You may have some questions and doubts regarding breast milk, such as how long (till how many months of age) a baby should be given breast milk and about “exclusive breast feeding”. Many of these questions and doubts are clarified in this article.

How Human milk is produced?

During pregnancy female body secrete a hormone known as prolactin, which causes stimulation of breast cells to produce milk. The more mother breastfeed the baby the more is the production of milk, which do not depend on the size of the breast. Another hormone ‘oxytocin’ causes contraction of the tiny muscle cells within the breasts and squeezes the milk down the milk ducts towards nipple. These stimulations (contraction of muscles to express milk) take place every time baby is put to the breasts or the baby suckles.

What are the advantages of breast feeding for the baby?

• Breast milk is wholesome food and provides all the nutrients (proteins, carbohydrates, fats, vitamins and minerals) to the feeding baby that is required by the baby. Except iron breast milk contains all the nutrients required by the baby.
• Breast feeding makes the emotional bond between mother and her baby stronger which makes care for the baby pleasurable and makes mother and the baby less prone to psychiatric problems.
• Breast milk can help in protecting the baby from infectious (like measles, chickenpox, diarrhea etc.) and non infectious diseases (like allergy). Breast fed babies tend to suffer less from allergy. The colostrum (which is the first milk that is thick/heavy yellowish liquid) is packed with antibodies which protect the baby from many infections for first few days of life.
• Breast milk is easiest to digest for the baby and premature infants can also easily digest breast milk.
• Breast milk is available to the baby at correct temperature unlike formula milk or cows/buffalo milk and it need no preparation.

What are the advantages of breast feeding for the mother?

• Breast feeding burns more calories and help the mother to remain in shape. Burning more calories reduce body weight which was gained during pregnancy.
• The risk of breast cancer and ovarian cancer is very low among mothers who breast feed their babies. The risk is very much low in mothers who have more than one child and breast fed her babies.
• Breast feeding can delay starting of menstruation and ovulation by several months after delivery and help in spacing children.

When should breast feeding be started for the first time after delivery?

Breast feeding should ideally be started as soon as possible after delivery and it is recommended by most pediatricians and gynecologists to start breast feeding within an hour or two after delivery. After starting breast feeding the milk flow increases and become normal in 2-3 days. A normal mother generally produces 500-750 ml of milk every day which is sufficient for the baby till 6 to 8 months of age.

If the delivery is not a “normal delivery” or it is a cesarean delivery, the mother may not be able to breast feed her baby immediately after delivery as milk production may be delayed by few days. But the baby should be given to suckle the nipples, which will stimulate milk production and as soon as mother starts producing milk the baby should be given breast feed regularly.

How frequently breast feeding should be done?

Breast feeding a baby should be based on “feeding on demand”, which means feeding baby when the baby cries. Breast fed babies tend to demand milk (cry) frequently in compare to formula milk fed babies because breast milk is easier to digest. Instead of following time according to clock, breastfeeding should be done according to need and demand of the baby. If the gap between breastfeeding becomes longer mother may also have problem as the breasts become full of milk, which may cause pain in the breasts. During every breastfeeding baby should be put to both of the breasts. The latter part of the breast milk is rich in fats which provide higher calories for the growth of the baby.

How to know if baby is getting enough milk?

A baby generally becomes hungry in 2-3 hours. If a baby is gains weight progressively, it indicates the baby is getting enough milk and a baby gains approximately 25 grams body weight in first three months of life. If the baby is passing more than one stool (not more than 4 or 5) and getting diaper wet for at least six times in 24 hours; it indicates the baby is getting sufficient milk.

What are the common problems during breast feeding?

The common problems that may be encountered during breastfeeding are mastitis, fever, inverted nipple, cracked nipple, long nipple, fullness of breast, blood in milk, blocked duct etc.

Mastitis:

Mastitis is infection (and consequent inflammation) of breast tissue and there is swelling redness and pain in the breast.

Fever:

Fever may be a common problem during breastfeeding and you should consult your doctor immediately. Generally breastfeeding can be continued as the infection generally does not spread to the milk. Fever during breastfeeding should be treated appropriately and promptly with appropriate antibiotics, breast support, pain killers, warm compression etc.

Inverted nipple:

An inverted nipple is drawn inwards and on trying to pull outwards, it goes inward instead, is inverted nipple, which can cause problem during breast feeding. Generally inverted nipple does not come out erect and make it difficult for the baby to get a proper grasp on the areola for suckling. Most of the cases of inverted nipples are corrected by itself during pregnancy and true inverted nipples, which are not corrected during pregnancy, can easily be corrected by appropriate consultation with your doctor.

Cracked nipples and sore nipples:

Cracked and sore nipple can occur due to improper breastfeeding techniques. If there is cracked nipple, the first thing should be done is correct breastfeeding technique. If breast feeding technique is correct, the cracked nipple and sore nipple usually disappear by itself.

Cracked nipple should be kept dry and warm and washed at least once a day (by exposing nipple to air and sun) with clean water avoiding soap. Medicated creams and any other cream should not be applied to the nipple. Breast feeding should not be stopped even if you get sore nipple and cracked nipple.

Long nipple:

Long nipple may sometimes be a problem for the baby to suckle, as baby may suck only the nipple and unable to grasp enough of areola and breast tissue inside mouth, which aid suckling and drawing milk. To overcome the problem of long nipple the baby should be held closer to the breast to enable the baby to suck more breast tissue inside mouth.

Fullness of breast:

Fullness of breast may be a common problem, which may be painful and feel tight. The fullness of breast occurs due to continuous production of milk and if enough milk is not fed to the baby at right interval. The common causes of fullness of breast are delayed initial breastfeeding, long interval in between breast feeds, feeding the baby with formula milk and baby do not demand much breast milk, not feeding the baby how much the baby needs, if baby is unable to feed properly due to some illness etc.

To prevent breast feeding the baby should be fed on demand. If baby is not given enough breastfeeds, sooner the breast milk production will reduce and to have sufficient production of breast milk the baby should be fed on demand. Exclusive breast feeding can help overcome fullness of breast due to engorgement.

Blood in milk:

Sometimes mother may notice presence of blood in the milk, in absence of cracked nipple or in absence of any fissure in nipple. Generally it is harmless and breast feeding should be continued. If it continues doctor should be consulted for proper treatment.

Blocked duct:

A particular segment of breast may be blocked due to thick milk, which can cause very painful condition and swelling of breast. If blockage of duct continues it can lead to infection (mastitis) and even breast abscess.

To overcome blocked duct the blocked area should be massaged to promote emptying. Cloths worn by the mother should be loose and the baby should be fed more frequently from the blocked breast. If baby is unable to express enough milk it should be expressed manually. Warm water fomentation can also reduce pain associated with blocked duct and also help in clearing the blockage. If these are not giving prompt result, doctor should be consulted immediately.

What precautions should be taken during breast feeding regarding foods and medication?

Regarding foods, breastfeeding mothers can eat any food they like. Avoid a food only if it bothers the baby every time after eating the particular food.

Regarding medication ideally all medicines should be avoided if practicable. Consult your doctor if you are breastfeeding, before taking any medicine, because it may harm the feeding baby.

Some tips on breastfeeding:

• Start breast feeding immediately after delivery or as soon as practicable.
• Drink plenty of liquid in the form of water, fresh fruit juice etc. but avoid any artificial and flavored juices or drinks. Taking enough fluid will replenish the amount of water baby is taking from you.
• Learn to feed the baby in different positions and feed from both the breast equally and alternately.
• Leaking of milk is common, especially during first few weeks and if milk production is good and you should keep special breast pads tuck in the bra and change them regularly to keep the breasts dry and clean.
• Feed the baby on demand which will help to produce sufficient milk for the baby.

Some breastfeeding skills:

• Position yourself in comfortable position (may be sitting or lying sideways) so that baby gets free access to the breast, as improper positioning can result in poor breastfeeding.
• Support the whole body of the baby and held the baby in a position so the baby’s nose is opposite your nipple. Allow the baby to take as much of the breast as possible into his/her mouth, which help in sucking enough milk.
• If baby is placed in proper position there will be eye contact between mother and baby. Other signs of proper positioning are baby is very close to you and turned towards you with support to the whole of the baby’s body.
• Improper positioning signs are no eye contact between mother and the suckling baby, baby’s body is away from mother, if whole body of the baby is not supported by the mother.

Some facts about breastfeeding:

• Practically all mothers can breastfeed their child, as it is natural way of nourishing a newborn baby.
• Breastfeeding should be done for at least one year and is recommended to breast feed for 2 years or more.
• Exclusive breastfeeding should be done for at least 6 months as breast milk can supply all the nutritional needs of a baby for at least 6 months.
• Start breast feeding immediately after delivery or as early as possible (preferably within one hour after birth) which can supply colostrum, which is rich in nutrients and antibodies (which fights infection).
• Continue breast feeding even if the baby is sick, it will not harm the baby in any way.
• Breast feed your baby on demand.
• All commercial food preparations are inferior to breast milk for your baby.

What should be Father’s Role in Breastfeeding?

Father’s full, committed support and cooperation is essential for successful breastfeeding. The father can help in many ways for breastfeeding to be successful to fulfill the nutritional needs of the baby. The father can help in the following ways:

• Breastfeeding can be a demanding work and need proper emotional support and encouragement. Most of the mothers, especially first timers suffer from doubt about the adequacy of breast milk supply, as well as their ability to take care of the newborn infants. The mother needs to be praised and supported.
• The father can look after the newborn infant while the mother rests, because breastfeeding and looking after a newborn baby may be exhausting and need support.
• Father can also help by looking after the elder child, if elder child is there, which can be of great help to the mother.
• Father should not have any doubt about the ability of the mother about breastfeeding her baby.
• Giving some extra time for the mother and baby can be of great help in caring for child and breastfeeding.

Some myths and facts about breastfeeding:

Myth: Small breasts will not produce enough milk to feed baby adequately.

Fact: For successful and adequate breastfeeding, size of the breast is not important. Smaller breast are due to less amount of fatty tissue underneath the skin in the breast and milk production occurs in the glands of the breasts (not in the fatty tissues which makes the breasts bigger), which all women have in adequate numbers. The more frequently the mother breastfeeds the baby the more milk is produced as it stimulate secretion of hormone which produce milk i.e. prolactin.

Myth: I could not breast feed earlier and will not be able to breastfeed this time also.

Fact: Successful breastfeeding do not depend on previous pregnancies and breastfeeding. Be confident and you will be able to breastfeed successfully, irrespective of your previous breastfeeding experiences, which may not be successful.

Myth: I should avoid certain foods during breastfeeding.

Fact: You can eat any food you like. You should only avoid if you are allergic to certain foods. You can also avoid eating certain foods if it gives trouble to you or your baby every time you eat that particular food. In general there is not restriction on eating any food.