南華早報文章:New mothers should seek help from professionals if they want to breastfeed – by Heidi Lam

星期日南華早報 (4 Mar 12) 刊登了Heidi Lam的一篇文章,回應之前報導有關餵母乳的困難。文章題為:New mothers should seek help from professionals if they want to breastfeed. Heidi 指出,儘管在香港餵哺母乳有不少阻力,但仍有很多成功餵哺母乳的例子,包括全職媽媽及上班媽媽,而她們都有一些共通的特徵,值得我們借鏡。詳情參閱文章剪報原文,或看以下的轉載。

本文章是回應一篇之前的報導,題為:Before babies hit the bottle — Despite good intentions, nursing mothers in Hong Kong are held back by a lack of support. 報導指很多媽媽都難於持續餵母乳。詳情參考原文

In response to an earlier report on breastfeeding obstacles, Sunday Morning Post (4 Mar 12) published an article by Heidi Lam, titled: New mothers should seek help from professionals if they want to breastfeed. Heidi said despite obstacles, there are many mothers who are successful in breastfeeding, including full time mothers and workings mothers.  And they have common traits. For details please see the article, original newspaper clipping, or the post below.

Heidi’s article is published in response to an earlier report titled: Before babies hit the bottle — Despite good intentions, nursing mothers in Hong Kong are held back by a lack of support. See the original report.

(以下是Heidi的文章。Below is the article by Heidi.)

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Published in Sunday Morning Post on Mar 04, 2012

New mothers should seek help from professionals if they want to breastfeed

I am writing refer to the article by Vanessa Yung (“Before babies hit the

bottle”, February 26).

Many mothers in Hong Kong experience difficulties with breastfeeding,

and even though most of them try to breastfeed in hospital after giving

birth, most fail to continue. The article rightly mentions a number of

obstacles. But how about those who are successful, how can they do it?

In my years of counselling mothers (as a certified lactation consultant), I

have seen many cases of successful breastfeeding. There are full-time

mothers, working mothers and those who work part-time who are all

breastfeeding. Those who have to work will pump their milk during

separation and nurse when they are back home.

These successful mothers have common traits.

First of all, they are determined and they never gave up.

They did their homework before giving birth to learn more about

breastfeeding and so they were knowledgeable. They attended classes,

joined meetings and talked to other breastfeeding mothers so they could

understand real-life situations.

Also, whenever they faced challenges they asked for help.

Breastfeeding problems can often be fixed if you ask for help from

experienced counsellors or professionals. There are volunteers who are

willing to help and lactation consultants who are professionals.

I would like to stress the importance of learning breastfeeding and

getting well prepared before birth. In Hong Kong, bottle-feeding

dominates and the breastfeeding culture is weak, so how can new

mothers be expected to know how to breastfeed and look after a

breastfed baby if they never see anyone doing it?

How many times do readers see a mother breastfeeding in Hong Kong?

New mothers should learn from reliable sources and get to know

breastfeeding mothers.

They should avoid breastfeeding seminars run by formula companies,

which lure mothers with free gifts. Not only is that against the

International Code of Marketing of Breastmilk Substitutes, their purpose

is to get women to bottle-feed.

Before we can get more maternity leave, nursing rooms, and better

support, it is up to mothers to improve the breastfeeding rate. If they are

determined they can make a change.

Heidi Lam, Discovery Bay

Copyright © 2012 South China Morning Post Publishers Ltd. All right reserved

Risks of Informal Breastmilk Sharing versus Formula Feeding

當妳遇到哺乳上的困難,需要補奶的時,根據世界衛生組織的指引,首選是媽媽自己擠出來的母乳,其次是別人的母乳,亦即古時候的奶媽,最後是才是奶粉。但最近有些討論,私下捐贈的母乳有風險,但奶粉亦有很多風險,那如何選擇?

以下這篇文章有詳細分折。

無論如何,當遇上哺乳困難,最重要尋求協助,而在使用補奶之時,同時要有返回乳房餵哺的方案,才可讓媽媽們成功餵哺自己的孩子。

展望將來,政府應設立母乳庫,好像血庫一般,幫助有需要的寶寶。

Risks of Informal Breastmilk Sharing versus Formula Feeding.

Baby’s Journey from Sterile to Germs

By Heidi Lam, B.So.Sci(Hon), IBCLC

We are living in a world full of microorganism like bacteria, virus and fungi. Even varies part of the human body have bacteria, like the skin, gut, and mucosal membranes.  They are needed for a normal life.  When we look closely into the immunology of breast milk, we will be amazed how Mother Nature intends to protect our offsprings to sustain a world full of bacteria.

 Born Naturally from Sterile to Germs

Baby lives in a sterile environment inside the mother’s womb, well nourished, protected and germs free. Suddenly, one day, the baby is born right next to mother’s anus, where you will expect plenty of bacteria.

Then the baby is put on to the mother’s body for skin-to-skin contact.  He touches and licks the mother’s skin, contacting bacteria there.

So what would happen to all those germs?

These are actually normal bacteria that will colonized the baby’s skin, gut and varies mucosal membranes, namely microflora.  The microflora will prevent the growth of dangerous bacteria by competing them for nutrients and space.

In the baby’s gut, the normal bacteria flora will compose of more “good” bacteria like Bifidobacteria and Lactobacilli, and less “bad” ones such as E. coli and Staphylococcus aureus.

However, babies are born very immature comparing to other mammals.  All their body systems are still developing.  The epithelium lining of infant’s gut is not yet intact, meaning germs and antigens may get through the “holes” of the “leaky gut” and goes into the blood stream and body tissues.

If that happens, a war will rise between the bacteria and the baby’s still immature immune system! The baby will defense his body against the “invader” and starts a series of reaction, namely infection.  This will cause inflammation, tissue damage, clinical symptoms and high energy cost.

To put it plainly, the baby gets sick.

He needs to use a lot of his energy to fight the war, and normal growth and development is compromised.

Breast Milk Defenses

This sounds a bit scary. So let’s go back to the newborn at the mother’s chest after birth.

He moves and searches and touches his mother’s nipple by his tiny hand.  After some efforts his mouth finds the nipple!  He latches on easily and gets colostrum in reward.

As you can see now, having contact with all the germs right after birth, the baby has a far greater need for immunological protection than for nutrition in the early days.

Mother nature is well aware of this too! The quantity of colostrum is low, but it has a high concentration of a major protein component called SlgA antibodies.

SlgA antibodies in breast milk are specific to mother’s bacteria in the gut. Can you see now how lucky that baby is born next to mother’s anus, so that he gets the same bacteria of his mother, which the SlgA antibodies are targeting to.

One important function of SlgA is to protect against the “bad” bacteria that colonized the newborn’s gut.  SlgA antibodies will bind the specific microorganism, so that they cannot attach to baby’s mucosal membrane, thus avoiding infection.  SlgA also support the development of baby’s own immune system.

 Varies components works together

Other breast milk protein components also work together with SlgA to protect the baby.  Lactoferrin kills bacteria, virus and fungi, while Lysozyme, working with Lactoferrin and SlgA will attack E. coli.

Moreover, carbohydrates call oligosaccharides will act as food for the “good” bacteria and enhance the growth of bifidobacteria and lactoobacilli.  More “good” bacteria in the gut means less space and food the “bad” pathogenic bacteria to grow.  Oligosaccharides will also catch and sweep the bacteria from the intestine and urinary tract and get excreted.

Now, what a good news to the baby’s still mature immune system.  Mother’s breast milk defenses.  Breast milk get rids of the enemies before they can go into the blood stream and tissue.  Infection is avoided and the baby does not need to react with inflammation, tissue damage, clinical symptoms, nor to lose energy.  War is relieved!

 Importance of normal gut bacteria

This first contact of mother’s bacteria, together with the defense of breast milk, is a good education for the baby’s immune system. The normal bacterial colonization in baby’s gut significantly stimulates the growth of his immune system.  It learns how to defend the baby from infection. It also learns not to react to normal substance such as food or pollen, which may otherwise induce allergic reactions.

These lessons are learned in a safe and energy saving way.  Now the baby can use his energy for optimal growth and development.

What a happy and healthy breast-fed baby mother nature has intended!

 Risk when against the nature

Now lets consider another scenario.

Baby was born via cesarean section.  He did not contact mother’s gut flora near the anus. He was then separated with mother for hospital procedures while mother being sewed up.  The baby was handled by varies hospital staffs, other than his mother and father.  He came in contact with the bacteria of other people’s skin and hospital environment.

After two hours, baby was brought to the mother to nurse. However, the most alert timing for the baby after birth is passed, and he seemed to be very sleepy.  He latched briefly and went to sleep.  Mother was in pain and baby was kept in the nursery.  Every 3-4 hours the nurse would bring the baby to the mother but breastfeeding did not go smoothly.  After trying for a few times, the baby started formula.

Since baby did not develop the normal gut and skin flora as his mother did, he had a different bacterial colonization.   He also contacted germs of other people, which he may not have those specific SlgA antibodies from colostrum to fight for.  With early start of artificial feeding, he do not have the supply of necessary SlgA and other factors to promote a growth of “good” bacteria in the gut, nor to help killing and blocking out pathogenic bacteria.  Since his immune system was still immature, when some bacteria was able to attach to the mucosa in the gut or urinary tract, so unfortunately, infection occured.

The baby then had to fight a war between his immature immune system and the germs. He had inflammation, tissue damage, energy loss and clinical symptoms.

He was then prescribed antibiotic.  However antibiotic treatment has a strong effect on the gut microflora.  It promotes the growth of some “bad” bacteria like Klebsiella and Enterobacter, risking for more serious illness. Antibiotic may also suppress the growth of some “good” bacteria, risking the colonization of disease causing bacteria.

Furthermore, cows milk protein is a common allergen.  It may, leak through the immature “leaky gut” and goes into the blood stream, which then cause a series of allergic reaction.

This tragic condition does sound very familar!  How many times we see baby get sick early on and having allergic reactions?

By looking into the different scenarios, we can see breastfeeding is a natural way to protect our babies and allow him to have a normal and healthy growth and development.

Starts skin-to-skin contact with baby after birth and goes on to breastfeeding is the key!

{End}

Reference:

Hanson Lars A., Immunobiology of Human Milk: How Breastfeeding Protects Babies, 2004, Sweden, Pharmasoft Publishing.

(updated: Nov 2011)

© Copyright 2011 Lam Yan Yee Heidi.  All rights reserved. No reprint or upload in any format and in any media without permission. Enquiries or reprint permission contact Heidi. Email: ibclcHeidi@gmail.com Tel:(852) 9301 6381