OUR BABIES

Northern Advocate, 7 February 1925, Page 2 (Supplement)

OUR BABIES

By Hygeia.

Published under the auspices of the Royal New Zealand Society for the Health of Women and Children. "It is wiser to put up a fence at the top of a precipice than to maintain an ambulance at the bottom." BREAST-FEEDING. Use of Both Breasts at Each Nursing. Our readers will remember that the mother whose letter we dealt with last week referred to a case where a young mother had tried to carry out the advice to empty one breast before giving the other to her baby, and how she could never tell exactly whether she had emptied the first breast, as it always seemed that some milk remained, and so she put her baby to the same breast again. Our correspondent had had a similar experience, and she was advised by Dr. King to allow her baby to suckle each breast for the same length of time. After doing so, all went well, and there was no further trouble. Naturally she advised the mother who was in difficulties to do the same, and the result was good. This week we shall discuss the circumstances in which a baby may be allowed an equal time at both breasts at each feeding in spite of the fact that ingeneral it is better to practically ensure the emptying of each breast at alternative feedings by allowing the baby a longer time at the breast first used at each suckling.

EXTRACT PROM "THE -EXPECTANT MOTHER." The following extract from "The Expectant Mother and Baby '8 First Month" shows what commonly proves most satisfactory—viz., allowing the baby to nurse about twice as long at the breast first used at each suckling as at the other breast. NORMAL BREAST-FEEDING. Mothers are generally told that after the first week the baby must be given only one breast at each nursing —the breasts being used at alternate nursings. This advice was not unreasonable where the mother was instructed to nurse every two hours (as was the general custom until comparatively recently) and if her milk supply tended to be excessive. But, when four-hourly nursing is adopted from birth (as now recommended) the rule should be: VtTse both breasts at every nursing." « This means drawing off the milk from each breast every four hours—the same frequency as when the .breasts are suckled "alternately" every two hours. In general'the baby should remain at the second breast

only half as long as lie lias taken at

the first. ROUTINE FOE FOUR-HOURLY FEEDING. The mother should be told to change the order of using the breasts at each nursing: thus, if she nurses at 6 a.m. and 10 a.m., and the right breast is used first at the 6 a.m. feeding, the left breast should be used first at the 10 a.m. feeding, and so on. By this procedure each breast is both stimulated and relieved every four hours in the daytime (five times daily); and at every second nursing one breast is more or less completely emptied, because the sucking tends to be twice as vigorous and effective in the first five minutes as in the second, and to lose force steadily the longer the baby nurses. Even where the breast supply exceeds the needs of the baby, there is no ground for departing from these instructions. All the mother needs to do to prevent the baby taking too much is to shorten the time allowed for nursing—reducing the suckling if necessary to seven minutes at the first breast and three minutes at the second; and if too much is taken even then, withdrawing the nipple several times, or squeezing it so as to lessen the supply still further.-

I The idea that the above course ; ipight sometimes cause the baby to get [ slightly less fat than would be deI eirable (on the ground that the final "stoppings" are richer in cream) is 1 fallacious, for two reasons:— 1 (1) If the supply of milk is excessive it tends to fall off quickly to the baby's daily need provided he is put to the breast regularly and only at the right time. (2) In the' first week or two of life, a slight lowness of the proportion of fat is beneficial, rather than otherwise, because fat tends to tax the digestive power of the new-born babe more seriously than the other food elements. NOTE ON FOUR-HOURLY INTERVALS. Doctors who advise three-hourly feedings sometimes contend that with fourhour intervals the in creased quantity of milk taken into the baby's stomach at each feeding causes distension. Nothing of the kind takes place. Rontgen rays proved long ago that while the milk is passing into stomach and curdling at one end, why fluid is passing out of the other end into the intestine, ao that the stomach is not j asked to accommodate the whole of the j meal, but only as muQh curd, etc., as j it can hold and deal with conveniently j and satisfactorily. Further, it takes j

from two and a-half to three and a-half hours for the stomach to complete its work on the curd. On every ground the longer interval is preferable j the stomach needs a rest between meals. COMMENT BY "HYGEIA." From the fact that, generally speaking, a baby draws off much more milk from the breast during the first five minutes of nursing than in the second, and that proportionately little is usually drawn off in the third period, it is suite clear that even where equal times at the two breasts are allowed at each suckling the baby tends to draw off much more from the breast first used and may practically empty it. On the other hand, if the amount of milk present in both breasts is only about sufficient for each meal, the baby would tend to do better if allowed at least as long at the second breast as at the first, possibly 'even longer. Seeing that there are variations in the available supply on the part of the mother and variations in the relative vigour of sucking of different babies in the earlier and later stages of each nursing, it is impossible to lay down definitely what will prove most suitable in a given case. However, taking into account the foregoing facts, it seems clear that, generally speaking, the baby will do best if the total suckling occupies not more than 20 minutes and not much less than 10 minutes. The average time allowed at each breast may be twice as long at the first as at the second, but in special cases a baby may do better if allowed equal times - " at each breast. If the baby were not doing satisfactorily with either method, the Plunket Nurse could arrange for weighing the baby before and after nursing, and noting the quantity drawn off at each nursing, when different relative times were allowed —■ thus arriving at a definite conclusion.