by Jodi Albuquerque – Lactation Consultant
This week we are celebrating World Breastfeeding Week and all the ways we can support you on your breastfeeding journey.
The WHO and UNICEF recommend exclusive breastfeeding for all infants for the first 6 months and then continued breastfeeding until 2 years of age.
The Fourth Trimester
We know that breastfeeding can be challenging for many mothers and their families – particularly during the Fourth Trimester, a time of great physical and emotional change.
Newborns take up lots of time and it’s very easy for new mums to be overwhelmed in the first few weeks by the demands of feeding, sleeping – or lack of it, crying and looking after a baby. Combine this with the physical recovery after birth and hormonal changes, it’s no wonder mums can feel exhausted!
Putting aside those challenges for a moment, did you know breastfeeding makes your brain happy?
Breastfeeding provides a special opportunity for mothers to take some ‘welcomed’ time-out, releasing ‘feel good hormones’ Prolactin and Oxytocin, which are important in not only providing milk but establishing a beautiful bond with your baby. So next time you might be feeling overwhelmed with visitors, you have the perfect excuse to take a break.
Good nutritious food
Have you thought about some healthy snacks to nibble on while you breastfeed your baby? Breastfeeding burns a tonne of calories- that’s around 400-600 calories per day! Mothers will need lots of energy in those first few months after birth, so eating a variety of healthy foods will help give you the boost you need.
Breastmilk provides protection for mothers and their babies. Many studies show that breastfed babies have fewer ear, respiratory and gastrointestinal infections. Did you know that if you or your baby is sick the number of white blood cells and antibodies in your milk increase to fight infection? Breastmilk is amazingly adaptable. In addition, breastfeeding also protects mum too, reducing her risk of developing ovarian, uterine and some breast cancers.
Make an appointment
Have you thought about booking into an Antenatal Breastfeeding Class or seeing one of our experienced Lactation Consultants?
One for Women encourages all women who are pregnant or breastfeeding to reach out for help and contact us anytime. We are happy to discuss any concerns that you might have and provide you with all the information you need to know to get your breastfeeding off to the best start possible. We can create individualised breastfeeding care plans that build on new knowledge and a better understanding about how breastfeeding works, milk supply and what those changes in your breasts are all about.
Let me share with you some advice that I wish I knew when I was navigating motherhood and breastfeeding my three children.
After the birth – skin to skin
After birth, you will be encouraged to feed your baby within 1 hour of birth and to spend as much time as you can with your baby so that you can have the opportunity to read their early feeding cues. This is best done when placing your baby skin to skin.
Cuddling your baby on your bare skin is a great comfort to them, where your smell and the sounds of your heartbeat are warm and familiar.
Allowing your baby to use their instinctive feeding reflexes to find their way to the breast is a remarkable thing!
Hand express colostrum
Colostrum is the first milk the baby will receive. Its golden glisten may first appear as little droplets on the nipple but with lots of stimulation from baby and suckling at the breast the quantities of this concentrated goodness will increase.
Sometimes after birth, your baby may become sleepy and difficult to feed. Hand expressing is a great way for you to stimulate the milk-making process and collect colostrum so that it can be given to baby.
Did you know that Colostrum will provide your baby with the first natural vaccination? As mentioned before, it’s also alive and rich in nutrients, white blood cells and antibodies that help protect your baby from infection, establishing immunity as well as priming the gut with good bacteria, helping with digestion. Colostrum is very easily digested, gentle on tummies and helps baby to pass the first poo called meconium.
So how much milk does baby really need in those first few days?
A baby’s tummy is about the size of a cherry when it is born and slowly gets bigger with increasing milk intake during the first week of life. In the first few days, your baby may take anywhere from a teaspoon of breastmilk up to 20-30 mls per feed.
Did you know that every mum has her own unique breastmilk storage capacity? There is a wide range of normal when it comes to supply and your baby will determine how frequently they need to feed in order to feel satisfied.
By day 3-4 the volume of breastmilk will increase considerably with your milk coming in (a process we call ‘secretory activation’). By the end of the first week, milk volumes can be up to 500-750ml per day! Your breasts will begin to feel firmer, appear fuller and your baby will become more alert and active in the way that they feed, opening their eyes, sucking more nutritively and enjoying those increased milk volumes. With that, will come a lot more wet and dirty nappies too! So get practising now for all those nappy changes we expect around 6-8 wet nappies and at least 3-4 dirty nappies a day.
Do you know how often a newborn baby needs to feed?
It’s during this time we encourage you to feed your baby at least 8-12 times per day.
On average newborn babies will demand every 2-3 hours during the day and night and sometimes want to feed hourly. This is called cluster feeding and is a completely NORMAL newborn feeding behaviour, especially when they are having a growth spurt or wanting that little bit more milk to feel satisfied. Your breasts get it, and with all that frequent emptying the fat content of the breastmilk increases.
I won’t lie to you though; this can be a really tough time to get through.
Sleep when you can
Are you getting adequate periods of rest? Your baby can have you up at all hours of the night and it’s going to take a while for your baby to settle into a routine. Even then, things can change quickly so try and sleep whenever your baby is sleeping or ask your partner or family member to look after baby while you get some rest.
Find a comfy place to feed
Finding a comfortable place to feed is important. Set yourself up with all your supplies you may need such as your water bottle, lip balm, snacks, remote and phone to name a few. Perhaps you have a new favourite series to watch on TV or find listening to music a nice way to relax.
How long are breastfeeds taking?
Many mothers ask me how long should a breastfeed take. It really does vary a lot and depends on how hungry your baby is, breastmilk storage capacity, milk flow and the effectiveness of positioning and attachment.
Offer both breasts
Try and offer both breasts each feed- interestingly did you know that a woman’s right breast usually produces more than her left?
Follow your baby’s feeding cues, they are really clever.
Are they comfort or nutritive sucking? When a baby successfully latches to the breast, often they will start with comfort sucking, which are those short little butterfly sucks that assist a mother to stimulate a milk letdown usually within the first 1-2 minutes. Then once the milk let down occurs you will notice the sucking pattern will change to a more coordinated, rhythmic and nutritive sucking pattern. This is in response to an increased flow of breastmilk and should feel stronger in vacuum like a firm tug. Milk letdown usually lasts a minute or so and may occur a few times over let’s say a 15-minute period.
Feel for softening of the breast
Slowly the breast will begin to soften as the flow of milk slows down. Baby’s may become sleepy with a much weaker sucking effort. This is when I encourage mums to take the baby off if they haven’t done so themselves yet and offer the second breast. This is really important to discuss with mums in the early days after birth when I often visit mums on the postnatal ward who are exhausted after feeding for more than an hour at a time.
Have a look at the shape of the nipple
Another important thing to look at is the shape of the nipple after a feed. Does it look pinched and was there any discomfort during the feed? This may suggest that baby’s latch may have slipped causing some compression of the nipple. If there is any sign of discomfort, take baby off and re-attach the best you can. This is going to avoid nipple trauma such as blistered, grazed, cracked and bleeding nipples.
Feel for any lumps or tender areas
It’s also a good idea to feel for any lumps or tender areas of the breasts too- particularly if engorged, if these can’t be removed by gentle massage during a feeding, try using some cool compresses and if they still won’t budge a breast pump may be helpful.
Ask for help with positioning and attachment
One of the most difficult things to learn in the early days especially for new parents is confidence with handling baby and finding the right feeding position. This can take some time. Your midwife will show you some different ways to try and feed. As you can imagine every mother and baby is different so we need to explore this together so that breastfeeding is comfortable and doesn’t cause any pain.
One of the most natural ways to begin a breastfeed is using baby-led attachment. Babies are born hard-wired to breastfeed and mothers can be reassured that they don’t have to know it all.
Simply by placing baby skin to skin with mum provides a natural way to get baby to latch onto the breast using instinctive feeding behaviours such as mouthing, licking, bobbing the head from side to side, wriggling, finding and grasping the nipple, latching on to the breast and suckling. These behaviours can be seen as early as 1-2 hours after birth and continue for at least 3 months after birth.
Sometimes, however, a mother and her baby’s instincts may be reduced by drugs used during birth or by hospital procedures such as limited or delayed skin to skin time.
If your baby isn’t latching particularly well, I encourage you to please ask your midwife for assistance and seek out a lactation consultant early on. This can make the world of difference, providing you with a plan to move forward and will better prepare you for a more positive breastfeeding experience. I really believe that no one fails at breastfeeding. Every bit of breastmilk that you give your baby is valuable.