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World Alliance of Breastfeeding Action (WABA) organises world breastfeeding week from 1st to 7th August 2019. This years theme was to empower parents to enable breastfeeding. We all have to be aware that babies are meant to be breastfed immediately after birth preferably from the delivery room itself. The infant must be exclusively breastfed till their six months and only after that, they can be fed with solids. It is a must that We should avoid sweetened water, gripe water, honey, animal and powdered milk before six months and also avoid the use of bottles and pacifiers, as they are likely to make babies sick. It is always safe for the babies to be close and sleep with the mother. It is mandatory to breastfeed during the day or at night up to 8 times whenever a baby shows hunger symptoms.

A properly breastfed baby has a reduced risk of diarrhoea, pneumonia, ear infections, and even death in the first phase of their life. Breast milk is meant to be a complete food for the baby that can be easily digested and well-absorbed And also helps to protect against infections and brain damages. Breastfeeding is one of the keys that makes a baby create an emotional bond with the mother. This helps the mothers to help in the involution of the uterus, delays pregnancy, lowers the risk of breast and ovarian cancer, decrease the mother’s workload. An exclusively breastfed baby is more likely to have a healthy future life. Breastfeeding can even be continued after two years after the baby’s life. In India, children used to be breastfed till their five years old and the longer they are breastfed, the healthy they grew up.

We have to understand the dynamics that happen in our body while breastfeeding. This is a reflex called prolactin reflex for the secretion of milk, which is enhanced during sucking, emptying breasts frequently while feeding at night for about 4 to 5 times each. Another reflex called oxytocin reflex Which is responsible for milk injection during feeding is enhanced by thinking of your baby, your babies sound or site when you’re relaxed. This reflects is inhibited By stress, strain, pain, worries, doubts, etc.

The need for breast milk varies day by day or even week by week. On the first day, breast milk is a yellowish thick liquid known as colostrum that contains more antibodies, high protein content and white blood cells. Colostrum should never be discarded,

It is like the first immunisation to the baby. After two weeks the milk will convert to transitional milk that is nutritious. The immunoglobulin and protein content decreases while the fat and sugar content increases. Mature milk follows transitional milk. It is thinner and watery but contains all the nutrients essential for the optimal growth of the baby. The breast milk of a mother who delivers prematurely contains higher quantities of proteins, sodium, iron, immunoglobulins that are needed by her preterm baby. Foremilk is the milk secreted at the start of a feed and it quenches the thirst of the baby because it is watery. It is also rich in proteins, sugar, vitamins, minerals and water. Hind milk, which comes later towards the end of a feed, satisfies the baby’s hunger because it is richer in fat content. The baby should therefore be allowed to empty one breast to get both foremilk and hindmilk. The other breast should be offered after emptying the first if the baby continues to be hungry.

Poor attachment of an infant’s mouth to the breast can lead to cracked nipples and subsequent problems like breast engorgement, mastitis and breast abscess.

These are some of the challenges while breastfeeding, Inverted/flat nipple, sore nipples, breast engorgement and so on. These differences can affect the feeding procedure. 

One has to make sure that the mother’s perception about the adequacy of milk is true. The baby is having adequate breastfeeding if the baby passes urine 6-8 times in 24 hours, goes to sleep for 2-3 hrs after the feeds, gains weight and crosses birth weight by 2 weeks. Reassurance is needed if the baby is gaining weight and passing an adequate amount of urine.

Some of the reasons for inadequate breastmilk can be delayed start, feeding at fixed times, infrequent feeds, no night feeds, short feeds, poor attachment, use of bottles, pacifiers, offering other fluids;  mother’s psychological factor such as lack of confidence, worries, stress, tiredness; mother’s condition such as illness, pain and smoking or baby’s illness. Nasal block can interrupt feeding. It can cause frequent crying in the baby due to hunger, producing a perception of inadequate feeding. Nasal block can be relieved with nasal saline drops.

If the baby is not gaining weight adequately, ask the mother to feed the baby more frequently and feed at least 4-5 times during the night. Take adequate drinking water, rest and sleep especially during day time. Make sure that the attachment is proper.  Any painful condition in the mother such as sore nipple, mastitis should be taken care of.  Back massages are especially useful for stimulating lactation. Back massages are helpful in the relaxation of the mother thus stimulating hormone production. Back massage can be done with oil using the thumb pressing over the back muscles on both sides of the back. Massage should be avoided over the spine. Massage should be provided for 15-30 minutes, three-four times a day. To conclude breastfeeding is a key milestone towards a better mother and baby health outcome. However, it needs proper support for the establishment and maintenance of lactation from the family and community. Problems are always possible as it occurs in any other activities of life and these problems can be prevented or resolved with timely guidance and interventions