WORLD BREASTFEEDING WEEK(WBW), 2023

 WORLD BREASTFEEDING WEEK (WBW), 2025.

Welcome again to the 2025 global week of awareness for breastfeeding.

THEME: Prioritize Breastfeeding.

Breastfeeding of newborns remains part of their fundamental human rights, and Exclusive breastfeeding is encouraged no matter the perceived difficulty.

Exclusive Breastfeeding entails giving a newborn only breast milk(BM) till at least 6 months of age before incorporating other foods (Complementary foods), while continuing the breastfeeding to 1-2yrs based on capacity & other factors.

There are a lot to talk about here, but i would like this piece to be short & comprehensive.

Why Do we discourage/restrict administration of water to newborns other than breast milk?

Why do we encourage emptying one breast first before feeding the other?

Just patiently read to the end, I'll remember to answer these two questions & maybe more in your mind, satisfactorily.

First of all, let's briefly delve into breast milk components.

Due to changes in appearance & Nutrient composition of breast milk(BM) during the months of breastfeeding, BM could be categorized into three: Colostrum,  Transitional milk & Mature Milk.

1.) COLOSTRUM:

This BM category flows from delivery to about 6 days. It is thick & yellowish. It's as well rich in nutrients, antibiotics, immune system cells & enzymes.

The nutrient content of Colostrum is about 5x that of the Mature milk; high vitamin A & antibodies for fighting infections as the baby's immune system is still immature. An instance is immunoglobulins(Igs) & Lactobacillus bifidus factor(which grows the L. bifidus). These bacteria inhibits the growth of some pathogenic organisms in juvenile guts of the newborns. Also, Igs are not absorbed but wage war against pathogens that enter the juvenile gut.

Some people especially in the olden days, ignorantly discard this milk category(colostrum) because of its colour & consistency. This is absolutely wrong & should be discouraged, as this milk is rich in Human milk Oligosaccharides (HMOs), which strengthens the intestinal health of breastfed newborn, and much more concentrated nutrients.

2.) TRANSITIONAL MILK:

As the name sounds, this is when the milk is trying to change (transit) from colostrum to Mature milk.

This milk flows from the 7th day of delivery to the 10th day. It is just a period of transiting to mature milk.

The nutrient content & concentration of this milk category is lower than colostrum, but higher than mature milk.

3.) MATURE MIK:

As the name implies, this is the category of milk that is mature & is expected not to undergo further drastic change(s).

Mature milk starts coming up from 10th day of delivery till the cessation of breastfeeding.

Mature milk can be further categorized into 3 as: Fore Milk, Intermediate milk & Hind milk.

a.) Fore Milk:

This is the first aspect of mature milk that flows out while breastfeeding with mature milk. It is about 60% of the milk volume.

It is watery, resembles skimmed milk(fat-free milk) & satisfies the baby's THIRST. This is the answer to the first question i asked earlier. With fore milk, there is no need for water while breastfeeding; since all the water needed by the baby is naturally imbedded in the fore milk of the BM. Giving water can deprive the newborns of more nutrients as their little stomach will be occupied with the water & the lowly nutritious fore milk. No other space to accommodate other.

b.) Intermediate Milk:

This is similar to full cream milk. It contains high proportion of fat.

It starts flowing out immediately after the fore milk & supplies the baby with energy. It is far more nutrient dense than fore milk.

c.) Hind Milk:

As the name implies, this is the last category of mature milk. It is the last to flow out during breastfeeding.

Hind Milk is highly creamy & concentrated, satisfying the hunger of the newborns.

Hind Milk, which starts being released from 10-20 minutes into feeding, is the highest energy & nutrient dense category of Mature milk.

By implication, the newborns are expected to be nursed long enough to be able to access this hunger-satisfying Hind Milk.

Now, back to my 2nd question above.

I always encouraged parents in postnatal clinic to always try emptying one breast before going to the other. I discovered that many mothers routinely feed both breasts halfway to maintain postural balance (according to them).

Not emptying one before going to the other means depriving the newborns access to part of intermediate milk & then Hind Milk.

It means giving the newborns double access to fore milk once, which is more water with very little milk. It won't be long and this child will start looking for more food.

Some accuse some children of sucking too much, but in this case it is not their fault but yours; let me be their jury for now.....Lol.

Even when an  adult is hungry, rather than eating food, if this adult fills his/her GIT with only water, the brain could be temporarily deceived into stopping hunger hormone signalling, but it won't last long.

Moreover, apart from energy & essential fatty acids, part of intermediate milk & Hind milk is where the HMOs & nutrients(especially fat-soluble vitamins) are stuffed.

When a child, while breastfeeding, starts feigning sleep, scratching the occipital region in style, raising legs up & down, etc, know it that the child is actually accessing part of the intermediate milk & especially the hind milk. The satiety nature of the creams (fats) accounts for this.

Summarily, Exclusive breastfeeding is highly recommended as there are numerous advantages to both children & their mothers. Mothers should endeavour to feed on foods high in vitamin D during pregnancy to increase their stores, or routinely involve their babies to early morning sun exposure, as BM is low in vitamin D as well as vitamin K.

Meanwhile, the mothers should be given optimum support by spouses, Bosses and others, in order to possibly PRIORITIZE Exclusive breastfeeding.

© Dtn. Okereke Dickson O.,RDN, LD, mDAN,

     (Clinical Dietitian).