Dr Jasjit Singh Bhasin
Aug 1- Aug 7 World Breast Feeding Awareness Week
Breast feeding is the safe, sound, and sustainable way to feed an infant. For the first six months of life a child should be exclusively breastfed with no other foods or drink and continued on breastfeeding with appropriate complementary foods up to two years of age. This can be achieved when mother knows its benefits and gets necessary support and encouragement.
Breast milk is not just a food it is a live tissue with many immune factors which give a baby continuous, active protection against various infections, when the baby’s immune system is immature. For the initial few days after birth, a mother provides the ideal immunization for her baby with colostrums which is very rich in antibodies. Exclusively breastfed children are much healthier. Artificially fed and mixed-fed infants are sick more often with diarrhoea, pneumonia and other infections.
Breast milk contains just the right amount of energy, protein, vitamins and other nutrients for a baby for the first six months of life, and all the water that a baby needs too. The nutrients are of perfect quality for a baby, and they are more easily and completely digested than any other milk or food. When they are older, breastfed babies are less likely to be overweight than artificially fed babies; they have fewer allergies and higher scores on intelligence tests.
So every lactating mother needs to understand about exclusive breast feeding and should believe in its benefits. But, unfortunately there are lots of common myths about breast feeding which needs to get removed from people’s mind and few of the myths and their facts are as follow:
* MYTH: Many women do not produce enough milk.
FACT: Majority of mothers are capable of producing sufficient milk for their babies, except for a few with primary lactation insufficiency ( rate 1-5%). Initial 2 days all mums produce colostrums by day 3-4 breast heaviness appears( a sign of copious milk production) and from here onwards the milk production rate is in direct proportion of the suckling at breast with a good latch. So if a mother gets proper guidance about how to assess good milk transfer, there’s a very rare chance that she will have inadequate milk production.
* MYTH: It is normal for breastfeeding to hurt.
FACT: Breastfeeding if done correctly never hurts. So if it hurts then it needs to get in notice.
* MYTH: There is no or not enough milk during the first 3 or 4 days after birth.
FACT: The milk during the initial days is less but is always sufficient for the baby and if the baby is positioned well at the breast, they will get enough. Stomach capacity of a normal term newborn for the first 48 hrs is roughly 5 to 15 ml/feed.
* MYTH: A baby should be on the breast 20 (10, 15, 7.6) minutes on each side
FACT: Baby should be fed on demand and unrestrictedly.
* MYTH: A breastfeeding baby needs extra water in hot weather.
FACT: There’s no need to give water during the initial 6months if the baby is on exclusive breastfeed.
* MYTH: A mother should wash her nipples each time before feeding the baby.
FACT: It is not necessary, infact, it can cause sore/ cracked nipples.
*. MYTH: It is easier to bottle feed than to breastfeed.
FACT: On the contrary its much easier to breastfeed than top feed.
*. MYTH: There is no way to know how much breast milk the baby is getting.
FACT: By day 4 of life, If the baby is passing 6 to 8 good volume urines and 2 good size stools a day ,gaining weight, sleeping after feeds, means baby is getting sufficient milk. A mother can also feel obvious softening of her breasts after a good feed.
*. MYTH: A mother cannot feed for first 2 days post caesarean.
FACT: There are various positions in which a mother can feed her baby post C.S without having to get up or turn side, even immediately after surgery.
* MYTH: One shouldn’t feed lying down.
FACT:  It’s absolutely safe and comfortable to feed lying down.
*  MYTH: Pumping is a good way of knowing how much milk the mother has.
FACT: Pumping only shows how much milk can be pumped with that particular pump at that time. Swallowing, wet diapers, frequent stools and weight gain are better guides to baby’s intake.
* MYTH:  A mother’s milk will go bad if it stays in her breast or if she gets scared or angry.
FACT: Human milk is always fresh and cannot spoil in the breast. Feelings cannot change the composition of human milk.If a mother is upset, her milk flow may be slower but the milk is fine.
* MYTH: Breastfeeding makes the breasts sag.
FACT: Pregnancy, heredity, and aging cause the breasts to sag, not breastfeeding.
* MYTH: Combination feeding ensures the baby is getting enough.
FACT: Babies are born to exclusively breastfeed. Giving formula in normal circumstances in addition to breastfeeding can result in overfeeding, reducing the mother’s milk supply, and increasing all the known risks of formula.
* MYTH: If the mother is sick, she has to stop breastfeeding.
FACT: If mother gets sick, her baby has already been exposed to her illness and mother’s milk will have antibodies to protect the baby. If baby does get sick, the illness is likely to be less severe. Mothers can breastfeed if they have a cold or flu. Mothers should not breastfeed if they have HIV, active untreated tuberculosis, or HTLV1. Most over the counter and prescription medications are safe to take while breastfeeding.
A step to social Cause
According to a joint statement made by the WHO and UNICEF “The best food for baby who cannot be breastfed is milk expressed from the mother’s breast or from any other healthy mother”.  Human milk banks provide an alternative to formula feeds for preterm babies when the mother’s breast milk is unavailable. All high risk newborn especially very low birth weight babies, abandoned and adopted infants, babies separated from their mothers and mothers who is not able to express due to some medical reasons can be benefitted .
A lactating woman who has enough milk after feeding her baby satisfactorily and if baby is thriving appropriately also can donate their breast milk. Donor should be healthy and well nourished with no evidence of tuberculosis or other infectious diseases (negative for HIV, VDRL, Hep B), should not on any medications contraindicated for breastfeeding and most important willing to donate.
(The author is senior Consultant & HoD Deptt of Neonatal Paediatric DLK Super Speciality Hospital, New  Delhi)