Are you breastfeeding correctly?
Billed as the most natural thing in the world so why does breastfeeding often go - well - tits up? And what can be done to help? Once you get these few basic tips under your belt (or your bra) you may find putting nipple to mouth a little easier.
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 tips 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.
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.
Baby's 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.
Quick breastfeeding tips
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 questions.
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.
Getting a hold
We’re constantly bombarded by beautiful images of mothers nursing their babies in the classic cradle hold. But there are many other effective breastfeeding holds, 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.
Getting a latch
Even experienced mamas have to learn how to feed each individual baby. It can come as a shock, especially to first-time mums, that a newborn doesn’t instinctively know what to do. Remember that you’re both learning, and experienced midwives are keen to stress that it takes between six and eight weeks for mothers and their babies to get the hang of a properly established nursing technique. Respected lactation consultant and midwife Lynda Leach has these top tips:
Make sure you’re sitting comfortably and both you and your baby’s clothes are arranged so there are no restrictions.
Your baby’s whole body should be turned towards you, supported behind their shoulders – not head – so they can tilt it back slightly.
Have your baby at the same level as your breast, using a pillow or rolled-up towel if necessary.
Babies breastfeed, they don’t nipple feed. It is essential to offer your baby the breast, not just the nipple.
Position your baby just short of the nipple, aiming to offer areola and breast tissue rather than the nipple itself
Try placing a finger or thumb above your nipple, parallel with baby’s lips. This means you can tilt the nipple up and offer your baby more breast below it.
Ensure your baby is ‘seeking’ your nipple, with their chin and mouth forward and their head tilted back.
Encourage a wide gape by stroking their lower lip with breast tissue, not your nipple. Repeat until you get a wide gape.
Once your baby responds with the widest open mouth, quickly hug them onto your breast, positioning their bottom lip a good 3-4cms below the nipple. Ideally you should see plenty of areola above their nursing mouth.
If the latch is not right, break the seal by inserting your finger into the side of your baby’s mouth. Never pull your nipple out as this can cause injury. Then re-position and try again.
TIP Always try to soothe your baby before latching on. A crying baby will find it harder to get their tongue in the correct position, meaning frustration for them and an increased risk of sore nipples for you.
The benefits of breastfeeding for mother and baby
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.
Benefits for baby:
- 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.
Benefits for you:
- 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 forms of breastfeeding pain 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 breastfeeding 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. Painful 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.
New mums often ask if they need to make changes to their diet whilst breastfeeding. The short answer? No. Fat stores laid down during pregnancy provide the extra 200-500 calories a day needed to nurse a baby, and all other dietary needs can be met by following a healthy, balanced eating plan. Incorporate plenty of starchy foods, fruits, vegetables and lean proteins, and continue to take your pregnancy supplement, as this will meet your vitamin D and calcium needs. Don’t worry about upping your water intake, either, as your body will compensate all by itself. However, keep in mind the release of oxytocin whilst nursing can make you feel thirsty, so it’s worth keeping a drink within arm’s reach. Try to limit caffeine to just two cups of tea or instant coffee (one cup of filter) a day, as caffeine will pass to your baby through your milk and, whilst harmless, it may make them restless and affect their ability to sleep.
Cow’s milk in mum’s diet can make some babies bloated, wheezy, prone to diarrhoea, reflux, itching and eczema. If you’re recommended to eliminate dairy from your own diet, it’s worth knowing that it can take between 10 days and three weeks to eliminate the offending milk proteins from your own system, so it may take a while to see the benefits in your baby.
Your guide to breastfeeding lingo
CLUSTER FEEDING When a baby has several short feeds close together, rather than more evenly spread over a 24-hour period. This tends to happen less often as baby grows.
EXPRESSING Using either a mechanical pump (check out Medela and Ameda double pumps for the best, hospital-grade devices) or hand massage to ‘milk’ your breasts. Expressed milk can then be bottle-fed to your baby, but this is ideally left for at least six weeks once your supply is established.
FEEDING ON DEMAND Allowing your baby to nurse at will rather than imposing a feeding schedule. This approach helps your body regulate a good supply of milk for your baby’s individual needs.
FOREMILK The initial watery milk in a breastfeed that’s thirst-quenching and full of lactose sugar.
HINDMILK Loaded with fats and calories, this part of the feed satisfies a hungry baby.
NIPPLE CONFUSION Suckling from your breast requires your baby to use 40 different muscles, while sucking on the teat of a bottle requires minimum effort. As a result, the use of dummies and bottles alongside breastfeeding can lead some babies to refuse to nurse from mum’s nipple. Try holding off on the bottles for a while if possible to limit the chance of nipple confusion.
LET DOWN REFLEX The sensation, sometimes a tingle, in your breasts and nipple as cells around your milk ducts contract to push out or ‘let down’ the milk. This can sometimes happen in response to seeing your baby, hearing them cry or even just thinking about them.
PUMP AND DUMP Some mothers pump and discard their milk after drinking alcohol in a bid to prevent it passing to their babies. Studies now show that this is unnecessary as alcohol in breast milk behaves the same as in the bloodstream, meaning it fades after time rather than staying stored until suckled. If you’re having a drink, experts advise just one glass, and suggest drinking whilst nursing, as the units of alcohol will have already passed through your system by the time you come to feed again in two or three hours’ time.