Rhesus Negative

People who are rhesus positive or RhD positive have a protein known as D antigen on the surface of their red blood cells. People who do not have the D antigen are known as RhD negative. Most people are RhD positive but this varies slightly depending on your ethnic origins:

-85 per cent of people of white European origin are RhD positive

-94 per cent of people of African origin are RhD positive

-90 per cent of people of Asian origin are RhD positive

Rhesus status only matters if an RhD-negative mum is carrying an RhD-positive baby (the child inherits this from an RhD-positive dad). If some of your baby's blood gets into your own bloodstream, your immune system may react to the D antigen in the baby's blood as if it were a foreign invader and produce antibodies against it. This is known as sensitising.

Sensitising is not usually harmful in a first pregnancy, but when you become pregnant again, and if your new baby is RhD positive, the antibodies in your system can cross the placenta and attack the blood cells of your baby, causing anaemia, jaundice or in severe cases, heart or liver failure. This condition is called haemolytic disease of the newborn (HDN).

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Breastfeeding / Fact #10.

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The next step: phasing in new foods

To meet the growing needs of babies at six months of age, complementary foods should be introduced as they continue to breastfeed. Foods for the baby can be specially prepared or modified from family meals. WHO notes that:

• breastfeeding should not be decreased when starting complementary feeding;
• complementary foods should be given with a spoon or cup, not in a bottle;
• foods should be clean, safe and locally available; and
• ample time is needed for young children to learn to eat solid foods.

Breastfeeding / Fact #9.

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Work and breastfeeding

WHO recommends that a new mother should have at least 16 weeks of absence from work after delivery, to be able to rest and breastfeed her child. Many mothers who go back to work abandon exclusive breastfeeding before the recommended six months because they do not have sufficient time, or an adequate place to breastfeed or express and store their milk at work. Mothers need access to a safe, clean and private place in or near their workplaces to continue the practice.

Breastfeeding / Fact #8.

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Support for mothers is essential

Breastfeeding has to be learned and many women encounter difficulties at the beginning. Nipple pain, and fear that there is not enough milk to sustain the baby are common. Health facilities that support breastfeeding - by making trained breastfeeding counsellors available to new mothers - encourage higher rates of the practice. To provide this support and improve care for mothers and newborns, there are now more than 20 000 "baby-friendly" facilities in 152 countries thanks to a WHO-UNICEF initiative.

Breastfeeding / Fact #7.

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Regulating breast-milk substitutes

An international code to regulate the marketing of breast-milk substitutes was adopted in 1981. It calls for:

• all formula labels and information to state the benefits of breastfeeding and the health risks of substitutes;
• no promotion of breast-milk substitutes;
• no free samples of substitutes to be given to pregnant women, mothers or their families; and
• no distribution of free or subsidized substitutes to health workers or facilities.

Breastfeeding / Fact #6.

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HIV and breastfeeding

For HIV-positive mothers, WHO recommends exclusive breastfeeding for the first six months unless replacement feeding is:

• acceptable (socially welcome)
• feasible (facilities and help are available to prepare formula)
• affordable (formula can be purchased for six months)
• sustainable (feeding can be sustained for six months)
• safe (formula is prepared with safe water and in hygienic conditions).

Breastfeeding / Fact #5.

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Why not infant formula?

Infant formula does not contain the antibodies found in breast milk and is linked to some risks, such as water-borne diseases that arise from mixing powdered formula with unsafe water (many families lack access to clean water). Malnutrition can result from over-diluting formula to "stretch" supplies. Further, frequent feedings maintain the breast milk supply. If formula is used but becomes unavailable, a return to breastfeeding may not be an option due to diminished breast milk production.