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Problems during Lactation


Breastfeeding is the feeding of an infant or young child with breast milk directly from female human breasts. Breast milk also providing nutrients for healthy growth of children and development (León-Cava et al., 2002). The promotion, protection, and support of breastfeeding practice are the most cost-effective strategy for improving quality life of child and reducing the burden of childhood disease, particularly in developing countries (Jones et al., 2003, León-Cava et al., 2002).

Increasing optimal breastfeeding practices could save 1.5 million infant lives every year. Exclusive breastfeeding for the first six months of life contribute important benefits on the infant

The global strategy for infant and young child feeding, invites governments and all stakeholder to promote and support exclusive breastfeeding for six months and continued breast feeding for two years or beyond, and to promote timely, adequate, safe and properly fed of  complementary feeding (WHO, 2003).

Unfortunately, exclusive breastfeeding practice was low, whether in world level or district level, for instance,  in the world was 34.8% and in 33, Asian country was 46.0% (WHO, 2009, IBFAN, 2010). In Indonesia, slowly decreased during two past decade from 63.0% in 1987 to 32.0% in 2007 (WHO and UNICEF, 2010, BPS and International, 2008), also in South Sulawesi Provinces and Maros District, the prevalence was 48.64% and 30.82% respectively.

First month of infant age was the crucial period for success or failure of breastfeeding. Mothers in this period were more likely to fail to initiate breastfeeding. They may develop engorgement of breasts, or soreness of nipples due to ‘poor positioning’ of the baby. During this time, many mothers also start getting doubts about breast milk adequacy, one study from Mallikarjuna et al., (2002) showed that problems during lactation were persisted, around 31.7%, 1.2%, 13.4%, 9.8%, 18.3%, and 25.6% cases during 0-1, 1-2, 2-3, 3-4, 4-5, and 5-6 months respectively.

Study from Abou-Dakn et al., 2009, showed that from 379 mothers, 67.8% of them have at least one of the lactation problem and breastfeeding duration very sort only 6.35±4.12 months. Study by Februhartanty et al., 2006, showed that from 277 mothers, 87.3% of them have a lactation problem. Study by Lamontagne et al., 2008, from 140 mothers, 56.4% of them have lactation problem and study by Mallikarjuna et al., 2002, from 420 mothers, 46.1% of them have a lactation problem.

Problems during lactation were common and treatable, sometimes the problems causing breastfeeding cessation, shorter breastfeeding periods or complement breastfeeding with formula milk/other food. Mothers who did not experience problems during lactation practised exclusive breastfeeding as compared to mothers who experienced at least one lactation difficulty  (Lamontagne et al., 2008, Abou-Dakn et al., 2009, Amir et al., 2007, Februhartanty et al., 2006, Giugliani, 2004, Mallikarjuna et al., 2002, Andrew Hsi MD and Larry Leeman MD, 2010).

Several problems which occurring during lactation were feeling emotionally upset, feeling tired and fatigued, Painful nipples/breasts, perception of low milk supply, plugged milk duct, breast infection/ implamation, insufficient infant weight gain, Sucking difficulties, frequent baby crying, Mastitis, breast engorgement, breast abscess, the absence of infant bowel motions, latching problems, and breast refusal   (Lamontagne et al., 2008, Abou-Dakn et al., 2009, Amir et al., 2007, Februhartanty et al., 2006, Giugliani, 2004, Mallikarjuna et al., 2002).

Problem during lactation usually emerges because of incorrect techniques, breastfeeding frequency was low, breastfeeding on scheduled and using of pacifiers (Giugliani, 2004).

The adequate approach to overcome of those problems is important, if not well treated, usually lead to early weaning. Mostly, problems managed by non-medical professionals. On the other hand, several problems should be under supervision by medical professionals. In ability of mothers to overcome her lactation problems and lack of support from the community and health provider make the problem more severe (Giugliani, 2004, Februhartanty et al., 2006, Andrew Hsi MD and Larry Leeman MD, 2010)

There are various reactions of mother when they experienced with lactation problems i.e to complement breastfeeding with formula milk or other food, would stop breastfeeding, and the still continue breastfeeding (Februhartanty et al., 2006).

Mostly previous study focus on identify the type of lactation problems. Study on when the problem occurring and how the mother overcomes her problems were limited explored. Study on the type, when and how mother to overcome the problems are important to be known as a base information for the health providers in counseling process to the mother especially regarding how to handle their lactation problem.

References

ABOU-DAKN, M., SCHAFER-GRAF, U. & WOCKEL, A. (2009) Psychological stress and breast diseases during lactation. Breastfeeding Review, 17, 19-26.

AMIR, L., FORSTER, D., LUMLEY, J. & MCLACHLAN, H. (2007) A descriptive study of mastitis in Australian breastfeeding women: incidence and determinants. BMC Public Health, 7, 62.

ANDREW HSI MD, M. & LARRY LEEMAN MD, M. (2010) Management of Common Breastfeeding Problems. Breastfeeding Residency Curriculum. Mexico, University of New Mexico School of Medicine

BPS & INTERNATIONAL, M. (2008) Indonesia Demographic and Health Survey 2007. Calverton, Maryland, USA, BPS and Macro International.

FEBRUHARTANTY, J., BARDOSONO, S. & SEPTIARI, A. M. (2006) Problems During Lactation are Associated with Exclusive Breastfeeding in DKI Jakarta Province: Father’s Potential Roles in Helping to Manage These Problems. Mal J Nutr, 12 (2), 167-180.

GIUGLIANI, E. R. J. (2004) Common problems during lactation and their management. Jornal de Pediatria, 80, s147-s154.

IBFAN (2010) The State of Breastfeeding in 33 Countries, Delhi, India, BPNI/ IBFAN Asia.

JONES, G., STEKETEE, R. W., BLACK, R. E., BHUTTA, Z. A., MORRIS, S. S. & GROUP, T. B. C. S. S. (2003) How many child deaths can we prevent this year? The Lancet, 362, 65-71.

LAMONTAGNE, C., HAMELIN, A.-M. & ST-PIERRE, M. (2008) The breastfeeding experience of women with major difficulties who use the services of a breastfeeding clinic: a descriptive study. International Breastfeeding Journal, 3, 17.

LEÓN-CAVA, N., LUTTER, C., ROSS, J. & LUANN MARTIN, M. A. (2002) Quantifying the benefits of breastfeeding: a summary of the evidence, Washington D.C, Pan American Health Organization.

MALLIKARJUNA, H. B., BANAPURMATH, C. R., BANAPURMATH, S. & KESAREE, N. (2002) Breastfeeding Problems in First Six Months of Life in Rural Karnataka. Indian Pediatrics, 39, 861-864.

WHO (2003) Global strategy for infant and young child feeding, Geneva, World Health Organization.

WHO (2009) The WHO Global Data Bank on Infant and Young Child Feeding. World Health Organization.

WHO & UNICEF (2010) Countdown to 2015 decade report (2000–2010): taking stock of maternal, newborn and child survival. Geneva, Switzerland.

One comment on “Problems during Lactation

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    24 November 2011

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