Dr. Promilla Butani
Q. I breast-fed my daughter for the first time 48 hours after delivery but I am not too sure that this is the best way. Can you please tell me when is the right time to start breast-feeding?
A. Breast feeding should begin as soon as possible – ideally in the labour room immediately after delivery. Not only does this help create a closer bond between mother and child, breast feeding helps to contract the uterus and quicken recovery. Even after caesarian, a baby should be allowed to suckle at the breast as soon as possible, generally 6 hours after delivery. The suckling sets up a reflex stimulus in the mother that promotes production of milk.
Q. Should a newborn be given water or glucose initially?
A. A newborn should not be given any prelactal feed, be it honey, water or glucose water. The baby doesn’t need anything at that time apart from the colostrum.
Q. Should honey be given to a newborn?
A. No. Honey is thick and viscous and can choke the baby. Also honey is not sterilized and can be a source of infection.
Q. Is the pre-milk (colostrum) good for the newborn?
A. Yes, this milk is excellent for the newborn. It is high in calories, high in fats and essential proteins. It also high in antibodies therefore helps boost the immunity of the child.
Q. What is the best way to feed a baby?
A. The best way to do so is sitting up. Though feeding while lying down is very comfortable for the mother, there is a chance that the mother could inadvertently fall asleep and roll over the child suffocating him by her breast.
Q. How often should one feed the baby?
A. Feed the baby as often as he asks for milk. Milk is not just a source of nutrition to the baby, it is also a source of comfort.
Q. Should you feed a baby when you have fever?
A. Yes, the only contra indications to nursing are when the mother suffers from diseases such as open tuberculosis or when she has a heart condition or any other serious medical conditions which precludes nursing.
Q. How does one feed with inverted or retracted nipples?
A. Teach the baby to suck on the areola. Once the baby starts suckling on the areola the suction force will help pull out the nipples. As it is the source of the milk is not the nipple but the areola. The nipple is only used by the child to latch on to.
Q. How long can you keep expressed milk?
A. Expressed milk can be kept in the fridge for 4-6 hours depending upon the climatic conditions.
Q. How should you express milk?
A. You express either by using your hands or with a breast pump. Clean your hands before expressing. Always sterilize the breast pump. Remember to express from the periphery on to the center.
Q. Should an infant be given water apart from his feeds?
A. No. The mother’s milk is sufficient to slake the thirst of a new born as there is a large percentage of water in it.
Q. When should one start their child on semi-solids?
A. You can start your baby on semi-solids by 4-6 months, depending on your baby.
Q. What creates iron deficiency in children in India?
A. By and large, parents in India still put a lot of stress on milk in the child’s diet even once the child has started eating proper food and is getting calcim from a lot of other sources. As a result of such an overemphasis of milk the children don’t take in enough iron rich food. Actually, if about 80% food is given as compared to 20% milk then the chances of iron deficiency are much less.
Q. Are cottons nappies better than diapers for a child?
A. Definitely. In a hot climate like ours breathable cotton porous nappies are extremely important. Plastic diapers limit exposure to air and can cause nappy rash.
Q. How can you beat Nappy rash?
A. Exposure to air is the single most important treatment. Wash the affected area with flowing water rather than with wet cotton. Do not rub but pat gently with a soft cloth to dry it. Talcum powder should not be used as it blocks pores. And finally, change nappies frequently.