Breastfeeding critical for child survival

http://www.who.int/mediacentre/news/releases/2004/pr19/en/

Joint press release WHO/UNICEF

Global Strategy: Breastfeeding critical for child survival
UNICEF and WHO call for increased commitment to appropriate feeding practices for all infants and young children

23 MARCH 2004 | NEW YORK -- Calling on governments to promote and protect breastfeeding, UNICEF and WHO today jointly launched the Global Strategy for Infant and Young Child Feeding. The document, developed over two years of global consultation, pinpoints the main problems affecting infant and young child feeding and identifies approaches to their solution.

"There is no better way than breastfeeding to make sure that a child gets the best start in life," said UNICEF Executive Director Carol Bellamy. "The strategy is an invaluable roadmap for governments to create supportive environments where women can make informed choices about feeding their children."

Breastfeeding alone provides the ideal nourishment for infants for the first six months of life as it provides all the nutrients, antibodies, hormones, immune factors and antioxidants an infant needs to thrive. It protects babies from diarrhoea and acute respiratory infections and stimulates their immune systems.

"Virtually all mothers can breastfeed provided they have accurate information, and support within their families and communities and from the health care system," said LEE Jong-wook, Director-General of WHO. "Governments should move swiftly and effectively to implement this important strategy."

Lack of breastfeeding - and especially lack of exclusive breastfeeding during the first half-year of life - are important risk factors for infant and childhood morbidity and mortality. These risk factors are compounded by inappropriate complementary feeding as infants grow.

"Exclusive breastfeeding in the first half-year of life and continued breastfeeding coupled with appropriate foods reduce the number of children under five who die from malnutrition," said Dr Lee. Malnutrition is associated with more than 50% of deaths among children under five.

The strategy calls for a dramatic increase in the number of infants who are exclusively breastfed. Currently, no more than 35% of infants worldwide are exclusively breastfed during even the first four months of life. Complementary feeding frequently begins too early or too late, and foods are often nutritionally inadequate and unsafe. Malnourished children who survive are more frequently sick and suffer the life-long consequences of impaired development.

"The long-term impact of poor feeding practices in infancy and early childhood include poor school performance, reduced productivity and impaired intellectual and social development," Bellamy said.

In addition to stressing the link between the health and nutritional status of mothers and children, the strategy addresses the challenges of feeding in exceptionally difficult circumstances, such as natural or man-made emergencies.

The strategy also highlights the issue of optimal feeding of the roughly 2.6 million children who are born to HIV-infected women each year. The absolute risk of HIV transmission through breastfeeding - globally between 5% and 20% - needs to be balanced against the increased risk of morbidity and mortality when infants are not breastfed. All HIV-infected mothers should receive information about the risks and benefits of various options and guidance in choosing the most suitable option.

The Global Strategy for Infant and Young Child Feeding, available in six languages, was presented by UN Under Secretary-General for Management Catherine Bertini on 23 March to the Standing Committee on Nutrition session at the UN. It was distributed 24 March during a session on Breastfeeding and Complementary Feeding and their contribution to achieving the UN Millennium Development Goals.

For more information contact:

Randa Saadeh
Telephone: +41 (22) 791 3315
Email: saadehr@who.int

David Porter
Media Officer,
Telephone: +41 (22) 791 3774
Email: porterd@who.int

Erin Trowbridge
Telephone: +1 212 326 7172
Email: etrowbridge@unicef.org

Kate Donovan
Telephone: +1 212 326 7452
Email: kdonovan@unicef.org

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Sumber : http://www.news-medical.net/print_article.asp?id=1381

Survey serious misunderstandings about breastfeeding

Posted By: News-Medical in Women's Health News

Published: Monday, 10-May-2004

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A survey published today by The UK Department of Health for National Breastfeeding Awareness Week (9 - 15 May) shows that serious misunderstandings may be stopping women, particularly young women, from breastfeeding. Although the benefits of breastfeeding are well known, the UK has one of the lowest breastfeeding rates in Europe. Almost a third of women (29%) in England and Wales never try to breastfeed compared to 2% in Sweden. Younger women in particular are less likely to breastfeed with over 40% of mothers under 24 never trying. The new survey of 1000 women shows: Myth: Over a third (34%) of women believe that modern infant formula milks are very similar or the same as breast milk Fact: Infant formula milk does not contain the antibodies, living cells, enzymes or hormones present in breastmilk. Breastmilk is designed for each individual baby and changes over time whereas infant formula milk is designed for every baby. Myth: A fifth (20%) of young women aged 16-24 years believe that breastfeeding will ruin the shape of their breasts/body Fact: Breastfeeding uses up 500 extra calories a day. It helps the womb return back to normal and does not affect the shape of breasts in the long term Myth: Over two thirds (67%) of women believe that the general public find breastfeeding in public unacceptable Fact: Most people (84%)think it's fine for mothers to breastfeed their babies discreetly in public/in front of others (5) Myth:  Nearly all (95%) women believe that breastfeeding comes naturally to some and not to others Fact:  Breastfeeding is a skill and takes practice. It is important that women feel able to ask for help. Myth: Nearly all women (87%) believe that some women don't produce enough milk to be able to breastfeed. Fact:   Virtually all mothers can breastfeed provided they have accurate information and support. (4) Minister for Public Health, Melanie Johnson, says: "Breastfeeding is a major public health issue. A decision to breastfeed, especially if sustained for the first six months of a baby’s life, can make a major contribution to infant health and development as well as benefiting mums. "Our message is a simple one – if you are an expectant or new mum don’t let these myths discourage you from giving breastfeeding a go!" Give it a Go is the theme of National Breastfeeding Awareness Week this year which focusses on encouraging those with the lowest breastfeeding rates such as the young and those in disadvantaged areas to start breastfeeding. Among events planned are a series of evening presentations at Mothercare stores where health professionals will explain the benefits of breastfeeding and answer questions. Breastfeeding advocates include film and TV personalities Sadie Frost, Fiona Phillips, Davina McCall and Donna Air who says: “Because Freya is my first child I was extra cautious to give her the best start in life. Breastfeeding was a great way to help her avoid allergies and infections. I am so pleased I made the decision to breastfeed. It has proved tough at times, but is also very rewarding for both myself and Freya.” Davina McCall agrees: “Breastfeeding isn't always easy.  Both times I've nearly given up at six weeks but with some encouragement and reassurance I've persevered and I'm glad I did.  It's a wonderful experience and I always feel sad about stopping.”

How can I tell if my baby is getting enough milk?

This may be the most asked question for La Leche League Leaders. It is understandable, since breasts are neither see-through nor marked off in ounces. Thank goodness there are other signs that indicate baby is getting enough milk.

Typically during the first few days, while the baby is receiving mother’s thick, immunity-boosting colostrum, he will wet only one or two diapers per day.

Once mother's milk comes in, usually on the third or fourth day, the baby should begin to have 6-8 wet cloth diapers (5-6 wet disposable diapers) per day. (An easy way to feel the weight of a wet disposable diaper is to pour 2-4 tablespoons of water in a dry diaper.)

In addition, most young babies will have at least two to five bowel movements every 24 hours for the first several months, although some babies will switch to less frequent but large bowel movements at about 6 weeks.

A baby that is sleeping rather than feeding every 2-3 hours or is generally lethargic may need to be assessed by a health care provider to make sure that he is adequately hydrated.

These are additional important signs that indicate your baby is receiving enough milk:

·         The baby nurses frequently averaging at least 8-12 feedings per 24-hour period. 

·         The baby is allowed to determine the length of the feeding, which may be 10 to 20 minutes per breast or longer. 

·         Baby’s swallowing sounds are audible as he is breastfeeding. 

·         The baby should gain at least 4-7 ounces per week after the fourth day of life. 

·         The baby will be alert and active, appear healthy, have good color, firm skin, and will be growing in length and head circumference.

The physical act of breastfeeding is more than the quantity of milk that is supplied, as you will find once you hold your baby in your arms. Breastfeeding is warmth, nutrition, and mother's love all rolled into one. Understanding and appreciating the signs of knowing when your baby is getting enough to eat is the one of the most important things a new mother can learn. If you have any concerns regarding your baby, they should be addressed with your health care practitioner.

If you do need to increase your milk supply after keeping track of wet diapers, bowel movements and weight gain, there are several options you can try to increase your milk supply. See our FAQ on “Increasing Your Milk Supply” for further information. Keep in touch with your health care provider if your baby is not gaining well or is losing weight. In most cases, improved breastfeeding techniques will quickly resolve the situation, but occasionally, weight gain may indicate a health problem.

La Leche League's THE WOMANLY ART OF BREASTFEEDING is the most complete resource available for the breastfeeding mother and can be ordered from our online catalogue or through your local Leader. The online catalogue also has information sheets, such as “How to Know Your Healthy Full-Term Breastfed Baby is Getting Enough Milk” and “Increasing Your Milk”. These are also available from your local Leader. You can find a LLL Leader and Group by going to our Web page on finding a local Leader.

Last updated Tuesday, December 11, 2001 3:48 PM by sak.

http://www.lalecheleague.org/FAQ/enough.html

FAQ Seputar Penyimpanan ASI

BERAPA LAMA ASI HASIL POMPA/PERAS BISA DISIMPAN PADA SUHU RUANG?
Jika ruangan tidak ber-AC, disarankan tidak lebih dari 4 jam
Jika ruangan ber-AC, bisa sampai 6 jam
-catatan: suhu di atas harus stabil, misalnya ruangan ber-AC, tidak mati
sama sekali selama botol ASI ada di dalamnya.

BERAPA LAMA ASI HASIL POMPA/PERAS BISA DISIMPAN PADA SUHU LEMARI ES?
Jika Ibu mengetahui bahwa dalam 4 jam ke depan ASI hasil pompa/peras tidak akan diberikan pada bayi, maka segeralah simpan di lemari es. ASI ini bias bertahan sampai 8 (delapan) hari dalam suhu lemari es, jika ditempatkan dalam compartment yang terpisah dari bahan makanan lain yg ada di lemari es tsb.
Jika lemari es Ibu kebetulan tidak memiliki compartment terpisah untuk
menyimpan botol ASI hasil pompa/perasan, maka sebaiknya ASI tersebut jangan disimpan lebih dari 3 x 24 jam.
Ibu juga dapat "membuat" compartment terpisah dengan cara menempatkan botol ASI dalam container plastik yang tentunya dibersihkan terlebih dahulu dengan baik.

BERAPA LAMA ASI HASIL POMPA/PERAS BISA DISIMPAN PADA SUHU FREEZER?
ASI hasil pompa/perasan dapat disimpan dalam freezer biasa sampai 3 (bulan) lamanya. Namun Ibu jangan menyimpan ASI ini di bagian pintu freezer, karena bagian ini yang mengalami perubahan dan variasi suhu udara terbesar.

Jika Ibu kebetulan memiliki freezer penyimpan daging yang terpisah (biasanya disebut deep freezer) yang umumnya memiliki suhu lebih rendah dari freezer biasa, maka ASI hasil pompa/perasan bahkan dapat disimpan sampai dengan 6 (enam) bulan di dalamnya.

BAGAIMANA CARA MENYIMPAN ASI HASIL POMPA/PERASAN YANG BAIK?
- Simpan ASI dalam botol yang telah disterilkan terlebih dahulu
- Botol yang paling baik sebetulnya adalah yang terbuat dari gelas/beling,namun jika terpaksa menggunakan botol plastik, pastikanlah bahwa plastiknya cukup kuat (tidak meleleh jika direndam dalam air panas)
- Jangan pakai botol susu yang berwarna / bergambar, karena ada kemungkinan catnya meleleh jika terkena panas
- Jangan lupa bubuhkan label setiap kali Ibu akan menyimpan botol ASI,
dengan mencantumkan tanggal dan jam ASI dipompa/peras
- Simpan ASI di dalam botol yang tertutup rapat (jangan ditutup dengan dot,karena masih ada peluang untuk berinteraksi dengan udara)
- Jika dalam satu hari Ibu memompa/memeras ASI beberapa kali, bisa saja Ibu menggabungkan hasil pompa/perasan tsb dalam botol yang sama, dengan catatan bahwa suhu tempat botol disimpan stabil, antara 0 s/d 15 derajat Celcius).
Penggabungan hasil simpanan ini bisa dilakukan asalkan jangka waktu
pemompaan/pemerasan pertama s/d terakhir tidak lebih dari 24 jam

BAGAIMANA CARA PEMBERIAN ASI YANG SUDAH DIDINGINKAN KEPADA BAYI?
- Panaskan ASI dengan cara:
(a) membiarkan botol dialiri air panas (bukan mendidih) yang keluar dari
keran
ATAU
(b) merendam botol di dalam baskom / mangkuk yang berisi air panas (bukan mendidih)

- Jangan sekali-sekali memanaskan botol dengan cara mendidihkannya dalam
panci, menggunakan microwave atau alat pemanas lainnya (kecuali yang memang di-design untuk memanaskan botol berisi simpanan ASI)

- Ibu tentunya mengetahui berapa banyak bayi Ibu biasanya sekali meminum
ASI. Sesuaikanlah jumlah susu yang dipanaskan dengan kebiasaan tsb. Misalnya dalam satu botol Ibu menyimpan sebanyak 180 cc ASI tetapi bayi Ibu biasanya hanya meminum 80, jangan langsung dipanaskan semua. INGAT bahwa susu yang sudah dipanaskan tidak bisa disimpan lagi!

BAGAIMANA SAYA MENGETAHUI APAKAH ASI YANG DISIMPAN SUDAH BASI?
Sebenarnya jika Ibu mengikuti pedoman pemompaan/pemerasan ASI dan penyimpanan yang baik, ASI tidak akan mungkin basi. Kadang memang setelah disimpan / didinginkan akan terjadi perubahan warna dan rasa, tapi itu tidak menandakan bahwa ASI sudah basi. Asalkan Ibu berada dalam keadaan bersih ketika memompa/memeras, menyimpan ASI dalam botol yang steril & tertutup rapat, dalam jangka waktu yang dijabarkan seperti di atas dan saat memanaskan juga mengikuti petunjuk, mudah-mudahan ASI Ibu terjaga dalam kondisi yang baik.

Dibandingkan susu formula, ASI lebih tahan lama. Pada saat berinteraksi dengan udara luar, biasanya yang terjadi bukan pembusukan ASI tetapi lebih merupakan berkurangnya khasiat ASI, terutama zat yang membantu pembentukan daya imun bayi.

SELAMAT ! Bayi Ibu sungguh beruntung memiliki Ibu yang menyadari betul arti dan manfaat pemberian ASI dalam awal kehidupannya. Semoga ia tumbuh sehat dan selalu berada dalam lindungan Tuhan. Amiin.

------------------------------------------------------------------------

Nara Sumber:

Barger, J. and Bull, P.A., Comparison of the bacterial composition of breast milk stored at room temperature and stored in the refrigerator. Intl Journal of Childbirth Ed 2: pages 29 and 30 1987.

Hamosh, M. et al., Breastfeeding and the working mother effect of time and temperature of short term storage on proteolysis, lipolysis, and bacterial growth in milk. Pediatrics 97 (4) 492 to 498, 1996

Mohrbacher, N. and Stock, J., The Breastfeeding Answer Book, La Leche League International, 1997, pp 30 to 31.

Pardou, A. et al., Human milk banking: influence of storage processes and of bacterial contamination on some milk constituents. Biol Neonate 65:302 to 309, 1994

11 Tips Mengatasi Baby Blues Syndrome

Berikut ini ada beberapa hal yang bisa Anda lakukan untuk mencegah dan mengatasi Baby Blues Syndrome maupun Postpartum Depression:

Sebelum Melahirkan

1. Mulailah meminta dukungan dan bantuan keluarga sebelum proses melahirkan
2. Persiapkan mental dan pengetahuan Anda seputar perawatan dan kesehatan bayi
3. Jika Anda sudah menguasai berbagai kiat merawat bayi sejak sebelum melahirkan, maka mental Anda pun akan siap untuk menjadi seorang ibu

Sesudah Melahirkan

1. Mintalah bantuan suami, orang tua, mertua, serta kerabat dalam mengurus bayi Anda
2. Tidurlah selagi ada kesempatan
3. Ceritakan berbagai kesulitan Anda kepada suami Anda
4. Bergabunglah bersama komunitas ibu untuk berbagi pengalaman dan perasaan
5. Jangan terlalu membebani diri Anda
6. Manfaatkan waktu luang untuk rileks
7. Perhatikan pola makan Anda
8. Beri penjelasan kepada suami Anda tentang Baby Blues Syndrome, agar ia bisa memahami berbagai perubahan sikap dan tingkah laku Anda

Pada kasus Postpartum Depression (PPD), situasinya bisa sangat memburuk, sehingga tips-tips di atas tidaklah mencukupi. Sebaiknya konsultasikan dengan dokter Anda jika sepertinya Anda atau keluarga Anda menderita PPD, karena diperlukan perawatan lebih intensif.

Back to Bright Ideas

Bayi Jangan Langsung Dimandikan Setelah Lahir

Cegah Hilangnya Refleks Menyusu

Penelitian di Swedia baru-baru ini memperlihatkan bayi yang diletakkan di dekat puting ibunya segera setelah lahir memiliki respon menyusui yang lebih baik, dibandingkan bayi yang dibersihkan lebih dahulu. Kondisi itu sangat menguntungkan sang bayi karena tidak saja mendapatkan kolostrum dari ASI --yang kaya zat gizi untuk kekebalan tubuhnya-- tetapi juga melatih refleks menyusunya dengan benar.

Dalam sebuah tayang video disajikan bagaimana bayi baru lahir itu diletakkan di samping puting ibunya mampu menggerakkan tangan dan kakinya untuk mendapatkan puting ibunya. Begitu didapat, bayi dengan cepat membuka lebar mulutnya, lalu menyusui tanpa dibantu tangan ibunya. Setelah 10 menit bayi kemudian dibersihkan, kemudian diletakkan kembali ke dada ibunya. Refleks menyusunya sangat cepat dengan menggunakan tenaganya sendiri.

Sementara bayi yang dibersihkan setelah lahir, lalu diletakkan disamping puting ibunya tidak memperlihatkan respon atas puting ibunya. Meski sudah diletakkan diatas puting, bibir si bayi hanya diam saja. Keinginan menyusu dari bayi baru terjadi 10 jam kemudian, itupun harus dipandu sang ibu karena bayi kesulitan mendapatkan puting ibunya sambil menangis.

"Jika begitu lahir bayi langsung dimandikan, refleks menyusu ini langsung hilang 50 persen. Jika bayi lahir dengan operasi Caesar dan langsung dimandikan, refleks itu 100 persen hilang," kata Ketua Sentra Laktasi Indonesia, dr Utami Roesli mengomentari tayang yang menarik itu dalam sebuah diskusi tentang ASI, di Jakarta, Jumat (30/7) sehubungan dengan peringatan peringatan Pekan ASI Dunia 2004 yang jatuh pada 1-7 Agustus.

Penelitian terbaru itu, menurut dr Utami Roesli, seharusnya bisa mematahkan prosedur persalinan yang selama ini langsung membersihkan bayi segera setelah dilahirkan. "Bila melihat efek yang luar biasa pada bayi, kenapa kita tidak mencoba mempraktekkannya. Tetapi memang usaha ini bukan perkara mudah, karena bukan saja terkait dengan kebiasaan yang sudah mengakar masyarakat, tetapi juga harus berhadapan dengan produsen susu formula yang melakukan praktek gelap di rumah sakit," katanya.

Beberapa rumah sakit memberikan susu formula pada bayi yang baru lahir sebelum ibunya mampu memproduksi ASI. Hal itu menyebabkan bayi tidak terbiasa menghisap ASI dari puting susu ibunya, dan akhirnya tidak mau lagi mengonsumsi ASI atau sering disebut dengan "bingung puting".

"Menghisap susu dari botol itu lain dengan menghisap puting susu ibu. Bayi harus belajar sejak awal dan ibu juga harus belajar menyusui, karena ketrampilan itu memang harus dipelajari oleh keduanya," ujar dr Utami Roesli.

Sejak lahir, seorang bayi harus diajari menyusu dengan cara memasukkan seluruh areola payudara (daerah berwarna cokelat di payudara ibu) ke dalam mulut bayi. Jika bayi hanya mengisap puting susu saja, ASI yang keluar hanya sedikit. "Gudang ASI terletak di bawah daerah cokelat itu. Jika yang diisap hanya putingnya saja, ASI yang keluar hanya sedikit. Sedangkan, kalau dari daerah cokelat itu, ASI yang keluar akan banyak sekali," jelas Utami.

Jika ASI di gudang itu habis, pabrik ASI (alveoli) akan segera memproduksi lagi. Alveoli berbentuk bulat dan bergerombol seperti buah anggur. Alveoli dikelilingi otot yang disebut myoepithel. Otot inilah yang memompa ASI keluar dari alveoli menuju gudang ASI.

Namun, kinerja myoepithel sangat tergantung pada hormon oksitosin yang dikirim otak. Jika oksitosin keluar, otot pun bekerja. Sedangkan, oksitosin bisa keluar jika ibu merasa tenang dan disayang oleh suami serta mendapat dukungan dari orang-orang di sekelilingnya. "Makanya hormon ini disebut hormon kasih sayang. Dan di sinilah ayah memegang peranan penting," tegas Utami.

Macetnya proses pemberian ASI ini disebabkan beberapa hal. Misalnya, bayi yang tidak bisa mengisap, posisi menyusui yang salah, ibu merasa tidak nyaman, atau suami dan lingkungan tidak mendukung. "Tidak ada cerita seorang ibu tidak bisa menyusui atau ASI yang tidak cukup.

Perhatikan saja seekor marmut yang kecil bisa menyusui 12 ekor anaknya. Bayi gajah yang besar juga bisa disusui dengan cukup oleh induknya. Mereka tidak memerlukan susu hewan lain untuk memenuhi kebutuhan susu. ASI diproduksi berdasarkan jumlah yang dikeluarkan," ungkap Utami.

Dua Persen

Ia memperkirakan jumlah ibu yang memberikan ASI eksklusif kepada bayinya sampai berumur enam bulan saat ini masih rendah, yaitu kurang dari dua persen dari jumlah total ibu melahirkan. "Itu antara lain terjadi karena pengetahuan ibu tentang pentingnya ASI masih rendah, tatalaksana rumah sakit yang salah, dan banyaknya ibu yang mempunyai pekerjaan di luar rumah," ucapnya.

ASI eksklusif adalah pemberian ASI tanpa makanan tambahan lain pada bayi berumur nol sampai enam bulan. ASI eksklusif adalah makanan terbaik yang harus diberikan kepada bayi, karena di dalamnya terkandung hampir semua zat gizi yang dibutuhkan oleh bayi.

"Tidak ada yang bisa menggantikan ASI karena ASI didesain khusus untuk bayi, sedangkan susu sapi komposisinya sangat berbeda sehingga tidak bisa saling menggantikan," jelasnya.

Menurut dia, ada lebih dari 100 jenis zat gizi dalam ASI antara lain AA, DHA, Taurin dan Spingomyelin yang tidak terdapat dalam susu sapi. Beberapa produsen susu formula mencoba menambahkan zat gizi tersebut, tetapi hasilnya tetap tidak bisa menyamai kandungan gizi yang terdapat dalam ASI. "Lagi pula penambahan zat-zat gizi tersebut jika tidak dilakukan dalam jumlah dan komposisi yang seimbang maka akan menimbulkan terbentuknya zat yang berbahaya bagi bayi," katanya.

Ditegaskan, ASI sangat diperlukan untuk pertumbuhan dan perkembangan kecerdasan anak. "Menurut penelitian, anak-anak yang tidak diberi ASI mempunyai IQ (Intellectual Quotient) lebih rendah tujuh sampai delapan poin dibandingkan dengan anak-anak yang diberi ASI secara eksklusif. Karena itu, mengkonsumsi ASI bagi bayi merupakan hak anak yang hakiki," ujarnya.

Anak-anak yang tidak diberi ASI secara eksklusif juga lebih cepat terjangkiti penyakit kronis seperti kanker, jantung, hipertensi dan diabetes setelah dewasa. Kemungkinan anak menderita kekurangan gizi dan mengalami obesitas (kegemukan) juga lebih besar.

Selain pada anak, pemberian ASI juga sangat bermanfaat bagi ibu. ASI, selain dapat diberikan dengan cara mudah dan murah juga dapat menurunkan resiko terjadinya pendarahan dan anemia pada ibu, serta menunda terjadinya kehamilan berikutnya.

Hal lain yang jauh lebih penting adalah timbulnya ikatan bathin (bonding) yang kuat antara ibu dan anak. "Ibu juga tidak perlu susah-susah melakukan diet untuk mengecilkan perut setelah melahirkan, karena hisapan anak pada puting susu ibu merangsang keluarnya hormon yang dapat mengencangkan dinding-dinding perut ibu kembali," katanya. (T-1)

Breastfeed a Toddler—Why on Earth?

Source : http://www.kellymom.com/newman/bf_toddler_01-03.html

Handout #21. Toddler nursing. January 2003
Written by Jack Newman, MD, FRCPC. © 2003

Because more and more women are now breastfeeding their babies, more and more are also finding that they enjoy breastfeeding enough to want to continue longer than the usual few months they initially thought they would. UNICEF has long encouraged breastfeeding for two years and longer, and the American Academy of Pediatrics is now on record as encouraging mothers to nurse at least one year and as long after as both mother and baby desire. Even the Canadian Paediatric Society, in its latest feeding statement acknowledges that women may want to breastfeed for two years or longer. Breastfeeding to 3 and 4 years of age has been common in much of the world until recently, and it is still common in many societies for toddlers to breastfeed.

Why should breastfeeding continue past six months?

Because mothers and babies often enjoy breastfeeding a lot. Why stop an enjoyable relationship? And continued breastfeeding is even good for the health and welfare of both the mother and child.

But it is said that breastmilk has no value after six months.

Perhaps this is said, but it is wrong. That anyone (including paediatricians) can say such a thing only shows how ignorant so many people in our society are about breastfeeding. Breastmilk is, after all, milk. Even after six months, it still contains protein, fat, and other nutritionally important and appropriate elements which babies and children need. Breastmilk still contains immunologic factors that help protect the baby. In fact, some immune factors in breastmilk that protect the baby against infection are present in greater amounts in the second year of life than in the first. This is, of course as it should be, since children older than a year are generally exposed to more infection. Breastmilk still contains factors that help the immune system to mature, and which help the brain, gut, and other organs to develop and mature.
It has been well shown that children in daycare who are still breastfeeding have far fewer and less severe infections than the children who are not breastfeeding. The mother thus loses less work time if she continues nursing her baby once she is back at her paid work.
It is interesting that formula company marketing pushes the use of formula (a very poor copy of the real thing) for a year, yet implies that breastmilk (from which the copy is made) is only worthwhile for 6 months or even less ("the best nutrition for newborns"). Too many health professionals have taken up this absurd refrain.

I have heard that the immunologic factors in breastmilk prevent the baby from developing his own immunity if I breastfeed past six months.

This is untrue; in fact, this is absurd. It is unbelievable how so many people in our society twist around the advantages of breastfeeding and turn them into disadvantages. We give babies immunizations so that they are able to defend themselves against the real infection. Breastmilk also helps the baby to fight off infections. When the baby fights off these infections, he becomes immune. Naturally.

But I want my baby to become independent.

And breastfeeding makes the toddler dependent? Don't believe it. The child who breastfeeds until he weans himself (usually from 2 to 4 years), is generally more independent, and, perhaps, more importantly, more secure in his independence. He has received comfort and security from the breast, until he is ready to make the step himself to stop. And when he makes that step himself, he knows he has achieved something, he knows he has moved ahead. It is a milestone in his life.
Often we push children to become "independent" too quickly. To sleep alone too soon, to wean from the breast too soon, to do without their parents too soon, to do everything too soon. Don't push and the child will become independent soon enough. What's the rush? Soon they will be leaving home. You want them to leave home at 14? If a need is met, it goes away. If a need is unmet (such as the need to breastfeed and be close to mom), it remains a need well into the childhood/teenaged time.
Of course, breastfeeding can, in some situations, be used to foster an overdependent relationship. But so can food and toilet training. The problem is not the breastfeeding. This is another issue.

What else?

Possibly the most important aspect of nursing a toddler is not the nutritional or immunologic benefits, important as they are. I believe the most important aspect of nursing a toddler is the special relationship between child and mother. Breastfeeding is a life-affirming act of love. This continues when the baby becomes a toddler. Anyone without prejudices, who has ever observed an older baby or toddler nursing can testify that there is something almost magical, something special, something far beyond food going on. A toddler will sometimes spontaneously, for no obvious reason, break into laughter while he is nursing. His delight in the breast goes far beyond a source of food. And if the mother allows herself, breastfeeding becomes a source of delight for her as well, far beyond the pleasure of providing food. Of course, it's not always great, but what is? But when it is, it makes it all so worthwhile.
And if the child does become ill or does get hurt (and they do as they meet other children and become more daring), what easier way to comfort the child than breastfeeding? I remember nights in the emergency department when mothers would walk their ill, non-nursing babies or toddlers up and down the halls trying, often unsuccessfully, to console them, while the nursing mothers were sitting quietly with their comforted, if not necessarily happy, babies at the breast. The mother comforts the sick child with breastfeeding, and the child comforts the mother by breastfeeding.

Questions? see my book Dr. Jack Newman's Guide to Breastfeeding (called The Ultimate Breastfeeding Book of Answers in the USA)

Handout #21. Toddler nursing. January 2003
Written by Jack Newman, MD, FRCPC. © 2003

 

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This handout may be copied and distributed without further permission,
on the condition that it is not used in any context in which the WHO code on the marketing of breastmilk substitutes is violated

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Link : http://www.lalecheleague.org/FAQ/advantagetoddler.html

Frequently Asked Questions

Our FAQs present information from La Leche League International on topics of interest to parents of breastfed children. Not all of the information may be pertinent to your family's lifestyle. This information is general in nature and not intended to be advice, medical or otherwise. If you have a serious breastfeeding problem or concern, you are strongly encouraged to talk directly to a La Leche League Leader. Please consult health care professionals on any medical issue, as La Leche League Leaders are not medical practitioners.

What are the benefits of breastfeeding my toddler?

Toddlers breastfeed for many of the same reasons infants breastfeed: for nutrition, comfort, security, for a way to calm down and for reassurance. Mothers breastfeed their toddlers for many of the same reasons they breastfeed their infants: they recognize their children's needs, they enjoy the closeness, they want to offer comfort, and they understand the health benefits. (See LLLI's FAQ, "What are the Benefits of Breastfeeding My Baby?" for more information.) The American Academy of Pediatrics currently recommends that "breastfeeding continue for at least 12 months, and thereafter for as long as mutually desired." * The World Health Organization and UNICEF recommend that babies be breastfed for at least two years.
Breastfeeding a toddler helps with the child's ability to mature. Although some experts say a toddler who is not weaned will have difficulty becoming independent, it's usually the fearful, clingy children that have been pushed into situations requiring too much independence too soon. A breastfeeding toddler is having his dependency needs met. The closeness and availability of the mother through breastfeeding is one of the best ways to help toddlers grow emotionally.
Breastfeeding can help a toddler understand discipline as well. Discipline is teaching a child about what is right and good, not punishment for normal toddler behavior. To help a toddler with discipline, he needs to feel good about himself and his world. Breastfeeding helps a toddler feel good about himself, because his needs are being met.
Just as babies do, toddlers receive health benefits from breastfeeding. Your milk continues to provide immunities and vitamins, and can help protect your toddler from illness and allergies. If your toddler does get sick, nursing will help comfort him. In fact, a toddler with an upset stomach may be able to tolerate nothing but human milk.
Toddlers have a huge world to explore, and breastfeeding provides them (and their mothers!) with some quiet time in their busy, waking hours.
*See "Breastfeeding and Use of Human Milk" in Pediatrics, Volume 100, Issue 6, December 1997, pages 1035-1039.

Resources for Additional Information

Articles of interest to mothers of breastfeeding toddlers can be found in LLLI's Nursing an Older Baby FAQs.
A variety of articles can be found NEW BEGINNINGS article collection on Extended Breastfeeding.
A BREASTFEEDING ABSTRACTS article on extended breastfeeding and the law is here.
These items are available from LLLI's online catalogue or through your local Leader:
THE WOMANLY ART OF BREASTFEEDING, published by La Leche League International, is the most complete resource available for the breastfeeding mother. (Softcover, 465 pages.)
Breastfeeding Makes a Difference: This popular publication from LLLI has just been revised to include information on DHA and brain growth, protection against obesity, and how human milk kills cancer cells. Great for anyone, from new mothers to health care professionals, that wants to know why breastfeeding really does make a difference. No 1196-17 English, 95¢
MOTHERING YOUR NURSING TODDLER, revised edition, by No

http://www.abm.me.uk/10toddler.htm

10 Good Reasons to Breastfeed Your Toddler

by Elizabeth Bruce

The average American may not be ready to admit it, but myriad cultures past and present have accepted the fact that babies past infancy can benefit from nursing. The !Kung of Africa represent the natural state of human feeding. Mothers of this nomadic tribe breastfeed each child for up to six years. Sherman Silber, MD, points out that

the human species has spent more than 90 percent of its existence leading this type of nomadic hunter/gatherer life, and ‘civilization’ with its pressures is too recent to have had any appreciable impact on their genetic makeup.

In our culture, many men and women are uncomfortable with the functional role of breasts, probably because of our national obsession with breasts as sexual objects. Unfortunately, people’s psychological discomfort seems to increase as the nursing baby grows. Most Americans choose to wean their babies at about six months. Whatever the psychological complexities may be, we can no longer deny the health and social benefits of prolonged breastfeeding. Even the conservative American Academy of Pediatrics now officially recommends that breastfeeding continue for at least 12 months.² But what about nursing through a baby’s second or even third year? Is breast still best for toddlers? If we can get past our collective ambivalence, I think the answer is a resounding yes.
While most of your neighbours probably aren’t doing it, there are plenty of enlightened mothers out there who are. Alice Bailes, CNM, co-owner of Birth Care and Women’s Health in Alexandria, Virginia, says that the majority of her clients breast­feed well into their babies’ second year. In fact, she has clients who tandem nurse - they continue nursing their toddler through their next pregnancy and even after the new baby is born. Bailes, who has had personal experience tandem nursing, believes that it helps a toddler’s transition into being a big brother or sister.
Of course, the decision to continue nursing is a personal one, and it often is not made until the time comes. Rest assured, according to most moms who have decided to keep going, once you’ve managed to breastfeed through the challenging first year the rest is a breeze. In case you’re still not convinced, I am sharing my top ten reasons to breastfeed your toddler.

Convenience

I must confess that convenience was my number one reason for continuing to breastfeed my babies. OK, call it laziness. For one thing, weaning a baby before he’s ready takes a lot of time and effort. You have to carry messy snacks around and deal with tantrums. Fortunately, by the time the baby turns one, most moms have mastered the art of discretion, so nursing is the easiest thing in the world to do with a minimum of privacy.
Even better, there is no easier way to get a toddler to sleep on your schedule than by nursing him. I always feel sorry for mothers of toddlers who aren’t nursing, because their job is probably a lot harder than mine. If worse comes to worst, I know an induced nap is right around the corner.

Instant Tantrum-tamer

As any parent of a toddler knows, they are naturally insecure creatures. One moment your one year old is happy, and the next she is dissolved in a puddle of tears  seemingly over nothing. Well, surprise! Often the best way to handle your volatile toddler is to briefly treat her like a baby. Take her in your arms, nurse her for a few minutes, and voilà! - your little screamer is transformed into a confident child once again. If you’re at a party when your child melts down, you can discreetly take him or her into another room or to the car. Friends will marvel at your great mothering abilities when you return with a magically transformed, happy toddler.

Less Reliance on "Mommy Substitutes"

The toddler years are peak years for attachment objects like blankets and dolls. The major problem with these objects is that they can be lost. Such an episode can take on tragic proportions. Believe me, I know because my first son never nursed. There’s nothing quite like arriving at a Holiday Inn after a day of traveling with a cranky toddler only to discover you have left the critical object at a rest stop 300 miles back!
Life is too short for all that unnecessary drama. If you are nursing your toddler, you can forget the frantic search for an identical blanket and the Fed-Ex­ing of Barney. With Mommy as the primary security object, you can rest easy on those long family trips. It is basically impossible to lose a breast, no matter how distracted you are! Plus, you never have to steal the beloved object away for a round in the washing machine. Much trauma is spared for all.

Allergy Prevention

My second little boy was so attached to nursing that I became (reluctantly) a toddler nurser. He ate absolutely no solid food until he was 17 months old. Even La Leche League veterans suggested that the situation was, well, unusual. Looking back, I think my baby’s wisdom was in avoiding possible allergens. Studies (as well as anecdotal evidence) indicate that breastfeeding reduces the incidence of allergies.^3,4 My first child, who was solely formula-fed, had all sorts of food allergies, including rice and dairy products. In hindsight, my second child’s lengthy, exclusive breastfeeding makes sense. Most likely, it was nature’s way of protecting him from foods his body just was not ready to process. Undoubtedly, some children need longer than others to "outgrow" their allergies, and breastmilk provides the ideal support for their developing immune systems.

Nutrition

Good nutrition is admittedly tricky with toddlers. On some days they cram every morsel offered into their mouths, and other days you can’t coax them to take a bite of even their favourite food. In short, they’re picky eaters, and their appetites are capricious and unpredictable.
One popular myth that even paediatricians promote is that breastfeeding somehow loses its nutritional quality after the first year. In reality, the benefits change, but they are still there. Does it really make sense that after 12 months of providing your baby with optimal nutrition the breasts suddenly get "stupid" and start making something "less than optimal"? Obviously, the addition of solid foods changes the balance, but breastmilk is still an important element in the diet while your baby is sampling what the world has to offer. Certainly, there can be no harm in continuing with nature’s perfect food.

Speech Development

In general, it’s believed that breastfeeding provides better development of the teeth and jaws than sucking a hard, unnaturally shaped nipple.⁵ Margaret Connor, a 35-year-old mother in Austin, Texas, has discussed the subject at length with her son’s speech therapist. Both of them believe that Connor’s five-year-old son’s speech/motor apraxia would have been worse if his muscles had not been "worked out" through extended nursing. If nothing else, Connor is happy she made the decision she did. "At least I won’t look back and wonder if his articulation would have been better if I had breastfed longer than a year." she says.

Fighting Dehydration during Illness

Unfortunately, toddlers, breastfed and otherwise, get sick. Some get sick a lot, especially those in child care and those with older siblings. When my 14-month-old son got bronchitis, he wouldn’t eat or drink anything other than breastmilk. Had he not been breastfeeding, the situation could have turned into a nightmare. When a bottle-fed baby gets dehydrated, the parents have to struggle to get oral rehydration products down the child. When this tactic doesn’t work, paediatricians have no choice but to order an IV for the child at the hospital. This is not only traumatic for a toddler, but it also exposes him to other germs that could complicate the original infection. With breastfeeding, you can almost always get the child to nurse, which might even save his life! Further, it comforts the mother. It feels so much better to be able to help your child through illness in a uniquely positive way.

Weight Loss for Mom

It’s accepted that a woman’s body stores up enough fat during pregnancy to exclusively feed her infant for at least the first six months. While there are few studies on this topic, anecdotal evidence suggests that a mother’s weight loss may continue during the second year of nursing a baby. The fact is, Mother Nature never intended for human babies to be weaned from their mothers in the early months, so our bodies make sure we have plenty of fat stored up for years.
For the first year, our bodies seem to like to stay soft, almost like a cushion for the infant. After that time, the weight is not quite so resistant to leaving. The increased calorie requirements of toddlers help the process of weight loss as well. For every day she nurses, a lactating woman uses an extra 500 calories. Personally, I found that stubborn fat stores that had lived on my thighs for years melted away during the second year of nursing.

Delayed Menstruation

For those women using Natural Family Planning or the Fertility Awareness Method for birth control, breastfeeding provides a bonus. Research done by the Kippleys in "The Art of Natural Family Planning" showed that a nursing mother who uses no supplements for the first four to six months gets her first post­partum period on average after 13 to 16 months.⁶ Among the !Kung tribe, babies are spaced about 48 months apart - all due to exclusive breastfeeding.⁷ Contrast this with the usual six to eight weeks for a bottle-feeding mother. Naturally, PMS and the other related troubles usually disappear for as long as the periods stay away, and the return of fertility is also put off. In addition, delayed menstruation means decreased exposure to oestrogen, which may protect against cancer of the breast and reproductive organs. Breast cancer risk is associated with earlier menarche and later menopause, which points to estrogen exposure as a risk factor for the disease.^8,9

It’s Good for the Planet

Breastfeeding is the best ecological thing going. No cups to wash, no bottles to sterilize, and nothing for the landfill. Postponing the use of cows’ milk helps our planet. Because of their methane gas emissions, cows are major destroyers of the atmosphere.¹⁰ Overgrazing of land is responsible for serious ecological troubles, as well. As a bonus, the baby is not exposed to the unhealthy hormones and antibiotics injected into dairy cows.
Like most other mothers of toddlers, I originally continued nursing out of a desire for convenience. Frankly, it was just easier to keep going than to stop. Along the way, I discovered how much simpler continuing to breastfeed made our lives. If at all possible, the transition away from Mommy should be a gradual one, made at the baby’s own pace. Toddler life is difficult enough. Why not make it a little more manageable for everyone?
Elizabeth Bruce, MA, currently stays home with her four children, ages 9, 7, 5, and 2. She’s been breastfeeding for seven years and counting.

Notes

1. Sherman J. Silber, MD, How Not to Get Pregnant (New York: Warner, 1990): 92 - 93.
2. American Academy of Pediatrics, "Breastfeeding and the Use of Human Milk" (Policy Statement), Pediatrics 100 (December 1997): 1035 - 1039.
3. E. E. Ziegler et al., "Cow’s Milk Feeding in Infancy," Journal of Pediatrics 116 (1990): 11—18.
4. J. N. Strimac and D. S. Chi, "Significance of IgE Level in Amniotic Fluid and Cord Blood for the Prediction of Allergy," Annals of Allergy 61 (1986): 133 -136.
5. La Leche League International, The Womanly Art of Breastfeeding (New York: Penguin, 1991), 375—376.
6. John and Sheila Kippley, The Art of Natural Family Planning, Third edition (Cincinnati, Ohio: Couple to Couple League, 1991) 201.
7. Sherman J. Silber, MD, How Not to Get Pregnant (New York: Warner, 1990), 92—93.
8. F Grodstein et aI., "Postmenopausal Hormone Therapy and Mortality," New England Journal of Medicine 336, no.25 (1997): 1769—1775.
9. Ruth Westheimer, MD, Dr. Ruth's Encyclopedia of Sex (New York: Jerusalem Publishing House, 1994), 56.
10. Pamela Teisler, 101 Reasons Why I’m a Vegetarian (New York: Pamela Teisler, 1 992).

For More Information

Mothering Your Nursing Toddler, by one of the founders of La Leche League, Norma J. Bumgarner, offers support and guidance for toddler nursing. (La Leche League International, 2000)
Breastfeeding and Natural Child Spacing: How Ecological Breastfeeding Spaces Babies, written by Sheila K. Kippley, a founder of the Couple to Couple League, offers practical advice, even if you don’t agree with the moral overtones. (Couple to Couple League, 1999)
Leche League has leaders in practically every community and can be found in the yellow pages. Their website, www.lalecheleague.org contains a new category of articles called "Extended Breast-feeding" (click on "Breastfeeding Information from LLLI Periodicals" to find it).
For additional information about breastfeeding a toddler, see the following articles in past issues of Mothering - "To Wean or Not to Wean?" no. 97; "Breastfeeding Your Older Baby" no. 69.
This article originally appeared in "Mothering" Magazine, issue no. 103, November/December 2000, and is reprinted with kind permission.

http://www.kellymom.com/bf/bfextended/ebf-benefits.html

Extended Breastfeeding Fact Sheet

By Kelly Bonyata, BS, IBCLC

PDF version (great for printing) | Portuguese | Bulgarian | Russian

Breastfeeding benefits toddlers and young children...
nutritionally, immunilogically and psychologically.

• Nursing toddlers benefit NUTRITIONALLY
• Nursing toddlers are SICK LESS OFTEN
• Nursing toddlers have FEWER ALLERGIES
• Nursing toddlers are SMART
• Nursing toddlers are WELL ADJUSTED SOCIALLY
• Nursing a toddler is NORMAL
• MOTHERS also benefit from nursing past infancy
• Poll
• Additional Resources

Breast Problems During Pregnancy and Lactation: Frequently Asked Questions

Carol Scott-Conner, M.D.
Department of Surgery
University of Iowa Hospitals and Clinics
Creation Date: April 2000
Last Revision Date: April 2000
Peer Review Status: Internally Peer Reviewed

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Most of the common problems that occur during pregnancy, or lactation, can be managed without interrupting either the pregnancy or the breast-feeding. A woman who develops a lump in her breasts should see her physician because occasionally it is a sign of something more serious.
What are the most common problems a woman faces with her first child and breast-feeding? How can an expecting mom prepare herself for these issues?
The most common problem is nipple irritation and associated with that is mastitis, or inflammation and infection in the breast. The best way to prepare for this is by seeking the guidance of someone who is experienced in breast-feeding. There are now lactation consultants in many communities, and they are excellent sources of information. The nipples are a very sensitive area, and when the new baby starts to nurse, irritation may occur. Careful hygiene and cleanliness are important.
How can a woman prevent "cracking nipples" during lactation?
The best way to prevent cracking nipples is to use an approved lubricant of some kind. Check with your physician or health care provider for something to put on the nipples to keep them from drying out.
What advice would you give someone who developed a significant galactocele during her first lactation? Do I need surgery to correct it?
It may or may not re-accumulate during the 2nd pregnancy and lactation. I would not advise prophylactic surgery. Galactocele's are generally treated by aspiration and if this one recurs, then you should see your physician.
I am not sure if I am in right room, my son is almost 2. I never breastfed him, but I continued to leak until he was 8 mo. Now 2 years later I am leaking again, any ideas?
You should see your physician. That could be something serious.
What is galactocele, and is it preventable?
Galactoceles are single or multiple nodules that contain milk. Anything that obstructs the duct of the breast during lactation may cause a galactocele. Most often, galactoceles occur at the end of breast-feeding when the milk is allowed to stagnate in the breast. Sometimes the mass isn't found until months later. There really aren't any preventive measures, and galactoceles are simply dealt with by aspirating the milk with a needle.
Unfortunately, my OBs had trouble diagnosing the galactocele and it achieved about 8 centimeters in diameter. Would you consider surgery prophylactic at that point?
Again, we don't generally advise prophylactic surgery for galactoceles. If a large galactocele has been a problem in the past, then early detection and aspiration, if it recurs, should solve the problem.
Is there any reason a mother should consider not breastfeeding?
That is an individual decision that a woman should take up with her obstetrician but I am not aware of any specific conditions, with the exception of some very rare illnesses, that would make it wrong for a woman to breast feed. Some medications that a woman might have to take for life-threatening illnesses are excreted in the breast milk and that could be a problem. A woman should talk this over with her obstetrician. Remember, there are numerous benefits to mother and child from breast-feeding. Also, studies show that breast feeding reduces the risk of getting breast cancer later in life.
Can women continue to nurse, even when experiencing problems such as galactoceles?
Yes, a woman can continue to nurse and sometimes keeping the breasts empty by nursing helps the problem go away. Occasional repeated aspiration is needed. If the galactocele keeps coming back, surgery may be required.
Are lactation consultants a good idea?
I think that if it is your first baby, getting advice from someone who knows how to teach you the ins and outs of breast feeding is very important. For many women, a lactation consultant is the best option. Depending upon your circumstances, you may find that a nurse, a nurse midwife, or your obstetrician may be able to offer similar advice. Of course, some women get the support from other women in their family. The La Leche League is a nationwide organization that helps women with breastfeeding.
During lactation, one of my breasts grew quite larger than the other (obviously my son preferred that one because it seemed to produced more milk!) Is there any way to prevent this from happening with my next child?
I don't know of any way to prevent this. It is normal for the breast to increase during size and weight during pregnancy. Usually the increase is symmetric but occasionally one breast enlarges more than the other. It is likely that if this has happened once, it may happen again.
How do you manage breast infections? Do you have to stop breast-feeding?
Breast infections don't have to interrupt breast-feeding. Antibiotics can treat most of the common breast infections, and the woman can continue to breast-feed. Keeping the breasts empty by the baby nursing actually helps by avoiding the accumulation of milk in the breast because milk is a culture medium and the bacteria can grow in the milk. It does not have to interrupt breast-feeding.
What happens if a woman is diagnosed with breast cancer during pregnancy?
We can treat breast cancer during pregnancy without interrupting the pregnancy. Fortunately breast cancer is rare during pregnancy, but it occasionally occurs. Women that have breast cancer have had children come to term and do well. There isn't any danger of transmitting the cancer to the unborn child. We have enough alternatives in treatment now that we can treat the cancer adequately.
I've heard that bloody nipple discharge can be a sign of cancer. What about bloody nipple discharge during pregnancy?
During the last part of pregnancy, that is the last trimester, the nipple undergoes changes preparing for breast-feeding. With these changes, it is fairly common for women to have nipple discharge that may even be bloody. It usually gets better once a woman starts breast-feeding. It is not necessarily a sign of cancer. We don't do anything other than watch and carefully examine the woman.
What are the most common reasons women give up on breast-feeding?
Sometimes women think they don't produce enough milk, and they become discouraged and give up. I think it would be better to supplement with formula if necessary and continue breast-feeding as long as possible. That has probably been the most common reason I have seen women give up.
What should a pregnant woman do if she finds a lump on her breast?
A pregnant woman who finds a lump in her breast should see her physician for a careful examination, an ultrasound of the breast, and possibly an aspiration. Most breast lumps that occur during pregnancy are benign but occasionally women do develop breast cancer during pregnancy. Any lump that develops should be taken seriously whether the woman is pregnant or not. We don't do mammograms in pregnant women because the breasts are so dense from the pregnancy that mammograms are not very effective. Ultrasound is an excellent way to study various masses and is very useful. A woman who develops a lump in her breast during pregnancy should have it evaluated.
When should you stop breast-feeding?
That is something that ought be worked out with your own physician.
Do you need to do anything after you stop breastfeeding to stop the milk production?
Generally, just stopping breast-feeding suppress lactation. In addition, there are medications that a physician can prescribe.
What are some of the more common breast problems experienced during pregnancy? Are they hereditary? What types of breast problems occur in women who are NOT pregnant?
Breast lumps are very common in women who are pregnant and women who are not pregnant. Most of the time, these are caused by benign problems that are not cancerous. Once in a while, a lump is a sign of something serious. For that reason, any women, pregnant or not, who finds a lump in her breast should see her physician and have it checked out. Nipple discharge, as discussed earlier, is also a fairly common sign and in pregnant woman is also less worrisome but again should be evaluated by a physician. Breast pain is a very common and nonspecific problem in both pregnant and non-pregnant women. During pregnancy, the breasts enlarge; they get heavier and the blood supply increases. This makes it harder to feel lumps and makes it very important that a woman have a good breast exam early in pregnancy as a baseline for later comparison. Most of the common problems are not hereditary.
How do you fix an inverted nipple?
We usually leave inverted nipples alone and most women with inverted nipples are able to breast feed. If the nipple inversion is new, that is if the woman has not had it all of her adult life, it may be a sign of a problem and she should see her physician.
Do fibrocystic breast become more "lumpy" after pregnancy?
After pregnancy and after breast feeding, once you are finished breast feeding and they have shrunk down again, or involuted, lumps may be more prominent which creates the appearance of being more lumpy.