Why breast milk is best

It’s Nutrition Month once again and in its 30th year, theme of the celebration is something close to my heart (and other mothers’ hearts): Breastfeeding or specifically, "Breastfeeding, panatilihin, dagdagan ng wastong pagkain."

From my experience as an obstetrician-gynecologist, I have always claimed that one of my greatest accomplishments is having breastfed my twins, Giovanni and Giulia, for 10 months. It was the most difficult thing I ever did yet the most gratifying! I didn’t resume a full-time clinic schedule till about four months after delivery. I started with a half-day schedule during which time I expressed milk manually. I lugged around my "Igloo" to preserve the milk that I expressed. Breastfeeding really strengthened the bond between me and my children which carries on to this day.

Make That Commitment

Breastfeeding is not easy. Because we have become so civilized, we have also lost the instinct and it has also ceased to be natural. We must, ironically, relearn breastfeeding through books and manuals. The most critical aspect to insure its success is this: You must make the commitment to pursue breastfeeding no matter what the odds may be.

Get Knowledgeable

>Before or during pregnancy, get yourself a comprehensive book like The Womanly Art of Breastfeeding, by the La Leche League International, an NGO committed to promoting breastfeeding. If not available in the bookstore, order via www.amazon.com. Pregnant couples should be encouraged to enroll in childbirth classes because an informed couple is prepared and committed. Check out Rome Kanapi who teaches the Lamaze technique and may be reached at 436-1757 or 0917-5415114 while Chiqui Brosas (0917-532 7892) conducts the Bradley technique. Lactation consultants are Nona Castillo of Birthing, Breastfeeding and Beyond, call 0917-3686134; and Ines Francisco of Arugaan at 0919-2330200.

Find A Support Group

Have a support group of women who have successfully breastfed. Attending childbirth classes develops an instant support group of committed women who are more or less delivering at about the time you are. Or hook up with any person whom you know has successfully breastfed for at least six months – a relative, a neighbor or an officemate so you can exchange information. Your doctor should also be your best support person.

Consider The Home

Motherhood is considered a precious phase in a woman and child’s life that cannot be recovered. It is the most selfless and heroic decision a woman can make for her child knowing that such initial mother-child relationship will provide the foundation for her baby’s emotional growth. A disruption of this natural continuum will automatically create an anxiety state in the child that can produce either inconsolable crying or a withdrawal into unnatural quietness. Research shows that the long-term consequences can translate to greater aggressiveness in the child, a reduction in intellectual prowess and a reduced capacity to love.

It is essential to decide as a couple if you can afford to give up your paycheck. The husband’s support is a vital factor for a woman to successfully and continually breastfeed. If you absolutely cannot, consider arranging with your employer for a reduced workload, or greater flexibility by allowing you to pick up and deliver your work and doing most of it at home. You may also consider creating other income-generating activities with more flexible time. If you are a musician, an artist, or can tutor, you can give lessons from home. Writing, photography, graphic designing, computer-based jobs and networking businesses can all be done at home. Weigh the weight of sustaining your lifestyle, finances and career versus the weight of mothering.

Save Your Milk

You can combine breastfeeding and working. One of the first things to learn is to pump your milk and store it so your baby has a supply of food while you are out at work. There are several advantages to pumping your milk versus giving formula milk. Expressing milk would keep up your milk supply in contrast to formula milk which decreases it. It relieves breast fullness, minimizes leakage and prevents plugged ducts and breast abcesses. Your baby is exposed less to the allergens that formula milk can sensitize them to.

Invest in a breast pump. They come in a variety of models and prices, from a syringe-type of manual pump to battery and electric-type models. The double cup electric pump by Medela is most effective in drawing out the most milk because it pumps both breasts simultaneously. The horn-type pump which requires squeezing a rubber bulb to draw out milk is the least effective. After establishing a steady milk supply, try shifting to pumping milk using your hands. This can save you the trouble of sterilizing the pump plus the added benefit that you always have your hand with you. All it takes is to cup the breast with the four fingers under the breast while the thumb above the nipples presses on the milk-filled ducts. Disposable feeding bottles are ideal to work with because they have plastic containers that you can express milk directly into, label with the date and store directly in the freezer. This saves transferring the milk from one container to another that might increase the risk for contamination. However, for long-term storage, it is not ideal because it can tear when you separate it from the freezer compartment When keeping it in the freezer, remember FIFO or first one in is first one out. In the freezer compartment, frozen breast milk can stay up to two weeks. If you have a separate freezer door that is opened frequently, your milk can be kept up to four months. If you have a separate freezer that is hardly opened so it stays constantly below 0° C, it can be kept at least six months. If you place it in a storage container or baby bottle, remember that when frozen, milk expands so do not tighten caps until milk is completely frozen. Store in batches of 2 to 4 ounces to avoid wastage because once thawed, it cannot be frozen again. If not consumed, it must be discarded. In case of a brownout and the freezer thaws out, what cannot be used immediately must be discarded.

In the refrigerator, milk can be kept for 3-5 days and on room temperature, for 6-10 hours since breast milk has the ability to retard the growth of bacteria.

How To Give The Milk

You have to educate your caregiver as to how to give your milk to your baby. Milk that has been refrigerated in small amounts and batches can be mixed together for a feeding. If the refrigerated milk separates, that doesn’t mean it has spoiled; it is expected since the milk is not homogenized. Gently shake it to mix. Do not put the milk directly on a stove or in a microwave to heat up as direct heat can destroy some of the valuable proteins, enzymes and nutrients that are beneficial to the baby. Instead, immerse the bottle of milk on a pan of warm water. Use this same technique to thaw out frozen milk, or simply transfer the frozen milk from the freezer to the fridge for thawing out, then heat the milk to body temperature when the baby needs it. Milk that has been frozen and thawed out can safely be kept in the refrigerator for up to nine hours.

Final Tips

The working mother must get enough rest and reduce the stress level to maintain a steady milk supply. And getting proper nutrition free from chemical foods and toxins, as well as enough hydration. Feed the baby before leaving the house even if it means getting up half an hour earlier than usual. You may prefer to keep the baby asleep during the day and awake at night because the baby will require less feedings while you are in the office. The downside would probably be less sleep for you, but it will mean more breastfeeding for the baby. Your weekends will be especially precious to catch up on lost breastfeeding time and rest.

Your commitment to breastfeeding is one of the most important factors that can influence your child’s physical health as well as emotional growth. The working mother will always be beset with pressures that may influence her to stop breastfeeding or may force her to spend more time away from her baby. Resist this and always bear in mind the observation of Mary Ann Kerwin, founder of the La Leche League, "Babies need quantities of quality time."

(Dr. Rebecca B. Singson is a fellow of both the Obstetrics and Gynecologic Society and Philippine Society of Cervical Pathology and Colposcopy. Currently, she is holding clinics at Rm. 381, Makati Medical Center, 892-7879; and at Rm. 202-203, Asian Hospital and Medical Center, 771-9204 and 771-9206 or e-mail obmd@surfshop.net.ph.)