Gynecology And Obstetrics-

Breast milk

composition

Most breast milk consists of water. It contains substances such as carbohydrates, proteins, fats, minerals, trace elements, vitamins, hormones and immune cells.
The main sources of energy are fats, which can be optimally absorbed (absorbed) by the simultaneous presence of the splitting enzyme lipase. During breastfeeding, the composition, amount and even the taste of the milk changes.

In the first few days after the birth, the breasts contain colostrum. This has a slight laxative effect, so that the first bowel movement can occur soon. Its composition is very well adapted to the untrained stomach of newborns. It contains relatively little fat and carbohydrates, but a lot of protein, vitamins, minerals and, above all, immune cells.

After about four days, the Foremilk the Transition milkwhich turn after about a fortnight of the mature Breast milk is replaced. During these transitions, the content of proteins and minerals decreases continuously, while the carbohydrate and fat content increases in a compensatory way in order to meet the infant's higher energy requirements. The consistency of the Breast milk becomes more fluid and the color lighter.

When breastfeeding, the thin, thirst-quenching front milk comes out of the breast first (see also female breast) in the milk lakes behind the Areola is saved. The child then sucks the more substantial and filling one Hindmilk, from the posterior parts of the mammary gland.

Fluid needs of the child

The fluid requirement in a healthy newborn is determined by the Breast milk sufficiently covered. Even on summer days, no additional fluids are necessary - the child will meet their increased fluid requirements by drinking more often.
An additional fluid supply can even overload the small stomach and disturb the milk production - by less frequent application.

Proper suction

With correct suction / Breastfeeding the child's lips are turned outwards and also enclose the areola. Its face is close to its chest and its cheeks are plump. If this is not the case, i.e. lips are turned inwards, the cheeks are rather drawn in or only the nipple is sucked in, the child is drinking incorrectly. Nipple pain should also only occur briefly, if at all, when you start breastfeeding.

Since wrong suction easy to Lack of milk, Milk congestion or inflamed nipples, breastfeeding should be briefly interrupted. To do this, the little finger should be gently pushed into the corner of the child's mouth so that he can let go of the chest and try again.

Note: nipple mess

The wrong sucking on the chest can also be called a so-called Nipple mess occur. This occurs when feeding with a bottle and when using pacifiers or nipple shields. Since these objects require a completely different suction technique than sucking on the breast, the child can become confused and practically unlearn how to suckle correctly during breastfeeding. It is therefore important, especially in the first six weeks after the birth, to forego these suction aids and to use cups, syringes or special breast feeding sets instead. If possible, these should only be used if supplementary feeding is really necessary, since breastfeeding alone is the best learning method for correct suction technology.

"Expressing" breast milk

The breast can be emptied manually or with a pump.

Pumping down is suitable for bridging when Breastfeeding temporarily not possible as well as to create a supply Breast milk. Care should be taken to ensure good hygiene. Hands should be washed before expressing breast milk and the pump should be put in the dishwasher afterwards.

Is it a sick or premature baby, the hygienic measures should be tightened. Daily showering and daily bra changes as well as a brief cleaning of the breasts directly before pumping are recommended.
The first expressed drops of breast milk should be discarded and the pump boiled. Which pump is suitable depends on the requirements. With regular use, an electric pump is used to pump out the Breast milk makes sense. As soon as a pump is necessary from a medical point of view, a pump is available on prescription.

The breast should be warmed up and / or massaged slightly before pumping. Pumping both breasts at the same time stimulates milk production particularly well, but is only possible with a double pump. With a single pump, the side must be changed after a few minutes and the process takes about twice as long as with the double pump (30 min).

Hand emptying is particularly suitable for relieving the breasts when there is too much breast milk. As a result, the pressure decreases and, in contrast to the pump, milk production is not stimulated. Before doing this, warmth and a light massage are useful. During the subsequent emptying, the nipples should never be touched - the pressure is only ever distributed around the nipples.

Like in C handle First, the milk lakes in the immediate vicinity of the nipples are smeared with the thumb, index and middle finger. Then the fingers should be placed again in a radius of a few centimeters around the nipple. The thumb is again above, the index and middle fingers below the nipple. Now the chest is lifted rhythmically one after the other, with the fingers against the Rib cage pressed and then thumb and forefinger pressed forward against each other.

Proper storage of breast milk

Breast milk should be stored in plastic or glass containers with screw caps. As a check, these should also be provided with the date and time the breast was emptied.

If the frozen milk is to be brought from one freezer to another, the cold chain must not be interrupted (Cool bag !). For the ingredients, it is best to thaw the frozen milk in the refrigerator for 24 hours. However, if it has already been opened, it will only last 12 hours in the refrigerator. Alternatively, frozen milk can also be heated in a hot water bath, however never in a microwave. Milk that has already thawed must not be refrozen and warmed breast milk should be thrown away completely.

Info: Shelf life of mother me

At room temperature the Breast milk only about seven hours, in the refrigerator (4 ° Celsius!) can be kept for up to eight days. Breast milk stays in the freezer for around two weeks and in a freezer (-18 ° Celsius) for half a year.

To feed

If additional feeding is necessary in the first four to six weeks, but weaning is not desired, one should Bottle application can be avoided (Nipple confusion, see above).
In this case, one is best Breast feeding kit. The mother carries a bottle with additional food around her neck, from which two small tubes lead to the right and left breasts. The child drinks breast milk and additional food at the same time and stimulates milk production.
Injecting some milk into the child's mouth with a small syringe (Finger feeder) directly on the chest is possible. If both do not work, you can use one Cup or spoon be fed. The child should lick the milk out of the cup himself. These methods have the disadvantage that milk production is not stimulated.

Becomes a Adding solid food necessary (ideally only after the 6th month), this should be done slowly and in stages. Another milk meal should always be replaced by a porridge meal after one month. The ingredients must be tried out, which the child likes and gets. If the child rejects the porridge at first, it can be fully breastfed again and another attempt can be started a few days later. If the porridge is prepared yourself, the ingredients should come from organic farming.

You should start with one Vegetable puree, to which potatoes and meat or alternatively whole grains and fruit are added later. You should avoid any kind of spice (including salt and sugar!). Potatoes and parsnips, as well as carrots and pumpkin, are particularly good vegetables. The amount per meal should be increased from about five teaspoons to about 200 grams. If you do not breastfeed after the meal, about a tablespoon of sunflower oil should be added to the meal.

An evening meal is a good second meal Milk and cereal porridge. The grain should be up to the tenth month gluten free (buckwheat, millet, corn grits), then wheat and oats and after the first year of life also rye can be fed.
So that the iron can be well absorbed from the grain, some fruit should be added to the porridge.
The third meal is a pure one Cereal fruit meal in question.
In between, the child can be given some solid food to practice, such as pieces of fruit or rice cakes, so that they can participate in meals at around the age of twelve months.