FAQ’s on breastfeeding

By Marie-Louise Steyn, lactation consultant, doula and author of Breastfeed your Baby.

I’ve heard breastfeeding hurts. Does it?

If your baby is positioned correctly and latched deeply onto the breast, breastfeeding shouldn’t hurt. Expect some discomfort in the first week or two, though, especially at the beginning of feeds. Try using the 30-second rule to determine if this is “normal”. If you need to grit your teeth when latching baby, slowly count to 30. If the pain improves considerably, or disappears completely, you’re probably experiencing normal sensitivity. If it is as bad or worse after half a minute, baby probably isn’t latched well. Break the suction with your little finger, and try again. If your nipples remain sore or if they look pinched, squashed or damaged, get professional help.

I’d love to start exercising again. Will this affect breastfeeding?

Exercise is fantastic for you. It relieves the stress of new motherhood and helps you shed those pregnancy kilos. Studies show that it makes the adjustment to motherhood easier and improves your relationship with your baby. Except for wearing a supportive bra, there are no special measures you need to take during breastfeeding. Even when you exercise to exhaustion, the taste and composition of your milk shouldn’t be affected. Neither should your milk supply. If you exercise in a chlorinated pool, it’s best to shower before nursing. Babies have sensitive noses and may be bothered by the smell. In the first weeks you may find it hard to get to the gym. Consider taking a brisk walk with baby in his carrier. He’ll enjoy the change of scenery. Plus, being carried reduces crying and enhances babies’ vestibular development.

Which foods should I avoid during breastfeeding?

Babies are individuals. There is no list of forbidden foods that will make all babies fussy. Eat a healthy, well-balanced diet (like you did during pregnancy) and remember, eat everything in moderation. Then watch how your baby reacts. Limit your intake of coffee to less than three cups per day, as caffeine may cause fussiness and sleep problems. You should also limit your alcohol intake. One unit (a small glass of wine) will take two hours to clear from your milk. You don’t need to “pump and dump”, just wait the required time before nursing.

What if I need to take medication?

Contrary to popular belief, most medications are safe during breastfeeding, as only a small percentage pass into your milk. If you do need a contraindicated medication, your doctor should be able to find a safe alternative. When in doubt, get more information. La Leche Leaguers or lactation consultants have access to specialised sources and can provide your caregiver with the relevant references to further research the matter. Always remind your healthcare provider that you are breastfeeding. Never take over-the-counter medications without medical advice. Warning: avoid oestrogen-containing contraceptives and flu preparations with pseudo-ephedrine. Both will reduce your milk supply.

My baby wants to nurse every two hours. Is my milk too weak or not nutritious enough? Your milk is always perfect. Breast milk digests within 90 minutes, therefore most babies nurse 10 to 12 times in 24 hours, or even more often when going through growth spurts.

NOTE: If you’re a strict vegan or had gastric bypass surgery, you’ll need a vitamin B12 supplement. Consult your doctor or nutritionist.

How long can I store breast milk?

For a healthy, full-term baby, you can store breast milk:

■ At room temperature (lower than

26° Celsius) for four hours.

■ In a cooler box with ice packs for 24 hours. ■ In a fridge for five days (put it in the back and not in the door).

■ In a two-door fridge/freezer for three to four months.

■ In a chest freezer for six to 12 months.

■ Write the date on the containers, and use the oldest milk first.

How should I defrost breast milk?

Thaw frozen breast milk in the refrigerator, and warm it in water. Never defrost breast milk at room temperature or in the microwave. Discard any leftovers – don’t reheat or refreeze. Store and defrost breast milk in small quantities. Your baby will usually need 60 to 120ml for every feed you’ll be away.

How do I know if I have enough milk?

Many moms are concerned about their milk supply. You can count your baby’s nappies to see if he is getting adequate fluid and calories. After all, if it’s coming out it must be going in! Use the following as a guideline:

DAY 1: One wet and one dirty nappy.

DAY 2: Two of each.

DAY 3 AND ONWARDS: Five or six wet disposables and three or more stools in 24 hours. After six weeks, breastfed babies may only pass stool once every two weeks. This is normal and not a sign of constipation.

Your baby should not lose more than 10 percent of his birth weight. He should be back at birth weight by two weeks after birth and continue gaining steadily thereafter.

Does my breastfed baby need water?

No, breast milk contains everything your healthy, full-term baby needs for the first six months. At the beginning of a feed, your milk is low in fat and calories and high in water. This quenches baby’s thirst. As he continues to nurse, the milk gradually becomes richer in fat and calories to satisfy his hunger. In the first few months, water, tea and solids are actually harmful. A newborn baby has a “leaky” gut: there are gaps between the cells lining his digestive tract. This is where viruses, bacteria and allergens pass through. If you breastfeed exclusively, the IgA in breast milk plugs up these gaps like putty, so the gut becomes impermeable to pathogens.

Oh no, I’m getting sick! Should I wean?

It’s not fair, but even moms of little ones get ill. The good news is that you can – and should – continue nursing. By the time you feel unwell, you’ve already exposed baby. The germs have been shared, now you may as well share the cure. When your body fights an illness, antibodies pass into your milk. This offers your baby partial or complete protection against the disease. Furthermore, breastfeeding allows you to get more rest while you’re recovering. What a relief: no getting up to sterilise or prepare bottles. Simply get into bed with baby, sleep while you nurse, and rest assured that you’re giving your little nurseling the best protection. ●

Get in bed with baby, sleep while you nurse, and rest assured that you’re giving your little one the best protection