WHEN BREAST­FEED­ING ISN’T WORK­ING

New Idea - - Practical Parenting -

New mums are taught that it’s im­por­tant to breast­feed their baby from birth. And as much as that is true, that doesn’t nec­es­sar­ily work out for ev­ery­one.

But why are mums stop­ping? Ac­cord­ing to re­cent sur­veys, the big­gest rea­sons for giv­ing bub bot­tle feeds were: not enough milk (30 per cent); it was just time to stop (23 per cent); prob­lems in­clud­ing cracked nip­ples (10 per cent); and go­ing back to work (eight per cent).

And it’s ap­par­ent that moth­ers who find them­selves wean­ing their ba­bies from the breast of­ten feel a deep sense of loss and fail­ure.

“While this is a com­pletely nat­u­ral re­ac­tion, it is im­por­tant to re­mem­ber that you cer­tainly have not failed and even if your baby re­ceived one drop of colostrum, you have pro­vided [them] with a great start to life,” says Ash­lee Stir­ling, a lac­ta­tion con­sul­tant at the Lady Ci­lento Chil­dren’s Hospi­tal in Bris­bane.

“Don’t feel con­cerned that

be­cause you aren’t breast­feed­ing, you have lost your op­por­tu­nity to bond with your baby. You are still her main carer and your con­nec­tion will be strength­ened ev­ery time you re­spond to her needs,” she ex­plains.

Thanks to her job, Ash­lee talks to many mums about their op­tions when fin­ish­ing up with breast­feed­ing. Here are some choices to con­sider.

EX­PRESS­ING MILK Grow­ing a baby from your own milk is an in­cred­i­ble feel­ing, but when your baby isn’t able to be fed di­rectly from the source, there is an­other op­tion.

“If you are un­able to breast­feed ... ex­press­ing and feed­ing your baby your breast­milk is far su­pe­rior than any other breast­milk al­ter­na­tive,” says Ash­lee.

The World Health Or­ga­ni­za­tion and UNICEF Global Strat­egy for In­fant and Young Child Feed­ing states “the choice of the best al­ter­na­tive de­pends on in­di­vid­ual cir­cum­stances”, but lists “ex­pressed breast­milk from an in­fant’s own mother” at the top. Many mums are con­cerned they may find it harder to bond with their baby be­cause they aren’t phys­i­cally hold­ing him to the breast, but there are ways around this.

“By in­cor­po­rat­ing lots of skin-to-skin con­tact into your day and cud­dles and in­ter­ac­tion into feed­ing times, you can still re­tain the close­ness felt when feed­ing your baby,” says Ash­lee.

Talk to your lo­cal breast­feed­ing coun­sel­lor or lac­ta­tion con­sul­tant about qual­ity breast-pump choices, or even con­sider hir­ing a hospi­tal-grade pump, as it will likely get a good work­out. Search on­line for exclusive pump­ing sup­port groups – there are more of you around than you think!

US­ING DONOR MILK Talk of us­ing an­other mother’s milk is mak­ing a resur­gence, too, with for­mal milk banks pop­ping up world­wide, as well as a huge net­work of in­for­mal milk shar­ing be­tween moth­ers, fa­cil­i­tated by the ev­er­ex­pand­ing so­cial me­dia

net­work. “As milk shar­ing is not with­out risks, it is im­por­tant that mums are pro­vided with enough in­for­ma­tion to make in­formed choices to help them choose the safest source of donor breast­milk,” says Ash­lee.

In Aus­tralia, there are five for­mal breast­milk banks – in WA, Vic­to­ria, Queens­land and two in NSW – with many re­stric­tions around who can ac­cess and do­nate this milk.

“Milk banks are able to pro­vide tested, pas­teurised breast milk to min­imise the risks of trans­mis­sion of com­mu­ni­ca­ble dis­eases, but in Aus­tralia, these are few and far be­tween,” says Ash­lee. If you are con­sid­er­ing donor milk ob­tained through the in­ter­net, you should be aware of the risks, in­clud­ing ex­po­sure to in­fec­tious dis­eases as the mother is un­likely to have been screened, and the pos­si­ble con­tam­i­na­tion of milk if it’s not han­dled and stored prop­erly.

If you’re still con­sid­er­ing it, Ash­lee sug­gests in­ter­ested mums con­tact Hu­man Milk 4 Hu­man Ba­bies(hm4hb.net), a not-for-profit, so­cial-me­dia-run com­mu­nity pro­mot­ing safe milk shar­ing by en­cour­ag­ing full dis­clo­sure and the for­ma­tion of re­la­tion­ships be­tween donor mums and re­cip­i­ents. In Aus­tralia, it is il­le­gal to ac­cept money for breast­milk.

US­ING FOR­MULA The most com­mon al­ter­na­tive to breast­milk is in­fant for­mula. For many mums, it is a dif­fi­cult de­ci­sion to switch from giv­ing bubs their own milk to a com­mer­cially made prod­uct. Of­ten, how­ever, there is no choice, and at the end of the day your baby needs to be fed in or­der to thrive, and there­fore you shouldn’t feel guilty about this op­tion.

“Once you have made the in­formed de­ci­sion to for­mula-feed your baby, it is im­por­tant that you are shown the cor­rect way to pre­pare, han­dle and store for­mula in or­der to re­duce the risk of pass­ing an in­fec­tion to your baby,” says Ash­lee.

COM­BI­NA­TION FEED So breast­feed­ing isn’t work­ing, but you’re not quite

ready to give it up yet? “Breast­feed­ing doesn’t have to be ‘all or noth­ing’,” says Ash­lee. “It’s very ben­e­fi­cial to breast­feed your baby or give her the ex­pressed milk you have, along with donor breast­milk or for­mula. Re­search has shown that the im­muno­log­i­cal prop­er­ties of breast­milk in­crease as sup­ply de­creases so even a small amount is in­valu­able.”

If sup­ply is the is­sue, it’s even pos­si­ble to com­bi­na­tion feed (where you breast­feed and top-up with for­mula or donor milk) un­til your baby starts solids, and as the amount of food builds up, drop the bot­tles un­til you are only of­fer­ing a few breast­feeds a day and solid food.

Other women find they re­lax when the pres­sure is off them to ex­clu­sively breast­feed, and their milk sup­ply ac­tu­ally boosts up to their baby’s need as a re­sult. To make com­bi­na­tion feed­ing work to your best ad­van­tage, it’s good to talk to a lac­ta­tion con­sul­tant, as there are tech­niques they can share with you to stop prob­lems such as breast re­fusal as baby gets older.

RELACTATION What if you give up and then change your mind? De­spite what many peo­ple think, stop­ping breast­feed­ing isn’t ir­re­versible, and if mums are want­ing to re­build their milk sup­ply and have the right sup­port net­works, they can cer­tainly relac­tate.

Ash­lee ad­vises mums in­ter­ested in re-start­ing their milk sup­ply to seek help from an In­ter­na­tional Board Cer­ti­fied Lac­ta­tion Con­sul­tant, prefer­ably one with ex­pe­ri­ence in relactation to help work out a plan to meet your breast­feed­ing goals.

“The plan will gen­er­ally in­clude lots of time at the breast for your baby – if they are will­ing – or skin-to-skin con­tact, an ex­press­ing regime and herbal sup­ple­ments as well as phar­ma­co­log­i­cal med­i­ca­tions to in­crease the milk sup­ply,” ex­plains Ash­lee.

Relactation takes a lot of pa­tience and per­se­ver­ance, so seek out emo­tional sup­port from fam­ily or friends, or look up your lo­cal Aus­tralian Breast­feed­ing As­so­ci­a­tion group, which may be help­ful in con­nect­ing you with a like­minded sup­port net­work.

There are lots of op­tions for mums want­ing – or need­ing – to ex­press milk, in­clud­ing hand-held pumps and elec­tric pumps. Bear in mind that any pump will get a good work­out, so con­sider hir­ing a hospi­tal grade elec­tric pump, which are of­ten avail­able at your lo­cal chemist.

Pro­fes­sional lac­ta­tion coun­sel­lors are worth their weight in gold.

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