Hala Sahili, Lactation Consultant & Pediatric Nutritionist, joined our Wellness Wednesday on Instagram Live on April 15th, 2021 to talk about breastfeeding.

Health Coach Hala Sahili is a professional who educates and helps mothers with breastfeeding matters. She is also a dietitian for children. She is responsible for encouraging healthy food choices for children of all ages and backgrounds by assessing and coordinating nutritional menus. 

All the questions asked during the Live session are answered below. Let’s have a look!

Q: Is it really that important to breastfeed?

A: Breastfeeding is a personal choice for the mother to make. She is the one who decides if she wants to or not, but we definitely recommend she breastfeeds. The first 1000 days of our lives are the most important. Just a reminder that these days consist of the nine months of pregnancy (275 days), the first (365 days), and the second year of life (365 days). They are the ones who shape us as people. The World Health Organization (WHO) recommends that women breastfeed during those first two years of life. WHO guidelines recommend exclusive breastfeeding for the first six months, then we introduce solid food to the baby’s diet starting six months old and we continue breastfeeding with complimentary food. This number includes women in third-world countries and women who do not have access to baby formula.

However, the American Academy of Pediatrics says women should exclusively breastfeed until six months of age. From then on, they should introduce solid foods to the baby while continuing to breastfeed up to a year of age or as long as desired by the mom and the baby. Why one year? Because at that age we can safely introduce cow’s milk as an alternative to breast milk without going through formula. Again I insist that formula is not bad, but breastmilk is the ideal nutrition source for the baby. Each mom produces breast milk tailored to her baby.

Q: Whether you are breastfeeding or not, should the baby be introduced to solid food at 6 months?

A: Yes. At six months or whenever the baby is ready.

Q: What are the benefits of breastfeeding for the baby?

A: There are thousands of benefits for the baby. I’ll mention just a few important ones especially for now. Breast Milk boosts the immune system. It contains antibodies and immunological parties. For example, if the mom, someone in the family, or even the baby is sick, the mom will produce antibodies to fight the sickness that will be transferred through breast milk to the baby. Nowadays, with Covid-19, if the mom tested positive or she had contact with someone positive, her body will produce antibodies to fight Covid, and these antibodies will be transmitted to the baby through breastmilk. What we’re saying is that the baby will suffer from fewer illnesses, diseases, respiratory and intestinal problems, infections, etc. It also decreases the risk of Sudden Infant Death Syndrome (SIDS) by 50%. Breast Milk helps get rid of a great number of allergies also. 

The breast milk produced is tailored for her baby. We hear a lot of moms saying “I changed the brand of formula and this one gave my baby diarrhea while another made the baby constipated.” Not only is the breastmilk tailored for illnesses, but its taste changes according to what the mom ate. Children that were breastfed grow up to be less picky eaters because they were already exposed to the taste during breastfeeding. Breastfeeding is also linked to fewer weight problems and obesity later on.

The only constant in breastmilk is that it changes all the time, unlike formula. Again, the baby formula is not bad, but it doesn’t change. Breastmilk on the other hand changes to fit the baby’s needs. It changes according to the age of the baby, according to the temperature because in summer it becomes more watery, it changes in flavor, if it’s day or night, it changes if it’s the beginning of the feed or the end, and more. 

Q: Is it true that some babies reject their mother’s breast milk?

A: They might reject the breast, but not the milk because this is the first thing they are exposed to like a food source unless it has to do with allergies, Cow's milk protein allergy (CMPA), etc.

The baby might reject the breast if it got used to the bottle. Around four months old, some babies have a nipple strike and refuse the breast, but there are a lot of techniques to help with this issue.

If the baby gets used to the breast from the first day of birth, everything will go well and the baby will not reject breastfeeding. It is natural, but the mom should be emotionally and physically ready to breastfeed. It’s a big decision that needs preparation. In the end, it is something very natural. It is in our system to give milk to our offspring. 

Q: What about the Covid-19 vaccine?

A: The opinions are very conflicted, some are for and some against. Personally, I would rather not give my opinion on the matter. Breastfeeding mothers should check with their OB-GYN because each vaccine is different. Some are saying that the baby will receive the antibodies, but we don’t know anything for sure yet. That’s why I say that this is a personal decision to be made with their health care provider.

Q: You mentioned that breastfeeding requires preparation, what goes into those preparations?

A: We have sessions with the mom before the baby is mom to explain everything about breastfeeding, to tackle truths and rumors. We try to alleviate these obstacles and prepare her mentally and emotionally to know what to expect in prenatal consultations.

Q: Could you tell us more about breast milk allergies?

A: We usually tell the mother that she can eat whatever she wants. There is no problem unless the baby is uncomfortable. For example, let’s say the baby had a reaction to dairy products, here we stop dairy products. Sometimes you hear people telling women not to eat beans or lentils, but she definitely can. Unless the baby had a reaction we stop them. The mom can eat sushi, beans, anything. There are no restrictions.

Q: What are the benefits of breastfeeding for the mother?

A: For the mother like the baby, there are several benefits. The first benefit or what we call “the non-milk benefit” of breastfeeding is just putting the baby on your chest and creating this bond. 

If the mother has a good experience in breastfeeding, studies have shown that breastfeeding decreases the risk of baby blues and postpartum depression because the levels of the love hormone oxytocin are higher while breastfeeding. This rush of oxytocin helps the uterus return to its regular size after pregnancy. 

Research is showing that mothers who breastfeed are sleeping better because breast milk lowers the risk of allergies and diseases so the baby sleeps better which in turn means the mom sleeps better. 

It helps the mother lose weight with 500 kcal as if she did one hour of intense workout. Some mothers reach 800 kcal if they produce a lot of milk like mothers of twins. 

Breastfeeding decreases the risk of ovarian and breast cancer, diabetes, cardiovascular disease, osteoporosis.

Breastfeeding is easier. There is no preparation involved or equipment to take everywhere while being always available. In this economic crisis, I hear it all the time “we can’t find this brand anymore or this brand is too expensive”.

Q: My milk is not enough for my baby, what can I do? I’m pumping to know how much he is eating, but I can only pump 120 mL.

A: 120 mL is very good. I don’t know if the mom only relies on pumping, but I would suggest she starts nursing and pumps to increase the supply. The more we demand, the more the supply so you have to breastfeed more and pump more. You can always increase the supply.

Q: If a mom decides, even before birth, not to breastfeed. What other options are available?

A: The first two to three days immediately after giving birth the mother produced the colostrum. She even starts to leak before giving birth. It’s going to come either way. The baby will get this colostrum because it is a shot of immunity that is extremely important. Even if the mom decides not to breastfeed, I advise her to give the colostrum because it is very rich in antibodies and immunological factors. It would be like giving the baby a vaccine. Afterward, if she doesn’t want to breastfeed, she will stop producing milk. As simple as that, when you don’t have a demand, there will not be a supply.

You can never know before trying if breastfeeding is for you or not. A lot of moms say they don’t want to do it, but try it and love it. Other moms say they will, but after trying they change their mind. So I always recommend trying and then deciding. 

Q: Does pumping reduce milk?

A: Not at all. The more you demand from your body, the more it will supply. We can increase the demand by way of two things: breastfeeding whenever the baby wants or by pumping.

Q: If the mom is in terrible pain and suffering while breastfeeding, what can she do? Will it end? She only started breastfeeding recently. 

A: She definitely should not be in pain. There is a problem with the latch. The baby is not latching well and the gums or the tongue of the baby are rubbing on the nipple which is why she might be in pain. So we need to correct that. Of course, in the beginning, this is new so she will feel weird, but it should not be painful or cause any complications like bleeding. 

We correct it by checking that the baby is taking the breast in the correct way. Just like you eat a sandwich and stuff it all to take a bite, we advise the sandwich the breast inside the baby’s mouth and keep the nipple away from the baby’s gums so they do not rub together and hurt the mom. Direct the nipple towards the roof of the mouth and the areola to be on the gums. We try to insert a big part of the aureola into the mouth because it is less sensitive than the nipple, so if the gums rub on it, it hurts less.

Q: Any tips on establishing a good supply for the first couple of weeks?

A: We go back to the idea of demand. Increase the demand by breastfeeding as much as possible, and if the mom suspects that she has a low supply, add pumping.

Q: When does the milk typically come in?

A: There are two types of milk and this is not well-known information. We have the colostrum first that stays sometimes until day 5. It is a thick yellow liquid. After that comes transitional milk which is a mix of colostrum and transitional milk, between white and yellow in color. Transitional milk stays until the end of the second week after which starts the mature milk. The mom can feel this transition because her breasts become heavier and she might have a small spike of fever. Mature milk is mainly white that stays with her until the end of her breastfeeding journey.

Q: Can a breastfeeding mom fast?

A: There are no general rules for breastfeeding. This is something very personal to each mom. If the mom can consume the amount of food and water she needs during Iftar and Suhur, she can definitely try to fast. The moment she notices any signs of dehydration in herself or her baby, or the baby is fussy, is sleeping more, or if she feels exhausted, has vertigo, she needs to stop fasting. 

Q: For my first baby, the nurse recommended I use a silicone nipple shield, does that mean I need it for my second baby?

A: No. It’s not a rule.

Q: Do you have to stop giving breast milk after you stop breastfeeding?

A: No, every drop of milk counts. A mom I know gives her kid a spoon of her breast milk after every meal and regards it as a boost of immunity and antibodies.

Q: Is it true that periods starting postpartum mean that the milk will decrease?

A: Periods starting means that we have a small dip in supply, but you need to breastfeed or pump more to higher the amount of milk.

Q: Can I consume coffee while breastfeeding?

A: You can have between 300 to 350 mg/day or two to three cups of coffee. If you notice that the baby is extremely aware, we decrease it. We recommend you breastfeed or pump and then drink coffee.

Q: When to decide to switch from breastfeeding to formula?

A: Whenever you want. It’s a personal choice, there is no right answer.

Q: I’m exclusively pumping. Is it necessary to pump every three hours at night?

A: At night, definitely no. Of course, she will not wake up every three hours to pump. You can go for four to five hours. It depends on the mom’s schedule and how much she is producing.

Q: What is the composition of breast milk?

A: Everything. Everything that your baby needs. This topic needs a Live session by itself. Breast milk everything contained in baby formula in addition to live cells, stem cells, antibodies, immunological factors, vitamins, proteins, fats, and more. It has iron in it that stays until the end and it is more bio-available in breast milk.

Q: How to stop breastfeeding?

A: You stop it gradually. You decrease gradually because if you stop suddenly, the mom will experience some discomfort and side effects. We decrease the demand.

Q: Are all breast pumps good?

A: This is also a personal choice. If you want to pump once a day, a manual pump is fine. If you are a working mom or you pump exclusively, electric pumps are better. There are different pumps depending on the need and why the mom wants to pump.

If you’re a mom-to-be or already a mother, check out Hala Sahili’s Instagram page @beyondbreastfeeding for more useful information about you, your baby, and everything else you need to know!

That’s all folks! Thank you for joining us for this session and thank you to Hala Sahili for this valuable information. Stay tuned for more Wellness Wednesdays to come.

If you have any questions or topic suggestions, feel free to reach out to the Mint Basil Market team.

April 16, 2021 — Mint Basil Team

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