Exclusive breastfeeding revisited

There is little controversy about the benefits of breastfeeding for most newborns. However, I have noticed in my practice and in research that even the most well-intentioned women fail to exclusively breastfeed.

Milk formula is offered at an early stage to newborns with sometimes unfortunate side effects. Some women say to me that they weaned the baby because he/she did not want it. I heard these comments long before I had children and used to wonder how a newborn baby could not want breast milk.

With the experience of breastfeeding my first child for more than one year and now currently nursing my newborn, I still find the comment somewhat puzzling. I think the most likely reason for the baby not wanting breast milk is that he/she received alternative feeding too early in life.

However, nursing two very different children has improved my understanding of the reasons that women fail to exclusively breastfeed. One of my close friends, also a new mother who was unable to exclusively breastfeed, informed me that her biggest regret was that she accepted the nurse's offer of formula for her baby. She was tired, frustrated, and in pain. Her experience and that of some of my patients have inspired me to offer survival tips for exclusive breastfeeding.

Tips

1. I encourage all women who plan to exclusively breastfeed to prepare themselves before the baby is born. This can involve participating in antenatal classes and reading. Review pictures on the proper ways to hold baby while feeding and latch-on techniques.

2. After your precious bundle is born, put him or her to the breast as soon as possible and try to put baby there often. If he or she spends a lot of time sleeping, it is recommended that you wake him or her up every three hours to attempt a feeding. While my first child latched on with ease, my second had difficulty, and this can be particularly frustrating. But don't give up. Keep trying and ask your nurse and or doctor for advice. Be sure to drink a lot of fluids and eat adequate amounts of food. Be sure to ask for pain medication on a regular basis, especially if you had a Caesarean section.

3. Be prepared for some discomfort. The breastfeeding literature suggests that nipple soreness can be avoided if the infant latches on properly. However, my experience has been different. I have been unable to avoid soreness and while part of the problem could be poor latch-on technique, teaching a baby to latch on can sometimes be quite difficult. I recommend that the nipples be moisturised with lanolin regularly to assist with their healing. This should be done before the nipples become too traumatised.

Dr Monique Rainford is a consulting obstetrician and gynaecologist; email: yourhealth@gleanerjm.com.