HIGH INCIDENCE OF EXCLUSIVE BREASTFEED PROBLEMS AMONG WORKING MOTHERS AT KORLE GONNO Early breastfeeding within one hour

and exclusive breastfeeding for the first 6 months are the key interventions to achieve Millennium Development malnutrition and mortality respectively. Breastfeeding is therefore the act of feeding a baby with milk from a mothers breast according to the Longmans dictionary. According to the American Academy of Pediatrics (AAP), human milk is the optimal form of nutrition for infants and the AAP recommends breastfeeding a baby during the first 12 months of life. For many new mothers this makes their return to work following family leave especially difficult. Even though recent Dutch figures indicates an increase in breastfeeding rates, the latest statistics still show that only 25% of Dutch mothers feed their children mainly breast milk `during the first 6 months. Hence exclusive breastfeeding rates remain low despite numerous health benefits associated with this behaviour.Similarly, exclusive breastfeeding is when mothers feed their babies with breast milk for 6months without the addition of any supplement such as water or artificial feed. Exclusive breastfeeding is internationally the preferred way of feeding infants during the first 6 months of their lives and is recognized as being one of the most natural and best forms of preventive medicine.

BENEFITS OF EXCLUSIVE BREASTFEEDING The governments new goal by 2010 is for at least half of mothers to breastfeed exclusively until age 6months,when solid foods are added and for at least 25% to continue breastfeeding until the babys first birthday.Breastfed babies are therefore said to receive several benefits and some include the following;According to Lautan Neergaard,AP medical writer in Nov 6 2000,babies feed with supplementary feeds suffer fewer illnesses such as diarrhea,ear ache,pneumonia,gastrointestinal conditions and other infections as compared to babies not exclusively breastfeeding.This is because most artificial feeds are not prepared correctly by the mothers and despite that,these mothers do not use the good methods and these babies tend to be at risk of these illnesses.Some studies suggests that breastfed babies also may be less likely to develop asthma,diabetes or childhood cancer and heart diseases in later life. Lauren Neergad further researched that, mothers breastmilk also transmit antibiotics and other protecting substances to the baby.80% of the cells in the breastmilk are macrophages and cells, that kill bacteria,fungi and viruses and also help to stop the growth of cancer cells.A factor in breastmilk is said to encourage the production of babys own antibiotics that is also identified.Other elements in breastmilk also confers protection. The views of Lauren Neergard,AP medical writer included that,exclusively breastfed babies seems to develop their brains faster.Their immune system respond better to vaccines and they are less likely to become fat later in childhood.An average daily sample of breastmilk contain protein,fats,carbohydrates,protective immunoglobulin,lactoferrin,lysosome,antitrpsin factor,bifidus factor,vitamin A,B,C,D,E and very low levels of vitamin K,calorific value,mineral salts,water,leukocytes and dead epithelial casts.This contain the right nutrients in their right proportion naturally to help in the development of the child(Anatomy and Physiology Applied to Obstetrics)(pages1,11) .Exclusive breastfeeding also good for the babies tooth and jaw development.Babies at the breast have to use as much as 60 times more energy

to get food than those drinking from bottle or cup.The suckling has as much or all of the areola in the mouth and baby moves his jaw back and forth and squeeze hard with the gum to extract the milk.As these muscles are extraneously exercised in suckling,their constant pulling encourages the growth of well developed jaws and straight health teeth. Breastmilk is said to be always available and natural. In the sense that at a time when so much of our life pass on uncertainly unnatural aspect with chemicals in the air we breath,in the clothes we wear and in the food we eat,more and more of us are striving to recapture some of the natural joys of life on earth.When mothers breastfeed their babies they know that they are giving the natural food whose purity is tainted with no synthetic compound,with no preservations and artificial ingredients. Also there is no need for the mother to worry about feeding the baby as long as she eats well and free herself from any stress. It is therefore said that once the mother is there so is the babys milk or feed. Breastfeeding mothers also benefit as well,and the few includes;Nursing your baby helps to regain your figure more quickly since the process of lactation causes the uterus to shrink more quickly to its pre-pregnant size and shape.Exclusive breastfeeding is also much more convenient because its already made and formed naturally. Its also the only time in the mothers reproductive life when shes not loosing iron through the menses. This help build up her iron stores and corrects the anaemia tendency.Exclusive breastfeeding also help promote good mother-baby relationship and stimulate lactation(Catlaneo and Buzzetti 2001)(ch 41) Lastly exclusive breastfeeding serves as a birth control eventhough its not totally relied on.Exclusive breastfeeding can cut down HIV transmission rates from HIV positive women to their offspring by half in comparison with those who practice mixed feeding.The new intervention cohort study from South Africa,assessed the HIV-1 transmission risk and survival associated with exclusive breastfeeding and other types of infant feeding in HIV positive women.Risk of acquisition of infection at 6months of age through exclusive breastfeeding was 4.04%.

Breastfed infants who received some solids had eleven times higher risk of infection and if other milk or formula is given along with breastfeeding,the risk could almost double.A study shows that ,HIV free infant survival was much higher in exclusively breastfed children at 3 months(Indian Pediatrics,Volume 46-January 2009)

REASONS FOR STARTING SUPPLIMENTARY FEEDS Introduction of early supplementary feeds with a wrong notion of not having enough milk appears to be most detrimental to exclusive breastfeeding. In most of the situation,this apprehension is more conceptual than real because the amount of milk the breast produces is determined by the amount the baby takes.It increases when the baby takes in more. Even in societies where a womans diet is poor,most mothers are able to produce breastmilk in amount adequate for infant growth.

If supplementary feeds are given there is less sucking leading to less secretion of breastmilk. If the mother is ignorant about this fact does not believe in this and does not know how to assess adequacy of breastfeeds she starts supplementary feeds at any early possible sign of inadequate feeds.Example;excessive crying in baby and this leads to further reduction in production of breastmilk and lactation failure.In the event of maternal and infant illness also introduction of supplementary feeds further reduce breastmilk production.

REASONS WHY WOMEN FAIL TO BREASTFEED Some people in the USA and many western culture simply live in a bottle-feeding culture .It is very unusual to see a breastfeeding mothers and even more unusual to see a mother nursing a toddler or an older child,yet even world Health Organization recommends breastfeeding for at least 2years. Television and book usually show a baby with a bottle not a baby at its mothers breast.Little girls grow up perceiving formula-feeding as a norm. Breastfeeding is natural but not instinctive.It needs to be learned,however it is hardly to learn about breastfeeding in a bottle-feeding culture.Mothers thinks breastfeeding is indecent.Breast are to feed babies.There is nothing indecent about breastfeeding a baby.Think about a cat mother feeding her kitties,or a dog feeding her puppies.Even just thinks about it?Isnt it cute and natural.The same is true for humans feeding their babies(By Rebecca Ephraim discussing Americans attitude towards breastfeeding). Some mothers do not believe in breastfeeding and some reasons includes;Mothers past sexual abuse,in which one out of five American women has been sexual abused during childhood,and it is estimated about 20% of those show significant symptoms during adulthood.There are wide reactions to past sexual abuse.Some women who have been abused cannot tolerate the thought of breastfeeding while others find breastfeeding as an experience.Espectially in difficult situation such as,early post partum period with its demands,night time feedings since the nights remind the mothers of earlier abuse and the older infants who play with their breast and smiles at them.These mothers may need extra support of those around her or from mental health professionals for extra reassurance to know what is normal behavior with a baby and how to redirect a babys behavior towards breastfeeding.On the other hand,breastfeeding reduce child abuse and abandonment of mothers9by Kathleen Tendall-Tacket,PHD IBCLC).

Another problem the women encounter is the negative opinion of their husbands or partners.Unfortunately many men think womens breast is a sexual organ ,so they become jealous over the nursing mothers breast ,or start thinking that the baby is doing something indecent and pervert when it feeds.It can be pleasurable to the mother but it is not a sexual pleasure, just a good feeling of being close to your baby. Another reason noticed is that some mothers also complains of not getting support from family but they should noticed that breastmilk can also be expressed given by cup and spoon when at work by relatives(hpttp://www.007b.com/early weaning.php). PROBLEMS IN EXCLUSIVE BREASTFEEDING ; These include sore nipple,flat nipples,mastitis,breast abcess,blocked ducts,ect.(MYLES)(ch 41,801).By far most of the breastfeeding problems are solvable with adequate nursing within one month.Certain medications that mothers take does not allow them to breastfeed.Mismanagement of breastfeeding;Breastfeeding works best when baby is put to the breast very soon after birth,and is allowed to feed as frequent as the baby wants.(A commentary by marie Davis, RN,IBCLC.).Milk supply is built up how frequent the baby feeds and is very important in the beginning.Mothers do not do demand feeding because of work schedules and wrong ideas about bottle-feeding.also mothers do not know that the more give supplementary feeds their babies suffer from many fetal condition.difficulties with public breastfeeding;Even though mothers are allowed to breastfeed in public in US and other countries any time baby demands breastmilk ,mothers leave public places like;mall,restaurants, supermarkets,public vehicles to etc,to bedrooms and secret places to breastfeed.Since breast are perceive as sex organs mothers find it difficult to breastfeed in public.( A commentary by Marie Davis,RN,IBCLC.)(5).Because of the general attitudes Americans societies has about breastfeeding and of breast many women wont feel totally free and at ease when nursing in public ,but in reality when mothers get over the fears they

find that the general public doesnt pay much attention to the act.Misconceptions about weaning;Many people in US think that breastfeeding is only first couple of months of an infants life.Expects dont agree with World Health Organization (WHO)recommends breastfeeding to 2 years of age,and Acadamy of Pediatrics clearly states in their policy statement Breastfeeding and the Human Milk,Exclusive breastfeeding is ideal nutrition and sufficient to support optimum and development for approximately the first 6 months after birth.It is recommended breastfeeding continue for at least 12 months,and thereafter for as long as mutully desired.(A commentary by marie Davis,RN IBCLC.)(9).Working;American society does not give mothers mothers a long maternity leave or otherwise them to stay at home so breastfeeding would be easier.Nor provide places at the workplace to breastfeed/pump milk.So even though the best solution would of course be if women could stay home longer or still pump milk whiles at work,and continue normal nursing whiles at home,or possibly arrange your baby to be brought to you at certain hours,if this is possible.breastfeeding do not have to end just because you have returned from maternity leave.Also about all the infant formulas used in the United States is purchased for poor women through the Special Supplemental Nutrition Problem for Women, Infant and Children(WIC).(http://www.007b.com/early weaning.php)