Kenya Is Latching On

Many mothers understand the slogan that “Breast Is Best” because the benefits of breast milk and breastfeeding to both baby and mother are well documented. For instance, breast milk provides babies with essential nutrients and antibodies that cannot be found in any other substitute, including infant formula milk. The act of breastfeeding not only promotes bonding but also triggers the release of hormones within a mother that can lower the risk of her getting certain cancers and diseases.

Fortunately, the benefits of breastfeeding extend beyond baby and mother, to society at large. This is the message that is being spread during this year’s World Breastfeeding Week celebrations that will be held from 1st – 7th August 2016.

wbw2016-logo-wordThe purpose of the celebrations is to anchor breastfeeding as a key to sustainable development by 2030, so that by understanding how breastfeeding links to the Sustainable Development Goals (SDGs) proposed by the United Nations, we can also truly understand why “Breast is Best”.

Of the 17 SDGs proposed by the United Nations, Kenya chose to focus on the 5 goals that matter most to the country, namely:

  1. Health
  2. Agriculture and Food security
  3. Employment and Enterprise
  4. Universal Education and Gender
  5. Environment

These 5 goals are echoed in the main themes of this year’s World Breastfeeding Week:

  1. Nutrition, Food Security and Poverty Reduction
  2. Survival, Health and Wellbeing
  3. Environment and Climate Change
  4. Women’s Productivity and Employment

wbw2016-anim

Breastfeeding impacts on the goals and themes listed above through the benefits it provides to babies and mothers. For instance, for low-income families, a mother who is able to exclusively breastfeed her baby for the first 6 months of life saves money because breast milk is ‘free’ and she does not need to look for or buy additional food for the baby. Also, the high nutritional value of breast milk and the antibodies it provides increases the chances of a baby’s survival because it reduces the chances of a baby developing diseases such as diarrhea, thus also reducing the money spent on health care and time a mother has to take off work to look after her baby.

wbw-what-lawmakers-can-doIn Kenya, the impact of breastfeeding on women’s productivity and employment was highlighted when Parliament approved a bill forcing employers to provide special breastfeeding areas for working mothers . By doing so, productivity will increase because a working mother will be able to focus on meeting her goals at work and at the same time, provide the nutrition her baby needs to remain healthy.

In relation to the environment and climate change, breast milk does not require the construction of factories and it does not contribute to littering because its packaging is ‘natural’, not in plastic or metal tins. The use of substitutes usually also requires a sustainable source of clean water and additional resources, which may not be accessible to a mother with little to no income.

It is for the reasons listed above, and many more, that a group of breastfeeding counsellors and lactation educators are using the slogan #KenyaIsLatchingOn to raise awareness about the far reaching benefits of breastfeeding and its impact on sustainable development. We have promised to protect, promote and support breastfeeding because we understand how breastfeeding can help Kenya meet its Sustainable Development Goals (SDGs) by 2030.

During World Breastfeeding Week, we will be visiting maternity wards at 2 major hospitals in Nairobi to spread the word amongst mothers and the staff. As qualified breastfeeding advocates, we know we can contribute to the efforts being made to meet the SDGs by providing mothers with the information and support they may need to exclusively breastfeed their babies for the first 6 months of life, and in addition to the appropriate foods, until their children are at least 2 years old.

HAPPY CELEBRATING!

 

Best Parenting Book

I am part of a parenting support group on Facebook, and one mum recently asked “…if you could recommend 1 good parenting book, what would it be?”

I quickly wanted to type… “Mine!”

Not that I’m an author mind you or an authority on parenting but I am a mother of 2 beautiful boys and thanks to them, I’ve been able to “write” my own parenting books. I have not done it alone of course and I’ve used other published well-renowned authors as references but my babies have been too unique to follow one particular book.

stack of books

My oldest son is 2 and a half and I’m still writing his book. His brother is 11 months and I’m also writing his! Why 2 different books? Well it turned out that whatever I’d written about “The Boss” wasn’t really applicable to “The Deputy”. The latter had his own routine, his own likes and wants, his own quirks and irritations, therefore I needed to write a whole new book for him and use completely different reference points. Out went the “What to Expect” series and in came “The Great Oracle” a.k.a Google. It was un-nerving because my issue was no longer how to get him to sleep through the night by 8 weeks, I now just needed him to sleep for at least 2 hours on his own, out of my hands. Boy! What a book it has been!

I really wish my boys came with manuals… right after delivering the placenta, I wouldn’t have minded a neatly wrapped book that explained what each one needed and what I should do in certain situations but since that’s not the case, I’ve come to realise that’s why the parenting books are so many… because every parent does it differently and if what they do works for their children and their friends’ children then Hey, Presto! you can write it all down and have it published.

Don’t get me wrong, I have the books… 2 of Gina Ford’s, the What To Expects, Dr. Sears and thanks to Kindle and iBook, I can start a library filled with parenting books. Somehow, however, one book hasn’t been sufficient because it is “too strict, too lax, too confusing, or too unrealistic”, always “too something”, until I realised that I can pick and mix! I can pick what I feel works and what baby/toddler responds to and mix it in. And there folks is how I started writing my own well-referenced book!

Will I publish my books? I don’t think so but I can use them to help those around me. Most importantly, they’re a lovely reminder of how far I’ve come with my boys and I know I’ll constantly be adding new chapters to them. If my mum is anything to go by, I pray that I’ll still be writing my parenting book for the next 50 years and beyond!

Happy Parenting and Writing!

Josie Karoki originally published this post in 2012 on her personal blog. It has been edited and used with her permission.

Basics of storing expressed breast milk

Now that we’ve gone through the basics of expressing breast milk, it’s important to also know how to store and thaw the milk so that it is safe for use by your baby immediately, the next day or even after a few weeks.

The Academy of Breastfeeding Medicine recommends using the following guidelines for storing expressed breast milk (EBM) for healthy term babies.

ABM milk storage guidelines

By following these guidelines, you can be sure that all the important nutrients in the breast milk are preserved and bacterial contamination is minimised.

Therefore, if you’re a working mum or away from home and your baby for a long period of time and you’ve expressed during the course of the day, you can either store your expressed breast milk (EBM) in a refrigerator or if you don’t have access to one, you can use an insulated cooler bag with ice packs. This is especially important if you’re likely to take a while before getting home to refrigerate the milk or to feed it to your baby.

V-COOOL-large-ice-pack-cooler-bag-double-breast-milk-storage-bag-backpack-eight-colors-mother

 

Some insulated cooler bags come with their own ice pack(s) that are placed in the freezer then removed as and when required for use without the need to add water to the pack. These tend to be less messy than “home-made” ice packs because when they begin to defrost, they won’t leave pools of water or spill out.

 

However, if you’re unable to find an insulated cooler bag with ice packs or if they’re too expensive, you can still buy a basic cooler/thermal lunch bag and make your own ice pack using zip-lock bags which you then add water to and freeze.

When you’re ready to leave the house for work in the morning, remove the now frozen ice pack, place it in the cooler bag and it should still be frozen once you’re ready to store your EBM in the bag.

TIPS FOR FREEZING AND THAWING/DEFROSTING EXPRESSED BREAST MILK

  • Avoid filling storage bottles/ bags to the brim in order to allow space for possible expansion when the milk freezes.
  • Label the bottle/bag with the date you expressed the milk so that you can follow the “first in, first out” rule. This means that with the earliest date should be used first because it has been in the fridge/freezer for the longest.
  • Avoid storing breastmilk in the refrigerator door. Store it in the lower back area of the refrigerator, where the temperature is coolest.
  • Expressed breast milk can be used straight from the fridge or it can be warmed gently by placing the bottle or bag in a bowl of warm water.
  • Thaw/defrost frozen breastmilk in the refrigerator overnight and use the milk within 24 hours of removing it from the freezer.
  • You can also thaw/defrost the milk quickly by placing the bottle or bag in a warm water (max. 37° C).
  • Defrosted milk should be used within a few hours to avoid contamination.
  • DO NOT thaw/defrost frozen breastmilk in a microwave oven or in a pan of boiling water because microwaves do not heat evenly, and exposure to high temperatures can destroy essential nutrients and antibodies in the expressed breast milk.
  • DO NOT return defrosted breast milk to the fridge for a later feed if the baby does not finish it the first time, and this also applies to freshly expressed breast milk. As long as the baby’s mouth has come into contact with the milk, any left overs should not refrigerated. If you are afraid of wastage, store your expressed breast milk in smaller quantities.

HAPPY STORING!

 

Express Yourself

As a new mum, especially a working mum, you may be wondering how you’ll be able to exclusively breastfeed your baby for the first 6 months of life and partially thereafter, if circumstances keep you away from your baby for extended periods.

Fortunately, there is a way of ensuring that breast milk remains the only form of nourishment your baby receives in your absence, and this is by expressing your breast milk.

Expressing breast milk is the act of emptying the breast without your baby suckling. It can be done using the following methods:

  • By Hand
  • Manual Breast Pump
  • Electric Breast Pump

Hand expression is the cheapest and most convenient method because it doesn’t require any special equipment and can be done anywhere so long as your hands and your surroundings are hygienic. All you need is a sterile container to collect the milk in.

Expressing by hand can however be a difficult technique to master because it requires you to massage and compress the milk ducts behind the nipple rather than the nipple itself.

Some common mistakes mums make when hand expressing are rubbing the skin on the breast and/or squeezing the nipple but this only hinders the flow of milk.

The most effective technique is to:

Hand-expressing-breast-milk

  • Massage the breast with the palm of your hand to stimulate let down
  • Place your thumb and forefinger on either side of your nipple at the edge of the areola
  • Using your thumb and finger, gently press your breast tissue back towards your chest wall and compress forwards. By doing this way you’re moving back along the milk ducts and pushing the milk forward.
  • Continue pressing back and compressing in a rhythmic massaging movement until the milk begins to flow but take care not to move your fingers onto the nipple otherwise you might block the flow of the milk.
  • Keep changing the position of your fingers around the breast to ensure you empty all the ducts.
  • Once the milk flow slows down, change to the other breast. Keep alternating between both breasts until the compression no longer trigger a substantial let-down or flow.

Here is a link to an informative video on how to hand express: http://newborns.stanford.edu/Breastfeeding/HandExpression.html

In the beginning it can be time consuming and tiring but once you master the technique, hand expression is the best way of making sure you collect the most milk.


Breast pumps are designed to mimic the suckling action of your baby thus stimulating the let-down reflex automatically.

Majority of pumps have a suction cup at the top (which is placed on the breast) and attached to a container for collecting the expressed milk.

manual and electic pumps

 

Manual breast pumps have a handle that needs to be repeatedly squeezed in order to extract the breast milk whereas electric breast pumps have motors that are mains and/or battery operated and automatically run the pump.

The best pump for you will depend on:

  •   How often you intend to express you breast milk
  •   How much time you’ll have for expressing

If you only intend to express occasionally, for instance once or twice a day, a manual pump and hand expression are most suitable.

If however, you need to express 3-4 times a day and with a limited time period to do so, an electric breast pump is most suitable.

If you’re expressing on more occasions than you are breastfeeding, for instance, you work far from home or you have multiples or a baby who cannot latch on well, a double electric pump is advisable.

pumping at work
Woman using a double pump to express milk at her work desk. Photo courtesy

 

Key Tips:

  • Expressing should not be painful
  • Take time to learn how to express your breast milk properly. As with breastfeeding, expressing is a learned skill and be prepared to seek professional help if necessary.
  • Expressing can be used to stimulate and increase breast milk supply by increasing the frequency with which the breast is emptied.
  • Aim to express or breastfeed every 3-4 hours in order to maintain your milk supply. The longer you leave it before emptying your breasts, the less your body will produce.
  • The best time to express your milk is between midnight and 4am when the level of prolactin (the milk producing hormone) is at its highest.
  • Use the hand expression technique at the beginning of a breast pumping session to stimulate the let-down reflex and at the end to ensure you completely empty the breast.

 HAPPY EXPRESSING!

 

Breastfeeding Positions

One of the key components of successful breastfeeding is positioning. It is important to ensure that both mum and baby are well positioned. As explained on this page, the baby needs to face the mum’s body (tummy-to-tummy) and the mum should be able to give the baby face-to-face attention and make eye contact during the feed. Mum also needs to be seated in a comfortable position with her back supported in order to avoid developing aches and pains due to poor posture.

Breastfeeding positions
Photo courtesy

As shown in the illustrations above, there are many ways to position your baby when breastfeeding but regardless of the position in which the baby is held, mum and baby’s bodies are touching with no barriers between them, and mum is able to make eye contact with the baby.

It is also possible to see that even in the different positions, baby’s ear and shoulder remain aligned with each other, meaning that the baby’s head and body are facing the same direction, and this is important because the baby will not have difficult swallowing. To understand this better, turn your head to the left or right as your body is facing forward and then try to swallow. Can you feel how uncomfortable it is? However, when your head and body are facing the same direction, with ears aligned to the shoulder, the neck and throat are not twisted and swallowing is comfortable.

Newborns are unable to correctly position themselves because they have no control over their neck muscles, so it is important to make sure from the beginning of a feed that both the body and the head of the baby are facing the same direction and most importantly, that they are facing the mum’s body.

Breastfeeding_positions_PI
Photo courtesy

These second set of illustrations above demonstrate how to hold a baby in the different positions and they also clearly show how a mum should hold her breast when supporting it during a feeding. It is important to position the fingers and thumb to form a C shape because this allows a mum to support the breast without her fingers getting in the way of the baby’s latch or restricting milk flow.

scissor hold
Photo courtesy

Unfortunately it is common to see mums supporting their breast using the “scissor hold”, which is when the aureola is held between the forefinger and middle finger.

This is NOT the recommended way to support the breast because:

* the fingers can get in the way of a baby’s mouth when latching

* it can also lead to restriction of flow if the fingers inadvertently press together during a feed.

Good positioning helps to achieve a deep latch and can prevent nipple pain, therefore a mum should not be afraid to experiment with different positions illustrated in this post as long as she sticks to the basic principles of holding her baby and breast that have been highlighted above.

HAPPY BREASTFEEDING