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  1. BREASTFEEDING TIPS

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    My Top 10 tips for getting breastfeeding off to a good start. 

    A common concern amongst new mothers is that there is not enough milk to feed their babies in the early days.  Colostrum is available from approximately mid-pregnancy and will support your baby in the first few days up until the milk transitions to a more mature milk. This is often called ‘the milk coming in’, which can be misleading in itself, as actually your milk is already there from mid-pregnancy but in the form of colostrum and is full of wonderful nutrients, antibodies and calories to support your little ones in the early days. 

     

    However, although at the time of birth there is enough milk to feed your baby, it is often the case that new mothersstruggle with a good attachment at the breast and therefore the milk that is available for your baby is not transferred effectively. 

     

    The other problem we have is that peopleoften don’t understand the physiology of breastfeeding arend how it all works.  A new baby is programmed to feed really frequently – small amounts are transferred atregular intervals.  These frequent feedings signal to the breasts to make more milk.  Howeverfar too often, mothers are told that their babies are ‘starving’ and that if they had taken enough milk they wouldn’t be demanding such frequent feeding.  The next they know they are being informed to top baby up with formula milk.  Consequentlythe baby does not nurse so frequently at the breast and therefore the signals to the breasts to make more milk are not being received. 

     

    The problems mothers have with breastfeeding often stem from the first few days. Here are my Top 10 tips to help you get breastfeeding off to the best possible start….. 

     

    1. Offer skin to skin: ensure your baby is skin to skin with you as soon as you possibly can. Newborn babies can ‘crawl’ and attach to the breast by themselves (known as the breast crawl). This is demonstrated beautifully in this video here by the Global Health Media: https://globalhealthmedia.org/videos/breastfeeding-in-the-first-hours-after-birth/?msclkid=aefa18e0d06811eca6bfbf9009ef5de3  Research shows us that it takes an average of 60-90 minutes for a baby to attach at the breast. So don’t rush this process! Allow your baby the time it takes for them to attach to the breast – they will have learned so much in the process.  Ask your midwife about skin to skin in a caesarean birth too as this is usually possible. In most instances you do not need to wait until you are in recovery to place baby skin to skin. Skin to skin has so many benefits (I will discuss this more in another post). 

     

    1. Don’t force the feed: at first a baby may just lick the nipple and that is fine. This is part of the natural process.  Forcing babies on to the breast may result in refusal to take the breast. 

     

    1. Understand normal newborn behaviour: often referred to as ‘the 4th trimester’.  This can be a very unsettled time for babies as they adapt to their new world and the 4th trimester is often described as lasting around 12 weeks. Think about the womb environment – it is warm, there is a built-in‘white noise system’ going on with the soothing sounds of your heartbeat and your digestive sounds. In additionyour womb provides the perfect temperature so your baby has never felt hot or cold before,hungry, or thirsty and then all of a sudden they are born and must adjust to a very different environment. Their digestive systems have to work for the first time and they may be experiencing some discomfort.  Theyneed so much reassurance from you as their new world is scarily unfamiliar and they are having to learn to feed, sleep   and adapt to their new environment.  The result of this is crying – and often a lot of it, which causes everyone to assume that your baby is hungry and can’t be getting enough milk. Whereas the reality is that they are much more likely to be finding it difficult to adapt to their new environment. They want to be close to you at all times and this is completely normal.  P.U.R.P.L.E crying is an acronym that is used to describe typical newborn behaviour in the first few weeks.  Read all about it here: The Period of PURPLE Crying | PURPLECrying.info   

     

    1. Room-in together: this is sometimes known as ‘babymooning’, a little like a honeymoon except with you, your partner if you have one, and your baby.  Keep visitors to a minimum so that you can have your baby with you as much as possible so that you can learn to breastfeed together without constant interruptions. 

     

    1. Follow your baby’s feeding cues: don’t restrict length or frequency of feeds. You may find well meaning people suggest you give strictly timed feeds.  In order to establish a good milk supply, following a baby’s feeding cues is essential. Feeding cues include when your baby starts stirring, turning their heads seeking/rooting for the breast, sucking on their fistsand increasing physical movement.  Avoid late feeding cues such as crying as it is far more challenging to attach a frustrated and potentially cross baby to the breast. 

     

    1. Focus on positioning and a good latch: This really is the key to successful breastfeeding! A well attached baby will be getting good milk transfer and the breasts will be getting those all important signals to produce more milk.  Ask as many health care professionals as possible if your baby appears to be well attached and learn the key signs that your baby is well attached.  This video from the Global Health Media is really helpful in understanding good attachment: Attaching Your Baby at the Breast - Video - Global Health Media Project 

     

    1. Establish a good milk supply before introducing any bottles: this is to avoid what is sometimes called ‘nipple confusion’ where once a baby has a bottle teat in their mouth they may start to refuse the breast.  There are other ways to give milk to your baby if necessary such as syringe or spoon feeding, cup feeding and via a supplementing nursing system (SNS). 

     

    1. Accept this is a skill that you both have to learn: your initial journey may not be as straightforward as you may have initially imagined but you will get there and with the right support, breastfeeding becomes much easier in time. For most mothers the first two months are the most challenging whilst your baby is busy establishing your milk supply. Reminding yourself that it takes around 6 weeks for a good milk supply to establish, and once it has, feeding will very likely become easier and often quicker. This knowledge may help you to keep going even when you are feeling exhausted. Breastfeeding becomes easier in time. 

     

    1. Ask for help from family/friends: put a list of chores up on your fridge and get visitors to tick one off before they are allowed a cuddle with your baby! People actually like to help and when you are tired and exhausted in the early days there is never a better time to ask for support.   

     

    1. Reach out for the right support: Ensuring you are accessing the right support is essential.  Ask your midwife what support is available to you locally or contact a qualified Breastfeeding Counsellor or an IBCLC Lactation Consultant for private support.  The International Board of Certified Lactation Consultants website offers an opportunity for you to pop in your postcode and find an IBCLC in your area: Find an IBCLC -International Board Certified Lactation Consultant - LCGB.  Be mindful of who is providing you the support. Make sure it is evidence-based and comes from someone who knows exactly what they are talking about. There is a lot of well-meantbutnon evidenced-based information floating around which has the potential to have a negative impact on your personal feeding goals. 

     

     

  2. How often should your newborn feed?

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    Humans can be described as ‘carry animals’.  Other examples of carry animals are apes and kangaroos. Carry animals are the the most immature at birth and they are dependent on the warmth of mother’s body and need to be carried constantly. Human babies have tiny tummies that ensure that they are kept close to their mother due to their constant need to feed. Breastmilk is really easily digested and newborns need to be fed between 8 and 12 times in a 24 hour period. This equates to 2 or 3 hours from the start of one feed to the start of the next. When babies are first born they may even feed hourly which allows the breasts to be regularly stimulated in order to establish a good milk supply. The constant closeness to mother helps with bonding and the release of Oxytocin, which postnatally is responsible for milk ejection. 

    So whilst we know babies need to be feed between 8 and 12 times in a 24 hour period it is essential that we follow our baby’s feeding cues.  Babies feed for many reasons, for thirst, hunger, comfort, because they are feeling cold or just simply need some reassurance.  I will explore this in greater detail in a future blog when we discuss the fourth trimester, the first 12 weeks with your baby. 

    newborn-baby-sucks-breast

    Milk Storage Capacity 

    Some babies may need to feed more often than others due to a mother’s storage capacity. What this means is that mother’s breasts can store differing amount of milk and there can also be a variation in each of your breasts.  Perhaps surprisingly, this does not necessarily link to how large or small your breasts are. Breasts have varying amounts of glandular tissue (milk-making tissue).  One mother may have the capacity to store 90ml or lessin each breast whereas another may be able to store 150 ml or perhaps even more.  As a result of this mother’s with less storage capacity will find that they are likely to need to feed more frequently than a mother with a greater storage capacity. However, the amount of milk that a baby gets over a 24 hour period will be similar, it is just that babies will be asking for the breast more if the storage capacity in their mother’s breasts is less. So, don’t compare yourself to others and how often they may be feeding their own babies.  Their storage capacity may be greater than yours and therefore their baby may feed less often but actually, the babies will be getting a similar amount of milk over the 24 hour period.   

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    Image sourced from Queensland Government Website