouth. Do not stroke both cheeks as it will confuse your baby. The same sort of stimulation can be used if you find that the baby is either drinking slowly or is falling asleep at the breast.
The baby has to be at one breast as long as possible before moving on to the other breast; 20 minutes is reasonable.
For the baby to suckle properly, the nipple has to be well inside the baby's mouth. The whole nipple and its surrounding brown circle, the areola, have to disappear into the baby's mouth or the baby will not be able to create a vacuum between its tongue and the soft back part of its palate. If the baby only suckles the tip of the nipple it will not empty the breast and the nipples will become sore.
It is a good idea to get into the habit of taking the baby gently away from the breast. If the baby is pulled away in the middle of feeding, your nipples will become sore quite quickly. Instead, put the tip of the little finger in the corner of the baby's mouth and he or she will automatically open his or her mouth. This will break the vacuum the baby creates in its mouth to suckle.
The amount of milk produced depends on how often the baby suckles.
When you feed the baby, the suckling motion causes hormones to be released into the bloodstream from the pituitary gland in the brain. The hormones released are oxytocin and prolactin.
Oxytocin causes the mammary glands in the breast to contract, releasing milk for the baby. Many women experience this as a pulling sensation or a weight on their breast when the baby begins suckling. The prolactin controls the volume of milk produced. The more the baby is fed, the more prolactin is released and the more milk produced.

Links to reference abstracts.

The aim of this web site is to provide a general guide and it is not intended as a substitute for a consultation with an appropriate specialist in respect of individual care and treatment.

David Viniker retired from active clinical practice in 2012.
In 1999, he setup this website - www.2womenshealth.com - to provide detailed
information many of his patients requested. The website attracts thousands of visitors every day from around the world.
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The Advantages and Disadvantages of breast feeding

Introduction To Breast Feeding

Infection

Advantages For The Mother

Technique

Links to reference abstracts.