India is considered a breastfeeding nation but only 41.8 % of newborns get breastfed in the first hour of birth even as 88% of births take place in hospitals. Nupur Bidla, national coordinator, the Breastfeeding Promotion Network of India (BPNI), tells Kavita Bajeli-Datt that the best time to start preparing for breastfeeding is during pregnancy itself.
When is the best time to start preparing for breastfeeding?
We need to start this conversation during pregnancy itself. The antenatal period is the best time to start preparing for breastfeeding. Pregnant women should get counselling about breastfeeding from health workers/professionals with whom she is planning their delivery. It is also good to start the discussion with the husband and family members as their support will be of great value after birth.
Women usually face the problem of not having enough breast milk for their babies. Is it a real issue or a perception?
Mothers often worry about the amount of breast milk they produce as early as the first day after delivery. Usually, relatives, friends or even doctors/health workers may tell them that they may not have enough milk and that shatters her confidence and creates self-doubt, which affects her milk flow by hampering prolactin and oxytocin reflex - prolactin controls milk flow while oxytocin makes the milk that is already in the breast flow for the current feed, and helps the baby to get the milk easily. Even when you think your milk is insufficient, your baby usually gets all the milk needed. Factually, the amount of milk she can make is determined by the amount that the baby needs and suckles, and it even increases if the baby suckles more. Signs of getting an adequate milk supply are the baby passing urine six times or more in 24 hours and the baby gaining a weight of 500g/month.
What is the best way to latch the baby for breastfeeding?
Good breastfeeding skills include proper positioning and latching the baby on the breast for effective feeding. Mothers can feed their babies in any comfortable position such as lying (sideways) or sitting. The baby needs free access to the breast. This is important because poor positioning often results in poor latching. For feeding, the mother should hold the baby with the head straight, facing the breast with the nose opposite to her nipple and body close, supporting the baby completely, not just the neck and shoulder. The mother’s nipple should touch the infant’s mouth. Wait till the mouth opens wide and offer the whole breast to the baby to get as much into the mouth.
Can poor latching lead to breast conditions like a cracked nipples, mastitis and how can they be addressed?
The most common cause of sore nipples in the first few days of feeding is incorrect latching, resulting in the baby suckling only at the end of the nipple. If feeding continues in this position, it may lead to a cracked nipple and later, mastitis and breast abscess. If it pains during breastfeeding, you should wait until your baby releases the breast, or put your finger gently into the baby’s mouth to break the suction first, to avoid nipple injury. Start again in the correct position and if the baby is attached properly, it will not cause pain to the mother. Breastfeeding should be continued on the affected breast as sore nipples usually heal after correcting the suckling position. If the problem persists, mothers can consult a skilled lactation support professional.
What treatments are available for engorged breasts?
Engorgement or fullness of the breast is a frequent problem. Milk production is continuous and, if enough milk is not released, it may result in engorgement of breasts. The engorged breast is usually tight, shiny and painful. Improved suckling/ positioning of the baby and frequent feeding from the affected breast and different suckling positions will help facilitate emptying the engorged breast, apart from massaging the lump towards the nipple to promote emptying of the breast. Rest and wearing loose clothes are also important.
Where can mothers get support for breastfeeding issues?
BPNI has been creating support structures for pregnant and lactating mothers since its inception three decades back. Pregnant mothers can visit www.idecide.org.in to get information on breastfeeding. Additionally, the BPNI & Association of Health Care Providers India (AHPI) joint initiative to give accreditation to maternity hospitals as Breastfeeding Friendly across India has also created a pool of breastfeeding-friendly hospitals abiding by the World Health Organization’s ten steps to successful breastfeeding. BPNI urges all women and their families to start demanding for breastfeeding-friendly maternity hospitals to deliver their babies for better support. For more information, visit www.bfhi-india.in
BPNI is a national network of organisations and individuals promoting mother and child health through the protection and promotion of breastfeeding. BPNI is notified in the Gazette of India as a child welfare NGO to initiate action under section 21(1) of the Infant Milk Substitutes Feeding Bottles and Infant Foods (Regulation of Production, Supply and Distribution) Act 1992 and Amendment Act 2003 (IMS Act) for officially monitoring and implementing IMS Act since 1995.