Article originally posted here:
http://simplybalancedbeginnings.com/2015/08/31/guest-post-breastmilk-its-liquid-gold/

We have all heard the adage “breast is best” and I’m sure for some mothers, they have grown rather tired and bored of this saying.  We often know that something is good for us but we may lack the motivation to make it happen; such as getting 8 hours of sleep a day, drinking 2 litres of water, or eating 5 servings of fruit and vegetables.  How is breastfeeding your child different to the above scenario?  It is true that a very small percentage of mothers are physically unable to produce milk, and some choose not to breastfeed for medical reasons.  I think for the majority of us though, breastfeeding is discontinued because we have not had the adequate support, encouragement, and motivation to breastfeed. It is certainly not an easy job, and as with most things, takes practice, skill and patience. By offering mothers - and their families - education and focused care, I believe the rates of breastfeeding can be greatly improved. 

Let’s look a little closer into the reason “breast is best” and more than that, why it is specifically suited to your own child and their individual requirements. Breast milk is a living, changing biological fluid.  It is unique and dynamic.  No two mothers have the exact same milk and milk supply.  It contains all essential amino acids, perfect for baby’s growth.  It has a relatively low percentage of protein contributing to total energy which is why it takes 48 minutes to digest whereas formula takes 78 minutes.

What’s in it?

·         The main energy source is lactose. 

·         87.5% of breast milk is water. 

·         Immunoglobulins are important in protecting baby from infection. 

·         Enzymes digest the milk efficiently and quickly. 

·         Fat in the milk is made in the mammary gland is and is drawn from mother’s blood stream. Fat stores from pregnancy are used to make long chain polyunsaturated fatty acids, which helps to get back to your pre-pregnancy weight within 6 months. 

Amazingly, the mother’s diet and any supplements that she may take do not change the composition of breast milk.  The only vitamin which is deficient in breast milk is vitamin D – but in South Africa we have plenty of access to sunshine, so 5 to 10 minutes in the sun is all baby needs to meet the requirements for Vitamin D.  Vitamins and minerals are highly bioavailable in breast milk, so that the body metabolizes them very efficiently. 

Breast milk is mature by Day 4 after baby is born.  Before this time, the body produces an incredible substance called colostrum (also known as liquid gold!).  It is yellowy and thick and packed full of immune boosting substances. 

When your baby is born her immune system is immature.  When she ingests breast milk - the immunological components increase the rate of development of the immune system.  Immunoglobulin A wards off an infection before you’ll see a response in your baby.  Breast milk provides targeted immune protection for your baby.  Micro-organisms that you are exposed to stimulate a response from your immune system, anti-bodies are then produced to fight off the infection.  These are passed through to your breast milk.  So your baby receives exactly the right antibodies to fight off the infection she is exposed to.  If you go to your baby’s day care and breastfeed her there after touching chairs, mats etc. – your breast milk will contain specific immunity to ward off infections from that particular environment.  Aren’t our bodies amazing?

A super-hero substance in breast milk called lactoferrin is a fantastic antibacterial/ antifungal/ antiviral agent which declares war on organisms that would cause baby to be ill.  Alphalactalbumin causes malignant cells (which are cancer-causing) to be destroyed.  Breast milk also contains prebiotics called oligosaccharides which sweep away bacteria in the gut.  Lipids attack and neutralize harmful microorganisms.  In this way it sounds like a fierce battle is going on in your baby’s digestive system – and it is!  By giving your child breast milk you are equipping him with the perfect weapons to defeat enemy attacks.

We see that in artificially fed babies, there is a higher incidence of Type 1 Diabetes, Inflammatory Bowel Disease, obesity, cancers and allergies to name a few.  We are told formula is just as good, but unfortunately man cannot produce a substance to rival this biologically advanced bodily fluid. 

For the mother, breastfeeding reduces her risk of developing Type 2 DM, breast and ovarian cancers, osteoporosis and anaemia.  She has better birth spacing between children as breastfeeding delays ovulation, thereby preventing conception, more especially in the first 6 months postpartum.  And she saves herself valuable money, time and resources by not using artificial formulas.

Yes, I want to breastfeed my baby, but how do I know I have enough?

TRUST yourself and your baby – we can’t see how much milk we are producing but it is just right for your baby. 

Let’s look at this practically:

How much can a baby’s stomach hold:

Day 1: size of a cherry tomato (5-7ml)

Day 3: Size of a globe grape (22-27ml)

One week: Size of a small lemon (45-60ml)

One month: size of a large egg (80-250ml)

You do not need to top up with formula as is so often recommended in hospital (unless there is a medical reason to do so).  As the breast milk matures and progesterone levels decrease, more and more milk is made.  Extra fluid is drawn into the milk producing cells.  The rate of milk synthesis is determined by how often and how much milk baby removes from the breast.  Each mother also has a different breast capacity (which does not depend on the size of her breasts).

This makes sense as to why babies breastfeed frequently – as I mentioned earlier, breast milk digests in less than an hour.  Because their tummies are so small, newborns can only handle a small volume at a time.  Many mothers ask why their babes wolf down a bottle if they are given a top up feed after breastfeeding.  Just having a teat in baby’s mouth will elicit the suck and swallow reflex.  Because the teat fills the mouth, baby has no choice but to keep sucking.  They will then fall asleep because of all the energy they expended sucking.   They may not wake up and want to breastfeed which would help the mother to produce more milk according to baby’s needs.  So the more formula top ups – the less breast milk produced!

We might think we don’t have enough milk as we are not aware of typical infant feeding patterns and normal sleep/awake times.  We are not as a culture around breastfeeding enough. What do babies do when they are hungry? They search for the breast by turning their heads (rooting), putting fists or fingers into their mouth, and then a late sign of hunger is crying.   Relatives may tell us baby is hungry and needs more, or your breasts don’t feel full or you don’t feel a “let down” reflex – these are not always indicators that you don’t have enough.

Rather use these signs: Is baby having wet nappies and dirty nappies?  You should notice 5-6 wet nappies and 3-4 stools in 24 hours (by Day 5 after birth). Stools should be yellow in colour, and have a “butternut” texture.  You would also look at baby’s development and milestones to ascertain if baby is getting enough and then check the growth chart is following the curve of one of the lines (it does not have to be the middle line).  Does baby have periods of being alert and awake, and content after feeds?  If so, you should not have to worry about baby not getting enough milk. This being said, please do seek the help of a health professional such as a lactation consultant, midwife, your clinic sister or paediatrician if you are concerned that your baby is not thriving.

Breastfeeding is a natural process, but definitely does not come naturally to all mothers.  It is a skill that is mastered over time.  Our children teach us a great deal about their own characters during this “nutrition journey”.  Every child is different and we need to respond to their unique cues, whilst also being aware of our own strengths and weaknesses.  Don’t be afraid to seek help and open up to others.  We all need a community around us to lean on, laugh and cry with, and help us through difficult days.

May the mothers among you enjoy this special time with your baby, and for those who support mothers and infants, remember how invaluable your role is.