Breast Feeding - FAQs

Dr Prasanna Muniyappa, Dr R. Kishore Kumar
Breast Feeding - FAQs - Patient Education
Why Breast Feed?
Breast milk is the best food for the babies as it meets all the requirements. It comes with the right nutrients, ready any time the baby wants at the right temperature with no need for sterilisation of equipment or preparation. It is the precious gift any mother can give it to their babies. There is enough evidence to suggest Breast milk offers short term and long term benefits both in developing and developed world.

What are the Benefits of Breast feeding?
Breast milk contains all the nutrients which are required for the normal growth and development. All babies can easily digest and absorb Breast milk. There is enough evidence to suggest it decreases the risk of necrotizing enterocolitis(NEC) in Preterm babies. Breastfed babies have lower rates of diarrhoea, respiratory tract illness, acute and recurrent otitis media and urinary tract infection. Breastmilk also protects babies against allergic diseases and reduces sudden infant death syndrome (SIDS).

Breastfed babies have lower risk of obesity, cancer, coronary heart disease, inflammatory bowel disease and Diabetes mellitus. Breastfed babies have lower chances of malocclusion. Breastfed babies have better cognition, Intelligence quotient(IQ) and visual function as Breastmilk is rich in docosahexaenoic acid (DHA). Breastfed babies have lower risk of behaviour problems later in life.

Breastfeeding improves bonding, helps in uterine involution, reduces postpartum haemorrhage. It also protects against pregnancy, breast cancer and ovarian cancer. It also helps mother to loose weight. Breastfeeding is convenient, time saving and economical to mothers.

What is the composition of Breastmilk?
The Breastmilk is a complex fluid which comprises many chemical and cellular components.
Breast milk is 70% whey and 30% casein. The predominant whey proteins are alpha-lactalbumin, lactoferrin, lysozyme and IgA.
Lactose and oligosaccharides are the main carbohydrate present in breastmilk.
Breast milk fat is rich in polyunsaturated fatty acid and is the major energy source. The hindmilk fat is 1.5 to 3 times more than foremilk fat. DHA (docosahexaenoic acid) is of the omega-3 type of Long- chain polyunsaturated fatty acid(LCPUFA) which has anti-inflammatory property and present in brain and retina thereby helps in neurodevelopment and visual acuity. Breast milk also contains Vitamins, minerals, growth factors, enzymes and hormones
Colostrum: It is secreted during 3 – 4 days after delivery. It is produced small in quantity, 15 – 20 ml during day 1, yellow and thick and it is rich in antibodies, macrophages and Vitamins.
Transitional milk: Milk secreted after 3-4 days until 2 weeks.
Mature Milk: It follows transitional milk.
Foremilk: secreted at the beginning of breastfeed and is rich in proteins, sugar, vitamins, minerals and water that relieves baby’s thirst.
Hindmilk: secreted during later part of breastfeeding and is rich in fat which provides energy and gives a sense of satiety.

What are the common recommendations on Breastfeeding?
All hospitals should have written policy on Ten Steps to Successful Breastfeeding developed by WHO and UNICEF as criteria for a Baby – Friendly Hospital.
All mothers should be prepared and counselled during antenatal period regarding benefits of breastfeeding and how to initiate and manage breastfeeding.
Help all mothers to breastfeed within one hour after birth.
Encourage breastfeeding on demand
Exclusive breastfeeding for 6 months
Long term benefits depend on the duration of Breast feeding.

How to manage and support successful Breast feeding?
Figure : Breast Feeding
Breast Feeding

Mother should be shown different breast-feeding positions and how to hold a baby during breast feeding. Mother should be taught how to recognise Good Latching and poor Latching. Effective milk transfer requires good coordination of suckling and swallowing.
Minimum Breastfeeding frequency is at least eight times in 24 hours. Mother should try to demand feed and taught to recognise signs of hunger and satiety and cues for readiness to Breastfeeding. Mother should offer both breasts at each feeding and make sure breast is completely emptied so that baby can get the benefits of both Foremilk and Hindmilk.

How to express Breast Milk?
Sometimes mothers need to express their milk when baby is not ready and unwell and breastfeeding is not completely established. Mother can either express the milk by hand or using a breast pump (Manual or electrical). Mother needs to be demonstrated the different steps involved and how to use breast pump.
The expressed milk can be stored at room temperature for 4 hours, in a fridge for 24 hours and a freezer at -20C for 3 to 6 months.

What are the common problems of Breastfeeding?
Breastfeeding problems are commonly seen in clinical practice and most of the problems can be easily prevented by simple advice. Mother can have sore nipple, inverted nipple and flat nipple. Sore nipple is more common when latching is not adequate. If breast is not emptied fully then mother can have breast engorgement and breast abscess. Candida infection of the nipple and oral thrush in babies are commonly seen in clinical practice. Early recognition and referral to lactation consultant is very important in managing breastfeeding problems.

Breast Feeding - FAQs Breast Feeding - FAQs 09/05/2018
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