Breastfeeding may seem like a consensus to most people as the best form of nutrition for babies. However, there are still many taboos and questions surrounding breastfeeding. August is, by law, the month to discuss this practice and highlight its importance for the healthy and sustainable growth of children. Take the opportunity to clarify the main issues in this article.
In 2017, the Brazilian National Congress defined, by Law nº 13.435,as Golden August the Month of Breastfeeding. Thus, awareness and clarification and actions on the importance of breastfeeding should be intensified.
International organizations, such as the World Alliance for Breastfeeding Action (WABA), also promote this agenda. In 2020, World Breastfeeding Week addresses breastfeeding as a key factor in making the Planet healthier.
In this article, check out some questions that may arise during pregnancy or in the first months of breastfeeding. Information is the starting point for success in this process.
- The benefits of breastfeeding
- Preparation for breastfeeding
- Colostrum: first milk
- Breastfeeding on demand
- Watch out: tongue brake and mastitis
- Breastfeeding at the end of maternity leave
- Gentle weaning: the end of a story
- Myths and truths of breastfeeding
- Boa Hora and good milk
1. The Benefits of breastfeeding
Breastfeeding is an important process for newborns because of the many benefits studied and proven over the years. Through breast milk, the baby is protected from infections, especially gastrointestinal and respiratory diseases, by the presence of secreting IgA antibodies (IgAS).
To give you an idea, breastfeeding all babies in the first 2 years of life can save the lives of more than 820,000 children under the age of 5 every year, according to a report by the World Health Organization – WHO and the United Nations Fund. United for Children – Unicef.
A study released at the European Obesity Congress also points to breastfeeding as a tool to prevent excess weight in the long run. Data from 100,583 boys and girls from 22 European countries were used.
The result indicates that, when compared to those fed exclusively with breast milk for six months, children who are not breastfed or who have received human milk for shorter periods are more likely to be obese.
According to the obstetric nurse Cinthia Calsinski, from the Federal University of São Paulo (Unifesp), breast milk naturally has a protective and immunomodulatory function – that is, it alters the immune system according to the body’s needs. For the current time of pandemic, there is no evidence of risk and keeping the baby breastfed remains a great form of protection.
“Every day, the body modifies the composition to provide specific nutrients and components suitable for each age and situation”, explains the specialist, who works on Boa Hora, Omint’s program aimed at providing guidance to pregnant and postpartum clients.
Breastfeeding also has benefits for the breastfeeding woman, who has less risk of developing ovarian, breast and uterine cancer, less chance of suffering diseases such as rheumatoid arthritis, diabetes and cardiovascular problems.
Here in the blog: Ask questions about pregnancy and Covid-19
2. Preparation for breastfeeding
Breast milk should be offered exclusively in the first 6 months of life and in a complementary way until 2 years old. The first question related to the topic for women who are pregnant is how to prepare for this journey. The best way is to seek updated and supported information to understand what kind of situations it will be possible to face.
Currently, experts do not recommend carrying out any physical preparation to be able to breastfeed. For Cinthia, who is also a breastfeeding consultant, the hormonal preparation that happens during pregnancy is what will help breastfeeding to flow naturally.
“The areola tends to grow and the secondary areola appears, which is like a ‘shade’ around the areola. It darkens right after delivery due to hormonal stimulus for the baby to ‘find’ where to bite,” explains the obstetrical nurse.
Information is so important because there are still myths about breastfeeding. Until recently, common sense led women to use artifacts such as “shells” to help form the beak, especially those with flat or inverted nipples. However, the accessory can press the breast ducts, impairing milk production.
Another factor that contributes to a smooth breastfeeding is the support that women receive to insist on breastfeeding. “Several studies show that breastfeeding women who do not receive support, care and support end up giving up breastfeeding, harming themselves and the baby”, says Cinthia.
3. Colostrum: first milk
Colostrum is the first milk, yellowish in appearance, found in the breast alveoli from the last trimester of pregnancy until the first days of postpartum. Therefore, it is the newborn’s first nutrition contact, consisting of protein, lactose, fat, leukocytes, vitamins A, E K, immunoglobulins and other essential nutrients for child development.
Cinthia explains that colostrum is adjusted to the needs of the moment, according to the baby’s stomach capacity. The main function is to immunize the newborn, but it also has a laxative effect to expel the meconium that is present in the intestine, in addition to preventing jaundice, allergies, diarrhea and intestinal infections, favoring the balance of the intestinal flora.
To help stimulate the descent of colostrum, the obstetrical nurse advises that mothers offer the breast on demand and have patience until the “descent of milk” that usually happens around the third postpartum day.
4. Breastfeeding on demand
According to the Primary Care Booklet of the Ministry of Health (number 23, 2009), it is recommended that the child be breastfed without restrictions on the time and length of stay on the breast: it is called breastfeeding on demand. Naturally, in the first months, it is normal for the child to breastfeed frequently – the document points out that it can happen 8 to 12 times a day.
Free demand is the way to adjust the milk production according to the needs of the child over time, because as he grows and gets bigger he needs more volume. Each baby has a feeding rhythm and each woman has a volume of milk production.
The constant crying and the high demand is not necessarily a sign of the baby’s hunger, “weak milk” or little milk. It means he is creating his own pace and adapting. “There is a prejudice that the child needs to feed every 3 hours and that all crying is due to hunger. They forget that it can be sleep, dirty diapers, boredom, need for affection or physical contact, among others ”, reassures Cinthia.
5. Watch out: tongue brake and mastitis
Breastfeeding is not always easy. The woman may encounter problems along the way and, without information and without understanding the signs, can lead to early weaning. One of these causes of pain is the baby’s short tongue brake, ankyloglossia.
Since 2014, it is determined by law that the “TongueTest” be carried out in maternity hospitals, in public and private hospitals to check if the baby’s tongue is short. This congenital problem can cause pain in the breastfeeding woman by generating nipple cracks and also prevents breast milking. Milk accumulates and can lead to engorgement and mastitis.
In addition, a baby with this condition has more work to do the correct “grip”, which can cause gas, colic and difficulty gaining weight – all of these considered risk factors for early weaning.
However, the good news is that ankyloglossia correction is a simple surgery and can be done by a trained doctor or dentist, who performs a small cut on the tongue brake. When necessary, local anesthesia is used.
In addition to the evaluation of the “Tongue Test”, if the mother notices difficulties with these characteristics, she should seek a qualified breastfeeding consultant and also seek information from the pediatrician who monitors the child’s development.
Another problem that may be a consequence of the tongue brake, but that is also common in other situations, is mastitis. “When the baby does not properly bite the areola, there is no complete emptying of the breast, favoring inflammation”, explains the obstetric nurse.
Infection can also occur during food introduction, with an increase in the interval between feedings, in an abrupt weaning, with the use of artificial nipples or inappropriate bras.
This is one of the guidelines that Cinthia usually provides to Omint customers in the Boa Hora Program. “We teach the mother to do the breast self-examination to identify problems such as engorgement or blocked ducts so that she knows when to seek help,” she says.
Among the main signs of mastitis are redness, local heat, swelling, pain, tenderness, high fever, malaise, muscle pain, chills etc. When mastitis is infectious and pus leaves, breastfeeding is suspended and the breast is milked until its complete recovery. It is also necessary to make use of antibiotics prescribed by the doctor.
6. Breastfeeding at the end of maternity leave
Although the World Health Organization (WHO) recommends that breastfeeding be exclusive for at least the first 6 months of the baby’s life, many mothers need to stop breastfeeding at the end of maternity leave.
The continuation of this process must happen for all the health benefits already mentioned. However, it will be necessary for the mother to organize herself and help from the support network so that it is possible to extract the milk (with a pump or with her hands) on a routine basis, as well as continue breastfeeding whenever she is with the child.
On returning to work, you will need to stock up. It is important, however, to pay attention to the expiration date of breast milk, which is 15 days in the freezer and 12 hours in the refrigerator. Cinthia recalls that the ideal recommendation is to offer this milk through breastfeeding cups, coffee cups and / or dosing spoons, as these utensils do not cause “nipple confusion”, when the baby ends up preferring artificial nipples (such as bottles) for demanding easier suction
7. Gentle weaning: the end of a story
Each mother will have her own history of breastfeeding, which can often be short for several reasons and others, long. Breastfeeding depends a lot on access to information, the support network, the woman’s routine and the health conditions of the mother and baby.
So, when is the right time to stop breastfeeding? There is no single formula, but Cinthia indicates that the best way is when the mother and baby “feel” the exact time together. Weaning starts with the introduction of food, since the baby starts to breastfeed less by starting to consume other foods and milk production is reduced.
According to the obstetrical nurse, weaning can occur in some ways:
– abrupt weaning: when the mother needs to stop breastfeeding overnight due to illness, mastitis, engorgement or some other reason of force majeure;
– planned or gradual weaning: qwhen the mother needs to go back to work and knows that she will not be able to breastfeed the baby on demand as before and milk production gradually reduces;
– partial or gentle weaning: when the feedings are interrupted gradually and replaced by other moments of pleasure and bonding;
– natural weaning: quando a criança deixa o peito por livre e espontânea vontade.
when the child leaves the breast freely and spontaneously.
If she chooses to stop breastfeeding, the woman must feel confident that the bond with the baby will not change because of this. For the process to occur without trauma, the obstetrical nurse indicates that the mother does not offer the breast, “but also do not refuse if the baby looks for it”.
The father or partner can be a great ally, helping to make the baby sleep without sucking and helping to distract the child with games and “explorations” when the request for breastfeeding arises.
Here in the blog: Expert tips for pregnant moms and dads
8. Myths and truths of breastfeeding
Common sense often brings outdated and outdated ideas on topics important to society. With breastfeeding, many women still experience a universe of hunches and misinformation. For the avoidance of doubt, here are some myths and truths about breastfeeding.
1) Big breasts = a lot of milk, small breasts = less milk.
Myth. The size of the sinus is due to the body composition of glands, muscles and fat. Therefore, milk production cannot be estimated by breast size.
2) Flat or inverted nipples make breastfeeding impossible.
Myth. The flat or inverted nipple can make the first feedings a little difficult until the baby understands how it should be done, “but after a while breastfeeding goes smoothly”, guides Cinthia.
3) It is not necessary to offer artificial milk until the milk is lowered.
Truth. Soon after delivery there is already the production of colostrum, a type of milk with special characteristics for the first days of life. The drop in milk usually occurs around 72 hours after delivery and colostrum is enough for the baby during this period.
4) The baby must be breastfed every 3 hours.
Myth. The baby must be breastfed on demand. When you cry and your mother identifies crying as hunger, it’s time to breastfeed.
5) Artificial nipples can cause early weaning.
Truth. It is a consensus among researchers on the subject that the use of artificial teats increases the chances of early weaning.
6) Drinking water increases the volume of milk produced.
Myth. Drinking a good amount of fluids during breastfeeding is very important for the mother and the functioning of her body, including milk production. But it does not mean that the more water ingested the more milk will be produced.
7) Every woman can breastfeed.
Partly true. Anatomically, all women are able to breastfeed, but not all can. Physical and emotional health factors are decisives.
9. Boa Hora” and good milk
The questions and insecurities that afflict women during pregnancy, including breastfeeding, can be addressed by family members and women close to the pregnant woman with their experiences. A competent and up-to-date medical team is also essential for this very special and challenging moment when this woman writes her own story.
Boa Hora is an Omint program that offers this welcome full of information throughout pregnancy and postpartum. In the cities of São Paulo, Rio de Janeiro and Campinas, the program has face-to-face meetings between pregnant women and trained professionals, such as nurses. In other regions, the service is provided virtually, which does not change the main objective, which is to meet the needs of each mother in a personalized way.
Obstetrical nurse Cinthia Calsinski has worked at Boa Hora for ten years and met the proposal as an Omint client. “I have a double look. It was a program that greatly impacted my life as a mother and as a professional as well. There is no secret formula at Boa Hora. Each woman is unique and we help her to find herself in her own maternity. It is a work that the impact is visible and very positive, a privilege”, she reports.
In the case of breastfeeding, Cinthia points out that often the situation is not flowing well and is able to revert in a single consultation. “We have devices to make women feel well in the postpartum period. It is a pride to be part of this team and to experience the transformations of these families ”, she concludes.
To learn more about Boa Hora, contact the Call Center on 0800 726 4000, via chat or WhatsApp. The program is subject to prior review and approval by Omint’s health management team.