Breast milk provides the ideal nutrition for infants. It has nearly the perfect mix of vitamins, minerals, proteins, and fat which are a must for the immune system. Breast milk is everything that your baby needs to grow. It is also provided in a form of an easily digested formula. Breast milk contains antibodies that help the baby fight off viruses and bacteria. Breastfeeding lowers the risk of having asthma or allergies. Plus, babies who are breastfed exclusively for the first 6 months of life without any formula have lower incidences of ear infection, respiratory illness, and bouts of diarrhea. 

Breastfeeding awareness week is a global campaign to raise awareness and galvanize action on themes related to breastfeeding. WBW 2021 theme is “Protect Breastfeeding – A Shared Responsibility.”

Dr. Aditi Shah is the Director at Small Wonders children's clinic. She has experience of 30 years. She's also attached to Nanavati Super specialty Hospital, She has also done multiple guidance lectures for parents especially to help them how to take care of their babies in the best possible way, especially during their initial years of parenthood. 

Breastfeeding is a must for newborn babies 

Dr. Aditi Shah says, “We know that breastfeeding is an actual normal process for every mother. God has given the gift to mothers as well as to children, that even if there is no training, the mother will still be able to breastfeed and the child will still be able to breastfeed whenever required. The mother is going through a lot of changes when she has just delivered a newborn baby. She's not very aware of the right things and the wrong things that need to be done. The baby's also adjusting to a whole new environment, a new world outside. And, with both of these new things happening at the same time, if the mother gets any form of encouragement from a doctor from social media or her relatives, she will just be even in a better position to give breast milk to her mother or to the baby, which is the most required thing for the baby.”

The need for breast milk 

Dr. Aditi informs,” The baby needs only breast milk. So that's what the mother has to do in the right way. Now this question arises in the mother's mind, about the feeding frequency?

So, as soon as the baby's born within half an hour if it is a normal delivery If it is a certain section, sometimes you have to wait a little longer till the mother is a little more comfortable. And then initiation of breastfeeding has to be done as soon as possible. 

Once the baby starts breastfeeding most often it is the baby who decides when he needs to take the next breastfeed. This is called On-Demand breastfeeding. So most of the time, it is at an interval of two hours, but of course, it's never mathematics with children. And therefore, the mother can follow on-demand breastfeeding, which means whenever a baby wakes up, crying, it is mostly for hunger or thirst, then she has to latch the baby to her breast so that she can give her breast milk.” 

Timings for breastfeeding

Dr. Shah says, “We generally asked mothers to keep a gap of two to three hours between two feeds and not to feed for longer than around 45 minutes during each feed. If we calculate that, then it comes to about six to eight feeds in 24 hours. This is true for all babies still the first six months, but it's always independent. Every individual baby is different. So, some babies may feed every two hours, some babies may feed every three hours. And then that's why we always encourage on-demand feed.” 

Know when the breastfeeding is adequate 

Dr. Shah informs, “If she's not following a correct schedule, we can judge by looking at the baby's urine output. If the baby's passing six to eight times in 24 hours, that means the mother's milk is enough. The other way that a pediatrician looks at whether mother's milk is enough or not, is by looking at the weight. So, we have to make sure that the babies are being checked at regular intervals, then only it is possible to know for sure that the mother is feeding the right amount, and at the right frequency that the baby needs. The weight gain is adequate in such cases.”

 Advice to Working Mothers 

Dr. Aditi says, “No babies should be kept devoid of the mother's milk. I always tell mothers that just before you leave from work, and immediately after you come back from work, make sure you breastfeed your baby what to do in between. So, in between the mother can express her milk in a clean style bottle and keep it at room temperature. It can be kept for around six hours at room temperature whenever the baby needs it like we discussed on-demand breastfeeding.

This mother's milk which has been expressed and kept can be fed to the baby at that time and whenever required, mostly every two hours. But, if she manages to pre-feed before going and feed after coming back most often this issue will not be required because the mother will not be working more than five to six hours. And, therefore this can be tackled very easily by giving Express milk to the baby at that time.”

All you need to know about Express Milk 

Dr. Aditi informs, “ Here are some important points for Express Breast Milk to be borne in mind of every mother-

Express breast milk can be kept for up to six hours at room temperature every time before giving it to the baby. It's a good idea to shake the bottle. There'll be a little bit of yellow supernatant which doesn't mean that the milk is spoiled.  If there's any form of curdled milk then that is spoiled milk and that should not be given.  If the mother can express a good amount of milk then she can put it in the refrigerator, not freeze but put it in the refrigerator for up to 12 hours. Now the important point here to remember is that all these portals or whichever part is going to come in contact with the baby has to be sterilized. That means it has to be kept in boiling water. It has to be kept in boiling water for at least 15 minutes at least once a day. It can even be the nipple at the bottle, the top of the bottle, and the bottle itself has to be sterilized. This is so that no form of infection reaches the baby through the wall.

 COVID positive mothers

Dr. Aditi states, “The Indian Academy of Pediatrics also endorses this and the American Academy of Pediatrics, that breastfeeding can be continued even if the mother is COVID positive. So, that breast milk is going to have advantages, it is going to transmit the antibodies which protect the baby. Therefore, the baby's main fact is getting protected by giving breast milk even for newborns with what is born out of a mother who is COVID positive.

Even for them, we encourage breastfeeding, the mother can continue feeding just like she would in any other case, but the only thing is she has to maintain all the precautions of  Hand hygiene handwashing sanitizing before and during the duration of breastfeeding She has to make sure that she's wearing a mask.  After the feeding is over, she can stay a little bit away from the baby. 

The Indian Academy of Pediatrics says -

One healthy person from home is allowed to stay with a mother who has just delivered a newborn baby who is COVID positive.  Even that person should be following hand hygiene practices, wearing a mask, sanitizing the hands, and taking care of the baby. The caretaker for the baby can mostly help the mother with breastfeeding even if she's COVID positive. But, there is no other reason why she should stop breastfeeding.  Even if the mother has a fever, they can still breastfeed the baby Certain medicines which are used for COVID treatment are not allowed in breastfeeding. So these mothers should talk to their doctors and consult them. 

Breastfeeding is important for a mother’s weight fluctuations 

Dr. Aditi informs, “There have been several studies suggesting that even for in general maintenance of a good hormonal balance for the mother for her mental well being as well as long term for protecting her from breast cancer, breastfeeding is beneficial. It improves the bond between the mother and the baby. So, there are not only physical but even mental and even long-term benefits of breastfeeding. And, weight loss is of course one of them. There are so many other advantages not only to the baby but to the mother also. And that's why encouraging breastfeeding becomes so important.”

 (Edited by Dr. Rati Parwani)