Breastfeeding

 

This page aims to go through some common concerns breastfeeding mothers may have using guidance from the NHS and other official breastfeeding support groups.

 

For a personal perspective, check out our blogs: Breastfeeding: advice from an ordinary mother  and An Ordinary Mother's breastfeeding journey.

Another way to give your baby breastmilk is to express or pump. For guidance on pumping, click here. Some of the information below will also apply to your journey.

 

I've never breastfed before. What should I expect?

 

When your baby is born, you should ask for immediate skin to skin, even if you have a c-section. Shortly after birth (or in post-op recovery), your midwife should help you position your baby to latch onto your breast to begin the first feed.

The midwife may ask to touch your breast to squeeze a tiny amount of colostrum from your nipple. She may put some on baby's lips. She will then try to encourage your baby to open their mouth wide by aiming your nipple to baby's nose; this forces baby to tilt their head back and aim your nipple to the top of their mouth. This is the optimal latch for every single breastfeed.

How you hold them is up to you and you should experiment with different positions that feel comfortable for you and get the best angle on your boob for baby. Click here for photos of different positions. You may have a different position during the day to the one you have at night; you may find one position allows you to feel more covered when feeding in public. Do whatever works for you and baby.

Breastfeeding is different for every woman but some things to expect are:

- some soreness in the early days as you and baby perfect the latch. It should not feel painful. If it does, unlatch baby by hooking your little finger into the corner of their mouth and trying again, going back to the basics of a good latch. This is a time of learning for you both and soon you'll quickly be able to identify a good latch from the look and feel. You can use nipple cream that is safe to leave on your nipple if your nipple feels too sore.

- once your milk comes in, your breasts may feel heavy and full until baby has a good feed. You are unlikely to need to pump to relieve this feeling in the early days as baby will feed little and often in the first few weeks especially. However, if at any point you feel too full, you can hand express a little in the shower for example. 

- you are likely to be ravenous! It is really important you have a really good balanced diet whilst breastfeeding. You are keeping a little human alive! Have some easy to eat healthy snacks to hand.

- you'll also be thirsty. Keep a BPA free water bottle near you at all time (and get your partner to refill regularly when they are home!) Again, you need to be hydrated to keep up your milk supply so don't overlook this aspect.

- as new parents you will feel worried about absolutely everything but new breastfeeding mums have the additional worry or not knowing how much milk their baby is drinking so it is vital you read our section below about whether baby is getting enough milk. Nappies are a vital indicator here, so learn what to expect in those early days, and know what behaviour would indicate dehydration. Armed with this knowledge, you will then just need to trust your body in between each check with the midwife/ health visitor. It is also important to be realistic about newborn sleep...

- you will feel very very tired, and your baby will not sleep when you want/need them too! You have just given birth to a human so there is no way you can feel at your best, and bringing a baby home is the most overwhelming experience. For more on these early days, read our tips on Leaving Hospital but also remember, regardless of how you feed your baby, they WILL wake up throughout the night for a good while yet. Babies do not know the different between night and day yet (having lived in the dark in your belly for 9 months!). It is also a protective measure against SIDS. So do not think that if a baby is up all night on your boob constantly that they are not getting enough milk....  Which leads nicely onto...

Is my baby getting enough milk?

 

A very common reason why people give up breastfeeding early on is that they feel the baby isn’t getting enough milk or is too hungry.

 

It is true that you cannot tell exactly how much a breastfed baby is drinking, so it is important to know how to tell if everything is going well. You should get support at the hospital before you leave to check all of the traits below, and then from your Midwife/ health visitor during home visits.

 

Reasons to seek support:

  • your baby has not regained their birth weight within 2 weeks;

  • your baby is not producing enough wet nappies as outlined below:

 

Day 2: 2+ wet nappies in 24 hours

Day 3/4: 3+ wet nappies in 24 hours

Day 5: 6+ wet nappies

 

  • there are red/orange specks in your baby’s nappy (urates);

  • poos remain dark. By day 5, they should be mustard colour;

  • your baby seems unsatisfied after feeds;

  • breastfeeding is very painful all the way through a feed;

  • your baby is not feeding often (fewer than 8-12 times in the early weeks);

  • your baby is excessively sleepy, reluctant to wake, or falls asleep at the breast after only a very short suckle;

  • your baby is not waking to feed in the night (so don’t believe anyone that says babies should be sleeping through the night anytime soon!)

 

If you have any concerns about your baby, seek medical support. Maternal instincts are strong and so trust your gut if you are worried. This list is not exhaustive but some signs of dehydration requiring urgent medical help include:

  • listlessness

  • lethargy

  • dry eyes and mouth

  • weak crying

  • sunken fontanel (soft spot on the head)

  • fever

  • not enough wet nappies (less than 2 in 24 hours from day 3)

  • if skin is pinched, it stays looking pinched

 

You are not sent home from hospital if your baby has not produced enough wet nappies. This is the main indicator that all is going well with breastfeeding, and one you can check every day once home. The second indicator is weight.

 

Weight loss (around 7%) is normal regardless of how you feed your newborn, and the health visitor/midwives that see you around days 5/10 will be checking this to monitor how feeding is going. You can then go to have your baby weighed at walk in clinics. If you express by any method, do not take the amount produced as an indication of how much your baby is getting, as babies are much more effective at getting milk out.

 

Once your milk has come in (around day 3), you may be able to hear your baby swallowing and you may notice your breasts feeling fuller, and then softer after a feed. 

However, sometimes a baby may need more milk. Check out this guide to supplementing.

 

How do I know whether my baby is hungry?

 

Look for feeding cues such as:

  • sucking their fists

  • opening their mouth and searching for your breast (rooting)

  • late cues may include agitation and crying so they may need calming before feeding.

 

The sooner you can respond to these cues, the less frustrated your baby will become between feeds. Sometimes your baby may be crying and not showing these obvious signs of hunger. The joy of breastfeeding is that it will often calm babies anyway! But of course check the other likely suspects too such as a wet nappy, their temperature etc.

 

My baby doesn’t fit any of the traits on the lists above, but seems to be feeding a lot. Why? When will they sleep? When can I sleep?

A baby that feeds ‘often’ is normal. This frequent feeding helps your milk to come in during those first days - see below for cluster feeding. Check out this image of how small a baby’s stomach is compared to a 2oz bottle of formula (the smallest bottles).

 

 

 

 

If you try to feed your baby so much at the start, they are likely to spit it back up, and reflux may be blamed so do consider this if you choose to use formula. Newborn babies do not need that much milk at each feed; instead, their stomachs are designed to feed little and often as breast milk is so easily digestible. 

 

Colostrum (the first thick milk you produce) is amazing and will provide everything your baby needs in just those tiny amounts. And you cannot over-feed a breast-fed baby. But yes, they will want and need to feed more often than a formula fed baby, and all babies should be fed on demand. As newborns get older, they will usually nurse less often, feeds may be quicker, and they may develop a more reliable schedule (as they will with naps too).

 

Nighttimes are often the most difficult to get used to. Some people want their partner to be able to give bottles at night to share the load. There are plenty of other ways for dads to support overnight: they can do the nappy changes; they can wind baby after a feed; they can put them down into the cot. They can basically do anything else you need at night. All you have to do is lie there and feed! Furthermore, research has shown that mothers who exclusively breastfeed get 45 minutes more sleep than mothers whose babies are given formula! Yes, your baby will no doubt wake through the night for feeds, but those night feeds are important for your supply, plus the breast milk at this time comes full of sleep inducing ingredients!

 

In addition, if nighttime breastfeeding is reduced or ceased, some women find their menstrual cycle returns - that’s one major reason to keep going! Check out our guide for partners about how to support breastfeeding mums.

Cluster Feeds

It is normal for babies to sometimes cluster feed during growth spurts (the first one usually happening in week 1). These may be the most challenging days/ nights. A cluster feed - when babies feed frequently in a short space of time - is NOT an indication that a baby is not getting enough milk. It might be feel like a hard day but it will not be like that long-term, and take comfort that you are helping your baby cope with the big changes they are going through. Remember that your baby is used to being fed on demand through the umbilical cord!

 

If you are using formula, you will not want to overfeed them so you will be left trying lots of other ways to comfort your child when milk isn't an option; whereas you can ALWAYS offer breastmilk.

Check out this guide about when cluster feeding is NOT normal, such as when your baby is unsettled and crying even right after being fed and immediately looking for another breastfeed, after MOST feeds. They may not be awake for very long at all and may have very long feeds at MOST feeds. If you are ever unsure about what is normal, speak to a professional for support.

Breastfeeding and Bedsharing

New parents are often sleep deprived, especially mothers who must wake up several times a night to nurse their infants. Sleeping with your baby can help you get more shut eye while nursing, but it is important to do it safely. If you are considering co-sleeping, or bedsharing, check out the La Leche guidance here. Check out our page on this and evaluate if this would work for you. 

When breastfeeding seems tough...

 

Just remember, in other ways breastfeeding is easier than bottle feeding.

  • There is no bottle prep in the middle of the night whilst your baby cries that you’re taking too long! 

  • There is nothing to sterilise unless you choose to express.

  • It is already the perfect temperature.

  • It costs nothing!

  • You usually have a spare hand to check out Instagram or the Ordinary Mothers website!

  • You have every excuse to let your partner do the chores whilst you do the most important thing: feed your baby!

 

And of course, try to remember why you wanted to breastfeed in the first place:

  • It provides exactly what your baby needs at the right time. When it is hot, you will produce more thirst-quenching foremilk; tryptophan levels are higher at night, allowing the body to make melatonin, a hormone that helps to induce sleep; if your baby is sick, your breast milk contains antibodies to help them fight it.

  • It reduces the rates of SIDS (Sudden Infant Death Syndrome).

  • Nighttime feeds before 6 months can be a factor for not getting your period back yet.

  • It has numerous other health benefits for the baby and the breastfeeding mother.

 

Try to enjoy your maternity leave cuddled up with your newborn (and hopefully beyond) and the bond that you will build. It will not be long before your child is independently exploring the world and you’ll be longing for those cuddles.

Will I need to pump/express?

You will only need to pump/express if:

- you need to leave baby for a period of time, during which they would normally need to nurse;

- you need to increase your supply because baby isn't latching on enough (baby nursing is the best way to increase supply in the first instance);

- you want your partner to give baby an expressed bottle to bond/share the load. Please remember, however, that you will still need to pump when baby would be feeding to maintain supply, and there are many other ways for partners to share the load and bond with baby.

For a guide to pumping/expressing, click here.

Other breastfeeding issues

 

"My baby had not quite regained his birth weight by day 10 so my midwife checked for a tongue tie, and he did have a slight tongue tie, although he could fully extend his tongue. I found out afterwards that tongue and lip ties are a surprisingly common reason why babies struggle to latch or why it can be painful so ensure these are checked before you leave the hospital. Luckily, these can be easily rectified once spotted. I chose not to have my son’s tongue tie cut after the consultant checked him out as feeding was not painful and he had good elevation of his tongue so it was not severe enough to possibly disrupt his feeding which I felt was going well. I was on fluids after he was born which can affect the weight too. We kept a close eye on his weight, which increased quickly over the next few weeks." - Check out this Ordinary Mother's blog here.

 
 
 
 
 
 
 
 
 

Top Tips to prolong breastfeeding.

 

1. Read the guidance about why babies feed the way they do, and how to know if breastfeeding is going well. Understanding things like cluster feeds in advance will help you not to panic, and knowing what a good latch looks and feels like will help prevent problems like sore nipples.

Use the guidance to make informed choices about feeding your baby e.g. whether to supplement, which feeds you should avoid replacing with a bottle etc.

Some good websites are linked at the bottom of this page.

 

'The Mothers and Others Guide to Pregnancy, Feeding and Parenting’ is really comprehensive. You learn how to tell that babies are having enough and whether they are feeding effectively. See if your local hospital will provide the guide upon the birth of your child on the website below. If then you can also order your own copy here for a fee. 

2. Trust your body. If a baby is putting on weight (after their initial weight loss), producing enough wet nappies, and appearing satisfied after a feed, then you are clearly doing something right (not to mention amazing!) It is very unlikely that you won’t be able to produce what you need for your baby to thrive so if a baby is constantly at your boob, it may be a cluster feed or a growth spurt. This often happens around day 3 when your milk ‘comes in’ so don’t panic that your baby is starving, but always check with your midwife or health visitor if you're unsure.

 

3. Invest in a nursing wardrobe. You don’t always feel your best after giving birth so some nice clothes that fit are important anyway to help you feel more like yourself, but ones that allow you to nurse easily and discreetly are also a must for any breastfeeding mother. You can buy tops and dresses with additional panels, and bras that once unclipped will give baby access to the breast. If you want to make use of normal tops in your wardrobe, buy a nursing vest that can go under anything - that way you don’t expose your belly during a feed. 

4. Conquer the fear of feeding in public. If you have a good nursing wardrobe, it will be barely noticeable when you’re breastfeeding as you’ll look ‘fully dressed’. If you use the cradle hold, it will look like you’re just cuddling your baby. If you still don’t feel confident, you could try a nursing cover, or drape a muslin over your shoulder. Find a good spot where you don’t feel totally overlooked and use what’s available to support your arms etc (changing bags can work well as a makeshift cushion!). But remember, you're protected by the Equalities Act 2010 when you breastfeed in public. This includes communal spaces like parks, public services like transport and libraries, and businesses like cafes and restaurants so don't ever feel you need to hide in a restroom.

 

5. Ask for help. Being the sole source of food for your baby can be emotionally and physically draining at times. Make sure your partner keeps you topped up with water (a bottle may be easier than a glass); ask your partner to do the nappy changes. Direct your partner to our guide. And if you need specific support with breastfeeding concerns, contact La Leche, or a midwife/ health visitor. 

6. Ensure friends and family are on board. Be clear from the outset that you want support for whatever way you choice to feed your baby. If you want to exclusively breastfeed, it is unhelpful for family to suggest a bottle of formula if you moan about a bad night's sleep, or for a friend to question your choice not to drink on a night out if you will want to breastfeed when you get home. Equally, if you want to combi-feed (bottle and breast) or you have reached the point of weaning your baby off the breast, then those around you should respect that you are making the best choices for you and your baby, and should support you no matter what.

 

The next tips are just from readers' personal experiences and may not always strictly follow NHS guidance so please refer to point 1 - read and make a choice that suits you and your baby.

 

7.  Pump to give yourself some flexibility, once breastfeeding is established. It can be a daunting prospect if you feel you cannot leave your baby ever for the entire time you’re breastfeeding. It is important to be able to have some time away (even if you just want a long bath!), or at least know you have the option. The cheapest way is to hand express. A quicker way is to use a hand pump. However, if you are going to regularly express, invest in an electric pump.  Check out our page here on pumping/expressing.

 

Introduce a bottle early on to save issues later down the line when you might NEED to give baby expressed milk.  Find the bottle and teat that works for your baby. If you do encounter problems, consider cup feeding.

 

8. Invest in accessories! Try breastmilk collection shells to collect milk from leaking nipples. They seem to be a secret hack as there is very little about them on the internet, but check out this review of one brand here. These sit in your bra and are often best used when you are feeding on the other side. You won't get as much as a pumping session, and most of it is likely to be foremilk, but at least you are making the most of every liquid drop!

 

Try silicone breast pads like LilyPadz Reusable Nursing Pads for swimming or visiting a spa where normal breastpads might get wet; these can also be used if you want to go bra-less but may not be suitable if you leak quite a bit so use them with caution in this situation!

Why not treat yourself at some point to a breastfeeding keepsake? Google 'breastmilk' jewellery for ideas of how to commemorate your journey, however long it may last.

9. Evaluate bedsharing.  New parents are often sleep deprived, especially mothers who must wake up several times a night to nurse their infants. Sleeping with your baby can help you get more shut eye while nursing, but it is important to do it safely. If you are considering co-sleeping, or bedsharing, check out the La Leche guidance here.

 

The last one is the most important bit:

 

10. Enjoy it. Breastfeeding is an amazing opportunity to bond with your newborn. Enjoy it and be proud of yourself.

 

Helpful Websites/ Sources:

Start4Life

KellyMom (some guidance will be applicable to USA)

La Leche 

The Milk Meg

© 2018 by Ordinary Mothers