Ten answers to burning questions
Expert advice on the most common questions lactation consultants get asked.
WHY ARE MY NIPPLES CRACKED AND BLEEDING?
Sore, cracked and bleeding nipples are most commonly due to an incorrect latch. Pay careful attention to positioning your baby comfortably close up against you, and be sure that your baby is opening his mouth very wide and taking a large portion of breast tissue into his mouth. It is not meant to hurt.
Other reasons for soreness may be that your baby’s inability to suck correctly is due to a tongue tie (short frenulum) or even birth injury (due to an assisted birth, such as a forceps or vacuum extraction), which may have caused discomfort or stiffness, making it difficult for your baby to suckle effectively.
Contact a breastfeeding support group or a lactation consultant who can observe and assess the situation and provide the correct information to fix the problem.
WHAT CAN I USE TO MAKE MY SORE, SWOLLEN BREASTS FEEL A BIT BETTER?
Full, heavier breasts are normal in the first week after birth. Massage your breasts, and follow your breast care routine as often as necessary.
Keep a head of cabbage in the fridge just after birth. Cold cabbage leaves are recommended as a home remedy to help relieve full, swollen breasts and alleviate pain. It really works!
It is especially important to feed your baby frequently, as removing milk from the breast relieves congestion and the discomfort it brings.
WHY DOES MY BABY WANT TO BREASTFEED EVERY TWO HOURS? THIS CAN’T BE NORMAL!
Breast milk digests easily and matches a baby’s sleep cycles.
As long as your baby is feeding effectively, and thriving, then there is no reason for concern.
Identifying the reason that your baby is feeding frequently will help you to accept the feeding pattern that your baby has formed.
In the first few days, your newborn needs to stimulate your breasts to establish a supply that is sufficient.
As your baby grows, he may go through periods where he stimulates your breasts more often to increase your supply according to his growing needs, which will settle within a few days.
This is not an indicator of how much milk you have.
Giving any extra fluids or foods to your baby interferes with breastfeeding and may be the start of many problems.
In the afternoon, your volume of milk may be lower than at any other time of the day.
As a result, your baby may want to cluster feed for a few hours to get enough to help him settle longer in the night hours ahead.
Sometimes your baby may want to suck for comfort and to relieve symptoms such as thrush or regurgitation.
Rest assured that your breast milk is the perfect food for your baby and is all he needs for the first months of his life.
CAN I CONTINUE TO BREASTFEED WHEN I’M SICK?
If you have a minor infection such as a cold or flu, you should continue to feed your baby as usual, or even more often. The antibodies that you are building to fight off the infection are passed through your breast milk to protect your baby. Even through mild gastrointestinal upsets, it is recommended that you breastfeed. Make sure you keep up your fluids when you’re sick, and drink small sips of rehydration solution to replace fluids you may have lost through vomiting or diarrhoea.
HOW DO I KNOW MY BABY IS GETTING ENOUGH?
Breastfeeding is all about gaining confidence to know you can do it! The golden rule of breastfeeding is to know the law of demand and supply. The more your baby effectively feeds, the more milk is made.
This is the key to establishing and maintaining a sufficient quantity of milk to adequately nourish your baby.
In the first few weeks after birth, your baby will gain an average of 170 grams per week. Most babies lose 5 to 7 percent of their birth weight after birth, and usually regain their birth weight within 2 weeks of age.
Your baby will have more than three bowel movements per day, and at least six wet nappies. You will notice swallowing and active feeding when your baby is at the breast. You will note your breasts are fuller before a feed and softer after. Your baby is content and satisfied and settles easily after feeds.
The contraceptive pill that contains a combination of hormones, including oestrogen, should not be taken while breastfeeding.
Oestrogen interferes with the normal balance of the milk-making hormones and is known to decrease your milk supply. The “mini-pill” is often prescribed for new mothers who are breastfeeding, as it only contains progestin.
This is considered safer and less likely to interfere with your supply.
You might notice a slight dip in your supply and that your baby is somewhat fussy after you start taking the mini-pill. You might also notice the same when your period returns.
With correct guidance and motivation, you can get through this short period of change. Pumping for a short time directly after feeding, and allowing Baby to feed on demand usually corrects the situation. Rest and fluids also contribute to quickly getting back to normal.
CAN I DRINK COFFEE OR ALCOHOL WHILE I’M BREASTFEEDING?
Excessive alcohol or caffeine in coffee can delay or inhibit the let-down of milk from the breast, which may also cause the baby to be wakeful and fussy at the breast. Alcohol is not recommended during lactation. If you choose to consume alcohol or caffeinated drinks, then do so in small amounts, with a meal, and not right before a feed.
HOW LONG SHOULD EACH BREASTFEEDING SESSION LAST?
If your baby is latched and sucking correctly, then there is no need to limit the length of his feeds.
Watch your baby closely during feeding. Note his interest and response – he needs to be actively feeding and suckling effectively to be doing well.
If he tires, encourage him to continue, by calling his name and talking to him. Squeeze your breast a bit to encourage him to release your nipple and come off without discomfort.
Give your baby a little break to wind. Burping your baby doesn’t only allow him to bring up trapped air but also wakes him from his “milk coma”, so that he will be more alert when you offer the other breast to finish the feed.
WHAT SHOULD I EAT WHEN I’M BREASTFEEDING?
Contrary to popular belief, there is no food (besides alcohol) that should be excluded from your diet while you are breastfeeding, unless you personally note any reactions that you think may relate to what you are eating.
It requires a lot of energy for your body to manufacture the milk in your breasts. An average of 2 000 kilojoules (610 calories) are required each day to do this and should be obtained from healthy, nutritionally dense foods. Protein and unrefined carbohydrates should be a good part of your daily intake, including vegetables and fruit.
A variety of foods is the key. Make a list of quick, high energy snacks and keep them in stock. Fresh fruit, avocado pear, crackers and cheese, cream cheese, baked potato (which you can pop into the oven while feeding), sandwiches/toast with nut butters, eggs, yoghurt and cereals, nuts, seeds and dried fruit are good foods to include in your daily diet. ●