Almost every hospital today is campaigning for breastfeeding to be the sole provider of nutrition for babies and almost every establishment provides a breastfeeding room for mothers who want to breastfeed their children. As healthcare providers, we should educate mothers on why breastfeeding should be their priority and how it can benefit both the mother and the baby.
Breastfeeding and its Physiology
Breast milk is agreed to be the most recommended milk for newborns because of its benefits to both the mother and the newborn. What is the physiology of breastfeeding?
- Acinar cells or alveolar cells are responsible for the formation of breast milk.
- Progesterone levels fall after the placenta is delivered, leading to the stimulation of prolactin.
- Prolactin stimulates the production of milk.
- On the fourth month of pregnancy, the acinar cells start producing colostrums, which is full of nutrients for the newborn.
- Colostrum production continues for the first 3 to 4 days after birth.
- Transitional breast milk replaces colostrums on the 2nd to 4th
- True or mature breast milk is produced on the 10th
- Milk flows through its reservoirs, the lactiferous sinuses, which are located behind the nipple.
- Foremilk is the constantly forming milk.
- When the infant sucks at the breast, oxytocin is released and the collecting sinuses of the mammary glands contract.
- Milk is forced forward through the nipples, and this action is called the letdown reflex.
- Let down reflex can be triggered by thinking about the baby or whenever the mother hears a baby crying.
- After the letdown reflex, new milk or hind milk is formed, and it has higher fat than foremilk.
- Hind milk makes the infant grow more rapidly than foremilk.
- Oxytocin also helps in the contraction of the uterus so that the woman will feel a small tugging or cramping in the lower pelvis on the first few days of breastfeeding.
Advantages of Breastfeeding
Breastfeeding must also depend on the preference of both the woman and her baby, so both of them could enjoy the experience and gain benefits as well.
Advantages for the Infant
- Breast milk contains immunoglobulin A which binds viruses and bacteria so they will not be absorbed from the gastrointestinal tract into the infant.
- Lactoferrin, which is from the breast milk, also interferes with the growth of pathogens.
- An enzyme from the breast milk, the lysozyme, destroys bacteria by lysing their cell membranes.
- Leukocytes in the breast milk provide protection against common respiratory infections.
- Macrophages that produce interferons protects against common viruses.
- Lactobacillus bifidus in breast milk prevents colonization of pathogenic bacteria in the gastrointestinal tract, reducing the incidence of diarrhea.
- Breast milk contains the ideal composition of electrolytes and minerals for infant growth.
- Rapid brain growth in the infants is achieved because breast milk is high in lactose which provides ready glucose.
- Breast milk also contains linoleic acid which is an essential fatty acid for skin integrity.
- The levels of nutrients are enough to supply the infant’s needs and also spare the infant’s kidneys from processing a high renal solute load of unused nutrients.
- Breast milk is free from allergens, unlike cow’s milk.
- Calcium is regulated better in newborns that are breastfed.
- Breastfeeding prevents excessive weight gain in infants.
Advantages for the Mother
- Breastfeeding helps prevents breast cancer.
- Oxytocin aids in uterine involution as it helps the uterus contract.
- Breastfeeding empowers women because only women can master it.
- Feeding and preparation time is greatly reduced.
- The bond between the mother and the baby is strengthened.
Common Concerns in Breastfeeding
Some mothers may love breastfeeding their babies, but there are others who are quite hesitant to do so. These are mainly due to some of their concerns during breastfeeding, and examples of these concerns are as follows.
|The mother worries about the amount of milk taken by the baby because she cannot see it.||The nurse should assure the mother that to be certain that an adequate amount is taken by the baby; she must observe whether the baby appears content between feedings and is wetting the diapers.|
|The infant does not suck well because of the possible effect of analgesia during birth.||The nurse should guide the mother in adjusting the feeding pattern of the infant to meet its needs, and assure her that the effect of analgesia is temporary.|
|The infant also cannot suck well when it is not hungry or was exhausted by crying from hunger.|
|The mother is worried because the infant’s stools are loose and thin, but these are normal because stools are normally lighter and looser for breastfed babies.||Explain the normal stool pattern and transitions to the mother and also examine the infant’s stools.|
|The father feels shut out of the mother-baby relationship, so he does not participate in infant feeding.||Advise the father to look for other ways to bond with the infant aside from feeding.|
|The mother has sore nipples because the nipples were kept wet, so the infant cannot grip the entire areola properly.||Assist the mother by helping the infant grasp the nipple correctly and advise the mother to expose the nipple to air between feedings.|
|Advise the mother that she can apply aloe vera or vitamin E to help heal the tissue.|
|The engorgement of the mother’s breasts causes a lymphatic filling as milk production begins.||Encourage the infant to suck and advise the mother to apply warm packs to breasts.|
|Instruct the mother to take a warm shower before breastfeeding the infant to soften the breast tissue.|
|The mother does not want to breastfeed in public because some people make them uncomfortable.||Encourage the woman to use discretion to avoid confrontation.|
Practice Quiz: Breastfeeding 101
Test yourselves with this 5-item quiz about breastfeeding.
1. How does breast milk help prevent infection in a newborn?
A. It is rich in fatty acid, so bacteria are destroyed by it.
B. It is always flowing forward in the breast so it is not static.
C. It contains maternal antibodies and viral binding factors.
D. It is low in lactose, so it becomes a poor culture medium.
2. How is prolactin stimulated so it can also stimulate the production of breast milk in return?
A. Acinar cells start producing colostrum.
B. Progesterone levels are reduced by the delivery of the placenta.
C. The letdown reflex takes place.
D. Progesterone levels increase after the delivery of the placenta.
3. What would you advise a mother who has an allergy to protein but still wants to breastfeed?
A. Assure her that breastfeeding would not pass on the allergy to the infant.
B. Advise her to consult her primary health care provider regarding this issue.
C. Advise her to use formula milk instead to avoid allergies.
D. Let her alternate between breast milk and formula milk to reduce chances of acquiring the allergen.
4. What can a mother benefit from breastfeeding?
A. Breastfeeding mothers would lose weight rapidly.
B. Breastfeeding is a 100% effective contraceptive method because of lactational amenorrhea method.
C. Breastfeeding mothers can teach the fathers how to breastfeed so they can enjoy feeding time.
D. Breastfeeding prevents breast cancer.
5. What should a nurse do when the mother complains that the infant is not sucking well?
A. Instruct her to place warm compresses on her breast to soften breast tissue.
B. Advise the woman to apply aloe vera to increase sucking ability.
C. Guide the mother in adjusting the feeding pattern of the infant so it can still get the nutrients it needs.
D. Advise her to take a warm shower before breastfeeding.
Answers and Rationale
1. Answer: C. It contains maternal antibodies and viral binding factors.
- C: Maternal antibodies help prevent infection just as viral binding factors prevent invasion of viruses.
- A: Fatty acids protect the skin integrity of the newborn.
- B: Although it is always flowing, it is not the main reason for the prevention of infection.
- D: Breast milk is high in lactose for rapid brain growth.
2. Answer: B. Progesterone levels are reduced by the delivery of the placenta.
- B: As progesterone decreases, prolactin is stimulated.
- A: Acinar cells are only responsible for the production of colostrum.
- C: The letdown reflex is activated whenever the mother hears a baby crying or thinks about her baby.
- D: The progesterone should decrease to stimulate the release of prolactin.
3. Answer: A. Assure her that breastfeeding would not pass on the allergy to the infant.
- A: Breast milk does not contain protein unlike cow’s milk, so it is safe to let the mother breastfeed the infant.
- B: The nurse should inform the mother of the benefits of breastfeeding and should not simply hand over the responsibility to the physician.
- C: Formula milk contains cow’s milk protein which could trigger an allergy.
- D: The mother is still using formula milk which could trigger the allergy because of the protein in cow’s milk.
4. Answer: D. Breastfeeding prevents breast cancer.
- D: Woman who breastfeeds reduces her chance of acquiring breast cancer.
- A: This is not true; women still need a balanced diet during breastfeeding and therefore should eat more.
- B: Some breastfeeding women are already ovulating four weeks after giving birth, some even during breastfeeding.
- C: The father can find other ways to bond with the infant aside from feeding.
5. Answer: C. Guide the mother in adjusting the feeding pattern of the infant so it can still get the nutrients it needs.
- C: The analgesia may not have worn off, or it is exhausted from crying.
- A: This is an intervention for engorgement of the breasts.
- B: This is an intervention for sore nipples.
- D: This is an intervention for engorgement of the breasts.
Breastfeeding is one of the most natural things that a mother could give to her children. As breastfeeding provides so many benefits, nurses should promote this action to ensure that every newborn is given the care that it deserves.