Will You Be breastfeeding Your Newborn?

Breastfeeding is nature’s own way of providing nourishment for your newborn baby.  As it requires more sucking than in bottle feeding, breastfeeding encourages optimum development of the jaw, teeth and palate.  In many respects, it is ideal for both mother and child in the following ways:

For mothers:

For babies:

• Breastmilk contains all the nutrients required by babies for normal growth and development.
• The composition of breast milk is able to change to meet babies’ needs.  Initially after childbirth, a clear, yellowish fluid rich in protein called colustrum is produced.  This changes within the first few weeks of breastfeeding to more mature milk.  Mature breast milk provides babies with the watery foremilk that takes care of his liquid needs, and the creamier hindmilk that supplies protein and fat, with additional antibodies.  Hindmilk is released after the letdown reflex.
• Breastmilk is rich in antibodies that protect baby against many forms of infection.
• It is easily digested by babies.
• It prevents constipation, as the stools of a breastfed baby are always soft.
• It is inexpensive and conveniently available at the right temperature any time, any place.
• Breastfeeding is important in building bond between mother and child.  Nothing makes the baby feel more secure than to suckle at his mother’s breast.

Changes in your breasts

Even before your baby is born, your body is already preparing itself for milk production.  Your breasts become bigger and more lumpy.  The dark area around each nipple called areola grows darker as the milk ducts mature, and you may feel a little tingling sensation and soreness.  Nipples also become easily sensitized.

How to prepare your breasts for breastfeeding

Once you have decided to breastfeed, start preparing your breasts in early pregnancy.

• As your breasts enlarge, wear a nursing bra or any comfortable bra that provides good support.
• Keep your breasts clean with daily baths using mild soap and water.
• Gently wipe off any dried secretions blocking the openings of the milk ducts.  Dry completely with a clean towel.
• Rub lanolin cream daily on your nipples to keep them supple for breastfeeding and to prevent the skin from cracking.

A suitable diet for breastfeeding

A breastfeeding mother does not need a special diet but she should eat a well-balanced diet and drink plenty of fluids.  She may eat up to 1 and 1/2 times the amount of protein (beancurd, dried peas and beans, fish, poultry, meat, milk and eggs) that she normally takes, but she should not overeat.  She should also stay away from:

1. herbs and medicines not prescribed by her doctor.
2. too much ginger, vinegar, or spices,
3. stimulants like strong coffee or tea and
4. alcoholic drinks and cigarettes.

When to breastfeed

The first two months is the most crucial time for breastfeeding.  You can start breastfeeding as soon as the baby is born.  At first, you should feed him as often as he wants.  This helps to establish milk flow and also allows both of you to get used to each other.  Gradually, baby will settle down to a more definite pattern of feeding, usually once every three to four hours.

Breastfeeding positions

Any breastfeeding position is fine, as long as you are comfortable.  Just make sure you have good support for your back and the arm holding your baby.  Here are some positions:

How to breastfeed:

1. Wear dresses and brassieres that open in front so that you don’t have to undress each time to breastfeed your baby.
2. Always wash your hands with soap and water before you begin.
3. Clean your nipples and areola with cotton wool dipped into water that has been boiled and then cooled.
4. Hold baby close to your breast, supporting his head in the crook of your arm.  Let your nipple touch his cheek.  Baby will automatically turn his head to face your breast.
5. Stretch your nipple between your index and middle finger and guide it into his mouth.  Make sure baby holds both the nipple and the areola in his mouth.
6. Do not squeeze his cheeks or push him toward the breast – he might end up refusing the breast altogether.
7. Use your fingers to push down the part of the breast nearest to his nose so that he can breathe without difficulty.
8. Feed baby from both your breasts at each feed, say 5-10 minutes at each breast, to prevent nipple soreness.  As you become more accustomed to breastfeeding, you can gradually increase the length of the feeds to 15-20 minutes at each breast.
9. After baby has finished, help him to let go of your nipple by pressing gently on your breast.  This allows air to enter his mouth, and breaks the suction.  If this does not work, you may need to put your finger into the corner of his mouth.
10. After feeding on each breast, rest baby’s head on your shoulder or sit him on your lap and gently pat/rub his back.  This helps him to burp and bring up any swallowed air.
11. Once the feed is over, clean your nipples and areola and let them dry naturally.  Rub lanolin cream into your nipples if necessary to keep them supple and to prevent cracking.
12. Always start the next feed on the breast that the baby suckled on last at the previous feed.
13. Weigh baby once a month to make sure he is growing well.  Babies that are fully breastfed may pass soft yellow stools.  This is perfectly normal.

Breast milk expression

For mothers who stay out of the house but choose to breastfeed, breastmilk can be expressed into a bottle and stored.  A mother can express as much as 400-500 mL of milk after breastfeeding.  Some women can express even up to 800 mL of milk.  Milk expression can be done using the hand or a breast pump.  If you are unable to do it at home, you can also do it in your workplace.

Preparing breastmilk

Mimicking baby’s feeding pattern conditions milk expression, thus, keeping up your milk supply. Before you start expressing milk manually or by pump, gently massage your breast around the nipple toward the center to help let down the breast milk.  You may apply warm compress to stimulate milk flow.  To maintain this breast milk supply, try to express both breasts each time.

Breastfeeding discomforts

Some breastfeeding problems or discomforts occur in the first few weeks of your baby’s life.  If such happens, do not treat it as a signal to give up breastfeeding and hit the bottle.  Instead, continue to breastfeed for you and your baby’s own good, after all, these discomforts are often short-lived.

Sore/cracked nipples. This discomfort results when your baby is allowed to suck only onto the tip of the nipples or when your nipples become dry and cracked from frequent washing with soap. To prevent sore nipples, keep the nipple area dry between feeds but do not wash off the milk secretions since they also help lubricate the nipple. Breast engorgement/swelling.  When breasts are overfull with milk, they become hard, tender and shiny. In effect, the nipples are so stretched that the baby cannot readily suck through them.  Engorgement can lead to poor milk let-down which means your baby is not getting enough milk to satisfy him and yet your breasts remain uncomfortably full.

Massaging your nipples to letdown your milk and expressing enough milk prior to breastfeeding your baby will help prevent breast engorgement.

Blocked milk ducts, mastitis and breast abscess are merely different degrees of the same problem.  It may begin as a tender lump, pinkish to reddish and hard to touch, and you may feel feverish.

The lump formed is due to milk buildup in the ducts which must be dislodged.  To relieve this discomfort, you may consider to dislodge this milk buildup by breastfeeding your baby long enough or frequently, offering the breasts with the blocked ducts first and ensuring that it is emptied.  You may also try a more comfortable feeding position that would allow to drain your breast completely.  Gentle breast massage, applying hot or cold compress, or taking a hot shower may relieve you as well.

Check also that your bra is not too tight as this may also be a cause for some blocked milk ducts.  If symptoms persist, it may develop into a mastitis and eventually into a breast abscess, so it is important to treat the first signs as early as possible.

If the lump still does not clear up in a day or so and the flu-like symptoms persist, consult your doctor immediately.  Infection may have set in due to mastitis and there is a risk that your milk may become infected.  Low milk production.  Some mothers worry that they do not have sufficient breast milk when in fact it is perfectly adequate.  Reasons for low milk production include breast/nipple infection, anxiety on the mother’s capacity to become a good mother, stress and tiredness in coping with the demands of running a household, and to some being a working mother at the same time.