Some women in urban areas, including Bangalore, aren’t just willing to continue with breastfeeding babies for long. Why? Are their fears valid, or solvable? Here’s an insight into the issue.

The world recently observed breastfeeding week, to spread awareness on the importance of breastfeeding babies. In Bangalore too there were several awareness campaigns, seminars, rallies, advertisements and related promotions.

The government has for sometime been campaigning aggressively on malnutrition and importance of breastfeeding through a series of advertisements with film actor Aamir Khan as the ambassador. Experts however are pointing to a declining graph among educated women on the willingness to breastfeed their babies even for first six months.

Why unwillingness to feed the baby?

Breastfeeding a baby brings its own set of ‘problems’ which many new moms find tough to deal with. Not able to dress up as they want to, need to maintain nutritious diet besides the need to shed weight, problem of leaking milk, the stress of work that makes it tough to reach home at a fixed time etc. are some problems that bother new mothers.

However, all these problems can be overcome with some tactical planning and personal care, provided the new mom has the willpower to continue with breastfeeding the baby.

Dr. Asha Benakappa, a paediatrician and lactation consultant, says: “Breastfeeding is a skill. It needs to be learnt quickly by a new mother. A mother needs to be firm on the decision to breastfeed as long as she can. At least for first six months, a baby needs to be fed exclusively by breast milk. Unfortunately very few educated mothers are encouraged or show the willingness to breastfeed their babies.

Mother is the only one who can ensure the well-being of a newborn. File pic.

Not enough milk?

Many of these women want ease and convenience in feeding patterns. Again many are under this myth of ‘I do not have enough milk.’ Dr.Asha says that if a newborn, except for the first three days after birth, urinates at least six times a day, it means the baby is getting sufficient milk.

Says Dr. Anitha K. Mohan, Consultant Obstetrician at Fortis hospital, Bannerghatta road: “Lack of milk supply in the new mother should be judged by the specialist and not by relatives or by the mother herself. Breastfeeding is not only easy but also the best nutrition for a newborn baby. While there are enough advertisements promoting breast feeding, many urban women do not know the technique. This has to be seriously thought about and addressed by experts.”

Dr. Ravneet Joshi, paediatric and lactation consultant at Manipal hospitals says: “Fortunately in my professional life, I have come across educated young women who want to do their best for the child. The concern of not having enough milk in the mother is related to control of demand. So if a mother nurses often, she will have enough milk supply. She can prevent other problems too if the breast milk is getting drained in adequate quantity.”

Encouraging working women to breastfeed, Dr. Ravneet adds, “Working women should start practicing expressing milk and storing it to feed the baby at least 15 days before they begin work. Increase night-time feeds to have good milk production. However as many would be aware, direct breastfeeding is anytime better than expressed milk as it keeps the mother and baby in close contact.”

What increases breast milk supply?

In her book written on the subject, ‘Breastfeeding-the basic instinct,’ Dr. Asha Benakappa says, “Adequate nutrition, frequent suckling and emotional support are the physiological ways to increase milk production.”

Ginger, garlic, mint, jaggery, dates may be a good diet to be incorporated in the mother’s food plan. however, doctors caution on relying only on foods to encourage mothers. Dr. Asha says a mother should never be made to feel that she will not be able to lactate or that her milk will not be good unless she consumes a particular food.

Breast milk flows naturally from a woman’s body soon after childbirth.  Women need to accept the breast milk it as the only diet to feed their babies and avoid formula milk.

You are working. How can you breastfeed baby?

Dr. Anitha advises, “Some foods like garlic, methi (fenugreek) and oats help mothers to produce more milk. Working professionals too must breastfeed their babies. Women must avail of special leave or flexible work hours to facilitate at least 6 months of exclusive breast feeding. Expressed breast milk is the next best option to direct breastfeeding and must be taught to all mothers. Once breast milk is expressed, it can be kept at room temperature for six hours. This can be given to the baby with a spoon, without heating it or adding anything.”

Says Poornima Sharma, a mother to a three-month old infant, “There is a huge lack of awareness on how to help the baby latch on, hardened breasts and other concerns among new mothers. The consulting obstetrician can play a good role in guiding and counselling new mothers. I could not breastfeed my first baby in the beginning, but I was counseled and encouraged by my doctor. Thankfully, now I do not have any problem in breastfeeding my baby.”

On primary concerns among new mothers during the breastfeeding phase, Dr. Anitha says, “Sore nipples happen because of poor “latch-on” technique. If larger part of the areola (dark area around  the nipple) is in the baby’s mouth during breast feeding, baby gets enough milk and sore nipples do not happen. After breastfeeding, the mother can apply a drop of her breast milk on the sore nipples and allow them to air dry.  This helps healing the soreness.”

Mother’s milk is the best

Lactation consultant at Cloudnine, Ruth Patterson says: “One doesn’t find a rural mother taking help of an obstetrician or lactation consultant for breast feeding. It is something she has always seen and grown up with. Urban women are educated but they have no time, patience, have huge disposable incomes so they easily give in to bottle feeding. For working women, expressed milk option is the best one to ensure the baby is on a right diet.”

Breastfeeding has a number of advantages for the baby and the mother. Fewer incidences of breast and cervical cancer have been found in women who breastfeed babies until one year or longer. Due to natural method of calories being shed out, new mothers are able to lose weight easily in breastfeeding phase when combined with regular exercise.

Babies who are breastfed are healthier, have lesser digestion problems and better immunity. Experts say women right from early pregnancy should read books on post delivery and have practical idea of taking care of a little one who is going to be completely dependent on the mother. Lactation experts advise mothers to breastfeed 12 to 14 times a day as per demand of the baby. Finally they have a word of advice- Do not fret of losing some sleep for a few months.

How do you select the hospital in which you welcome your baby? What to pack for the hospital stay? What care should be taken?

You have endured the tension those nine months could cause, and experienced the joy that lies in the anticipation of becoming a new parent. However, have you chosen the right place to welcome the young one?

Yes, it is important. Choosing a hospital where the would-be-mom is comfortable is of utmost importance and should be planned in advance.

While some of the would-be-moms choose to be with one hospital right through their pregnancy, there are a few who end up delivering at a different hospital with a different obstetrician, as they change doctors or hospitals towards the end of the pregnancy.

Reasons for this vary. It can be due to factors like complications that can arise during pregnancy where a specialised obstetrician at another hospital needs to be consulted; or due to women spending the last trimester at their maternal home and choosing a hospital nearby for delivery.

Treating a newborn with care is essential, for which the hospital should be equipped. Pic: Nagachandrika Bhat

What to look for while choosing a hospital

In any case, choose a hospital that has a team equipped to handle birth of a baby efficiently. Examine all facilities required to deliver a healthy baby with no complications. This is important, as the would-be mom has to be healthy and has to be in a safe environment.

Giving birth to a baby is a time-tested natural process. It is therefore important to choose a hospital or an obstetrician who believes in encouraging women to go through natural deliveries, unless a medical condition dictates a caesarean delivery.

Says Dr. Fatima Poonawala of Alfa Clinic, “A good hospital or a good doctor’s credit in case of deliveries lies in facilitating natural deliveries for moms-to-be in a safe environment so that the mother and the baby can be safe. One needs to have a check on the credentials of the obstetrician, how long the obstetrician has been practicing and availability of the doctor in one or two hospitals. Also it is advisable to see an obstetrician with a birth plan and discuss fears, concerns or any apprehensions during one’s consultations to be comfortable on the final delivery process.”

Poonam Bhandari, a mom to one-year-old Jia, says, “It is of immense value to have the comfort level with the gynaecologist you will be seeing through your pregnancy. I was looking at a hospital that adhered to basic cleanliness, had NICU (Neonatal Intensive Care Unit) as I knew I will be having a premature baby and a doctor who could patiently listen and understand my concerns.”

According to Dr. Anu Sridhar, Consultant Obstetrician and Gynaecologist at Fortis Hospitals, Bannerghatta Road, “Good maternity hospitals should have maternity set-up in the form of fully functional labour unit with trained staff and doctors specialised in Obstetrics. It also requires 24-hour anesthesiologist, pediatricians, OT and blood bank. “

A few pointers to consider when choosing a maternity hospital

Your comfort with your Obstetrician: In your first few meetings with your obstetrician and gynaecologist, you will be able to gauge if your doctor has time and patience to answer your questions calmly. Obviously you want to be with an obstetrician who can make you feel comfortable about your pregnancy, help you build that trust and give the assurance he or she will be with you to handle any concern during pregnancy.

Credentials of the obstetrician and ability to handle complex deliveries: It is essential to choose a hospital and a doctor who has a philosophy and attitude towards birthing that matches with yours. If yours is a normal pregnancy with no other ailments like overweight, diabetes etc., then you have more options on choice of hospital ranging from basic to luxury ones. However if you have any ailment, it is advisable to approach an obstetrician who has experience in handling complex pregnancies, regardless of other facilities like AC rooms and other pampering which is optional for moms-to-be who want to cherish this phase.

Transparent attitude: Again it is important for your obstetrician to be open and talk to you about all stages during your pregnancy. Even in the case of a complication, your obstetrician should be able to take you through with confidence and ensure the best is done regarding the pregnancy and baby.

Availability of NICU and adult ICU at the hospital: Most deliveries happen without requiring the baby to be placed in Neo-natal Intensive Care Units (NICU). However if you do not want the last–minute shift in transfer of baby or mother for a critic condition (which is rare, but can happen) then you can choose a hospital that has both NICU and adult ICU at the hospital.

Proximity to your home: Choose a hospital that is near to your home, as right through the pregnancy there would be many check-ups and routine tests. Shorter the distance, easier it would be for you. However according to Dr. Fatima, the distance does not really matter regarding birth of a child as long as one is taken care under a good obstetrician.

Feedback from various sources: Make it a point to obtain feedback on the doctor, nursing team and hospital in general from various sources like relatives or friends, online feedback etc. and then decide.

Hospital Care during night hours, holidays and emergencies: It is very important for a would-be mother to consider emergencies, and check if there would be sufficient staff during odd hours. Also discuss with your doctor during the later stages of pregnancy – how soon can she be with you when the labour pain begins, so that you know your lead time before your doctor takes charge of your delivery.

Other added factors that can help you make the final choice

• Availability of a pediatrician at the hospital.
• Fitness programs like aerobics, yoga which can help in smooth pregnancy phase and even in post-natal care.
• Courteousness of staff like the reception and at the general attitude and approach of nursing towards moms-to-be.
• Cleanliness, hygiene maintained at operation theatres, NICU, and Labour Recovery Room- the room where you will spend the three days with your baby. You may not choose a fancy boutique hospital but do check on hygiene and basic facilities that can help you go through the birthing process smoothly.
• Availability of Lactation Consultant, Nutritionist and a Physiotherapist at the hospital
• Whether you want your partner to be with you in the labour room and does your hospital support that opinion.
• Availability of 24X7 hot water. Traditionally a new mom is not supposed to touch cold water. Bangalore is known for its cold weather, so hot water is a must for both baby and the new mom.

To wrap up, choose a hospital where you feel as a gut-feeling that you and your baby will be taken care well at the hospital. Good Luck to step into happy motherhood.