Prolongation of breastfeeding.

Although some scholars believe that exclusive breastfeeding only up to four months would be adequate to obtain sufficient protective effects for mother and baby; others, on the contrary, maintain that until there is more evidence, the ideal indication for exclusive breastfeeding is up to 6 months, as recommended by the World Health Organization.

Contraindications of Breastfeeding

Breastfeeding is contraindicated only in a small number of unavoidable situations in which its practice may put the mother or child at risk of illness. In any case, the mother should ask the doctor for information about any type of medication or medical treatment she is following, since some of them -drugs, chemotherapy, etc.- may affect the infant. When in doubt, the mother should consult her doctor and never stop breastfeeding on her own.

Some absolute contraindications are: maternal cancer, chemotherapy, tuberculosis, drug addicted mothers and mothers with severe psychosis, among others.

How can the mother continue breastfeeding after returning to work?

Mothers who return to work and continue breastfeeding often manage to prolong breastfeeding longer than stay-at-home mothers. Each family will need a plan to adapt breastfeeding to the needs of the working mother and baby.

Since babies older than three months do not need more than 30 minutes for each feeding, some mothers may be able to go to the baby's place two or three times a day or wait for someone to take them to work to breastfeed. They may also express milk before going to work and have the father or someone else give it to her while she is away.

After the child is six months old, it would be easier, since supplemental feedings could be planned during the hours when the mother is at work and the rest of the time she would continue with breast milk.

Can breastfeeding be reestablished after interruption of breastfeeding?

Any mother can reestablish breastfeeding -relactation- after having interrupted it for a few days, weeks or even months, as long as she has sufficient motivation, the support of her partner or family and the guidance of health professionals.

To achieve latch-on, the mother should follow the following advice:

• Put the baby to the breast every one to two hours, even throughout the night.

• The baby should remain on each breast as long as desired.

• Ensure that the baby latches on correctly to avoid nipple trauma, empty the breasts completely and stimulate milk production.

• If it is necessary to use complementary artificial milk, it should be given to the baby with a cup, since the use of bottles or pacifiers would cause confusion when sucking the breast, reducing the amount of milk that can be extracted.

Can adoptive mothers manage to breastfeed even if they have never had offspring?

Yes, many women who have never had offspring are able to breastfeed without supplementing their babies with formula.

Myths about breastfeeding

Small breasts produce less milk

• Milk production does not depend on the size of the breasts, but on the needs of the baby; if the baby suckles more, milk production will be greater.
• That is why small breasts, being easier to suckle, can produce more milk than large breasts.

Nipples should be washed before and after breastfeeding.

• It is neither necessary nor recommended to wash the breasts before or after breastfeeding. The mother's daily general body cleansing is sufficient to maintain proper breast hygiene. The substances that surround the nipples produce odors that attract the baby and also contain germs that help develop the baby's immune system.

During breastfeeding, the mother will suffer from sore nipples.

• The aches and pains that mothers experience in the first days of breastfeeding are transitory. As the days go by, both mother and baby adapt their posture and latch on to the breast until all symptoms of discomfort are eradicated and breastfeeding is also pleasurable for the mother.

Whenever the baby cries after breastfeeding, it is because the mother does not have enough milk to feed the baby.

• The causes of crying may be various, the most common being colic, which is generally caused by intestinal immaturity. When the baby cries, it is recommended that feedings occur more frequently; in addition, while the baby cries, he/she should be held with the head resting on the mother's or father's shoulder, while the baby's back is massaged.

Immediately after birth, the baby should be taken away from the mother to rest.

• It is recommended that babies be placed on the mother's breast within the first half hour of life. This practice helps to establish exclusive breastfeeding and contributes to the intestinal colonization of the newborn by beneficial bacteria from the mother's microbiota that protect against infectious diseases.
• The first approach is very important even if the baby does not manage to drink a drop of milk, since the skin-to-skin contact will favor milk let-down and stimulate the baby's reflexes so that he/she will begin to suckle as soon as possible.

If you start giving your baby formula milk, he/she will no longer accept breast milk.

• It is possible to give formula milk to the baby and continue to breastfeed successfully if the mother continues to offer the breast to the baby as often as possible. The mother should keep in mind that the introduction of other types of milk into the infant's diet should be guided and supervised by the pediatrician.

Breastfeeding is not possible if the mother is sick or taking medication.

• Mothers can continue breastfeeding when they are sick as long as the doctor authorizes them and guides them to the appropriate treatment. It is also necessary for the mother to inform the doctor of any other medications she is taking.

If you return to work, you will have to wean your baby.

• If the nursing mother has the support of family members and coworkers, she can continue to offer breast milk to the baby even if she returns to work.