Breastfeeding is a very cheap and effective way of nurturing healthy babies and ensuring child survival. Breast milk is the ideal food for infants, as it provides all the energy and nutrients needed in the first six months and significant nutrients needed by them thereafter and up to two years of life. Breast milk is unique in the sense that the composition is tailored to the need of the baby at any particular time as the baby grows from stage to stage such that the baby is not deficient in both energy and nutrients.

Exclusive breastfeeding

This involves feeding an infant with breast milk only for the first six months of life, not adding water or any other thing except medically indicated, such as when a child is sick and drugs are prescribed for the child by doctors. This shields the child from being infected through contaminated water / food and allows time for the immune system of the body to develop. Complementary feeding is added after six months, as only breast milk may not be able to supply the energy needs of the child from that point onward.

How frequently should a child be breastfed

Newborn babies may feed every two to three hours. The frequency may reduce as from about two months of life as they can now hold more quantity of breast milk in the stomach to last them for a longer time (possibly for 3-4 hours).

Will only breast milk be enough for a baby to feed on?

Breasts respond to stimulation. The more a baby sucks, the more breast milk is produced. In the first few days, the milk may seem scanty but the quantity is enough for baby at that point and the nutritional contents are adequate for its need.

Does a baby need water after breastfeeding to quench its thirst?

Children on exclusive breastfeeding do not need water after being breastfed. This is because significant part of breast milk is water and this is sufficient for the child at any particular time.

Advantages of breastfeeding

Breastfeeding is beneficial both to the mother and baby. The following are some of the benefits of breastfeeding:

1. It is free from contamination and therefore safe for children at the most vulnerable part of their lives.
2. It is available at the right temperature. There is no need to worry over it being too cold or hot for the baby.
3. It enhances the development of the immune system so that the body can fight diseases.
4. It helps proper brain development as breastfed children perform better on intelligence test.
5. Breastfed children are less likely to be overweight or obese and therefore, they are less prone to diabetes in the future.
6. Breastfed children are less prone to chronic diseases like asthma and other allergic diseases.
7. It mitigates the effects of malnutrition in early life as it contains all the nutrients needed by children.
8. Breastfeeding protects against diarrhoea diseases in children and reduces the risk of death due to diarrhoea diseases and other infections.
9. Reduced risk of breast and ovarian cancer for the mother.
10. It helps in child spacing.
11. Breastfeeding enhances bonding between mother and child.
12. It helps the body recover quicker from the effects of childbirth. For example, the hormone (oxytocin) released through the process of breastfeeding helps the uterus to contract and return to pre-pregnancy state as soon as possible.

Breastfeeding in mothers with HIV

Mothers with HIV who have been on antiretroviral drugs can safely practice exclusive breastfeeding with minimal risk of mother-to-child transmission of the disease. Their children are also placed on antiretroviral treatment to further reduce the risk. It is also recommended that they continue breastfeeding till the child reaches one year of age. Mixed feeding in the first six months should be avoided as this may heighten the risk of mother-to-child transmission of HIV.

Breastfeeding while pregnant

Some women get pregnant while still breastfeeding and are confused whether to stop breastfeeding of continue. A woman who gets pregnant while breastfeeding can continue breastfeeding, especially when the child being breastfed has not matured to the point of weaning. Breastfeeding does no harm to either the baby being breastfed or the pregnancy.

Conditions that may prevent a woman from breastfeeding

The following conditions may partly or whole prevent a woman from breastfeeding.

1. A baby born with a metabolic disorder of milk digestion known as galactosemia – Children in this category are deficient of the enzyme that metabolise galactose (a component of the sugar in the milk), thereby developing serious abdominal discomfort when fed with breast milk.
2. Mothers living with HIV – In some countries, these women are allowed / encouraged to breastfeed once they are on treatment with antiretroviral drugs and their children are also on drugs. This helps to reduce the risk of mother-to-child transmission of HIV.
3. Mothers with active tuberculosis – Women in this category can express breast milk to be given their children who will be separated from them during the infective period. The infection is not transmitted through breast milk but through contact. After the first two months of treatment of the mother, she can safely breastfeed her baby directly.
4. Mothers with chicken pox – Babies should be separated from the mother at the beginning of the illness when the risk of transmission is very high but breast milk can be expressed and given to the child.
5. Herpetic infection on the breast – If this involves one breast, the baby can feed from the other breast pending resolution of the infection on the affected breast. Otherwise, breast milk can be expressed to give the child while the infection lasts.
6. Patients receiving cancer chemotherapy or on radioactive treatment for cancer – Breastfeeding should be discontinued during the period of this treatment.
7. Women with hepatitis C – Women in this category who have cracked nipple / areola or bleeding from nipples / areola should stop breastfeeding until there is a resolution to avoid transmitting the disease to the child.
8. Women on hard drugs – Women on cocaine, marijuana, heroin etc should not be allowed to breastfeeding but taken for care / rehabilitation.