Breastfeed Or Bottle feed

           

Occasionally, artificial milk may have to be given  to adopted babies or those who have lost their mothers, or to infants who have become 'hooked' to bottle feeding and stopped breastfeeding completely for some times. Even in such cases, breastfeeding is possible. An adoptive mother who has never given  birth to a child  can fully or partially breastfeed her adopted baby. Wet nursing is an another alternative, where a breastfeeding mother  may also like  to breastfeed an adopted baby or a baby or a baby who has lost his mother. Relactation is also possible in mothers who have stopped lactating. For Details, wright to

 

Breast Feeding Promotion Network of India (B.P.N.I) 

BP 33,

PITAMPURA

Delhi 110088

  

Introduction

The advantages of breastfeeding undoubtedly far overweight bottle feeding. Sometimes the bottle may be restored to for some reasons. There is no need to feel guilty if that is the case. The aim of both is well nourished, happy and active baby.

At times bottle feeding may be restored to, if the mother is working. In that case the baby can still take  one or two breast feeds, early morning and late at night.

If the baby does not gain adequate weight, bottle feeding may be restored to.

At times recurrent cracking of nipples, mastitis or surgery for mother might lead  to a switch.

An exhausted mother, unable to cope with  demand feeding  and other house hold chores, may get so tired and anxious that it might interfere with her lactation. It is therefore advisable to arrange for extra help at this time.

                   

A women may have in laws, friends or a husband who are not very enthusiastic about breast feeding. On other hand some women may give up breastfeeding from wrong advice or hearsay, for example some women believe breast feeding ruin their figure or makes their breast sag. There is no credibility in this as it has been seen from medical experience that many women breast feed several babies with no bad effects  on their figure, others end up with even better figures. Very few women gives breast feeding for the reason listed above. Basically if a women decides to breast feed, she normally succeeds. Most mothers give up because they feel they have fed long enough or as long as they had planned.

A breast fed baby is not prone to allergies. There are less chances of diarrhea, eczema, coughs, colds and asthma in breast fed babies. 

Breast milk comes sterilized and at the right temperature, so you do not waste  time and energy  making feeds for the baby. You also save a lot of money by avoiding a need of sterilizing equipment, bottles, and tins of milk powder.

As you breastfeed, the hormones released by your body cause your womb to shrink to its normal size and you also loose weight since feeding burns up calories. Some women fear feeding will make them less sexy. This is not true, since sex, childbirth and breastfeeding are linked with the some hormone. 

While drinking breast milk, the baby can pause between sips to breathe, look around or simply to smile at mother. On the other hand, a bottle fed baby gets a constant flow of milk through bottle's nipple and develops a tendency to drink too much. Therefore, bottle fed babies may be more chubby and less active as compared to breast fed babies.. However this obesity will be difficult to get rid of even in adulthood and could bring with it health hazards.

It is easier to breast feed when you are travelling. No hassles of sterilizing bottles and running around to find a place to make feeds. All you need is yourself and may be shawl or scarf to cover yourself discreetly.

 A working mother can combine breast feeding with bottle feeding. Ideally a baby should be breast fed for two years, or for a minimum of three to six months.

Some mother who breast feed their babies find giving one bottle feed at night useful, since the baby sleeps longer after a bottle feed which is heavier and takes longer to digest.  The mother can therefore catch up with her much needed sleep at that time. Besides in an emergency , the baby can be given the bottle, whereas, if the baby is totally breastfed it may not take to the bottle. For instance, if the mother needs surgery for mastitis , the bottle can be given while the mother is away.. Also if the mother is an air hostess or a doctor, her duty hours could be 24 hours or longer, so that the bottle will have to be resorted to.

                                  "Carries of tooth is common in bottle - feed babies."

Case against the Bottle

Bottle feeding should be resorted to when absolutely necessary, and its potential hazards must be born in mind. Bottle feeding also require a lot of hard work, since one has to sterilize the feeding bottles, nipples etc.and make the feeds.This is very important if sterilizing is not done properly. It can cause diarrhea and dehydration in the baby. If the milk is not made properly, it can mean a sick baby.

Once you start one bottle feed, the baby may begin to prefer it. It will upset the balance of your milk supply, which will be reduced.

The contraceptive effect of breast feeding, will also lessen. When a baby is 100 % breast fed, breastfeeding is more reliable for its contraceptive effect.

If you give a bottle feed at night you will have to be fully alert and awake to make bottle feed and bring it to the right temperature. It is easier to simply put the baby to the breast.

Milk Powder

Making a powdered milk feed  should be done exactly according to the instruction on tin. Some people put extra milk  powder in feed, since they feel the milk looks very thin.This could be dangerous. It could lead to a concentration of minerals in the baby's bloodstream, which can lead to dehydration and illness.

On other hand , some people might put less milk powder as compared to the instructions on the tin, thus running into the danger of giving inadequate nourishment to the baby. You must discuss with your doctor which is the best milk to give the baby. If you are going to be traveling a lot, it is best to give powdered milk, so that there are not many frequent changes, since you can carry the milk powder with you where ever you go.. Besides is sterilized and does not become easily infected.The brand you use should not be changed; it is best to stick to one brand.

Cow,s Milk

Cow,s milk has more protein than mother,s milk. This unnaturally large intake of  proteins results in an unnaturally large load of  nitrogen for infants kidneys. Cow,s milk should therefore be given diluted with one part of water to three parts of cow's milk. The water dilutes the protein and minerals like sodium and nitrogen. A little sugar should be added to the milk, since mother's milk has more lactose than cow's milk.

How to sterilize bottles

                   

You must keep aside a large vessel in the kitchen for boiling bottles in. You can buy one with a lid, since a covered vessels uses up less fuel. You would also need a bottle brush, which you must make sure to keep it clean.

              

Unscrew the cover of the bottles. Separate nipples in order to get the slime of nipples, rinse them in water, then apply salt inside and outside them and put them in a sun on a plate. To wash the bottles, rims, and cover of the bottles, use a liquid soap like Tee pol or soapy solution of surf detergent powder. 

                  

Scrub them well with the brush to remove the slime that milk tends to leave behind, the slime forms the breeding ground for germs. You could fill used bottles  with water after use so that milk does not dry in them and they are easier to clean. When the bottles are nicely scrubbed clean, fill them with water before you immerse them in the vessels of water, so that you have a minimum number of air bubbles in the bottles and they remain nicely submerged. 

                  

When all parts of the bottles are scrubbed and immersed in water, put the vessel on fire, with its lid on it. When the water boils it will send up steam and bubbles of air, and make a gargling sound, It is important that this stage is reached, for only when the water boils actively do the germs get killed.

                     

When the water is boiling, bring the nipples inside and wash them thoroughly in running water, to remove every trace of salt. It should not be left behind in the nipple, since the baby should not get an unnecessary extra daily dosage of salt. Then remove the lid of the vessel, put the nipples in the vessel and turn off the flame  after a couple of minutes.

 

When the water is cool enough to handle, wash your hands with soap and remove the feeding equipment.  Fix the nipples on the rims and put the covers on the bottles and keep aside for use during the day.

If you have to go out to work, you can make the milk and pour it into individual covered or sealed bottles and leave behind in the refrigerator, so that it can be fed while you are away.

How to bottle feed

                

The baby while being bottle fed, should be held close as in breastfeeding. Do not place the baby on bed and feed it like a doll.  Bottle feeding should not only provide nourishment but also warmth  and security to the child. You can also hold the baby next to your naked skin. This is specially important if the baby has been separated from you earlier on, on account of illness,  premature birth or any other reason. The mutual feedback you and your baby gets from each other at this time will build a new relationship and bond  between you both.

Before giving the bottle check, the temperature of the milk by letting a few drops of milk fall at the back of your hand from the bottle. If the milk feels pleasantly warm, it is right temperature. If it feels hot , cool it by waiting a little or standing it in a cold water. 

If during a feed you keep a bottle aside  for a little while, cover it with a special cap that comes with feeding bottle Do not let the nipples be exposed to flies or do not cover it with your hanky or towel. Avoid touching nipples with your fingers.

When feeding hold the baby fairly upright, that is head higher than the rest of the body. Hold the bottle firmly at a slant, and make sure nipple reaches way back in the baby's mouth. The nipple should always be full of milk or else the baby will take in too much air and have a lot of wind. If the teat flattens and the milk stops going through, pull the bottle gently backwards, to release the vacuum.

BREAST FEEDING AND WORKING WOMEN

Breast To Bottle

If you know you have to go back to work, it is wise to combine breast feeding and bottle feeding. At the start  give the baby a breastfeed when ever it demands a feed, except for one bottle feed in the morning around 10 AM. When the baby is two months old start introducing a routine, in which gradually cut off breastfeeds and introduce bottle feeds instead.

Start by cutting out breast feeds that are due at the time  you are likely to be away to work. By the third month you can be giving three to four breast feeds, one early in the morning and two in the evening. Or two in the morning and two in the evenings. You can also introduce cerelac / meshed bananas and bland preparations of  Khichadi / kheer / halwa / upma.

If your work is going to require you to be away for a few days on and off, switch to the bottle totally by the third month.

Liquid milk or Powder Milk

 0-6 months 

(1) From birth up to six months, those who can afford and can safely use  milk powder should prepare the formula in the proportion of 1 level measuring spoon (placed in the tin) of infant milk powder to 1 ounce (30 ml) of water.

(2) Before six months, if the choice is between liquid milk and powdered milk , one would suggest liquid milk for most poor and lower middle class families. There is less risk of  over-dilution with liquid milk than with powder milk. Traditionally, the milk is boiled before it is given to the child. Therefore danger of infection is also minimized. The child can be given two parts of pure cow,s milk and 1 part of water until she is 4 months old. The undiluted milk can be given. In case of pure buffalo milk , the cream can be removed. A teaspoon of sugar is added  to 4 ounces(120 ml) of the feed.

6 months +

If artificial milk is to be given, undiluted cow's or buffalo for children above 6 months of age. If the milk is very rich in fat, remove the cream. Some companies have started marketing' follow -up' formula in powder form for children above 6 months of age. Iron is added to some of these preparations. Follow-up formula add to the cost of bringing up  your child and no special advantage.Actually their use is not recommended. skimmed milk or condensed milk should never be given to the infants.

Frequency and amount of milk

Aim at 5 four hourly  feeds. Start with an ounce (30 ml) per kilo of weight per feed. For instance if the baby weights 4 kg give 4 ounce (120 ml) of milk every 4 hours and omit the midnight feed. If baby finishes all 4 ounces then give 41/2 ounces for the next feed. A little milk should always be left behind.

The maximum feed is 8 ounces.

Bottle or Cup Feeding

           

    

Cup feeding, feeding with an ordinary glass or a paladai (also called jhinook or bondla- a traditional small katori with a long spout is much safer than bottle feeding and is to be preferred. it is observed that of giving milk with cup or an ordinary glass to premature babies who have already developed the swallowing reflex- in other words, babies who are ready to swallow. It is only recommended that the baby should be propped up a little and offered the milk from these utensils (other than bottle) very slowly. These utensils are easier to clean.Feeding from them is preferable  even to spoon feeding which consumes more time then cup. or glass feeding. With spoon feeding, wastage of milk and the  risk of catching infection from our fingers is higher.  Special cups have a spouts with number of holes in it  are nor recommended, as they are more difficult to clean.

        

Special Precaution To Be Taken while feeding with bottle

Ensure proper sterilization  of bottles. It is better to have about half a dozen bottles, out of which one is used for giving water or fruit juice. After each feed the bottle and the teat must be cleaned in cold water with a soap or detergent. Remove any milk curd from the teat by rubbing it with a little salt. Keep the bottle aside. Keep the teat covered with the cap  that comes along with the bottle.

Sterilization : After all the 4 or 5 bottles are used, place these washed and cleaned bottles in a big pan containing cold water.. Boil for about 10 minutes. After the water is cooled, drain the water. Keep the pan covered. Whenever the bottle is to be used, wash your hands before picking up the bottle and teat.

The bottles can also be sterilized by keeping them soaked for 4 hours in water containing 5 drops of Lugol's iodine to 1 liter of water. A convenient substitute is the solution of sodium hypochlorite (available as milton or substitutes). One teaspoon (5 ml ) of this solution is added to one liter of water for sterilization.

• The milk offered to the child should be at the right temperature. Test it by putting a few drops  on the back of your hand.
• The teat should also have  a hole of the proper size. Fill the bottle with milk and invert it. If the milk comes out in drops, the hole is of the right size. If you have to shake it  or if it pours out in streams, the hole is too small or too big respectively. A small hole can be enlarged with a sewing needle. Make it red hot by holding it in the fire with the help of kitchen tongs.
• If cow or buffalo milk is used, it must be strained before being put into bottle because the cream may block the hole.
• Once a feed is prepared, it should be consumed as soon as possible. It should not be left for more than 2 hours at room temperature. However, it can be kept in refrigerator and warmed by keeping it  in a bowl of hot water for some time before offering it to the baby.
• When you buy a feeding bottle make sure that you buy one  with a wide mouth. Glass bottles are preferable, but they break easily. If you go for  unbreakable bottle , see that they are made up of thick material, are transparent and that the markings on the bottle are clearly visible.

Holding the bottle while feeding

For better bonding, the mother should take the baby in her lap, hold her close to her  and then feed her in her loving arms.  Ensure that the bottle is propped up so that the teat is kept filled with milk all the time. Otherwise, the baby will swallow air necessary.

Bottle-fed babies swallow more air then breast fed babies. They need to be burped more, half way more half way through the feed and then after the feed is over.

Never give the child the bottle in her sleep; she is likely to feel full when she gets up, and so  will never experience hunger and the joy of hunger being satisfied. It also leads to increased incidence of carries of teeth. As soon as possible try to get rid of the bottle and let your child get used to taking milk from a glass or a cup. In any case, bottle feeding should not be continued beyond 12 to 15 months.

Babies given artificial milk (including milk powder) need boiled and cooled water between feeds. They also may not get Vitamin C through the milk. So they should be given fruit juice or vitamin drops. Babies on cow or buffalo milk  also need Vitamin drops. If a preparation of multivitamin drops is used, there is no need to give extra drops of  Vitamin C 0.6 ml of most such preparation will provide the right amount of vitamin  C as well.

Most powder milk preparations have added vitamins, so babies on these preparations need not be given multivitamins.

Restrictions on the Marketing of Baby Feeding Bottles

To protect and promote breastfeeding government of India  has put certain restrictions  on the marketing of infant formulas, feeding bottles and commercial weaning foods.(these are banned)

 From Bottle To Breastfeed Totally

If you want to increase the number of breastfeeds and reduce the number of bottle feeds, breastfeeding more often will cause the release of prolactin hormone and an increase in breast milk production, Each time you are to give a bottle, first put the baby to the breastfeed, and then give the other milk with the spoon, not from the bottle. Gradually in a few days your own milk supply will build up  and you will not need the other milk at all.

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