Breastfeeding is the best way of providing nutrients to young infants for their healthy growth and development. World Health Organization (WHO) and UNICEF recommend that breastfeeding should be initiated as early as possible after delivery and exclusive breastfeeding should be continued till 6 months of age.
In many cultures, women assume that they will breastfeed. In other cultures, where breast milk substitutes are widely advertised and promoted, most women decide whether or not to breastfeed before their baby is born.
A joint report by the United Nations Children Fund (UNICEF) and World Health Organisation says more than 70 per cent of infants in Nigeria are denied the benefits of exclusive breastfeeding. In addition, only 44 per cent of infants benefitted from exclusive breastfeeding in their first six months of life, leaving them more vulnerable to disease and death.
An increasing number of studies suggest that decision-making on breastfeeding begins before pregnancy and is finalised in the prenatal period. In fact, studies have identified that counselling in breast milk and breastfeeding during pregnancy has a significant effect on the earlier initiation of breastfeeding and exclusive breastfeeding for the first six months of life.
“Breastfeeding starts from pregnancy; it starts during antenatal care when we prepare the mother’s mind psychologically to breastfeed. Some women do not want to breastfeed because they don’t want to lose their figure,” MrsAdekemi Bode-Oguntoke, an assistant director of nursing at the University College Hospital said. She spoke during a lecture at UCH to mark the 2022 World breastfeeding week in Ibadan.
Mrs Bode-Oguntoke stated that antenatal discussion is an important aspect in ensuring pregnant women learn about the benefits and importance of breastfeeding, discuss their individual worries and concerns about breastfeeding, reinforce their knowledge about early and exclusive breastfeeding, teaching on nipple preparation, good positioning and attachment, proper diet for nursing mothers and reassurance that most women breastfeed with no problems.
“It is after delivery that you see that some mothers have inverted nipples. This is something that could have been corrected during pregnancy; during antenatal visits, they are thought and encouraged to pull out their nipple. During bathing, they can foam lather, lubricate and pull it. Even their husbands can help with pulling their nipples.
“Like every other individual, pregnant women need to eat well. It is not a time to say they wouldn’t eat because they don’t want to get fat. They need the right diet and in good proportion at every meal.
“Also breastfeeding needs to be initiated within the first hour of life; the baby is placed on the mother’s tummy which will help with the initiation of breastfeeding and to continue to breastfeed while in the hospital and beyond the hospital stay.
“Breastfeeding is important to children, to mothers and to families. Breastfeeding protects infants’ health. It helps the physical and emotional development of the child. It lowers the risk of infections and ensures fewer hospitalization and hospital visits and a higher IQ. For the mother, it reduces the risk of breast cancer, burns extra calories, ensures the womb returns to its state before pregnancy and lowers the risk of breast and ovarian cancers.
Mrs Bode-Oguntoke stated that for maximum breastfeeding benefits, mothers need to also understand their baby’s cue for feeding given that breast milk is readily available, there is nothing to buy and it needs no preparation or storage.
According to her, “The most common sign when baby is hungry is cry. But others may be licking their lips or sticking out their tongue, putting their fingers in their mouth, opening their mouth or sucking on things. In some cases, the baby may be fussy or moving the jaw, mouth or head to look for the breast.”
She said the use of pacifiers to comfort a baby when crying should also be discouraged, adding that, “Pacifiers can negatively impact breastfeeding outcomes. Over time, a child that gets used to it may lose interest in feeding.”
Mrs Bode-Oguntoke declared that breastfeeding can be challenging, especially in the early days due to sore nipples, low milk supply, engorgement (hard and painful breast swelling), mastitis (breast infection) and plugged duct, but all can be helped by ensure consistent breastfeeding.
Several studies have revealed that starting training on breastfeeding during pregnancy affects the increase in exclusive breastfeeding rates. In a study conducted in Turkey, it was determined that 54.9% of the mothers who were given prenatal care breastfed their babies within the first hour after birth.
More so, a study in Spain identified five factors that were associated with the mother’s prenatal decision to breastfeed: partner support, previous experience of breastfeeding, having two or more children, attending breastfeeding education, and having a condition during pregnancy.
The 2020 study in the International Breastfeeding Journal was a cross-sectional observational online study conducted in Spain on women who gave birth between 2013 and 2018. The total number of participants was 5671.
It is undisputed that the family and the healthcare team play an important role when it comes to the decision to breastfeed, however making an informed decision about breastfeeding is key to successfully breastfeeding a baby and overcoming any difficulties.
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