In an interview with PREMIUM TIMES, a medical doctor with expertise in sexual & reproductive health, Damian Avar, also known as Sabi Doctor, speaks on the medical and health implications of breastfeeding and the role of a man in this noble business.

Excerpt

PT: Breastfeeding is an integral part of family life; as a medical practitioner, what will be your advice to women on breastfeeding?

Sabi Doctor: Well, when it comes to breastfeeding, there is a guideline by the World Health Organisation (WHO) that prescribes the modalities of breastfeeding a newborn.

According to WHO, immediately after a woman gives birth, breastfeeding should be initiated within one hour. That is, once a woman gives birth, within an hour of her delivery, she should commence breastfeeding.

Secondly, new mums are expected to introduce exclusive breastfeeding to their children for six months.

Exclusive breastfeeding involves only breastmilk for six months. Then, after six months, they can introduce complimentary food and continue breastfeeding the child for two years or beyond. That is as stipulated by the WHO.

PT: What is the health benefit of breastfeeding to the mother and the child?

Sabi Doctor: This question has been over-emphasised over the years; it is the basis for why there have been numerous breastfeeding campaigns in recent times.

Of course, some benefits accrue to the baby and then some to the mother, but specifically, the emphasis is always on the baby.

So we know that because of the richness of breast milk, a baby that is breastfed exclusively tends to enjoy protection against infections. Their immune system is robust to a large extent, which helps them fight infections better.

PT: What are the health benefits of exclusive breastfeeding?

Sabi Doctor: Specifically, exclusively breastfed babies enjoy protection against gastrointestinal infections. These are infections that often cause diarrhoea, and diarrhoea is one of the serious causes of a substantial amount of mortality in the newborn. But if they are breastfed exclusively they tend to do better in fighting these infections.

Also, it is an essential source of energy needed by the baby’s growth, and don’t forget that the early stages of the baby’s growth and development are critical.

Hence, they need a sufficient supply of nutrients and energy to sustain growth and development, and breast milk is a very natural and primary source of those nutrients and energy.

Another important fact is that exclusively breastfed babies tend to do well in weight control as they grow into adulthood and adolescence. Overall, they tend to have a lower rate of developing obesity. And by inclusion, that also spirals into conditions like diabetics.

PT: Some people often say breast milk helps the child become more brilliant. Is that true?

Sabi Doctor: It is a controversial standpoint that exclusively breastfed babies are doing better in terms of intelligence quotient (IQ) performance.

There are several arguments and different schools of thought but the point has been that exclusively breastfed children tend to do better in intelligence.

PT: You have spoken about the health benefits for the child; what are some of the health benefits of breastfeeding for the mother?

Sabi Doctor: The almost immediate benefit for her is that she does well with weight control. Exclusively breastfeeding a baby can help the mother lose some of the weight that she gained during the pregnancy.

Another one is that, although it does not apply to all women, a good number of women can prevent pregnancy for six months when they are exclusively breastfeeding their baby. We call that the Lactational Amenorrhea method of pregnancy control. It can be a temporary method of contraception, but there are limitations to this method, so nobody should depend solely on it as a method of preventing pregnancy.

Another very important one is that women who breastfeed exclusively have a lower incidence of ovarian and breast cancer.

PT: Speaking about breast cancer, some people say that men should suck their wife’s breasts to reduce cases of breast cancer?

Sabi Doctor: Well, at least in theory one may reason that if during the sucking action, the man notices a lump, that would increase the indices of the suspicion of breast cancer.

There is that aspect of the argument, at least in theory, that in the sucking action, the man would quickly notice early signs of a lump or maybe an unusual discharge, which may prompt them to seek better evaluation and early detection in early treatment.

If not for anything, it can help increase the likelihood of a tumour being detected and adequately addressed.

This would imply that the man would have to feel the breast while sucking. When a man is sucking his wife’s breast, he should take a minute or two to touch the breast, just in case he could notice anything usual; also, look out for discharges that may point to disease. It offers a lot of benefits that come with the pleasure of breastfeeding.

Also, some studies have shown that the overall risk of breast cancer is drastically reduced when the breast is vigorously sucked over time. But this is not a general medical doctrine.

PT: You said that the breast should be ‘vigorously’ sucked ‘over time’, how often should a man suck his wife’s breast?

Sabi Doctor: Well, there is no clinical recommendation that a man should suck his wife’s breast, let’s say, three times a day; there is nothing like that; we don’t have that; it is not a prescription.

So there is no amount of time that a man should suck his wife’s breast. If you want, you can suck your wife’s breast as many times as you want, as long as she is not feeling any discomfort; it is possible that if the breasts are over-sucked, the nipples may get sharped or irritated, and that might cause the woman pain.

As long as the woman is not having any pain or discomfort from the sucking action, they can go at it as many times as possible.

PT: What common practices can lead to breast cancer?

Sabi Doctor: Some of the risk factors associated with breast cancer some of these risk factors are behaviours; number one is smoking; whether you are smoking actively or passively increases your overall rate of having breast cancer.

When I say smoking, I am referring to Tobacco, cigarette specifically. So, women who smoke cigarettes have an increased rate of developing breast cancer.

Another one is not being physically active, which is associated with being overweight and obese. And if you are not physically active, there is a corresponding risk of being obese, and that is where the risk of breast cancer ties in.

The idea is that women who are obese or on the thick or big side tend to have denser breast tissue compared to slimmer ladies. But there is another dimension to that: women who are on the big side tend to have more estrogen receptors, which play out in the development of breast cancer.

Another is the abuse of oral contraceptive pills or hormonal contraceptives; a woman who is abusing or using oral contraceptives heavily is at risk of developing breast cancer, which is one of the reasons women whose mum had a case of breast cancer or genital cancer are advised not to use oral contraceptive.

These are some of the medical inclusion why some contraceptive pills may not be ideal for some specific group of women.

There are also factors like when a woman has a first-degree family member, maybe the sister or the mother, who has cancer, it increases her risk of having breast cancer as well.
Also, women who have never given birth before tend to have more risk of breast cancer as compared to women who have given birth; because breastfeeding reduces the risk of breast cancer.

PT: Is breast cancer limited to only women?

Sabi Doctor: It is important to note that men have breast cancer, but the risk is high in women, so if you are a woman, you already stand the chance of having breast cancer because you already have a well-formed breast.

PT: Some women are deterred from breastfeeding because they fear that breastfeeding would cause their breasts to sag or fall. Is that true?

Sabi Doctor: That is a misconception; it is not breastfeeding that causes sagging breasts or fallen breasts; it is pregnancy itself that brings about breast sagging, not breastfeeding action.

The fact that you are pregnant already puts you at risk of breast sagging. Hence, physical fitness is essential during and after pregnancy to save your breast from sagging.