Who helps me with breastfeeding?
How many mothers abandon breastfeeding because they are not properly supported? How to run for cover? Who to ask for help? Let’s see together how to do it.
Although mothers are informed about the importance of breastfeeding, the advantages for the woman and the child, once home from the hospital, the first difficulties arise, as it should be, especially if it is the first experience with a newborn.
The first doubts arise, the first problems of breast attachment, the baby cries, seems not to grow and the baby blues does the rest. Who to ask for the right help?
The 10 steps to successful breastfeeding (WHO/UNICEF)
Each birth and care point for the newborn should:
- Define a written protocol for the promotion of breastfeeding to be made known to all health personnel.
- Train healthcare personnel to put this protocol into practice.
- Inform women already during pregnancy about the benefits and conduct of breastfeeding.
- Help mothers to start breastfeeding within half an hour of giving birth.
- Show mothers how to breastfeed and how to maintain milk production even if separated from the newborn.
- Do not give infants food or liquids other than breast milk, unless medically indicated.
- Practice rooming-in, that is, allow the mother and child to stay together 24 hours a day during the stay in the hospital.
- Encourage breastfeeding on demand.
- Do not give artificial teats or pacifiers during the breastfeeding period.
- Encourage the establishment of breastfeeding support groups to which mothers can turn after discharge from the hospital or clinic.
What to do once at home
International health organizations (WHO, UNICEF) as well as Italian societies, including the SIN, agree in recommending that mothers breastfeed babies exclusively in the first six months of life.
Although mothers are informed about the importance of breastfeeding, about the advantages for the woman and the child, once home from the hospital, the first difficulties arise, as is normal, especially if it is the first experience with a newborn. The first doubts arise, the first problems of breast attachment, the baby cries, seems not to grow, and the baby blues does the rest. Who to ask for the right help?
Many struggling moms turn to other moms, grandmothers, and mothers via Facebook groups. Often, however, they receive in return a series of opinions or methods that can be counterproductive.
Too often the wrong interlocutors are asked for help.
Who to get help from?
There are a variety of people who can help, from midwives to certified lactation consultants.
This advice can be done in person, or, why not, even through new means of communication, which may be preferable in the historical period we are experiencing. It is now commonplace to make video calls or conferences with Zoom or other communication software.
The consultant is able to evaluate the position of breastfeeding, the attack, the rhythm of feeding, suggest new positions or correct those adopted. The advice and reassurances that come from counseling are fundamental, but also the possibility of diagnosing traffic jams or obstructed ducts, and indicating solutions.
In Italy, for example, we have IBCLC (International Board Certified Lactation Consultant) consultants. These are professionals “specialized in the clinical management of breastfeeding and human lactation” – The IBCLC can be a health professional (midwife, nurse, pediatrician, etc.), but also an au pair or other certified person.
Some hospitals have equipped themselves with pre- and post-natal courses. Always consult the website of the hospital where you plan to give birth to find out about the initiatives underway.
Finally, there are many private activities, some really well managed that follow the future mother and the neonmamma step by step also through online meetings. They are activities of freelance midwives, or doulas or perinatal educators such as Gaia by Ilaria Magrinelli that we recommend.
Breastfeeding in times of Covid19 pandemic
We remind you that given the undoubted advantages for mother and newborn deriving from breastfeeding and the zero or minimal risks of contagion, international scientific agencies and the Italian Society of Neonatology confirm the indication for breastfeeding even in the presence of maternal Covid-19 infection.
In the Special Breastfeeding 2020 of the SIN, we find highlighted that
mothers affected by Covid-19 in an asymptomatic or pauci-symptomatic way can remain in the same room and breastfeed with the appropriate hygiene precautions and mask, while they are breastfeeding the baby and washing their hands before and after touching it. If a mother is too ill to care for her newborn, she should be supported to provide breast milk by extracting and storing her own milk. interim guidance on the Covid-19 outbreak indicates that sick women continue breastfeeding because the child who has already been exposed to the virus by the mother and/or family will benefit more from direct breastfeeding. Therefore, any interruption of breastfeeding can actually increase the baby’s risk of getting sick.
In summary, therefore, breastfeeding is also recommended in mothers affected by Covid-19 and the task of health personnel is to promote it through bonding in the delivery room and rooming-in afterwards.
Breastfeeding in Italy
The latest ISTAT data that we have available are grouped in a publication of the National Institute of Statistics dating back to 2017. Until then, with reference to the previous twenty years, there had been an increase in both women breastfeeding and the average number of months of breastfeeding.
Although the increase has been encouraging, there are strong territorial discrepancies. For example, the highest breastfeeding rates were recorded in the Autonomous Province of Bolzano (89.3 per cent) and Sardinia (83.9 per cent) and the lowest in Sicily (50.9 per cent) followed by Liguria (62, 1 percent) and Lombardy (66.5 percent).
Despite the clear increase in months of breastfeeding, which went from an average of 6.2 to 8.3 months, here too the territorial differences cannot be overlooked. Sicily stands out not only for the low prevalence of breastfeeding, but also for the lowest average duration of breastfeeding. However, the fact should not be overlooked that, again in Sicily, there has been a slight and constant increase in recent years.
This increase certainly bodes well, even if the lack of postpartum care remains evident, which does not favor the best diffusion and consolidation of breastfeeding. What is defined as the Fourth Trimester of Pregnancy is one of the periods related to women’s health, probably most neglected by health policies.
Instead, there is a Lack of of ongoing assistance aimed at giving mothers confidence and supporting them in times of difficulty.
As far as breastfeeding is concerned, the data shows that
- 11.9 per cent of women who started breastfeeding gave up before the third month of the child’s life.
- Only 30.6 percent say they have reached six months of exclusive breastfeeding
Among the causes that hinder breastfeeding we find the health reasons of the newborn that impose temporary separation from the mother (separation in the first hours and in the first days of life clearly limits the success of breastfeeding):
- Twin birth
- Premature babies
- Born underweight
Often these characteristics are found more frequently in babies born by caesarean section. If these characteristics and events add up during the birth process, they can strongly affect the failure of breastfeeding.
Other causes that hinder breastfeeding and its continuation / consolidation, we also find situations related to less complicated pregnancies. Many factors that intervene, but to move the hand towards the success of breastfeeding, substantially affect some practices adopted by the birth centers in the immediate hours after the birth event.
We remind you that it is very important that the 10 steps recommended by the WHO are adopted in the hospital .
Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.
Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.