Breastfeeding

Breastfeeding is when a woman feeds an infant, toddler or a young child with milk produced from her breasts, usually directly from the nipples. Babies have a sucking instinct that enables them to take in the milk.

Feeding options and requirements

Exclusive breastfeeding means feeding a baby nothing but breast milk. Predominant or mixed breastfeeding means feeding breast milk along with some form of substitute – infant formula or baby food and even water, depending upon the age of the child. Babies feed differently with artificial teats than from a breast. When feeding from the breast, the tongue massages the milk out rather than sucking, and the nipple does not go as far into the mouth; when feeding from a bottle, an infant will suck harder. Therefore the advice is not to mix breastfeeding and bottle-feeding (or the use of dummies) until the baby is used to feeding from its mother. Orthodontic teats, which are generally slightly longer, can be used to better replicate the breast.

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Exclusively breastfed infants feed, on average, 6–14 times a day. The requirement varies greatly between children. Newborns consume about 30 to 90 ml (1 to 3 US fluid ounces). and after the age of four weeks, babies consume about 120ml (4 US fluid ounces) per feed. Each baby is different, and as it grows the amount will increase. It is important to recognise the signs of a baby's hunger and it is advised that the baby should dictate the number, frequency, and length of each feed, based on the assumption that it knows how much milk it needs. The supply of milk in the breast is determined by the frequency and length of these feeds or the amount of milk expressed. The birth weight of the baby may affect its feeding habits, and mothers may be influenced by what they perceive its requirements to be. For example, a baby born small for gestational age may lead a mother to believe that her child needs to feed more than if it larger – they should, however, go by the demands of the baby rather than what they feel is necessary.

Related Topics:
Birth weight - Small for gestational age

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One concern about breastfeeding is that it is hard to accurately measure the amount of food the baby consumes. This should not be a worry; the baby will feed to meet its own requirements. It is also easy to monitor output from wet and soiled nappies. 8 wet cloth or 5–6 wet disposable, and 2–5 soiled per 24 hours) indicates an acceptable amount of input for newborns older than 5–6 days old. After 2–3 months, stool frequency is a less accurate measure of adequate input as some infants may go up to 10 day between stools as part of their normal function.

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Expression

When direct breastfeeding is not possible a baby may still be fed breast milk. By expressing (artificially removing and storing) her milk, a mother can enable her child to be fed while she is away from the child. With expression through manual massage or the use of a breast pump the woman can draw out her milk and keep it in supplemental nursing system or a bottle ready for use. This bottle may be kept on the counter for up to seven hours, refrigerated for up to eight days or frozen for up to four months. Research suggests that antioxidant activity in expressed breast milk decreases over time http://fn.bmjjournals.com/cgi/content/abstract/89/6/F518 but it still remains in higher levels than in infant formula.

Related Topics:
Breast pump - Supplemental nursing system - Bottle

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Expression can be used to maintain lactation such as when the mother and child are separated for an extended period. If the baby is unable to feed, expressed milk can be fed through a nasogastric tube.

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Expressed milk can also be used to help a mother who is having difficulty breastfeeding, such as when a newborn causes grazing and bruising or when an older baby grows teeth and bites the nipple (though the reaction of the mother to a bite - a jump and a cry of pain - is usually enough to discourage the child from biting again).

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Some women donate their expressed breast milk (EBM) to others, either directly or through the hospital. Though some dislike the idea of feeding their own child with another person's milk, others appreciate the ability to give their baby the benefits of breast milk.

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Infant formula

The World Health Organization recommends that all mothers be encouraged to breastfeed. Hospitals that are accredited by the World Health Organization are tolerant of formula feeding but do not offer it to infants who can be breastfed. (Feeding a new baby with formula undermines the establishment of breastfeeding.)

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If the decision is made not to feed the child with breast milk or if breastfeeding is not possible, then infant formula is given to the infant, usually using a baby bottle. Infant formula may also be introduced as a supplemental liquid drink to weaned babies. Because it is formulated for human babies it may be seen as healthier than simply drinking the milk from another mammal.

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While it is clearly inferior to breastfeeding, Infant formula has been effectively marketed and promoted to new mothers as a modern, easy or convenient option to feeding a baby. A 2004 UK Department of Health survey showed that 34% of women believe infant formula to be very similar to or the same as breast milk. http://www.dh.gov.uk/PublicationsAndStatistics/PressReleases/PressReleasesNotices/fs/en?CONTENT_ID=4081944&chk=b8wDo%2B In 1979 the International Baby Food Action Network (IBFAN) was formed to help raise awareness of such practices as supplementary feeding of new babies with formula, inappropriate promotion of baby formula and to help change attitudes that discourage or inhibit mothers from breastfeeding their babies.

Related Topics:
2004 - UK - Department of Health - 1979 - International Baby Food Action Network

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Tandem, extended, and shared breastfeeding

Feeding two infants simultaneously is called tandem breastfeeding. The most common need for this is after the birth of twins whereby both babies are fed at the same time. It is not necessarily the case, however, that the appetite and feeding habits of both babies are the same. This leads to the complication of trying to feed each baby according to its own individual requirements while also trying to breastfeed them both at the same time.

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In cases of multiple births with three or more children it is extremely difficult for the mother to organise feeding around the appetites of all of the babies. The breasts can produce a high quantity of milk, according to the demand placed upon them, and many mothers have been able to feed their infants successfully http://www.lalecheleague.org/NB/NBSepOct92p135.html. It is common, however, for the woman to use other alternatives.

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Tandem breastfeeding is also convenient if a woman gives birth to a newborn while still feeding an older baby or child. Under these circumstances during the late stages of pregnancy the milk will change to colostrum for the benefit of the newborn. Some older nurslings will continue to feed even with this change while others may wean due to the change in taste.

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Although some may find it controversial, some women breastfeed their offspring for as many as three to seven years from birth. This is referred to as extended breastfeeding. Supporters of extended breastfeeding say that all the benefits of human milk–both nutritional and emotional–continue for as long as a child nurses. Detractors believe that prolonging breastfeeding for several years can result in the child developing emotional or psycho-sexual problems.

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In developing nations within Africa and elsewhere, it is sometimes common for more than one woman to feed a child. This shared breastfeeding has been highlighted as a source of HIV infection amongst infants born HIV-negative http://www.aidsmap.com/en/news/72E08565-12B7-43CF-A71E-7A57292B30DF.asp.

Related Topics:
Developing nation - Africa

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See also: wet nurse

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