What is Early Initiation of Breastfeeding (EIB)?

Early Initiation of Breastfeeding (EIB) is a critical process where a newborn is placed skin-to-skin on the mother's chest or abdomen within the first hour of birth, allowing the infant to naturally crawl and locate the nipple to nurse independently.

This direct skin-to-skin contact establishes a powerful initial emotional bond between mother and child.

Key Requirements for EIB

EIB can be conducted effectively provided that both mother and baby are in a stable condition:

1. Mother's Stability: Blood pressure and vital signs are normal, uterine contractions are strong, and postpartum blood loss is within safe limits.

2. Baby's Stability: The baby is active and cries immediately upon birth.

Medical Note: If the newborn faces medical complications such as birth asphyxia (not crying immediately), medical resuscitation and neonatal care are prioritized first. Similarly, if the mother experiences intrapartum complications (severe hemorrhage, shock, or seizures), EIB will be postponed until the medical safety of both mother and child is secured. Medical safety remains the paramount priority.

The Power of Colostrum: A Baby's First Natural Vaccine

A prevalent myth suggests that the initial yellowish fluid secreted from the breasts after delivery is spoiled or harmful and should be discarded. Medical science firmly refutes this. This golden liquid is known as colostrum.

Colostrum acts as a natural first vaccine for the newborn because it contains:

• High Antibody Content: Rich in immunoglobulins (antibodies) that protect the newborn's digestive system and immune system against early infections.

• Nutrient-Dense: Contains high concentrations of proteins and natural vitamins that cannot be matched by any infant formula.

• Hypothermia Prevention: Skin-to-skin contact during colostrum feeding aids in regulating the infant's body temperature, preventing chilling.

EIB and Maternity Services for Psychiatric Patients

As a healthcare referral center specializing in both mental health and general medicine, Marzoeki Mahdi Hospital provides inclusive maternity care. Every mother, including patients living with psychiatric conditions, holds equal rights and opportunities to practice EIB and breastfeed her child.

Mothers with psychiatric conditions who are compliant with safe medication regimes and remain calm can be guided and supported by healthcare staff to nurse and care for their newborns. The midwifery team provides comprehensive family education on home newborn care, including swaddling, diapering, and safe positioning and latching techniques.

Overcoming Common Lactation Challenges

Breastfeeding does not always run smoothly. Below are common lactation challenges and their practical solutions:

1. Delayed Milk Production on Day 1

Initial breast milk or colostrum output on days 1 to 3 is naturally small in volume. Practicing EIB and regular suckling act as natural triggers for prolactin and oxytocin release, accelerating milk production. Mothers are encouraged to stay calm and continue nursing, as maintaining a positive, relaxed emotional state is essential.

2. Preventing and Treating Sore Nipples

Sore or cracked nipples are primarily caused by improper latch-on positioning. The infant's mouth should encompass most of the areola (the dark area around the nipple), rather than suckling on the tip of the nipple alone. Proper latching effectively prevents pain and skin damage.

3. Managing Hyper-Lactation & Engorgement

Hyper-lactation occurs when milk supply is extremely abundant. If breasts are not drained regularly, milk stasis or engorgement can develop, raising the risk of swelling, fever, and inflammation (mastitis).

• Action Steps: Alternate nursing between the right and left breasts until thoroughly emptied.

• Working Mothers: Establish a consistent pumping routine during work hours.

• Medical Follow-Up: If hard lumps, redness, or high fever persist despite warm compresses and mild analgesics, consult an obstetrician or lactation specialist promptly.

Mother's Nutrition and On-Demand Feeding

• Balanced Menu: Lactating mothers do not require restrictive dietary prohibitions unless specific food allergies or digestive intolerances exist. Mothers are encouraged to consume a balanced diet rich in complex carbohydrates, healthy proteins, fresh vegetables, fiber, and fruits.

• Feeding Frequency: Feeding should follow an on-demand schedule (whenever the baby shows hunger cues). However, if a newborn sleeps continuously for more than 2 to 4 hours, mothers should gently wake the baby to feed, ensuring steady nutritional intake and preventing hypoglycemia or jaundice.

Maternity Care & BPJS Services at Marzoeki Mahdi Hospital

Marzoeki Mahdi Hospital Bogor features a comprehensive 24/7 Emergency Obstetric and Neonatal Care (PONEK) unit dedicated to maternal and infant emergencies:

1. Obstetrics & Gynecology Outpatient Clinic: Provides routine prenatal and gynecological care during weekday operational hours.

2. 24-Hour Obstetric ER: Staffed by physicians and midwives ready to handle urgent delivery and maternal care at any time.

3. BPJS Health Coverage: Accommodates BPJS healthcare referrals progressively and handles emergency cases seamlessly without cost barriers.

4. Free Tubal Ligation / MOW Program: In collaboration with the Bogor City Family Planning Board (DPPKB), free Tubal Ligation (Medis Operatif Wanita / MOW) services are provided for qualified mothers meeting clinical indications.