Breast is best

World Breastfeeding Week, 1 - 7 August

Most women will agree that modern life can be demanding and stressful, causing us to choose the more convenient option whenever possible. However, although many do not realise it, a quicker or easier way of doing something is not always better. This is most certainly the case when it comes to feeding your baby.

As part of the Government Employees Medical Scheme's (GEMS) on-going effort to educate our members and future members on a range of healthcare topics, we would like to share real life member stories and their outcomes with you. This article explores the subject of breastfeeding this World Breastfeeding Week.

The best possible start in life
Precious Masibuko* is a 29-year-old GEMS member who has just become a mother for the very first time. While she is ecstatic that her little bundle of joy has finally arrived in the world, she says that she is uncertain about how to do what is best for her baby as well as manage the rest of her life.

"As a new mother who is inexperienced, I have spent quite a bit of time trying to find out about what babies really need. One of the most important topics seems to be the way in which you feed your baby. Many of my friends and family members prefer to start using formula very early on because they say it is often more convenient but I have heard that breastfeeding is better for babies."

According to the World Health Organisation (WHO), breast milk is the ideal source of nutrition for infants and one of the most effective ways to help ensure their good health. This is because it contains important nutrients that are vital for a baby's physical and mental development. It also contains antibodies that help to protect against dangerous illnesses such as diarrhoea and pneumonia - the two most common causes of infant mortality in the world.

The WHO recommends that breastfeeding begin within the first hour of birth if possible, as this is when the mothers body produces colostrum, a thick and creamy liquid that is produced in small, easily digested volumes. This encourages the clearing of the baby's intestines, which is an important way to help prevent jaundice. It is also advised that exclusive breastfeeding, or feeding with breast milk only, continues for six months before introducing other sources of nutrition.

However, breastfeeding is not always possible due to reasons such as oestrogen-containing birth control pills, illnesses or hormonal disorders and breast surgery. For these mother's formula is the best option.

Good for mom too
As the WHO points out, breastfeeding is not only important for the health of infants, it also has enormous health benefits for mothers. Breastfeeding has been shown to help women to lose the excess weight gained during pregnancy more easily, which can make it easier to adjust to life with a baby. Furthermore, there are indications that it may even help to reduce the risk of breast and ovarian cancer in later life.

Precious finds that breastfeeding is also a wonderful opportunity to bond with her child. "I have to admit that at first I found it difficult to get used to having a baby. It is a huge responsibility and completely changed my life. Somehow breastfeeding made it easier for me because it is such a magical experience and one that only you and your baby can share. It takes a little getting used to in the beginning but after a while it feels like the most natural thing in the world."

Learning about breastfeeding
While it may look simple enough to do, breastfeeding is not as easy as it may seem. "I had to be taught how to breastfeed after I had given birth," recalls Precious. "At first it was very difficult to get my baby to latch properly. I experienced nipple pain and was worried that I was not producing enough milk. However, eventually I became more comfortable with the process and was very glad that I had kept on trying."

Women learning how to breastfeed often have concerns, just as Precious did. Below are some of the most common questions that breastfeeding mothers have:

• "Am I producing enough milk for my baby?" - In the first few days you only produce colostrum in small amounts but this is nothing to worry about. Colostrum is so nutrient rich that your baby only needs it in small amounts. This also makes it easier for your baby to digest. A baby who is wetting between six and eight nappies a day is most probably getting enough milk.
• "Why is my baby losing weight?" - It is normal for your baby to lose a little weight in the first three to five days after birth. This does not mean that you are not producing enough milk. Your body will naturally adjust to produce the exact amount of milk that your baby needs. 
• "Why are my nipples sore and/or cracked?" - Again, it is normal that you experience some pain and/or dryness of the nipples when breastfeeding but there are ways to ease the pain and prevent dryness. Try to nurse with both breasts equally and empty the milk-ducts completely to avoid swelling.  Keep your nipples dry between feeds by changing your bra pads often. Do not use perfumed creams or soaps as these can make dry and cracked nipples worse.

HIV transmission
Approximately 15% of children born to HIV-positive mothers contract HIV from breastfeeding, according to the United Nations Children's Fund (UNICEF). HIV-positive mothers who are able to afford a constant supply of formula and prepare it safely and hygienically are advised to do so. If however an HIV-positive mother cannot afford formula or does not have access to clean water or facilities to sterilise bottles, the WHO recommends breastfeeding. This is because formula does not contain the vital antibodies that breast milk does and if not prepared safely and hygienically, formula can lead to serious illness and even death in infants.

HIV-positive mothers who are breastfeeding are advised to do so exclusively for six months by the WHO. Studies have shown that certain factors in breast milk can directly fight cells that contribute to HIV transmission. Findings of a study conducted in Durban showed that exclusive breastfeeding in the first three months of life is more effective in reducing the risk of mother-to-child transmission than mixed feeding - breastfeeding combined with other foods, juices or water.

Women who are HIV-positive and pregnant or with infants should consult a healthcare professional about the feeding options available to them and to discuss possible anti-retroviral therapy.

Breastfeeding for the working mother
Like Precious, many mothers work and may not be able to breastfeed exclusively for six months. In these cases it is recommended that exclusive breastfeeding take place for as long as possible before the mother has to return to work. At this stage the mother should continue to try and breastfeed as often as she can between formula feeds. If possible, a breast pump should be used and breast milk stored in the fridge for use while the mother is away.

The GEMS maternity programme
The GEMS maternity programme is available to all GEMS members who are expecting to have a baby and offers a number of services, including access to a special telephonic advice and support line. Many breastfeeding women find this particular service to be of great help in the early months of parenthood.

Members are required to register on the programme as soon as their doctor has confirmed their pregnancy.

If you would like to know how GEMS can assist you to obtain more information about any of your healthcare needs, you can phone the GEMS call centre on 0860 00 4367 or send a SMS to 083 450 4367. GEMS will assist you in every way possible to ensure your family's health and well-being.

Sources:
1. The World Health Organisation, www.who.int 
2. The United Nations Children's Fund, www.unicef.org
3. Avert, www.avert.org 
4. WebMD, www.webmd.com

*The member's name has been changed in order to protect her identity.