Between 1st and 7th August this year, the world commemorated Breastfeeding week. In this interview, Dr. Esa Oga, a Consultant Obstetrician and Gynaecologist at the Dalhatu Araf Specialist Hospital (DASH), Lafia, Nasarawa State speaks with our Correspondent, ESTHER AKAA, on the numerous benefits and other issues concerning breast feeding.
What is exclusive breastfeeding?
Exclusive breastfeeding is a kind of breastfeeding that is done whereby the baby is solemnly on breast milk without any other supplementary or complementary feeding for the first six months of life. That is to say, the baby is breastfed on demand. Each time the baby is hungry and the baby needs to feed, the baby is breastfed unconditionally. That is because of the various uncountable benefits of breast milk. Some people will argue that why not give water to the baby but breast milk itself contains about 85 to 90 % of water so there is no need to add water.
How much better is breast milk than the alternatives?
Breast milk is unequal to any other form of feeding in infant. Breast milk is alternative to none but there are some few conditions whereby you may have to use an alternative mode of feeding but if those conditions are not available, every mother or every prospective mother should be encouraged to plan for breastfeeding, if possible, exclusive breastfeeding because the importance are enormous. Breast milk has nutritional value to the baby, psychological value to the mother and protective bonding between the mother and her child.
How long should a baby be breastfed?
A baby should be breastfed close to two years but most mothers, the moment the baby celebrates his or her first birthday, they will begin to think of stopping the breast milk because they will begin to plan to add another baby. Most times in our cultures a lot of people believe that a woman cannot be breastfeeding when she is pregnant but that doesn’t have any effect. A lot of people due to cultural beliefs feel that the quality and the quantity of the breast milk at that point of pregnancy is poor and tends to affect the child.
How can an expectant mother prepare for breastfeeding?
The preparation of expectant mothers for breastfeeding dates back to antenatal. For instance, if she is a first timer or her first pregnancy, the doctor in question needs to examine the breasts to ascertain whether the nipple is well positioned, inverted, retracted, diverted, flat or pointed properly. This is because the baby needs to lash the nipple properly for adequate breastfeeding to be ensured. So that is the preparation. And if the nipple is inverted or diverted or flat as the case maybe, in most primigravida, what I mean is first time mothers or first time pregnancy, there are some modalities to correct it before the baby is delivered because the nipple will be properly positioned for the baby to lash on properly for adequate breastfeeding.
Recently, a chief nursing officer advised pregnant women to allow their husbands to suck their breasts to prepare them for breastfeeding. What is your take on this?
Very correct! The chief nursing officer who gave that advice did that very correctly because there are certain things we advise mothers to do particularly for their husbands to use his mouth to bring out the nipples when pregnancy occurs. As crude as this may sound or as simple as it may sound, it is very therapeutic. If the husband does that gently and passionately because at that time the breast may be so tender and may not be as comfortable as the case may be so the husband needs to be gentle as much as possible otherwise if that is not done and the mother delivers, the midwife or the doctor may need to use certain devices to bring out the nipple. Particularly I say again that for the first time mothers, especially for breast examination during antenatal, we advise husbands to suck nipples in order to bring out the diverted, inverted or flat nipples. It is very therapeutic and is like saving for the rainy days.
What are the benefits of breastfeeding?
Each time issues of breastfeeding come up, we are very glad to discuss the benefits of breastfeeding because it’s enormous. The benefits of breastfeeding should be sung daily to all prospective mothers and to all women of reproductive age group because a lot of young ladies who are venturing into marriages don’t look at breastfeeding as a component of motherhood. In fact, breastfeeding is key because it is protective to the baby. It increases the incidences of mother to child bonding. The covalent bonding between mother and child is enormous with a baby who is breastfed as compared to a baby who is not breastfed. The breast milk has antibiotics that are protective and protect against germs, bacterial infections that cause diarrhea respiratory tract infection in childhood. It also protects fungal and even viral infections. The common cause of childhood diseases is diarrhea respiratory infections and breast milk is very protective of it. Breast milk contains specific macrophages that engulfs or makes the life of other micro organisms inactive in such a way that they will be unable to harm the baby. Breast milk contains about 80 to 90 % water which makes it very useful and reduces dehydration in the baby. It contains about 7 % of lactose, a very special carbohydrate and sugar which enriches, energies and nourishes the baby. It also contains about 1% of protein and 4% of fats which nourishes the baby. It has immunogenic properties that prevent the baby from developing childhood immunological conditions.
A baby who is properly breastfed as compared to a baby who was not properly breastfed, the acumen and thinking capacity and academic performance have been studied and shown that those who were breastfed adequate perform better in classes and academics. So every woman of reproductive age group or every woman preparing for pregnancy should plan for adequate lactation.
How will mothers infected with Human Immune Virus (HIV) breastfeed their babies exclusively?
In the past, mothers with HIV were encouraged not to breastfeed their babies to prevent mother to child transmission of HIV. This was done on condition that alternative feeding is easily Available, Feasible, Accessible, Safe and Sustainable (AFASS). Easily available means, if you start alternative feeding and you are using, for example, NAN 1 infant Formula, you should have what it takes to make the NAN 1 available but the question now is that, is the alternative food available? Is it feasible? Is it Accessible? Is it safe and sustainable? So if in an environment, it is a mother who can afford that should be the one to prepare the alternative feeding. Even at that, is it safe? Is the water you are using safe? Is the water boiled? Because if you are not making the alternative feeding safe, what you are trying to prevent will indirectly come on board because it will cause diarrhea and that will kill the baby faster than what you are trying to prevent. That is why a study was carried out somewhere in Africa and it was realized that a baby whose mother was HIV positive and was on HIV drugs consistently, the mother’s viral load was low and the transmission of the virus to the breast milk and to the baby was minimal. As such, if the baby is delivered, that baby should be on HIV drugs for prevention. The baby should be taking the anti retroviral drugs for a number of time and duration. The baby should be breastfed as long as the mother is on drugs. This is because of what we call weighing the benefits as opposed to the danger or side effects. So if the benefits or the numerous importance and advantages of breastfeeding outweigh the danger, why not use breastfeeding as far as the baby and the mother are on anti retroviral drugs.
Is there any disadvantage of breastfeeding?
Breastfeeding is almost devoid of any disadvantage. Well, a lot of women claim that breastfeeding makes their breast to lose shape. I really don’t get that because your structure will give way when the time comes. More so, all the organs in the body have their own functions. Having known the importance of breastfeeding, I don’t know why any mother will deny her child of breast milk when the person knows the adequate importance of breast milk. So mothers who deny their babies of breast milk do it because of their “selfish interests”. This is because when a woman is pregnant for instance, her breasts become bigger due to pregnancy hormones and so on. So breast milk is a natural food for babies given by God.
What is your advice to women?
The clarion call to all women or prospective mothers particularly women of productive age group is that the importance of breastfeeding can never be overemphasized, therefore, they should breastfeed their babies. They should also speak to other women to breastfeed on demand, breastfeed unconditionally for the safety and protection of their babies so that their babies can be immunologically balanced, sound and withstand the numerous childhood diseases that affect children.