Breastfeeding: Making the Most of Your Liquid Gold

Contemplating a tragic headline I have read, “If I had given him one bottle, he would still be alive”, I realized for the first time the considerable amount of pressure that mothers face regarding breastfeeding. This headline was about the unfortunates story of a mother, who lost her newborn due to dehydration while she thought she was properly breastfeeding her baby .

Motivated by this woman’s unfortunate tale, I was inspired to start this blog. I thought, let’s start from the begining. As every mother holds her child for the first time after a long wait, we are overwhelmed with our need to nurture and protect this fragile being. The first struggle we face at this moment is feeding. So I conducted a survey in order to know what are the issues that mothers struggle with the most. Many mothers have mentioned that they felt bullied by family members for not being able to breastfeed. We know that breast is best and many campaigns were made to pinpoint the downfalls of formula feeding. Yet, before ever making a judgement, we should never forget that formula was originally invented to save lives. Luckily, with the right support, the majority of mothers should be able to breastfeed.
To help shed some light on the subject, I thought about my first interview. Who better can explain the different aspects and challenges of breastfeeding than Iman Sarhan, the founder of the “Mother Support group” on Facebook. She was the first person who came to my mind, because back then when I was desperate for help, she was so generous with her advice. She advocated breastfeeding with a passion, dedication, and tolerence I had not foreseen. Iman Sarhan, who often refers to breastmilk as ‘Liquid Gold’, is a Certified Lactation Counselor and the co_founder of the Mother Child Friendly Care Association (MCFC) in Egypt, promoting Breastfeeding through social media and the Baby Friendly Hospital Initiative with UNICEF .

Hi Iman, in regard to the incident I referred to earlier, how can mother know if her newborn is breastfeeding adequately? How many dirty diapers per day can indicate that the baby is getting enough nutrition? How to make the most of the first 48 hours after birth?
Hi May, thank you for choosing me as your 1st interviewee! I am glad I can help and reach out for as many mothers as I possibly can.
It is heart breaking to know about this mother & many more that live in agony due to the loss of their young ones for so many different reasons. Nonetheless, breast milk has been tailored to meet the needs of baby’s, emotional & biological, needs during the 1st two years of life.
It is crucial that the mother Initiates breastfeeding as soon as the baby is out of the womb through immediateskin to skin contact with the mother until the baby suckles at the breast. In some rare cases, if baby and mother are separated right after birth then skin to skin contact should take place as soon as they are back together. Also, how the newborn latches on the breast plays an important role to assure that the baby is getting all the milk he/she needs, hence, aiding the success of breastfeeding.
A mother should breastfeed her baby to his/her cues and for as long as the baby needs, 8-12 times in a 24 hour period, the pace of suckling differs from one baby to another affecting the duration of the feed. A mother should never leave her infant sleeping for more than 3-4 hours especially during  the first 2 weeks of life. During that time, a mother can judge if her baby is getting adequate milk by monitoring baby’s wet & dirty diapers, the former being at least 6 per day and the latter at least 2 per day. If a mother has any doubts, she should seek professional help.

In 1995 a premature baby girl saved her twin sister’s life just by hugging her. The twins, who were born 12 weeks premature in The Medical center of Central Massachusetts, were placed in separate incubators. When one of them was dying, their nurse desperately placed the healthy baby next to her sister, a procedure that was common in come parts of Europe but unknown in the United States. The stronger baby wrapped her arms around her sister, which immediately stabilized her heart rate and temperature and eventually saved her life. This incident, changed the way the medical community regarded the power of human touch. Skin to skin contact can have miraculous effects, how does it affect breastfeeding?
Skin to skin means that babies are placed, after drying them well, naked on mother’s bare chest preferably between her breasts. This procedure is very helpful to regulate the baby’s body temperature, heart rate and breathing. Also, It stimulates the mother glands to start producing milk and the baby’s instinct to latch on properly and suckle. It makes use of the first hour of alertness after birth. It is important for bonding and for awakening motherly feelings towards her baby. Because of the tremendous benefits it offers for both the mother & the baby, it is recommended to be done as frequently as the mother possibly can.

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Newborns, who have not been exposed to medications and are placed skin to skin with their mothers and left undisturbed, they will instinctually crawl up to their mother’s breast and attach themselves to her nipple, which is known as the ‘breast crawl’. However,  the baby is usually taken away from the mother after birth to be bathed and dressed. Don’t you think that hospitals need to reconsider how the first hours after birth is dealt with?
We are already working through our NGO “Mother Child Friendly Care” (MCFC) in coordination with the UNICEF and other partners on training and educating healthcare professionals in Egypt to implement “The Baby Friendly Initiative” in hospitals. This initiative is based on the UNICEF/WHO Ten steps to successful breastfeeding of which step 4 encourage early initiation through the skin to skin contact during the 1st half hour after birth.

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What does a latch mean? And how to ensure a good latch?
A proper latch on is when the baby attaches onto mothers’ areola from below rather than the nipple only. A good latch is achieved when the baby is held close to the mother, with body in line (straight) facing, and well supported with no barrier in between. A mother should not feel pain nor listen to ticking noises when the baby suckles. Also, baby should start the latch with a wide open mouth, on the breast: lips should be everted for good sealing, chin touching and rounded cheeks to ensure proper latch on.

What’s the colostrum and how is it different from the milk that comes afterwards?
Colostrum is the mothers’ concentrated milk that is produced for the first couple of days after delivery. We call it the baby’s 1st immunization as it is rich in antibodies and meets all the nutritional needs of newborns. Nothing else can make up for the mother’s colostrum. It is yellowish in color with a thick texture. Colostrum changes into milk within a few days after delivery, which is whitish in color and comes in much more quantities to accommodate baby’s needs.

How does the structure of milk change throughout the feed and throughout the day? What’s the difference between Fore Milk and Hind Milk and how is the Breastmilk tailor made for the baby?
Usually a feed starts with foremilk and is followed by hind milk which is rich in fat needed for brain development and weight gain. Breast milk varies from day to day and over the day and even from summer to winter to meet the needs of babies. Some research even suggests that it changes depending on gender & baby’s health condition.

Many mothers suffer from engorgement during the first weeks after labor, is there anyway to ease it?
Early imitation and frequent, on demand, breastfeeding prevents engorgement, & if for any reason mother can’t breast feed then hand expression is an excellent way to empty the breast & avoid engorgement. Sometimes a mother may need to do both if she has an over flow.Engorgement can be eased using upper back massage to stimulate the release of the hormone that eject milk (oxytocin) as well as other methods to alleviate pain and release milk.

What about pain during breastfeeding?
Nipple pain is usually due to bad positioning and poor latch on. However if pain persist after a feed then she should consult her doctor as there may be an underlying infection.

Many mothers stop breastfeeding because they believe that they don’t produce enough milk, which may not be necessarily true. What is usually the reason behind this misconception?
Some mothers interpret baby’s crying, frequently feeding with prolonged feeding sessions, & losing weight during the 1st 2 weeks of life as a sign that their milk isn’t enough. Nonetheless, this is totally normal & has nothing to do with the mother’s milk. Mothers need a good support system from family, friends and healthcare providers.

How can a mom increase her milk production?
Generally, this happens through increasing the frequency of breastfeeding and stopping use of artificial nipples. Also, hand expression or pumping, staying away from stress, being confident that she can make it, eating healthy food, & getting help with a good support system. If that isn’t enough, then a lactation consultant can prescribe medications to help mother increase her milk.

There are inventions that were created to facilitate breastfeeding. Let’s talk a bit about some of them. What are breast shield and what are they used for?
Not recommended at all, as they interfere with baby’s latch and can cause other complications like thrush and mastitis.

How to make the transition from breastfeeding with a shield to direct feeding?
Removing the shields and focusing on baby’s position and latch on.

What about breast pumps? They are usually used to express milk, but can also be used to increase milk production, how is that?
Since breastfeeding is based on a demand & supply cycle, pumping along the side helps mothers to empty the breasts more frequently which stimulates her body to produce more milk.

One of the challenges that can face a nursing mother is mastitis. What is it exactly and what is the most natural way to deal with it?
Mastitis happens when a duct gets blocked and causes some kind of infection. Signs of mastitis are: redness, hotness and swelling and sometimes fever and cold like symptoms. The severity differs from one case to the other that’s why it is very important to seek medical help as soon as a mother’s suspect that she has it. Yet, keep breastfeeding and if it’s painful then at least hand express or pump to avoid further complications.

Another challenge can be a nursing strike, what are nursing strikes and how should they be dealt with?
When the baby suddenly refuses to breastfeed, it can happen with some babies; it doesn’t usually last for long. Mother should just keep trying to nurse the baby,also, skin to skin is a great way to ease the way for a bay on strike.

Why is extended breastfeeding is trending now ?bWhat about weaning after extended breastfeeding, how can it be done peacefully?
Extended BF, usually takes place after 2 years. Some mothers decides to do so – however, the recommendations are for 2 years and usually the baby weans itself off when it’s ready to.

What type of bad advise do women tend to get?
To breastfeed on the clock, to leave baby to settle on its own And to supplement with herbs or just ONE bottle a day!!!!

What about breastfeeding and Vitamin D?
The recommendations now are that babies should get vitamin D, usually orally, starting birth onwards.

As an advocate of breastfeeding, what would you like to tell people lastly?
To mother: To learn about breastfeeding & healthy nurturing during pregnancy, to take it day by day – breastfeeding needs some time to become well established. A mother can do what she desires to if she believes in herself and her abilities. Not only that breastfeeding saves babies lives, it also shapes their future wellbeing, character, & performance.
To people: By supporting mothers on their breastfeeding journey you are contributing to better communities and healthier societies.

imageIman is a graduate of The American University in Cairo who completing her MSc in Business Psychology at Heriot Watt University in Edinburgh (UK). She has over 15 years of work experience. She is a Certified Lactation Counselor, NLP practitioner, Relationship Management & Conflict Resolution expert. She is a licensed representative for Gordon Training International in Middle East since 2010. She works in multinationals, FMCGs and Telecom companies. She is a founder and member of Mother Child Friendly Care Association (MCFC) in Egypt, promoting Breastfeeding through social media and the Baby Friendly Hospital Initiative with UNICEF . Iman is, also, the co-founding vice president for Life Coachers in the Middle East & the founder of Leaders Globe in the UK, as an organizational psychologist & a Leadership Coach, she strives to help Professionals achieve a Work-Life balance, where they are able to enjoy their own life, progress in their career, as well as enjoy their parenthood. 
Connect with Iman email: iman.sarhan@lifecoachers.net
Facebook Group: https://www.facebook.com/groups/612569375515438/
Visit: http://www.lifecoachers.net

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Statue of a peasant woman nursing her baby, made of Terracota by French artist Jules Dalou in 1873. I took the picture of this statue a few years ago in The Victoria and Albert Museum and ever since it has been one of my favorites.

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