Breast-feeding, the best source of food for babies

Breast-feeding, the best source of food for babies

By Donya Betancourt

SANUR, Bali (JP): As we know , breast-feeding is the perfect
source of food for babies, it is full of nutrition and immunities
and it is the cheapest milk in the world.

But a few mothers have problems when breast-feeding. Why is
breast-feeding so simple and easy for one mother and, at the same
time, it is so hard and difficult for the other, especially a
working mother? What is the problem?

Feeding is something babies have to learn. When a newborn baby
is hungry or thirsty, he feels uncomfortable so he cries but at
this early stage he is not crying to be fed. Not until after
suckling will he learn that suckling brings food and comfort.

Some babies are already sucking their fingers in the womb and
when they are born they suck anything that comes their way making
it easier for their parents. Other babies are quite different.
They cry but when their mothers try nursing them they yell even
more, possibly making the mom feel anxious. But don't worry, once
they have suckled a few times, the feeding lesson is learned.

Starting with breast-feeding keeps your options open while
giving baby a host of benefits. If you find you don't enjoy it,
or it doesn't suit you, you can always switch to bottle-feeding.
But if you start with the bottle, you can't switch to breast milk
because your breasts will not be producing milk.

The fact is, breast-feeding is not instinct. It is a learning
process between mother and baby so the mother should learn as
much as possible about it before the baby is born. The best
person to learn from is someone who has successfully nursed a
baby, also obstetricians, pediatricians, nurses and midwives can
help.

Question: Can the mother guarantee success in breast-feeding?

Answer: Almost always if the mother follows a few steps, such
as during pregnancy the mother eats optimal nutrition foods i.e.
all five food groups: meat, dairy products, grains, fruit and
vegetables; and increases intake by 300 Kcal a day more than
before pregnancy and gains at least 10 kg.

Take care of your breasts by using a support bra during
pregnancy because breast weight will increase by three to four
times. If the mother has a blind nipple, she should get early
advice. Do not massage the breasts in your third trimester
because it may stimulate preterm labor.

After delivery. Tips are early suckling, proper suckling and
frequent suckling with no water or formula supplements. Nursing
should begin as early as possible. The best time is within an
hour and not more than six hours after delivery.

Positioning the baby so it has a good latch on the areola is
important for success. First, roll the baby's body in towards you
while the baby's mouth should be wide open and then, move the
baby onto the breast with his jaw well down the areola and its
mouth full of breast and the nipple down right back in the baby's
mouth.

The baby doesn't suck milk from the nipple but presses the
milk sacs with his jaws and tongue. The more the baby suckles the
more milk is produced so the baby should be fed frequently, at
least every two hours and not on any strict schedule.

Why is breast milk so good?

Breast milk has optimal nutrition and provides the best
immunity for babies.

As regards the nutrition aspect, in the first two to three
days after giving birth you will produce creamy "colostrum",
which has the right amount of water, sugar, protein, and minerals
plus many important antibodies from you that protect the baby's
health while he is building his own immune system. There is no
artificial equivalent of colostrum. From three days to two weeks
after that, you will produce "transitional milk" and then "mature
milk", which is higher in energy, with carbohydrate and fat but
less protein than colostrum.

Protein in breast milk has no "beta-lactoglobulin", which is
found in cow's milk and causes allergies. Mother's milk
carbohydrate is lactose, which is easy to digest and also has an
effect on stool formation -- which is why a stool from a breast-
feeding baby is softer than that from a bottle-feeding baby.

The fat in breast milk has essential fatty acids in the
concentration that baby needs. If the mother eats right, the
breast-fed baby will get all the vitamins that it needs without
supplements. Minerals in breast milk are absorbed better than
they are with cow's milk.

As for the immunity aspect, it is true that breast-fed babies
have less gastrointestinal and respiratory infections than
bottle-fed babies. You don't have to worry about the hygiene of
breast milk because it comes right out from your own breast at
the right temperature and level of sterility. Other than that it
also has antibodies, antiviral factor, bidifidus growth factor
(which inhibits yeast, bacteria, e.g. Eschericia coli,), white
blood cells, and some other beneficial enzymes that inhibit
bacteria and yeast.

Which nutrients are inadequate in breast milk?

Iron should be supplemented when solid foods are started.
Vitamin D should be added when exposure to sunlight is reduced.
It is also recommended for dark-skinned infants.

Are formula and water supplements necessary in breast-fed
babies?

No!

How long can I feed my baby breast milk?

It is recommended to feed for at least one year with the
introduction of supplementary food at four to six months. The
amount of milk production differs at different times. In the
first month the amount is 500-700 gm/day. It will reach a maximum
of 700-1100 gm/day at 9 months and slowly decrease to 350-700
gm/day at 24 months. The carbohydrate content is quite similar
over the whole period up to 2 years but protein and fat will
decrease after 1 year. The important thing is to breast-feed your
baby as long as possible and enjoy it, even 1 month is better
than nothing.

Should breast-feeding be continued throughout most maternal
illness?

Yes. The exceptions are where the mother is HIV positive, or
has active untreated tuberculosis, herpes of the breast region or
primary herpes. Most common illnesses such as colds, diarrhea, or
breast skin infection (mastitis) can't pass through breast milk.
If a breast abscess occurs, nursing can continue on the
unaffected breast.

Which drugs should be avoided during breast-feeding?

Oral anticoagulants (coumadin) may produce a bleeding problem;
tetracycline produces dental staining; thiouracil may inhibit the
infant's thyroid function; and cimetidine which achieves higher
levels in milk than in maternal serum, antineoplastic agents
(chemotherapy), radioactive drugs, lithium, atropine, and ergot
alkaloid.

Is it true that breast-feeding decreases the risk of childhood
obesity?

There was a study done in Germany in 1999 and the results show
a prevalence of obesity in children who have never been breast-
fed at a rate of 4.5 percent as compared with 2.8 percent in
breast-fed children.

The study also showed that the duration of breast-feeding
effects the prevalence of obesity: 3.8 percent for two months of
exclusive breast feeding, 2.3 percent for three to five months,
1.7 percent for six to 12 months, and 0.8 percent for more than
12 months.

In industrialized countries promoting prolonged breast-feeding
may help decrease obesity in children. As obese children have a
high risk of becoming obese adults, this will also decrease the
risk of cardiovascular disease and other related diseases of
obesity.

There are many common questions and problems which arise when
breast-feeding. The next issue will discuss some problem cases.
Wishing you every success in giving your baby the best start.

-- The writer, a pediatrician based in Sanur, Bali, welcomes
questions, comments and concerns through drdonya@hotmail.com.