Breastfeeding - we reply to your questions

There’s no doubt breast milk gives your baby the best start in life, but it isn’t without its challenges, as these mums’ questions demonstrate!

Breastfeeding - your questions answered

There’s no doubt breast milk gives your baby the best start in life – it’s the ideal source of nutrition for your newborn, always on tap and at the right temperature. The World Health Organisation recommends breastfeeding for the first two years of your baby’s life and the benefits continue as long as he receives it, with breastfed babies suffering fewer allergies and ear infections, and lower rates of SIDS. It isn’t without its challenges though, as these mums’ questions demonstrate!

How will I know when my milk comes in?

In the first few days after the birth, your breasts produce a creamy first-milk called colostrums – it’s packed with vital antibodies. It’s not until three or four days after the birth that breast milk proper comes in – and you’ll know about it! You’ll feel a hot, full sensation and your breasts may literally expand before your eyes. They may become uncomfortably hard, to the extent that there is actually no ‘give’ in them for your baby to latch on to. If this happens, express a little milk by hand to reduce the fullness and help your baby latch on as usual.

Believe it or not, slipping cold cabbage leaves inside your bra really can help relieve the discomfort!

How can I tell if my newborn is getting enough milk?

Your newborn has a tiny stomach, which means she won’t be able to go more than a couple of hours between feeds in her first few weeks. As long as your breasts feel full you can be sure you’re producing enough milk to satisfy her, and if you can see her continually swallowing while she suckles you’ll know she is taking it in. Stack that alongside a sleepy, content baby after feeds, at least six wet nappies over 24 hours and a poopy one anything from once to several times a day, and you can be sure she’s getting the nourishment she needs. The final proof should be in weight gain: on average, breastfed babies gain around an ounce a day for the first two or three months. If she’s not putting on any weight then you’ll need to discuss your milk supply and feeding schedule with your paediatrician or lactation consultant.

I feel like my baby nurses 24-7. Is this normal?

It is perfectly normal for newborns to feed often – as much as eight to 12 times in 24 hours – in fact, it’s this constant feeding that stimulates your breasts to produce more milk so it has its advantages. However, it can be exhausting for you, especially if your baby is going through a growth spurt (these often occur at around 10 days and 3 weeks old).

Stress and tiredness can affect your milk supply, meaning your baby needs to feed even more often, so if being on call is really sapping your energy take to your bed if you can and rest in between feeds. If you have other children, get your partner, a relative or a trusted friend to help out with the school run and maybe step in to take them out to the playground for some fresh air while you stay with your baby. Think about having groceries delivered and if there are any teens living nearby, ask their mums if they might be interested in earning a few pounds doing a load of washing or vacuuming for you. And don’t ignore your own needs: eat a nutritious diet and drink plenty of fluids to give you the energy you need for the work you’re doing.

How long should my baby nurse at each breast?

Back in the day mums were often advised to switch sides after 10 minutes but in fact it’s vital your baby drinks his fill from each breast without being disturbed. This is because breast milk has two components: protein-rich foremilk, which flows first in a feed and quenches your baby’s thirst; and the richer hindmilk, which follows afterwards and helps his body and brain develop. Always offer your baby the second breast after he finishes the first and if he only stays on there for a couple of minutes and doesn’t drain it, offer him that breast first when he next feeds.

Are there any foods I shouldn’t eat while breastfeeding? I’ve heard that some things might not agree with her.

As a rule, you can eat whatever you like: your food affects the flavor of your breast milk and getting your baby accustomed to a wide range of tastes might make him less likely to be a fussy eater later on! However, if he’s colicky or develops a rash, it could be that something you’ve eaten is at fault. Wheat and dairy seem to be the most likely culprits, along with peanuts, onions, broccoli and spicy foods. Try eliminating these foods from your diet and see if your baby’s symptoms clear up, then gradually reintroduce them one at a time, in small amounts, to pinpoint the offender.

My baby prefers to feed on the left side – does this mean the milk supply will dry up on the other side?

Your baby may often appear to favor one side simply because your hand preference means you find it easier to latch her on there – for example, if you’re right-handed, you’ll probably find it easier to position her for the left breast and it leaves your right hand free to read a book or operate the TV remote control! Your breasts may well look a tad lopsided if she does have a preference so you could try the old fashioned method of attaching a safety pin to the side you last fed from to remind you to latch her onto the opposite breast for the next feed. Alternately, pump from the less favored side, to help keep up the supply.

Ouch! My baby has cut his first teeth and he’s chewing on my nipple every time he latches on. How can I train him not to?

Teething babies love a good chew and unfortunately your nipple won’t be immune… in fact this may be one reason why so many mums stop breastfeeding at around 6 months. Yelping “ouch” could frighten your baby and put him off latching on, so if he does sink his teeth in gently insert your clean little finger into the corner of his mouth and unlatch him for a few seconds. He’ll soon get the message that biting you means he’ll be taken off the nipple. Learn to anticipate your baby’s biting, too – it’s something he’s more likely to do at the end of a feed when he’s full up and doesn’t feel the urge to suckle properly.

I feel really self-conscious about feeding my baby in public. How can I get over my inhibitions?

This is a common problem but you can easily overcome it. The first thing you need to bear in mind that anyone who sees you doing it is likely to feel far too self-conscious to actually eyeball you anyway! Secondly, it’s very easy to breastfeed so surreptitiously people probably won’t even realise what you’re doing – just wear a bra with an easy drop-cup release, and wear a light shawl to keep your baby hidden from view. Practise in a mirror so you have it down before you go out anywhere. Carrying him in a sling can also make public breastfeeding easier. Above all, focus on the fact that you’re feeding your baby in the way nature intended, and giving her the very best start in life. There is nothing ‘dirty’ about breastfeeding and it isn’t something you need to feel awkward or embarrassed about. If you sense a vibe from others then let it be their problem, not yours.

Will giving my baby the odd bottle of formula affect breastfeeding?

Exclusive breastfeeding is the best target to aim for, but giving your baby a bottle of formula every few days won’t put him off breastfeeding. But ideally, hold off until your baby is over a month old so he can get the hang of breastfeeding and won’t end up with ‘nipple confusion’ (the action of nursing is totally different to sucking milk from a bottle). Remember too, that just because you may need to offer a bottle doesn’t mean you need to offer formula (unless your paediatrician has recommended it as a way of helping your baby gain weight faster) – consider expressing breast milk and freezing it for the times when you use a bottle.

Can I start expressing as soon as my milk comes in?

You can start using a pump to express breast milk as soon as your milk comes in, and it will keep in the freezer for the odd bottlefeed. In fact, if your baby is a fairly light feeder, pumping after he finishes can help stimulate your milk production by emptying your breasts. If you find you are producing excess breast milk, find out if there is a local milk bank you can donate it to – these provide breast milk to preemies or babies whose mums aren’t able to breastfeed for health reasons.

Some women find it difficult to produce much milk with a pump and this can be a problem if they are relying on it to keep up their supply once they return to work. It can help to have a photograph of your baby to hand, or even a recording of his cries or cooing you can listen to on an MP3 player. Pumping at the times you would usually have nursed your baby can also help.

I’m taking medication – can I still breastfeed?

It’s generally safe to continue with medications, including most anti-depressants if you’re breastfeeding, but do run it past your physician and your baby’s paediatrician, in case they feel the dosage should be reduced (don’t stop taking medication for chronic conditions without checking). You should also double check any over-the-counter medication with your doctors. If your doctor recommends a short course of treatment that is unsafe for your breastfeeding baby and you don’t feel she’s ready for weaning you can keep up your milk supply by ‘pumping and dumping’ – expressing at feed times and disposing of the milk while you temporarily switch your baby to formula.

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