Seunga (Jasmine) Han, PharmD Student
Whether you’re a soon-to-be mother or already have a child, there is one topic that’s always withstood controversy – breastfeeding. The world of breastfeeding is perplexing. Mothers often have many questions like: When should you breastfeed? How long should you breastfeed? Should you even breastfeed? If these questions are something you’ve thought about, read on.
When Should I Breastfeed?
According to the World Health Organization, exclusive breastfeeding of infants (no solids or liquids including water, with the exception of vitamin drops/syrups) is considered the gold standard for feeding infants for the first 6 months of life.
While this is a controversial topic for some, hence the lower rate of breastfeeding after 6 months of age, breastfeeding a child up to 2 years of age offers nutritional, emotional and immunological benefits to the child.
Though rare and unlikely, there are times where it’s not recommended for the mother to breastfeed. This can apply to mothers who:
- Are HIV antibody positive
- Have become acutely infected with H1N1 influenza (may breastfeed once afebrile)
- Have cancer and are undergoing chemotherapy (or tamoxifen treatment for breast cancer)
- Have untreated, active tuberculosis (a mother being treated for active tuberculosis can breastfeed if she is considered noninfectious, meaning she has been treated for at least two weeks)
- Have untreated brucellosis
- Have active herpes simplex viral outbreaks on the breast
- Have human T-cell lymphotropic virus (HTLV) type I or II
- Are taking a drug not compatible with breastfeeding
Breastfeeding is also contraindicated when the baby has galactosemia, an inborn error of the metabolism where the ability to break down galactose is absent, and the baby can’t tolerate breast milk.
What are the Benefits?
People often talk about the benefits of breastfeeding infants, but not many are specific about what that actually means. Here are some short-term and long-term benefits to breastfeeding:
- Improved function of the digestive system
- Enhanced immune system
- Better brain performance/functioning
- Reduced incidence and severity of illnesses like asthma, atopic dermatitis, diabetes, and infections
The benefits of breastfeeding in heart health, obesity and cancer still require more research; however, it seems apparent that breastfed children often have better developmental outcomes, whether it’s social, psychological, or economical.
Additionally, not only does breastfeeding benefit the infant, it offers benefits for the mother as well. These include reduced risk of type 2 diabetes, postpartum bleeding or depression, and cancers such as breast and ovarian cancers.
How Often Should I Breastfeed?
For the first week postpartum, it’s recommended to breastfeed every 2-3 hours or about 8-12 feedings within a 24 hours period. While you do this, it’s important to understand the signs of hunger, satiety and good latch and letdown. Don’t be alarmed if the infant seems to be more awake and needs to be fed more frequently. This is because human milk is easily and readily digested. In fact, infants who don’t readily arouse for feeding should be awakened to feed, if more than 4 hours have elapsed since the start of the last feeding.
Colostrum, the yellowish milk produced in the first two days postpartum, is rich in nutrients and immunoglobulins. Because this substance is present in small amounts, the baby should be stimulated to nurse frequently. On days 3-4 postpartum, the milk changes to mature milk and increases in its supply to meet the baby’s needs.
Am I Giving Enough?
You can determine if the baby is receiving enough milk by observing the number of wet diapers. If they receive adequate intake, you’ll notice 3–5 wet diapers daily by day 3–5, and 4–6 wet diapers daily by day 5–7. After breastfeeding is established, the number of feedings usually declines to 6–8 every 24 hours. You should also check the urine colour with each diaper change. Pale and odourless urine is a sign of a healthy infant. If you notice brick-coloured crystals in the diaper, the baby should be taken to a pediatrician, as it could indicate that the infant isn’t receiving enough fluid.
Once the baby’s first stool – called the meconium, has passed in the first several days postpartum, the breastfed baby will have 2–5 loose, unformed yellow/green/tan bowel movements per day. After six weeks of age, the number of bowel movements and wet diapers may become less frequent. Healthy breastfed infants typically don’t require extra water, even in hot weather, as long as breastfeeding is readily available to the infant.
The Bottom Line
Breastfeeding is a crucial component for the proper development of a baby, especially in the first six months of their life. Breastfeeding offers several nutritional, emotional and immunological benefits. Breastfeeding also benefits the mother in regards to the prevention of chronic illnesses. If you find yourself not producing enough milk to maintain the baby’s needs, seek help from an expert to ensure proper technique. If this isn’t successful, there are other treatment options, including using medications to promote milk production, which you can discuss with your healthcare provider or breastfeeding expert.
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