World Breastfeeding Week 1 - 7 August 2015

According to South African Breast Milk Reserve, studies have shown that breast milk is the most critical factor in reducing infant mortality and morbidity, especially in developing countries.

As part of the Government Employees Medical Scheme's (GEMS) ongoing effort to educate existing and future members on a range of healthcare topics, we would like to explore certain important healthcare issues. This article looks at breastfeeding this World Breastfeeding Week, 1 - 7 August 2015.

What are the benefits of breastfeeding for my baby?
The benefits of breast milk extend beyond providing basic nutrients and vitamins for your baby in their first six months of life. It also contains antibodies that help fight off diseases, including the two most common causes of infant mortality worldwide - diarrhoea and pneumonia. Breastfeeding also has long-term benefits for babies, such as protecting them from developing allergies. According to the BabyCenter, "babies who are fed a formula based on cow's milk or soy tend to have more allergic reactions than breastfed babies." Further, researchers have found a link between breastfeeding, cognitive development and vocabulary. Children who have been breastfed achieve higher scores on IQ, intelligence and vocabulary tests.

What are the benefits of breastfeeding for me?
Studies indicate that breastfeeding may help to reduce the risk of breast and ovarian cancer in later life among women who have breastfed. Breastfeeding may assist them with weight loss after pregnancy, which can be helpful in adjusting to life with a baby. Over and above this, many women consider breastfeeding to be a special time of bonding with their child and an experience that both mother and baby can share together.

How long should I breastfeed for?
According to the World Health Organization, you should breastfeed exclusively for six months following the birth of you baby, before introducing other sources of nutrition. It is important for breastfeeding to begin within the first hour of birth if possible, as this is when the mother's body produces colostrum, a thick and creamy liquid that is high in nutrients and is easily digestible for babies. Colostrum encourages the clearing of the baby's intestines, which helps to prevent jaundice.

How do I know if I am I producing enough milk for my baby?

According to the Babycenter, you can tell if:

• Your breasts feel softer after nursing, because your little one has emptied some of the milk that was making them firm.
• After a feeding, your baby seems relaxed and satisfied.
• After gaining back their initial weight loss, your baby continues to gain weight.
• In the first few days, when your baby is getting colostrum, you may need to replace their wet diapers once or twice a day. After your milk comes in, this increases to six to eight cloth diapers a day, or five or six disposables.

How to start breastfeeding
The BabyCenter recommends you turn your baby's whole body toward you, chest to chest. "Touch her upper lip with your nipple, and, when she opens her mouth wide, pull her on to your breast, holding your breast for support. Her mouth should cover not just the nipple but as much of the areola (the darker part surrounding it) as possible. Don't panic if your newborn seems to have trouble finding or staying on your nipple. Breastfeeding requires patience and lots of practice. Don't hesitate to ask a nurse to show you what to do, and request visits from a lactation consultant while you're in the hospital (many hospitals have them on staff)."

How often you should nurse?
According to guidelines from the American Academy of Pediatrics, nurse your newborn whenever they show early signs of hunger, such as increased alertness or activity. Waiting for your baby to cry is usually a late sign of hunger - ideally, you should start feeding them before they start crying. The BabyCenter also notes that the more you nurse, the more milk you'll produce. "Nursing eight to 12 times every 24 hours is pretty much on target."

What if I can't breastfeed?
Some women may find that they are not able to breastfeed. This may be as a result of oestrogen-containing birth control pills, illnesses or hormonal disorders and breast surgery. For these mothers formula is the best option. However, when using formula it is of the utmost importance that you wash the bottle and its rubber teat with clean water and that you sterilise them completely before feeding your baby the formula. You must also be sure that the water you are using to mix with the powdered formula is clean and safe for your baby to drink. Formula that is not prepared safely and hygienically can lead to serious illness and even death in infants.

If I am HIV positive, can my baby get HIV from my breast milk?
An HIV-positive mother who is not being treated for HIV during pregnancy, labour, or delivery has a one in four chance of passing the virus on to her baby, reveals AIDS.gov. However, antiretroviral (ARV) drug therapy in either the mother or HIV-exposed baby can significantly reduce the risk of transmission through breastfeeding.

It is important for HIV-positive mothers who are breastfeeding not to give their children any other liquids and/or foods, as studies have shown that exclusive breastfeeding for up to six months can lead to a significantly reduced risk of transmission. Studies have shown that certain factors in breast milk can directly fight cells that contribute to HIV transmission. 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.

What if I am a working mother?
There are many working mothers who may not be able to breastfeed exclusively for six months. For these women it is recommended that exclusive breastfeeding take place for as long as possible before returning to work. At this point 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 has been introduced to ensure that expectant mothers receive high-quality care during their pregnancies, and to help reduce the risk of possible complications.

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

For any member queries please phone the GEMS call centre on 0860 00 4367 or visit our website at www.gems.gov.za. GEMS will assist you in every way possible to ensure your family's health and wellbeing.

As a member on the programme you have access to a team of experienced midwives for assistance with general health and pregnancy-related questions. You also have access to healthcare information that will make it possible for you to make informed decisions with your midwife or doctor about your health and birth choices.

Other advantages of joining the Maternity Programme include:

• Receiving a GEMS pregnancy, birth and early parenting book when you register.
• We will send you a free maternity bag during your third trimester. This is a gift from us to you and your baby.
• You will receive information about the benefits offered by GEMS during your pregnancy and after the birth of your child.
• You will receive a Care Plan to guide your doctor in the appropriate treatment necessary for the duration of your pregnancy.
• You will receive authorisation to your admission to a hospital/birthing facility of your choice.
• You will get telephone support if you experience problems during the first six weeks of parenthood.

Please note: Sapphire and Beryl members must be referred by their GMS Network GP to the gynaecologist, even if they are registered on the Maternity Programme.

References:
Aids.gov:  http://aids.gov/
Babycenter: http://www.babycenter.com
The World Health Organization: www.who.int 
The United Nations Children's Fund: www.unicef.org 
UK National Health Service: www.nhs.uk 
WebMD: www.webmd.com