In the absence of family support structures and inadequate work environments, breast-feeding can become an easy casualty for new mothers. As we observe World Breast-feeding Week (August 1-7), some things that can be done to promote a new-mother- and baby-friendly ambience at home and the workplace…
She is in tears… she has not slept in two nights and the baby is not easy to feed. The little one is cranky and crying, refusing to suckle for more than few minutes at a time. Everyone, family and friends, around her is saying the milk is not enough, but the doctor says no additional feeds…
The image of a baby content and suckling at the breast of a gently smiling mother is the image that comes to mind when we think of a newborn and a new mother.
Breast feeding is a “by default” activity — it is expected to come naturally and be the easiest and most intuitive thing in the world. For many it is and for many it is not. The initiation and sustaining of breast feeding requires constant support and motivation especially when the woman has had a long and tiring labour and is exhausted. Sometimes it is because some babies don’t take to the breast as easily and there is a need to support establishing a good hold, grip and latch.
Oftentimes today, even in “baby friendly” hospital environments there is very little hands-on support for new mothers to help them adjust to the demands of breast-feeding.
Equally, the traditional family support systems that we prided ourselves with in India are fast disappearing. The grand mothers and aunts of today are as clueless as the new mothers sometimes — with the nuclear family structure of today oftentimes the last baby they may have handled is the one who has just had a baby now. So they are as anxious, if not more, than the new parents.
It is, therefore, as important to educate the family care-givers and husbands about the importance of breast-feeding, the value of support and positive reinforcement. It is a fact that the more the mother gets stressed, the less milk she may produce. Constantly hearing that there is no milk is not a positive reinforcement at all. Colostrum that is produced is vital and important to the baby and most term normal weight babies need not have any supplement or formula in the first 24-48 hours it takes to establish good lactation.
Maternity units and neonatal units must be dedicated to ensuring breast milk is the only milk given except in situations where it is not possible or medically indicated. They must work to provide support for this. It is here that the role of nurses or people trained in lactation support becomes important. While as doctors we talk about the importance of breast-feeding, we do not have the time to stand there and help a mother and baby who have difficulty through a feed. When we have dedicated personnel or a named nurse to help with feeding they can focus time and supervise feeds for those who are having a problem.