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Monday, August 14, 2006

personalized baby blanket: Hard road to discover breast is best

15 August 2006

The reality of breast-feeding is not as rosy as the idea. For some women, it's not possible. But advisers maintain it's the healthiest option for a good start in life. Kim Ruscoe reports.

Mother and child nestle together in a window-facing rocking chair, cocooned by the soft glow of the moon, the silence broken only by the gentle mewling of a baby at the breast.

This romantic portrayal of maternal bliss is put to us often but achieved by few.

Plunket figures show that just six weeks after giving birth, half of new mothers have given up trying to breastfeed their babies or are supplementing by bottle feeding.

The number of women still exclusively breastfeeding their babies by the time they are six months old drops to 13 per cent.

It is a far cry from the World Health Organisation recommendation to breastfeed infants till they are two or older.

For first-time mother Sarah Glenny, the agony of having a baby suckle on already dried, cracked nipples was almost too much to bear.

"Initially, breastfeeding is worse than actually giving birth," she says from her home in Raumati, on Wellington's northern coast. "I'd break out in a sweat just at the thought of it."

On one occasion, before her milk had come in properly, her son Zachary was latched on for eight hours.

"It was all on in the first six weeks. I got to the stage where I was going to express and feed it to him in a bottle," she said. But in the end, she decided expressing would be a hassle and stuck with breastfeeding.

By the time Zachary was six weeks old, Sarah's nipples had healed and mother and baby had settled into a comfortable routine at home. She even started to enjoy feeding in the middle of the night.

"It felt like you were the only two people in the world," she says.

Shy by nature, Sarah was at first uneasy about breastfeeding in front of others, particularly her single friends.

The couple's best man didn't know where to look during a visit to their house soon after the baby was born.

He later told her husband Damian "there's something wrong about sitting there watching your best mate's wife get her breast out".

"But you get over the embarrassment pretty quickly," Sarah says.

Feeding in public can be easily made discreet by draping a shawl or baby blanket over your shoulder, she says.

Sarah says she has breastfed in a shopping mall only a few times, but frequently does so in cafes.

Zachary, now one, is still being breastfed three or four times a day, though more for comfort than nourishment, she says. She will carry on breastfeeding him till he doesn't want it any more.

Despite her success with breastfeeding, there were times when Sarah's confidence wavered. Sometimes she worried Zachary wasn't getting enough, other times she simply thought he'd been on the breast long enough.

The time it takes to breastfeed is also an issue. While sitting feeding Zachary she'll be looking around thinking she should be vacuuming the floor or folding washing. But Damian encouraged her to keep going, reassuring her that she "can do it".

"He would sit with me and keep me company (while she fed)," Sarah says.

"Your partner's support is crucial to continuing breastfeeding."

In the bigger scheme of things, it really doesn't matter if the house is not always spotless and tidy.

Plunket's national clinical adviser and lactation expert, Allison Jamieson, agrees that breastfeeding can be difficult, especially for those with cracked nipples or breast infections. It is also hard for breastfeeding mothers to know how much milk their babies are getting.

Breastfeeding is by demand, she says, with the baby letting the mother know when it is time to be fed.

The demands can change from day to day and may mean the baby is sometimes feeding for up to 40 minutes with just an hour's sleep in between feeds.

Bottle-fed babies, on the other hand, tend to feed every four hours.

But Allison likens it to adults going to the pantry or fridge for food whenever they are hungry.

"Why should babies have to wait?"

Eating three healthy meals a day plus snacks, keeping to the 5-plus a day rule and getting plenty of rest goes a long way to ensuring a continuing supply of milk, she says.

But the amount of time that has to be dedicated to breastfeeding can make it difficult for new mothers with older children to get enough rest. She suggests making baby's sleep time a quiet time, perhaps with mum reading a book to the older child while sitting down together on the couch or lying on the bed.

Breast milk is not only the best food for babies, says Allison, it impacts on a person's health for the rest of their life.

It can even protect girls from getting certain types of ovarian cancers years down the track.

A year-long survey by American doctors Thomas Ball and Annette Wright in 1999 compared the health of 1000 babies who had never been breastfed with that of 1000 babies exclusively breastfed for three or more months.

They found the never-breastfed group went 2033 more times to the doctor, spent 212 more days in hospital and were prescribed 609 more prescriptions for drugs. A recent consensus report shows 54.4 per cent of women in paid employment stop breastfeeding, compared with 34 per cent of women who are at home.

Allison says some working mothers do manage to carry on breastfeeding. Some have their babies brought into the office for them to feed if they are being cared for at nearby childcare centres, others prefer to express and take the milk home.

"But there just aren't the facilities at work to breastfeed or express in private," she says.

It is not acceptable to expect women to breastfeed or express in the restrooms.

"We wouldn't eat our lunch in the bathroom, so why would you express or feed your baby in there."

Breastfeeding is gradually increasing in popularity and employers are going to have to face up to the issue at some stage, she says.

"Women have to be able to negotiate," she says.

This year, the Health Ministry set up a National Breastfeeding Advisory Committee which aims to identify barriers to breastfeeding and ultimately boost the number of women breastfeeding.

"Breastfeeding supplies food in a hygienic, cost-effective, balanced and convenient way," chief public health adviser Ashley Bloomfield says.

New Zealand College of Midwives spokeswoman Norma Campbell says that breastfeeding must become the accepted lifestyle choice of new mothers, rather than just agreeing to "give it a shot".

"We are a quick and instant society. We want things immediately and time seems to be in short supply for many important things in life," she says.

"Breastfeeding takes time. The rewards, though, are numerous."

One of the main roles of midwives is to provide breastfeeding support, which starts off by encouraging skin-to-skin contact within 30 minutes after birth.

"That first contact forms an imprint, a mental and physiological reference for the newborn," Norma says. "That first feed, that little mouth looking for milk, can be the start of a wonderful experience."