11 minute read
Breastfeeding: what to expect
World Breastfeeding Week, 1 – 7th August 2021
Theme: Protect Breastfeeding – A Shared Responsibility
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Breastfeeding is somewhat a controversial subject, yet it is as natural a topic as they come. Annually, from 1st to 7th August, breastfeeding week is held in 120 countries across the globe; Malawi participates in commemorating this week. The World Health Organization promotes breastfeeding as the most effective way to ensure the survival of babies. Breastfeeding improves the quality of life through its nutritional, immunological, biological, and psychological benefits. After six months, a child must eat nutrient- rich foods to complement breast milk. Various organizations such as World Alliance for Breastfeeding Action (WABA), World Health Organization (WHO), and UNICEF promote activities around breastfeeding to bring awareness. They advocate for exclusive breastfeeding for the first six months and then continuation for up to two years for the health and well- being of the baby. Currently, around the world, less than 40% of babies are breastfed exclusively. In Malawi, although the statistics may vary according to region, it is observed that 97% of all mothers breastfeed their children. However, only 45% exclusively breastfeed for the first six months. The low number of mothers breastfeeding in Malawi is a consequence of modernization. Modernization has increased access to artificial milk formulas allowing more women to join the workforce. Furthermore, advances in technology have invented the breast pump. The pump helps in collecting and storing milk for feeding when the mother is not physically available. Malawi published a policy titled: *Infant and Young Child Nutrition Policy and Guidelines 2003-2020. The policy articulates feeding practices and guidelines that public health officials promote to the general population. It also provides guidelines for mothers with HIV, discusses health supplements, diet diversification, and fortification standards of foods given to infants
to ensure the best outcomes for babies. Commemorating this year’s theme, the Minister of Health observed that the pandemic has adversely affected mothers and babies as mothers are focusing on the economic effects of the pandemic instead of their children. Health services have also been overwhelmed and are not providing child and maternal services to their full extent. Unfortunately, breastfeeding has been negatively affected by the COVID-19 rumor mill. Some people say that breastfeeding can transmit COVID19 to babies, but so far, health experts argue that there is no scientific evidence to the claim. Health experts encourage breastfeeding mothers to wash their hands thoroughly before feeding the baby and to wear masks. There are many beliefs and myths surrounding breastfeeding, though it is a natural and normal part of raising a child. For instance, in the West, there is always outrage when mothers breastfeed in public. Ironically, those who argue against public breastfeeding also argue against having meals in toilets. Herein sets in the hypocrisy when the public believes that lactating mothers should breastfeed their babies in toilets. In addition, in some cultures, men are discouraged from having sex with their breastfeeding partners, which fuels promiscuity and sexually transmitted infections. While other cultures claim that if breasts are too large or small, the mother cannot breastfeed. However, breastfeeding remains key to an infant’s growth and well-being and should be a necessary part of their development without believing the myths.
*Microsoft Word - Malawi IYCN policy FINAL.DOC (who.int)
By Steveria Kadangwe
My breastfeeding experience was one of the most incredible things. Literally a whole human is dependent on food that your body produces. I think that is mind-blowing.
In the first few weeks, it was really difficult because the baby did not know how to breastfeed. I know they are born with a natural instinct. However, they do not actually know how to latch on and feed. And you do not always know how to position your nipples inside her/his mouth. So as a result, it was painful. It was frustrating for the baby and it was painful for me. It resulted into cracking of the nipple and sores. And those sores, my goodness, they are extremely painful! That was the bad experience for me. It was really painful in the first few weeks. I had sores. I had to take a break. Thankfully, I had breast pumps. When I developed sores, I would pump out the milk because the problem is that if you stop, you can get mastitis and your ducts get clogged. You develop an infection because the milk is not coming out. Mastitis is very painful. You get really sick. You get a fever and it can get so bad you need antibiotics. Therefore, make sure that even when breastfeeding is painful at first, keep learning. Take a break when you need to and use a pump until the sores heal so that you can get back to it. That is what I did.
The other thing to note is that breastfeeding takes a lot of time and is a lot of work. My child was a big eater, so I was breastfeeding every hour at times. At one point, I found myself sitting on the couch the whole day wondering, “What is this? What kind of life is this? I cannot even go out?” I could not do much because when I was not breastfeeding, I was pumping through the night. It was difficult to get a good night's sleep. After the sixth month, I realized that my baby was getting some rashes and they kept getting worse to the point where every time I breastfed him, he would just get this breakout which was itchy and sore. Some allergy tests revealed that he had some mild allergy to milk and dairy products. This is something that I would never have expected. He was reacting to the milk that I would drink or the cheese and any other dairy product I would eat.
Because of this, I had to stop breastfeeding
earlier. At the six-month mark, we transitioned completely to formula. I knew that what you eat can pass on to the baby. However, I did not know that the baby can be allergic to some of the things that you eat that pass through the milk. That is why it is really important to be careful what you include in your diet.
And finally, the last thing that I really enjoyed about breastfeeding is that it is cheap. Formula is so expensive! Breastfeeding, on the other hand, is really cheap especially if you are able to produce milk. When you breastfeed and pump in between, you can get a really good supply. There were times when I would have a week's worth of milk in the fridge. As a result, there was enough milk in case I fell sick or something happened where I could not breastfeed. This also allowed me to take some breaks or decide to sleep a bit more during the night.
I would say, if you can afford to get a breast pump, get one and if you have a fridge, freeze your milk. It can last there for between three to six months. Check with a trusted expert for the latest information on precisely how long you can freeze it to be sure. That for me was really convenient.
Chifundo Chilera-Eze, a first time mom. Washington, USA
Ina May Gaskin
when breastfeeding is not recommended
by Amy O’Connor
It's true that some women are unable to breastfeed, at least not exclusively. Some women will produce a low supply of breast milk, for example, and others will encounter other breastfeeding issues that make nursing difficult. If you hope to breastfeed, you can still give nursing a try, but be prepared to supplement with a bottle of infant formula in case it does not work for you. There are other reasons why you might be unable to breastfeed, and, rarely, circumstances when it is not advisable to breastfeed. Here's an overview to help you make the best decision about breastfeeding for you and your baby.
HIV infection You should not breastfeed if you have been infected with the human immunodeficiency virus (HIV), because the virus can be passed to your child through the milk. Women infected with cytomegalovirus and hepatitis C generally can breastfeed, but not if their nipples are cracked or sore. If you have any kind of infectious disease, discuss the r is ks and o p t io n s fo r b re as tfe e d ing wi th yo ur do ct or be fo r e d e c id ing wha t to d o.
Radiation therapy You shouldn't nurse if you are receiving radiation in any form, and you may not be able to for a period of time before radiation treatment, or after being near a person who is receiving radiation treatment. Radiation can be a serious health risk to your baby, so be sure to discuss it with your doctor if you or anyone you know is getting radiation treatment.
Medications that pass into breast milk A report by the American Academy of Pediatrics finds that most medications and immunizations are safe to use during lactation, but don't make the decision to nurse while taking medication without discussing it with your doctor. There are some medications that pass into the breast milk and can hurt the baby, like anti- thyroid medication, chemotherapeutic agents, and some mood-altering drugs. Check with your practitioner to see whether any drugs you are taking present a problem, and don’t forget to mention supplements, vitamins, herbal teas and remedies, and overthe-counter medications too.
Serious infections You should not nurse if you have a serious infection like active, untreated tuberculosis.
Drug or alcohol addiction You shouldn't nurse if you have a drug or alcohol addiction and you are still using drugs or alcohol.
Smoking Smokers can breastfeed, but you shouldn't light up at least 95 minutes before every feeding, to reduce the nicotine or other chemicals that are in your milk and never smoke around your baby. A much better idea: quit smoking and keep breastfeeding your baby.
Medical reasons why breastfeeding may be difficult
Hypoplasia or IGT Hypoplasia of the breast, also known as insufficient glandular tissue or IGT, occurs when the mammary tissue and glands don't develop normally. Women with this rare condition often have breasts that don't produce enough milk to nurse.
Serious illness While it's ok to breastfeed with some conditions, if you have a serious illness — heart failure, for example, or severe anemia — breastfeeding might not be healthy for you or baby. It's a good idea to discuss any health conditions you have or are at risk for with your doctor before making the decision to breastfeed.
Breast reduction surgery If you've had breast reduction surgery, chances are good that you'll have a low supply of breast milk and won't be able to nurse exclusively, because the breast tissue that was removed contained milk glands and ducts. (If you've had breast augmentation, there's also a small chance that you'll have a low supply of breast milk.)
Postpartum depression or anxiety While you will be physically able to breastfeed with postpartum depression or anxiety, studies suggest there is a link between the two. This doesn't mean breastfeeding causes postpartum depression or anxiety, but it could be an added stressor. If you are coping with any psychological condition, discuss the risks of breastfeeding with your doctor, and don't feel guilty or distressed if you have to stop. Regaining your mental health should be you and your family's top priority.
Feeding baby when breastfeeding is not possible
Pumping supplemented with formula Whether you're having trouble producing enough milk or need a break from trying, pumping supplemented with formula is a handy option. A good breast pump will allow you to fill and store milk and can help you maintain your flow during periods when your baby is formula- feeding.
Formula feeding While the decision to transition from breastfeeding to formula can be emotional for some moms, most little ones switch to a baby bottle without protest. Just remember that snuggling, closeness and all the good bonding rituals are still important, whether your baby feeds from a boob or a bottle.
T ake n f r o m the W h at to E xpe c t e d ito r ia l te am an d He i di Mu rk o ff , aut ho r o f Wh a t to E xpe c t Wh en Y o u'r e E xpe c tin g . Wh at to E xp e ct h as s tr i ct r e po r t ing g u ide l i n e s an d u se s o nl y cre d ib le p r i ma ry s o u rce s. He al th in f o r m a tio n o n th i s s ite i s r e gu lar l y mo ni to r e d base d o n p e er - re v ie we d me dic al j o ur n al s and h ig hl y respected health organizations and institutions.
Pr in te d at w ww .w hat to e xpe c t. co m 1 0t h Au gu st, 2020
