Breastfeeding: why it is good for mother and baby

We talked to Prof. Sofia Colaceci, Programme Director of BSc Midwifery at UniCamillus

A mother breastfeeding her baby: there is probably no image that recalls motherly care more than this. The baby, after being part of its mother in the womb, continues to nourish itself from her. An act so natural that it needs no explanation, yet there are so many interesting facts about breastfeeding that you need to know. Breastfeeding is good for mothers and babies, and Professor Sofia Colaceci, Programme Director of the BSc Midwifery at UniCamillus, explains it best.

What are the main benefits of breastfeeding for the baby?

‘Milk is a species-specific food: this means that human milk is the best nourishment for our babies because it is perfectly adapted, quantitatively and qualitatively, to the nutritional needs of human infants, ensuring healthy growth.

For decades now, our focus on breastfeeding has not only been on the nutritional aspect, but also on its countless health benefits. When a woman is breastfeeding, she is transferring with her milk both antibodies and other immune substances that protect the baby from infections, reducing the risk of otitis, respiratory infections, gastroenteritis and other diseases. In addition, breastfeeding contributes to the development of the child’s immune system, reducing the risk of allergies, asthma and other autoimmune conditions.’

What are the main benefits of breastfeeding for the mother?

‘Mothers benefit from breastfeeding in both the short and long term.

In the short term, breastfeeding stimulates the uterus to contract, thus reducing the risk of haemorrhage after childbirth. In addition, breastfeeding can help women regain their pre-pregnancy weight more quickly as it involves some energy expenditure.

Among the long-term benefits, studies show that breastfeeding mothers have a lower risk of developing certain diseases such as type 2 diabetes, osteoporosis, breast, ovarian and uterine cancer. They also have a lower risk of developing cardiovascular diseases such as hypertension and heart disease.

It is also important to emphasise that breastfeeding is cheaper than the use of artificial formulas, it is a zero-kilometre product, always available and at the right temperature. It is also a sustainable practice that does not require the use of plastic or aluminium containers, with which we contribute to reducing environmental impact.

From a psychological point of view, breastfeeding fosters a strong emotional bond between mother and child, contributing to the emotional and psychological well-being of the mother. Indeed, breastfeeding can be a rewarding experience, offering a sense of fulfilment and satisfaction in feeding your baby with your own milk.’

Are there better positions to ensure effective sucking?

‘There are many positions that the mother can take for breastfeeding. Certainly, the best known is the classic cradle position. Which position to adopt depends on the mother’s and baby’s preferences, the time of day and the context in which she is breastfeeding, as well as any specific situations that may arise. For example, at night, women may find it comfortable and practical to breastfeed lying on their side in bed. In the case of a blocked duct, or even with twins, one can adopt the rugby position―the mother holds the baby’s head close to the breast and the body along the forearm, next to the hip and with the feet turned towards the back of the chair.

Especially at the beginning, from birth to the first weeks of life, the semi-reclining position can be advantageous: the woman is in a semi-reclining supine position and the baby is prone on her. This position provides for full contact of the mother-baby dyad, and, especially if the mother has her chest exposed and the baby is naked (skin-to-skin contact), stimulates innate infant reflexes, enhances contact and interaction as well as postnatal bonding.

But there are many others as well: the koala position, the she-wolf position, etc… It is important to experiment with different positions and to seek the support of breastfeeding specialists in order to find the most suitable position for each specific need and case.’

How to realise that the baby is getting enough breast milk?

‘The first suggestion is very simple: in everyday life, parents should observe how the child is. It should look satisfied, relaxed and healthy. Then specifically it is useful to look at the nappies. A breastfed baby should wet at least six nappies a day with clear urine. This indicates that the baby is getting enough milk and is hydrating properly.

Apart from this, of course, the baby’s weight is one of the best indicators of the baby growing healthily and, by extension, of how the breastfeeding is going. After birth it is normal for babies to lose some weight (the so-called ‘physiological drop’), but they should then start to gain weight steadily. The paediatrician will monitor the child’s weight at follow-up visits to ensure that it is growing properly. On the other hand, the so-called ‘double weighing’, i.e. the practice of weighing the baby before feeding and immediately afterwards to check the amount of milk taken in, is not recommended, as it may generate unjustified anxiety to parents.’

Does breastfeeding cause pain? If so, how should it be managed?

‘For many women, breastfeeding can be a pain-free experience or one with minimal discomfort. However, some women may experience pain during breastfeeding, especially in the first weeks while the body adapts, and the baby learns to suck effectively.

Generally, the pain may be due to nipple rhagades, i.e. ‘cuts’ that are caused by a superficial attachment of the baby to the breast. The attachment, to be effective, must be deep, in fact the baby must not only suck from the nipple, but must take a large part of the areola in its mouth. In this way, their tongue will not rub the nipple and furthermore, the latter will be in contact with the soft palate, whereas a more superficial and anterior attachment means that the nipple is in contact with the hard palate, increasing the risk of rhagades.

In the case of rhagades, but also without them, as a preventive measure it is advisable to allow a few drops of breast milk to dry naturally on the nipple.As milk has anti-infective properties, it can help to protect the nipples from any microbial agents that, infiltrating from the rash, could cause mastitis. The latter is a painful inflammation of the breast that requires rest, hydration, frequent breastfeeding if practicable, and possibly the use of antibiotics on prescription.

In general, however, milk accumulation in the mammary glands can also cause swelling and pain. Applying heat before feeding can help the milk drain. In some cases, it may be necessary to squeeze the milk manually or with a breast pump to relieve the engorgement.’

Is there a time when you realise you have to stop?

‘The decision to stop breastfeeding is very personal and depends on individual needs and circumstances. Recommendations advocate exclusive breastfeeding for the first six months of a child’s life, followed by the gradual introduction of solid foods while continuing breastfeeding until two years of age and beyond, or as long as mother and child wish.

However, there are many factors that can influence the decision to stop breastfeeding, including time availability, family organisation, the health of the mother and baby, the mother’s work environment and personal preferences.’

Breastfeeding and other activities: how to manage breastfeeding in social situations?

‘If you feel comfortable, you should not hesitate to breastfeed the baby when hungry, even in social situations. The discomfort that a person may feel when watching a mother breastfeeding her baby should not be a concern of this mother, whose priority is to meet a primary physiological need of her child. The breast was designed by Mother Nature to produce milk and ensure the survival of human babies.

If you feel insecure about breastfeeding in public, it is helpful to ask for support from your partner, family members or friends who can offer companionship and support, and to seek a more secluded place where you can have privacy. The important thing is to do what is best for yourself and your baby.

From an organisational point of view, if you know that you will be attending a social event, it is advisable to plan in advance how to handle breastfeeding. For example, you could bring along a towel to cover your breasts if you feel more comfortable.

It is also helpful to dress comfortably, choosing practical clothes that facilitate breastfeeding, such as shirts or dresses with buttons or zips that allow easy access to the breast. It is helpful to communicate openly with others present about your breastfeeding needs and to look for a quiet place to breastfeed if the baby is easily distracted.’

If a mother needs more information on breastfeeding, who can she turn to?

‘There are several resources a mother can consult for information on breastfeeding. First of all, within the breastfeeding spaces of counselling centres, midwives provide support and advice. However, already during pregnancy, attending antenatal classes at counselling centres or other facilities, is useful to receive information not only on pregnancy and birth, but also on breastfeeding.

Freelance midwives, and lactation consultants in general, can provide personalised support and counselling at their facilities or even at home.

In addition, there are peer support groups―mother-to-mother―where experienced breastfeeding mothers share their knowledge and can offer advice and support to less experienced ones.

It is also important to seek reliable and qualified sources of information to ensure that you receive safe and accurate breastfeeding advice.’

If little milk is produced, how should the situation be handled?

‘Starting from mid-pregnancy and up to the first few days after delivery, the breast begins to produce the very first milk called colostrum. It has a typical golden-yellow colour and is rich in nutrients and antibodies. Although colostrum is produced in limited quantities, it is still sufficient to meet the infant’s needs during the first few days of life. Subsequently, with the so-called ‘onset of lactation’, which generally occurs 3-4 days after birth, the milk production process becomes more ‘mechanical’, i.e. regulated by a supply-demand mechanism. Milk production will therefore be driven mainly by the baby: the more the baby suckles at the breast, the more milk will be produced. When the baby latches on to the breast, it activates neurological stimuli that induce the maternal release of prolactin and oxytocin, two hormones that are crucial for the production of milk and its release into the ducts. Consequently, a woman who produces little milk will frequently stimulate the release of prolactin and oxytocin by frequently attaching the baby to the breast, thus increasing the amount of milk produced.’null