1. When do I start feeding my child and what should I give first?
The child should be put to the breast as soon as the mother and child are ready, preferably within the first hour of birth. Breast milk alone is recommended, and there is no need to give prelacteal feeds like sugar water, cow’s milk, honey etc.
2. I have had a caesarean section. How can I feed the baby?
Most mothers who have had C sections can feed their babies exactly like after a normal delivery. If you are unable to sit up, raise yourself with pillows to an angle of 45 degrees, and then feed. Avoid the temptation to feed the baby lying down.
3. What should I do after I finish feeding my baby?
The baby has to be burped. With every gulp of milk, the baby swallows some amount of air, so that by the end of a feed, a significant amount of air has collected in the stomach. If this air is not brought out, it enters the intestines of the baby causing pain, distention, 'gas', excessive crying, etc. Burping is done either by making the baby sit upright on your lap, or putting the baby on your shoulder, and gently tapping and jerking the baby till the swallowed air is brought out i.e burped. A baby should be burped at least twice after every feed.
4. I am very comfortable feeding the baby while lying down. Why don't you recommend that?
When the baby is fed in the lying down position, there is a likelihood of the baby vomiting, and the milk may enter into the lungs, ear etc, causing problems. Also, feeding while lying down makes it difficult for you to burp the baby. More ominously, the mother can fall asleep while feeding, and there have been instances of babies being injured or suffocated by the unsuspecting mother!
5. How do I make out if my baby is getting sufficient milk?
Unfortunately, many mothers feel that their milk is not enough just because the baby cries a lot, or by seeing that no milk flows when they squeeze their breasts. You can convince yourself by making the following observations. If your baby is passing urine more than 5 to 6 times in 24 hours, and is gaining weight (at least 20 to 25 gms a day, or 130 to 150 gms a week), you can rest assured that your baby is getting enough.
The two important stimuli that help mother produce milk are
First, frequent suckling at the breast by the baby and second. Complete and frequent emptying of the breast i.e the breast is like a 'akshaya patra', the more milk you take out, the more the milk that fills in! Conversely, pain and worry are two factors that reduce the production of milk. My advice to mothers would be to stop stressing yourself out worrying about whether you are producing enough milk or not. Let nature take its course.
7. How often and how long should I feed my baby?
Babies should be fed 'on demand' and not 'by the clock'. Wait till the baby is hungry before putting the baby to the breast. The usual interval between feeds is one and a half, to two hours, but sometimes babies may sleep for longer hours at a stretch, and there is no need to wake them up for feeds. At the same time, there is no need to feed the baby the moment it starts crying. Make sure the baby is not crying because of some other reason like a wet nappy, or improper burping. See that the baby does not suckle at one breast for more than 20 mins, otherwise the nipples become cracked and sore. Don't let the baby use the breast as a pacifier!
8. What are the danger signs that I look out for?
Signs like poor feeding, lethargy or lack of active movement of hands and feet, excessive sleeping, incessant/inconsolable crying, abnormal movements of hands, feet , lips or eyes, persistent vomiting, cold body and extremities etc, need you to bring the child for a consult immediately.
9. What are the general measures that I should take to see that my baby remains healthy?
Keep visitors down to the minimum. See that everyone washes their hands thoroughly before touching the baby. Exclusively breast feed your baby till the baby completes 6 months. Avoid the temptation to start bottle feeds, and top feeds. Avoid potentially harmful traditions practices like Sambrani smoke, feeding the baby mashed herbs, honey and donkey's milk, castor oil instillation into nose etc.
10. Why are you doctors so much against bottle feeds? Babies in our family have been bottle fed for generations!
By offering your baby the bottle, your are causing what is called 'nipple confusion'. The baby is alternately offered one nipple (breast) which is short, firm and difficult to latch on, and then the bottle where the nipple is long, soft, easy to suck with minimum of effort and, if formula is offered, the milk also tastes different. No prizes for guessing which one the baby will choose! A further deterrent to mothers should be the fact that the feeding bottle is one of the commonest causes of loose motions, ear infections recurrent respiration infection, colic, teeth problems etc.
11. I am getting confusing advice regarding the things I should eat, clothes I should wear etc, after delivery. Can you set the record straight?
The first thing to remember is that a mother who is pregnant, or is breastfeeding, is not 'ill' or 'sick'. Much of the well-meaning advice from relatives and friends actually do not have proper scientific basis, and are just unquestioned and followed blindly. There is no need for a new mother to wear multiple layers of clothing, sweater, muffler etc, or is there any need to restrict nutritious food like vegetables, fruits and non-veg. plenty of liquids should be given to the mother, including water and milk. The mother should be given all the encouragement and love, and not scolding and harsh words. A mother who is comfortable and relaxed will be able to establish adequate breastfeeding very easily, and the stressed out mother always has most of the problems.