What you need to know:
- From bacterial infections, to viral infections that are characterised by diarrhoea and vomiting, Dr Lorraine Oriokot, a paediatrician, says these present a great challenge when using bottles.
Recently, Kenya’s Ministry of Health announced a ban on feeding bottles which will come into effect on May 28. This comes after the Kenyan Parliament recently passed into law the Breast Milk Supplements (BMS) Regulation and Control Act of 2012 that listed bottles used for feeding infants as items that are within the scope of regulation by the law.
While addressing delegates at the country’s first ever National Maternal, Infant and Young Child Nutrition Symposium, organised by the ministry, Esther Mogusu, the principal nutrition and dietetics officer at Nairobi Metropolitan Services, praised the government’s position and maintained that feeding bottles do more harm than good.
Dr Lorraine Oriokot, a paediatrician, says holding all other factors constant, breastmilk is ideal for babies and whatever we (parents and medical personnel) do must be geared towards facilitating breastfeeding. When the issue of bottles is fronted, it means the mother is going to use an alternative food, which may not be suitable.
“That said, we also know that the bottles are used for expressed breast milk,” she says.
From bacterial infections, to viral infections that are characterised by diarrhoea and vomiting, Dr Oriokot says these present a great challenge when using bottles.
“There is no certainity that the nipple will be washed thoroughly and when it is not, it harbours dangerous microorganisims at the neck and teat. These will be transmitted to the baby, causing sickness,” she says, adding that the alternative is feeding either with a spoon or cup.
Dr Daniel Tumwine, a paediatrician, says tooth decay is common among bottle-fed babies since the saliva and bottle contents form an acidic mixture that is bad for teeth.
“Additionally, when a baby is being fed on alternative milk, they are prone to tooth decay due to the sugar content which is higher than that found in breast milk,” he says.
When a bottle is introduced before the baby gets acclimatised to their mother’s nipple, it creates confusion. According to Dr Oriokot, when breastfeeding, the baby must suck the breast so as to get milk which takes a bit of effort unlike when using the bottle nipple. Because of this, the baby will most likely opt for the bottle, which discourages breastfeeding.
Usually, a baby cannot move their bottle away or tell you when they are satisfied. Dr Tumwine says in such instances, they run the risk of chocking. Dr Oriokot adds that there is also trouble with positioning the baby or regulating the flow of milk, which can also cause chocking.
“For instance, the baby should not feed while lying down. Additionally, with bottles, you cannot regulate the amount of milk the baby takes since as they grow older, they chew on them creating holes that release more milk,” she shares.
Milk accumulates at back of the mouth more in bottle fed children which Dr Tumwine say creates an environment for infections. According to the National Library of Medicine, an online portal, it is said that these ear infections are common among children aged between six months and three years as well as those that are bottle-fed.
Dr Tumwine says while these may not say that they have an infection, the symptoms include being fussy, tugging at the ears, unexplained fever, trouble sleeping, and trouble hearing subtle sounds.
Understandably, a number of mothers may feel weary at the thought that the people with whom they leave their children may not be as patient to feed their baby until they are satisfied using a cup and spoon or simply a cup.
Some fear their babies will be more exposed to infections due to unhygienic practices.
However, Dr Oriokot says, whether the milk is in a cup or bottle, hygiene is still important and emphasis should be placed on handwashing before each feeding.
Dr Oriokot adds that the cup and spoon-feeding method is more affordable compared to using bottles.
“Of course, you have to be careful not to hurt the baby with the cup seeing that some have rough edges. Also, one needs to use a smaller spoon and be gentle and careful,” she advises.
Dr Oriokot adds that the positioning is also important because either way, the baby must be fed in a position that prevents chocking. “You must also pace yourself according to how the baby is feeding. As such, it is a responsive process where their pace determines the pace and amount of milk given,” she adds.
While the best way for creating a bond between a mother and her baby is through breastfeeding, Dr Oriokot says this bond can still be created if the mother feeds her baby.
In instances where the mother cannot produce enough breastmilk for the baby, they will look for ways to ensure the child is well-fed, hence alternative milk. However, Dr Tumwine says, cow milk is bad for children below one year.
“This contains solutes that may damage the kidneys, and may cause inflammation of the gut, causing bleeding, which may lead to iron deficiency,” he says.
Additionally, even though cow milk contains higher iron than breast milk, Dr Tumwine says a baby’s body is unable to absorb the iron in cow milk, which leads to iron deficiency yet iron is essential for maintaining body immunity and brain development. Besides, cow milk is full of allergy-causing proteins,” he shares.