Growing Little Humans | Transcript: Feeding Your Baby: Navigating Breastfeeding, Formula and Beyond

February 25, 2025 • 28 Minutes

Feeding Your Baby: Navigating Breastfeeding, Formula and Beyond

Transcript
ENGLISH AND ARABIC

Breast Feeding VS Bottle Feeding

Guest: Zahra Mokhber Senior Lactation Consultant, Kings College Hospital London, Dubai.

00:00 
I'm Melissa. And I'm Lea and we are busy mums, company founders and all round early learning nerds. Welcome to our podcast, Growing Little Humans. Kids aren't born with a user manual so each week we'll try and cover many topics that you guys encounter and worry about each and every day while you're raising your little humans. Good morning. Hi, today we have Zahra with us. Thank you for joining us Zahra. Thank you. And today we're here to talk about

00:28
breastfeeding versus formula feeding, which is a very ongoing debate. That's true. Thank you very much. That's a very good question. So, first of all, I have to just say that with no doubt breastfeeding is the optimal way of feeding a newborn because of the benefits that it provides for the mother and for the baby. However, there are some conditions that formula feeding might be required. It could be because of a

00:54
medical indication, it could be the mother's choice, it could be temporary, it could be permanent, depending on the condition. So, I will discuss both of them. So, what would be the reasons that it's discussed that breastfeeding is, yes? It's a time that's very fraught with anxiety for new mums, isn't it? Because you know, you're having a baby for the very first time, or it might be a second or third baby, and perhaps the first child that you had, you could breastfeed, but the second baby, you're

01:24
very anxious, isn't it Mel? It is, it certainly is. And as we know every pregnancy and every birth and every child is different, so it might have very different experiences. Absolutely, absolutely. So that is why it's very much recommended that we see the mother in advance. We see the mother in advance, check everything to make sure that how we can help the mother and customize that

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how we can help this baby and how it's going to be the feeding decision for the mother. So, then they can make an informed decision about how they want to feed the baby and what their feeding goals are. And I think you started to touch on a few things that could impact on being able to breastfeed. Can you go into a little bit more depth about that? Absolutely. So, there are some medical indications that a mother might not be basically able to feed the baby.

02:13
Like say just an example is that if mother is going through chemotherapy, so this is a contraindication with the breastfeeding. If baby has, for example some inherited diseases like galactosemia, the baby needs a special formula, but they are very rare conditions. Yes. So, we have to make sure. Not for the average mom. Exactly. And the average mom is that you have to, it's just the common challenges. It could be social cultural. It could be.

02:41
you know, the pressure of the community. It could be the mother hasn't been educated, doesn't know about it. And breastfeeding overall needs practical skills. So, without those practical skills, without delivering the evidence-based information to the mother, you cannot expect the mother to do everything on their own. This is a shared responsibility. Mother needs the full support from family, from community, from health workers, everyone

03:09
has a share in this. And I think you made a really good point before Zahra as well about mums getting education on breastfeeding prior to having the baby so that they're in a good place before they even give birth. They know about breastfeeding; they know about the challenges of breastfeeding. What kind of things do you offer at King's prior to the baby being born for the mums? We have a very nice antenatal

03:39
classes, it's a group classes, we invite fathers and mothers both because we always, it's very important to get them involved because they are the support system for the mother and mother will never be left alone. When the father knows about all these things he's always in the picture. And they can understand. They can understand it. They can take roles, which part I can help, which part I need to support you that you have to do that. So, all those things come to a conclusion

04:09
have antenatal education overall and specifically for breastfeeding and get the family involved in that. And supporting. Exactly. Because even like you said before that pressure, that can actually impact on the breast milk as well. So having everyone involved, supportive, absolutely. helps mom. It's all about mom. Absolutely. Because if we don't support the mother, we don't deliver evidence-based information for the mother, no practical skills or

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it has been introduced to the mother and helped, then mother might have challenges. Might struggle. Exactly. So, they will have a struggle. But the problem is that the thing is that now, feeling the guilt of it, the shame of it, and the fear of judgment, that will lead to anxiety for the mother and prevent her from seeking help. This is when often the majority of the challenges are easy too.

05:05
I think too, if you've attended those antenatal classes and if you've listened to the evidence-based research, the actual facts of the matter, and you have an understanding of how breast milk can actually help your child in those first six months of their life more significantly, then a mother would always choose, I think, to breastfeed her child if she's got the choice. You don't always have the choice.

05:34
But if you've got the choice, I think you understand that the benefits far outweigh everything else. Yes, one of the biggest topics that have to be communicated with the parents is the benefits of breastfeeding, not just for the mother and the baby, for the community and for everybody. But what specifically are the benefits to a newborn to have the breast milk as opposed to formula? Very good question. There are lots of benefits for the baby. Number one is that the ideal

06:00
food for the babies. Mother's milk is a perfect balance of whatever baby needs for the first six months of life. And on top of that, the mother's milk boosts up the immune system in the baby, so it makes them strong against infections, specifically ear infection, lung infection, gastro infections for the baby, so significantly low in the breastfeeding babies. At the same time, the episode of asthma allergy

06:26
these are much less with the breastfeeding, it's easier to digest for the baby. And the intimacy provided by the breastfeeding actually is the loss of evidence. That bonding. That bonding helps with the brain development of the baby. Amazing. And for the parents, do you want me to talk about the benefits for the mother? That's what I was going to say. Yeah. I know that in my research, I saw that these obviously benefit mom as well. So, can you let us know about that then? There's absolutely benefits for the mother.

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And number one is that I would always emphasize that the research shows that breast and ovary and cancer is significantly less. Wow, that's amazing. Breastfeeding mothers and the hormones in the breastfeeding in the mother's body basically, one of them is called oxytocin and it helps the uterus to contract and go back to pre-pregnancy size. And the breastfeeding is a recovery of all the changes mother had in pregnancy and it's actually

07:22
very nice to get back to pre-pregnancy shape. And back into shape. Exactly, we all want to get back into our jeans. Exactly. But, you know, I mean, I've had two children. I didn't know that breastfeeding actually helps with that and also that it can help to prevent cancer. I had no idea. Yeah, it's amazing. These are the things that when you basically discussed, and you might actually

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help them better to make an informed decision. Exactly. Because when they don't know, they are not making an informed decision. It's just a decision. It's just to help them persevere a little bit when it gets a bit tough. Absolutely. And when I was reading up about you and about kings, I stumbled upon the statement, responsive feeding quite a lot. Yes. Can you explain what that is, responsive feeding? That is my favorite topic, I would say. Great. Because responsive feeding means that

08:19
the parents look at their babies, follow the feeding cues of the baby, and respond to that and feed the baby. It looks like you're talking about feeding, but it's a little bit deeper than that. So, you're grabbing the attention of the parents from the clock to the baby's face. There's nothing written on the clock. Everything is written on your baby's face. So, what happens?

08:43
I as a parent, I'm just looking at my baby. I'm just looking at my baby. And I make sure that I understand every single bit of move of my baby. So, it's not just about the feeding cues. It is about cues of the baby feeding cues at the beginning, but then it becomes in time, it becomes a habit. So, you respond to the baby. So, the idea, the deeper meaning of responsive feeding is to build a strong relationship

09:09
between the parents and the baby. So, what happens? Parents actually responding to the baby starts with feeding cues, fulfilling, satisfying the baby's feeding needs. But then later it's a habit. You just keep responding to the baby. You hold the baby more often; you pay attention more often to the baby. But at the same time, on the other hand, the baby learns, oh, there are two people around me. I need to give cues. Or even more than that. With this, no, with this smell

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with this touch, with this voice, that they are there for me. Now they start building a relationship based on trust. And that is very important. So, it's so much bigger than just feeding, isn't it? It does apply to breastfeeding and formula feeding babies. So that means responsive feeding, it's not just about the feeding. It's about responding to the baby, building a relationship with babies on trust. Wow.

10:07

That's really amazing. So, you're not just doing the, okay, I'm going to feed the baby, you know, two, four, six, eight kind of thing. You're just, you're taking the cues, you're establishing that bond with a child and understanding the nuances in their behavior. Absolutely. Their personal routine rather than our routine. Yes, absolutely. Enforcing a routine on the baby. Enforcing a routine, yes. So, when we talk about breastfeeding, can you discuss some of the challenges that mums face.

10:37
Absolutely. The first few days, it feels sometimes that it's a wow, it's a full-time job day and night. And it makes mother tired and sometimes the father even feels left out. And so, these are the things that sometimes happen. But again, when you prepare them, that set the expectations, that this is because of the

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small stomach size of your baby because your milk needs to be built up, you need to work like a team. Give it a week, give it a couple of weeks and then you see things will be different. So having that discussion and the mindset that they have in advance before they come after the baby in their arms, then it makes a huge difference. And the father understands that okay, there are some parts that I can take the role and always mother can

11:32
pump milk, express some milk and father can feed the baby. Yes. They will understand after some time that, OK, how can I help better? Where are the gaps that I can feel? Yes. And I am involved. Definitely I'm not left out. But how can I help? And mum just kind of needs to, I guess the first few days, it's a very intense time. You've got the blues, a little. Some women experience that a lot, some just a little. And then you're also just trying to get used to breastfeeding and learn how to do it. Absolutely.

12:01
Some women take to it so naturally and other people like me just totally did not take to it. And it was really a challenge for me to learn how to breastfeed. And then I got mastitis and several other things which can be really painful and really put you off breastfeeding as well. Yeah, so I was going into those other challenges like with the one that you just mentioned. Usually what happens when the mature milk starts to kick in and come

12:31
mother feels heaviness on the breast. This is what we call it engorgement. This is one of the things that we call a challenge for the mother, but it can be prevented. It can be, again, the mindset of the mother within these days, you're going to have a little bit harder breast, you're going to have a production starts to kick in. So, I want you to be aware of your body. It's a simple language with the mother. Get their hands on the breast. So, this is what it feels like

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getting hard. This is what it feels like, oh it's okay. So, within those days they'll make sure that you're more aware of your body, check your breasts regularly and don't let it get super heavy because when it gets super heavy it becomes painful, it can cause potential infections, so it can be prevented. So, the best way of helping the mother first is to

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teach them how to prevent things, rather than when it comes the problem, of course, to discuss how you basically overcome the challenges, how to manage them, but how to prevent them is the most important part. One of them, one of, sorry. I was just going to say, I feel really sure, and in my own experiences too, those first few days in hospital, if you've got a really supportive team of nurses and midwives around you, that are helping you with those things, showing you

13:50
you know, the indicating signs, okay, now can you feel the difference in your breasts now? And just getting, you know, even mentally, just getting you through those first few days when you're experiencing all these things. Absolutely. As you mentioned, the first few days are crucial days. And we have to understand that mother is also recovering from the birth as well. Yes. It's not about just the baby. You have two people to take care of. But let them work as a team, put them together.

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remove all the barriers between mother and the baby, keep them in the same room, help them to understand how to responsive feeding, how to feed the baby. One of the main challenges is the soreness on the nipple, which is usually is about the way the wrong positioning and attachment techniques, which can be easily taught to the mother. So, it's very important those first few days that

14:46
fully support the mother and the baby, has a lot of hands-on practical skills for the mother and make sure she gets confident. I think it gives you lots of ways to cover, you know, if you're feeding, this might not feel comfortable for you, even when you have twins or multiple births, all different suggestions on what you can find so that you're comfortable with the experience. You're absolutely right. And like Lea said, you know, those people that are there in those first early days to say, look, that doesn't kind of feel right. You don't really know what right is.

15:14
Yes, okay. Well, put a pillow underneath you or you might want to hold them this way and that's absolutely I mean you can go home feeling a lot more confident. Yes, what you're saying is absolutely right. I mean when I asked your mother that she says well, I'm breastfeeding is sore but it's okay and I said it's not okay. Yes, it's not how come?

15:35
being sore is okay. That means that we can do a little bit better work. So, let's see how I can help. Let me watch. Let me see. Yeah, let me watch and see. Exactly. What we can do. And sometimes it's the smallest change, isn't it? Like you're just talking about the position of the baby or the head or the smallest change, but it can make such a difference, can't it? Yes. Absolutely. It's true. Yes, absolutely. So, we've talked about the challenges of breastfeeding. What about the challenges of formula feeding? Very good question.

16:03
So, the challenges for formula fitting basically, number one is the convenience and availability. We all understood that, better understood that in the pandemic time, that it was not always available, but mothers' milk was available with the mother, with the baby at all times. And the cost involved in that, and the preparation is timely.

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But it's very important for us to understand that once formula feeding is in the picture, again that is our duty to make sure mother knows exactly what type of formula is the best

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formula that suits her own baby's needs, because it's different, it might be different with each baby, right? There are so many different formulas. Exactly. So, there are different formulas, not that they are completely different, it's just marketing sometimes, but however, so mother knowing scientifically that which one is the best one for her own baby, suits their own baby's needs.

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At the same time, how to prepare it, that formula. And the sterilization process. And the sterilization, how to safely provide it by W-Drug guideline. At the same time, how to store it, how to give it to the baby. How to, the paste bottle feeding. All those things are actually a skill that nobody knows. So don't assume that, okay, go and buy this and then no. It's a full session. So, as we discussing and

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teaching mother how to breastfeed, remember, you never, nobody should be making decision for the mother. Our job is to make sure that they know about all these facts, advantages, disadvantages, but the decision on how they want to feed the baby is from the mother. So, we have to make sure that they make an informed decision, but once they make the decision, it's everybody's job to make sure that they support the mother, to make sure that she actually fulfills the

18:06
meet the goals of her infant feeding, what she wants to do. So, this is... I remember feeling very jealous of breastfeeding mothers when it was 2am in the morning and you have to get up, wander down to the kitchen and do a full prep of a formula bottle instead of just grabbing Bubby from the cot and, you know, attaching them in bed laying down and I used to feel very jealous that I had to fully wake up

18:32
and you know go through that entire process. So, I know that I wished I was breastfeeding many times instead of and the sterilization it's intensive isn't it that whole bottle washing process. When you're when you're basically formula fitting is very time-consuming. Very. And they're breastfeeding as you mentioned they just wash your hand to feed the baby. Yes, don't go on holidays with your formula feeding. Don't go on holidays.

18:57
You've got to take the sterilizer and then you've got to make it clean. You don't need any equipment; you don't need anything actually. It's ready at the right temperature. I just wash my hands and feed the baby. Yes. But one more thing is important, that we know that there are no formulas. There are no formulas. This is an acceptable food in the absence of mother's milk, but there are no formulas that provide any immunity. Right. They don't help to build the baby's immunity. That's another thing that we have to consider.

19:26
Right. But I would always say that the first priority is to feed the baby. Every baby is different. As you mentioned, every mother is different. So, you have to make sure that at the time, at the condition of them both considering both how you can help them, of course, with the priority of the mother's milk and the mother's decision how she wants to feed the baby. However, if formula is in the picture, again, we have to make sure.

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that mother has full education and to minimize the risk of infection because formula, usage of formula can be associated with higher episodes of sickness for the baby. And whether a mother is breastfeeding or formula feeding, when it's time for her to return to work, what are the things that

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mums kind of need to be aware of in that preparation for going back into the workspace. Yes, very good again. Preparing mother in advance is the key for that. So, if mother is breastfeeding and wants to go back to work, we usually ask the mother to start having some stored milk in advance that always will become easier later when she goes back to work and she can start pumping and from day one that baby is born. But the extra milk to store

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we usually suggest from third weekend after. I remember you used to have a lot of.

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I did, I think. Yes, I'm a preparer, so yes, I used to have, I was worried that something was going to happen, and I did. Very nice, very nice. And you know you can't do much. There was nothing else in the freezer, just that. Just breast milk. I had to buy a chest freezer at one point, but there was food in there. I had mothers, they had to buy another freezer, actually an extra one. So, you probably were one of them. So yes, that, it always brings. So, after three weeks, they can start

21:23
the first two weeks, whatever your extra pumping give to baby. Because they are losing weight, gaining weight. At the beginning, right. They are at the higher risk of growing jaundice. We want the baby to feed more. And dad can enjoy feeding the baby too with a bottle then. Quality time feeding the baby. So, it's another thing to leave mother and rest. But from third week, if baby getting what baby needs from the breast, that extra milk that mother is pumping, instead of

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let's say the last week she wants to go back to work and now she has to rush. Yes, then she can spread the work true twice a day. You can pump and keep it in the fridge. You didn't use it at the end of the day put it in the freezer It can be stored in the freezer six months six months. I was just going to ask you yes; six months you can store it in the freezer now right before going back to work a week before going back to work I usually discuss with them. It's very wise for the mothers to have a discussion with the workplace

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discuss about is there a possibility that I can work from home? That is, is that an option? If not, then discuss the breastfeeding time with legally every mother is entitled to. So, or pumping time, check the private area, make sure everybody's mindset at work knows that this is what you're going to be doing when you're going back to work. Now, when mother goes to work, it's like pumping at work.

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breastfeeding at home plan to make sure that she maintains her milk supply at the same time baby benefits from the milk that mother is pumping. The milk she pumps at work, she keeps it in a cool box with an ice pack, transfers it definitely in Dubai, everything should be transferred to the cool box in an ice pack and then goes to the fridge when baby will use it the day after. Now today I was at work, I was super busy. I was supposed to pump three times; I pumped two times only.

23:18
Then where is the backup? In the freezer. Yes. So, you see that backup, how it can fill the gaps. So, it's not routinely you're going to use it. You still will briskly and pump after going back to work, but you have a nice backup in the freezer. And then how long do you think that people should just breastfeed for and when should solids be introduced ideally? A good question. What is the WHO UNICEF recommendation is that

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the first six months, if mother's breastfeeding, all baby needs is the mother's milk for the first six months. But at six months is not enough. And to be adding the solid food for the baby, at six months and continue breastfeeding as long as mother and baby wants, but the recommendation is up to two years or beyond because the research has been done on those timing. However, the decision is mother. I have people going over that, I have people less than that. But at six months is the

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a time that they are suggesting even for the formula fed baby. The first six months, they are using the formula age appropriate for the baby, and the six months you add solid food. The pediatrician who's checking the baby, either breastfeeding or formula feeding, they will suggest otherwise if it's needed.

24:35
Okay, okay, so it's, yeah, most babies, the average is six months, but on a case-by-case basis, as we know, every baby is different... Absolutely. Let's say premature babies a little bit earlier, like babies born before, let's say, 35 weeks... To try to put on weight. Yes, exactly. And so, I've heard many times that when we had our children that you should not bottle feed post 12 months because it can damage their teeth. Is that correct?

25:03
There is much research done on the bottle with teeth usage. And first of all, it's not recommended for the first month because nice cups are provided in many hospitals that baby can either mother's milk or formula, baby can get it through a cup. And that is because the way a baby sucks on the bottle with teeth is totally different from the way that baby sucks at the breast.

25:30
So that can actually interfere with the mother being sore or affect her milk supply. So, because of that, it's not the first one until milk supply is established, it's not recommended. After that, with very good hygiene because it can be usage of pacifier and this can be the number one source of the, as you mentioned, the oral formation of the baby. At the same time, the thrush and infection.

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this kind of infection for the baby in the mouth. That's why the sterilizing is very important. And yeah, many mothers choose to do cups, sippy cups. And once you start, we have many mothers that once they start from the first month and they continue doing that. Unless the mother wants to go back to work or they have a provider for the baby, they're not sure if they can do it. So, in those cases, they go to the bottle. But usually you are right, there is evidence that we are

26:28
talking about that and we want to avoid it as much as possible but then again if it's needed then with good hygiene it can be used. Well, thank you Zahra, we've really enjoyed talking to you about this. It's such an important topic for mums and I think you know from our conversation today my biggest takeaway is that we really need to ensure that mums are doing their antenatal classes

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so, they have that really good understanding, they're setting the expectations ahead of the birth. And then they have that support network that's around them, community, family, you know, their hospital, their midwife, their nurse team, and their pediatricians, so that in a post-baby environment, they have everything they need to thrive. Absolutely. Thanks for joining us. Thank you. Thank you so much. Thank you very much. And here come the legals.

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Our podcast is purely brought to you for educational and entertainment purposes. We are just two hectic mums, and we are certainly not licensed therapists. This podcast is not intended as a substitute for the advice of licensed or qualified professionals and if you do need some help, please seek out some professional advice.

الرضاعة الطبيعية مقابل الرضاعة بالحليب الصناعي

تاريخ الحلقة: الجمعة 19 يوليو 2024
الضيف: زهرة مخبر، استشارية الرضاعة الكبرى، مستشفى كينغز كوليدج لندن، دبي.