Breastfeeding rates in South Africa are considered to be at an all-time high. According to a report titled “A policy-friendly environment for breastfeeding”, compiled by senior policy analyst Patricia Martin-Wiesner, and published by the DST-NRF Centre of Excellence in Human Development, University of Witwatersrand, there has been a massive increase in the number of mothers who exclusively breastfeed their babies, from 8% in 2003 to 32% in 2016.
There are a number of reasons for this increase in exclusive breastfeeding, including the call for legislation to promote public breastfeeding and protect mothers who decide to do so. As a result, more than 90% of South Africa’s public facilities have been accredited as being mother-baby friendly.
Amy Brown, professor of child public health at Swansea University, and author of The Positive Breastfeeding Book, explains that while many mothers start off breastfeeding, there is a tendency to stop after six weeks. “Unfortunately, the majority of women who do stop are not ready to do so, leaving them feeling demoralised and guilty, and even at an increased risk of postnatal depression.” She adds that while some mothers may be unable to breastfeed, most women, given the right environment, will be able to exclusively breastfeed for the first six months, as recommended by the World Health Organization. The benefits of breastfeeding have been well-documented for both mother and baby.
Even so, there are common issues that may challenge your desire to breastfeed. We share the 10 most common breastfeeding challenges and how you can work through them.
It hurts when I feed
Lactation experts share that breastfeeding should not cause you any pain. And, if you do experience pain, this could be due to your baby’s latch. You may find that your baby has not taken enough of your breast into her mouth. A few changes in position can help. If you aren’t certain, speak to a lactation consultant or a clinic sister for help regarding the correct latching position.
I think I have thrush or an infection
Research conducted by the Department of Gynaecology and Obstetrics at Horsens Hospital in Denmark, has found that one in four mothers will experience some form of infection post birth, which often affects the ability to breastfeed. The most common is mastitis (12%) or blocked ducts. Symptoms include a pain in the breast and a hot, red patch. Interestingly, the best way to work through mastitis is to continue to feed. Another common infection is thrush, which can be transferred to your baby. Symptoms include itching or painful nipples and white patches in your baby’s mouth. Both you and your baby should be treated for thrush. You can continue to breastfed, but it may be very painful. You may choose to express milk during this time.
I need to take medication, but I’m afraid it will harm my baby
According to experts at the Mayo Clinic, almost any drug that is present in your blood will transfer into your breast milk. However, these are usually trace amounts and shouldn’t pose any risk to your baby. It is important that you tell your doctor which medications you are on, and to check before using any medications while breastfeeding. Dr Peder Ahnfeldt-Mollerup, one of the researchers at the Department of Gynaecology and Obstetrics at Horsens Hospital in Denmark comments that some women may stop breastfeeding because they are taking antibiotics. “Most types of antibiotics are harmless to the child,” he says, adding that it is important to inform your doctor or pharmacist that you are breastfeeding. If you are taking medication, find out from your doctor about timing, as taking the medication immediately after feeding may help to limit your baby’s exposure. If you notice any changes in your baby, including his eating or sleeping patterns, or unusual fussiness, consult your doctor immediately.
I am worried about breastfeeding when I return to work
South African law states that breastfeeding mothers should have two 30-minute breaks a day to either breastfeed or express milk. Unfortunately, not many work environments are conducive to this. When returning to work, discuss this with your manager and see what options are open to you.
I am craving junk food, will it affect my baby?
The overall fat, lactose and protein content of your breast milk is not affected by your diet, according to Australia’s National Health and Medical Research Council. The main determinant of supply is how often and how well your breasts are “drained”. The more you feed, the more drained your breasts are, the more breast milk you make. In fact, an unhealthy diet will more likely affect you than your baby. While you don’t need to avoid any specific foods while breastfeeding, a small percentage of breastfed babies may show signs of a food sensitivity by reacting to something in your breast milk.
I had a glass of wine, will it affect my breast milk?
The good news is that breastfeeding mothers can have the occasional small amounts of alcohol without it affecting your baby.
According to Dr Wendy Jones and the Breastfeeding Network, alcohol can pass into breast milk, however maternal blood levels have to reach 300mg/100ml (0.3%) before mild sedation is reached in your baby. Considering the legal limit to drive is 0.05%, at this level, you would be highly intoxicated. Alcohol passes out of your milk at the same rate as your blood, so it’s recommended that if you do have a drink, it’s occasionally, and no more than two. According to the experts, peak levels appear 30 to 90 minutes post-drinking. To reduce your baby’s exposure, Dr Jones recommends you avoid breastfeeding for two to three hours after drinking. Interestingly, beer, and in particular Guinness and stout, have been linked to increased milk production. However, Dr Jones shares, non-alcoholic beers may have similar stimulating properties.
I think my baby is over-feeding
Breastfed babies naturally feed often − every two hours or more. This is because breast milk is easily digested and your baby has a tiny tummy. If you have noticed an increase in feeding, or your baby demands to be fed on and off over a period of a few hours (known as cluster feeding), you may find he is going through a growth spurt. Remember, the more your baby feeds, the more milk you are producing.
I don’t think my baby is getting enough milk
On average, babies have eight or more feeds within a 24-hour period. Causes for concern are less than six feeds within a 24-hour period; your baby consistently feeds for only five minutes or less before falling asleep, your baby consistently feeds for longer than 40 minutes, he is fussy, seems dehydrated or is not peeing or pooing like he should. If any of these scenarios are present, consult your healthcare provider.
I am not exclusively breastfeeding
This could be due to a health condition, a true milk insufficiency or you may have decided to introduce a bottle. Just because you have introduced formula, it doesn’t mean you need to stop breastfeeding altogether. You can have the best of both worlds if you want. Speak to a lactation consultant or breastfeeding expert for advice.
My family wants to be involved
It can be hard in the beginning, particularly for your partner, when you are your baby’s only source of food and comfort. Partners, siblings and even new grandparents may ask to be involved in the feeding process. They may do this out of concern for you and think that they are helping, but expressing milk and introducing a bottle is not as straight-forward as it seems. There are other ways to involve your family, such as burping or winding after a feed, or even taking over the bath and bed duties, to help them feel they are involved.