From August 1 to August 7, the World He alth Organization organizes World Breastfeeding Week. We spoke with Vladimir Trofimov, CEO of Medela LLC in Russia, about new scientific research that is changing the way scientists think about breast milk.
Expert: Vladimir Trofimov, General Director of Medela LLC in Russia
Home: Many people say: our mothers fed us mixtures, and we grew up to be quite he althy people. Maybe breast milk isn't that important?
Vladimir Trofimov: If we are talking about a he althy full-term baby, then, probably, even on completely artificial feeding, he will not have serious problems. However, no one will ever know what a child has lost without receiving mother's milk at the right time. In addition to the known constituents of breast milk, which the industry is still unable to replicate in formulas, every year new information about the composition of breast milk emerges. For example, recently there was evidence that breast milk contains stem cells that contribute to the development of organs and tissues of the child. And it will certainly not be copied by the industry in the near future.
But this is if we talk about a he althy baby born at term. For a premature baby, breast milk is life. There are more than shocking figures showing how much the death rate in premature babies is reduced, provided that they get even a few drops of breast milk. For example, when using breast milk, mortality from necrotizing enterocolitis is significantly reduced (in premature newborns weighing less than 1500 g, mortality from this disease can reach 50%, with a weight of more than 2500, mortality ranges from 0 to 20%).
Home: It turns out that we still do not fully know the composition of breast milk. And what can be said about the mechanism of its appearance?
Vladimir Trofimov: The science of breastfeeding has stood still for a long time. For example, almost until the end of the 20th century, data on the anatomy of the lactating mammary gland belonged to studies of the middle of the 19th century. From textbook to textbook, pictures of Dr. Cooper were copied, who conducted his research on cadavers by retrograde injection of molten wax. Is it necessary to say that the anatomy of the mammary gland with this method of research was described incorrectly? At the same time, for a long time, doctors had misconceptions about the mechanism of sucking a child: it was believed that it was based on the perist altic principle that milk enters the child's mouth by squeezing it out of the chest. This is completely wrong.
With the support of the Medela company, which initiated scientific research in this area, it was possible to find out that vacuum plays the main role in the mechanism of sucking a child and, accordingly, extracting milk from the mammary gland. In addition, it was found that the baby sucks differently. He starts with frequent shallow sucking movements - the stimulation phase, and after a few minutes goes directly to the sucking phase. By imitating a similar mechanism in breast pumps, you can increase the amount of milk and reduce the pumping time.
Home: It would seem that breastfeeding is a simple thing, which at the level of biology should be clear to mothers. Why do many moms have so many problems breastfeeding?
Vladimir Trofimov: Today they often say the phrase: "Before, they gave birth in the field, and nothing." Yes, they used to give birth in the field. But only not so many children survived after being born in the field. The same goes for breastfeeding: if the parents could not hire a wet nurse if breastfeeding was not possible, the child might not survive.
If mom's breasts are okay. If the child is he althy. If the mother manages to be always next to the child. If everything is calm. If the mother is supported by the family, there is no stress, then she will do just fine without our products. But all these "ifs", unfortunately, very rarely gather at one point. Something is going wrong. It is very important that these “ifs” do not cause a woman to refuse breastfeeding. She should know that so many problems can be solved. And here we try to be as useful as possible: the company has been operating a “hot line” for several years, by calling which mothers can get competent advice both on the use of breast pumps and on all issues related to feeding and pumping. The main goal of the company is to help, guide, suggest, and maintain the he alth of mother and baby. After all, babies usually know best what they need and how to get it. However, sometimes babies and their mothers still need support.
Homemade: When do you need breast pumps?
Vladimir Trofimov: Indications for the use of breast pumps can be divided into two large groups - medical and social. There are quite a few of both. Medical indications for a mother are a lack of milk, an excess of milk, engorgement or lactostasis, cracked nipples. Also, a medical indication can be considered the need to start lactation after childbirth. If the baby, being he althy, for some reason does not suckle very well, or in a medical institution there is no way to ensure the joint stay of the mother and child and normal attachment to the breast, the breast pump will help to fully start lactation in order to avoid problems in the future.
Social reasons no less. Modern mothers, even those who are on parental leave up to three years old, are likely to be forced to leave from time to time: for work or study, due to illness of their own or their child. And even just to maintain your social status - meeting with friends, going to the cinema, theater - sometimes you need to leave the child with a grandmother or a nanny. To maintain lactation and provide the child with breast milk for the period of his absence, a breast pump is useful. In addition, milk frozen in the freezer can be stored for up to six months, so that a mother can create her own milk bank, and in case of a lactation crisis, a temporary cessation of feeding or returning to work, she can continue breastfeeding.
Homemade: How to take care of your breast pump?
Vladimir Trofimov: There is a general rule: after each pumping, all parts of the breast pump that come into contact with the skin or milk must be separated, disassembled to the smallest detail, thoroughly washed from milk residues, after which are disinfected. This can be done by boiling, using a household sterilizer, or in the microwave in special bags. If mom uses boiling, it is imperative to monitor the water level in the tank, because if it boils away, the parts will be hopelessly damaged. It is advisable to boil in soft water, otherwise the parts will very quickly become covered with limescale. The microwave is a very convenient and fast way. Our company has developed special reusable sterilization bags, in which you can sterilize breast pump parts, bottles, nipples, etc. in the microwave several dozen times. into the microwave. Usually three minutes at maximum mode is enough to disinfect the product. However, these methods are only suitable for home use. It must be understood that infection in medical institutions is an order of magnitude more dangerous than at home. That is why maternity hospitals and perinatal centers should use clinical breast pumps that meet sanitary requirements and that can be sterilized according to the regulations approved for medical institutions.
Home: Are there clinical breast pumps in maternity hospitals? None of our friends have ever seen them.
Vladimir Trofimov: Currently there are clinical breast pumps in maternity hospitals. But not in all and not in sufficient quantities. It is for this purpose that we supported the program of the Russian Association of Perinatal Medicine Specialists (RASPM) "Safe Expression" and are ready to equip maternity hospitals and perinatal centers of several regions with clinical breast pumps free of charge.
Home: If a woman takes her machine with her, what rules should be followed in the maternity hospital? And how is inpatient care different from home care?
Vladimir Trofimov: First and most important: in no case should you give your domestic breast pump to your neighbors in the department. Secondly, it is necessary to pay close attention to the issues of washing, sterilizing the breast pump and subsequent storage of milk after pumping. The fact is that domestic breast pumps cannot be sterilized using clinical methods.
When using a domestic breast pump in a hospital, a mother must understand that she does this at her own peril and risk. Most likely, the medical staff is unlikely to help in sterilization. But if the mother uses a clinical breast pump, the medical staff is obliged to ensure sterilization.