Breastfeeding Quiz

Reason: Glucose Water/Sugar/Jaggery/Plain Water or honey or anything else should not be given to a baby because it increases the risk of infection. These pre-lacteal feeds may decrease the baby’s eagerness to suckle at the breast. Thus, the first & subsequent breastfeeds may get delayed.  This may lead to breastfeeding failure. Though produced in small amounts in the first few days after delivery, breastmilk (Colostrum) is enough for the baby. Hence traditionally offered pre-lacteal feeds are not required. Colostrum is rich in substances that protect the baby from germs.

Reason:

• Baby is very alert & eager to breastfeed in the first hour after delivery.
• Rapidly learns to suckle at the breast in a proper position.
• The child remains warm being in close touch with the mother
• Risk of infections is reduced
• Ensures short-term & long-term breastfeeding success (Total Duration)
• Post-delivery bleeding (Post-partum hemorrhage) decreases
• A strong emotional bond begins to develop between the mother & the baby.
• Thus, the baby gets rapidly adjusted to the environment outside the womb.

Reason: Breastfeeding is also possible in lying down or semi-reclined position. Hence even a mother who has undergone a Caesarean section can breastfeed with appropriate help. WHO & UNICEF have similar recommendations for breastfeeding in Caesarean & Normal deliveries.

Reason: Though produced in small amounts in the first few days after delivery, breastmilk (Colostrum) is enough for the baby because a newborn’ s stomach is smaller in size. A baby needs to feed frequently (Minimum 10 times in 24 hours) to get all the protection & nutrition it needs from the mother.

If the baby is fed outside milk it can lead to

• Infection
• Less suckling at breast causing engorgement
• Lesser breastmilk

Reason: Proximity with the mother results in few benefits like

• Promotes demand feeding. Mother can easily identify a baby’s hunger cues & feed
• Baby remains warm
• Lesser risk of infection
• Helps breastmilk to come in
• A stronger emotional bond between the mother & the baby.

If the baby is kept in the cradle, then these benefits will be partially available. The benefits will be lost if the baby is kept in a baby roomanother room

Reason: Exclusive breastfeeding is established in 7-15 days.  During this period, it is necessary to feed the baby more frequently (at least 10 times in 24 hours, every 1.5 – 2 hrs) by giving close skin-to-skin contact & recognizing the early feeding cues.

After breastfeeding is established, the child starts urinating frequently (more than 6 times in 24 hrs.) & starts gaining weight. Then the baby can be fed on demand i.e. whenever the baby wants (about 8 times in 24 hours). Very few babies demand feeds with the regularity of 2-3 hours. Hence all the other answers are wrong.

Reason: Some babies are slow feeders, & some are fast feeders. Less than 10 min.is too short a feeding time. The baby may not gain weight properly. More than 45 min is too long a feeding time. In prolonged feeding baby will get tired & frequency of feeding can be affected. Whatever the baby has to get she will get in 45 minutes. Hence continuing a feed beyond 45 minutes is not beneficial. Breastfeeding assessment for improper position & attachment & inadequate milk transfer is necessary if feed is getting prolonged beyond 45 minutes.

Reason: Giving formula & animal milk can leads to serious infections like pneumonia & Diarrhoea which is more dangerous than the risk of HIV transmission through breastfeeding. With mothers getting Anti- HIV drugs, the risk of transmission through breastmilk has reduced considerably. If the baby is exclusively breastfed, breastmilk prevents the entry of the HIV virus in the body. Mix feeding will increase HIV Transmission. Hence it is even more dangerous. Crack nipples, engorgement, & oral thrush can increase the risk of HIV transmission even though the baby is exclusively breastfeeding. Hence, good counseling is required to prevent & overcome these problems.

Reason: Milk is stored below the black part which is called areola. Hence if the baby takes nipple & maximum black part in mouth, she will get breastmilk in good amount. If baby will suckle only on nipple or nipple with small part of areola, she will get less milk & can cause soreness or cracks on mothers’ nipple. Because baby will get less milk baby will pass less urine & may not have adequate weight gain.

Reason: Baby can cry for many reasons including hunger. It may be due to any discomfort like feeling cold or warm or due to a wet loincloth. It may be also because of illness or colic. A baby can express any discomfort only by crying out. A persistently crying baby needs to be assessed by a doctor. If the baby is more than 15 days old, the mother can easily confirm feeding adequacy by good urine output & weight gain. Before 15 days of life, frequent passing of yellow stools indicates adequate feeding but the mother will need medical help to confirm the same.

Reason: As soon as the lactation starts getting established (3-5 Days), the baby starts stooling frequently & over next few days may start passing stools almost after every feed.  After 1 month of age, breastmilk composition starts changing & hence stooling frequency decreases. Over next few weeks the baby may start passing stools once in 7-8 days. This cannot be labeled as constipation. Kindly consult your doctor if less stooling in this period is associated with distension of abdomen.

Reason: After breastfeeding is established (1-2 Weeks) if an exclusively breastfed baby passes urine 6 – 7 times/24 Hours & gains minimum 500gm/month then we can presume that the child is getting adequate breastmilk. However ideally it is important to plot on WHO Growth charts for confirming adequacy.

Reason: After 6 months of age the baby should be initiated on food. Giving even 1-2 cups of animal milk can

• compromise on baby’s food intake & learning to eat food can get delayed & prevent the baby from getting proper nutrition
• Giving liquid food like milk will hinder learning to chew food

Animal milk which has no advantage over breastmilk can reduce the breastmilk intake & prevent the baby from benefits of breastmilk & breastfeeding.

Reason: Recommendations state that breastmilk alone (Exclusive Breastfeeding) can support optimal growth till the end of six months (180 days). Complementary foods are required beyond this period. It was earlier recommended to start complementary food at the ‘end of 4 months’, but now this has been shifted to the ‘end of six months’ because it was scientifically proved that giving exclusive breastfeeding till the end of six months is more advantageous than starting early complementary feeding.

Reason:  Families usually initiate babies on watery food items because these are easy to swallow for the baby & save caretaker’s time, but the baby will get fewer calories & hence can affect her weight negatively.

By ten months of age, the child should be eating all family foods or else there is a risk of feeding difficulties later (‘critical window’ for introducing ‘lumpy’ solid foods)

Reason: Continuing to breastfeed in the second year is important because

• 35-40% of calories are derived from breastmilk.
• Breastmilk is a richer source of fats & energy. Higher fat content helps better absorption of Vitamin A.
• During illnesses, children prefer breastfeeding much more over food. This ensures that baby continues to get fluids & nutrients to some extent. Resistance power (antibodies) in breastmilk helps faster recovery.

As a source of nutrition, breastmilk along with food is important till 2^nd birthday. Beyond this period, it is important that the mother continues to breastfeed more for the non-nutritive benefits of breastmilk & breastfeeding until the child is 5 years old.

Reason: It is always unsafe to use the bottle. The risk of vomiting & loose motions (acute gastroenteritis) & other infectious diseases is much higher in bottle-fed babies.  Since it is easier to feed on a bottle, the child may subsequently refuse to breastfeed (nipple confusion). While bottle feeding, a child can accidentally aspirate milk (suck milk into lungs). This may endanger her life. Many times, the bottle is used to feed formula. The risk of feeding formula gets added up under such circumstances.

It is always safe to use a cup, Katori-spoon or a Bondla to feed the baby.

Reason: This custom is inappropriate because it increases the risk of infection. These items may decrease the baby’s eagerness to suckle at the breast.  Thus, breastfeeding may get affected.

Breastmilk is all that a baby needs for optimal growth. Hence all the items mentioned in the question are also unnecessary.

Reason: Breastmilk is produced from blood. The composition of blood remains unchanged irrespective of what mother eats & so does composition of breastmilk. Hence restricting certain food items does not stand for any reason. Such restriction may prevent satiety in mothers & may also result in mothers eating less food. This, in turn, can affect breastfeeding negatively. Not only that the mother takes a balanced diet but should eat some extra food (one meal more) to support lactation. The routine tradition of giving ghee enriched sweet preparations to a breastfeeding mother would stand to reason only if she is undernourished, or else this would only contribute to making a mother more obese. The mother should avoid eating outside food due to the risk of contracting an infection.

Reason: Mothers do not resume their menses for a few months after delivery. An exclusively breastfeeding mother may not get periods for a longer period. However, a mother can go into the next pregnancy even before she gets her first menses. Hence, every mother should start using a contraceptive method after a reasonable time post-delivery. The most suitable contraceptive method is Copper-T (IUCD). Oral Contraceptive pills especially those containing estrogens can decrease breastmilk supply & hence are not suitable for breastfeeding mothers. Barrier contraceptive has a disadvantage of higher failure rates.

One & a half months post-delivery is a good time for IUCD insertion. However, for many years now doctors have been inserting IUCD soon after delivery if the mothers wish so.