Rosalee Brown

'Breastfeeding in the first hour saves one million lives' is the theme for the 2007 World Breastfeeding Week observed here between September 16 and 21.

Jamaica adopted the Mother/Baby Friendly Hospital Initiative (BFHI), a global campaign of UNICEF and PAHO/WHO. The initiative seeks to foster national action by preparing the health system and mobilising health care workers to protect, promote and support breastfeeding.

Initiating breastfeeding within one hour of birth is step four of the 10 steps to successful breastfeeding under the BFHI. There is now new evidence to suggest that not only is skin-to-skin contact important in the first hour, but that there are many benefits to babies and mothers as a result of this first hour initiation. Findings from one study, published in the journal Pediatrics 2006, showed that ensuring initiation of breastfeeding within one hour of birth could cut, by 22 per cent, all neonatal mortality.

Yellowish, sticky milk

Early breastfeeding increases the contracting of the uterus, which reduces bleeding after giving birth. The hormone oxytocin, which helps with milk ejection, is also vital for contraction of the uterus and is increased by the baby's touch and suck. Another very important reason for initiating breastfeeding in the first hour is for the baby to benefit from the colostrum. This first liquid from the breast is thicker than breast milk, yellowish, sticky and very important to the infant's health. Colostrum is produced for up to three days after birth and in small amounts, unlike breast milk. Many mothers complain that they are not producing enough milk in the first few days or have milk and sometimes, unfortunately, give the infant other forms of feed.

The colostrum is very high in calories, proteins and carbohydrate and low in fat in comparison to breast milk. This highly dense liquid is designed to suit the newborn's small digestive system. Colostrum contains very large amounts of antibodies 'secretory immunoglobulin' which protect the mucous membranes in the throat, lungs and intestines and leukocytes which protect the infant from harmful bacteria and viruses. The antibody content of colostrum is highest during the first 12 hours after birth and so it is vital that early initiation be encouraged to provide the infant with its first immunisation.

Breast crawl

If facilitated, healthy babies can instinctively find the breast and will initiate breastfeeding in the first hour in women who have normal vaginal delivery. The baby's senses are highly developed and a healthy baby is very alert during this period. Studies show that if the baby is wiped, except for hands which should retain the taste and smell of the amniotic fluid, covered and placed skin to skin on the mother's abdomen, then the baby will crawl and latch on to the breast. This first skin-to-skin contact is also important in causing the bacterial colonisation of the baby's skin with the mother's bacteria.

Other advantages of this first hour initiation is that baby learns feeding skills quicker, it prevents low blood sugar levels in the infant and the mild laxative effect of the colostrum helps in the passage of the meconium - the first blackish stool.

There are various routines which surround this initial period which prevent initiation in the first hour. Many times babies are initiated with artificial formula to prevent low blood sugar levels, among other procedures, and it is only after these routine procedures are complete that the 'cleaned' and swaddled baby is given to the mother to be put to the breast. Research suggests that the benefits are greater to the mother and baby to delay these routines until after the initiation of breastfeeding in a healthy mother and baby.