It was another breastfeeding week on 1st to 7th August, 2017. This year's theme challenged us to work together to make breastfeeding sustainable. It requested the support of every man, woman, manager, policy maker, NURSE, doctor, health attendant, Husband and everybody.
Breastfeeding is a BIG task, it drains energy, you may have witnessed or heard about women fainting after breastfeeding; such is the energy it consumes and this shows that the level of support needed by a breastfeeding woman is unquantifiable/ enormous.
If you did not talk to someone last week about breastfeeding , you didn't do too well, you still have the chance to do that before it is too late or better still forward this piece of information to them.
Can we have Breastfeeding celerebrated every week just to lay emphasis on the importance of breastfeeding?
I need not bore us on why breastfeeding or breast milk is important, its rich contents and the protections it offers are superior.
What I want us to pay attention to is helping the breastfeeding women around us do it well, any form of encouragement done properly will be appreciated; a thumbs up, a pat, money, food, space, breastfeeding leave with pay , a space in your establishment for brastfeeding mothers to breastfeed are just some of the supports that will make the breastfeeding mother do it well.
If you look around well enough this task is often left for the aged women in the community who themselves need support, they pass down traditional practices (big kudos to them), some of these practices are very helpful. That they are willing to help always is commendable. However, we are now in an era when we know better and our knowledge should set us free, set our community free also.
My major concern today are the challenges and myths of breastfeeding.
I have been in a nursery bay where HOT water was prescribed, to help uterus contracts and breast milk flows. Right in the hospital, even in labour wards you see people including healthcare practitioners prescribe bland PAP etc as a form of galactogogue. These are based on traditions and psychology; they have little scientific basis.
The challenges of breastfeeding are numerous, I will mention a few:
1. Milk not flowing: this is common in the first 3 days after birth, it is a normal finding in most mothers and will soon flow, as a mother, you need to relax, eat well and drink a lot fluids, be happy, ensure you are not in any form of pain as this can cause delay in milk flow.
Please my fellow doctors, DO NOT PRESCRIBE HOT WATER FOR THESE WOMEN, doing so has no established basis ,tell me how much hot water can a woman who should be well hydrated drink? The breastfeeding mother should take about 3litres of water daily, normal (water at room temperature) will do. If the lack of milk flow extends beyond the 3rd day with all the above mentioned stuffs clearly addressed pleas see your doctor (pregnant woman doctor (Obstetrician) or babies doctor (Paediatrician)).
Palm wine is not a special fluid, if you are not interested don't drink, don't blame your inability to produce enough milk on lack of palm wine, a lot of people get unneccessarily worried because of this temporary problem to the extent that such worry inhibit their milk flow.
Pregnant women and breastfeeding mothers need GOOD FOOD,simple well prepared meal, No mandatory Pap .
The list below is a well illustrated 10 steps to
SUCCESSFUL BREAST-FEEDING
Every facility providing maternity services and care for newborn infants should accomplish the following:
1 Have a written breast-feeding policy that is routinely communicated to all health care staff.
ii Train all health care staff in the skills necessary to implement this policy.
iii Inform all pregnant women about the benefits and management of breast-feeding.
iv Help mothers initiate breast-feeding within a half hour of birth.
v Show mothers how to breast-feed and how to maintain lactation even if they should be separated from their infants.
vi Give newborn infants no food or drink other than breast milk unless medically indicated., please babies do not need water while breastfeeding exclusively, herbal concoction is not needed, brestmilk is all in all in the right proportions.
vii Practice rooming-in (allow mothers and infants to remain together) 24 hr a day.
viii Encourage breast-feeding on demand.
ix Give no artificial teats or pacifiers (also called dummies or soothers) to breast-feeding infants.
x Foster the establishment of breast-feeding support groups and refer mothers to them on discharge from the hospital or clinic.
2. Pain while breastfeeding , this could be a normal finding initially but breast feeding should soon be itch free, free flowing , if the pain is disturbing lasting more than few hours after delivery, please prescribe pain killer for these women also encourage them to breastfeed more often during this period, yes the reasons for this pain may inlude
A) Breast engorgement..... Breast is overfilled, overstretched and painful, mother will need to Breastfeed more often to prevent this very painful challenge, give pain killer if one develops , other treatment modalities include warm compress, warm shower etc
B) Breast abscess.... Please never allow it get to this level, if this develops see a doctor fast. The woman will have pains, fever and may have chills.
C) Sores on the nipple(s)..this should not be, it is usually due to bad techniques of breastfeeding, the technique is about the most important thing , if the nipples have sores, the treatment is more breastfeeding to avoid engorgement and one can also express the milk and give through cup till the sores heal, the proper techniques must be emphasized. These techniques are usually taught during the antenatal vists and in the post natal ward after delivery (make it a point of duty to learn the proper technique, such that you can help yourself and people around you).
The technique is illustrated below properly.
Babies are designed to breastfeed and every mother is built to provide beast milk but the techniques must be right, everything must come together at the point baby attaches to the breast.
Get in a comfortable chair with great back support to feed your baby. Using a stool to rest your feet on will help with good posture and prevent you from straining your neck and shoulders.
Use your breastfeeding support pillow if you have one. (And if you don’t, use whatever kind of pillows you can find to help support you and the baby). A good breastfeeding pillow can make a huge difference in getting the baby in a proper position to latch on well.
Make sure your baby is tummy-to-tummy with you at all times.
Make sure you bring your baby to you, and do not try to lean onto the baby. Not only will this cause severe strain on your neck and shoulders, but it can affect the baby’s position.
Remember to keep your baby’s ear, shoulder, and hip in alignment, which will make swallowing easier.
The baby’s nose should be opposite the nipple.
You might need to hold your breast to help guide the nipple to your baby’s mouth. Grasp the breast on the sides, using either a “C” hold or “U” hold. Make sure you keep your fingers far from the nipple so you don’t affect how baby latches on.
Aim the nipple toward the baby’s upper lip/nose, not the middle of the mouth.You might need to rub the nipple across the top lip to get your baby to open his/her mouth.
The baby’s head should be tilted slightly back. You do not want his chin to his chest.
When he opens his mouth wide with the chin dropped and tongue down, he should latch on to the nipple. If he does not open wide, do not try to shove the nipple in and wiggle the mouth open. It is best to move back, tickle the lip again with the nipple and wait for a wide open mouth.
Try to get as much of the lower portion of the areola (the area around the nipple) in the baby’s mouth.
The baby’s chin should indent the lower portion of your breast.
Look to see if the baby’s bottom and top lip are flanged out like fish lips. If they are not, you may use your finger to pull the bottom one down and open up the top one more.
Positioning your baby to feed
Cross-Cradle Hold:
This position is often the most helpful for moms right after birth and until they get more confident in getting their baby latched on correctly. It feels awkward for many moms at first, but once they see how it allows them to use both their hands more effectively, moms get more comfortable with it.
You will use the arm on the opposite side you will be feeding from to hold and support your baby, while you use the hand on the side you are feeding from to support your breast.
Lay your baby next to you, tummy-to-tummy, with your opposite hand supporting the back of his head. You want to make sure you are holding at the neck, so you are just guiding the head. You will use the other hand (on the same side the baby is feeding from) to hold and navigate your breast and nipple. Once the baby is securely latched on, you can move your arms to the cradle hold.
Numerous other methods exist, check and learn.
3.Lastly for today, is a 3rd challenge
Breast leakage: innocuous, the milk overflows , stain wears and can be smelly, More hygiene needed, it resolves on its own.
The myth are numerous and challenges enormous the scope of today's blog can not exhaust them all. We shall revisit some other ones later .
Here I rest my case for this week, help mothers breastfeed, give the needed support.
Leave your comments , questions and suggestions in the box below.
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