JANE CHITANDA, Lusaka
THE first week of August is a great time to learn about all things on breastfeeding. As we commemorate World Breastfeeding Week, themed ‘Breastfeeding Foundation of Life’, the Nutrition Association of Zambia will share with you information on the importance of breastfeeding. Let’s start by understanding exclusive breastfeeding.
Mayanga, a school teacher, was expecting her fourth child who she hoped would be her last born. As the expected date of delivery approached, she and her husband were determined to give their baby the best start at life by exclusive breastfeeding.
When their son, Morgan, was born, they were overjoyed. He was exclusively breastfed for the first six months but not without challenges. Morgan is now a healthy 11 months old baby. He was introduced to other foods at six months and still continues to breastfeed.
Looking back, Mayanga acknowledges that her decision to breastfeed exclusively was challenged at various stages.
For many mothers, the desire to breastfeed exclusively does not always materialise. Breastfeeding is indeed nature’s way of feeding a new-born. It is a successive step in the reproduction process after conception, pregnancy and childbirth. However, like many of nature’s gifts, breastfeeding must be learnt in order to maximise its benefits.
You may be asking, ´ what is there to learn about breastfeeding?’ To begin with, it is important to recognise that breastfeeding is not just a biological act but also a learnt behaviour for both the baby and mother. There are salient features that are needed to achieve exclusive breastfeeding according to the recommended period – the first six months of life. Knowing these provides a solid point of departure for sticking with exclusive breastfeeding even when challenges to practise it arise.
Exclusive breastfeeding means giving a baby only breast milk for the first six months of life and no other food or drink, not even water, vitamin and mineral syrups unless medically indicated. This confers various benefits including the fact that it provides ideal food for the healthy growth and development of the infant. It also helps protect the newborn from illnesses including diarrhoea, ear and respiratory infections.
Mayanga highlights some of the challenges she faced in practising exclusive breastfeeding. There were times she felt that she did not have enough milk to satisfy the baby. At times the baby would cry a lot, want to breastfeed often and for a long time to the point where her nipples would become sore.
One of the crucial areas that can enhance exclusive breastfeeding is the timing of when a new-born is introduced to the breast. The World Health Organisation recommends that breastfeeding should be initiated within one hour of birth. This is important as there are various factors at play. One such factor relates to reflexes in the baby. For instance, a baby’s desire to breastfeed (sucking reflex) is strongest soon after birth. This should be taken advantage of as this stimulation increases the chance of triggering milk production and also prompting milk flow. Otherwise, milk flow is likely to delay due to delayed stimulation which is often further re-enforced as the baby falls asleep.
Starting to breastfeed soon after delivery also ensures that the baby has access to the first milk, (colostrum), which is rich in nutrients and antibodies that help to protect the baby. Colostrum is also known as the ‘first ‘’immunisation’. It is rich in growth factors and helps the baby to pass the greenish –blackish stool, also known as meconium.
Effective breastfeeding requires that a mother learns how to best position herself and the baby. Proper attachment of the baby to the breast is also crucial for effective suckling.
When the baby is well attached to the breast, the mouth is wide open, the lower lip is turned outward and the chin is touching the breast.
If a baby is not well attached to the breast, the mother is likely to experience painful, cracked nipples and engorgement. The baby will also be unsatisfied and therefore, cry a lot. In addition, the baby feeds frequently and for a long time. Furthermore, milk production will reduce, resulting in the baby failing to gain adequate weight.
The aspect of demand of breast milk having a bearing on supply is not to be underestimated. Effective suckling means that the breast is emptied so that the baby has access to the fore milk, which comes at the beginning of each feed and is more watery, and hind milk, which comes towards the end of the feed and is rich in fat. Access to both types keeps baby satisfied after each feed. Empting the breast triggers the hormone (prolactin) to stimulate more milk production. Have you ever wondered why milk supply eventually stops when the baby is restricted from the breast? It is because the demand has reduced. Therefore, a mother should breastfeed at least 8 to 10 times in a day to keep the demand high enough to maintain a sufficient supply. Should a mother be separated from the baby due to a work schedule, funeral or other reason, she should express the breast milk. Expressed breast milk can be stored safely at room temperature for 24 hours, in the fridge for 8 hours and in the freezer for 6 months.
Exclusive breastfeeding is achievable with adequate information, skill and support. Mayanga contacted the nearest health facility for support to exclusively breastfeed her baby.
JANE CHITANDA, Lusaka