If breast-feeding is successfully established, how should a woman decide which breast to feed the baby on?
The standard advice is to alternate the breasts with each feed. It is important to ensure a breast is empty before moving the baby to the other breast. Sometimes, the baby is satiated on one breast, in which case he or she can feed on the other breast next time round.
The importance of emptying the breast lies in the fact that the milk that comes first (fore-milk) differs in content to hind-milk. The fore-milk is rich in protein and water, while the hind-milk is rich in fat. Moving the baby from one breast to the other before one is empty means he or she is likely to miss out on the fat-rich hind-milk which is so crucial at this stage of life.
Complete emptying is also important in maintaining lactation. Incomplete emptying has a long-term effect of reducing the amount of milk produced.
Some women, in spite of all their good intentions, fail to breast-feed because of inverted nipples. Can these women be helped?
This is an important subject. This is a problem which, with the right help and perseverance, can be overcome in the majority of cases. There are devices available to help with this problem. In the UK, the National Childbirth Trust has excelled in helping women with this kind of problem.
There are breast-feeding counselors who can offer all the necessary help, and all maternity units provide this service. In most countries, this kind of help is readily available. In developing countries, breast-feeding remains the norm and therefore the problem is rare.
In developed countries, there is some kind of paradox in that affluent middle class women are more likely to breast-feed than women who are less well-off. Why is this?
This trend is true and is quite probably an indictment of public education in these countries. It almost certainly means the message is not getting through to the less well-off and that strategies in mass education need re-appraisal to see what is being done wrong. However, the pattern is really one facet in a complex socio-economic picture and there cannot be a quick fix.
Another disincentive to breast-feeding is the fact that breast-feeding in public is frowned upon, especially in the West.
This is a result of cultural trends. There have been attempts to overcome this difficulty. Most departmental stores and even some workplaces now provide mother and baby facilities, which include purpose-made areas for feeding babies. It may be a little harder on a public bus, where some people may feel inclined to disapprove, quietly or otherwise. It must be said that this antipathy is baseless and illogical but it is also a fact of life.