Dr Harini Manjunath MBBS, MD, Clinical Pharmacology, Chief Scientific Officer, NeoLacta Lifesciences explains why is it necessary to initiate breastfeeding within the first hour after the baby is born
In the complex world of neonatal care, ensuring the crucial role of optimal nutrition is critical, especially for preterm children. Human milk is the most complete and ideal form of nutrition for both term and preterm infants. It contains all the essential nutrients and bioactive compounds that a baby needs for healthy growth and development. It contains antibodies that protect the baby from several infections and provide immunity. Breastfeeding is beneficial for mothers as well as it helps in reducing the weight gained during pregnancy and offers protection from breast cancer and ovarian cancer.
Understanding the importance of human milk in infants
It is necessary to initiate breastfeeding within the first hour after the baby is born. Breastfeeding within 1 hour of birth prevents infection and reduces neonatal mortality. It promotes emotional bonding between mother and baby. It also has a positive effect on breastfeeding duration. Early breastfeeding within 1 hour of birth stimulates breast milk production. Colostrum also called “Liquid Gold” is yellowish-white in colour and is the first milk produced in the first 2 to 3 days. It is nutrient-dense and boosts the baby’s immune system.
In several instances, the mother’s milk is not accessible either due to the separation of the baby and the mother or the mother is unable to produce breastmilk due to clinical situations. This article explores the available options that allow the mothers to continue to feed the baby with human milk.
Continue to express the breastmilk
In most cases of preterm babies, born before 37 weeks of gestation, the baby is admitted to the Neonatal Intensive Care Unit (NICU) starting from day 0 of life. In such instances, the mothers are encouraged to express the breast milk either by hand expression or by using a breast pump. The colostrum expressed in the initial day is used as mouth paint in the first hour. Later the milk is fed as minimal non-nutritive feeds using the feeding tubes. Providing early feeds to the baby allows priming of the immature gut of the preterm infants.
Feeding the term infants with the expressed mother’s milk is also beneficial within the first hour when that baby is unable to breastfeed. Expressing breast milk also allows the production of breast milk by maintaining the demand and supply of breast milk.
Pasteurised donor milk
In situations where the mother is unable to produce breast milk, then pasteurized donor human milk is the next best-recommended option. Its optimal composition closely mirrors that of mother’s milk, offering a lifeline to premature infants, ensuring they receive the nourishment necessary for their survival and well-being. Donor human milk provides a plethora of immune-boosting components, including antibodies, immunoglobulins, and antimicrobial proteins, which help the preterm infant’s immature immune system and gut development. This immune defence helps to reduce the risk of infections, which is especially important for preterm with compromised health. Donor human milk has been found in studies to prevent allergies and disease later in life. Studies have shown that preterm infants who received donor human milk in the absence of mother’s milk had a lower incidence of lung infection, systemic infection, or inflammation of the intestine. Essential fatty acids in donor human milk, such as docosahexaenoic acid (DHA), are pivotal for brain development and cognitive function. Pasteurised donor human milk with high calorific value is beneficial, especially in the management of the nutritional needs of preterm infants.
Lyophilised donor human milk
In recent days with the advent of patented technologies lyophilised powdered form of donor human milk is available that can be used after reconstituting with lukewarm water. This option is highly beneficial in our country as PDHM is supposed to be stored in frozen conditions (-20c) which is not practically possible in all situations/locations due to various constraints. This was one of the biggest deterrents in the adoption of Donor human milk solutions across the country. Thanks to technology this option can be considered in situations where both the mother’s milk or donor human milk is not available and can be stored at room temperature. This will ensure providing enteral nutrition with human milk in the first hour of life and also acts as a bridge when mother’s milk is unavailable and the required quantity is very minimal in the initial days.
In conclusion, healthcare providers and mothers should be encouraged and supported to initiate breastfeeding as soon as possible after birth to provide feed within the first hour of birth. When direct breastfeeding is not possible, mothers should be encouraged to express their milk to provide for their babies. In instances when mother’s milk is not available pasteurised human milk or lyophilised powdered human milk ensures the nutrition needed in the first hour is taken care.
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