Five tricks to breastfeeding success
1 Be prepared
Gone (thankfully) are the days when preparing nipples for breastfeeding meant roughing them up by rubbing them with a towel. “It has been found that doing so can remove the protective substances produced by the breast during pregnancy and afterwards,” says Esme Nel Hough, professional liaison for La Leche League South Africa, a non-profit organisation providing information and support to breastfeeding women.
Lotions, too, aren’t really necessary, Esme says. “Your nipples are already producing what they need for their protection. Don’t use soap on your breasts, as this can dry them out. When you bathe or shower, rinsing with clear water is fine. If your nipples are very dry, you could apply a lubricant.”
Rub a bit of your colostrum (if you have any) into your nipples before birth and in the first few days of breastfeeding, adds Linda Britz, a nurse, midwife and lactation consultant based in Johannesburg. “Letting your breasts air and exposing them to sunlight is a good idea too.” Sister Britz is a strong advocate for proper breast care, before and after birth, and emphasises that there is a difference between nipple and breast care.
“I believe inadequate breast care is one of the biggest reasons for problems such as mastitis, which is another word for inflamed breasts,” she says.
She recommends gently massaging your breast tissue for a minute or so while in the shower each day.
“Start at the base and move upwards towards the nipple, almost as if you’re milking yourself, but do it gently. This will help prepare your breast for draining milk.”
Increase this to three to four times a day in the first week of breastfeeding, she says. “When you’re not in the shower, first warm up the breast with a nice warm facecloth and then use an oil, like olive oil, for the massage.”
While valuable, preparation for breastfeeding shouldn’t be restricted to only your breasts. Dr Nan Jolly, a medical doctor and lactation consultant who has been helping women breastfeed for 36 years, believes the most important part of preparation is becoming well informed about the normal challenges that breastfeeding brings and setting up a good support system to help you deal with these. “You should be well informed of the risks of not breastfeeding, of the basics of breastfeeding success, and that breastfeeding is not something you ‘try’ to do. It’s something you learn to do,” she says. “It is often very challenging in the beginning, but gets easier with practice – you have to hang in.”
Preparing to breastfeed isn’t something you necessarily have to do by yourself either.
“My husband and I attended antenatal classes, and one of the sections we covered was breastfeeding,” says mom Aaniyah Omradien, 36.
“Later, it was very useful having him ensure that baby was latching at the right angle, as he was able to observe and assist with this from his perspective. It was a great way to include and involve him.”
2 Don’t blame your breasts
Small, lopsided, one big, one small… it doesn’t matter and it makes no difference to your ability to breastfeed. As Dr Jolly says, “Shape, size and appearance of breasts is no more relevant to breastfeeding than the shape of our ears is relevant to how we hear.” Inverted nipples, which are rare, can sometimes affect the transfer of milk from mom to baby, but this in itself is rare, Dr Jolly says. “Inverted nipples usually correct themselves during pregnancy – only rarely do they not. But most moms with inverted nipples can still breastfeed, it just takes more work and time.”
Breast augmentation (a boob job) also shouldn’t affect your ability to breastfeed, Esme says, but it’s best to discuss options with the surgeon before having the operation, as it is possible for size of the implants and their placement to have an effect. “Surgery where the nipples have been removed is more likely to affect milk supply,” she says. Breast reductions, however, can sometimes pose a problem. “Not because there isn’t enough working breast tissue, but because the ducts carrying milk to the nipple, or the nerves of the nipple and areola, have been damaged to a variable extent,” Dr Jolly explains. “It’s not usually a major issue with current surgical techniques, but in some cases it may be necessary to supplement your milk to ensure that baby gets enough food.”
Bear in mind many women who’ve had breast reductions, even with the older surgical techniques, have no problems breastfeeding. Karen Pino, 37, who had her breast reduction 20 years ago, easily breastfed her daughter, now 4 years old. “I was expecting not to be able to breastfeed, but she latched straight away, and my milk flow was good,” Karen says.
3 Be confident
Having the confidence to know and understand that your body is capable of breastfeeding is crucial to breastfeeding success.
Dr Jolly strongly believes that it is due to a widespread erosion of this confidence that so many mothers give up on breastfeeding. “So many mothers who planned to breastfeed end up having difficulty and ‘have to’ turn to the bottle, often because of poor advice from well-meaning healthcare professionals who are unaware that there’s more to learn about breastfeeding than they know.”
It’s a vicious cycle, she says, as the more women there are who attempt breastfeeding and give up, the less confidence other new mothers have in their own abilities. “When all the women you know say they tried to breastfeed and failed, it doesn’t give you much confidence.” Confidence in your body and what it can do is not only important psychologically but from a physical perspective, too. “Confidence matters because fear and anxiety will delay the let-down reflex,” Dr Jolly explains. “This reflex is necessary for milk to exit the breast into the baby.” She adds it’s important to remember anxiety only delays the let-down, it does not stop milk production altogether: “Waiting a bit, relaxing, thinking about the baby and not the let-down will allow the milk to come out.”
Esme says a good way to boost confidence is to keep reminding yourself that your baby is born with the reflexes to breastfeed, and you are, except in extremely rare cases, perfectly capable of meeting that need.
Dr Jolly believes having an encouraging support circle is vital. Good support was what helped Aaniyah persevere through the challenging early days. After not being able to have the natural birth she wanted, she was determined to breastfeed her son, now 3 years old. But cracked and sore nipples for the first few weeks made it a trying experience. Aaniyah stuck with it, thanks to support and encouragement from friends and especially her midwife. “She told me I just need to push through, it would only get better with time. She was right. After three weeks, it got better, and I was so happy I could do it.”
4 Get the latch right
Getting the latch right is the most important physical aspect of breastfeeding, Esme says. “Not only will a proper latch prevent damage to your nipples, it also allows baby to drain the breasts effectively.” The best way is to allow baby to self latch, she advises. “Nowadays you’re advised to use lots of skin-to-skin contact and try the laid-back position. These trigger the baby’s inborn reflexes, and most babies will latch by themselves with maybe just a little assistance.”
Remember that baby needs to be much closer to you than if they were getting a bottle, Dr Jolly adds. “This is a skin-onskin thing; think of it like Velcro.” It’s also important for your baby’s mouth to open very wide and “to feed at the breast, not suck on the nipple,” she says. Melanie Commeignes, 32, wishes she’d heard these tips sooner. “Within minutes of being born, my daughter wanted to feed, so I put her on my breast and thought, ‘Hey, this is easy, we’re both naturals!’ Little did I know we didn’t have the latch right – her mouth wasn’t opening wide enough, and my hold was off. By the time I realised that eagerness on both our parts didn’t necessarily equate to a good latch, it was too late, and within three days, I had a nasty cracked nipple that took weeks to heal. It almost sent me over the edge; I found it worse than the birth itself.”
5 Ask for help
As Melanie learnt the hard way, getting help can save you a lot of drama and pain. Both Dr Jolly and Esme recommend setting up support systems long before you may need them.
“Mothers who have support usually also enjoy successful breastfeeding relationship for longer,” says Esme. “You should start at the beginning of pregnancy by establishing your subculture of breastfeeding support,” Dr Jolly advises.
Gather all family and friends who successfully breastfed. Join and attend La Leche League meetings. La Leche League offers support in the form of monthly meetings, with other moms, phone calls and email assistance.
Take time to learn about breastfeeding. “When help is needed, it is important to make sure that the person helping you is indeed an expert in the field of lactation, such as an International Board certified lactation consultant,” Esme adds.