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