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Breastfeeding 101 … from an experienced midwife

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Breastfeeding doesn’t always come naturally, so thankfully we have these very helpful tips from midwife Karen Stevenson at our disposal.

I have been a midwife, paediatric and child and family health nurse for more than 20 years and helped and supported a lot of mothers to successfully breastfeed. Some mothers have described the initial establishment of breastfeeding as a frustrating time and one of the hardest things they have done. However, overwhelmingly, those mothers who persevere and hang in there feel it is so worth it. The reality is breastfeeding for most women takes practice, a lot of patience, work and support. Certainly, the early days of breastfeeding can be a challenging time as both the mother and baby discover and learn about each other and how to feed. So here are my top five tips for breastfeeding successfully.

1. Get support if needed

Get help and support early if you are experiencing any difficulty with feeding. Breastfeeding support can make the difference between succeeding and stopping. Support can come in many different forms including midwives at the hospital, child and family health nurses and centres who may offer breastfeeding drop-in support, Australian Breastfeeding Association (ABA) counsellors, and other breastfeeding experts such as Baby Care Fundamentals, which offer in-home consultations. Support from groups such as those offered by the ABA or new baby groups through community child health centres are also great for providing ongoing support from other mothers experiencing the same problems. Support from family and friends is also really important.

2. Correctly attach

You might be surprised that researchers have shown that up to 90 per cent of new breastfeeding mothers experience nipple pain and this is one of the main reasons women stop breastfeeding. Cracked and sore nipples usually happen when new mothers are not sure how to attach the baby, or it can be as simple as the baby not attaching correctly for one feed only (usually a night feed). Breastfeeding should not be painful –most mothers describe a short instant pain on attachment in the first few days, but this should disappear within 20-30 seconds. Be sure to seek help and support for correct attachment. 

What can you do if you have nipple damage?

  • Continue to breastfeed with support to ensure correct positioning and attachment
  • Use a nipple shield (seek support)
  • Rub breast milk into your nipples after each feed and let it air dry
  • Avoid shampoo and soaps on nipples
  • If using breast pads, replace damp pads frequently

3. Don’t watch the clock

The old adage ‘10 minutes each side every four hours’ is a thing of the past. A baby should feed on one side until it stops feeding and comes off the breast spontaneously. Then offer the other side (some baby’s may take only a few sucks, others will have a full feed on this side as well). The length of each feed is highly variable – it will vary according to the infant’s need and rate of milk transfer.  Typically, when newborns are establishing breastfeeding (in the first four weeks) they can feed eight to 12 times over a 24-hour period. New mothers often feel like they are feeding constantly in the first few weeks, but allowing the infant unrestricted and regular breastfeeds is fundamental in establishing milk supply. Night feeds are also important in maintaining supply.

How do I know my baby is ready to feed?  

He or she is:

  • starting to stir and wake
  • alert
  • rooting and moving the head to suck
  • sucking on hand or putting hand to mouth
  • crying, demanding or making other noises (note it can be harder to attach correctly when the baby is very upset and crying, so it is important to identify the early sounds that they are ready to feed).

4. Get to know your baby

Really important during this period is getting to know your baby. And the more time you spend with your baby, the more you will get to know each other. You will start to identify the different cues for sleeping and feeding. This can take months to achieve so don’t have unrealistic expectations. It most often is through trial and error that you discover your baby’s signals, so don’t be too hard on yourself.

Things you can do to help learn about your baby.

  • Rooming-in or having the baby in a cot/cradle next to your bed
  • Use eye contact
  • Give them cuddles
  • Spend time together
  • Seek out support, new baby groups

5. Look after yourself

Mothers are very good at meeting their baby’s needs and putting everyone else first. However, it is really important at this time to think about looking after yourself. If you become tired and unwell it will affect your milk supply and your enjoyment of your new baby.

Here’s how to look after yourself.

  • Take time to relax and rest (you can do this when your baby is sleeping or take advantage of help offered)
  • Eat well. You may need to increase the amount of food you eat as breastfeeding will increase your appetite (It is estimated that a breastfeeding mother needs an extra 2000-2100 kilojoules per day). Eat a balanced diet
  • Seek emotional support

My most frequently asked question?

It’s ‘How do I know my baby is getting enough milk?’

You will know they are getting enough if:

  • they are having frequent breastfeeds (8-12 in 24 hours)
  • they’re passing 5-6 wet nappies (disposable) a day.
  • their urine is clear or pale in colour
  • the colour of their bowel movements is correct. Initially, a baby’s bowel actions will be greenish black. After 24-48 hours it changes to brownish, and then by day four, it is usually anywhere from yellow to green or even orange in colour. A typical breastfed infant’s poo will be runny mustard/yellow with what looks like seeds (these are milk curds). The number of poos can be anywhere from 2-3 per day to every nappy change.
  • they are gaining weight. It is normal for babies to lose up to 10 per cent of their body weight in the first few days and then regain it as the ‘milk starts to come in’ by two weeks of age. As a guide, infants put on 150-200 grams a week until three months of age. However, this should be looked at over a four-week period, not just one week in isolation.

Always seek support and help if you are concerned about you or your baby. Regular checks on your baby will also help to identify any problems early.

For an in-home consultation or to book a group education session with Karen, email [email protected] or call 0434 049 404.

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Have you found breastfeeding a challenge? We’d love to hear your story in the comments section below…

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