Second Draft

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. Early in the morning and I was sleepy as always. While I was reviewing the skills on my way to the hospital, I was thinking about the breastfeeding skills which my teacher emphasized more on that. Based on the fact that baby is hungry and craving for prepared milk and new mom has engorged breast with milk and as a person that never being a mom I thought it shouldn’t be hard to feed baby at all. But I was completely wrong! They all need the specific 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 and 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 crying 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. I’d say most of them choose breastfeeding with all the difficulties that they may have for the first time.

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 stopped at that moment because this decision is completely personal so I decided to bring her some pamphlets and brochures from hospital. I knew that talking about breastfeeding for her first baby is late but I just hope she changes her mind for next ones! After that day I was looking for answers for lots of questions such as: why some new mothers decide to use and don’t breastfeed? Do they 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 fed me for about 2 years. What did my mom know about breast feeding that nowadays mothers don’t know? I can remember our conversation around 5 years ago when we discussed about breast feed. My mother knows 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.

Scientifically, human milk is a highly complex, species-specific fluid uniquely designed to meet the human’s infant needs. According to The American Academy of Pediatrics and World Health Organization (WHO) it has the results in improving neonate and maternal health based on its standard ingredients for infant feeding and nutrition. Therefore, based on the positive effects of breast milk as the short and long terms of medical and developmental stages on infant, this issue should be considered as a public health issue. 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 Pediatrics that endorsed by WHO/UNICE. Breastfeeding plays the significant role in disease control and prevention in infant such as Respiratory Tract Infections and Otitis Media, Gastrointestinal Tract Infections, Sudden Infant Death Syndrome and Infant Mortality, Allergic Disease, Obesity, Diabetes, Childhood Leukemia and Lymphoma. Gathering some information about each these diseases can give the positive reinforcement to the parents to see the differences between their children who have been breast-fed and the ones that bottle-fed.

Bounding between new born and mother is the most significant psychological reason that encourages mothers to start breastfeeding. The baby needs the reassurance of his mom continued physical presence, after the thrust from the close, dark womb into an overwhelming experience of lights, noises, and new smells. By holding the baby and being in the skin-to-skin with baby while he is gazing into the mom’s eyes he comes to understand that he is loved and protected and that his mother is there to provide for his needs as he adjusts to this new world. Also, this strong attachment between them affects the baby’s developmental stage and milestone for years to come. In addition, breastfeeding releases hormones in your body that promote mothering behaviours.

After all this argument, there are plenty of reasons that new mothers give up and choose formula instead of breast 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 mother. Frustration, changing the hormones level in the body, thinking about baby’s future and her multi roles and much more other affecting things are causes for them to become exhausted and decide to start bottle feeding. For nursing the baby, new mother need to learn how to do that. It looks like a natural process but it doesn’t mean that it should be easy for a non-experienced mom. A proper latch is crucial to success. This is the key to a successful breastfeeding. If baby has a poor latch, it will cause nipple pain “hurt”. 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 causes many mothers to start bottle for their babies is low milk supply. They should know that breastfeeding is a supply and demand process 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 favourite ones 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 in postpartum unit, I’ve been asked every day by mothers about the food that can increase milk and unfortunately it is hard to answer this question because there is no special diet for the healthy post pregnancy women while breastfeeding. After discussion with my teacher, we could have a valuable meeting with the dietician in this floor. Her respond to this question 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.”

For the sake of the barriers of feeding, I can recall a story. One night around 10 o’clock, the fire alarm started and in a short time I found myself in the apartment’s lobby with other tenants. There was crowd but just only one thing got my attention, a mother with her newborn with nonstop crying. Interestingly, she couldn’t stop her crying. I was thinking the first action to stop that for every mother would be offering the breast but she never attempts. Because of that, I tried to make myself close to her while she was talking to the other woman. Why she doesn’t start breastfeeding her baby instead of being anxious?! My sense of curiosity and bad feeling about the baby made me to eavesdrop their conversation. She forgot to bring the bottle when she left the apartment and she was wishing to breastfeed her baby. Unfortunately, I judged her easily when I found out she did the breast surgery after the accident about 3 years ago and that was her barrier for breast feed.

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