Necessity, the mother of interventions

“Just like other moms, I thought feeding is easy. Baby will just take feed and I can stay normal. But this wasn’t the case”, says first-time mom Malini Ratnam.

Motherhood is an overwhelming experience, and feeding a baby is considered one of the many selfless acts of the mother. Often, due to biological changes that a mother goes through during pregnancy, her body is unable to produce the required amount of milk for feeding the baby. 

Several mothers go on a guilt trip, blaming themselves for the lack of milk instead of understanding the medical reasons. Sometimes, it takes proper counselling from medical professionals to overcome the problem.

Breastfeeding Support For Indian Mothers (BSIM), a peer-to-peer support group, has filed a petition to create awareness to provide safe and hygienic feeding rooms for mothers. Delhi Government had drafted a policy for building feeding rooms in 2019. 

In 2020, Barakhamba metro station got Delhi’s first women’s lounge with a separate area for feeding and changing diapers.  However, most public spaces still lack these facilities.

Helping hands

New mothers often have doubts about their own capability and compare themselves with other mothers in their own family: ‘Am I doing enough?’ For mothers with such queries, there is only one answer: “Remember that you are not alone,” says gynaecologist Dr Manjula A.

“Lactation consultants can help you find ways to make breastfeeding work for you and your baby.” She received a Padma Shree for pioneering work in minimally invasive laparoscopic surgery.

Breastfeeding provides the ideal nutrition for infants. It has a nearly perfect mix of vitamins, protein, and fat — everything a baby needs to grow. It is more easily digested than infant formula. 

Breast milk contains antibodies that help infants fight off viruses and bacteria. It also lowers a baby’s risk of having asthma or allergies. 

According to the WHO guidelines, breastfeeding up to two years or more is recommended. The American Academy of Paediatrics recommends that mums feed their babies only breastmilk for the first six months; it can be increased depending on the mother.

“Keep in mind that breastfeeding even for a few weeks has benefits. Your friends and family may have strong beliefs about how long to breastfeed. But in the end, it’s up to you. Only you and your child know what’s best”, advises Dr Manjula.

Undoubted benefits

Breast milk contains antibodies that can fight infection. Those antibodies are present in high amounts in colostrum, the first milk that comes out of the breasts after birth. However, there are antibodies in breastmilk the entire time a mother continues to nurse. Research shows that breastfed babies have innate immunity that lowers the risks of diabetes, obesity and cancer.

Apart from the benefits for the baby, breastfeeding helps mothers to lose pregnancy weight faster, and lowers the risk of breast and ovarian cancer and osteoporosis.

Hannah Grace, a registered nurse and lactation consultant, started a breastfeeding and pumping support group to guide mothers on lactation and pumping. Through virtual platforms, she guides mothers with low supply issues, exclusive pumping, relactation, inducing lactation. She also supports moms whose babies are in the newborn intensive care units (NICU) to maintain supply, handle premature birth and monitor newborn weight.

The major problems faced by mothers are sore breasts, engorgement (milk isn’t fully removed from breasts), flat nipples, inverted nipples, mastitis, and lack of milk. “All breasts and nipple sizes and shapes are different. In case of inverted or flat nipples, we teach mothers certain exercises and positions to pull up the nipple”, says Grace. She continues, “The type of nipple is not a big matter of concern, that’s why it’s called breastfeeding.”

Usually, mothers who depend completely on formula powder, consult her. “We set up small targets like swapping one formula feed to breastfeed, and if a mother can do that, then it’s a big achievement”, she adds. 

“The major cause of pain is when the baby can’t properly attach to the breast”, says Dr Manjula. The remedies to this issue include a breastfeeding pillow, making sure the nipple is positioned correctly, and tilting the baby’s head back a little. Consulting a lactation consultant is a way to get personalised advice. 

Lactation consultant Grace tries to help her clients understand the issues and then guides them with proper emotional and physiological support. 

The pumping option

While the use of breast pumps is prevalent in the US, Indian mothers have also started using these pumps in the recent years. It’s for the mother to decide when does she want to start pumping, and depending upon the amount of milk expressed, she can choose from hand pumps, battery-operated pumps or electric pumps.

Ratnam had to rejoin work at her public sector company after six months of maternity leave. The stress of rejoining and other personal issues resulted in a drastically low supply of milk. Pumping milk was also challenging due to the pandemic. 

She says, “I couldn’t spend much time pumping, but I was able to pump for 15 mintues in the morning and 15 mintues after customer service time gets over.” After the advice of her lactation consultant, she started to pump frequently. 

With regular pumping, she now expresses 250-200ml of breast milk everyday. “From 20ml to 100ml, it’s not an easy journey”, she adds.

Another challenge is storage. She sanitises her hands frequently and uses ice packs and ice cubes inside a freezer box. “My baby is 16 months old now, and I’m still happily feeding her”, says Ratnam.

While new mothers find it difficult to adjust to the situation, it is necessary to point out that the city has very few feeding rooms. Most of the offices expect toilets to be used as feeding rooms, which are unsuitable for various reasons. Mothers require a comfortable chair to pump the milk, provision to lock the door and no CCTV cameras.

IT employee turned lactation profesional Shruty Kanchan has been weaning her twins from birth. She started using pumps because it helped her express some milk when tandem breastfeeding seemed overwhelming. She would pump out 150-200 ml of milk and breastfeed one baby lying down, while the other baby was offered expressed breast milk by her mother-in-law. 

Fortunately for her, HR policies in her company were very accommodating to help new mothers post maternity leave. “They had converted a meeting room into a room exclusively for pumping mothers. They ensured to remove CCTV cameras from the room, and covered the glass panels with posters”, she says.

Kanchen is working now to spread awareness about breastfeeding and helping new mothers identify their struggles. 

 

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