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breastfeeding

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Breastfeeding has been proven to protect the health of mothers and babies. It naturally inoculates babies against disease because the mother’s immune system kick starts the baby’s ability to resist illness. This applies in both low-income and high-income settings.

For mothers, breastfeeding is also good. It is a natural contraceptive because it interrupts the menstrual cycle, and it protects women against breast and ovarian cancer.

Despite all these benefits, only 38% of babies are exclusively breastfed across the world.

A number of initiatives have been put in place to turn this situation around. One of these is the Baby-Friendly Hospital Initiative, a UNICEF and World Health Organisation scheme launched in 1991. The idea was to make sure that all maternity wards, whether free standing or in a hospital, became centres of breastfeeding support.

Since its launch, more than 152 countries have signed up to the initiative. And by 2012 more than 21 300 facilities were designated baby friendly. This is close to 30% of all facilities worldwide and 31% of facilities in low and middle income countries.

But of the 152 countries, only 18 have reported setting up a government committee to direct and enforce the initiative.

South Africa, despite its bold commitments to improve breastfeeding, has not reported to the World Health Organisation. It still does not have national data to monitor breastfeeding rates to ensure that its policies are being effective.

And unless the country creates structures that ensure facilities become mother and baby friendly, breastfeeding rates in the country are unlikely to improve.

What it means to be baby friendly

The 10 Steps of the Baby-Friendly Hospital Initiative is a proven strategy to provide this support at the critical time of delivery and just after. It increases all aspects of breastfeeding – initiation of breastfeeding immediately after birth, exclusive breastfeeding in the first six months of life, and continued breastfeeding until the child is a toddler.

Its success is evident in countries like Cuba where, as a result of most of country’s 56 hospitals and maternity facilities being baby-friendly, the rate of exclusive breastfeeding at four months almost tripled in six years from 25% in 1990 to 72% in 1996. This success is related to government commitment and ongoing monitoring.

No official data has been released, but South Africa’s National Department of Health claims that the country has accredited 70% of its public hospital as baby friendly. The fact that 30% are not accredited indicates that there is no uniform system and no concerted push for accreditation.

There is also no information readily available on the accreditation of private facilities.

Hospitals and clinics are considered “baby-friendly” when they don’t accept free or low-cost breastmilk substitutes, feeding bottles or teats, and implement 10 specific steps to support successful breastfeeding.

The ten steps include:

a written breastfeeding policy which all health care staff know about and are trained in

informing pregnant women of the benefits and management of breastfeeding

helping mothers initiate breastfeeding within one half-hour of birth and showing them how to breastfeed and maintain lactation

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A woman who has had a child before might hazard a guess; while the one who is a first-time mom might base her expectations on all the tales she has heard from other moms.

Yet, apart from the fact that each birth is unique and may not necessarily follow the same pattern when having another baby, individual experiences are never the same, as many factors such as age, genetics, finance and the expectant mother’s health all combine to shape the experience each person would have during child delivery.

Physicians say a lot could be achieved when pregnant women know what to expect during labour, as it will enable them to cooperate with their health care providers, thus making delivery a lot easier for everyone concerned as a newborn is being ushered into the earth.

Attend antenatal clinics religiously

Consultant Gynaecologist, Dr. Mosunmola Emmanuel, says no pregnant woman should miss any of her antenatal schedules because it is the avenue to learn many things about the progress of the pregnancy, while it also affords the opportunity to relate or socialize with expectant mothers.

“More important, it provides the patient the opportunity to see her doctor and to discuss her concerns, if any.

“It is also on such visits that the progress of the pregnancy is measured; while the expectant mother also uses the occasion to obtain her necessary medications such as folic acid and multivitamins,” the physician says.

She notes that a good hospital will let a pregnant woman how labour works and what to expect, without necessarily inducing fear, especially among first-time mothers.

Your body

To start with, you need to know how your body prepares for the eventual delivery.

According to General Practitioner, Dr. Moye Pariola, by the middle of a pregnancy, the pregnant woman sometimes experiences contractions, which seems to prepare the body for the real thing when labour actually commences in the ninth month.

He says, “This is medically known as Braxton Hicks contractions. As the pregnancy nears an end, these contractions may become more intense such that a pregnant woman can even mistake them for the commencement of labour.

“However, the difference between actual labour and the Braxton Hicks contractions is that Braxton contractions are not regular, they don’t last very long and although they can feel strong they should not feel painful.”

Pariola counsels that if you’re worried that the tightening you’re feeling might be the start of labour, it is necessary to contact your midwife, birth centre or labour ward for advice.

Have a fair idea about breastfeeding

Many women think breastfeeding is a walk in the park and that there is nothing to learn about it!

However, experts say even though breastfeeding a baby is a natural process, it is never an easy one.

Experts at baby.com advise that before you go into labor, you should take a breastfeeding class.

You and your husband should decide whether you want to do exclusive breastfeeding, which is highly recommended for the first six months.

“Beyond this, however, is the problem of engorgement that many new mothers sometimes experience.

“When breast is engorged, it may be difficult for the baby to feed, while the mother will also experience pain when the milk doesn’t flow.

“We always advise new mothers to have breast pump, which can be used to pump out milk and relax the pressure, thus enabling for milk flow, to the relief of mother and baby,” Pariola suggests.

Remember your EDD!

Dr. Emmanuel says pregnant women should be mindful of their Expected Day of Delivery, which their physician would have communicated to them in the first trimester of their pregnancy.

“For most women, EDD is exact, while for some, it is plus or minus a few days. Once you work with your doctor, there is nothing to fear,” she assures.

On the D-Day!

Physicians say it is advisable to eat light meal as you prepare to check into the hospital.

“Since you could vomit while in labor, it’s a good idea to have small snacks instead and drink plenty of water to stay hydrated.

“What’s more, some hospitals may not allow you to eat once you check in; so, it’s a good idea to give your body the energy it needs for labour while you can,” they suggest.

Experts also counsel that you are emptying your bladder every couple of hours.

“You may lie down, or take a warm bath; just as you may ask your caregiver for pain reliever if the pain gets unbearable.

“What is important at this stage is to listen to your nurse’s instructions and to cooperate. Standing, walking, kneeling, slow dancing, sitting and squatting, variously combine to help move the baby down and out. Explore the options,” Emmanuel suggests.

The bottom line: Labour and childbirth are hard work, manage them effectively.

PUNCH.