Liquid gold

Lactation, latching, and life-giving mother’s milk

By Diane Fabellon, MD


Breastfeeding is the most natural way of providing infants with complete nutrients needed for optimum growth and development. Almost all mothers can breastfeed, given the right support and information.

Breast milk benefits

Breastfeeding has numerous benefits for infants and mothers. Studies have shown that breastfed infants have improved brain and nervous system development, with an IQ advantage of 10 to 12 points compared to non-breastfed infants. Breast milk also contains disease-fighting antibodies. It helps protect infants from bacterial infections, diarrhea, respiratory tract infections, ear infections, urinary tract infection, sepsis, diabetes, obesity and certain childhood cancers.

Breastfeeding also provides physical and psychological benefits to both the infant and the mother by enhancing bonding. Maternal health benefits from breastfeeding include earlier return to pre-pregnancy weight, decreased postpartum bleeding, rapid uterine involution, decreased menstrual blood loss, increased child spacing and decreased risk of breast and ovarian cancers.

Breastfeeding is also environment-friendly and offers financial benefits by decreasing the family’s health care costs by about Php 40,000 to Php 60,000 every year.

Preparing to breastfeed

Prenatal classes are good way to know more about breastfeeding. Most classes usually cover the most important aspects of breastfeeding such as positioning, attachment, expression and breastfeeding problems. Parents who find out as much as they can about breastfeeding feel more confident when they start breastfeeding their baby.

What to expect in the first few days

Immediately after childbirth, increased skin to skin contact between a mother and her baby is advised. This promotes bonding. During the first few days after childbirth, mothers produce colostrum, a highly concentrated golden yellow milk rich in antibodies. Babies will only need about a teaspoon of colostrum per feed to sustain them.

Mothers are encouraged to feed their babies as often as they want and as long as they want. The goal is to breastfeed at least 10 to 12 times per day. Babies should be fed as soon as they exhibit the first signs of hunger such as stirring, rooting and putting their hands in their mouth.

Common Breastfeeding Problems

  • Sore nipples. Breastfeeding shouldn’t hurt. Some mothers experience nipple tenderness at the beginning of a feed for the first few days. This will gradually disappear in a few days as the mother and the baby become better at breastfeeding. It’s not normal for the tenderness in the nipples to become so painful and to show visible damage to the nipples. If this happens, immediately consult your doctor.
    Sore nipples are usually caused by poor attachment, secondary engorgement, baby being pulled off the breast without breaking the seal, Candida or fungal infections, tongue-tie and too-high suction of breast pumps.The most common cause of sore nipples is poor attachment. Pain at the start of the feed that fades when the baby lets go is most likely related to attachment. If this happens, check the baby’s latch and try different positions. Broken skin is also usually caused by poor attachment. To prevent this, don’t pull the baby off the breast to end a feed without first breaking the seal between the baby’s mouth and the breast. For those using a pump, make sure that the correct flange size is being used and the settings are not too high.A burning or stabbing pain that gets worse during the feed and continues after the feed has finished is more likely caused by Candida infection. This is characterized by red, shiny, itchy, and flaky skin around the breast, and requires medical attention.
  • Engorgement, clogged ducts and mastitis. On the second to fifth day of breastfeeding, mothers experience breast fullness or milk “coming in.” This occurs when milk increases in quantity and changes from colostrum to mature milk. The breast and areola remain soft and elastic, milk flow is normal and latch-on isn’t affected. To relieve the fullness, mothers have to breastfeed frequently, ensure proper latch and position and let the baby finish one breast first before offering the other side.
    If the normal fullness isn’t properly managed, the breast may feel hard, warm, swollen, tender and the skin feels tightly stretched and shiny. The nipple may become flat and taut, making latching difficult. Engorgement is usually caused by delayed initiation of breastfeeding, poor attachment and infrequent feeding.To address engorgement, milk must be removed from the breasts. A warm compress to the areola area and warm showers before a feed may help the milk flow. Mothers are encouraged to breastfeed more frequently. To soften the areola and make it easier for the baby to attach, mothers can gently express milk from their breasts before a feeding. Proper attachment of the baby to the breast is also important to ensure that the baby is able to feed effectively. If breastfeeding alone doesn’t relieve engorgement, mothers can express milk between feeds a few times until she is comfortable.Sometimes, a blocked milk duct occurs when milk gets stuck in one part of the breast. Untreated, this can lead to infection of the breast or mastitis. If the mother’s symptoms don’t begin to subside within 24 hours of frequent and effective feeding, or milk expression consult a health professional or lactation consultant. Fever, evidence of possible infection like an infected cracked nipple, red and swollen areas of the breasts need immediate medical attention. HT

Need more help? If you need more help, an International Board Certified Lactation Consultant® (IBCLC®) is a healthcare professional who specializes in the clinical management of breastfeeding.


References:
1. Baby-friendly hospital initiative: revised., updated and expanded for integrated care. Section 3, Breastfeeding promotion and support in a baby-friendly hospital: a 20-hour course for maternity staff. WHO and UNICEF. 2009. 2. Riordan, Jan and Karen Wambach. Breastfeeding and Human Lactation 5th Edition: Jones & Bartlett Learning. 2016. 3. National Health Services-UK Your Pregnancy and Baby Guide resources page. Breastfeeding the first few days. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/breastfeeding-first-days/#building-up-your-milk-supply. Accessed 02 July 2019. 4. The Mother and Child Health and Education Trust resources page. Benefits of Breastfeeding, Ten Steps to Successful Breastfeeding. Available at: http://www.tensteps.org/benefits-of-breastfeeding.shtml. Accessed 02 July 2019.