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Breastmilk is the best food for a baby. The discussion concerning the pros and cons of breast and bottle feeding has gone on for years and will no doubt go on for much longer. The growing consensus is that breastfeeding is better for the baby’s health.

Breastmilk contains just the right kinds and proportions of protiens, fats, and sugars for the baby. More than a hundred substances in breastmilk have been identified. Infant formulas cannot duplicate many of these substances. As the child gets older, the composition of the breastmilk changes to suit the needs of the baby. Breastmilk can even change during a single feeding. At the beginning of a feeding, the baby gets foremilk, which is high in liquids and low in calories. This is good for quenching thirst. This is fallowed by the thicker, richer, hindmilk. The hindmilk is good for nutrition. By switching breast at the right time, the baby can control the amount of liquid and calories they get. A bottle-fed baby cannot do this. Breastfed babies sleep longer, suffer less gas, and spit up less than bottle fed babies. Colostrom is the first milk that the baby recieves. Colostrom is a thin, yellow, milky fluid secreted by the breast before and after birth. It contains many antibodies, vitamins and minerals. The breast continue to produce colostrom for a few days after the baby is born. It is produced in very low quantities, but contains everything a newborn baby needs. Clostrom has several essentail ingrediants. It acts as a laxative to help eliminate meconium, the baby’s first bowel movements. It contains a substance that protects the baby against infections by lining the baby’s intestines. Antibodies are in colostrom. They protect the baby from many diseases and help to resist infections. Even if the mother plans to bottle-feed, letting the baby breastfeed for the first three or four days will give the baby a major health advantage.

Mature milk arrives after two to three days after birth. The baby’s suckling action stimulates the production of more mature milk. This milk is whiter and is produced in much greater volume. It is very important for the mother to maintain a good diet. Surprisingly, breastfeeding moms need more calories than during pregnancy. Producing this mature milk takes up a lot of energy. It is also likely that the mother will feel thirstier than usual due to the baby taking over a pint of milk a day. It is important that the mother drink plenty of water.

There are many health benefits for babies when they are breastfed. Not only is breastmilk the food source, but it has several medicinal benefits as well. Immune factors are passed from the mother’s immune system to the baby’s immune system through breastmilk. Breastfed babies are less likely to have allergies and asthma. They are also less likely to have intestinal problems since they are much less likely to be exposed to harmful germs like salmonella or coli bacteria. Bottle fed babies gets these from improperly sterilized bottles or contaminated water. Breastfed babies are much less likely to have ear infections, food allergies later on in life and to develop cancer as a child or adult. They are possibly less likely to be obese and suffer from hypertension and heart disease. Babies that are breastfed are considerably less likely to die from sudden infant death syndrome, commonly known as SIDS. The babies are not the only ones to benefit from breastfeeding. Breastfeeding is good for the mother’s figure. It promotes the loss of weight gained during pregnancy. While breastfeeding, oxytocin is released to stimulate milk flow. This also encourages the uterus to return to its prepregnant size. The pelvis and waistline will also return to normal more quickly. Studies have shown that breast cancer is lower in those parts of the world where breastfeeding is the norm. It is also possible that breastfeeding may provide some protection against disease.

Once a mother has decided to breastfeed she needs to pick a breastfeeding friendly hospital. Purchase nursing clothes, nursing stools or pillows. Mother’s need to remember to ask their obstetricians any questions they may have and learn about lactation consultants in their area. Getting off to a good start in the hospital is important. The doctors and nurses should know about the mother’s plan to breastfeed. Nursing as soon as possible after birth is beneficial for the baby and the mother. Most babies will be interested in nursing at some time during the first hour after birth. If this first breastfeeding opportunity is missed, it may be a day or two before the baby wants to nurse again. By rooming in, or keeping the baby in the same room with the mother, ensures that the baby is available to nurse at any time. Avoiding pacifiers during the first month of the baby’s life. Pacifiers can cause nipple confusion. Nipple confusion is one of the many hurdles in breastfeeding. Many hospitals will give the baby glucose water from a bottle to see if the baby has proper sucking reflex. This is very unnecessary and the mother can do this by putting the baby at the breast. Nurses sometimes will feed the baby formula during the night so they can avoid waking the mother. This too will cause nipple confusion. Drinking from the bottle is very different than suckling from the breast. To suckle the baby needs to open their mouths wide, pull the nipple far into the mouth, flange the lips out and use the lower jaw and tongue to pull back the areola to draw milk from the reservoirs. Bottle nipples are stiff and they are designed to drip by themselves. A baby does not need to apply as much suction to keep the nipple of the bottle in place. It is much easier to get milk from a bottle. Many babies who have been given bottles will get frustrated at the breast. New mothers often think that they do not have enough milk. The real reason is that the baby is confused. The baby expects the breast to work like a bottle. It is best to avoid bottles and pacifiers for a few weeks until the baby learns to latch on properly. Dealing with nipple confusion is frustrating for both the mother and baby. Contacting a lactation consultant may be helpful.

Positioning is another major factor in breastfeeding. The baby must have a good part of the areola in the mouth, not just the nipple. The milk ducts are located beneath the areola and the baby needs to apply pressure to the ducts to get the milk out. If the baby suck just on the nipple, the nipples may become sore. The baby’s nose should be touching the breast. This will ensure that the baby has enough of the breast in their mouth. The tongue should be covering the lower gum. The lower lip should be turned out and pushing against the lower side of the breast. Inserting a finger into the baby’s mouth will break the suction, pulling the baby off of the breast will damage the nipple. Holding the baby during nursing is also a part of positioning. There are three common holds. The sitting down position is the classic nursing position and the one used most often. The mother should place a pillow on her lap to raise the baby up high enough to reach the breast. They should be tummy to tummy with the baby’s lower arm around the mother’s waist. The football hold is especially good for mothers who have had cesarean section delivery. The baby should be placed at the mother’s side with her forearm supporting the baby’s back and her hand cradling the head.
The lying down position is great for feeding in the middle of the night. The mother should lie on her side with one arm bent behind her head and resting on a pillow. The lower breast should be offered to the baby.

To avoid sore nipples, engorged breast and a fussy baby, the mother must make sure that the baby is latched on correctly. All babies are born with a rooting reflex. Take advantage of the baby’s rooting reflex. When something brushes the baby’s cheek or lip they will turn their head towards that side. The baby will open the mouth very wide like a yawn. The mother should keep tickling the baby’s lips with the nipple until the baby opens the mouth really wide. While the mouth is opened wide the mother should pull the baby toward the breast all the way to the chest. It is important to pull the baby very close to make sure they get a good mouthful of breast instead of just the nipple. The mother may prefer to hold the breast in her hand while the baby is latching on. They should avoid holding the breast between the index and ring finger. Instead they should try using the thumb on the top of the breast and the four fingers on the bottom creating a C or U with the hand. Many breastfeeding mothers suffer from sore nipples. Many things contribute to sore nipples. Improper latch on may cause nipple to crack and bleed. Moisture can make sore nipples worse. Using cotton bra pads to absorb leaking milk and changing them often is a good idea. Another suggestion is to hand express a couple of drops of breastmilk after a feeding and rub it gently into the nipple and areola and then air dry the nipples before putting the bra on again. Soaps, ointments and creams should be avoided. They may dry out the nipple and cause bleeding cracks. The only cream that is okay to use is pure lanolin. Engorged breasts are common in the early stages of breastfeeding. Breastmilk is produced on a supply and demand system. In the few days to weeks after birth this system is not yet established. The breast start making large amounts of milk, more than the baby can consume. The breast will become overfull, hard and tender. Skipping feeding for any reason will also cause engorgement. Nursing the baby as often as they or the mother needs it will help reduce engorgement. Taking a warm bath or shower will get the milk to start flowing on its own relieving the pressure. It is very dangerous to leave the breast engorged. This may lead to plugged ducts or mastitis. Mastitis is a bacterial infection of the breast. The symptoms are flu like feeling, fever and tiredness. The breast with mastitis will have a hot, tender and red area. It may hurt a lot to touch this area. There will be a lump or several little lumps inside the tender area. Mastitis occurs when milk stays stagnant in the breast. Bacteria enter through the nipple and cause an infection. Tight clothing may cause mastitis by blocking the milk ducts. Applying a warm washcloth, massaging gently, taking a warm bath and nursing the baby with their lower jaw facing the affected area may treat the mastitis. Often time’s medical attention is needed. The doctor may prescribe antibiotics. The best way to avoid mastitis is to nurse often. Make sure the baby empties the breast completely, if not then pumping should be used.

It is hard to tell if the baby is getting enough milk. An exclusively breastfed baby should have at least six wet diapers every day. The baby’s urine should be colorless or very pale yellow. If the urine is bright yellow the baby is not getting enough o drink. The baby should be properly hydrated. The front fontanel should be curving out when the baby is crying and slightly curving in at other times. The mother should notice if her breast feel full before a feeding and softer after a feeding. The mother should avoid stress and nicotine. This may cause the breast to slow down milk production.

Feeding the baby on demand will help to maintain the milk supply. When the breast start to feel full or engorged or when they start leaking the mother should breastfeed. The baby should be nursing about eight times a day. The mother should maintain a healthy well balanced diet and get plenty of rest. Nursing mothers should drink more than the usual amounts of water. Birth control pills may decrease the production of milk. Since breastmilk is produced on a supply and demand system, nursing often and pumping in between feeding will increase the milk supply.

The milk ejection reflex or letdown is how the baby gets the milk out of the breast. Nipple stimulation causes the muscles around the milk producing cells to contract. This then pushes the milk into the milk ducts around the areola. If the ducts are already full or a lot of milk is produced, the milk will leak or spray out. The brain releases the hormone, oxytocin when the nipples are stimulated. Other things that can release oxytocin are seeing, hearing and thinking of the baby. Sexual arousal will also cause letdown. While nursing the baby the other breast may leak as well. This is called sympathetic letdown. By pushing on the nipple with the palm of the hand, the leaking will stop.

Breastfeeding a fussy baby may be very difficult. Most mothers feel that if their baby is fussy they do not have enough milk. Many people, even doctors, may suggest supplementing with formula in a bottle. The mothers need to be careful and not cause the baby to have nipple confusion. Other steps should be taken to increase milk production. Sometimes, a baby may react to something that the mother has eaten. The mother should be careful not to eat gassy foods since they will be passed on to the baby. Fussiness may result if the mother has too much milk and a hyperactive letdown. Most quite and sleepy babies are the ones who don’t get enough milk and fail to thrive. Their lack of alertness will not stimulate the breast to letdown the milk. A fussy baby is more likely to be well fed.

Demand feeding is usually the best way to feed a baby. This means that a mother should nurse the baby whenever they want it, for as long as they want it. This will make sure that the mother doesn’t have problems with insufficient milk or with lack of growth in the baby. The baby should nurse at least eight times in a twenty-four hour period. If the baby is too sleepy to nurse at least eight times a day, then the mother should wake the baby up to feed it. The mother should not worry about how long the baby nurses for. When the baby is full they will let go. The other breast should be offered and the baby should be allowed to nurse until they are finished.

Breastfeeding a young baby, under two months old, is easy in some respects and difficult in others. This is the best time for the mother and child to bond and is a learning experience for the mother and baby. During this time period the baby will begin to trust the mother and learn to depend on them to be there whenever they need it. In order for breastfeeding to go smoothly the mother needs to remain calm and patient. Stressed out mothers make stressed out babies. This is a learning process and mothers need to remember that it will take time.

By the time the baby reaches two to six months old, the mother and child have learned the mechanics of breastfeeding. The mother has gained confidence in her milk supply and the letdown reflex. Because they know all about positioning and latching on, they do not suffer from sore nipples. Engorgement no longer is an issue since the breasts have adjusted to the needs of the baby. Outings have become much more manageable now that the mother has built up enough confidence and ease to nurse in public. The baby is now at the stage where they start smiling and may come off of the breast to smile at the mother or the baby might try smiling with the nipple still in it’s mouth. Mothers of breastfed babies need to learn how to ignore people with negative comments on breastfeeding. They need to trust their baby to show the signs of a healthy appetite.

When the baby is six months to one year old they are ready to try solid foods. The mother should always offer the breast first before any meal since breastmilk is still providing most of the nutrition for the baby. Juice may be given to the baby in a cup, but limit the amount. Giving bottles of juice may cause tooth decay. Breastfeeding is still an excellent way to comfort the baby and to help them go to sleep. By this time, the breasts are so accustomed to making milk that the mother can probably afford to be away from the baby for half a day without worrying about the milk supply. On the other hand, breastfeeding is likely to be such a joy at this time that the mother may not want to be away from the baby at all.

One common question people have is whether they will have enough milk for multiples. Twins provide twice as much stimulation, so the breasts will make twice as much milk. With adequate breast stimulation and nutrition it seems to be no trouble for women to produce more than a gallon of milk per day. That is easily enough for three or four babies. The main impediment of nursing multiples is the time and energy it takes not the amount of milk they need to produce. But bottle-feeding multiples may be even more work.

Breastfeeding while pregnant is still an option. Many people say that nursing while pregnant may hurt the fetus. There is no need to worry unless the mother is severely malnourished, A pregnant nursing mother might hear that nursing during pregnancy might increase the risk of miscarriage. It is true that nursing causes uterine contractions, but there is no evidence that this may lead to a miscarriage. The mother may experience some breast and nipple tenderness during the pregnancy. Some time during the pregnancy, the milk will decrease and its taste will change. It will eventually change into colostrom. Many children wean themselves when this happens but some are happy to continue. The choice to tandem nurse is up to the mother.

Tandem nursing is when a mother is nursing an infant while they are also nursing a child. Few women choose to tandem nurse. The milk supply is not a problem. The mother will have plenty. The only that need to be avoided is letting the older child nurse immediately before the baby. The older child will also help keep the milk supply up if the baby gets ill or goes through a nursing strike. Some mothers find that they resent the older child’s nursing. This is a sign that weaning may be a good idea.

Many people think that returning back to work is incompatible with breastfeeding. Some women do not even start breastfeeding for this reason, but many mothers who return to work manage to continue breastfeeding. The longer that the mother can stay at home with the baby the easier it will be to continue breastfeeding when they return to work. Getting a hospital grade pump is important because they are much more efficient than smaller ones. These breastpumps are expensive. They can be purchased or rented. It will still be cheaper than bottle-feeding. The mother should nurse the baby last thing before leaving for work and first thing when returning from work. If it is possible the mother should visit the baby once or twice during the work shift to breastfeed. Pumping the breast as many times as possible and saving the milk for the babysitter is a good idea. This will keep the milk supply up. Mothers should nurse as often as they can during weekends and holidays. Mothers should also be prepared to supplement with formula or other foods. It is unlikely that the mother will be able to produce enough milk to feed the baby exclusively on breastmilk while working full time. This will work for most mothers. However, babies will gradually wean themselves when their mother returns to work. Breastfeeding in public is controversial, but it can be done. Before a mother starts breastfeeding in public, they should make sure that they have the mechanics of breastfeeding right. Making sure that the mother and the baby are comfortable with positioning and latching on will make it easier. Breastfeeding the baby before they get too hungry or are screaming will be easier and quieter. The mother should decide whether she wants to nurse discreetly or openly. They should do whatever makes them and their baby most comfortable and happy.
Breastfeeding mothers have legal rights. It would be helpful for mothers who breastfeed to know them. They might come in handy in a variety of situations. Women have the right to breastfeed in public. As seen breastfeeding has many great benefits not only to the baby but to the mother as well. The many advantages of breastfeeding can promote a healthy baby and a happy mom. Before mothers choose bottle they should remember that breast is best.

"Breast is Best".

Santrock, John W. (2003) 7th Edition Children.
New York, NY: McGraw-Hill

"The Breastfeeding Page".

Stoppard, Dr. Miriam (1995). Complete Baby and Child Care.
New York, NY: Dorling Kindersley Publishing, Inc.

     Keough, Carol (1998). Better Homes and Gardens New Baby Book. Des Moines, IA: Meredith Publishing Group.

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