After the baby is born, changes occur in the ductless glandular system of the mother's body which initiate the secretion of milk and vital antibodies. After an initial 2-3 day delay, true milk production begins.
During this delay (and during late gestation), a yellowish fluid called colostrum is secreted. Each of the first few feedings provides the infant with colostrum. The amount of colostrum decreases with each successive time at the breast until the mother begins to provide pure breast milk the third day after birth.
Colostrum has less sugar than milk and almost no fat, but it is much higher in protein. It has 10 to 17 times the Iron content of milk, 3 times as much Vitamin D and 10 times more Vitamin A. Like milk, colostrum is rich in IgA antibodies. Since these antibodies are resistant to digestion in the stomach, they may help to protect the infant's digestive tract against bacterial infection. Additionally, these IgA antibodies are absorbed, entering the bloodstream to provide even broader immunity.
An infant's intestinal tract is ready to receive this special food. Scientists have discovered that during the first 24-36 hours of an infant's life, its intestinal wall has many large pores through which to receive the immunoactive molecules supplied by colostrum.
The benefits of Colostrum...
Colostrum delivers some very special substances to infants including:
- Immune factors, which facilitate the development of a strong immune system.
- Growth factors, which are essential in the creation and maintenance of bone, muscle, nerves, and cartilage, as well as other essential functions.
- Antibodies (immunoglobulins) that protect the infant from invading organisms. Although having these antibodies is no guarantee that the infant won't get sick, it can minimise the severity of an illness and does provide the ammunition needed to ward off and fight invading organisms, including those the mother's body produced for diseases she had before her pregnancy, such as measles, mumps, and pertussis. Antibodies also stimulate the infant's own immune system to create immunity to invasion by disease-causing organisms.
- It contains substances that destroy viruses. It also starts proper bowel movements, imparts the desirable acidophilus bacteria to the baby's bowel, stimulates physical growth and initiates many other body functions. One researcher has estimated that colostrum triggers at least fifty processes and functions in the newborn that provide lasting benefits, some lifelong.
After birth, prolactin release gradually wanes, and continual milk production depends on mechanical stimulation of the nipples, normally provided by the sucking infant. Mechanoreceptors in the nipple send a message to the hypothalamus, stimulating the secretion of PRH. This results in a burst-like release of prolactin, which stimulates milk production for the next feeding.
The same impulses also prompt release of oxytocin from the posterior pituitary. Oxytocin causes the let-down reflex, the actual ejection of milk from the alveoli of the breasts. Let-down occurs when oxytocin binds to myoepithelial cells surrounding the glands, after which milk is ejected from both breasts, not just the suckled one. Many obstetricians recommend that mothers nurse because oxytocin also stimulates the recently emptied the uterus to contract, helping it to return nearly to its pre-pregnant size. In addition, it reduces the chance of haemorrhaging from the placental site, and gives the mother an opportunity to rest.
The advantages of breast milk...
Breast milk also has advantages for the infant:
- Its fats and iron are better absorbed and its amino acids are metabolised more efficiently than those of cow's milk (after all Mother Nature made it for our babies!).
- Besides IgA and other immunoglobulins it has a host of other beneficial chemicals that work to protect infants from life-threatening infections including complement, lysozyme, interferon, and lactoperoxidase. Mother's milk also contains interleukins and prostaglandins that prevent overzealous inflammatory responses (lowers the incidence of food allergies) and a glycoprotein that prevents the ulcer-causing bacterium (H. pylori) from attaching to the stomach mucosa.
- It has a natural laxative effect that helps to cleanse the bowels of meconium, a tarry green-black paste containing sloughed of epithelial cells, bile and other substances. Since meconium, and later faeces, provides the route for eliminating bilirubin from the body, clearing meconium as quickly as possible helps to prevent physiological jaundice. It also encourages bacteria (the source of Vitamin K and some B Vitamins) to colonise the large intestine. It also promotes healthy oral development, satisfies sucking needs, and enhances bonding and skin-to-skin contact between mother and child.
Human breast milk has a remarkably constant composition. Poor nutrition in a nursing mother seems to reduce the quantity rather than the quality of the milk. The body maintains the quality of milk by drawing upon the mother's own store of nutrients. It is the most nearly perfect food, but is low in Vitamin D, C, Iron and Fluoride, which may be supplemented. Recent research has indicated that babies who are breast-fed have a lower incidence of diabetes in later years. At 4-6 months, an Iron supplement may be needed.
While prolactin levels are high, the normal hypothalamic-pituitary controls of the ovarian cycle are damped, probably because stimulation of the hypothalamus by sucking causes it to release beta-endorphin, a peptide hormone that inhibits hypothalamic release of GnRH and hence the release of gonadotropins by the pituitary. Because of this prolactin-induced inhibition of ovarian function, nursing has been called the natural birth control. Nonetheless, there is a good deal of slippage in these controls, and most women begin to ovulate even while continuing to nurse their infants.
Breast feeding - supply and demand...
When nursing is discontinued, the stimulus for prolactin release and milk production ends, and the mammary glands stop producing milk. Milk secretion can continue for several years if the child continues to nurse, but some sources say women who nurse their infants for 6 months or more lose a significant amount of calcium from their bones. However, according to the American Academy of Paediatrics' position paper on breast feeding issued in 1997, 1 year is the recommended length of time to breast feed. Lactating has also been shown to protect women against osteoporosis, while not breast-feeding is a risk factor for its development. Women on sound diets usually replace lost bone calcium after weaning the infant and this is one of many reasons we recommend supplementing with a specifically prepared multiple formula for lactation.
Supplementing nutrients and following a varied, balanced diet will benefit the health of the lactating mother and her baby. The nursing mother needs at least 6000 IU of Vitamin A and 300 mg of Vitamin C daily. Protein needs are greatly increased. Vitamin K can be supplied by yoghurt, cabbage or spinach. Sufficient Vitamin E and Iron (in the organic form to prevent destruction of Vitamin E) is needed. If adequate Calcium is not provided in the mother's diet, the mineral will be leached out of her bones to supply the milk. Calcium requirements are higher during lactation than at any other time, and Magnesium and Vitamin D ensure proper absorption of Calcium. Sources of Vitamin D are sunshine, fish-liver oils, butter and milk.
The requirements for B1, B2, and B3 are related to caloric intake, and they are needed in higher than normal amounts. Sources are whole grain cereals, Brewer's yeast, milk, lean meat, and eggs. Consumption of refined flours and sugars increases the saturated fat content of breast milk; therefore, whole grain foods and natural carbohydrates are recommended.
If the baby is sick or has an immature sucking reflex, the sucking will not be enough to sufficiently stimulate the breast. Babies with malformations of the nose, lips, or tongue, premature or brain-damaged babies, and babies with heart defects or lung problems may be weak nursers. They can still be nursed with time and patience and small, frequent feedings.
Nasal congestion caused by an allergy or respiratory infection will make it difficult for the infant to breathe and nurse at the same time. Mild salt water nose drops and gentle removal of mucous with a nasal syringe, together with the proper treatment of the underlying problem, can help relieve the condition. Jaundiced babies often do not nurse well and should be treated for the illness while maintaining feedings.
Ailments that need special treatment and can interfere with the infant's obtaining full benefit of the nutrients in breast milk include hypoglycaemia, diabetes, and malabsorption diseases such as cystic fibrosis and coeliac disease.
In breastfeeding, as with anything else that is new and unfamiliar, problems will occur. This section offers explanation and solutions to the most common breastfeeding problems in order to help the new breastfeeding mother have a good experience.
This temporary problem can occur between 2-5 days after childbirth. It is caused by a combination of the increased blood supply to the breast and the pressure of the newly produced milk, resulting in the swelling of the tissues in the breast. A low-grade fever may be present, the breasts will feel full, hard, tender, and distended.
Engorgement prevention relies mainly on frequent feedings without delay (every 1 ½ to 2 hours - day and night) and the non-restriction of sucking time. Feedings should not be skipped or delayed during the day or night. Do not give the baby any formula or sugar water, and allow the baby to empty each breast completely at each feeding. This should take about 7 minutes each side.
Using milk cups between feedings to relieve pressure, and breast massage may help. Application of moist heat for thirty minutes preceding each feeding and massaging the breast during feedings will help to get the milk flowing. Do not use nipple shields, as they can confuse the baby's sucking pattern, damage nipples, reduce stimulation of the breast, and decrease the milk supply.
Encouraging the breast to expel any excess by warming the breast with water while leaning over the sink may bring relief. Freezing the extra milk in sterile bottles is good for emergencies, or for when you need a night off! Lying on your side may help relieve pressure and soreness. Nettle is a herb that regulates milk flow and can be taken in the form of tea.
A homoeopathic remedy for excess milk production and high fever is Belladonna. Hot, hard, and painful breasts may be helped with Bryonia.
This problem can occur even when the nipples have been prepared in advance. It is typically caused by improper nursing positions and improper nursing schedules.
To prevent sore nipples while nursing, the following tips are recommended:
Do not wash the nipples with soap, alcohol, or petroleum-based products. This washes away their natural protection. Keep nipples dry between feedings. Expose them to sunlight and air. Feed the baby frequently to avoid a baby who is overly hungry from biting down roughly on the nipple. Change nursing positions often to rotate the pressure on the breast. Learn to break suction correctly.
Treatment for sore nipples includes the following suggestions. Nurse on the least sore side first. However, if both breasts are sore, hand express (i.e. massage the breast) until let - down occurs and milk is readily available to the baby. Make sure that the baby's jaws exert pressure on the least tender spots. Use dry heat such as a low-wattage electric bulb for 12-15 minutes directed at the breast following each feeding. Do not pull away when the baby is about to begin feeding. Learn to relax.
If cracked nipples accompany soreness, applying Aloe Vera to the nipples will alleviate pain and promote healing.
A finger inserted into the baby's mouth to release air from the suction will help prevent soreness of the nipples. Breast milk has its own healing properties and will help if applied and left to dry. Vitamin E creams may also be used. Homoeopathic remedies for sore nipples are Chamomilla and Castor equi. Cracked nipples that are infected are helped with Silicea. Belladonna is for sore breasts from breast feeding. Calendula ointment is great for sore or cracked nipples.
Incomplete emptying of the milk ducts by the baby, or the wearing of a tight bra, can cause a plugged duct. Soreness and a lump in one area of a breast is an indication of this problem. Check the nipple very carefully for a tiny dot of dried milk. When this is removed by gentle cleansing along with frequent nursing on the affected breast, the duct will usually clear itself within 24 hours. Massaging the breast with firm pressure, from the chest wall to the nipple, also stimulates milk flow.
Alter the position of the baby on the nipple so all the ducts are drained. Make sure you offer the affected breast first, when the baby's sucking is strongest. Nettle 30c is a homoeopathic remedy for painful breasts when the milk flow is blocked.
Mastitis (Breast Infection)...
If a plugged duct is not taken care of, mastitis can result. Soreness and redness in the breast, fever, and flu-like symptoms are indicators of this problem. In fact, in a nursing mother all flu symptoms should be considered a breast infection until proven otherwise.
Any change in nursing patterns can be the cause, as can positioning the baby incorrectly, thereby preventing the breast from being completely emptied. Warming the breast before feedings may help unclog ducts. If there is a fever, or the condition lasts longer than 24 hours, consult a physician before using any therapy, even aspirin.
Treat mastitis by drinking plenty of fluids, getting plenty of rest, and applying heat to the area with a hot water bottle or heating pad. Do not stop nursing the baby, otherwise the ducts will remain full and could worsen the problem by allowing the ducts to overfill. In addition, your health care provider may prescribe antibiotics that can be taken while nursing.
In rare cases, a breast infection results in a breast abscess in which the sore breast fills with pus. This abscess may need to be incised to allow drainage. This procedure is performed in a doctor's office. During this time, milk should be hand expressed (massaged) from the infected breast and discarded. Breastfeeding should continue on the non-infected breast until the abscess is healed.
Colic in breast fed infants...
Mothers that are breast feeding should have a diet that avoids common triggers of colic. These include dairy products, spicy foods, caffeine and brewers yeast. Cabbage, onions and rich foods may also be a problem. It is said that eating garlic an hour before nursing may stimulate the baby to nurse and eat more. The odour that the milk attains from the garlic is thought to stimulate a baby's appetite. Be careful though as this may also aggravate colic.
Eating a healthy diet with fruit, vegetables, and lean meat is important and feeding the child in a relaxing environment is equally so. We have a homoeopathic product called Colimed that may help, but please consult a qualified Naturopath for specific advice.
Boosting an insufficient breast milk supply...
Too little B2, or Vitamin C, can produce insufficient milk in breastfeeding mothers.
Basil, and Borage leaves and seeds, stimulate the flow of milk in nursing mothers. Caraway promotes the secretion of milk, and is also good for flatulent colic (especially so in infants). Nursing mothers can use Dill to promote the flow of milk. Dill is particularly good when used in conjunction with Aniseed, Coriander, Fennel and Caraway for settling upset stomachs in baby and mother. Fennel stimulates the flow of milk in nursing mothers - use the tincture or boil the seed in barley water.
Fennel essential oil has traditionally been used to stimulate milk flow in breast-feeding mothers (it is, however, contraindicated in pregnancy). Fennel seeds help milk flow, and, reduces colic in the baby. Nursing mothers can eat Fenugreek seeds to increase their milk production.
Iceland Moss may stimulate the flow of milk, but must not be used if breasts or nipples are inflamed. Excessive doses may irritate your gastrointestinal tract. Milkwort is indicated for nursing mothers whose baby's appetite exceeds the supply of milk. It helps to increase milk production. Polygala amara and P. vulgaris do the same thing but are not quite as potent.
Herbal remedies are Goat's Rue infusion (extract of the dried plant), which may increase milk production. Nettle tea regulates milk flow, and can promote milk flow in breastfeeding mothers. Nettle leaf is rich in Iron and other minerals so makes a great tonic for mother too.
Blessed Thistle is used to increase prolactin levels, thereby increasing milk production. Alfalfa, Dandelion, Horsetail, Oatstraw, Cumin, Vervain, Chlorophyll, Red Raspberry, and warm Marshmallow herb will help bring in good rich milk.
Homoeopathy recommends Agnus castus.
Insufficient milk flow may also be a problem. To maintain adequate milk supply, both breasts should be given to the child during each feeding. Increasing the frequency of feedings may increase milk flow. If after a few days the supply of milk is still low, other factors may be the cause, such as low thyroid hormone secretion, high fever, fatigue, anxiety, and cigarette and marijuana smoking. Drugs of any kind, including alcohol, are passed onto the baby through breast milk. Illness and death from this transfer of substances to the baby are very real possibilities. No one can be sure just how long it will take each person to rid the system of the substances, so nursing while using them can be very dangerous.
Another pregnancy, birth control pills (have a harmful effect on the milk), and general anaesthetics are other causes of insufficient flow. Almost all drugs have been found to enter breast milk, including the following: alcohol, amphetamines, antihistamines, aspirin, barbiturates, caffeine, cocaine, cough syrups with iodine, decongestants, ergotamine, Librium, marijuana, nicotine, antibiotics, opiates (morphine, codeine, Demerol), Tagamet, Tylenol, and Valium. Some of the effects of these drugs on the infant include diarrhoea, rapid heart rate, restlessness, irritability, crying and poor sleeping, vomiting, and convulsions. In addition, some of these drugs may accumulate in the infant and cause addiction.
We have found that increasing your intake of protein, and drinking an optimal amount of water, is very useful for increasing milk production. Fluid can be replaced with water, soup, and juice. 2 1/2 litres would be a minimum amount of water for the average woman, this being increased with exercise and hot weather. 60 grams of actual protein (100 grams of chicken gives you 30 grams of actual protein) is a good amount for the average woman - with breastfeeding it is recommended that you increase your protein intake by another 20 grams (eg 80 grams a day). Pregnant and breastfeeding women have higher requirements for nutrients than normal, around 20% more of the RDA. Homoeopathic remedies are Calcarea carvonica and Pulsatilla.
Nutritional and Herbal support for Breastfeeding include...
Woman's Nursing Support Tea - Nursing Tea is a nourishing tonic that helps improve breast milk production in nursing mothers and assists in the management of digestive problems such as colic, flatulence, bloating and abdominal discomfort in mother and baby. For breastfeeding mothers.
Feeding Cookies - They contain a unique selection of natural herbs and wholesome ingredients that help promote healthy lactation in devoted, breast feeding mums. Included are the herbs Fenugreek and Fennel, both well known galactagogues, having been used for many years as a herbal remedy to help promote healthy lactation. They may also help counteract infant colic.
Multi for Pregnancy - represents the latest research into the nutritional requirements of pregnant and lactating women. Multivitamin and mineral formula containing the specific nutrients, in therapeutic amounts needed to support women through pregnancy and lactation.
Milk-Flow - A homoeopathic remedy to assist in establishing a regular flow of breast milk in the early days of breast feeding.
Efanatal - A combination of Evening primrose, Fish oil & Vitamin E. A rich source of Omega 3 fatty acids. Can help boost the body's own stress depleted reserves and help offset some of the more serious problems associated with long term stress. Vital for the healthy development of your baby's brain and skin.
Whey Protein Powder - This product is an excellent source of quality bio-available protein, that has one of the highest absorption ratios (able to be used by the body). Provides a complex array of essential building block amino acids, including BCAA's & L-Glutamine.
Some interesting points about Breastfeeding:
- Children who are breast-fed have higher IQs and less neurological dysfunctions than children who are not breast-fed.
- Infants who are breast-fed are one-fifth to one-third less likely to die of sudden infant death syndrome.
- Breastfeeding (as well as having your first baby at a younger age) lessens the risk of breast cancer - probably by interrupting the menstrual cycle and reducing lifetime estrogen exposure.
- Formula-fed infants are 10-15 times more likely to become hospitalised when ill than breastfed infants. 90% of deaths from intestinal disorders occur in bottle-fed babies. The UCLA medical school reported that mother's milk kills a tiny parasite (Giardia lamblia), which can cause intestinal disease in children. An article in Science Magazine August 1962 gave specific evidence of the value of the mother's milk in fighting dangerous infection, especially staphylococcus aureus. Retrolental fibroplasia is far less frequent in breast-fed babies.
- Breast-fed babies have fewer colds, less colic and croup than bottle-fed babies. They are, on average, stronger and healthier than bottle-fed babies. They are psychologically more stable, form friendships more easily, and adjust to change more rapidly.
- The more breast milk infants receive during the first 6 months of their life, the less likely they will be afflicted with diarrhoea or ear infections, two of the most common and troublesome problems in early childhood. Infants who are only breast-fed and those who are breast-fed for at least 3 months have a significantly lower incidence of middle ear infections than infants who are not breast-fed.
- Studies have shown that bottle-fed babies tend to get fatter and stay fatter than breast-fed babies. There is tendency in mothers feeding their babies by bottle to encourage them to drink it all, even though the infant may be satisfied with half to two-thirds of the bottle. Nursing mothers can't really tell how much milk their baby has taken, so when the baby is done, so is mum. But, the non-nursing mother often jiggles her baby to wake up or to start sucking again, and croons and coaxes the babe until the bottle is dry. This programs the baby to eat past the "full" feeling, to eat more than it wants or needs.
- If a baby has a cold, we have lots of great things to help, but the mother can also take extra Vitamin C.
- A nursing mother should not take cleansing herbs, or undertake any detoxification programs, as it may cause colic, diarrhoea, rash or other reactions in the baby.
- To dry up breast milk, 3 cups of Sage tea per day is recommended. A strong cup of Cranesbill tea poured over the breast every day helps to dry up breast milk too. Walnut bark discourages milk flow in breast feeding mothers. Yarrow is also recommended to dry up breast milk. Milk-Stop is a homoeopathic remedy that assists the weaning process.
Important, if you are unable to breastfeed for any reason, we recommend the following:
Karicare Gold Goat's Milk formula is one of the best formulas we've seen. It is far less allergenic than cow or soy milk, includes essential fatty acids and a great nutritional breakdown.
Add to this 100% Pure NZ Colostrum powder. This will give your baby many of the benefits your own colostrum would.
Also give your baby Inner Health Plus for Kids, which is suitable for children 3 months and over, or the Pro-B Baby drops, which is suitable to be used from birth. This will populate the bowel with good bacteria, protecting your child from intestinal problems and they also manufacture K and B vitamins. Important for keeping a healthy gut and immune system. Reduces the incidence of thrush and nappy rash.