It’s the most natural thing in the world, but that doesn’t mean breastfeeding comes naturally. Linda Britz, a lactation specialist, nursing sister and midwife, says getting it right takes a bit of practice…
BREASTFEEDING IS KNOWN as the gold standard to feed a baby, but it is about so much more than nutrition. It represents the common language of mothering; it is about intimacy and a relationship with your baby. Breastmilk is perfectly designed, with all the nutrients your baby requires for growth and physical development (especially his brain), and nourishes both body and soul. The best thing about breastfeeding is that your body naturally produces milk from before birth and the process is continued as your baby is born to breastfeed. You just need to be available to your baby. Most babies know exactly what they need to do, so be guided by your baby and have confidence in your body’s ability to nourish your baby. This doesn’t mean that you shouldn’t also get clued up on how to go about the dance of breastfeeding. Empower yourself with good knowledge that instils you with confidence, and surround yourself with people who will support you, from your partner and family members to healthcare professionals. Ask for help, if and when you need it. Have a breastfeeding plan, and make a commitment to face the challenges you may face along the way.
THE GOLDEN HOUR
The first hour after the birth of your baby is a once-in-a-lifetime opportunity – a sacred moment when a family is formed and your baby’s first impression of life outside the womb is made. The best way to start is heart to heart! As soon as your baby is born, place your baby on your chest, in skin-to-skin contact. Your body will naturally increase in temperature to warm your baby – even better than an incubator. Your baby should only be separated from you if there is a good medical reason. Routine procedures and observations can be done either while your baby is on your chest, or at a later time. This moment should be uninterrupted. Skin-to-skin contact not only promotes bonding, but is also a multisensory experience for your baby. Besides the powerful sense of touch and human contact, which confirms your baby’s out-of-womb habitat on your breast area, the sense of smell is well developed and very strong. Each mother and baby has a unique scent, and once your baby recognises yours, it provides security and comfort. Your baby’s sense of sight is also very important, although underdeveloped. You will have a natural desire to look at your baby. As he makes eye contact with you, and stares back, the love hormone oxytocin floods your brain, starting the dance of breastfeeding. Your baby’s suck reflex is at its most intense during the first hour after birth. Allow your baby his own time and be guided by him.
Research has now identified nine observable newborn stages that are instinctive for a baby who is placed in skin-to-skin contact with his mother, after birth: STAGE 1 The birth cry A distinct cry as baby’s lungs fill with air. STAGE 2 Relaxation Baby is skin-to-skin with his mom and relaxed. STAGE 3 Awakening Around three minutes after birth, small wave-like movements in the baby’s head and shoulders are noticed. Baby’s eyes are usually open. STAGE 4 Activity The newborn baby starts to make sucking movements as the rooting becomes more obvious. Baby looks at the breast and at mom. He will also make “cooing” sounds to capture the mother’s full attention. STAGE 5 Rest He may rest at intervals and continue to make sucking movements in his own time. STAGE 6 Crawling About 35 minutes after birth, the baby starts to leap, crawl, slide and push himself towards the breast to reach the nipple. STAGE 7 Familiarisation Baby licks the nipple and touches and massages the breast. This is usually about 45 minutes after birth and can continue for a further 20 minutes. STAGE 8 Suckling Baby takes the nipple into his mouth and attaches well onto the breast, and suckles. STAGE 9 Sleep Baby (and often mom too) falls into a restful sleep, about 90 minutes to two hours after birth.
COLOSTRUM – YOUR BABY’S FIRST MILK
The milk that your breasts will make for the first few days is called colostrum and is especially designed for your newborn baby. It is often known as a superfood. (A superfood is nutrient-dense and has superior health benefits.) Colostrum is rich in calories and protein, and is a sweet, golden milk that’s packed with antibodies to help protect your baby from infections, giving your baby’s immature immune system a boost. It changes and adjusts according to your baby’s age and requirements. Breastmilk constituents change throughout the day, every week, and in the months ahead, to suit your baby – it’s almost tailor made for your baby.
WHEN THE MILK COMES IN
In the first week after birth, usually around day three or four, your breasts will begin to feel fuller and heavier. The hormone prolactin naturally rises to produce copious amounts of milk, necessary for your baby. It is important to feed your baby frequently and effectively to maintain good drainage of your breasts and manage the filling. Warm baths or showers, gentle massage and the applications of cold cabbage leaves help relieve swelling. This lasts for around 24 to 48 hours, after which it settles to meet your baby’s demand.
GET A GOOD LATCH
Breastfeeding is a skill that needs to be practised by both mom and baby in the early days after birth, and the correct latch is key to preventing soreness and any nipple discomfort. In the first few weeks, cup and support your breast in your hand to latch on and throughout the feedings, to help it go more smoothly. Be sure your fingers are well behind the areola. Your thumb and index finger should form a C or U. Get comfortable. Good positioning and support with pillows, to keep baby at the right height, will ensure the correct latch and prevent nipple soreness or pain. Remember that it is a natural response and an instinctive rooting reflex by your baby to open his mouth wide as you tickle his top lip with your nipple. When he does this, lift him gently but firmly towards you to take a good mouthful of breast tissue – your baby needs to take in your nipple and areola (the darker skin around your nipple). Give yourself time to practise, gain confidence and master this new task.
SIGNS OF A GOOD LATCH
Your baby is facing you “tummy to mummy”, so that he doesn’t need to turn his head to reach your nipple. Your baby has taken a deep mouthful of breast into his mouth, chin first, well over the areola area. Your baby is pulled in close to you, and kept close with the support of your arms on pillows. Your baby is actively swallowing, with intervals of a suck, swallow and breath rhythm. Your baby is comfortable and you feel a deep (not painful) pull as he suckles.
GET INTO POSITION
There are many breastfeeding positions, and not one of them is wrong. You need to find which one is comfortable and effective for you and your baby. The cross cradle hold: This is the most common and is really helpful when mastering the latch-on. Hold your baby
along the opposite arm to the breast you are feeding from. Face him “tummy to mummy”. Support the base of his neck with your fingers, using your palm to support his shoulder and back. Firmly and quickly lift him towards you. Support your breast with the same side hand. The cradle or Madonna hold: This is most commonly used once you no longer need to guide him to the breast. Support your baby’s head in the crook of your elbow. This arm supports his back with his bottom in your hand. The side-lying hold: This is a great position to rest, but should only be attempted once you are confident in your feeding and have mastered your latchon. Both you and baby are lying down, facing each other. The football hold: This is great for moms with large breasts and a good position for twins to feed comfortably. Your baby’s body is tucked underneath your arm on the same side that you are feeding.
IF YOU HAD A C-SECTION?
Some labours are complicated, and there may be a good reason that a caesarean section is booked to birth your baby. The hormone oxytocin is active in labour and is responsible not only for the surges of contractions, but also helps initiate movement and flow of the first newborn milk through the ducts to the nipple. As a result of a C-section, however, there may be a delay in your milk coming in, and so your baby may work really hard to stimulate your breasts. Research shows that routinely doing your breast care for a few weeks before the birth of your baby is beneficial to the process. Continuing after birth will also encourage good drainage of the breasts and a steady milk supply. It is important to get skin-to-skin contact with your baby during the procedure in theatre, as soon as possible after birth. Chat to your gynaecologist about this before the time. Keeping baby with you decreases any sensations of pain and stress, even stress levels in baby. It stabilises your baby’s breathing and oxygen levels, decreases crying and increases the quiet-alert state. It can also create a positive memory and outcome for you regarding the birth, and help you feel relaxed, calm and content. Even though there may be a slow start to the breastfeeding, the obstacles can be overcome.
DEMAND FEEDING IS IMPORTANT FOR NEWBORNS
Don’t time your feeds in the newborn weeks, or try to place your baby on a feeding schedule – feed him whenever he is hungry. Early frequent feeding contributes to a longer duration of breastfeeding. It allows your new baby to receive all the immunological advantages of the colostrum, and protects your baby from possible infections. During the first weeks after birth, it is important to allow your baby to feed often, and effectively remove milk from your breasts. Although a breastfeeding mother’s breasts are never empty, drained breasts refill quickly. The sucking stimulation increases the prolactin receptors in the breast and encourages an abundant milk production. Prolactin is the milk-making hormone and is often referred to as the mothering hormone, as it is responsible, in part, for the intense feeling of needing to be with your baby. This enhances attachment and bonding. A feeding pattern will start to emerge within the first six weeks of life. You both need time to get to know one another, so try to enjoy the process.
The World Health Organisation (WHO) mother recommends that a for the exclusively breastfeeds and then, first six months of life of together with the introduction (solids), complementary foods two continues for a further years and beyond