An Overview Of Breastfeeding Essay, Research Paper

AN OVERVIEW

OF BREASTFEEDING

BREASTFEEDING

Breastfeeding is widely believed to be the most beneficial method of feeding

for the health and well being of most infants. It is the natural next step in

the continuum of pregnancy. Though breastfeeding is natural, technique is a

learned skill. As with any skill, the keys to successful breastfeeding are

knowledge, practice and patience. It is important to get started correctly and

know well in advance how to identify and avoid possible problems. Most

breastfeeding problems occur during the first few weeks as mother and baby begin

establishing nursing patterns. It is an important investment for the mother?s

and baby?s continued good health. Breast milk is the best source of nutrition

for an infant. It provides all the nutrition needs during the first six to

twelve months of life.

Breastfeeding offers newborns emotional as well as nutritional benefits.

Skin-to-skin contact helps to reduce the stress babies experience as they enter

the world from the security of the womb. Tension quickly subsides as the sight

of the mother?s face and the familiar sounds of her breathing, voice, and

heartbeat comfort the baby. This begins the important process of mother and baby

bonding.

Breast Milk Production

Milk is produced and stored in the glandular tissues called alveoli of the

breasts. It collects in the pockets known as lactiferous sinuses located beneath

the areola until it is released by a baby?s sucking. Stimulation of the

nipples cause the mother?s pituitary gland, located in the brain, to secret

prolactin. This initiates and maintains milk production.

The first milk the newborn receives at each feeding is the milk that has

collected in the lactiferous sinuses between feedings. This low fat foremilk is

high in protein and satisfies the newborn?s thirst. As breastfeeding

continues, a second hormone called oxytocin is secreted. Oxytocin causes the

tissue around the alveoli to contract, thus squeezing high fat hindmilk down the

ducts and into the pockets where it is available to satisfy the newborn?s

hunger. Many mothers experience a tingling or rushing sensation in the breast as

this ?let down? or milk ejection reflex (MER) occurs. Other mothers notice

only that sucking becomes longer and slower and that the newborn begins to

swallow rhythmically. Keys to establishing a quick letdown are relaxation and

confidence that the mother?s body is doing exactly what it was designed to do.

Composition of Breast Milk

During pregnancy, the mother?s body produces a substance called Colostrum.

This clear to creamy to golden yellow substance is found in the breasts during

pregnancy. Between the third and sixth day after birth, hormonal patterns of the

mother change rapidly. These changes cause colostrum to change to a transitional

form of breast milk. During this time, the amount of protein and immune factors

in the milk gradually decrease while fat, lactose and calories in the milk

increase. By the tenth day after birth, the mother produces mature breast milk,

which is also commonly referred to as human milk.

Health Advantages Of Breastfeeding Your Baby

Colostrum is the perfect starter food for babies. It is high in protein, zinc

and other minerals. It contains less fat, carbohydrates and calories than breast

milk. Colostrum acts as a natural laxative to clear the meconium (first stool)

from the baby?s intestine. This decreases the chances of jaundice. It also

contains the natural sugar lactose, which helps stabilize the newborn?s blood

sugar level, preventing hypoglycemia. Lactose is used in tissues of the brain

and spinal cord, and it provides the infant with energy. Bacteria in the infant?s

intestines feed on lactose and produce B vitamins. Lactose may also help the

infant absorb essential nutrients such as calcium, phosphorus and magnesium.

Breast milk from most women has the same nutrients. The proteins in human

breast milk are mostly whey and casein. Cows milk contains more casein, and

human breast milk contains more whey. Whey is more easily tolerated by an infant?s

digestive system. The fat in human breast milk is easily absorbed by an infant?s

digestive system. An enzyme called lipoprotein lipase helps an infant absorb the

fat in breast milk. A mother?s breast milk contains essential fats and

cholesterol. Both are needed by infants to make tissues of the nervous system.

The amount of fat in breast milk rises significantly at the end of a breast

feeding session. This may be nature?s way of making an infant feel full and

stop feeding.

Breast milk contains only a small amount of iron, but the iron in breast milk

is easily absorbed. Fifty percent of the iron in breast milk is absorbed

compared with only four to ten percent of the iron in cows milk or commercial

infant formulas.

Colostrum and breast milk are rich in antibodies and have anti-infective

factors. These help protect the newborn infant from viruses and bacteria that

the infant was exposed to in the birth canal. They also help protect the infant?s

immature digestive tract from infection. Breast milk promotes the growth of

bacteria that all humans normally have in the digestive tract. Breast milk

contains immune factors to help an infant fight infection and help prevent the

infant from developing possible food allergies.

While cows milk and formula mixtures can trigger allergic reactions and are

often difficult for a newborn to digest, a mother?s milk is perfectly designed

specifically for her baby. Since human breast milk is more easily digested than

formula, nursing usually results in fewer instances of colic, diarrhea and

constipation. Studies show that breast fed babies have fewer ear and digestive

tract infections; experience less vomiting and acute respiratory illness; and

are at lower risk for childhood diabetes, lymphomas and Crohn?s disease.

According to the American Academy of Pediatrics and American Dietetic

Association, among others, breastfeeding improves infants? general health,

growth, and development and significantly decreases risk for a large of number

of acute and chronic diseases. Studies also show that breastfeeding decreases

the incidents and / or the severity of lower respiratory infection, bacterial

meningitis, botulism, urinary tract infections and necrotizing enterocolitis.

But also according to the academy, a number of other studies show a possible

protective effect of breastfeeding against sudden infant death syndrome (SIDS),

insulin dependent diabetes mellitus, ulcerative colitis and other allergic

diseases. Breastfeeding also has been related to possible enhancement of

cognitive development.

Proper Steps to Latching On

Correctly latching on is the key to a pleasant, rewarding breastfeeding

experience. Nursing behavior patterns are established early. Once set, bad

habits are difficult to correct. Here are the steps recommended to get off to

the right start:

Step 1

For most women, sitting up in bed or in a comfortable chair is easiest. Make

sure the baby is comfortable and feels secure and supported. The baby should be

nestled in the mother?s arm at the level of the breast, his head and trunk in

a straight line to prevent having to strain or turn to attach to the breast. Do

not tilt the baby?s head down, as it will be difficult for them to swallow in

that position.

Step 2

Hold breast with your fingers underneath and thumb on top, making sure that

all are placed well away from the areola. Then manually express a couple of

drops to entice the baby to take the breast.

Step 3

Gently tickle the baby?s lower lip with the nipple to encourage the baby to

open his mouth wide. Once the baby?s mouth has opened wide enough, gently pull

him in close to the breast. The key to successful latch on and preventing nipple

soreness is teaching the baby to take a large portion of the areola into his

mouth.

As mentioned earlier, milk collects in the pockets beneath the areola. To

empty these effectively, the baby?s mouth must be positioned over them. If the

baby sucks only on the nipple, little milk will be drawn out, and this will

cause the nipple to become sore. If the baby does not latch on properly right

away, continue to encourage an open mouth and pull the baby close to the breast

again. These steps may be repeated several times until the baby gets the idea.

The mother should not feel any pain while breastfeeding. If discomfort is

felt, gently break the suction by inserting a finger into the corner of the baby?s

mouth between the gums then try again. Latch on discomfort is sometimes common

in the first week or two, but any pain should subside within a few seconds.

Burping

In the very early days of breastfeeding, most babies will swallow little or

no air and may not burp at all after feeding. Breastfed babies generally swallow

less air than bottle-fed babies. After the baby has finished feeding on one

side, the mother should burp them before offering the other breast.

Effective burping techniques require placing firm pressure on the baby?s

tummy. Lean the baby?s weight against the heel of your hand as they sit on

your lap, or drape the baby over your shoulder or on one knee, and firmly pat or

rub his/her back. If the baby does not burp within a minute or so, just continue

with the feeding and try again when finished.

Frequency of Feedings

Babies need to be nursed as often as they indicate the desire to breastfeed.

The mother should watch for her baby?s cues. Rooting, brushing his hand across

his face, or making little sucking motions are all indications that it is time

to breastfeed. Babies will demonstrate feeding cues for up to thirty minutes

before they start to cry. Crying can cause the baby to have an uncoordinated

suck, making it more difficult to initiate feeding.

Most babies need to breastfeed at least eight to twelve times in twenty-four

hours for the first few weeks. Once mother and baby are synchronized, the

frequency and duration of feedings per day may decrease. This process takes

about six weeks.

Beneficial Effects of Breastfeeding for the Mother

Babies are not the only beneficiaries of the breast feeding experience. The

mother benefits significantly in many ways. When a newborn is put to the breast

immediately after birth, the resulting release of the hormone oxytocin into the

mother?s system speeds delivery of the placenta and constricts uterine blood

vessels to minimize blood loss. Repeated release of oxytocin through nursing

helps the uterus contract and return to its pre-pregnancy size sooner.

The milk producing hormone, prolactin, is another wonderful by-product of

breastfeeding. Prolactin is commonly called the ?mothering hormone?. It has

a relaxing effect on the mother and stimulates maternal instincts. The ongoing

production of breast milk burns calories, therefore women who nurse often lose

their pregnancy pounds faster. Women who breastfeed have been shown to have less

incidence of pre-menopausal breast cancer, cervical cancer and osteoporosis.

Moms who breastfeed their babies may also enjoy no bottle cleaning, no

formula preparation and an enhancement of the unique bond between mother and

child. Add to these primary advantages the practical facts that breast milk is

always the right temperature, absolutely fresh, perfectly clean, instantly

available and you have the most nutritious, convenient feeding system there is.

Costs of Breastfeeding versus Formula

Breastfeeding may bring direct economic benefits to the family by

significantly reducing or eliminating the cost of purchasing infant formula.

Formula prices rose more than one hundred and seventy percent during the 1990?s.

Several studies compared breastfeeding and formula costs. A study reported in

the 1997 medical journal article, for example, found that feeding an infant

formula costs approximately $300 to $460 extra a year than breastfeeding the

infant. This differential included the cost of extra food that mothers require

for lactation.

As breastfed infants have been shown to be less likely to catch common

infectious illnesses than formula-fed infants, it is possible that mothers who

breastfeed may have to miss fewer days from work to care for a sick child than

mothers who are formula feeding. Attributing costs to time and wages lost by

mothers (and fathers) attending to a sick child should be considered when

estimating the possible economic benefits of breastfeeding.

Diet while Breastfeeding

Breast milk from most women contains basically the same nutrients. There

could be small differences, based on what a woman eats and how her body produces

breast milk. If the mother eats a poor diet, this can decrease both the amount

of milk produced and the nutrients found in the milk. Women who are

breastfeeding should consume an extra five hundred calories per day above their

maintenance calories. A healthy, well balanced diet, high in protein and complex

carbohydrates, similar to the one consumed during pregnancy, is all that is

necessary, with the exception of five hundred extra calories per day.

Occasionally, a baby may be sensitive to something in the mother?s diet.

The most common sensitivities are to protein antigens that are found in cow?s

milk, soy, wheat, fish, corn, eggs, and nuts. If the mother believes the baby is

reacting to something in her diet, she should eliminate that food for two to

three weeks, then try it again.

The Law of Supply and Demand

Milk production works on the principle of supply and demand. The more a baby

breastfeeds, the more milk a mother will produce, totally meeting the baby?s

needs. It is the frequency of breastfeeding as well as the amount of milk

removed from the breast that stimulates further milk production. Babies who are

given supplemental bottles of water or formula breastfeed less frequently,

ultimately decreasing the milk supply. Supplements, in bottles, should be

avoided for three to four weeks, unless medically indicated, until the milk

supply is well established and the baby is latching on to the breast without

difficulty. Babies need to be breastfed at least eight to twelve times in

twenty-four hours the first two to four weeks, or until well above birth weight.

Working and Breastfeeding

It is essentially important for working mothers to remember that milk

production is based upon the principle of supply and demand. The key to

maintaining a sufficient milk supply is to breastfeed often.

If the baby is under four months old, the mother should express milk during

the workweek when the baby would normally breastfeed at home. Additionally, the

mother should breastfeed in the morning just before going to work, again as soon

as possible after work, frequently during the evening and whenever the baby

wakes at night. Breastfeeding at night causes the prolactin level to rise, thus

helping the mother to relax and enjoy a good night?s sleep. Mothers should

breastfeed their baby as often as possible during days off from work. This will

help increase the supply for the next week.

In addition to understanding and mastering the art of breastfeeding, working

mothers face added challenges imposed by their schedules. First and foremost,

the mother should take full advantage of maternity leave to establish a good

supply before going back to work. Fatigue is a working mother?s biggest enemy.

The working mother should set a schedule that will slowly put her back into the

work force, giving both mother and baby time to adjust to the change in routine.

Storing Breast Milk

Breast milk varies in color, consistency and odor, depending on the mother?s

diet and storage container. Because breast milk is not homogenized, the cream

will separate and rise to the top of the container. Breastmilk may be safely

stored by carefully following these steps:

1. Wash hands well with soap and water before touching breasts or any milk

containers. Avoid touching the inside of bottles or caps.

2. Pump or express milk into a clean collection cup.

3. Transfer the milk into a clean storage container. If pumped directly into

a storage container, it will lessen the chances of contamination.

4. Label the container with the date and amount of milk collected. (oldest

milk should always be used first)

5. To inhibit the growth of bacteria, breastmilk that is not used within 8-10

hours should be refrigerated. If milk is to be stored for more than 5-7 days,

freezing is recommended.

6. For longer storage, freeze breastmilk. Frozen milk may be stored in a

refrigerator freezer for six months or in a deep freeze for up to twelve months.

When freezing, fill the container only ? full to allow room for expansion.

Never refreeze breastmilk!

Weaning

Around the world, babies are breastfed an average of two to three years.

There is, however, no perfect time to wean. Weaning is an individual decision

for each mother and baby. Most babies will not show signs of wanting to wean

before eight to nine months at the earliest. The American Academy of Pediatrics

recommends breastfeeding exclusively for the first six months, gradually

introducing new foods after that time. It is recommended that breastfeeding

continue for at least twelve months, and thereafter as long as mutually desired.

When a mother or her baby decide to wean, it should be done gradually to prevent

the discomfort of engorgement and to help maintain the baby?s sense of

security. Dropping one feeding every few days and replacing it with formula of

cow?s milk (depending on the age of the baby), will allow the mother?s

breasts to adjust to the decreased demand in comfort. Most mothers drop the late

night or early feeding last since this feeding is often the special snuggle time

with the baby.

References

American Academy of Pediatrics, Work Group on Breastfeeding; 1997,

Breastfeeding and the Use of Human Milk, Journal of Pediatrics, Volume 100, pp.

1035-1039

Crummette, B.D., and Munton, M.T.; 1980, Mothers? Decision about Infant

Nutrition, Pediatric Nursing, 6:16

Evans, H.E., and Glass, L.; 1979, Breastfeeding: Advantages and Potential

Problems, Pediatric Analysis, 8:110

Health Answers Medical Reference Library ? Breast milk @

www.healthanswers.com/MedEnc

Klaus, M.H., and Kennell, J.H.; 1982, Parent ? Infant Bonding, 2nd edition,

St. Louis: The C.V. Mosby Company

Lawrence, R.A.; 1980, Breastfeeding, St. Louis: The C.V. Mosby Company

Palma, P.A., and Adock, E.W.; 1981, Human Milk and Breastfeeding, American

Family Physician, 24:173

Ross, L.; 1981, Weaning Practices, J. Nurse ? Midwifery, 26(1): 9-14

Whaley, L.F., and Wong, D.L.; 1979, Nursing of Infants and Children, St.

Louis: The C.V. Mosby Company