THE UNTOLD DIFFICULTIES OF BREASTFEEDING
Breastfeeding is a highly rewarding and fulfilling adventure. The benefits for the mother and child can never be overemphasized. WHO recommends exclusive, on-demand breastfeeding fo the first 6 months of life, and this is to be continued (in addition to solid foods) until the baby clocks 2 years. However, some women still have challenges when initiating and continuing breastfeeding. There are lots of untold stories of the pains of breastfeeding. We don’t get to hear most of the stories; probably because the gains outweigh the pains
Some of the problems of breastfeeding will be discussed briefly as follows:
The process of lactation (lactogenesis and galactogenesis) starts during pregnancy. In the last few days of pregnancy, the breasts begin to produce a yellowish nutrient-filled liquid, known as colostrum. This means that all expectant mothers will produce breastmilk whether they like it or not! The success of breastfeeding depends on so many factors including the mother’s determination and keenness to breastfeed. A sick mother or baby may delay breastfeeding. Flat or retracted nipples can also discourage the baby from suckling.
*LACK OF ORIENTATION AND SUPPORT
It is the duty of the midwives and obstetrician to educate new mothers on how to breastfeed properly and effectively. Failure to understand the process of breastfeeding will result in frustration and early weaning. Family and friends often contribute to failed breastfeeding by encouraging the use of formula feed or added water which is not necessary at all.
Some babies suckle fast while others are slow and unwilling to suck. If the breasts fill up faster than the baby sucks, engorgement results. It could also be a problem when the baby dies or falls ill, or due to lactose intolerance. This can cause moderate to severe pain, fever, insomnia, headache and psychological unrest for the mother.
*CRACKED NIPPLES AND MASTITIS
This is often a direct effect of improper latching and prolonged engorgement. Cracked nipples gives way for infection with bacteria, which then gives rise to severe pain, fever, generalised body weakness and inability to continue breastfeeding. Natural oils or emollient creams can be applied to the nipples in between feedings. Mastitis is a serious problem which requires antibiotic therapy, strong analgesics and temporarily withholding breastfeeding.
There are certain maternal infections that need special considerations before breastfeeding. Chief among them are HIV and Hepatitis viruses. HIV positive mothers are encouraged to breastfeed exclusively and wean abruptly at 6 months. The baby must receive antiretroviral drugs for 1 year. These measures will reduce the risk of mother-to-child transmission to the barest minimum. Babies exposed to Hepatitis positive mothers should receive immunoglobulin injection at birth, in addition to the routine immunisation against Hepatitis B. Again, breastfeeding is not discouraged, but it must be STRICTLY EXCLUSIVE.
Breastfeeding requires a mentally stable mother. One of the effects of postpartum blues or depression, as well as other psychiatric problems, is inability to breastfeed effectively, as the safety of the baby might be jeopardised. In such cases, partners, family and friends have a great role to play. While the mother receives adequate care, she should also be encouraged to breastfeed, even if it’s through expression of breastmilk into bottles. Caregivers should take the baby and allow the mother to get enough rest so that she can recover quickly.
*BREASTFEEDING AND WORKING MOTHERS
Women are increasingly combining motherhood with active careers. Many have to resume for duty as soon as a few days after childbirth. This makes breastfeeding somewhat challenging. Many workplaces are yet to adopt the “baby-friendly” protocols, as recommended by WHO. A lot of women have to leave their babies at home or in daycare facilities. However, this still doesn’t preclude a successful breastfeeing. They can express breastmilk and store in a refrigerator, which can be reheated and given to the baby by spoon or bottles. They can also arrange with their employer to allow them bring the baby to work and continue breastfeeding. Women do not have to miss career opportunities or quit their jobs because they are nursing!
Irrespective of the difficulties, exclusive breastfeeding is still doable for the majority of mothers. Let’s have a look at some tips to overcome these problems…
*Prepare your mind.
Breastfeeding is supposed to come naturally after childbirth, but you have to be prepared for possible difficulties somewhere along the line. The baby will bite your nipples. The milk will stain your blouse. Family and friends will discourage you. If you’re a working mother, you may have to express milk, buy some gadgets and deal with your babysitter/nanny… You need to make up your mind and stick to your plan; long before the baby arrives.
*Keep your eyes on the prize.
Islaam enjoins parents to encourage breast their babies for two years (Qur’an chapter 2 verse 233). Whenever you feel tired or frustrated, just remember that you’re observing an act of worship, and you will get the rewards in manifold; both here and hereafter.
*Take care of yourself.
A burnt-out mother cannot breastfeed successfully. Take it easy on yourself. Eat well. Take lots of fluids. Take as many naps as you can. The dishes and laundry can wait. Stop acting like “superwoman” when people offer to help, let them help so that you can rest. Don’t be afraid to leave the baby with dad or grandma and go take some fresh air (alone) at the park or beach.
*Let the baby latch-on properly.
Whether you’re sitting or lying down, pay attention to your posture. Make yourself comfortable. Keep your back upright. Hold the baby close to your trunk with your hand under his buttocks and his head resting on your elbow. Let the entire nipple and areola (the brown area surrounding the nipple) be inside the baby’s mouth. This will enhance milk letdown and let the baby suck rather than bite.
*Alternate between the breasts.
That’s one of the reasons why the breasts were created in twos! If you concentrate on one breast alone, the other one will assume that you don’t need it and it will stop producing milk. After suckling from one side, put your baby on your shoulders, let him burp then put him on the other breast. If he’s satisfied with one breast (babies tend to prefer one breast to the other), let him feed on the other at the next feeding.
*Engorged breast? Keep feeding!
You’re not supposed to stop feeding your baby from an engorged breast, otherwise, it will get worse. It will hurt, yes, but you have to continue unless it becomes infected. Take analgesics, massage with any natural oil, have a warm bath and then, continue breastfeeding. If you think the engorged breast might be infected, see a doctor as soon as possible.
*Away for three days? The milk won’t go stale!
If you have to go without your baby for a few days, it’s OK to express/pump the breast milk and keep in the refrigerator (for 24 hours) or freezer (for 3-6 months). When you come back, all you need to do is put the baby to the breast and the feeding can continue. Milk doesn’t go sour in the breasts!
Weaning can be physically and emotionally traumatic for the baby and you. It’s better to do it gradually rather than abruptly. This will reduce the pain you’d feel after stopping, and give your baby enough time to adjust to adult foods. The absolute exception to this rule is when the mother has HIV or Hepatitis, in which she’s advised to stop abruptly.