Health Tips

FAQs about Breastfeeding : What should every mom know?

Q1. What is breastfeeding?

Breastfeeding or sometimes also known as nursing is a process where a baby is fed by human breast milk. Breast milk could be given directly from the mother's breast, expressed by hand, or pumped before being given to the baby.

Q2. When should breastfeeding start?

Ideally, as soon as possible! Breastfeeding during the first hour can be very beneficial to establishing the milk supply if mom and baby are both healthy and able to do so, and it should continue as often and as much as the baby wants.

Q3. When does breast milk for breastfeeding come in?

In the second trimester of pregnancy, around week 16, milk production starts. At that point, the body starts producing colostrum, a unique milk full of nutrients that are very important for the development of babies.

About 30 to 40 hours after the delivery of the placenta, the breast milk supply in the mother will suddenly increase. By then, the body has received a signal from the change in hormones that it is time to start producing more breast milk.

Following delivery, 2–5 days later, breast milk would change from thick, yellow colostrum to creamier, golden-hued or white milk. Around this time, there would be an increase in breast milk production, from a few milliliters to a few ounces. Breast milk supply would increase more rapidly if the woman had previously nursed.

Q4. Why does breastfeeding matter? 

For mothers and babies, breastfeeding has unrivaled health advantages. Breast milk is specifically designed to suit the health needs of a developing baby, making it the clinical gold standard for infant feeding and nutrition. More has to be done to provide moms who choose to breastfeed with a safe and supportive environment.

Q5. Benefits of breastfeeding to the baby?

For babies, breast milk is the main source of nutrition since it contains a variety of minerals and vitamins, as well as fat, protein, and carbs (such as lactose and human milk oligosaccharides). In addition to fostering a healthy immune system and gut microbiota development, breast milk contains elements that help protect an infant from infection and inflammation. Breastfed babies have lower risks of :

• Bronchial Asthma.

• Obesity (excessive fat accumulation that presents a risk to health which when measured by Body Mass Index (BMI) is over 30).

• Type 1 Diabetes Mellitus (T1DM)

• Serious lower respiratory disease.

• Acute otitis media (ear infections).

• Sudden infant death syndrome (SIDS).

• Gastrointestinal infections (vomiting/diarrhea).

• Necrotizing enterocolitis (NEC) for preterm babies.

Q6. Benefits of breastfeeding to the mother?

Nursing can assist in reducing a mother's risk of :

• Hypertension.

• Type 2 Diabetes Mellitus (T2DM).

• Breast Cancer.

• Ovarian Cancer.

• Endometrial Cancer.

Q7. How long should moms breastfeed their babies?

The World Health Organization (WHO) and UNICEF advises nursing exclusively for six months and continuing for at least two years. This means that no other foods or beverages are normally taken in the first 6 months.

Infants should receive breast milk on demand, or as often as the baby desires, day or night. Use of bottles, teats, or pacifiers is discouraged.

Q8. How often should mothers breastfeed their babies in a day?

Infants need to be breastfed between eight and twelve times a day throughout the first few weeks.

Q9. How long is the duration for each session of breastfeed?

Initially, sessions may run up to 45 minutes, but as the infant becomes more diligent, feedings may only take 10 to 20 minutes.

Q10. How to tell if the baby is hungry?

Babies who are hungry have attentive facial expressions, bowed arms, closed fists, and fingers placed near their lips. When a baby first starts putting his/her fingers to his/her mouth, the mother should offer him/her their breast. Crying is a late symptom of hunger, and a distressed baby will have trouble latching. Babies relax their arms and legs and close their eyes after eating.

Q11. How to know that the baby is receiving enough breast milk?

Signs that are listed below can help to decide whether the baby is receiving enough breast milk or not :

• A minimum of six wet diapers each day.

• Two to five daily loose yellow stools.

• Urine that is light yellow, not orange or deep yellow.

• Sleeping soundly.

• Steady weight gain.

• Baby appears alert and healthy.

Q12. Does breastfeeding hurt?

Many individuals are wondering whether nursing hurts or not. In general, nursing is not painful, however the first few weeks or months can be uncomfortable or difficult for several reasons. 

Pain in the nipple or breast can be brought on by engorgement, blocked ducts, poor latch, oral anatomical anomalies, thrush, nipple breakdown, or even a teething baby biting down.

A perfect latch can frequently alleviate difficult nursing sessions. In some circumstances, additional evaluation by a healthcare professional is necessary to identify and address the issue.

Q13. What is a proper technique for breastfeeding?

Baby must be appropriately positioned at the breast in order to initiate nursing. The act of placing and fastening a baby to the breast usually comes intuitively, but for some moms and babies, it takes time and practice to get it to work. These simple steps could be useful to refer for the proper technique of breastfeeding :

• Positioning.

  • Mother should hold the baby closely with their body turned towards the mother and their face facing toward the breast.

  • Ensure that the head and body of the baby are in a straight line.

  • Support the baby's buttock and back firmly.

  • The position could be in various ways as long as both mother and baby are comfortable. It could be :

1. Sit upright with the baby supported by one or two additional pillows.

2. Mother laying on the side with the baby facing her (Avoid dozing off in this position to prevent smothering the infant).

• Attachment.

  • Put the nipple close to the infant's lips. Watch for the baby to open his or her mouth widely.

  • Place the baby at the breast (not the breast to the baby). Baby should be brought all the way to the breast, not just the head. As much of the brown region (areola) surrounding the nipple should be taken as possible.

  • By holding the breast with free hand, mother can assist the baby in latching on. But be careful to keep the thumb far enough away from the areola to avoid pressing it against the breast.

• Assess the feeding status.

  When the baby is feed well, he or she should look like this:

  • Mouth is wide open.

  • Chin rests against a breast.

  • Outward curved lower lip.

  • Able to breathe freely since the nose is right up against the breast.

  • Baby suckes slowly and deeply before pausing and sucking once more.

  • Baby may be heard swallowing.

Q14. Can a mother breastfeed after a cesarean?

Yes, indeed. In fact, the mother should ensure skin-to-skin cuddle with the baby as soon as she is able to. While still in the operating room or in the recovery area, a midwife might assist the mother with skin to skin cuddle.

In order to increase the milk supply, the mother can put the baby to the breast frequently so that lots of skin-to-skin contact can be established.

Nevertheless, after a cesarean section, "rugby hold" position where the baby's body is around to the side of the body, supported by the arm on the same side is preferable than the normal position where having them lie against the stomach. Pain management could be discuss with the doctors in order to feed the baby more comfortably.

Q15. Can a mother still breastfeed with more than 1 baby?

Breastfeeding is safe for twins, triplets, and other multiples. In addition, breast milk is crucial for multiple babies because they are more likely to be born preterm and with low birth weights.

It can be simpler for the mother to feed each baby individually at the early phase. Then, the mother can feed them simultaneously once she feels more comfortable. This could take several weeks.

Q16. What considerations for breastfeeding does COVID-19 pose?

It can be difficult for mothers who have a symptomatic COVID-19 infection to breastfeed. However, breastmilk can help in order to prevent and decrease infections among babies due to their complex proteins, lipids, carbohydrates, other biologically active components and the most important is the antibodies :

• By planning initial skin-to-skin contact, followed by direct nursing and rooming-in, mothers, even those who are positive for COVID-19, can be encouraged to start breastfeeding. It is important to take precautions like wearing a mask and maintaining strict hand hygiene.
• It is important to encourage mothers to express milk for their babies when they are too ill to directly breastfeed or stay in the same room as them.

• The couple should not be let go of the birth hospital early. A breastfeeding assessment and community support referrals would need to be given before the patient leaves the hospital.

• Breastfeeding should be reevaluated after leaving the hospital by a skilled clinician who can assess for hyperbilirubinemia, sufficient milk transfer, weight gain, and any maternal troubles.

• It is important to promote community support and the use of support groups.

• Although there are no trials that prove the safety of immunizing women who are breastfeeding or lactating against COVID-19, there is a low chance that there will be any negative side effects. There is also reason to believe that the COVID-19 vaccine's produced antibodies will pass through breast milk and reach the infant. As a result, those who are breastfeeding or lactating should not be refrained from having the vaccine, and after receiving it, there is no reason to stop or withhold breastfeeding.

Q17. What are some pointers for effective breastfeeding? 

• Always keep the baby close to the mother.

  • In short, it gets simpler to recognise the various demands of the baby and assure proper nursing the more time the mothers spend with them.

• Get the right information from the experts.

  • Avoid becoming overloaded with friends and online resources. Lactation consultants can point women in the right direction and offer practical assistance in the hospital. Nurses can also answer inquiries by phone or email if the mother is unable to meet in person at the hospital.

• Go to a prenatal breastfeeding class.

  • The advantages of breastfeeding, the fundamentals of milk supply, how to keep milk when mom and baby are separated, how to interpret a baby's behavior and determine when a baby is well-fed, and positions for an effective latch are all covered in these classes. To accommodate a range of learners, classes frequently feature interactive activities and a variety of instructional techniques, including movies and baby models.

• Find a local support group.

  • Many hospitals organize breastfeeding support groups where mothers can tell stories, gain knowledge through one another's experiences, and practise breastfeeding in a group setting. There are also a numerous number of organizations that support women in their efforts to breastfeed successfully. It is advisable for a mother to find a group that they feel most comfortable with.

Note from DOC2US. 

Although breastfeeding is a natural process, it can take some time for you and your baby to learn before you and your baby could master it. The majority of women can and are able to breastfeed. Only a few women are unable due to medical conditions or other issues.

There is a tonne of support and aid regarding breastfeeding. You can learn everything you need to know from trained lactation consultants, nurses, doctors, and peer counselors. In the event that difficulties arise, they can also offer advice. 

Keep in mind that it's okay if you decide not to breastfeed or are unable to. You will discover the feeding method that is ideal for you, your baby, and your family out of the numerous feeding options available.

Written by Anas Fikri, MB BCh;
Medically reviewed by Nur Ariffin, MBBS UniSZA

References: 

1. National Institute of Child Health and Human Development. National Institutes of Health (NIH), U.S. Department of Health and Human Services. 19 December 2013.
2. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect.
   http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)01024-7/abstract
   Victora, Cesar G et al. The Lancet , Volume 387 , Issue 10017 , 475 – 490.
3. Johnston M, Landers S, Noble L, Szucs K, Viehmann L, et al. (Section on Breastfeeding) (March 2012). "Breastfeeding and the use of human milk". Pediatrics. 129 (3): e827–e841. doi:10.1542/peds.2011-3552. PMID 22371471

Written by

DOC2US Editorial Team