Breastfeeding is the most natural and by all accounts the best food that the newborn baby can have. For some breastfeeding comes naturally, while for many others this natural skill needs to be augmented by assistance from experienced mothers and breastfeeding counselors.
Some common misconceptions have created problems for breastfeeding mothers, in some leading to failure of feeding.
I will be discussing some of these common misconceptions here.
Small are breasts less capable of making milk!
It has been shown that the milk producing parts of the breast are of the same size in breasts of different sizes. The difference in size has been found to be due to difference in amount of supportive tissue like fat.
So breasts of different sizes are still capable of making good volume of good quality breast milk, regardless of whether they are small or big.
The size of the nipple affects breast feeding!
The size of the nipple may cause some difficulty with attachment and cause difficulty with latching on. However, with good attachment technique these problems can be over come and good feeding established.
It is important to note that with good attachment, the baby is not holding onto or sucking on the nipple! The nipple is deep inside the mouth and is only little more than the outlet for the milk.
With too large a nipple occasionally baby may have gagging. With time, the baby adjusts to this and can achieve good feeding.
No milk comes in during the first 2-3 days after birth!
Milk does come soon after birth. The first milk that comes is different in composition and is called Colostrums. Colostrum contains many important constituents; most importantly it contains agents that improve the immunity of the newborn baby.
It is true that the volume of milk is much less during the first few days, but the colostrums has more calories per volume than the milk that comes in later.
The transition to what is called the "mature milk" occurs during the first week to 10 days. This transition occurs sooner if the baby is allowed to suckle as frequently and for as long as he wants to.
Baby needs some water during the first few days!
Baby does not require any additional water at all during the first 6 months of life. The reason I say additional water is because breast milk contain about 70-80% water by volume. This is more than enough for the baby.
The additional water if given will be filling the baby's small capacity stomach with non-calorie containing fluid in place of breast milk that contains both calories and water.
Baby has to be given water to clean his mouth after a feed!
Breast milk contains agents that prevent the growth of bacteria and other harmful organisms. There is no point in washing away this protective effect of breast milk with water.
Some mothers are concerned about the yellowish color seen over the baby's tongue. This is a normal finding and is due to the fat content of the breast milk.
Others are worried that if the milk is not washed away, oral thrush may occur. Breast milk contains anti-fungal agents to that prevent that from happening.
Mothers who have had Caesarean section make less milk!
Some mothers (and their relatives) worry that because a mother is not allowed to drink and eat soon after a Caesarean section, they will not make enough or any milk at all.
These mothers are given fluids by other mean during this time. If fluid goes into the mothers body (whether by oral route or not) it does not make any difference. Water will still be available to make milk.
They may have reduced milk production for other reasons. Pain, discomfort and worry are known to reduce the amount of Prolactin (the hormone that act on the milk producing glands in the breast to make milk) that can result is reduced milk production.
Mothers need to drink milk to make breast milk!
Mothers need a nutritious diet to make breast milk. Milk may be part of that diet. However, milk is not necessary to make breast milk.
A balanced nutritious diet whether milk is a part of it or not make equally good breast milk.
Baby needs to be fed every 2 hourly!
Many mothers have been told that their baby needs to be fed every 2 hourly, especially during the first few weeks to a month.
The baby would need to be fed as frequently as he demands; this maybe every half-hourly or 3 hourly. In some babies, if not most, there is no fixed time interval between feeds.
If the baby is hungry, he needs to be fed and if he is not hungry he should not be forced to feed. A baby will wake up and demand feeds when he feels hungry.
Rigid feeding schedules (like 2 hourly feeds) can cause the baby to refuse feeds or take progressively less volume (or spend less time) at each feed because he may be filling up a stomach which is still too full! This refusal or apparent reduced feeding could cause much concern to the mother.
If the baby's nose touches the mother breast during a feed he can suffocate!
Mothers who have been either told this or believe it to be true on their own will be very concerned during each feed.
With a good attachment, having the baby's chin touching the mothers’ breast, the nose should be as far away from the breast as is possible. With the mouth (attached to the breast) acting as a fulcrum, the closer the chin is the further from the breast the nose moves.
Even if the nose does touch the breast, a very common finding even with good attachment, there is not risk of suffocation. The baby is attached to the breast on his own choice, he should not be held on to the breast by force. If for any reason the bay cannot breathe because of blocked nose (and touching the breast is not one of them), he would let go of the breast to breathe (his natural reflex being to cry).
Baby has to be fed from both breasts at each feed!
Once the "mature milk" has set in the character of the milk changes during the course of each feed. The milk that comes out during the first few minutes of each feed (called fore-milk) contains more water by volume. The milk that comes during the later part of the feed (called hind-milk) contains more fat and proteins and less water by volume that the fore-milk.
For this reason it is important to feed from the first side that is offered till that side is emptied, so that the baby gets the goodness of the proteins and fats in the hind-milk.
If the baby was offered one breast first and then before it was emptied, is offered the second one, he would not get much protein or fat that is essential for his growth.
The second breast should be offered if the baby is still hungry after finishing feeds from one side.
Breastfeeding has to be stopped if the mother becomes sick!
With most illnesses there is no need to stop breastfeeding. However with some illnesses and use of some medications breastfeeding has to be withheld for some time.
For minor illnesses, breast feeding should not be discontinued. If there is any doubt, the mothers’ doctor would need to be consulted especially for this issue.
If breastfeeding mother who becomes pregnant should stop feeding!
Some mothers have been advised to stop feeding their baby because they got pregnant with another.
There is no need for this. There is no evidence that breast feeding during pregnancy has any negative effect on the unborn baby or the breast milk itself.
However it is important to note here that, in this situation, mothers would need more nutrients to keep up with the demands of the unborn baby and production of milk.
Some common misconceptions have created problems for breastfeeding mothers, in some leading to failure of feeding.
I will be discussing some of these common misconceptions here.
Small are breasts less capable of making milk!
It has been shown that the milk producing parts of the breast are of the same size in breasts of different sizes. The difference in size has been found to be due to difference in amount of supportive tissue like fat.
So breasts of different sizes are still capable of making good volume of good quality breast milk, regardless of whether they are small or big.
The size of the nipple affects breast feeding!
The size of the nipple may cause some difficulty with attachment and cause difficulty with latching on. However, with good attachment technique these problems can be over come and good feeding established.
It is important to note that with good attachment, the baby is not holding onto or sucking on the nipple! The nipple is deep inside the mouth and is only little more than the outlet for the milk.
With too large a nipple occasionally baby may have gagging. With time, the baby adjusts to this and can achieve good feeding.
No milk comes in during the first 2-3 days after birth!
Milk does come soon after birth. The first milk that comes is different in composition and is called Colostrums. Colostrum contains many important constituents; most importantly it contains agents that improve the immunity of the newborn baby.
It is true that the volume of milk is much less during the first few days, but the colostrums has more calories per volume than the milk that comes in later.
The transition to what is called the "mature milk" occurs during the first week to 10 days. This transition occurs sooner if the baby is allowed to suckle as frequently and for as long as he wants to.
Baby needs some water during the first few days!
Baby does not require any additional water at all during the first 6 months of life. The reason I say additional water is because breast milk contain about 70-80% water by volume. This is more than enough for the baby.
The additional water if given will be filling the baby's small capacity stomach with non-calorie containing fluid in place of breast milk that contains both calories and water.
Baby has to be given water to clean his mouth after a feed!
Breast milk contains agents that prevent the growth of bacteria and other harmful organisms. There is no point in washing away this protective effect of breast milk with water.
Some mothers are concerned about the yellowish color seen over the baby's tongue. This is a normal finding and is due to the fat content of the breast milk.
Others are worried that if the milk is not washed away, oral thrush may occur. Breast milk contains anti-fungal agents to that prevent that from happening.
Mothers who have had Caesarean section make less milk!
Some mothers (and their relatives) worry that because a mother is not allowed to drink and eat soon after a Caesarean section, they will not make enough or any milk at all.
These mothers are given fluids by other mean during this time. If fluid goes into the mothers body (whether by oral route or not) it does not make any difference. Water will still be available to make milk.
They may have reduced milk production for other reasons. Pain, discomfort and worry are known to reduce the amount of Prolactin (the hormone that act on the milk producing glands in the breast to make milk) that can result is reduced milk production.
Mothers need to drink milk to make breast milk!
Mothers need a nutritious diet to make breast milk. Milk may be part of that diet. However, milk is not necessary to make breast milk.
A balanced nutritious diet whether milk is a part of it or not make equally good breast milk.
Baby needs to be fed every 2 hourly!
Many mothers have been told that their baby needs to be fed every 2 hourly, especially during the first few weeks to a month.
The baby would need to be fed as frequently as he demands; this maybe every half-hourly or 3 hourly. In some babies, if not most, there is no fixed time interval between feeds.
If the baby is hungry, he needs to be fed and if he is not hungry he should not be forced to feed. A baby will wake up and demand feeds when he feels hungry.
Rigid feeding schedules (like 2 hourly feeds) can cause the baby to refuse feeds or take progressively less volume (or spend less time) at each feed because he may be filling up a stomach which is still too full! This refusal or apparent reduced feeding could cause much concern to the mother.
If the baby's nose touches the mother breast during a feed he can suffocate!
Mothers who have been either told this or believe it to be true on their own will be very concerned during each feed.
With a good attachment, having the baby's chin touching the mothers’ breast, the nose should be as far away from the breast as is possible. With the mouth (attached to the breast) acting as a fulcrum, the closer the chin is the further from the breast the nose moves.
Even if the nose does touch the breast, a very common finding even with good attachment, there is not risk of suffocation. The baby is attached to the breast on his own choice, he should not be held on to the breast by force. If for any reason the bay cannot breathe because of blocked nose (and touching the breast is not one of them), he would let go of the breast to breathe (his natural reflex being to cry).
Baby has to be fed from both breasts at each feed!
Once the "mature milk" has set in the character of the milk changes during the course of each feed. The milk that comes out during the first few minutes of each feed (called fore-milk) contains more water by volume. The milk that comes during the later part of the feed (called hind-milk) contains more fat and proteins and less water by volume that the fore-milk.
For this reason it is important to feed from the first side that is offered till that side is emptied, so that the baby gets the goodness of the proteins and fats in the hind-milk.
If the baby was offered one breast first and then before it was emptied, is offered the second one, he would not get much protein or fat that is essential for his growth.
The second breast should be offered if the baby is still hungry after finishing feeds from one side.
Breastfeeding has to be stopped if the mother becomes sick!
With most illnesses there is no need to stop breastfeeding. However with some illnesses and use of some medications breastfeeding has to be withheld for some time.
For minor illnesses, breast feeding should not be discontinued. If there is any doubt, the mothers’ doctor would need to be consulted especially for this issue.
If breastfeeding mother who becomes pregnant should stop feeding!
Some mothers have been advised to stop feeding their baby because they got pregnant with another.
There is no need for this. There is no evidence that breast feeding during pregnancy has any negative effect on the unborn baby or the breast milk itself.
However it is important to note here that, in this situation, mothers would need more nutrients to keep up with the demands of the unborn baby and production of milk.
التسميات: breast feeding, feeding during pregnancy, misconceptions
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