Breastfeeding – our essential guide

mother breast feeding and hugging her baby

Nature designed breast milk to contain everything babies need to grow, develop and have protection against infections. It is quite amazing really – this is all a baby needs during their first 6 months of life, and a great base for their future months alongside other foods. Breast milk is not the only way to feed your baby, but we hope this helps with some of the most common questions mothers ask, and provides you with useful information for your reference.

 

What are the benefits of breastfeeding for you?

Breastfeeding benefits you as a natural form of contraception; it uses up about 800 calories per day and can assist with weight loss; with less risk of osteoporosis, ovarian and breast cancer. Remember, breastfeeding enables you to put your feet up, relax, enjoy time with your baby and not have to prepare and then wash bottles.

The hormone oxytocin is released during breastfeeding, helping with the flow and release of your milk. It also acts on the muscles in your uterus to contract “afterbirth pains”, stopping bleeding and returning your uterus back to its normal size. Oxytocin is also known as the hormone of love that helps you to connect to your beautiful baby.

Another thing to consider is the cost- breast milk is free, and you will never have to worry about whether your baby’s preferred formula is in stock at the shop.

 

What are the benefits of breast milk for your baby?

The benefits of breast milk for baby are numerous; it is a living fluid that changes during a feed and according to baby’s age, as well as being packed with antibodies to protect against infection.

Breast milk:

  • Improves brain development and visual acuity. (that’s visual development) There is DHA in breast milk which is food for the eyes; one of the main structural components.
  • Is easy for baby to digest with little leftovers. Breast fed babies digest breast milk so efficiently that they may go up to 10 days between poops!
  • Is sweet in taste and can be influenced by certain foods exposing baby to different flavors. A team of Danish researchers at the University of Copenhagen did a study in 2008 about the flavor of breast milk, and found that since babies are exposed to the family meal through breast milk, it stands to reason that when they’re on solids their taste preferences are aligned with what they’re used to.

 

How to assess a breastfeed – what the professionals look for

Position is your first step in assessing a breastfeed. Firstly look at your position; how are you sitting or lying? Is your back supported? How comfortable are you holding baby and do you have good line of sight to your nipple and baby’s mouth?

Next you’ll assess baby’s position – is baby close to your body, with their head in line with their body and nose at the level of your nipple. Change positions depending on your comfort and baby’s feeding ability, which will change over time. Good positioning will always be the key to smooth attachment of baby onto your breast.

Breastfeeding Attachment

Attachment is the second key step in what professionals look at when assessing a breastfeed. The following points will help you to review how you are attaching baby to the breast.

  • Line baby’s nose up with your nipple- baby will lift their head up and back when they open their mouth just like you do when you drink
  • You can encourage baby to open their mouth by stroking baby’s top lip with your nipple. Do this a couple of times – baby will open their mouth wider each time and the tongue will come forward. You are eliciting the gape and extrusion reflexes.
  • Once you are happy that baby’s mouth is wide open, bring baby to the breast firmly by guiding the shoulders forward, not the head, that way they will take a good mouthful of breast tissue and not just the nipple.
  • Point the nipple up towards the roof of baby’s mouth – this allows room for baby’s tongue to grab the breast tissue.

Remember you are both on your “learner” plates, most of us don’t progress to being super confident for 6 – 8 weeks, so don’t be too hard on yourself, relax and place baby close to you and watch what they do. Let them lick and nuzzle until they are ready to open their mouth, that’s when you can help if needed. Once baby gains mastery of their feeding skills and neck control they can attach without help.

Once baby is attached on the breast ask yourself, what can I feel, what can I see, what can I hear, as this will help you assess how your baby is feeding.

Good positioning and attachment means the baby will be effectively sucking at the breast – so a happy mother and baby!

Babies who have good attachment and drain the breast well will usually sleep better, gain weight appropriately and are generally more content. Effective breastfeeding also helps to prevent nipple pain, engorgement, mastitis and milk supply issues.

 

COMMON DIFFICULTIES WITH BREASTFEEDING

Nipple pain

Your nipples are highly sensitive in the first few days after birth and should improve when the milk begins to flow. You may feel a little uncomfortable, but pain is not normal. If you have pain, first check your positioning and attachment of the baby. If pain doesn’t improve after a couple of days see your lactation consultant or trusted health professional for advice.

Nipple shields are a tool to help with some breastfeeding difficulties. Babies still need to attach well to the breast and suck appropriately to prevent issues of poor breast drainage and nipple damage. Again if you have concerns, check with your health professional on a regular basis to avoid these problems.

Engorgement

Your breasts are engorged if they’re filled with milk and the tissue becomes congested. This usually occurs in the first few days of your milk coming in or if baby is not feeding effectively. Your breast may feel distended and uncomfortable. (Think rock solid lumps for boobs!) Frequent feeding with good positioning and attachment will help, but if it doesn’t resolve you could consider expressing with a manual or electric pump.  Seek advice if your breasts are not responding to your efforts.

Blocked milk duct

A blocked milk duct is the correct term for a ‘bank up’ of milk, which cannot flow and results in a hard, tender, painful reddened area on the breast. This needs to be cleared quickly to prevent engorgement or mastitis. A blocked milk duct can be caused by incorrect positioning of baby, baby not sucking effectively, pressure from tight clothing, consistently lying on the same side in bed or pressing too hard on your breast during a feed. Gentle massage of your breasts during breastfeeding, or in a warm shower may help to loosen blockages.

Mastitis

Inflammation of the breast tissue can result from a blocked duct, engorgement, nipple trauma, poor health, and sudden changes in baby’s feeding patterns. Excess milk is forced into the surrounding breast tissue, causing local inflammation and redness, and flu-like symptoms.  Ensure the affected breast is adequately drained by feeding frequently and expressing if necessary.

Mastitis can be quite painful, but this is not the time to wean baby. In fact, baby is your greatest ally here; it is essential that breastfeeding continues frequently from the affected breast in order to resolve the situation, and you may also consider expressing after feeds to ensure your breasts are adequately drained. Antibiotics may be needed if you have flu-like symptoms – seek advice from your Doctor or Health Care Professional.

Too much milk

In the early days/weeks of breastfeeding it is not uncommon to have more milk than your infant needs. It can take 4 – 6 weeks for your breasts to settle down to baby’s needs. If baby is not effectively draining the breast then this can be perceived as an oversupply. You may need to express prior to feeding to soften the areola and remove some milk, making it easier for baby to attach and feed. This will also help with breast drainage. Expressing after a feed may be necessary for comfort. If everything is generally going well, excess milk may be expressed and frozen for future use.

Not enough milk

Very few moms cannot produce enough milk for their baby, though many mothers feel they are not keeping up with baby’s needs. True causes of low milk supply can be related to poor positioning and attachment of baby on the breast, baby is not feeding enough or for long enough leading to inadequate breast drainage eventually affecting your milk supply. Retained placenta, breast surgery or insufficient glandular tissue in the breast are also causes.

You can help to stimulate supply by offering the breast more frequently and express your breasts after feeding to drain and stimulate.

Keep in mind that babies often ‘cluster feed’ during the ‘witching hour’ – that is, mid-afternoon to late evening. Babies have an instinctual need to drink as much as they can before their longer evening sleeps. Babies who demand more breast feeds in the afternoon/evening are not doing so because their mother is not producing enough milk. Keeping track of the number of wet/dirty diapers baby has, and how much weight baby is gaining are better indicators of how mom’s milk supply is going.

 

EXPRESSING BREAST MILK

What is the difference between pumps?

Expressing your breast milk can help if you are experiencing breastfeeding difficulties, do not have baby with you, are trying to increase your milk supply or are returning to work. So what is the difference between pumps?

The main difference is how the pump is operated either manually by hand or by a battery or electric motor, but other differences include overall effectiveness, comfort, ease of use and cost of the pump. Some mums will always have a preference in what they want to use. (which may also subconsciously impact how effective certain pumps are!)

Manual breast pumps require you to rhythmically squeeze and release the pump handle to create suction. The suction strength and rhythm are determined by how much and how quick or slow you depress the handle – you are in control. Manual breast pumps can be effective and convenient for occasional use, and are perfect companions for travel.

Electric pumps have been designed to do the work for you. They try to mimic the two rhythms of how a baby sucks on the breast – fast to get the milk flowing then slow like a baby feeding. The suction strength usually is adjustable, and a number of them also have multiple modes, since babies do not suck at the same rhythm for a whole feed. Mums who are expressing regularly over a prolonged period usually prefer a well-designed pump with a reliable motor –generally one of the more expensive options.

We suggest you ask yourself a few questions to help guide you in your choice –

  • How often do you want to use a breast pump?
  • What is the reason for using a breast pump?
  • What do you want to spend on a breast pump?
  • How easy is it to get spare parts for your breast pump?
  • Does the motor in the breast pump have a life span?
  • How well does the breast pump suit your needs and lifestyle?

 

Storing expressed breast milk

  • Refrigerate or freeze the breast milk after expressing it.
  • Write the date on the container at the time you express the milk. You may also consider writing the time if you express more regularly, as breast milk can change composition over the day.
  • Freeze any breast milk you won’t be using within a couple of days.
  • Adding any refrigerated breast milk to frozen breast milk is okay, provided appropriate care has been taken in handling the milk.
  • Leave some space at the top of the container of any milk to be frozen, as breast milk will expand as it freezes.

Thawing breast milk

  • Thaw any frozen breast milk in the fridge overnight.
  • Place the breast milk container in warm water.
  • Gently swish the breast milk to remix it before feeding your baby, because it separates into layers when stored –do not shake the milk as it can affect the protective proteins of the milk. (if you accidentally shake the milk, the broken up amino acids are still incredibly beneficial to baby – do not feel like you need to throw the milk away.
  • Warm the breast milk to body temperature only.

Transporting breast milk

  • Use an insulated container or bag to transport the breast milk.
  • If the breast milk has thawed, use it within 24 hours, and do not re-freeze it.
  • If the breast milk is still frozen when you arrive at your destination it is okay to place it in a fridge or freezer.

STERILIZATION – DO YOU NEED TO?

While advice around the sterilization of baby’s feeding equipment varies wildly, it is generally recommended. Guidelines include sterilization methods by using boiling water, a chemical solution or steam. Breast pump equipment and bottle feeding equipment “should be rinsed out then washed in hot water with detergent using a bottle brush to thoroughly clean bottles and teats, rinse again before sterilizing”.

Did you know that baby’s immune system is just starting to activate by 3 months of age and is not fully functional until around 1 year of age. You have given baby passive immunity while in utero and if breastfeeding baby is receiving antibodies through your milk.

 

RETURNING TO WORK – HOW CAN I CONTINUE TO BREASTFEED?

When returning to work and breastfeeding you have options, and this will also depend upon the age of your baby.

  1. Depending on your work situation and your babysitting arrangements you may be able to go to baby for their regular feeds.
  2. Breastfeed before leaving for work and again when you return. During your absence baby can have your expressed breast milk which you expressed the previous day.
  3. Breastfeed baby before and after work and baby has formula during the day.
  4. Breastfeed before and after work and if baby is older than 6 months he/she will have solid food and either breast milk or formula in a cup.

All options are achievable. You may need to pick up a breast pump either to express your milk when at work or to help you keep your breasts comfortable preventing engorgement or mastitis.

Workplace laws have changed worldwide recently to improve conditions for breastfeeding / expressing mothers to return to work. Condition requirements can include a clean, hygienic and private area to express breast milk or feed a baby, a fridge/freezer to store the milk and storage space for your equipment. Ask at your workplace and see what facilities are available for you.

breastfeeding guide
Our breastfeeding essential guide -everything you need to know

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