Along with a newborn comes a flood of advice – not all of it always helpful. In Bacchon Ki Doctor, Dr. Madhavi Bharadwaj offers honest insight into what’s normal and what’s not.
***
Breastfeeding: The First Food
Physiology
During one of my workshops for expectant mothers, I asked my participants to name their biggest fear about childbirth and the post-partum period. To my surprise, it was not labour pain or the fear of normal or caesarean birth, but the fear of breastfeeding, and the fear is real.
The unsaid pressure to do the best for your baby and the shoulds and woulds around breastfeeding and parenting in general put a lot of subconscious stress on the mother. Sometimes, the lack of knowledge and right guidance at the right time results in failures during breastfeeding. So, it becomes very important for a new mom to prepare herself with the right knowledge and then let nature take its course. Now, let us get our hands on some useful information about breastfeeding.
Even before the birth of a baby, a mother’s body is preparing for milk production and feeding.
Breast Size: As pregnancy proceeds, the size of the breasts increase as the glandular tissue matures to start producing milk. Breasts become soft as fibrofatty tissue increases too. They become sensitive under hormonal (oestrogen and progesterone) influence. Sometimes, mothers feel a tingling sensation, which is perfectly normal. Tenderness, heaviness or soreness felt by some to-be moms is fine too.
The nipple-areola complex enlarges and darkens under hormonal influence. Montgomery’s tubercles will appear on the areola. These are responsible for producing pheromones to attract a newborn towards the breast, and they have antibacterial properties. The nipple is sensitive and full of nerve endings. Suckling of nipples will send messages to the brain to produce both prolactin and oxytocin hormones, which are responsible for milk production and let-down, respectively. Some to-be mums may experience colostrum, a yellowish liquid secreted by the nipples, starting from the end of the second trimester itself. Some may experience it only after the birth of the baby. Both situations are perfectly normal.
Once the little one is born, both the baby’s and the mother’s natural instinct would be towards breastfeeding. A mother prepares customized food inside her body for the baby, but does breastfeeding come as naturally to mothers as they say? No! Breastfeeding is a skill that a new mother gradually learns with her newborn. It may take days or even weeks in order for breastfeeding to begin.
‘When the doctor was the patient’
Sharing a story straight out of my life. The memory is fresh in my mind, as if it happened yesterday. It was my second day after delivering my younger one via caesarean section. I was exhausted with pain and putting my baby to my breast every two hours. Yes, I am a paediatrician, but my baby was not. Like all babies, I knew my little one would also take her time learning to open her mouth wide open and properly latch on. During the morning rounds, a nurse came into the room, checked my vitals and, without preamble, pinched my nipples to check my milk output. I was still reeling from the shock of this physical assault when she announced that I have no milk and told my husband to get a formula ka dabba. I still find it hard to express my anguish and frustration in words. This is a common occurrence in hospitals and households where mothers are constantly told that their milk is not enough and they need to give their baby formula.
What they forget to inform the mother and the family is that it is perfectly normal to not have much milk in the first week post childbirth. Sometimes, milk takes a while coming in. In the meantime, stay stress-free and continue latching your baby to your breasts before topping up with formula. It is a complex crosstalk between hormones and the mother’s physical and mental health that determines the milk output. So let’s see some facts.
Crosstalk between hormones
For successful breastfeeding, the two most important hormones needed are prolactin and oxytocin. During pregnancy, prolactin secretion gradually increases and leads to the development of glandular tissue in the mother’s breast in preparation for the production of milk soon. Due to the presence of high oestrogen and progesterone during pregnancy, milk production by prolactin is blocked. But as soon as the baby is delivered, oestrogen and progesterone markedly drop, and prolactin is free to start milk production. That is why it takes three to five days post-delivery for milk to flow.
Nipples are full of nerve endings. This stimulation sends signals to the brain, where the anterior pituitary produces the hormone prolactin and posterior pituitary produces the hormone oxytocin. The sooner the baby latches on to the mother after birth, the sooner the breastfeeding hormone cycle is triggered in the mother’s body. The more the baby suckles, the more signals reach the brain, and the feeding hormones and cycle get consolidated. That is why even if you feel there is no milk, keep latching your baby on to your breast to establish the milk production soon.
***
Get a copy of Bacchon ki Doctor from Amazon or wherever books are sold.
