Breastfeeding

 

Breastfeeding is an ideal food for a normal neonate. It is the best gift that a mother can give to her baby.

The basic food of infant is mother milk. Breastfeeding is the effective way to provide a baby with a caring environment and complete food.

Breastfeeding meets the nutritional as well as emotional and psychological needs of the infant.

Benefits of Breastfeeding for Newborn and Lactational Mother

1. Breast milk contains all the nutrients in the right proportion which are needed for optimum growth and development of the baby up to the 6 months.
2. It is essential for brain growth of the infant because it has high percentage of lactose and galactose which are important components of galactocerebroside.
3. Lactose helps in absorption of calcium and promotes growth of lactobacilli.
4. Breast milk contains amino acids like taurine and cysteine which are important as neurotransmitters
5. Helpful in the myelination of the nervous system.
6. Breast milk contains mineral like potassium, calcium, sodium and chloride etc.
7. The protein of breast milk is mostly lactoalbumin and lactoglobulin which is easy to digest.
8. Enzyme lipase helps in digestion of fat and provide fee fatty acids example Arachidonic acids (ARA) or Docosahexaenoic acid (DHA).
9. Breast milk contains Vitamin D that protect newborn from the rickets.
10. Protect child from infection because it contains high amount immunoglobulins IgA and IgM or macrophages, lymphocytes, bifidus factors (Promote lactobacillus bifidus grow), unsaturated lactoferrin (Increase Iron Absorption), lysozyme and interferon (viral replication inhibited).
11. Breastfeeding promotes close physical and emotional bondage with the mother by frequent skin to skin contact, attention and interactions.
12. Breastfeeding promotes development of higher intelligence and feeling of security in infant.
13. Protect the infant from allergy.
14. Decrease the chance of postpartum hemorrhage and helps in involution of reproductive organs of mother.
15. Lactational amenorrhea promotes in recovery of iron stores in mother.
16. Breastfeeding decrease the risk of breast, ovarian and other reproductive organ cancer of the mother.
17. Breastfeeding is more convenient and time saving for the mother.
18. Mother can provide fresh, pure, ready-made, clean uncontaminated milk to her baby at right temperature without any preparation.
19. Save money, time and energy of parents. 
20. Act as a natural contraception.

Different Composition of Breast Milk

The composition of breast milk varies at different stages in the postnatal period to fulfil the nutritional need of the baby.

(1) Colostrum

1. It secretes first three days after delivery.

2. It is thick, yellow and small quantities.

3. It contains more antibodies and cells with higher amount of proteins and fat-soluble vitamin (A, D, E, K).

4. It is sufficient and protective for the baby and should not be discarded.

(2) Transitional Milk 

1. It's secretion starts follows the colostrum and secretes during first two weeks of postnatal period.

2. It has increased fat and sugar content and decreased protein and immunoglobulin content.

(3) Mature Milk

1. It is secreted usually from 10 to 12 days after delivery.

2. It is watery but contains all nutrients for the optimal growth of baby.

(4) Preterm Milk

1. This milk is secreted by a mother who has delivered a preterm newborn.

2. It contains more protein, sodium, iron, immunoglobulin and calories appropriate for the requirement of the preterm newborn.

(5) Fore Milk

1. It secreted at starting of the regular breast feeding.

2. It is more watery to satisfy the baby thirst and contain more protein, sugar, vitamins, minerals. 

(6) Hind Milk

1. It is secreted towards the end of regular breast feeding.

2. It contains more fat and energy which helps in weight gain of baby.

Physiology of Lactation

Although lactation starts following delivery, the preparation for effective lactation starts during pregnancy.

On the basis of  physiology of lactation, the lactation is divides into four phases:

1. Mammogenesis: Preparation of breast for lactation.
2. Lactogenesis: Start synthesis and secretion of milk from the breast alveoli.
3. Galactokinesis: Ejection of milk outside the breast.
4. Galactopoiesis: Maintenance of lactation.

Right Technique of Breastfeeding

1. Mother should be relaxed and comfortable physically & mentally before feed her baby.

2. Perform hand washing before and after the feeding.

3. Feed her baby in sitting position, the baby in an inclined upright position on her lap, the baby head on her forearm on the same side close to her breast. The neck is slightly extended.

4. Good attachment means baby mouth wide open, chin touches the breast and most of areola and nipple in the mouth or baby lower lip is everted.

5. Feeding in lateral position is given after caesarean section delivery.

6. Good sucking stimulates milk secretion and Prolactin reflex.

7. Milk ejection is occurred by Oxytocin reflex. (Let down reflex)

8. Feeding is on demand of baby (when your baby is hungry).

9. Feed the baby until the baby satisfied usually 15 to 20 minutes for each feeding.

10. After the infant has nursed, release suction by depressing the infants chin or inserting a clean finger into the infant’s mouth.

11. Burp baby well every after feeding. 

Hormones of Breastfeeding

Two hormones play important role during lactation period of mother.

(A) Prolactin Hormone: 

1. Responsible for lactation.

2. It is secreted by anterior pituitary gland.

3. Responsible for milk secretion reflex.

(B) Oxytocin Hormone: 

1. Responsible for milk ejection reflex/let down reflex.

2. Release from posterior pituitary gland.

Contraindication of Breastfeeding

1. Infant with HIV positive mother.

2. Galactosemia or Phenylketonuria. Phenylalanine hydroxylase enzyme (PAH) defect in newborn.

3. Mother with Anti-epileptic drug therapy, Anti-thyroid drug and cancer drug therapy.

Difficulties in Breastfeeding

1. Mother dislikes too feed her baby.

2. Inadequate milk production.

3. Cracked nipple, depressed nipple, mastitis, breast abscess, sore nipple in mother.

4. Birth of Low Birth Weight baby.

5. Congenital malformation like cleft lips and palate in newborn.

6. Breast engorgement. Working mother.

Expressed Breast Milk

If lactational mother is not in a position to feed her baby, she should express her breast milk in a clean wide-mouthed container and this milk should feed to her baby. Expressed breast milk can be stored at room temperature for 6-8 hours, in a refrigerator for 24 hours, and in a freezer at -20 ̊ C for 3 months.

Exclusive Breastfeeding

Exclusive breastfeeding means giving nothing orally other then colostrum’s and breast milk to her baby up to the age of 6 months if medically indicated. 

1. Oral contraceptive containing estrogens are not recommended for breast feeding mother.
2. Breastfeeding mother need extra 500 calories per day during entire lactational period.
3. For maintenance of effective and continuous lactation of a mother baby sucking to breast is essential.
4. A healthy breastfeeding mother will produce about 500 to 800 ml milk in a day or more in twin baby birth.
5. Mother should feed the baby allowing one breast to empty to provide both fore milk and hind milk, before offering the other breast.
6. Prolactin hormone is secreted in night time so breast feeding in night is very important.