Analysis Of The Antenatal And Postnatal Advice Given By The Midwife On The Advantages Of Breastfeeding
Midwives value breast feeding support and educating mothers on how to breast feed properly because it is a significant part of their role. However, the midwife journal (2016) states that the ways a midwife supports a woman will differ from person to person. This is because every new born baby is different, therefore the baby and the mother needs to be catered based on their needs and problems. This essay will explain and explore the antenatal advice that would be given by the midwife on the advantages of breastfeeding. Also, this essay will contain information on how the midwife supports the mother postnatally, so that the mother knows that she is properly breastfeeding.
Firstly, the role of a midwife is to look after a pregnant woman and her baby during, antennal care, labour and normal birth, and up to 28 days after the baby’s birth. Antenatal care is the care that is provided to a women whilst she is pregnant to endure the best possible care for the woman and her baby. During this time the midwife has an important job of ‘promoting’ breastfeeding and giving support to the mother based on the choices that she makes according to Battersby Susan (2014). This is why the knowledge that the midwives acquired and the way they deliver that information is extremely important. Forcefully shoving information onto the woman can sometimes be a deterrent, and lead to disempowering the woman from breastfeeding. Therefore, one of the jobs of the midwife during the antennal period is to provide information to the soon to be mother on the benefits of breastfeeding. At Kingston hospital it is thought to best give this information at the 36 weeks appointment. According to the NHS (2017) any amount of breast milk has a positive effect. The longer you breastfeed, the longer the protection lasts and the greater the benefits. Some of these benefits of breastfeeding that the midwife shares with the breastfeeding mother is that it lowers the risk of infections and disease, this is because the mother will use her own immune system to protect herself from microorganisms within her own immediate environment. Stirrat, G. (1991) and UNICEF ‘breastfeeding and relationship building’ (2016) both suggest that the baby will be protected because when breastfeeding, the mother will transfer this immunity through the lymph nodes in to the milk she gives to her baby. This is a system currently known as gastro-associated lymph tissue (GALT) and Broncho-associated lymph tissue. Other benefits include a lower risk of obesity, urinary infections, some childhood cancers, asthma, it can also Improves speech development and development patterns of baby’s brain. To add on, the benefits of breastfeeding for the baby is not the only advantages spoken about during the 36 weeks antenatal appointment. They also, provide information on the advantage of breast feeding for the mother also.
Educating the benefits of what the woman’s own breastmilk can do for the mother’s body could persuade the woman to be more open-minded on the option of breastfeeding. From personal experience at Kingston hospital, I have seen first-hand the positive effect of informing the mother that breastfeeding reduces her risk of breast cancers, ovarian cancer, osteoporosis and that it is perfect for the baby because there is no need to prepare or buy equipment. Upon hearing this, I have witnessed the mother-to-be became more enthusiastic to breastfeed. Moving on, the first 6-8 weeks after birth is considered to be the postnatal period. In agreement, the postnatal care of a woman should be a continuation and a midwife should take into account the woman’s individual needs and preferences. Its aim is to create a supportive environment in which families will be guided by professionals in how to care for themselves and their babies. It is also a time where a midwife should be able to recognise and act upon any deviation from the normal.
However, unlike in the antennal period of the pregnancy stated in the Department of Health Website (2004) the advice given to mother is completely different during postnatal. This is because the midwives now have to show the women how to breastfeed correction and education them of the science being what they do. For example the midwife had to show and inform about positioning, latching and the feeding schedule in order to effectively feed the baby. To being with, understanding the anatomy and physiology of the breast during pregnancy and after is extremely important because it allows the mother to better understand what is happening to her body and how does changes enables the breastfeeding process to start. Especially, if the midwife is to initiate a successful and happy breastfeeding experience for the women and baby. The midwife needs to explain to the lactating mother that she will supplies all the nutrients and hydration that a growing infant needs for the first 4–6 months of life.
UNICEF ‘breastfeeding and relationship building’ booklet (2016) states these hormones cause glandular tissue (alveoli) and the ducts to grow and increase in the second trimester, the breast starts to make its own milk. This milk is called Colostrum. Colostrum is thick, concentrated and yellow in colour. Once the baby and the placenta are delivered, the body will naturally starts to make more milk. Over the next couple of days, the amount of milk in the breasts of the mother make will increase and the colour will change. Alveoli where milk is produced and stored till it is released by babyís suckling. Milk travels from the alveoli, through milk ducts, into the milk sinuses (reservoirs that lie under the areola. ) There are 15 to 20 milk ducts in each breast, and milk flows from these through the openings in the nipple. On the outside of the breast. The areola is the darkened area around the nipple. It ís very important that babies latch on to the areola, not just the nipple, because that will mean that their mouth is compressing the milk sinuses. Montgomery glands, are visible as small bumps on the areola when a woman is cold or aroused. These glands produce a lubricating substance that keeps nipples moist and supple, and helps to prevent infection.
When breastfeeding, the midwife will advise the mother to wash the nipples with warm water only, as soap will wash away this protective fluid. A delicate balance of hormones is needed for the complex physiology of breastfeeding to keep start. The four hormones are prolactin and oxytocin estrogenic and progesterone. Progesterone and Estrogen prepare the breasts to make milk. These hormones are are released by the placenta during pregnancy. Their role is to increase the size and number of milk ducts in your breasts. They also prevent the body from making large amounts of breast milk until after the baby is born. After, the baby is born and the placenta is delivered, these hormones decrease. Prolactin is the hormone that peaks during early days and weeks after the baby is delivered, it helps your breasts make milk after the birth of your baby. UNICEF ‘breastfeeding and relationship building’ (2016). Frequent touch or sucking stimulates breast and nipple, which will active the milk-producing cells. This is why it is important for midwives to inform the mother of the important of breast stimulation for effective breastfeeding. Finally, the fourth hormone comes in as the baby continues to suckle, the stimulation from the nipple causes the mother’s pituitary gland, located in the brain, to produce a hormone called oxytocin. Oxytocin is the hormone that works on the breast muscles cells, causing them to contract and squeeze milk from the alveoli, into the duct, out of the nipple, and into the baby’s month. This is usually referred to as the ‘let down’ or the milk ejection reflex (MER). When the mother is stressed it can delay the ‘let down’ process, which is why it is important for midwives to tell the women to relax and show them how to properly give themselves a breast massage. Also, there is protein called feedback inhibitor of lactation (FIL) which alerts the milk-producing cells to stop making milk. When the FIL level drop then the milk production starts recommences. To add on, Hindmilk is a creamy milk that is high in fat and calories which satisfies the infant’s appetite. The opposite of that is Foremilk because it quenches the infant’s thirst. Many sources recommend that at each feeding, you nurse for at least ten minutes on each breast to ensure that you have one or more let-downs and baby gets a solid supply of hindmilk with each feeding. To establish a good milk supply, it is important to feed frequently: watch your baby for hunger cues and feed on demand. Also, let baby feed until full each time. There is no need to limit feedings, or restrict the amount of time spent feeding. You can not overfeed a breastfed baby.
On the other hand, delaying or limiting feedings, using a pacifier, offering supplements of formula or water, or attempting to put your newborn on a schedule of feeding only every 3 hours will delay your milk coming in and will decrease your milk production. You will notice that if you go three hours between feedings, your breasts may feel full and hard. At the end of a feeding, your breasts may feel ìemptiedî and soft. Always remember that you always have milk available to feed your baby. You donít have to wait till breasts are hard to feed baby even if itís only been a short while since your last feeding and your breasts feel soft, you will produce plenty of milk to feed baby as soon as you put him to your breast and he begins suckling. UNICEF (2016) states that attachment is when the baby takes the breast into the month to feed. To have a successfully attachment or ‘latch’, the baby will need to take a big month full of breast tissue. The breast most fill the baby’s mouth allowing the nipple to rest around the junction between the hard and soft palate. When the midwife looks after the women postnatally, the midwife will observe how the moth feed and correct her on the feeding. The midwife will check if the baby is attacked asymmetrically and not centrally.
Also, in relation to the anatomy of the breast the areola which is the dark area around the nipple get darker and expands in pregnancy. There are also small pimple like glands that appear on the surface of the areola which are called Montgomery’s tubercles stated in the UNICEF ‘breastfeeding and relationship building’ booklet (2016). These glands secrete a rich fluid that helps keeps the area moist. The reason why the baby knows to latch onto the breast is because those gland, when secreting the fluids, have particular scent that draws baby towards the area to feed. Neonate Antenatal screening procedures is the process that identifies babies who are at a higher risk of a disorder. Prenatal diagnosis establishes whether or not the disorder is definitely present in the unborn child. If the baby has been diagnosed with disorder, the midwife’s delivery of the breastfeeding information needs to be sensitive and understanding due to the higher risk of woman giving up the baby up for adoption due the parents not being able to look after a child with a disability. If the midwife had bad communication and did not take in the consideration of being empathetic during the antennal period of a woman who have a baby with a possible disorder, then that lack of support could lead to the her risks postnatal depression and traumatic stress disorder, . Unfortunately, a study conducted by Bolling K, Grant C, (2007) showed that the United Kingdom has the largest bottle-feeding culture in Europe back in 2007. UNICEF (2016) also showed that the United Kingdom has an entrenched bottle-feeding culture. Which is why is it vital for the midwives to be educated on what is actually inside the breastmilk. Breastmilk contains all the nutrients a baby needs for the first 3 years of the baby’s live. In fact, it contains triple the amount of nutrient of a formula, some of which a formula feed baby can never get. Some of these nutrient only found in breast milk are viral fragments, white cells, oligosaccharides, enzymes, bifidus factor, hormones, immunoglobulins and many more. Informing the mother of what is inside her breastmilk increases the duration of the mother’s breastfeeding the baby.
Adapting to the changes the mother’s body is going through is a normal part of pregnancy, but also acquiring and developing parenting skills is very essential, especially for new mothers. After the birth of the child and during the pregnancy is when a woman is more vulnerable according to Spiby, H, et al. (2003). Evidence suggest that most women are open to receiving new information. This is why during the postnatal stage a midwife needs to be very attentive to the women because as many know they usually have many questions in which they would like answered. In agreement, the midwife does help shape and developed parent for the new parenting world. This is because deciding how to feed and care for their new baby are major concerns for parent and parents-to-be. The decisions a woman makes are influenced by many factors and events that have happens in her life. Therefore, as a midwife should recognise that the woman might not have the right parenting attitude (NMC) has published ‘The code’ (2015) because you can notice early signs of neglects and depression. Furthermore, further understanding where there parenting skills is at such as their knowledge and attitude towards the baby would give the midwife the chance to target both the moth and father’s fears, in addition to answering any burning questions that they might have on the upcoming challenges of parenthood. In contrary, there are also positive signs of developed parenting skills that can be picked up by the midwife which is ensure that the mother is understanding the importance of the bond between a mother and her new born.
In conclusion, a midwife needs to differentiate the different information given to a woman during her antenatal and postnatal period of her pregnancy experience. This is because during the antennal period the midwife is mainly promoting and shines a light on breastfeeding, whilst also advising the mother-to-be on the advantages of breastmilk. However, during the postnatal period the woman might be really nervous due to her realising that she is now a mother. Nevertheless, with the support of the midwife, the women will be educated on how to breastfeed correctly. The anatomy and physiology aspect of breastfeeding should not just be for the midwife. That information should also be shared with the mothers in order for them to fully understand why proper position and attachment is vital. The nursing and midwifery council (NMC) has published ‘The code’ (2015) states that a midwife should listening to women and help the women to identify their feelings, yet still actively encouraging the women to think about their own health and the health of their babies.
