The truth about breastfeeding
Billed as the most natural thing in the world so why, asks Rebecca Howard Dennis, does breastfeeding often go - well - tits up? And what can be done to help?
Absolutely everyone, from the World Heath Organisation to the UK’s government and your very own midwife, will tell you a mother’s milk offers a baby the perfect nutritional start in life. What they won’t necessarily let slip is how tricky, stressful and downright frustrating that start can be – for both you and baby. Which is a pity, as the ‘Breast Is Best’ campaign is being heard loud and clear: recent figures show that 75 per cent of all expectant UK mothers want to breastfeed from birth, and a further four out of five new mums say they’re aware of the health benefits.
Unfortunately, of the 81 per cent of mums who start nursing their newborns, only 23 per cent are still exclusively breastfeeding at six weeks, a number that dwindles to just one per cent by six months. So why the drastic drop-out rate? According to a new survey by nursing brand Medela, it’s all down to a serious lack of support. Its results found that two thirds of new mums said they wished they’d received more breastfeeding advice while pregnant, and 70 per cent said they wished they’d been given a more realistic idea of what to expect.
And therein lies the (nipple) rub: while no one wants to dampen this renewed enthusiasm for breastfeeding, which fell to an all-time low back in the Seventies, there’s no doubt that a little management of expectations would go a long way towards keeping these willing new-mum recruits not only motivated to continue, but also braced for the inevitable challenges, that breastfeeding can bring.
Your cup runneth over
Changes in your breasts are often the first pregnancy ‘symptoms’. Tingling nipples, sore boobs, a network of veins appearing and a boost to your bra size are all normal side effects of the surge in baby-growing hormones oestrogen and progesterone.
Growing milk ducts and an increased blood supply to the boobs can make the first trimester in particular a pretty uncomfortable time. Tackle this with a stash of well-fitted maternity bras and wear them around the clock – even in bed.
Experts such as Rigby and Peller (rigbyandpeller.co.uk) recommend being measured around the ten-week mark and then again every two to three months, and swapping your pre-pregnancy underwires for a super-supportive soft cup instead. Most mums-to-be go up at least one cup size, and often a band size too because your rib cage will expand to accommodate your growing baby.
Nursing a newborn
Experts agree that skin-to-skin contact between you and your baby is key to getting breastfeeding off to a good start. In fact, studies have shown that babies who are kept on their mother’s chest for the first hour after birth are more likely to latch on without help.
This close contact will help you produce oxytocin, the ‘love hormone’ that triggers your milk let-down response and gives your baby a chance to learn and respond to your natural body odour. The tiny bumps that have developed on your nipples during pregnancy, called Montgomery’s tubercules, now come into their own and release an oil that smells of amniotic fluid. It’s this familiar smell that helps stimulate your baby’s natural instinct to hone in, latch on and start to suckle for their first feed. To help strengthen this bond, it’s a good idea to stop using perfumed body lotion or soap for the first few weeks after birth.
The first feed
Your baby’s first breastfeed outside the womb will be colostrum – a thick, sticky, yellowish milk that is antibody-laden and exactly what your baby needs for the first two to three days of life. Your body has been producing this beta carotene-rich liquid since week 16 of your pregnancy, and the tiny teaspoonfuls you produce are perfectly sized, nutrient-dense portions for your baby’s minute stomach. Often called ‘liquid gold’, this multitasking pre-milk is believed to calm any nausea babies might experience after the trauma of birth, as well as kick-start your little one’s digestive system by cleaning out meconium (a baby’s first bowel movement), and help to prevent jaundice.
Colostrum will nourish your baby until your milk starts to come in at around day three or four (this can take a little longer if you’ve had a C-section or a long pushing stage during delivery, but your midwife and health visitor can advise you on this). When your breasts feel fuller in the days after birth, this is a sign that your milk is on its way. As a rule, babies tend to lose around seven per cent of their birth weight in the first few days, so don’t panic – as soon as your milk arrives and breastfeeding is established most babies regain what they’ve lost by two weeks old.
Breastfeeding is an art, not a science, but many new mums get the idea that they simply aren’t doing it ‘right’. Here we answer your most common concerns.
How will I know when and how often to feed my baby? You’ll soon pick up on your baby’s hunger cues. Look for signs such as sucking their fists or opening their mouth and rooting (searching around) for your breast.
How long should a breastfeed last? There really is no hard and fast rule here. Some people say ten to 20 minutes per breast as a guide, but you will get to know your baby’s needs. Bear in mind that they will change, too, and some days your baby will be more hungry than others. It’s important to understand that your milk changes throughout a feed: it’s more watery and thirst-quenching to start, then becomes creamier and more filling at the end. It’s important that your baby feeds enough at this end stage to stay fuller for longer and gain weight.
How will I produce enough milk? You may have seen reports about women not producing enough milk to breastfeed their babies, but scientific data suggests that only one per cent of women actually fall into this category. The best way to boost your supply is to breastfeed as often as possible – working on a supply-and-demand basis, the more your baby takes, the more you will produce. This is why midwives advise feeding eight to 12 times every 24 hours for the first month or so, to establish a plentiful supply. Babies must breastfeed often because they digest your milk quickly and easily (taking as little as 60 minutes) and small, regular amounts are perfect for their tiny stomachs.
How do I know if my baby’s had enough? A baby who’s properly attached and, as a result, feeding well, will come off the breast when they’ve had enough. Babies often push the nipple away and can even look a little woozy and sleepy. If your baby still looks alert after one breast, then offer them the other side; if this isn’t necessary, just remember to start feeding them from that side first the next time. You’ll know your baby is getting enough milk if their skin colour is good and the skin tone firm, if they are active and alert, they are growing in head circumference, length, and filling out. You can check their weight against the standardised growth charts.
Get a grip
We’re constantly bombarded by beautiful images of mothers nursing their babies in the classic cradle hold. But there are many other effective breastfeeding positions, and there’s no such thing as one correct position. So if something’s not working, switch it – try our pick of these tried and trusted techniques.
SIDE-LYING HOLD Lay on your bed with your baby lying parallel beside you, tummy-to-tummy.
RUGBY BALL Place a pillow beside you at 90 degrees to your body; lay your baby on the pillow, holding them underarm with their legs extended out behind you.
KOALA HOLD Support your baby in an upright position by sitting them straddled across one knee, facing your breast.
LAID BACK Sit semi-reclined with your baby lying across your stomach (this is also known as biological nurturing).
OPPOSITE ARM CRADLE HOLD Instead of the classic same-side-arm-as-breast hold, put your baby across your lap, using the opposite arm to breast to support them. To see what some of these holds look like, go to ameda.com and search for ‘breastfeeding positions’.
The benefits for both of you
Yes, we’ve all heard breast is best for baby*, but did you know that nursing actually benefits you, too? Here’s how it helps you both to stay healthy.
- Antibodies passed from you to your baby via breast milk are thought to help protect against tummy bugs, colds, chest and ear infections; some studies also show that breast-fed babies are 80 per cent less likely to be hospitalised with gastroenteritis than formula-fed infants.
- According to the award-winning news website Science Daily, breast milk helps to create a healthier intestinal tract, allowing your baby to differentiate between good and bad bacteria, and between a virus and a food source.
Breastfeeding may reduce your baby’s risk of sudden infant death syndrome (SIDS). Some say respiratory and gastrointestinal infections contribute to the SIDS risk, and breastfeeding infants get fewer of both.
Breast milk contains long-chain polyunsaturated fatty acids, needed for healthy brain development.
Breast milk helps your baby prepare for different tastes when weaning because, unlike formula, the flavour of breast milk can change, leading some experts to believe it can prevent a child from becoming a picky eater later in life.
Breast milk is bespoke and gives your baby all the nutrition they need, even changing in volume and composition according to their specific, individual and day-by-day needs.
- Breastfeeding helps you bond with your baby, which could reduce your risk of developing postnatal depression.
It can help burn fat laid down during pregnancy, boosting both short- and longer-term post-partum weight loss.
Breastfeeding reduces the risk of developing premenopausal breast and ovarian cancer (and the longer you breastfeed, the greater the reduction).
Breastfeeding also reduces your risk of developing osteoporosis and Type 2 diabetes in later life.
*Not every woman can breastfeed, and not every woman wants to breastfeed. At Gurgle we respect the feeding choices mothers make every day for themselves and for their babies. Breast is only ever best if it’s also best for your family.
With so many mums citing a lack of support as their main reason for stopping nursing sooner than they’d hoped, here are some of the most common breastfeeding problems you might encounter, and how to tackle them.
SORE AND CRACKED NIPPLES Some soreness in the first few days is to be expected, as your nipples need time to toughen up. That said, ongoing pain and cracking is a sign that your baby’s latch might need attention. Purified lanolin will help your nipples to heal more quickly, but consider seeing a professional for latch advice. Remember that babies need to open their mouths really wide to allow the nipple to reach the back of their mouth, which is soft: too far forward and they’ll squash the nipple between their tongue and the hard roof of their mouth.
TONGUE TIE Four to 11 per cent of babies are born with tongue tie – their tongue is attached to the bottom of their mouth. Depending on the severity of the ‘tie’ this may stop them massaging and suckling the nipple properly. Newborns should be checked for this problem, which can be resolved with a simple snip (but be aware that it may reattach). Look for a baby who frequently slips off or who feeds often but fails to put on weight. Sore nipples and engorged breasts are also a sign.
THRUSH Sudden shooting or stabbing pains after previously pain-free feeding could be a sign of thrush. It should be treated with antibiotics for mum and baby, to prevent them reinfecting each other.
ENGORGED BREASTS Hot, hard, tender breasts are very common in the first days as nursing is established. Breastfeeding as often as possible is the best way to get relief and regulate your supply. But if this offers little relief, try expressing milk immediately after the feed – your midwife or health visitor can show you how.
MASTITIS Red, hard, hot, sore, swollen breasts, with or without hard lumps, are caused when milk is made faster than it’s removed, often because of an improper latch. Particularly common in the first three months and especially among firsttime mums (although anyone can suffer), this inflammation of the breast tissue – that can quickly become infected with bacteria – is often accompanied by flu-like symptoms. Miserable for mums in the short-term, it can be easily treated with medication and lactation support, so breastfeeding can continue successfully.
OVERABUNDANT SUPPLY Too much milk and full breasts can mean a mother’s nipples are either pulled almost flat so baby can’t latch on, or the flow is so fast that babies gag. Try expressing a little milk before starting to feed to help the nipple to protrude more and slow the flow. A koala hold can also help as it allows babies to tilt their head back a little more.
Your little black book of breastfeeding support
Before your baby is born, collect the phone numbers of support lines and local groups and keep them handy. Helplines and community organisations are often manned by experienced mums as well as healthcare professionals, and can make all the difference if you’re struggling to breastfeed. Here’s our cut-out-and-keep list of nationwide organisations.
LA LECHE LEAGUE GB LLL clubs offer a variety of ante- and postnatal classes for expectant and new mums; laleche. org.uk; 0845 120 2918
ASSOCIATION OF BREASTFEEDING MOTHERS Volunteer-staffed helpline (wo)manned mainly by mothers who have personal experience of breastfeeding; abm.me.uk; 0300 330 5453
NATIONAL BREASTFEEDING HELPLINE Offers mother-centred, non-judgemental support and a live online web-chat service; nationalbreastfeedinghelpline. org.uk; 0300 100 0212
LACTATION CONSULTANTS OF GREAT BRITAIN Specialising in individual help with both basic and complex breastfeeding challenges; lcgb.org
BABY CAFÉ A network of breastfeeding drop-in groups providing support for mothers nursing babies and children of any age; thebabycafe.org
FEEDFINDER A free app created by researchers at Newcastle University who appreciate feedback to make it even better; it lists highly rated locations to help you find breastfeeding-friendly places around the UK; feed-finder.co.uk