Breastfeeding

Breastfeeding

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Why breastfeed?

It’s never too early to start thinking about how you’re going to feed your baby. Breast milk is the only natural food designed for your baby.

  • Breastfeeding protects your baby from infections and diseases
  • Breast milk provides health benefits for your baby
  • Breastfeeding provides health benefits for mum
  • It’s free
  • It’s available whenever and wherever your baby needs a feed
  • It’s the right temperature
  • It can build a strong physical and emotional bond between mother and baby
  • It can give you a great sense of achievement

Health benefits

Breastfeeding is the healthiest way to feed your baby. Exclusive breastfeeding (giving your baby breast milk only) is recommended for around the first six months of your baby’s life. After that, giving your baby breast milk alongside other food will help them continue to grow and develop.

Breastfeeding is good for babies. Breastfed babies have:

  • Less chance of diarrhoea and vomiting and having to go to hospital as a result
  • Fewer chest and ear infections and as a result less chance of having to go to hospital
  • Less chance of being constipated
  • Less likelihood of becoming obese and therefore developing type 2 diabetes and other illnesses later in life
  • Less chance of developing eczema

Any amount of breastfeeding has a positive effect. The longer you breastfeed, the longer the protection lasts and the greater the benefits.

Infant formula doesn’t give your baby the same ingredients or provide the same protection. Breast milk adapts to meet your baby’s changing needs.

Health benefits for you

Breastfeeding doesn’t only benefit your baby. It benefits your health too. Breastfeeding is good for mums as it:

  • Lowers your risk of getting breast and ovarian cancer
  • Naturally uses up to 500 calories a day
  • Saves money – infant formula, the sterilising equipment and feeding equipment can be costly
  • Can help to build a strong bond between you and your baby

Exclusive breastfeeding can also delay the return of your periods.

Knowledge of lactation issues prepares and relieves anxieties regarding this new skill.

The person who lives with you and is closest to you highly influences your breastfeeding experience. Please discuss with them and chat about your thoughts on breastfeeding. You need support while you are breastfeeding as it is a learned art and is a worthwhile pursuit.

Before the birth

It’s good to find out as much as you can about breastfeeding before the birth. Knowing what to expect should help you feel as confident as possible when you’ve just given birth and want to breastfeed your baby.

Many areas have breast feeding groups, some specially designed for pregnant women who want to know more about breastfeeding.

You can find out more by asking your midwife or GP.

Immediately after your baby is born

Having your baby lie next to your skin also known as skin to skin contact straight after the birth will help to keep your baby warm, calm your baby, and help with the first breastfeed.

Every pregnant woman makes milk for her baby, which is ready and available at birth. This milk is called colostrum and is sometimes yellow in colour. It’s very concentrated, so your baby will only need a small amount at each feed (approximately a teaspoonful). Your baby may want to feed quite frequently, perhaps every hour. But they will begin to have longer feeds less often when your milk comes in on day 3 or day 4. The more you breastfeed the more milk you’ll produce. The time between feeds will vary, and you and your baby will settle into a pattern, which may change from time to time.

Getting Started

  • Be relaxed and kind to yourself
  • Get good emotional support while you establish breastfeeding
  • Take time out to learn a new skill, the baby’s learning too
  • Get practical help to support you
  • Look for help from a skilled assistance if difficulties arise
  • Try to get some sleep as you make your best decisions when rested

Getting Positioning Right

  • A comfortable position
  • Your body needs to be supported so you can hold your baby close
  • Do not lean forward or hunch over. Try sitting up straight as it helps latching
  • The way you sit or lie affects the angle of your breasts and therefore the amount of breast your baby can take
  • Try to relax and enjoy the experience

How to Hold Your Baby

  • Hold your baby tucked in very close to your body, with her body turned towards you
  • Her whole body should be supported from her head to her bottom
  • Hold her so that her nose is level with your nipple as you prepare to feed
  • Her head neck and back should be in a straight line
  • Ensure hands and arms do not get in way as she starts to feed
  • Her chin should press slightly against you chest, enabling her to swallow

Positioning

  • Lying Down to Breastfeed
  • Cradle Hold
  • Football or Clutch Hold

How Your Baby Takes Your Breast

  • Hold her head gently. Ensure her head has room to flex backwards as she attaches to your nipple
  • Brush your baby’s lips gently against your nipple
  • Wait for big wide open mouth before letting her take your breast
  • Calmly repeat this brushing action until she responds by opening her mouth wide
  • If she becomes frustrated and cries, stop and calm her. Then try again
  • Ensure she is breastfeeding and not nipple feeding. A large mouthful of your breast should be taken
  • A mother’s nipple is never damaged if it is far back into the baby’s mouth (at the soft palette of her mouth), therefore there is no friction created

Things to Observe When Baby Feeds

  • Her mouth is gaped widely
  • She takes a large mouthful of breast
  • She mostly sucks strongly and rhythmically, and pauses between sucking
  • She has no difficulty breathing
  • She comes off the breast herself when she is finished
  • During and after each feed give your baby a chance to burp/wind

Sleep Pattern of a Newborn

TimeSleep Pattern
Birth to 2 hours oldInfant alert
2-20 hoursLight and deep sleep
20-24 hoursWakefulness
- Cluster of 5-10 feeds over 2-3 hours with deep sleep of 4-5 hours
Ideal first time to feed: 2 hours post-delivery deemed most appropriate time as baby is alert and has not entered any sleep phase.

Readiness to Feed Cues

Baby CueStages of Readiness to Feed
Wriggling, moving arms or legsEarly
Rooting, fingers to mouthEarly
Fussing, squeaking noisesMid
Restless, crying intermittentlyMid
Full cry, aversive screaming pitch, colour turns redLate
Try to attend to baby in early to mid stages as may be difficult to feed in late stage as baby’s stress level is high. Calm baby first before attempting to breastfeed.

Wet and Dirty Nappies reflect baby’s intake

DayNappies/StoolsFeed Amount
11 wet nappy/1 tarry stool5mls colostrum per feed
22 wet nappies/1-2 tarry stools5-10mls colostrum per feed
33 wet nappies/some green stool15-30mls colostrum per feed
44 wet nappies/4 loose yellow stool30-45mls colostrum/milk
56 wet nappies/3-4 yellow stool45-60mls milk per feed
6-106 wet nappies/3-5+ loose yellow stool90-120mls of milk per feed

Reassuring signs that baby is receiving enough milk

  • Baby is alert and active, cues for feed and appears satisfied after feeds
  • Audible swallow is heard
  • 160-180 minutes a day in the first two weeks is usually needed to obtain sufficient milk
  • Mum and baby are satisfied with feeding
  • Baby’s mouth is moist
  • After feed, nipple should be comfortable wet and intact
  • By day 4-5 baby passes 3-5 or more, loose yellow stool
  • End of first week baby has 6 or more wet nappies

Baby may loose up to 7-10 percent of his birth weight during the first 3-4 days.

  • Baby should regain his birth weight by the time he is 14 days old
  • 0-3 months 4-7 ounces per week
  • 4-6 months 4-5 ounces per week
  • 6-12 months 2-4 ounces per week

If baby is:

  • Restless, fussy and irritated
  • Seems hungry all the time especially right after a feed
  • Sucks his fists, fingers or blanket
  • Moves his head from side to side at the breast
  • Comes off the nipple frequently
  • Cries or whimpers frequently
  • Eagerly takes formula or expressed milk from a bottle right after a feed
  • Falls asleep after a feed but does not let go of the breast

Consider that the baby might not be removing enough milk from the breast.

Remember the more breastmilk you remove the more breastmilk is created. It is always easier to latch baby to breast when milk supply is high.

If mum feels:

  • She does not feel the let down as strongly as she thinks she should
  • She has painful and or cracked nipples
  • Her breast stay full and hard even after a feed or her breast are soft most of the time
  • She is not able to express the amount of milk she thinks she should

Most mothers have sufficient lactation capacity to make at least one third more milk than their baby typically takes.

If milk is not drained from the breast of 75-85% of the breast content by baby sucking or expressing the rate of milk slows down to match to lower demand.

Nipple pain usually peaks at the 3rd-6th day and resolves after that, if pain continues and is persistent after the first week it is abnormal.

Don’t put time limits on baby’s feeding, watch for feeding cues and baby and mum’s experience is more satisfying and nutritionally rewarding.

Milk Supply & Release

While you are adjusting to breastfeeding your body is always working to get the milk supply and composition right.

Methods to increase Milk Production

  • Apply moist heat to breast before feeding for a few minutes
  • Massage the breast before and during feeding or pumping
  • Try to reduce stress which enhance let down – use relaxation techniques
  • Feed your baby or express at least 8 times every 24 hours
  • Continue frequent milk removal even if small amounts are obtained

Human Milk Storage

Breast milk is a precious component that cannot be replicated.

  • It combines the most appropriate nutrition with antibodies, live cells and other substances that protect baby from infection and aids in their growth and development
  • How you store your milk will affect how well it’s nutritional and anti infective qualities are preserved
  • Human milk anti-bacterial properties aid in its ability to keep the milk fresh
  • Human milk has the ability to discourage the growth of bacteria in a baby’s intestine and will prevent the growth of bacteria in milk stored in a container

Storage of Human Milk

  • Best practice – glass or hard plastic with well fitted lids
  • Ensure they do not contain the controversial chemical A (BPA)
  • They should be washed in hot soapy water, well rinsed and air dried before use
  • Can also be washed/dried in a dish washer
  • Put only small volumes 60-120 ml of milk in containers, the amount your baby is likely to take in a single feed, this avoids waste of a precious liquid
  • Small quantities are easier to thaw
  • Label, date and time every container of milk, milk is appropriate for the gestational age of your baby and should be used in accordance with the earlier date expressed

Storage Time

  • Ideally baby should receive fresh milk that has been refrigerated rather than frozen
  • Some of the anti-infective properties have been lost through freezing
  • Frozen human milk is much more beneficial that artificial formula
  • Previously frozen milk can be kept in the fridge up to 24 hours
  • Fridge temp should be 4°C (39°F) or less
  • On transporting milk keep content in an insulated container with ice pack

Stored Milk Usage

  • Swirl milk prior to usage, human milk can separate and settle into layers, this is completely normal
  • Human milk should be thawed and heated gradually; high temperatures can affect the beneficial component of human breast milk
  • Frozen milk should be thawed in the fridge overnight or under cool running water. Gradually increase the temp of the water to heat the milk to feeding temp
  • Or immerse the container in a pan of boiling water, take the milk container out and re-warm the water as necessary
  • Fridge milk: warm the milk under running warm water for several minutes, or immerse the milk container in a pan of water
  • Some babies accept milk straight from the fridge
  • Do not use a microwave to heat human milk; microwaves do not heat liquid evenly, with heat spots which would be dangerous for babies
  • On occasions, thawed breast milk can smell or taste soapy. This is still safe and baby can still take this
  • If you or your baby develop thrush or fungal infection continue to breastfeed during the episode, after treatment all leftover milk that was expressed during the episode should be discarded

Mixed Messages

Please be advised that this information does not replicate the true benefit of having a skilled practitioner facilitating your individual lactation needs.

Common Breastfeeding Misconceptions

Myth 1: “Breastfeeding will make my breasts saggy”
Fact: Breastfeeding doesn’t cause your breasts to sag, but the ageing process and losing or putting on weight can all have an effect.

Myth 2: “Infant formula is basically the same as breast milk”
Fact: Infant formula isn’t the same as breast milk. It’s not a living product so it doesn’t have the antibodies, living cells, enzymes or hormones that protect your baby from infections and diseases later in life.

Myth 3: “People don’t like women breastfeeding in public”
Fact: Surveys actually show that the majority of people don’t mind women breastfeeding in public at all. The more it’s done, the more normal it will become.

Myth 4: “Breastfeeding is easy for some women, but some don’t produce enough milk”
Fact: Almost all women are physically able to breastfeed. It’s a skill that every woman needs to learn and practice before it becomes easy. It happens more quickly for some women than others, but nearly all women can produce the amount of milk their baby needs.

Myth 5: “If I breastfeed I can’t have a sex life”
Fact: After you’ve had your baby you’ll decide when it’s time to have sex with your partner. The same hormone that helps to release your milk for the baby (oxytocin) is also made when you have sex. When having sex you may leak a little breast milk. This is normal.

Breastfeeding Problems

It can be hard to ask for help, but seeking help for breastfeeding problems quickly will give you more time to enjoy your baby’s early days. In many cases, there is a simple solution such as changing your baby’s position or feeding them more often.

If your baby is unsettled

If your baby is unsettled at the breast and doesn’t seem satisfied by feeds, it may be that they’re not attached to the breast correctly. Ask the midwife or a breastfeeding supporter to work with you to improve positioning and attachment of your baby.

Sore or cracked nipples

If your nipples hurt, take your baby off the breast and start again. To do this you can slide a finger gently into the corner of the baby’s mouth until their tongue releases. Putting up with the pain could make things worse. If the pain continues or your nipples start to crack or bleed, ask a breastfeeding supporter to help you get your baby attached effectively. Pain is not normal, so ask for help and support.

The following may help:

  • Squeeze out a drop or two of your milk at the end of a feed and gently rub it into your skin
  • Let your nipples dry before getting dressed again
  • Change your breast pads at each feed (if possible use pads without a plastic backing)
  • Don’t use soap, as it dries out your skin
  • Wear a cotton bra so that air can circulate
  • There’s no need to stop feeding. With help you should find that breastfeeding quickly becomes more comfortable again

Sore Breasts, Blocked Ducts, and Mastitis

An over-supply of milk can build up in your breasts for a variety of reasons. If your baby is not well attached it may be hard for them to feed effectively, and some parts of your breast may not be drained during a feed. This is the area of your breast that may feel sore or painful. It is worth checking to see if this is a possible cause so that you can prevent it from happening again. If you’re not sure, ask for help. Other common causes include wearing a bra that’s too tight, a knock or blow to the breast, or even missing a breast feed.

It’s important to deal with a sore breast or a blocked duct as soon as possible so that it doesn’t lead to inflammation of the breast a condition known as mastitis.

If you have mastitis you’re likely to have at least two of the following symptoms:

  • Breast or breasts that feels hot and tender
  • A red patch of skin that’s painful to touch
  • General feeling of illness, as if you have flu
  • Feeling achy, tired and tearful
  • You may have an increased temperature

This can happen very suddenly and can get worse very quickly. It’s important to carry on breastfeeding as this helps to speed up your recovery. If you think you might have a blocked duct or mastitis, try the following:

  • Check and improve the attachment of your baby at the breast – ask your midwife, or breastfeeding supporter
  • Feed your baby more often
  • Let your baby feed on the tender breast first
  • If your breasts still feel full after a feed or your baby can’t feed, hand express some milk to relieve the fullness
  • Warmth on your breast before a feed can help the milk to flow and make you feel more comfortable. Try warm flannels or a bath or shower
  • While your baby is feeding, gently stroke the lumpy or tender area towards your nipple with your fingertips. This should help the milk to flow
  • Get as much rest as possible. Go to bed if you can
  • If you can, take a painkiller such as paracetamol or ibuprofen

Mastitis may also be a sign of infection. If there’s no improvement within 12 to 24 hours, or you start to feel worse, contact your GP or healthcare professional. If necessary, they can prescribe antibiotics that can be taken while breastfeeding.

Stopping breastfeeding will make your symptoms worse, so ask for help and support early.

Thrush

Nipples that suddenly get sore and pink after you’ve been feeding without problems for a while you may have thrush which is an infection. Check that your baby is attached effectively or you may need to make an appointment with your GP.

You and your baby will need treatment. You can easily give thrush to each other, so if your baby has it in their mouth you will still need some cream for your nipples or an oral thrush drop to stop it spreading to you. You may want to ask your pharmacist for information. Some anti-fungal creams can be bought over-the-counter from a pharmacy.

Tongue-tie

Some babies are born with tongue-tie where there is a tight piece of skin between the underside of their tongue and the floor of their mouth. It can affect feeding by making it hard for your baby to attach effectively at your breast.

Tongue-tie is easily treated. If you have any concerns, talk to your GP.

Common Breastfeeding Questions

How often will my baby feed?

All babies are different, and it may depend on the type of birth you’ve had. Your baby should feed within the first hour after birth to get off to a good start. Babies then sometimes have a sleep and will start to give you signs that they’re ready for the next feed.

These signs include:

  • Starting to move about as they wake up
  • Moving their head around
  • Finding something to suck, usually their fingers

If your baby doesn’t have a feed in the first hour, try skin-to-skin again, putting them to your breast as soon as possible so that your baby is not without a feed in the first six hours.

Why is baby-led feeding so important?

A newborn baby’s stomach is tiny, therefore they will need to feed ‘little and often’. This is why baby-led feeding, or ‘on-demand feeding’ is so important. Your baby can have a good feed and be hungry again quite quickly. Babies go through patterns of feeding more and less as they grow. Letting them feed when they need to will ensure that they’re content and getting the milk they need, when they need it.

How long should each feed last?

Every baby is different. Some babies want frequent short feeds, and others prefer feeding for longer. Let your baby finish the first breast, then offer the second.

Can I breastfeed after a caesarean?

Yes, you can. Make sure you get a skin-to-skin cuddle with your baby as soon as you’re able to. Your midwife may help you have a skin-to-skin cuddle in theatre, or in the recovery room. Keep your baby close to you and maintain lots of skin-to-skin contact, this will give you the opportunity to put them to the breast often, and this will stimulate your milk supply.

How long should I breastfeed for?

Exclusive breastfeeding (with no other food or drink) is recommended for around the first six months of a baby’s life. After this, combining breastfeed with other foods for as long as you and your baby wish.

Every day you breastfeed makes a difference to you and your baby. There’s no need to decide at the beginning how long you’ll breastfeed for. Many mothers continue to breastfeed when they return to work.

Breastfeeding Help and Support

If you have any questions or concerns about breastfeeding, a lot of help and support is available.

  • You can ask a friend or family member who has breastfed
  • Ask your midwife or GP
  • You can look at reliable web based resources
  • You can join a local support drop in, Children’s Centre or group

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