The call to breastfeed
Benefits of breastfeeding
Breastfeeding positions and techniques
Latching on
Warnings of an approaching bad latch on
After latching on…
Storing breast milk
Common breastfeeding problems and solutions
Breastfeeding after a c-section delivery
Breastfeeding multiple babies
Nutrition Guide for Nursing Moms
A few other facts you should know about breast feeding

The call to breastfeed

‘How to feed your baby’ is one of the first decisions you will ever make as a mommy. Many credible medical authorities recommend breastfeeding for new-borns. According to the World Health Organization, exclusive breastfeeding should start within one hour after birth and continue till a baby turns six months. Nutritious complementary foods should then be added while continuing to breastfeed for up to two years or beyond.

 

Benefits of breastfeeding

Health benefits

Baby

Breast milk…

  • Is easily digestible for your baby’s still developing digestive system (breast milk is easier to digest than formula)
  • Contains antibodies which will help your baby fight bacteria and viruses
  • Is known to lower the risk of a number of diseases: Ear infection, Eczema, Diarrhea, Asthma, Vomiting, Lower respiratory tract infection, Childhood leukemia, Sudden infant death syndrome, Type 2 diabetes
  • Is just the right mix for your baby’s healthy growth

Mommy

Breastfeeding…

  • Will help your healing process after birth
  • Sometimes results in the burning of extra calories and may therefore prove useful in the loss of pregnancy fat
  • Releases the oxytocin hormone which helps to reduce post pregnancy uterine bleeding and aids your uterus in returning to its pre-pregnancy size
  • Could reduce the risk of you getting type 2 diabetes, ovarian cancer and certain types of breast cancer

Other benefits

  • The health benefits of breastfeeding guarantees fewer visits to the hospital
  • Breast milk is free, hence money is saved
  • Breast milk is readily available; anywhere, anytime and at the right temperature. Hence, time is saved
  • Breastfeeding brings you and your baby close, guaranteeing an emotionally rewarding experience

 

Breastfeeding positions and techniques

You’re bound to have numerous breastfeeding sessions with your baby, each of which could last as long as 30 minutes or more. So it is important that before beginning, you both get into comfortable positions which will not put strains on your bodies. Here are some well known positions you can choose from…

Cradle Hold position

This is the most natural position that most moms try out first.

Get seated in an upright position; an armchair would be your best bet. Place your legs on a stool  and put pillows on your lap in order to lift your baby up to your breast level and support him better. However, if you prefer sitting on a bed, properly support your lower back, shoulders and knees with pillows. Then, put a pillow on your lap.

After this, carry your baby, ensuring his neck rests in the bend of your elbow, his back along your forearm and his bum in your palms. Turn him to his side so that you are both tummy to tummy and then pull him close to you.

Ensure that your baby’s neck and head are straight and in line with his body. Tuck his lower arm under his body and hold his upper arm down with the thumb of the hand which you are using to cradle him.

Cross cradle position

Though similar to the cradle hold position, the cross cradle will give you more control over how your baby latches on.

Here, you don’t support your baby’s head with the crook of your arm. Instead use the hand of one of your arms to hold your breast. Your other arm should then come around the back of your baby and be positioned to stay fixed at the base of his head, providing support for his head, neck and shoulder. Ensure that you are tummy to tummy with him and your thumb and index finger are at his ear level.

Side lying position

The side lying position guarantees that your baby won’t put pressure on your tummy while feeding. Hence, it is perfect if you just had a c-section delivery. Also, if you simply want to relax whilst nursing, try out this position.

Here you lie on your side with your baby facing  you while lying on his side as well. Use your lower arm to support his back while holding your breast with your other hand. Ensure that your baby’s nose is opposite your nipple.

If adopting this method, you may probably want to use pillows to support your arms and raise your baby to your breast level.

Clutch or football hold position

This style will allow your baby take milk more easily. It will be excellent for you if you just had a c-section delivery. Also if you have twins whom you want to feed at the same time or if you have large breasts or a small baby, this position will also work perfectly for you.

Here you place a pillow next to you and cradle your baby upwards, facing you in your arms. Use the palm of your hand (of that same arm) to support your baby’s neck and snuggle his side closely against your side. Tuck his feet and legs under your arm and then lift him to your breast.

 

Latching on

Once you are settled into a comfortable position, use the hand that you aren’t using to support your baby, to hold your breast. Hold your breast by cupping it with your hand, palm and fingers underneath and your thumb on top. Your fingers should be kept off the areola so that your baby can get a sufficient mouthful.

Then pull your baby towards you (don’t push your breast towards your baby) and encourage him to open his mouth by using your nipple to tickle his lower lips, teasingly sliding your nipple from the middle of his lower lips to his chin, animatedly opening your mouth wide so he imitates you or pressing your index finger on his chin as you pull him close. As soon as your baby’s mouth is opened up the widest, direct your nipple towards its centre. As you do this, ensure that his tongue is down and that he grips a good mouthful of your areola, with more areola showing at his top lip than at the bottom. You must be fast because your baby will close his mouth just as fast as he opens it.

Also, ensure that you keep the weight of your breast off your baby’s lower jaw and chin as you breastfeed him.

 

Signs of a good latch on

  • Your baby’s lips will be turned out to give a fish mouth look. If your baby’s lip is pursed inward, use your index finger to pull it out
  • Your baby’s chin will rest into your breast whilst his nose will almost touch your breast. If his nose happens to press against your breast, he should still be able to breathe through the side of  his nose. However if he struggles to breathe, create an airway by pulling his bum closer to you and/or using your thumb to press gently on your  breast
  • Your baby’s gum will bypass the base of your nipple and he will take in at least one inch radius of your areola
  • You won’t hear smacking sounds as your baby feeds
  • Your baby’s cheeks will be rounded and not sucked in
  • You will hear your baby swallowing (sounds like a soft ‘kuh’)
  • Your baby will take long, rhythmic sucks and you would see his upper jaw, ear and temples move (these are called swallowing movements)
  • You won’t suffer from sore nipples and your baby is less likely to suffer from excess gas

 

Warnings of an approaching bad latch on

  • Your baby takes in your breast when his mouth is closing (instead of when his mouth is opened)
  • Your baby slurps your nipple in through half opened lips
  • Your baby’s grip is focused on your nipple instead of your breast

*In case of a bad latch on, it is best to disengage your breasts and start all over from the beginning in order to avoid sore nipples and situations where your baby takes in insufficient milk and too much gas. To disengage your breast, slide your finger into the corner of his mouth until he releases his tongue

 

After latching on…

As your areola is pulled into your baby’s mouth, you may experience pain. However after 30-60 seconds, the pain should subside and what you will now feel is a tug like pull as your baby sucks.

He will probably have about 4 -5 sucks and then pause for 5-10 seconds. The sucks will increase as the quantity of milk increases. Likewise, as the milk flow reduces, the sucks will reduce and the pauses will become longer

 

Storing breast milk

What kind of container should I use?

You can use any clean glass or hard plastic container which has a secure cap. Or you can go for the special plastic bags designed specifically for milk collection and storage. However don’t use these plastic bags for long periods because compared to containers, they are more prone to spills, leaks and contamination. Another down side of using a plastic bag is that certain important components of the milk could get lost by adhering to it.

What is the best way to store my breast milk?

Fill each container with just the amount of milk your baby needs per feed but because breast milk expands when frozen, don’t fill the containers to the very top. Then for easy identification, label each container with the date and time the milk was expressed. Use waterproof labels.

After the above, you are good to go. So, carefully place each container in the fridge, positioning them at the back where the temperature is coolest. Or, keep them in an insulated bag until you can transfer them to the fridge

Can I add freshly expressed milk to already stored milk?

Yes, you can. But first, cool the milk before adding it to previously chilled or frozen milk. However, don’t mix milks which were expressed on two different days

How long will my freshly expressed breast milk keep?

At room temperature – Up to 6 hours

Insulated cooler – Up to 1 day if the insulated cooler is filled with ice packs. However as soon as you can, transfer the milk to a fridge

Fridge – Up to 5 – 8 days if kept at the cool back of the fridge

Standard refrigerator freezer – Up to 3 – 6 months

Chest freezer – Up to 6 – 12 months

Note that storage guidelines vary for preterm, sick and hospitalized babies. Also, studies say that the longer you keep breast milk, the greater the loss of its Vitamin C content and the lower its fat quality. Refrigerating of breast milk for over 2 days is also said to reduce the bacterial killing properties of the milk.

How do I thaw frozen breast milk?

Place the frozen container in a bowl of warm water (not higher than 37C) or allow it thaw under warm running water. Alternatively, the night before its intended use, transfer the frozen container to the fridge. When fully thawed, gently twirl the milk in order to mix any separated fat.

Never thaw frozen milk at room temperature because bacteria will be encouraged to increase. Also, don’t use rapid heating methods such as microwaves or stoves, because the milk’s antibodies may get affected and the new temperature may not be evenly spread.

Thawed milk must be used within 24 hours. Never refreeze thawed or partially thawed milk

Is there a difference between thawed and fresh breast milk

They may differ in colour and consistency. If your baby rejects your thawed milk, try reducing its storage time

 

Common breastfeeding problems and solutions

Unsettled and dissatisfied baby 

Most women have what it takes to breastfeed. Some just master the breastfeeding skill slower than others.

So, if your baby is exhibiting the above symptom, you’re probably on the slow coach and are yet to learn how to properly position your baby for effective breastfeeding. Therefore it is advised you receive expert help in adopting a suitable breastfeeding position/technique

Sore or cracked nipples

If you have sore or cracked nipples, your baby is probably not latched on well while breastfeeding. So be sure to seek professional help that will show you what you are doing wrong and guide you through one of the breastfeeding positions/techniques previously described.  Also, whenever you notice a bad latch on, immediately remove your baby from your breast by sliding your finger into the corner of his mouth until he releases his tongue. Then, start over again.

To protect your sore nipples from infections, take advantage of the anti-bacterial properties of your breast milk by squeezing out a drop or two and rubbing it on your sore skin. However, for actual healing and prevention of scabs, apply a thin smear of paraffin or purified lanolin on the cracked skin itself. Then, let your breast dry before putting your bra back on. Also, change your bra after each feed, avoid using soap over the sore nipple because it will dry your skin and lastly, stick to cotton bras which will allow air circulate the sore nipple.

Mastitis

Mastitis is the inflammation of one of the tissues in the mammary glands inside the breast. It is caused by the build-up of milk in the breast. This build-up often occurs when the breast makes milk much faster than it is being removed. The resultant inflammation can easily turn into an infection.

Symptoms include red, swollen areas on the breast (which may be painful), hard areas on the breast, burning pain in the breast (either continuously or only during feeding), white or blood streaked nipple discharges, aches, fever, chills and tiredness. If suspected, see your doctor for a proper diagnosis and treatment which may include antibiotics. Also, get lots of rest and keep drinking to stay strong and hydrated. In addition, tight bras and clothing should be avoided.

To prevent mastitis, breastfeed exclusively for 6 months, encourage your baby to feed frequently especially if your breast is over full, ensure your baby latches on properly to your breast, avoid missing feeds, sudden cut down on feeds (cut downs should be gradual) and tight clothing and bras.

Know that infections such as mastitis don’t have to stop breastfeeding sessions. Instead keep breastfeeding, but always ensure your baby is properly latched on and any excess milk is expressed out.

If not curbed early, mastitis may lead to the more serious breast abscess.

Blocked duct

Your milk ducts could get blocked if your baby doesn’t consume your milk as fast as it is produced. Hence an accumulation of milk builds up, causing a blockage which then forms a swollen, painful, firm mass in the breast.

Blocked ducts, though very similar to mastitis, is different because it is not an infection and therefore doesn’t need antibiotics treatment.  Also when compared with mastitis, it is less painful, usually not associated with a fever and the redness is less intense.

To prevent and treat, follow the self help steps associated with mastitis. Don’t delay treatment because if blocked ducts are not quickly treated, they could go on to become mastitis.

Note that blocked ducts could actually make your milk flow slower and cause it to taste different. But in spite of this, keep breastfeeding because that remains your best helpline.

Abscess

This is a bacterial infection which brings about a painful collection of pus in the breast, making it to become red and inflamed. It is often linked to mastitis. Symptoms include painful, swollen lumps which may be red, feel hot, cause surrounding skin to swell and bring on a high fever.

Once suspected, see your doctor.

Breast engorgement

After birth, blood may flow to your breast and cause some surrounding tissues to swell and possibly become engorged. To prevent and treat engorgement effectively, ensure you feed your baby on demand and be sure he actually latches on well during every feed. Also, never cut a feeding session short, always let your baby finish on one breast first before moving to the other and until your body learns to produce just the right amount of milk, wear comfortable, supportive bras, drink enough fluids (as reducing your fluid intake doesn’t heal or prevent engorgement), apply cold packs on your breast, place fresh green or white cabbage on your breast to draw out the fluid (but wipe the leaves clean first), use a pain reliever and massage your breast when your baby is feeding on it.

Ideally after 24-48 hours of breastfeeding, you should be back to feeling comfortable again,

Thrush

Thrush is a fungus infection that can find its way into your milk duct and get transferred to your baby. Possible causes of thrush in mom include plastic lined nursing pads which restrict air flow, damp nursing pads which are not regularly changed, bleeding nipples, long term use of steroids, antibiotics taken during pregnancy and/or breastfeeding, diabetes and anaemia. Moms with a history of vaginal yeast infections are also prone to thrush. In babies, antibiotics and pacifiers could increase the risk of oral thrush.

Symptoms of thrush in mom include extreme nipple or breast pain, cracked nipples, vaginal yeast infection, sores at mouth corners, rash on moist body parts like under the arm or in the groin area, decrease in milk supply and itchy nipples that could have a burning sensation, look red (or flaky) or have rashes (or small blisters).

Symptoms of thrush in babies include yeast diaper rash, gas, unwillingness to nurse due to a sore mouth and creamy white patches inside the mouth (on the gum, cheeks, roof of mouth, throat and/or tongue).

Thrush can easily be passed from mom to baby and vice versa. So, both of you would have to go for treatment which will probably include an anti-fungal  cream for your nipples and/or an oral thrush tablet which will prevent it from spreading. Medication could also be necessary if the thrush is inside the breast and not just on the nipple.

While waiting for the thrush to heal, keep breastfeeding, don’t rub breast milk on your nipples because yeast thrives on milk, eat less of sugar and yeast rich food, use vinegar to wash all clothes that come in contact with breast milk, don’t freeze your milk because yeast is not killed by the cold, pump your milk if your breast is too sore to breastfeed, boil (for at least 20 minutes) all toys, bottles, etc that come in contact with breast milk, drink decaffeinated green tea 3-4 times a day to boost your immune system and/or take ibuprofen for the pain. If you have a vaginal infection as well, wear cotton panties and rinse your bum with vinegar and water solution whenever you go on a bathroom visit.

A good diet, adequate rest and a healthy immune system is your best bet at preventing thrush. In addition, wash your hands often, wash and air dry your nipples and change nursing pads as soon as they get damp.

Tongue tie

A tongue tie is when a baby has a tight piece of skin between the underside of his tongue and the floor of his mouth. This could present difficulties for him when latching on and feeding.

It is advised you see a doctor if your baby is faced with this challenge

Leaking

This is likely to occur when your milk production levels are still trying to regularize. The way around this is to catch the excess milk with breast pads and ensure feeding sessions are not missed or postponed.

 

Breastfeeding after a c-section delivery

Following a c-section delivery, it may take longer than normal for your breast milk to start flowing. Your baby may also take a little longer to regain his birth weight. This is probably because surgery creates less opportunities for early and frequent breastfeeding. However if you truly want to, nothing stops you from breastfeeding. Simply…

  • Request for skin to skin contact with your baby as soon as possible
  • Keep your baby in the room with you, as much as is possible
  • Don’t wait for the anesthetic to wear off before you start breastfeeding
  • Get someone to help you get into a comfortable breastfeeding position
  • Adopt a breastfeeding techniques which won’t put pressure on your tummy and use lots of pillows to support your body
  • Ask for pain relievers if you’re in serious pain. These relievers will definitely keep you relaxed, comfortable and alert for breastfeeding
  • In case you have to be unavoidably separated from your baby, express out your milk for him

 

Breastfeeding multiple babies

Multiple babies are often born prematurely and tend to have low birth weights. Considering the health benefits associated with breastfeeding, it’s important they are started off early on breast milk.

At the beginning you may feel more comfortable feeding them separately. But as you both gradually get a hang of breastfeeding, you can attempt feeding two at a time or for triplets, feeding two together and then one after. Alternately, you can rotate all three during each feed.

 

Nutrition Guide for Nursing Moms

Eat more

To keep up your energy, you will need to eat a little more than usual, about 400-500 calories more.

Eat healthy

To fuel your milk production and effectively deal with possible bowel and constipation problems, eat healthy. A healthy diet includes a  minimum of 5 daily portions of a variety of fruits and vegetables, starchy foods (like rice, potato and wholemeal bread), proteins (like fish, meat and egg), dairy food (like milk, cheese and yogurt) and fibre (which can be gotten from wholemeal bread and pasta).

Healthy snacks include fresh fruits, sandwiches filled with salads, yogurt milk drinks, 100% unsweetened fruit juice and fortified unsweetened breakfast cereal.

Eating a rich variety of food alternates the flavour of your milk, hence exposing your baby to different tastes. When the time comes, this just may help your baby adjust to solids faster.

Drink more

It is important to stay hydrated by aiming for at least 8 glasses of liquid per day. Hence, even if you don’t feel thirsty, reach for a drink and be sure to drink even more if your urine appears dark yellow. Do away with juices and sugary drinks which may cause you to gain unwanted weight. Also, avoid too much of caffeine which may agitate your baby or interfere with his sleep pattern.

Take supplements

You may be advised by your doctor to take vitamin B12 and D supplements. Vitamin B12 which is good for your baby’s brain development is almost exclusively found in animal products. Hence those on vegetarian diets may need to take them as supplements.

Vitamin D will help your baby absorb calcium and phosphorous and prevent ricket softening and weakening of the bone. Hence if you don’t take enough Vitamin D fortified meals such as cow milk and if you have limited exposure to the sun, you may be put on a Vitamin D supplement by your doctor.

 

A few other facts you should know about breast feeding

  • Exclusive breastfeeding can delay the return of your periods
  • Breastfeeding won’t make your breasts sag. Sagging breasts come with ageing and weight fluctuations
  • The oxytocin hormone that helps to release milk for your baby, is also produced during sex. Hence, it’s not uncommon to have leaky breasts during sex

(Source: Women’s health, ask dr sears, nhs uk, mayoclinic, kidshealth, breastfeeding-problems, webmd, nursingmothers.org. Picture courtesy:isaude.net, ph.theasianparent.com, pinterest, gettyimages, imgarcade.com, birthwithoutfearblog.com, mybrownbaby.com, newsone.com)