Post-delivery, the breast secretes colostrum – a deep yellow serous fluid which is alkaline in nature. It is rich in protein, vitamin A, sodium and chloride content and is low in carbohydrate and fat content. Antibodies IgA, IgG, IgM* and humoral factor – lactoferrin (a protein present in milk and other secretions, with bactericidal and iron-binding properties.), in colostrum provides immunological defence to the new born.
Although lactation starts following delivery, the preparation for effective lactation starts during pregnancy. During suckling a conditioned reflex is setup. This reflex is inhibited by factors such as pain, breast engorgement or adverse psychic condition. A healthy mother will produce about 500- 800 ml of milk a day to feed her infant. This requires about 700Kcal/ day for the mother, which should be made up from diet or from her body store. For this purpose, a store of about 5kg of fat during pregnancy is essential to make up any nutritional deficit during lactation.
Inadequate milk production may be due to infrequent suckling or due to endogenous suppression of prolactin – pain, anxiety and insecurity may be hidden cause. Unrestricted feeding at short interval in 2-3 hours is helpful. There are few drugs that improve lactation. Lactation suppression is needed for women who cannot breast feed for personal or medical reasons.
Premature infants of 700gms to 1250gms birth weight, supplemented with breast milk are discharged sooner and they have significantly lower risk of sepsis, retinopathy (disease of the retina), necrotising enterocolitis (tissue death of bowel) and bronchopulmonary dysplasia (chronic lung disorder of infants).
Burping should be done after each feed. Frequency of feeding should be every 2-3 hours or demand feeding. Nipple should be cleaned before each feed. Breast milk is the best possible food for your baby as it gives best start in life. It provides the required nutrition as well as immunity for your baby. It is best for you also.
Benefits of breastfeeding for you and your baby
Right nutrients, right balance: Breast milk has right proportions of proteins, carbohydrates, fats and other nutrients your baby needs to grow and develop
Easy to digest: Unlike proteins found in regular cow’s milk, the proteins in the breast milk are naturally gentle and easy to digest
Bio-available iron: Contains iron that is easy for your baby to absorb. The quality of iron in breast milk may be low but its bio-availability makes it significant for the baby
Builds tolerance: Helps protect baby against early food allergies, protein intolerance and sensitivity
Offers protection: Provides natural protective antibodies and other immune related benefits
Helps digestive system: Fosters a healthy environment in your baby’s digestive system
Evolves: Changes to meet the changing needs of your growing baby
Creates bonding: Provides a perfect opportunity for bonding with your baby
Reduces risk: Reduces the risk of diarrhoea and respiratory illnesses
Benefits of breastfeeding for mothers
Produces helpful hormones: Stimulates the production of hormone oxytocin, which causes your uterus to contract to return to its pre pregnancy size
Burns calories: Helps burn extra calories and lower fat stores, helping you to return to your pre pregnancy weight more quickly
Risk of becoming pregnant reduced: Mothers who breast feed exclusively and frequently have less than 2% risk of becoming pregnant in the first six months, provided they still have amenorrhoe
Longer health: Less chance of developing osteoporosis and breast or ovarian cancer later in life
New policy in US that protects a mother’s right to breastfeed in public without interference:
- All health-care staff must be trained to implement this policy
- All pregnant women must be informed about the benefits of breastfeeding
- Mother should be helped to initiate breastfeeding within half-an-hour of birth
- Mothers are shown the best way to breast feed
- Unless medically indicated, the new born should be given no food and drink other than breast milk
- No artificial teats should be given to babies
*Immunoglobulins are antibodies which are proteins made by the immune system to fight antigens, such as bacteria, viruses, and toxins. The body makes different immunoglobulins to combat different antigens. For example, the antibody for chickenpox isn’t the same as the antibody for mononucleosis. The five subclasses of antibodies are Immunoglobulin A (IgA), Immunoglobulin G (IgG), Immunoglobulin M (IgM), Immunoglobulin E (IgE) and Immunoglobulin D (IgD).
The author is a gynaecologist at Fortis Hospital