Essential facts a feeding mother should know.

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feeding mother

Nature’s most wonderful creation is a mother who creates life, the one who brings life on earth, feeds the offsprings to make them stronger, and guides them for the rest of their lives. Motherhood is all about learning. It’s the process to become a mother. Breastfeeding is one of the most beautiful experience a woman can have in her motherhood, where both the mother and the child share a feeling of bonding-care-belonging. So, one needs to be extra-careful about the little things like hygiene, timings, techniques, and food habits which play a major role in sustaining each other’s health for attaining future goals. 

Here are the top 10 facts a new nursing/lactating mother should know while breastfeeding: 

PREPARATIONS FOR A FEEDING MOTHER

Hygiene is a concerning factor in breastfeeding. Poor hygiene may make infant vulnerable to many bacteria and fungal infections. The milk itself is sterile and safe for the newborn, but unhygienic breasts can lead to painful nipple infections(streptococcal infection), which may be transmitted to the baby through oral means or deprive them of feeding. These are some points one can follow before feeding: 

  1. Wash your hands with soap or an alcohol-based hand rub.
  2. Keeping the nipple area clean and dry. Try to wash it with mild soap but never scrub them.
  3. Avoiding the usage of any plastic breast pads/tight clothing.
  4. Keep the breast pump clean and dry after everyday use.
  5. Avoid the usage of scented products.

TREAT THE SORE/ENGORGED BREASTS: 

Initiation of breastfeeding may seem a little painful to many mothers, but it gets normal over time. However, some common problems have been addressed here with their cause and cure. These shouldn’t be neglected, and if severity increases, one should seek medical help.  

The sore nipple is a problem for many new mothers where a mild pain or discomfort is felt after feeding due to damage or crack. Though it is a common incident, too much pain should be addressed to a doctor. The reasons can be improper feeding position, infant’s oral dysfunction, improper use of breast pump, use of cosmetics causing allergic reactions, etc. But one can prevent this and can take utmost care by following the steps given below:

  • Express enough milk before breastfeeding to stimulate the let-down reflex, thus preventing the infant from sucking too vigorously on the breast
  • Practice a proper feeding position. 
  • Feed on the least affected breast first and try to alternate the positions to avoid feeding on the most affected breast.
  • Use some expressed milk on the affected area first. The anti-infective property helps in the healing of the area and nourishes the deep layers. 
  • Breastfeed on demand.
  • Use warm and cold compress after feeding. 

Breast engorgement is another distressing and uncomfortable situation faced by many mothers in their postpartum period, including pain, throbbing, hard breast due to inadequate emptying of breast and obstructed mammary ducts/channels. If no relief is obtained, the residual milk starts reabsorbing within the channels, causing an intermolecular transformation that thickens the milk. It becomes really aching with reddish spots and improper milk flow. Here are some precautions and tips listed for the cure. 

  • Breastfeed on demand regularly. 
  • Try a gentle massage to fluidify the viscous milk, and it will help stimulate the let-down reflex.
  • Express some milk before feeding to become a little soft and easy-flowing for the baby to grasp. 
  • Apply a warm compress (not for a long time as it may increase undesirable milk production) to ejaculate milk.
  • Apply a cold compress ( not more than 20 mins) after feeding to reduce the tenderness and edema.
  • Avoid tight outfits.
  • If the condition worsens, consult your doctor. 
  • Prefer breastfeeding over bottle feeding. 

PROPER POSITIONS FOR LATCHING: 

Improper position during feeding is the main cause of painful breastfeeding which leads to non-exclusive breastfeeding. This time the baby and mother share a feeling of connection and love, so it’s very important to latch on properly. With the pace of time, one can figure out the right position to feed. Mothers are suggested to communicate, look into the eyes, touch and care for the baby while feeding. The newborn should be kept warm (almost like the warmth in the womb) by promoting Kangaroo Mother Care and promoting local practices to keep the room warm. 

The following are some suggested latch-on positions: 

CRADLE POSITION:   

Image by seeseehundhund from Pixabay
  • It is the most common position where the baby’s head rests on the mother’s arms at the elbow while the rest of the body on the forearm and faces towards the mother. It is suggested to sit comfortably on a chair/couch with a backrest.  
  • It is the most common position where the baby’s head rests on the mother’s arms at the elbow while the rest of the body on the forearm and faces towards the mother. It is suggested to sit comfortably on a chair/couch with a backrest.  
Image by seeseehundhund from Pixabay
  • In this position the mother’s hand supports the neck of the baby and the infant’s body rests on the forearm and places your palms between the shoulder blades. Incase mother/ child feels some problem, the mother can change the position. 

FOOTBALL HOLD: 

Image by seeseehundhund from Pixabay
  • This position works best for mothers who have delivered the baby through a C-section as it keeps the baby away from the incision. The baby is laid back with the support of the mother’s arms to the same side of the breastfeeding. The baby will be at her back, in between the arms and side with the baby’s legs at the elbow. 

INDICATIONS THAT YOUR BABY IS HUNGRY: 

Your child speaks gibberish which feels cute. But to understand whether they are hungry or not, a mother/the caregiver needs to do a little study on the behaviors of the little ones. Here are some common ways infants try to say they are hungry:

  • They start moving their head so as to touch something with their mouth. This is called rooting. 
  • After waking up they move more than usual.
  • Bringing their hand towards their mouth and suckling fingers/fists
  • Crying is a late hunger cue and mothers shouldn’t wait till they cry. instead, they should readily start feeding.

MYTHS & FACTS ABOUT MILK PRODUCTION: 

Studies show that though 81% of mothers initiated breastfeeding, the rate dropped to 42% by 6 months. While 71% reported the main concerns were: insufficient milk production, improper position, and painful breasts.

  • MYTH: Milk production depends on breast size. Decreased breast size indicates insufficient milk production. 
  • FACT: The milk storage depends on the number of mammary glands/tissues but not the size. Proper draining is also important.
  • FACT:   Milk production is a hormone and stimuli induced process where the hormones like prolactin and oxytocin and stimuli like suckling induce milk production by the process called let-down reflex. Due to a surge of estrogen and progesterone during pregnancy, these hormones slightly elevate breast size and initiates room for milk production. However, no studies have proved the production of low milk due to reduced breast size. Stress and anxiety can be other reasons that contribute to low milk production. 
  • FACT:  Insufficient nutrients cause low milk production. The main constituents of milk are calcium, protein, fats, etc. Mothers who are malnourished/deficient may not produce the desired amount of milk which might end up with non-exclusive breastfeeding. Dehydration can be another reason affecting milk formation. 

START-RESUME-STOP — TIMINGS MOTHERS SHOULD KNOW ABOUT FEEDING:

Breast Milk is the only food for your baby. You should have a sound knowledge of when to start, when to stop, and how many times you should feed so as to avoid overfeeding or underfeeding. 

WHO and UNICEF have suggested breastfeeding exclusively for the first 6 months, and not to give water even if the baby is thirsty, instead feed them milk. This is because milk itself contains 70-80% water, enough to quench an infant’s thirst. 

Mothers should be aware of stereotypical practices like discarding colostrum. Here’s a guide on timings:  

WHEN TO START: It is suggested to feed your baby within 1 hour of birth avoiding any delay beyond this time limit. The yellowish fluid is the colostrum which is highly essential for your baby as it contains immunoglobulins, proteins, and carbs to protect your baby from any kind of infection. For operative cases, mothers should be encouraged to feed the milk as early as possible after birth. 

HOW OFTEN SHOULD BE FED: Babies should be fed “on cues”, periodic feeding can be done under clinical surveillance. Generally, it is suggested to breastfeed 8-10 times in 24 hours until lactation is established (avg: 1-2 weeks). Babies generally feel hungry after 3-4hrs feeding on 50ml of milk. This may increase in the early months as this is the high time for their growth and development. Experts suggest expecting an increased need of 30ml/month until 6 months of exclusive breastfeeding. 

WHEN TO STOP: there is no reason not to breastfeed and to feed formula milk unless the mother is suffering from contagious diseases like HIV, under the use of any drug, post-operative cases of breast, unable to produce milk due to several reasons, the unfortunate death of the mother. In this situation, parents/caregivers need to talk to the pediatricians for complete guidance of the infant. After 6 months of exclusive breastfeeding, one can introduce complementary feeding or weaning along with the feeding of milk. It can be continued up to 2 years of the age of the newborn. 

ASSESS YOUR MILK SUPPLY: 

It’s very normal to be concerned about your milk supply and whether your baby is able to feed properly. In that case, mothers should be careful about: the weight gain and the stools/urine output of the infant. On average, infant should gain a weight of 105-210g/week. Consulting clinicians would be better to assess the weight gain. 

Another factor is the reduced amount of urination and stool output by your infant. Stools are initially dark green to black and sticky but become characteristically light mustard-seed yellow around day 5 to 7. 

FOODS TO CHOOSE BY A FEEDING MOTHER : 

Adequate nutrition is another crucial factor for a breastfeeding mother. The milk is prepared using her own body’s water, proteins, fats, vitamins, minerals, sugars, etc. To ensure optimum milk production and adequate nutrient repository in the mother’s body, one should consider the additional needs of the nutrients at this time, or unless any deficiency can hamper the milk production. Here’s guidance on nutrients to focus on; 

  • ENERGY: According to the latest RDA recommendations by ICMR, a lactating mother should have an additional of +600 kcal(0-6 months) and +520kcal(7-12 months). That is an average of 2500-3300kcal/day depending upon the activity status to meet the energy needs in milk production. Low energy diets can fail to meet the needs of both baby and mother leading to fatigue and irritability.
  • PROTEIN: An extra allowance of protein is suggested by ICMR. For the first 6months it’s +16.9g/day and the next 6months it’s +13.2g/day. Include at least 2-3 protein servings a day. Meat, poultry, fish, egg, dairy, nuts, etc. can be added to the menu.
  • FATS: DHA, EPA are some fatty acids that help in the brain development of the baby. ICMR suggests taking 30g/day fat which mainly constitutes PUFA like omega-6 and omega-3 fatty acids. Nuts like almonds, egg yolk, and liver are rich sources of PUFA. 
  • CALCIUM/PHOSPHORUS: The ratio of calcium: phosphorus should be 1:1. ICMR suggests daily consumption of 1200mg/day calcium. It’s the main constituent of the milk which makes the bones and teeth stronger. A deficiency in calcium may affect the quality of milk, and can cause osteoporosis in mothers as well. 
  • VITAMINS: The 3 vitamins which are important are vitamin A for eye and skin development, vitamin C for its antioxidant property and aids iron absorption and vitamin D for bone health and calcium absorption. All kinds of orange and yellow colored fruits and veggies are vitamin A source. Guava, amla, tomatoes are some richest sources of vitamin C. Sunlight, fortified foods, beef, liver, egg yolk are some authentic sources of vitamin D. 
  • IRON & FOLIC ACID: These two help in the brain development, blood formation, oxygen transport throughout the body etc. of the infant. Though milk is a poor source of iron, it’s adequate for the infant. 

WATER: Hydration is a major factor in this time. Milk constitutes around 80-88% water. While breastfeeding, it secretes oxytocin which stimulates thirst indicating to drink water to meet the extra needs. It is advised to drink at least 8 glasses of water per day even if they do not feel thirsty.

-Other vitamins like vitamin B complex, zinc, magnesium, iodine etc., are as important as the above and need to be incorporated into the diet. 

-Food and spices like oatmeals, chickpeas, fennel, fenugreek etc., serve as galactagogues

FOODS TO AVOID BY A FEEDING MOTHER: 

A mother should know that whatever they consume will be transferred even in a little amount to the baby through the milk. So, one should wisely cut off certain foods and drinks for the health of the newborn

  • MYTH: Gassy foods like cauliflower/cabbage may cause gas issues to the infant
  • FACT: It may cause gassing to the mother, but the components do not pass through the milk. 

PRACTICE MEDITATION AND MINDFULNESS: 

Along with your physical health, take care of your mental health as well. A stressful life can affect the baby. Make sure you calm yourself and then go for feeding. Do not use any screen while breastfeeding. Try to focus on your little ones and their swallowing patterns. Read books, practice meditation and yoga, talk to other new moms to know more about parenting and motherhood. Do not neglect any kind of discomfort, directly say it to your caregivers. 

Also, read Nutrition in Pandemic for Mother & Children.

Please consult our doctor online for more information!

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  • Article by: Ishita, Bsc Food and Nutrition

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