Four weeks to go - Breastfeeding dilemma – do I, don’t I?
Hannah says her baby girl is moving
like crazy – day and especially at night. I’ve heard it said that the way a
baby moves in the womb is a pretty good indication of their personality. With
both her parents self-confessed ‘firecrackers of ‘get up and go’, it’s not
surprising that Hannah’s little one will be a bundle of energy too. Time will
tell.
Hannah has been packing her bag for
the hospital. Now that she knows she will be having a c-section, there’s no
need to pack a ‘labour bag’. Only the essentials for her hospital stay which
shouldn’t be for longer than three nights.
Hannah’s hospital will supply a bag of essential ‘goodies’ like pads,
disposable panties and nappies. She only needs to bring toiletries and pj’s,
her going-home clothes, sleep-suits and blankets for her baby. Her dilemma is:
what does she pack for feeding?
If Hannah chooses to breastfeed,
she will need feeding bra’s, disposable breast pads, possibly nipple cream and
a cabbage in the fridge at home (in case her breasts are uncomfortably full on
her third day when she comes home from the hospital).
Her paediatrician has recommended
formula feeding (Hannah is HIV positive, taking ARV’s and has an undetectable
viral load – which means that there’s a possibility she could breastfeed
providing her viral load stays undetectable). If Hannah chooses to formula
feed, she needs to bring formula, bottles, teats and all the necessary feeding
and sterilising paraphernalia. This is because maternity hospitals no longer have
a ‘milk kitchen’ for formula-fed babies. This is because all women are
encouraged to breastfeed.
This is a toughie for women like
Hannah. In the first place, not every woman WANTS to breastfeed and women
should ENJOY their babies and not feel OBLIGED to breastfeed. An example of women
who can’t breastfeed is those who have had a breast reduction – especially if
the nipple was removed and reattached. Similarly, depending on the type of
surgery, women who have had a breast enlargement or treatment for cancer such
as a partial mastectomy or reconstructive surgery. There are also medical reasons,
such as severe type 1 diabetes, certain auto-immune diseases or conditions requiring
chronic medication like epilepsy.
Weighing
up the pros and cons:
Hannah worries that if she doesn’t
breastfeed, she will miss out on ‘bonding’, and the convenience of having milk
‘on tap’ – especially at night when she can simply lift her baby from the crib,
and latch her. MOM (Mother’s Own Milk) is custom made for each individual baby
which means not having to stress about which formula to use. Another bonus is
that breastmilk changes according to the baby’s needs. (To learn more about
breastfeeding, simply type the word breastfeeding into the subject line on the
blog dashboard)
On the other hand, if Hannah
chooses to formula feed, her partner, mom or sister can feed her baby – a
satisfying and bonding experience for them. Formula feeding means that you
don’t need to ‘wear your baby everywhere you go. Breastfeeding in public is
still taboo – especially in restaurants where the strongest objectors are men.
Formula-fed babies adapt more easily to a routine, and moms are spared discomforts
like engorged breasts, cracked nipples or a hungry baby when the milk supply is
low.
This is Hannah’s choice. My only
advice for her (and all other women facing this dilemma) is: trust your
instincts. This maternal instinct is a gift of motherhood. Learning to
trust your instincts is the first and most important lesson you’ll learn. It
comes naturally. Do you remember what happened 9 months ago? You realised that
something was different – and instinctively asked ‘Am I be pregnant?’
Breastfeeding
and Covid-19:
According to Professor Priya
Sama-Pillay, head of obstetrics and Gynaecology and the Research Centre on
Maternal, foetal and new-born and child health, Pretoria University, pregnant
women should be vaccinated (preferably at or after 14 weeks), breastfeeding
women can be safely vaccinated and shouldn’t stop breastfeeding.
Women who contract Covid-19 and are infectious can continue breastfeeding, but should be extra cautious – wearing a mask and sanitising. If she is unwell, she can express her milk, (this is safe to feed to her baby) taking all the necessary precautions to prevent contamination.
Photograph: Aloise Ireland
