Wednesday, August 1, 2007

Breastfeeding Your Adult Baby

Throughout human history there have been infants both young and old who have been nursed by wet nurses or surrogate mothers. During the medieval period, it was not uncommon for physicians to prescribe human milk for direly ill patients. Since sanitation and storage was poor to non-existent, the best type of feeding was directly from the breast of the wet nurse.

The Victorian distress (which has continued until today) with exposed body parts and breast-feeding wasn’t an issue at that period. Many men suckled at their wife’s breasts during pregnancy to induce a healthy flow of milk for their expected son. Non-maternal lactation supplements ordinary occurred at that period as a result of maternal death or illness, or because of the feudal position and duties of the birth-mother, or because of simple adoption. Usually, the wetnurse was already breastfeeding another baby, (either hers or another baby of the noblewoman) and her milk supply simply increased due to additional demand to meet the growth needs of two (or more) babies. If the father was poor and could not find or afford a lactating woman to serve as a wet nurse for the baby, goat’s milk was usually substituted in societies that raised sheep. Goats were usually raised with sheep to provide a substitute mother for an orphaned lamb in need. It is interesting to note that goat’s milk is the more similar to human milk than any other milk among the animal world.

Many women who have never had babies of their own immensely enjoy the intense physical pleasure of breastfeeding, even if the volume of milk they produce is relatively small in volume. The pleasure of breastfeeding is hard-wired into the Limbic area of the brain and is strongly tied to the sex drive of the R-brain. In the most concise words possible, it is entirely natural and normal for a woman to achieve climax by virtue of breast feeding alone.

The volume of milk produced varies considerably from individual to individual and it is difficult to predict the results of induced lactation. It is unusual in the United States to find women who can express a full supply of milk from induced lactation, but it is also rare to find women who cannot produce any milk at all.

Preferably, a woman should be able to induce lactation through mere manipulation or stimulation of her breasts. Playing with, manipulating or sucking on her nipples will usually produce an increase in both prolactin and oxytocin without having to resort to chemical or medicinal therapy. The volume of milk that is produced will not be as great as that produced after a pregnancy and delivery, but lactation will usually begin in and of itself. Mechanical stimulation via hospital grade breast suction pumps have also shown themselves to be effective in producing lactation without medication.

How does induced lactation work? Lactation is governed by two pituitary (not ovarian) hormones; prolactin and oxytocin. Therefore, even if a woman has had a hysterectomy, she can lactate, assuming her over-all health is good. Note that estrogen, in the form of birth control pills or for hormone replacement therapy, is a lactation suppressant.

Hormonal therapy to induce lactation generally consists of administration of estrogen to resemble the high-estrogen state of pregnancy. The estrogen is then abruptly withdrawn to mimic the rapid hormonal changes following delivery. A course of a prolactin-enhancing drug such as metaclopromide is then started. Once the prolactin, the milk-making hormone, is at a high enough level, then oxytocin, the milk-releasing hormone, will be produced in response to nipple stimulation. Sucking stimulation by the baby (or by a mechanical breast pump) is begun at this point. One study of induced lactation using medications describes beginning of milk production as occurring between 5-13 days.

If only manual or mechanical stimulation is employed, milk production typically begins between 1-4 weeks after initiating breast manipulation or vacuum evacuation and stimulation by breast pump. During the time that milk production is building, the woman may notice a darkening in the color of their nipples and areolar tissue. This is normal. Women who breastfeed may expect the areolas to double in size as well as darken in color. It is not abnormal for a woman’s breasts to become very tender and somewhat fuller or several sizes larger. Some women report increased thirst, and changes in their menstrual cycle or libido. All of these symptoms are normal and to be expected as a consequence of lactation.

Breastfeeding - Latching on, feeding and positioning

Latching on, feeding and positioning

When the baby's cheek is stroked with the nipple, the baby will open its mouth and turn towards it. So that the baby will latch on well, the nipple should be pushed into its mouth so that the baby has a mouthful of nipple and areola. The nipple should be at the back of the baby's throat, with the baby's tongue lying flat in its mouth. Inverted or flat nipples can be massaged so that the baby will have more to latch onto.

Many women wear nursing brassieres for easier access to the breast, but these are not always necessary and certainly not required. In the very early days a nursing bra can make breastfeeding complicated and uncomfortable. Wearing a bra at any time after birth will not affect how the breast changes with pregnancy and breastfeeding. Many women find that the size of their breasts change dramatically and so fitting a bra is better done after childbirth rather than before. An ill-fitting bra, whether designed for nursing or otherwise, can cause plugged ducts or mastitis.

Pain in the nipple or breast is linked to incorrect breastfeeding techniques. Failure to latch on is one of the main reasons for ineffective feeding and can lead to infant health concerns. A 2006 study found that inadequate parental education, incorrect breastfeeding techniques, or both were associated with higher rates of preventable hospital admissions in newborns.

The baby may pull away from the nipple after a few minutes or after a much longer period of time. Normal feeds at the breast can last a few sucks (newborns), from 10 to 20 minutes or even longer (on demand). Sometimes, after the finishing of a breast, the mother may offer the other breast.

The length of feeds varies a lot. Regardless of the time taken, the breastfeeding mother should be comfortable.

* Upright: The sitting position with the back straight and leaning back comfortably.
* Mobile: The mother carries her nursling in a sling or other baby carrier while breastfeeding. Doing so permits the mother to incorporate breastfeeding into the varied work of daily life
* Lying down: Good for night feeds or for those who have had a caesarean section
o On her back: Mother is usually sitting slightly upright; particularly useful for tandem breastfeeding (nursing more than one child)
o On her side: The mother and baby lie on their sides
* Hands and knees: The mother is on all fours with the baby underneath her (not usually recommended)

While most women breastfeed their child in the cradling position, there are many ways to hold the feeding baby. It depends on the mother and child's comfort and the feeding preference of the baby. Some babies prefer one breast to the other, but the mother should offer both breasts at every nursing with her newborn.

* Cradling positions:
o Cradle hold: The baby is held with its head in the woman's elbow horizontally across the abdomen, "tummy to tummy", with the woman in an upright and supported position image
o Cross-cradle hold: As above but the baby is held with its head in the woman's hand
* Football hold: The woman is upright and the baby is held securely under the mother's arm with the head cradled in her hands. This position is especially useful for feeding twins simultaneously image
* Feeding up hill: The baby lies stomach to stomach with the mother who is lying on her back; this is helpful for babies finding it difficult to feed
* Lying down:
o On its side: The mother and baby lie on their sides
o On its back: The baby is lying on its back (cushioned by something soft) with the mother on her hands and knees above the child (not usually recommended)

When tandem breastfeeding, the mother is unable to move the baby from one breast to another and comfort can be more of an issue. As tandem breastfeeding brings extra strain to the arms, especially as the babies grow, many mothers of twins recommend the use of more supporting pillows. Favoured positions include:

* Double cradle hold
* Double clutch hold image
* One clutched baby and one cradled baby
* Lying down

Monday, July 30, 2007

Breast Feeding - Time and Place

Breastfeeding at least once every two to three hours helps to keep up the milk supply. For most women, a target of eight breastfeeding or pumping sessions every 24 hours keeps their milk supply high. It is common for newborn babies to feed more often than this: 10 to 12 breastfeeding sessions every 24 hours is common, and some may even feed 18 times a day. Feeding a baby on demand (sometimes referred to as "on cue"), which may mean breastfeeding many times more than the recommended minimum, feeding when the baby shows early signs of hunger, is the best way to maintain milk production and ensure the baby's needs for milk and comfort are being satisfied.However, it may be important to recognize whether a baby is truly hungry, as breastfeeding too frequently may mean the child receives a disproportunately high amount of foremilk, and not enough hindmilk, potentially creating problems.

Babies usually show they are hungry by waking up (newborns), mouthing their fists, moaning or fussing. Crying is a late indicator of hunger. When babies' cheeks are stroked, the rooting instinct makes them move their face towards the stroking and open their mouth.

Breastfeeding can make mothers thirsty, especially at first, when both mother and baby are inexperienced and when feeding sessions can last for up to an hour or more (there is no time limit for breastfeeding). Having water readily available helps mothers maintain proper hydration.