REVIEW PHILIPS AVENT
«Professionals can give advice, but it’s the child that teaches us what they need»
her to lose the pregnancy weight. “Women have the right to make
informed choices and that starts with prenatal education and being allowed to ask questions while making decisions along with the midwife or her doctor. This ensures confidence, reduces fear and gives her back the control, ultimately respecting her as a person capable of birthing and feeding her child,” said Cecile De Scally, a independent midwife and midwife educator with more than 15 years experience and speaker at the event. “The focus should be on ensuring women have access to adequate information on which to base their choice – not the choice itself. Breastfeeding is not easy, and mothers have a lot of expectations, including learning the actual techniques of breastfeeding. They’re constantly asking ‘How do I know I’m doing it right?’.” Dr Mohammad Miqdady, Division Head
of Paediatric GI, Hepatology & Clinical Nutrition at Sheikh Khalifa Medical City in Abu Dhabi, offered expertise on the clinical benefits of breastfeeding as well as insight to complementary feeding. He helped quash common misconceptions about contraindications for breastfeeding such as smoking, alcohol consumption (even though these are strongly discouraged), maternal obesity, caesarian sections and other issues that people think may stop a new mother from breastfeeding. Any true contraindications to breastfeeding are actually very few, as most of them, such as miliary tuberculosis or radiotherapy only require a temporary break until treatment is finished. Women taking certain prescribed medications should consult their doctor, as often medications can be changed to offer a safer alternative when breastfeeding and doesn’t offer a true contraindication. True contraindications include: A baby with galactosemia A HIV positive mother or suffering from the human T-cell lymphotrophic virus
Herpetic/varicella lesions on the breast Chemotherapy The use of ‘street drugs’ Taking all this in to consideration, 99% of women should actually be able to breastfeed.
Arab Health Issue 3 2011 53
WEANING AND INTRODUCING SOLIDS Dr Miqdady continued his talk on complementary feeding and the importance of allowing children to discover a healthy variation of food and that as long the child is gaining weight, there are no ‘rights or wrong’ in what order the parent introduces the food to the child, on the contrary to some cultural beliefs. A delay or avoidance of certain foods doesn’t decrease or indeed increase the risk of developing food allergies. Unless there’s a known allergy in the family to a certain food such as fish, eggs or nuts, there is no reason not to include small amounts of these in the child’s diet. Honey should be completely avoided until 12 months of age, and cow’s milk should not be given as the main drink until the same age. There is no compelling evidence to
change the current recommendations of introducing complementary foods at 4-6 months, but introducing solids before four months could be as harmful as starting ‘too late’ i.e. after six months when breast milk or formula doesn’t provide enough nutrients and calories
for the growing child. Before four months, babies’ kidneys and intestines are not mature enough for solid food. Another reason to wait to at least four months is the indication that any ‘solids’ given before this age can increase the risk of allergies.
ADVICE FOR HEALTHCARE PROFESSIONALS Gynaecologists, midwives, breastfeeding advisors, nursing professionals, neonatologists and paediatricians must work together to provide new mothers and mums-to-be with all the necessary information on breastfeeding and child nutrition. They should take the view that it is every mother’s own personal decision how she wants to feed her child, and she should receive professional support in that decision. Encouragement to take part in ante- and/or postnatal support groups is essential to expectant mothers and will allow them to make a more informed choice. Cecile De Scally concluded her talk at the event: “We professionals can all give advice, but it’s the child that teaches us what they need.” ■
AH
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