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Women’s Health

Women’s Health

This issue discusses wellness in various stages of womanhood which includes keeping calm during periods; preventing urinary tract infections, the stigma around female infertility, the challenges of late pregnancy and how breastfeeding impacts both mother and baby.

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Just stay calm. Period.

Cramps, bloating and fatigue are common during periods. For some women, the symptoms are mild, for others, the days can be demanding. Exercising, eating nutritious food and staying hydrated can help relieve pain during periods.

Cramps, bloating and fatigue are not uncommon during periods. While for some women, the symptoms are mild, for others, the days can be demanding. Experts recommend a good diet, hydration, exercise and sleep to overcome the disquiet one can experience during periods.

Exercise is essential

During the menstrual cycle, oestrogen and progesterone levels are lower in the body, which can eventually make you feel lethargic. Although there is no compulsion to exercise during your periods, it is recommended to work out during periods. It can relieve pain and accelerate the mood,” says Paranjeet Kaur, assistant professor, applied medical sciences, Lovely Professional University, Punjab.

“Working out stimulates the release of endorphin (the hormone released during pain or stress) in the body, which becomes quite effective in reducing the pain you feel during periods. In a nutshell, it is wise to include milder exercises during periods,” adds Kaur.

Dr Varini N, senior consultant, obstetrician and gynaecologist, Milann Fertility and Birthing Hospital, Bengaluru, tells Happiest Health that women who don’t have symptoms during periods can continue with their routine exercises. “Women with heavy flow and pain should avoid doing heavy exercises and opt for mild to moderate exercises like walking and stretching that will help reduce the pain they are experiencing.”

Menstrual pain can vary from person to person. Hence it is important to understand the body signals and include the type of activities accordingly.

“Some have mild pain, while others go through extreme pain. If you can tolerate the pain, you should do exercises like yoga, cycling, slow walking, dancing, stretching, light cardio and other low volume strength training activities,” points out Kaur.

Exercising during periods also increases the blood supply which can help reduce pain, apart from improving mood and reducing other symptoms like cramps, bloating, stress and fatigue. This is because physical activity can help the blood exit faster from the uterus. Hence, staying active can be a great remedy say the experts.

Cigarettes and alcohol: a big no

Menstrual pain could increase while consuming alcohol and cigarettes.

“They might lead to dehydration in the body, and eventually you feel more pain. Further, the nicotine present in cigarettes is suspected to cause severe hormonal imbalance and further leads to several fertility problems,” says Dr Kaur.

Dr Varini also talks about the risks alcohol and cigarettes pose. “Since there is water retention in the body during periods due to hormonal disturbances, consumption of alcohol will aggravate the water retention in the body.”

What to eat

Dr Varini says that easily digestible food should be consumed during periods as progesterone hormone reduces the motility of the intestine. “Eating heavy food will cause discomfort. Greasy and spicy food and the food that takes longer to digest should be avoided.”

“Fuelling your body with nutritional foods can stabilise mood swings and boost fertility. The vital key nutrients are iron and vitamin B12. Normal food cravings can be satisfied with antioxidant-rich dark chocolate and seasonal fruits,” adds Kaur

Kaur advises that food rich in fats, refined grains and sweetened foods should be avoided during periods and consumption of coffee should be reduced as it might cause nausea, vomiting and bloating. Apart from this, energy drinks should be eliminated, as they can lead to headaches and constipation.

When food craving strikes

Kaur says a person during periods goes through food cravings and hunger pangs. The body undergoes drastic hormonal imbalance which causes cravings for high carbohydrates and sugary drinks in the diet.

“In such conditions, relish dark chocolates, wholegrain bread, rice, protein shakes, oats, fruits, nuts and yoghurts to calm down your cravings. Exercise is a real booster to re-energise and stabilise the mood swings,” adds Kaur.

For people who lead an unhealthy and stressful life, their period pattern may alter. “Keep yourself stress-free and maintain personal hygiene. They help in keeping periods attuned,” adds Kaur.

Hydration and sleep are indispensable

Dr Shivani Chandan L, consultant, obstetrics and gynaecology, Aster RV Hospital, Bengaluru tells Happiest Health that being hydrated and sleeping well are very important during periods. “They help to get over fatigue and beat weakness due to the loss of blood,” she says.

“Drinking warm water can also reduce period cramps,” notes Kaur.

Keep those UTIs at bay

Urinary tract infections (UTIs) affect both the upper and lower urinary tracts. Infection in the upper urinary tract is rare but is a more severe condition compared with lower UTIs. Women are more prone to these infections because of their anatomy. Find out about UTIs: their types, symptoms and preventive measures.

Urinary tract infections (UTIs) are caused by microbes (bacteria) affecting both the upper (kidney ureters) and the lower (bladder and urethra) urinary tract. Infection in the upper urinary tract is rare but is a more serious condition compared with lower UTIs. Women are more prone to UTIs because of their anatomy since the urethra lies in proximity to the vagina and the anal canal.

Dr Govardhan Reddy, lead consultant, urology and uro oncology, Aster CMI Hospital, Bengaluru, told Happiest Health that UTIs are caused by microorganisms or germs, usually bacteria. “However, some are caused by fungi and in rare cases by viruses,” he said. “When they enter the urinary tract and multiply, they can cause a UTI. Women, babies and old people generally get UTIs.”

Dr Chetan JV, a urology consultant at Manipal Hospital, Bengaluru, said UTIs occur in the elderly since ageing slowly deteriorates the body’s immune system. People living with HIV and diabetes are also prone to UTIs because of their weak immune system. It is important to maintain cleanliness and hygiene to protect oneself from these infections.

Dr Chetan said there are anatomical and physiological causes for UTIs.

The anatomical causes include obstruction to the flow of urine, abnormal architecture of the urinary system (narrowings in the urinary tract), stricture urethra, BPH (benign prostatic hyperplasia) and posterior urethral valves. Stricture urethra is abnormal narrowing in the tube which hinders the flow of urine. In BPH, the enlargement of prostate gland blocks the flow of urine. Posterior urethral valves are obstructive membranes that develop in the urethra. The valve can obstruct or block the outflow of urine through the urethra.

The physiological causes are the inability to completely empty the bladder (urinary retention) and neurogenic bladder (where a person lacks bladder control due to a weak neuron system).

The other causes of UTIs are inadequate intake of water or dehydration and honeymoon cystitis. The latter occurs when a woman has sex for the first time or after a long gap. Thus, all women are at the risk of getting honeymoon cystitis because of their anatomy.

UTI is also caused by Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal tract (the digestive system’s passageway that connects the mouth to the anus). Sometimes these bacteria can get out of the anus and into the urethra, and from there they can travel up to the bladder. If the infection isn’t treated, it can affect the kidney.

Symptoms of UTIs

The symptoms of a UTI depend on the part of the urinary tract that has got infected. UTIs are classified as lower UTI and upper UTI.

The symptoms of the lower-tract (urethra and bladder) UTI include a burning sensation while passing urine, increased frequency and urgency of urination, bloody or cloudy urine with a strong odour, and pelvic pain.

UTIs that affect kidneys are associated with symptoms such as pain and tenderness in the upper back and sides (flank), chills, fever, nausea and vomiting, said Dr Reddy.

Types of UTIs

Urethritis (infection of the urethra), cystitis (infection of the bladder), pyelonephritis (infection of the kidneys) and vaginitis (infection of the vagina) are the types of UTIs, according to Dr Reddy.

Some doctors classify the infections into simple and complicated UTI. People with a normal urinary tract get a simple UTI (most women are prone to this). People with an abnormal urinary tract (or when the bacteria causing infection cannot be treated) are prone to a complicated UTI.

Under simple UTI one can have symptoms like frequent visit to the washroom, a burning sensation while urinating and blood in the urine (haematuria).

A person having complicated UTI experiences weakness, fever with severe chill and low blood pressure or septic shock. A complicated UTI can sometimes be fatal if not detected or treated early.

Meanwhile, genitourinary tuberculosis (GUTB) is a special type of UTI in which a patient is infected with the TB bacillus rather than regular bacteria. The symptoms are more or less the same but can be severe, recurrent and difficult to treat. A person with GUTB tends to lose weight.

A CT scan, a urine examination for a special strain like Zn stain (used to identify tuberculosis bacillus) and a gene expert test (used to identify tuberculosis particles) help in detecting GUTB. This type of UTI can be treated by anti-tubercular therapy, said Dr Chetan.

Preventive measures

Dr Reddy said since constipation can also lead to UTI, one needs to eat healthy food that is rich in fibres and exercise daily. Simple tricks that help in prevention are not to hold the urge to urinate and to use a clean toilet for urination. One can carry a wet tissue to clean the seat before using it in public toilets.

However, Dr Reddy said toilet seats are not a common means of infection transmission to humans — and there is minimal chance of bacteria or microbes entering the body because of contact with toilet seats.

In this regard, Dr Chetan said though no randomized controlled trial study has been done, observational studies have concluded that it might be one of the factors for UTIs. He said the urethra does not typically touch the toilet seat and many organisms can only survive for a short time on the surface of the seat, but no conclusive evidence for or against has been found regarding toilet seats as a cause for UTI.

To prevent UTI, one should increase fluid intake, control and manage the sugar level, maintain genital hygiene and improve general health, said Dr Chetan.

Also, wiping from the front to back after urinating and bowel movement helps prevent bacteria in the anal region from spreading to the vagina and urethra. One should empty their bladder soon after intercourse and drink a full glass of water since it helps to flush the bacteria. As a birth-control measure, one should avoid using diaphragms or unlubricated or spermicide-treated condoms since they contribute to bacterial growth. All these measures can go a long way in helping keep UTIs at bay.

Understanding female infertility

For women hoping to conceive, a negative pregnancy test result could take a toll on their mental health. Getting periods around that time can be very stressful and overwhelming. It could lead to feelings of disappointment, guilt, and sometimes even rage

For a woman who has been planning to start a family and hoping to conceive, a negative pregnancy test result could take a toll on her mental health. Getting periods around that time can be very stressful and overwhelming. The inability to conceive could lead to feelings of disappointment, guilt, and sometimes even rage.

Thirty-five-year-old Vidya, a resident of Mysuru had severe depression and even quit her job because she could not conceive despite planning for it for three years. Speaking to Happiest Health, she said, “I worked for an IT company as a manager, and I was very career oriented. Due to this, I kept delaying my marriage. However, after I found the right partner, I got married to him. I was 32 then. I knew that I was settled in life, and I could start a family. But despite us trying for three years, I couldn’t conceive. I faced a lot of pressure from my family who later started to blame me for delaying my marriage.”

She lived in a joint family. During the pandemic, when she had to work from home, a bout of depression further affected her, when she had to answer family members’ queries about why she wasn’t pregnant yet. “I went into depression and started to hate myself for putting my career first. I felt I was too selfish and now everyone is suffering because of me and I’m not able to give a child to my husband and a grandchild to my parents and my in-laws. I had so much rage, anger and hatred towards myself. I even quit my job six months ago,” she said.

Going to a fertility clinic was still a very tough decision for her to make as she was afraid of the stigma attached to it. “I somehow overcame the fear and approached a fertility clinic in June where the doctor not only counselled me but also helped me with the right treatment. Now, I know that I had a uterine issue which can be solved and treated,” she said.

“It is common to experience infertility and it could happen because of many reasons. There could be problems with the uterus, ovulation, fallopian tubes and the quality and number of eggs apart from age and lifestyle factors like smoking and excess weight,” said Dr Rohit Gutgutia, medical director, Nova IVF Fertility, Eastern India.

He says that there are two types of female infertility:

  • Primary: Where a woman who has never been pregnant is unable to conceive after a year of not using birth control.
  • Secondary: Where a woman is unable to conceive after at least one successful pregnancy.

According to an article published in the Journal of Reproduction and Infertility, as a woman ages, her likelihood of infertility rises. In India, about eight per cent of currently married women experience infertility, with secondary infertility being the most common type (5.8 per cent).

Dr Vidya V Bhat, the medical director of Radha Krishna Multispecialty Hospital, Bengaluru said that the recent phenomenon of reduced fertility among Indian women is caused by delayed marriages, obsession regarding one’s career and use of modern contraceptives.

Dr Bhat said that as the age increases, the chances of getting pregnant reduce significantly. “This is due to the decreased frequency of sexual intercourse, lower quality of uterus and ageing egg cells that lead to poor-quality embryos. There is a reduction in the intrinsic fertility potential of egg cells after the age of 35. The decline in fertility begins around 32 years and becomes rapid around 37,” she added. Dr Bhat suggested that women should bear children between 25 to 33 years to avoid complications.

Stigma and stress

The stigma surrounding infertility is a problem linked to different psychological and social issues, particularly for women. The stigma is connected to a sense of secrecy and shame that is sometimes forced on women.

Dr Gutgutia said that to assist people in coping with the psychosocial effects of infertility, doctors offer fertility counselling to those (individuals and couples) who are contemplating or receiving reproductive treatments.  He said that the burden of not conceiving naturally falls highly on women. “In times like these, counselling them about their fears and tension is important as stress too can affect fertility and the fertility treatment itself,” he added.

Genetics play spoilsport

According to Dr Gutgutia, about ten per cent of female infertility is thought to be genetically influenced. He further explained, “large chromosomal abnormalities, sub-microscopic chromosome deletions and duplications, and DNA sequence variations within genes that control many biological processes involved in oogenesis (development of ovum), ovarian reserve maintenance, hormonal signalling and the anatomical and functional development of female reproductive organs are among the genetic abnormalities that cause infertility in females.”

He adds that female infertility can result from hormonal imbalances too. These imbalances can interfere with ovulation, hinder the uterine lining from thickening and also prevent a pregnancy from developing.

According to Dr Gutgutia, medical conditions like celiac disease, kidney disease, pelvic inflammatory disease, pituitary gland disorders, such as Cushing’s syndrome, sickle cell anaemia, uterine problems, thyroid disease and cancer are some of the severe medical conditions that can cause infertility in women. Lifestyle factors, such as age, dietary habits, weight, exercise, mental distress and environmental and occupational exposures can have a significant impact on both male and female fertility.

What happens if pregnancy is delayed?

Delayed pregnancies could be the reason for rising in cases of gestational diabetes among pregnant women, which sometimes even turns into type 2 diabetes, said Dr Bhat. She also pointed out that:

  • Women who have late pregnancies have higher chances of suffering from chronic hypertension from the beginning of the pregnancy.
  • They may also face issues during labour, such as non-progression of labour and non-descent of the foetal head.
  • There is also an increased risk of spontaneous abortion in women above 35, apart from chromosomal anomalies being found in the baby.
  • Obesity causes a lot of problems concerning fertility. Women who put on a lot of weight during pregnancy may face metabolic syndrome and could have

Treatment options

Dr Gutgutia said that treatments are identical whether infertility is primary or secondary. Treatments include:

  • Medications to trigger ovulation in women with ovulatory disorders.
  • Intrauterine Insemination (IUI), where sperm is surgically inserted into a woman’s uterus. Donor sperm may be used during IUI.
  • In vitro fertilisation (IVF), which entails daily injections to the ovaries to stimulate them, a surgical operation to remove the eggs, lab-based egg fertilisation to create embryos, lab-based embryo growth and lab-based embryo transfer into the uterus. Donors of eggs or sperm may be used during IVF.  Gestational surrogacy involves using a woman who is not the intended mother to carry the pregnancy to term.
  • Surgery to treat female patients with uterine issues. Doctors can fix structural issues by removing fibroids, polyps and scar tissue from the uterus.
  • Women with infertility who want to have a family may also have options such as gestational surrogacy and adoption.

Apart from proper medication and treatment for medical conditions, couples who are trying to conceive should:

  • Not smoke, use drugs or consume too much alcohol.
  • Eat a balanced diet to maintain a healthy weight.
  • Reduce their exposure to toxins.
  • Continue to be physically active, but not overdo it.

All about delayed motherhood

A closer look at recent childbearing trends shows how an increasing number of women are embracing delayed pregnancies (at age 35 and above) and motherhood. A detailed study of medical history could ensure a smoother pregnancy and childbirth for women post-30s, doctors say.

In her career as a medical practitioner spanning two decades, Dr Kavitha G Pujar has successfully handled several pregnancies and infertility cases. Many among those were cases of delayed pregnancies. In medical parlance, pregnancies post-30s are considered to fall under the delayed pregnancy bracket. A closer look at recent childbearing trends explains how an increasing number of women are embracing delayed pregnancies and motherhood.

Recalling one of her most rewarding cases, Dr Pujar, senior consultant, obstetrics and gynaecology, Kinder Women’s Hospital and Fertility Centre, Bengaluru, draws attention to the measures that could help women navigate delayed pregnancies with greater ease.

“A woman who had got married at 41 and was trying to conceive for two years came to me for consultation. Eventually, she underwent in vitro fertilization (IVF) treatment under my supervision and conceived within a year,” Dr Pujar told Happiest Health.

“Another patient of mine conceived at the age of 39. However, she developed gestational diabetes in her third month of pregnancy. Nevertheless, we advised her to follow a diabetic diet and include exercise to her daily routine. The woman was also treated with insulin. To everyone’s delight, she delivered a perfectly healthy baby.”

Delayed childbearing or late maternal age

According to the research paper ‘Delayed childbearing’, fertility declines with increasing maternal age, especially after the mid-30s. “For this reason, delayed childbearing is traditionally defined as pregnancy occurring in women aged 35 or above. This population has been referred to as advanced maternal age or late maternal age.”

Women’s reproductive physiology after 30

 Pregnancy is largely determined by the fertility rate of a man and a woman. “Among the two, female fertility is the larger determiner when it comes to conceiving. The oocytes (the immature eggs) are the main determining factor. As women grow older, these oocytes (eggs) deplete both in quality and quantity,” Dr Preeti Prabhakar Shetty, senior consultant, obstetrics and gynaecology, Apollo Hospitals, Bengaluru, told Happiest Health.

study titled ‘Ageing and assisted reproductive technology (ART): a waste of time and money?’ cites that “Female infants have 6-7 million oocytes at 20 weeks of gestation, 1-2 million oocytes at the time of birth, about 250,000 oocytes at menarche (the first occurrence of menstruation), 25,000 oocytes at 37 years of age, and only a few hundred or thousand at the end of their reproductive life.” 

Things to keep in mind

Experts recommend a few things to keep in mind for women planning to welcome a child into their lives after 30. “Women above 30 do conceive, but it would be a good idea to consult fertility experts to minimise the chances of any complications likely to arise during their pregnancy,” suggests Dr Sushma Appaiah, founder and director of Golz – Nutrition and Diet Solutions, Mysuru, Karnataka.

Some of the possible issues that could arise during delayed pregnancies are:

Lifestyle disorders

“As women age, they are more prone to develop lifestyle disorders such as blood pressure, excess weight, polycystic ovary syndrome (PCOS) – a hormonal issue among women of reproductive age – thyroid and insulin resistance,” elaborated Dr Appaiah.

“These conditions could lead to complications during conception. Moreover, women with pre-existing thyroid, PCOS and high fasting sugar levels are likely to develop gestational diabetes,” the doctor cautioned.

Gestational diabetes

“Gestational diabetes is one of the common health conditions in late pregnancies because women with this condition have higher hormonal disturbances due to their age,” states Dr Rashmi Dsouza (Rasquinha), consultant nutrition therapist and ENT surgeon at Kasturba Medical College Hospital, Mangaluru.

Elaborating on two other comorbidities associated with gestational diabetes, dietician Dr Soumya S Nair, who works in ESIC Hospital, Ezhukone, Kerala, says, “Infertility treatment increases the chances of weight gain. These women are also more prone to developing gestational diabetes. Secondly, gestational diabetes is also closely associated with hypertensive disorder such as preeclampsia.”

Multiple births

Doctors also pointed out that women who choose to conceive in their 30s and beyond are likely to go for ART. Studies show that resorting to assisted technologies to conceive sometimes leads women to give birth to twins, triplets or quadruplets. Commenting on the cases of multiple births among women going for ART, Dr Shetty explains, “It could be due to hormonal changes that lead to the release of more than one egg in each cycle.”

Talking about some of the other challenges associated with the process, the doctor adds, “ART could also lead to the delivery of premature babies. Sometimes, women might even have a miscarriage. Additionally, they could also develop diabetes or hypertension or both.”

Foetal chromosomal irregularities

 There are chances of chromosomal irregularities such as Down’s syndrome to develop in the foetus during delayed pregnancies. “The risk is said to be 1 in 250,” Dr Shetty informs.

Caesarean section

“Higher incidents of operative delivery or caesarean sections are also seen among women who give birth in their 30s or later,” said Dr Shetty.

Other issues include ectopic pregnancy (wherein the fertilised egg grows outside the uterus), placental abnormalities (such as placenta privia) and congenital anomalies (such as heart defects) in the child.

Can you overcome these challenges?

While a delayed pregnancy has its challenges, experts feel that with proper medical guidance and care, one could certainly overcome the hurdles. “Today, a delay in pregnancy could be due to various reasons, including late marriage, educational or professional or family commitments, history of miscarriage or abortion and pre-existing health conditions such as cancer or diabetes. However, a detailed study of the medical history of the patient could reduce the challenges associated with delayed pregnancy to a considerable degree,” said Dr Nair.

Tackle your lifestyle disorders

Dr Appaiah, who has handled several cases of delayed pregnancy with lifestyle disorders, specifies that hormone regulation could help women in their post-30s to conceive.

“Maintaining the body mass index (BMI) between 19 and 23 could also help. Monitoring haemoglobin levels along with nutritional intervention at the pre-conception stage could even reverse diabetes,” suggests the doctor.

Physical exercises and weight management

Dr Dsouza (Rasquinha) advises that for women who are diagnosed with gestational diabetes, hypertension or any weight-related issues, the first step should be to get to a healthy weight. “To achieve this, one needs to eat healthy foods and exercise for 30 minutes every day,” advises Dr Dsouza.

Freezing eggs

Dr Pujar has a word of recommendation for women who plan to embrace delayed pregnancies. “Such women could consider preserving their oocyte and ovarian tissues. Oocyte freezing and ovarian cryo-preservation could help younger women to freeze their eggs and utilise them later for conception,” says Dr Pujar.

Screening tests

Dr Shetty recommends opting for screening tests and pre-needle tests as a mode to eliminate complications during pregnancy. “These tests help in screening chromosomal defects during the first trimester of the pregnancy,” Dr Shetty explains.

A ray of hope

Throwing light on how women wishing to go in for delayed pregnancies could work around their situations, Dr Pujar shares an inspiring case of a young woman with early-stage breast cancer. “The cancer diagnosis left her devasted. Nevertheless, her family decided in favour of oocyte freezing before her chemotherapy (since chemotherapy may cause oocyte distraction). With the help of oocyte cryo-preservation, the patient concerned could plan for pregnancy after completing her treatment for breast cancer, preserving her chances of reproductive potential. She agreed to freeze the eggs before her chemotherapy sessions commenced. Her treatment got over in a year. A couple of years later, she underwent IVF and conceived,” Dr Pujar recalls.

Breastfeeding: myths, facts and best practices

Breast milk is not only the best form of nourishment for a newborn but breastfeeding also promotes food security among infants and sustainable development, say experts.

Along with being the prime source of sustenance for infants, breastfeeding also protects newborns from diarrhoea and pneumonia. A breastfed human baby is also less likely to be obese or have diabetes as an adult.

But children are not the only ones reaping the benefits of suckling on their mother’s milk. Numerous studies have demonstrated the direct benefit of breastfeeding for both babies and mothers.

Happiest Health busts some age-old myths and misconceptions surrounding breastfeeding.

Did you know that apart from being the prime source of sustenance for infants, breastfeeding also protects a newborn from diarrhoea and pneumonia and that a breastfed human baby is less likely to be obese or have diabetes as an adult?

And children are not the only ones reaping the benefits of suckling on their mother’s milk. Numerous studies have demonstrated the direct benefit of breastfeeding for both babies and mothers. Despite several campaigns directed at advocating and promoting exclusive breastfeeding in the first six months of a human child’s life, there still seems to be a lack of awareness about breast milk being the best form of nourishment for infants, feel experts.

According to a United Nations Children’s Fund (UNICEF) study, less than 50 per cent of newborns globally are put to the breast within an hour of birth, which basically means that they wait far too long to make this critical contact with their mothers and receive the key health benefits associated with breast milk. The practice, however, varies widely from region to region. South Asia has reportedly clocked the highest prevalence of exclusive breastfeeding, with nearly 60 per cent of infants being exclusively breastfed. In contrast, only 26 per cent of infants (0–5 months) in Northern America are exclusively breastfed. The report also suggests that good nutrition in early life is crucial to achieving sustainable development and food security and eradicating hunger among infants.

Sindhu Sivalingam, a communication professional and mother to a six-year-old girl, says she breastfed her daughter from birth until she was two and a half years old and wouldn’t have it any other way.

“On the first day, I had some difficulty getting the baby to latch on, mostly because I did not get any help at the hospital. When I told the nurse, she just handed me a tin of formula feed! Luckily, one of my aunts visited and helped in positioning the baby and that’s it — my child was comfortably feeding at the breast.”

Sivalingam feels that the long duration of breastfeeding helped her forge a strong bond with her little one. “When my baby was about two and a half years old, I started preparing her for weaning by telling her stories about how the milk storage is getting depleted and she would have to stop feeding from the breast. It wasn’t easy immediately after we stopped, more for me than for her. But things improved after about two weeks,” recollects Sivalingam.

A 2016 paper published in The Lancet, ‘Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect’, shows that scaling up breastfeeding to a near universal level could prevent 8,23,000 annual deaths in children younger than five years and 20,000 annual deaths from breast cancer among nursing mothers.

The worldwide study has further revealed that breastfeeding protects children against various kinds of infections, increases intelligence and promotes reductions in obesity and diabetes.

“For nursing women, breastfeeding gave protection against breast cancer and it improved birth spacing, and it might also protect against ovarian cancer and type 2 diabetes,” says the report.

Under the Global Strategy for Infant and Young Child Feeding, UNICEF and World Health Organisation (WHO) recommend:

  • Initiation of breastfeeding within one hour of birth.
  • Exclusive breastfeeding for the first six months of life.
  • Continued breastfeeding up to two years of age or beyond, with introduction of nutritionally adequate and safe complementary (solid) foods at six months.

Myths and facts

Here we bust some age-old myths and misconceptions surrounding breastfeeding and help you get your hands on the facts instead:

Myth 1: The first breast milk is too little for the baby

Fact: “This is a common misconception that families have because they feel that the mother is producing too little milk in the first few days, leading them to think that the newborn may need other foods to compensate the supposedly low nutrition intake. In fact, the ‘first milk’ or colostrum is thick and comes out in small quantities because at that stage, that is all the baby needs.

“This milk is rich in antibodies and protects the baby’s immune system from infections. Also, human milk shouldn’t be compared to cow’s milk, because the composition is different. Human breast milk adapts according to the growing baby’s needs and is packed with nutrients, which cannot be supplemented by other foods until the baby is six months of age,” Dr Ravneet Joshi, paediatrician and International Board Certified Lactation Consultant (IBCLC) practising at Manipal Hospitals, Bengaluru, told Happiest Health.

Myth 2: You should eat bland food when breastfeeding

Fact: Nursing mothers need a balanced diet packed with vitamins, minerals, proteins and carbohydrates. Lactating women burn about 500 extra calories a day. Therefore, it is essential that they replenish the loss with the help of a healthy and balanced diet. Simple, healthy and home-cooked meals that include a wide variety of foods are the best because, through breast milk, babies will also get acquainted with what the mothers are consuming. This will also help the children adapt and be open to different kinds of foods as they grow up, feel doctors.

Myth 3: Mothers do not need support with breastfeeding

Fact: The World Alliance for Breastfeeding Action (WABA), a global network dedicated to promoting breastfeeding, advocates that new mothers be given practical help and support for successful breastfeeding and to promote physical and emotional bonding between the mother and the child.

“New mothers are vulnerable and go through a lot of physical and emotional changes. Under the joint family structure common in many earlier societies, the other women in the household would often help the new mother in bringing up the child with tips and advice. Nowadays, many young mothers struggle to find their way around their newborn babies, be it the right techniques to hold them or the correct approach to feed them.

“They need guidance on feeding positions and helping the baby latch on to the breast and so on. The support has to come from healthcare providers, family members and the community — this is what we call the warm chain of support. In special circumstances, such as in vitro fertilisation (IVF) and preterm deliveries, the mother might need help in expressing milk and feeding the little one. That’s why receiving counselling and accurate information on feeding practices is important so that the mother feels relaxed, which again plays a role in increasing breast milk flow,” adds Dr Ravneet.

Myth 4: It is hard to wean a baby if you breastfeed for more than a year

Fact: According to UNICEF data, there are no studies to show that weaning is difficult. On the other hand, there is enough research that points that breastfeeding up to two years is good for both the mother and the child. It is, eventually, for the mother to decide how long she wants to nurse her baby.

Myth 5: Working mothers cannot breastfeed their baby

Fact: While it can be a challenge for working mothers to continue to breastfeed when they get back to work, it can be done with some planning and support from employers and family members. “While on maternity leave, prepare a solid ground for continuing breastfeeding when you return to work. Feed your baby frequently and on demand. Developing good feeding technique at this stage will help you build a good milk supply, which will make breastfeeding easier when you get back to work. If your workplace has a crèche or nursery, feeding your baby at regular intervals could be slightly easier. Else, consider feeding your baby in the morning; store expressed milk for the baby in sterile conditions so that a caregiver can feed the little one in your absence and breastfeed on demand once you are at home and at night. This way your baby won’t be denied the benefits of natural goodness that breast milk is blessed with,” advises Dr Ravneet.

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