Mr. Jeffrey Gandell
May 11, 2015
Breastfeeding, Benefits and Barriers
It was a beautiful, rainy day in September that I started my rotation in the postpartum unit in Royal Victoria Hospital. It was early in the morning and I was sleepy as always. While I was on my way to the hospital, I was thinking about the breastfeeding skill which my teachers emphasized more on it. I thought it shouldn’t be hard to feed a baby at all based on the fact that a baby is hungry and craving for prepared milk and a new mom is ready to nurse her baby with two engorged breast with milk. But I was completely wrong! They all need to learn about breastfeeding technique and I found that when I got my first patient and read her chart. It said “She had difficulty to breastfeed” and this sentence was the most popular one that I saw in the other charts for rest of my rotation. It was right. Nobody taught the one-day old baby how to latch on her mother’s breast, on the other hand, new mom had no idea about holding her baby while breastfeeding or even didn’t know when and how she could start breast feed. One of my valuable and emotional moments was while a mom could start feeding her baby after 2 days teaching and her baby wasn’t fussy anymore and they stopped talking about the formula as the solution.
As a student nurse, I am observing and caring for the lots of mothers with different ages, cultures, ethics and values. They may give birth to their first baby or second but the only common concern for them is baby’s nutrition and weight and most of them choose breastfeeding with all the difficulties that they may have according to their condition after labour and delivery process and lack of experience in breastfeeding.
Recently, I talked to my neighbour who gave birth to a baby boy around 3 months ago and I was curious about how her breastfeeding goes. “I am not giving my milk, I use formula” she answered. I didn’t continue my conversation at that moment because I knew that talking about breastfeeding for her first baby is a bit late and this decision is completely based on personal beliefs. However, I brought her some brochures and I just hope that she changes her mind for next babies! After that day I had lots of questions in my head: Do parents know about the benefits of breastfeeding or not? I am sure that they read on newspapers or hear on the TV or radio about how important this fact is but why they neglect? These questions always lead me to my mother who breastfed me for about 2 years. What did my mom know about breast feeding that some of the nowadays mothers don’t know? I can remember our conversation around 5 years ago when we discussed about breast feed. My mother recalled breastfeeding as “a joyful closeness” and she was aware of health benefits for herself and me, “My breast milk was specifically tailored to you and I didn’t want to deprive that from you”. She could remember how hard latch was for me as a first baby but she was glad for her supporters “your grandmother supported me and my nurse taught me the best position and encouraged me not to give up and now I am satisfied and proud.” It is predefined in the human and animal natures to protect their babies and I am sure that she did this by giving me the breast milk, the first step of my possible protection from all possible illness.
“Human milk is a highly complex, species-specific fluid uniquely designed to meet the human’s infant needs” (Perry, Maternal Child Nursing Care in Canada). Exclusive breastfeeding for at least the first 6 months and continue it with complementary foods up to a year is a recommendation of the American Academy of Paediatrics (Pediatrics, Breastfeeding and the Use of Human Milk) that endorsed by WHO/UNICE. According to the American Academy of Paediatrics (Pediatrics, Breastfeeding and the Use of Human Milk) and World Health Organization (WHO) (Organization, World Health. Protecting breastfeeding in Peru) human milk has the results in improving neonate and maternal health based on its standard ingredients.
Newborns are weak and vulnerable to disease due to not fully developed bodies’ systems. Parents by performing very simple things try to protect their newborn. Your baby is unable to provide his needs and make a best decision for himself. Therefore at this point the parental responsibility which was started with pregnancy will change and steps into the further level. Breastfeeding is like making sure that your baby is wearing the proper cloth in the cold weather. Breast-fed children are more immune to disease and infection than formula-fed children and some diseases, including diabetes, multiple sclerosis, heart disease, cancer, and allergic disease that are less immediately obvious. However, we can’t ignore the benefits to the mother such as; easily losing weight after labour, returning uterus to its normal size more quickly and has a lower risk of osteoporosis, breast and ovarian cancer in later years. Therefore, based on the positive effects of breast milk as the short and long terms of medical and developmental stages on infant and moms, this issue should be considered as a public health issue all around the world. (council, Natural Resources Defense.)
Bounding between new born and mother is the most significant psychological reason that encourages mothers to start breastfeeding. The baby obtains the reassurance of his mom physical presence after birth from the close and dark womb into the new world by holding and being in the skin-to-skin contact with him while he is maintain eye contact with his mom during breastfeeding. He understands that he is protected and his mother will provide his needs until he adjusts to his new world. Also, this strong attachment between them affects the baby’s developmental stage and milestone for years to come. (Palmer, The Baby Bond).
After all this argument, there are plenty of reasons that caused new mothers give up and choose formula instead of human milk to survive their babies. Without any doubt, starting to feed a baby after the stress and anxiety that caused by labour and delivery process could not be an easy intervention for all the mothers. Frustration, changing the hormones level in the body, thinking about baby’s future and her multi roles and much more other affecting things can be enough reasons that leave no room for them to battle against breastfeeding difficulties. Lack of knowledge regarding to benefits of human milk and support from spouse and physician are the main barriers for nursing the baby. Even though, it looks like a natural process but it doesn’t mean that it should be easy for a non-experienced mom and they need to learn how to perform breastfeed.
I remember a mother with her first baby in postpartum unit in the second week of my stage. She was young and her paled skin and tired eyes were enough for everyone to understand that she had the hard labour. Unfortunately, the baby was super fussy and she had no energy to hold him and keep him on her breast. Interestingly, I saw her partner with the open wide eyes and shaking hands was standing at the doorway, “you can come closer and help your wife, she needs your help” I stated. “We went to the prenatal classes six months ago and I forgot most of them” he cried. I tried to make him calm by giving some structures and finally his confident returns and I left the room while he was cuddling with his tiny baby and smiling wife.
“A proper latch is crucial to success” (Jack Newman, Breastfeeding – Starting Out Right). This is the key to a successful breastfeeding. If baby has a poor latch (What to Expect) it will cause nipple sore with pain and that would be an early sign to stop trying breast milk. Checking the position, asking for help and having a supportive system can resolve this problem. Mastitis, which is a bacterial infection in the breasts, could be another reason to stop breast feeding due to starting the antibiotics course. The other concern that caused many mothers to start bottle for their babies is low milk supply (Board, BabyCenter Medical Advisory. baby center). They should know that breastfeeding is a “supply and demand process” (Breast Milk Production) and frequent nursing and using mechanical pump machine can increase milk supply. Some moms start to increase the calories intake and change their diets to favorite foods in their post pregnancy based on the wrong myth that eating more equals more milk production for a new born. This is wrong! As a nurse student who is working in postpartum unit, I’ve been asked every day by mothers about the food that could increase the amount of milk and unfortunately it is hard to answer this question because there is no special diet for the healthy post pregnancy women while breastfeeding.
Fortunately, I had a valuable meeting with the dietician in postpartum unit. Her respond to my question according to relation between diet and among of milk in post pregnancy mom was quite amazing “they don’t need to make any major changes in diet, eat a well-balanced diet from all the food groups can help mother to have the good quality and quantity of the milk”. Her point of view about calories was interesting for me when she said “nursing moms should follow their hunger as a guide to how much they need to eat instead of counting calories. The exact amount depends on their weight, exercise, metabolism and how frequently they breastfeed.”
Other general barriers such as returning to the work and tiring after that, not being comfortable and too embarrassing to pump the breast, and having the infant at day-care are obstacles that action is needed to overcome them. (Hogan, “Overcoming Barriers to Breastfeeding.”) For the sake of the barriers of feeding, I can remember a night around 10 o’clock when the fire alarm started and in a short time, I found myself in my apartment’s lobby with other tenants. There was crowd but just only one thing got my attention, a mother with her fussy baby. Interestingly, she couldn’t stop her crying. I was thinking that the first action for making the baby calm would be offering the breast milk which the mother never did that. Because of that, I tried to make myself close to her while she was talking to other woman. My sense of curiosity and bad feeling about the baby made me to eavesdrop their conversation. She replied that she forgot to bring the baby’s bottle when she left the apartment and she is not able to breastfeed her baby. Unfortunately, I completely misjudged her because she had the breast surgery after an accident about 3 years ago and that was her barrier for breastfeeding.
In conclusion, breast milk is the most appropriate food for infants for at least the first six months of life. Breast milk is cheap, always ready with the correct temperature and safe. It is perfectly balanced and it can adapt in content to the babies changing needs. It contains vital and immune components and encourages healthy development of all body systems including the immune and digestive systems. Breastfed infants experience less illness and have better cognitive and neurological development compared to formula-fed infants. Breastfeeding mothers enjoy reduced risk of breast and ovarian cancer, increased bone density, more rapid involution of the uterus, easier weight loss and reduced perceived stress and negative mood then mothers who don’t breastfeed. Breastfeeding requires skill, practice and diligence of the mother and also it requires support and encouragement from family, friends and professionals. Having knowledge and support will lead to increase her own health and the health of her baby.
Board, BabyCenter Medical Advisory. Baby Center. n.d. <http://www.babycenter.com/0_low-milk-supply_8487.bc>.
council, Natural Resources Defense. NRDC. n.d. <http://www.nrdc.org/breastmilk/benefits.asp>.
Hogan, S. Eileen. “Overcoming Barriers to Breastfeeding.” CANADIAN JOURNAL OF PUBLIC HEALTH (2001).
Organization, World Health. Protecting breastfeeding in Peru. 07 2013. <http://www.who.int/features/2013/peru_breastfeeding/en/>.
Palmer, Linda Folden. The Baby Bond. 07 2013. <http://babyreference.com/nursing-its-more-than-breastfeeding-and-every-mother-can-do-it/>.
Pediatrics., American Academy of. “Breastfeeding and the Use of Human Milk.” PEDIATRICS Volume 129 (2012).
Perry. Maternal Child Nursing Care in Canada. Toronto: Pearson, 2013.
What to Expect. n.d. <http://www.whattoexpect.com/poor-breastfeeding-latch.aspx>.
Newman, Jack. Breastfeeding – Starting Out Right <http://www.naturalchild.org/guest/jack_newman.html
Breast Milk Production. http://www.babies.sutterhealth.org/breastfeeding/bf_production.html