Breastfeeding is technically known as lactation. After birth, a woman’s breasts automatically start to produce milk to feed the baby. The admonition “breast is best” features prominently on cans of infant formula and on advertising for breast milk substitutes in many third-world countries, and there is little doubt that it is true. Because of poverty, poor hygiene and poorly prepared formula, bottle-feeding should be actively discouraged in disadvantaged areas.

Unfortunately, for a variety of reasons, not all mothers are capable of breastfeeding. Those who can’t should not feel guilty, but should accept that this is a problem that can occur through no fault of theirs, and be grateful that there are excellent feeding formulas available for their child.

Breastfeeding protects the baby from some childhood infections and the stimulation it also helps the mother by stimulating the uterus to contract to its pre-pregnant size more rapidly.

Babies don’t consume much food for the first three or four days of life. Nevertheless, they are usually put to the breast shortly after birth. For the first few days the breasts produce colostrum, a very watery, sweet milk, which is specifically designed to nourish the newborn. It contains antibodies from the mother, which help prevent infections.

Breastfeeding may be started immediately after birth in the labour ward. All babies are born with a sucking reflex, and will turn towards the side on which their cheek is stroked. Moving the baby’s cheek gently against the nipple will cause most babies to turn towards the nipple and start sucking. Suckling at this early stage gives comfort to both mother and child. In the next few days, relatively frequent feeds should be the rule to give stimulation to the breast and build up the milk supply. The breast milk slowly becomes thicker and heavier over the next week, naturally compensating for the infant’s increasing demands.

After the first week, the frequency of feeding should be determined by the mother and child’s needs, not laid down by any arbitrary authority. Each will work out what is best for them, with the number of feeds varying between five and ten a day.

Like other beings, babies feed better if they are in a relaxed comfortable environment, with a relaxed comfortable mother. A baby who is upset will not be able to concentrate on feeding, and if the mother is tense and anxious, the baby will sense this and react, and she will not be able to produce the “let-down reflex” which allows the milk to flow. The milk supply is a natural supply and demand system. If the baby drinks a lot, the breasts will manufacture more milk in response to the vigorous stimulation. Mothers of twins can produce enough milk to feed both babies because of this mechanism.

While milk is being produced, a woman’s reproductive hormones are suppressed and she may not have any periods. This varies greatly from woman to woman, and some have regular periods while feeding, some have irregular bleeds, and most have none. Breastfeeding is sometimes relied upon as a form of contraception, but this is not safe. The chances of pregnancy are only reduced, not eliminated. The mini contraceptive pill, condoms, and the intrauterine device can all be used during breastfeeding to prevent pregnancy.

It is important for the mother to have a nourishing diet throughout pregnancy and lactation. The mother’s daily protein intake should be increased, and extra fresh fruit and vegetables should be eaten. Extra iron can be obtained from egg yolk, dark green vegetables (eg. spinach), as well as from red meat and liver. Extra fluid is also needed.

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