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This is with reference to the article titled “Maternal and neonatal factors adversely affecting breastfeeding in the perinatal period”. (MJAFI 2005; 61: 216-19.). We have the following comments upon the case report:
The authors must be congratulated for highlighting various risk factors which may interfere with successful establishment of breast feeding in the mother-baby pair. In addition to the various factors mentioned by the authors, antenatal preparation for breast feeding remains very important for successful lactation. The antenatal preparation involves breast examination to look for retracted nipples in the antennal clinic and advice to the mother about advantages of breastfeeding her baby. This helps in motivation of the mother and successful establishment of oxytocin reflex (milk ejection reflex) at the time of breastfeeding. Unfortunately this important component of the strategies to enhance the success of breastfeeding is often overlooked.
We carried out a survey of 100 successive mothers who delivered in our hospital. The mothers had been followed up at antenatal clinics at various services health centres locally and referred for delivery to our hospital. Of the 100 mothers, only 22 mothers had breast examination done in the antenatal period and only 17 mothers had received any advice about breast feeding. Seven mothers were found to have retracted nipples in the post natal period which interfered with establishement of successful lactation. These mothers needed special counselling and support for management of sore nipples. Earlier detection of retractile nipples in the antenatal period followed by appropriate maneuvers to make the nipples protractile would have helped in avoiding the breast feeding problems. The antenatal preparation for breast feeding is essential for ensuring the success of breast feeding in the perinatal period.