Breastfeeding is a universally accepted normative standard for the quality survival of a newborn baby. One of the most crucial aspects emphasised in promoting breastfeeding is early initiation, which involves initiating breastfeeding within the first hour of birth and practicing exclusive breastfeeding (no fluids or food other than breast milk) for the first 6 months unless medically indicated.

WHO-UNICEF recommends early initiation of breastfeeding within 1 hour and exclusive breastfeeding for the first 6 months, continuing breastfeeding along with complementary feeding up to 2 years or beyond. Most mothers are motivated and wish to breastfeed their infants successfully. However, when actually measured, the latest data reveals that the rate of early initiation and exclusive breastfeeding is only around 65% nationally. Health care professionals should be sufficiently trained to promote and support breastfeeding. Antenatal awareness of the importance of early initiation and exclusive breastfeeding has shown to be helpful in promoting breastfeeding.

Key Delivery Room Practices and Support Strategies

Delivery room practices like skin-to-skin contact, early uninterrupted sucking and bedding in with the mother help in the early initiation of breastfeeding. There is an early sensitive period in the initial 2 to 3 hours after delivery when babies are alert and actively sucking at the breast. Bedding in and assisting feeding during this critical period can solve many lactation concerns. Assessment and support from lactation counselors, help from reliable caregivers, ensuring proper positioning and LATCH, and providing emotional support to postpartum mothers can be of immense help. Nipple cracks, breast engorgement, flat nipples, and other lactation issues hindering exclusive breastfeeding should be addressed and solved at the outset itself.

Exclusive Breastfeeding: Beneficial Effects on Infant Health and Maternal Well-Being

Human breast milk, with its innumerable qualities, is a unique food for babies. Nature’s gift to the human infant remains a scientific enigma. Apart from providing all essential nutrients for the optimal growth of the baby, it is also a source of a wide variety of bioactive components that support beneficial microbiota, immune cells, and stem cells. These play a crucial role in immune development and thereby in programming health for life.

Exclusive breastfeeding has many benefits. There is enough evidence to support the fact that exclusive breastfeeding results in decreased rates of several diseases like lower respiratory infections, severe diarrhea, middle ear infections, obesity, asthma, atopic dermatitis, and other chronic illnesses. Initiating complementary food before 6 months, especially before 4 months, may be associated with an increased risk of overweight and obesity. Most infants show optimum growth while exclusively on breast milk until 6 months. There are many benefits for mothers too. Those who breastfeed experience a lower risk of type 2 diabetes mellitus, breast cancer, ovarian, and endometrial cancer.

Breastfeeding: Safe and Compatible in the Majority of Cases, with Rare Exceptions

There are very few situations where breastfeeding is to be avoided. These are very rare disorders like galactosemia and phenylketonuria, where breastfeeding has to be replaced with special diets. The majority of medicines are compatible with breastfeeding. If not, an alternative medication can be offered whenever possible.

In summary, preparation for the early and successful initiation of breastfeeding must commence from the antenatal period itself. The joint roles of the family, physician, nursing team, and lactation specialists need to be emphasized. Exclusive breastfeeding until 6 months of age and continuation even after the initiation of complementary feeds result in several lifelong health benefits for the infant and mother. Breast milk is a unique and invaluable gift to the human infant.

Dr Jyothi Prabhakar

Consultant

Department of Neonatology

KIMSHEALTH Trivandrum