Every August, the world marks Lactation Month to raise awareness about breastfeeding and support mothers in nurturing healthy infants. Globally recognized, the initiative highlights not only the unmatched nutritional value of breast milk but also its role in fostering a strong mother–child bond.
Breastfeeding is widely regarded as the gold standard of infant nutrition, providing vital vitamins, antibodies, and immune-boosting properties beyond what formula can offer. The WHO recommends exclusive breastfeeding for the first six months, followed by continued breastfeeding with complementary foods for up to two years or longer.
Lactation Month serves as a call to action—urging supportive workplace policies, community education, and professional guidance to empower mothers, normalize breastfeeding, and ensure healthier generations ahead.
In an exclusive interview with Mediworld Middle East, Ms. Mercy Alexander, Lactation Consultant at Medcare Women & Children Hospital, sheds light on the science and challenges of breastfeeding in today’s world. She explains that breast milk is a “living, adaptive fluid” that evolves in real-time to meet an infant’s nutritional and immunological needs, even producing targeted antibodies when the baby falls ill.
Ms. Alexander highlights the emotional and logistical struggles faced by working mothers despite modern breast pump technology. Limited workplace support, inadequate facilities, and lack of awareness continue to be barriers, often leading to early weaning and maternal stress.
She also dispels common myths such as the belief that frequent feeding means low supply or that formula-fed babies sleep better, emphasizing that breastfeeding is a learned skill that requires patience and guidance.
Exploring the unique bioactive components of breast milk, she underscores the role of immune factors like secretory IgA, lactoferrin, and HMOs, along with essential fatty acids such as DHA and ARA that aid brain development.
Addressing clinical indicators, Ms. Alexander notes that weight gain, diaper output, and feeding behavior remain the most reliable markers of adequate milk intake. She also outlines hormonal influences on lactation and stresses the importance of early skin-to-skin contact and frequent feeding for establishing supply.
She provides practical insights into managing common lactation challenges including mastitis, low milk supply, and painful latching—reassuring mothers that with timely guidance, most breastfeeding hurdles can be successfully overcome.
What makes breast milk uniquely adaptive to an infant’s evolving needs?
Breast milk is not a fixed recipe; it’s a dynamic, living fluid that adapts in real time to the needs of the growing infant. From the first feed, its composition changes hour by hour, responding to the baby’s age, developmental stage, and even health status. In the initial days after birth, mothers produce colostrum a concentrated, antibody-rich milk loaded with immune-protective components like secretory IgA, lactoferrin and leukocytes. These factors coat and protect the newborn’s gut, offering critical early defence against pathogens.
As the baby grows, the milk naturally adjusts, increasing in fats, calories and essential bioactive molecules that promote healthy development. One of the most remarkable features of breast milk is its ability to respond to illness. When a baby is unwell, their saliva communicates this through the nipple during feeding, triggering a targeted immune response in the mother’s body. This results in the production of specific antibodies that are then delivered to the baby through the milk. Breast milk is, in many ways, nature’s version of precision medicine tailored, timely and continually updated with every feed.
Even with modern pumping technology, what emotional or logistical hurdles do mothers still face at work?
Despite advances in breast pump technology, working mothers still encounter numerous systemic and emotional challenges that interfere with breastfeeding. One major barrier is time. Many workplaces do not offer sufficient breaks for regular pumping, which can negatively impact milk supply. In addition, appropriate facilities are often lacking. The World Health Organization recommends dedicated, clean, private and ventilated lactation rooms, but many mothers are forced to express milk in restrooms or unsuitable spaces like storage rooms.
The emotional burden of pumping at work is equally significant. It can be an isolating experience, especially in environments where breastfeeding is not openly supported. Many mothers feel pressure to maintain job performance while also managing milk supply and infant care, leading to stress and, in many cases, early weaning. Studies consistently show that robust workplace breastfeeding support not only improves the duration of lactation but also enhances maternal mental health and overall well-being.
What outdated beliefs about breastfeeding do you still encounter?
Despite increasing awareness, several outdated and inaccurate beliefs about breastfeeding continue to circulate. One common misconception is that frequent feeding indicates a low milk supply. In truth, frequent nursing often referred to as cluster feeding is a normal behavior, especially during growth spurts and plays a crucial role in stimulating supply. Another widespread myth is that formula-fed babies sleep better. While formula may take longer to digest, this does not equate to improved sleep quality. There’s also a belief that breastfeeding should be instinctive and effortless. While breastfeeding is a natural process, it is also a learned skill for both mother and baby and often requires guidance and support to establish successfully. Additionally, many women are told they must stop breastfeeding if they are on medication, but the reality is that most medications are compatible with breastfeeding. Trusted resources like LactMed and WHO guidelines offer accurate, evidence-based information on drug safety during lactation. Dispelling these myths through up-to-date counselling is essential for informed, empowered feeding decisions.
What are the key bioactive components in breast milk that influence immunity and brain development?
Breast milk is a powerhouse of bioactive components that play critical roles in shaping both immunity and brain development. Among its most important immune factors is secretory IgA, which provides mucosal protection by neutralizing pathogens. Lactoferrin, another key component, binds to iron and inhibits the growth of harmful bacteria. Human Milk Oligosaccharides (HMOs), unique to breast milk, function as prebiotics, feeding beneficial gut bacteria and supporting the development of the infant’s immune system via the microbiome.
In terms of brain development, breast milk provides essential long-chain polyunsaturated fatty acids such as DHA and ARA, which are crucial for retinal health and cognitive development. Additionally, it contains a range of hormones and growth factors like leptin and epidermal growth factor (EGF) that help regulate metabolism and promote gut maturation. These components work synergistically to support the infant’s development in ways that no infant formula can replicate.
Are there diagnostic markers to evaluate if a baby is receiving enough breast milk?
While there is no direct tool or device to measure exactly how much milk a baby consumes at the breast, several clinical and behavioral indicators provide reliable guidance. One of the most important is weight gain. Infants are expected to return to their birth weight by around day 10 to 14 and then gain approximately 150–200 grams per week during the first three months.
Diaper output also serves as a key marker. In the first couple of days, one to two wet diapers per day are expected. By day four onward, infants should be producing at least six wet diapers and three or more yellow stools daily. Other signs include rhythmic, effective suckling during feeds and a calm, satisfied demeanor afterward. Some research institutions are exploring biomarkers such as the creatine-to-creatinine ratio in infant urine to estimate intake, but this remains experimental and is not used in routine care. Regular pediatric check-ups and assessments by trained lactation professionals remain the gold standard for evaluating breastfeeding adequacy.
What hormonal changes regulate milk production postpartum—and what can disrupt this process?
Milk production is governed by a finely tuned neuroendocrine feedback loop. The hormone prolactin, secreted by the pituitary gland, stimulates milk synthesis, while oxytocin is responsible for milk ejection or the “let-down” reflex. Another important regulator is the Feedback Inhibitor of Lactation (FIL), a protein present in breast milk itself that slows production when the breasts are not adequately emptied.
Several factors can disrupt this delicate hormonal balance, especially in the early postpartum period. Delayed initiation of breastfeeding or infrequent feeding within the first 72 hours can significantly impair milk supply. Psychological stress, physical discomfort or a lack of skin-to-skin contact between mother and baby can also interfere with oxytocin release. In some cases, medical conditions such as thyroid dysfunction, retained placental fragments, or the use of certain medications (including decongestants and high-dose hormonal contraceptives) can inhibit lactation. Ensuring early skin-to-skin contact, frequent feeding, and maternal well-being is essential for establishing a robust and sustainable milk supply.
How do you assess and manage common lactation issues like mastitis, low milk supply, or painful latching?
Mastitis, characterized by breast pain, redness, swelling, and sometimes fever, is often caused by blocked milk ducts or bacterial infection. Treatment typically includes continued breastfeeding or pumping to ensure milk removal, along with warm compresses, gentle massage, and in some cases, antibiotics and anti-inflammatory medications.
Low milk supply is usually confirmed by signs such as inadequate infant weight gain or insufficient diaper output. Management strategies include optimizing latch and feeding frequency, using a breast pump after feeds to stimulate additional supply, and considering galactagogues like domperidone when medically appropriate. It’s also important to rule out underlying conditions such as hypothyroidism or hormonal imbalances.
Painful latching is another common issue and is often due to a shallow latch, tongue-tie, or anatomical challenges such as inverted nipples. A thorough assessment typically involves examining the breast and evaluating the baby’s oral anatomy. Treatment may include correcting positioning and latch, short-term use of nipple shields, or referral to a pediatric specialist if conditions like tongue-tie are suspected. Early identification and intervention can make a significant difference in breastfeeding success and maternal comfort.
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