“Breastfeeding is not a choice, but a responsibility; not just of the mother, but of the society”.
Breast milk is nature ordained food for all newborn babies. Breastfeeding offers innumerable benefits to babies. Mother’s and has economic benefits to society. Despite this many mother-baby dyads experience difficulty with achieving successful breastfeeding. The obstacles can range from lack of support/education, lack of motivation, medical factors, cultural issues, and very rarely actual low milk supply.
Even mothers with the intention to exclusively breastfeed are not able to achieve their goals due to a lack of support from hospital staff. About 1 in 3 mothers start supplementing their babies in hospital. Infant formula usage in hospitals is the biggest predictor of cessation of exclusive breastfeeding post-hospital discharge. The “Baby-Friendly Hospital Initiative” describes the ten steps for providing support to mothers for establishing successful exclusive breastfeeding. Mothers are maximally receptive to breastfeeding education during their initial hospital stay. It will be an optimal opportunity for doctors and nurses to educate mothers about breastfeeding positioning, latching, identifying breastfeeding problems, and offering customized solutions and suggestions. Parental concerns and choices can also be addressed, and they can be guided adequately. If a mother is having trouble getting breastfeeding to a good start, or if she develops a breastfeeding problem after she has been feeding for a while, it is important to get breastfeeding back on track as soon as possible.
In our hospital, we have a team of dedicated “Breastfeeding counseling nurses”, who with the guidance of Obstetricians and Paediatricians, counsel the mothers on daily basis regarding breastfeeding. They provide an opportunity for all mothers to discuss their simple doubts and problems with breastfeeding. It also offers a continuity of care, as the same nurse ta l ks to them repeatedly. The nurses and doctors form a closed-loop team where each one offers feedback to the other. Apart from teaching mothers about breastfeeding techniques, they also help in managing problems like breast engorgement, mastitis, sore or cracked nipples, thrush, and low milk supply.
One difficulty felt in promoting exclusive breastfeeding is when infant formula is introduced due to medical reasons. Prematurity, neonatal hypoglycemia (which is quite common in infants of diabetic mothers, which again is on a rise), dehydration, severe jaundice are the major conditions that make the Pediatric team prescribe infant formula supplementation. These infant formulas are given to babies using a cup, spoon, or paladai in the hospital. We do not use feeding bottles for such babies. The infant formula feeding by other methods like bottle, spoon, cup, or paladai has its own drawbacks.
a.The baby learns an easier way to be fed, be it bottle or spoon, and starts refusing to suck at the breast.
b.The mother gets less stimulated as the baby starts refusing to be fed. Milk secretion goes even low by negative feedback cycle.
c.Baby’s contact and attachment with his/her mother is compromised as other family members take over the responsibility of supplemental formula feeding.
d.Mothers develop a feeling of guilt and start feeling demotivated. Supplemental feeding tube method or Supplemental Nursing System (SNS)
It is a simple technique for breast supplementation or an alternative feeding tool. It enables mothers to get the feel of breastfeeding, trains the baby to suck. It is a simple system consisting of a disposable syringe and a thin caliber feeding tube (5F), the end of which is cut short and stuck close to the nipple. The baby is made to latch on the breast and the feeding tube together and milk is let down slowly as the baby sucks naturally.
The Supplemental feeding tube method is an ideal way to administer supplemental nutrition to babies while they are doing simple acts of breastfeeding (Figure 2). This system supports a unique bond between mother and baby motivating both of them to move towards a more satisfying breastfeeding experience. Through this baby can get additional milk they require without interrupting or interfering with breastfeeding. The supplemental feeding tube method additionally helps babies who have breast refusal. It is also preferred by a few surrogate mothers and adoptive mothers. It increases breast milk production as the baby sucks calmly for a longer time at the breast.
We have been offering this supplemental feeding tube method for babies with medical needs for formula. This includes preterm babies who are not able to suck vigorously at mother and babies in postnatal and special wards who are with their mothers. The system is found to be user-friendly, consuming less nursing time, with extreme satisfaction from mothers. It cannot be used when the baby does not have any sucking reflex, has respiratory distress, and is neurologically abnormal. Mothers’ frequent presence when baby is in NICU and the nursing time consumed are other limiting factors. Milk leaking and wastage is another factor. Slowly we intend to offer this technique for all babies who need supplemental formula.
