Expert Advice

Breastfeeding: Your Essential Guide

How often? Are they getting enough? Should it hurt? Here are the basics for fuss-free breastfeeding and how to get 24/7 help

Breastfeeding tips
You also need plenty of fluids and may get very thirsty while feeding.

If you're like most mums, you want to give your baby the best start in life – one way to do this is to breastfeed.

There are proven benefits to breastfeeding your baby such as protecting your baby against allergies, asthma and even childhood cancers. It also helps you to bond with your baby and is the perfect fuss-free food that's always sterile and at the right temperature.

However, while breast may be best, it's not always smooth sailing with a newborn. Here's what to expect and how to give you and your baby the best chance of having a successful breastfeeding partnership.

SUPPLY & DEMAND

Breastmilk is pretty amazing stuff. In the first three days after birth your breasts produce colostrum, which is a yellowish liquid that's rich in antibodies to help your baby fight infection. Colostrum gradually changes over the next few days and becomes whiter in appearance and much more abundant.

As your milk 'comes in' on about the third day your boobs will feel heavier and you will notice that your baby will be taking bigger swallows during each feed.

Don't worry about running out of milk. The more your baby feeds, the more you'll produce, so the best way to firstly establish your milk supply and then to maintain it, is to feed whenever he's hungry (7-12 times in 24 hours is normal in the early weeks).

BEING PREPARED

It sounds like it should come naturally, but breastfeeding takes a bit of preparation. The best strategy is to get some expert advice, so go to antenatal classes if you're still pregnant or ring the Australian Breastfeeding Association if you need help post-birth.

It's helpful to see breastfeeding in practice, too, so if you have a friend who's breastfeeding, arrange to spend some time with her so you can see what's involved. If you don't have any breastfeeding friends, you could attend a Breastfeeding Association meeting in your local area.

Although breastfeeding doesn't need a lot of equipment, there are a few things that may be useful. Get professionally measured during your pregnancy for nursing bras at around 36 weeks and stock up on breast pads for the inevitable leakage.

It's also a good idea to jot down the numbers and websites of some helpful organisations like the Australian Breastfeeding Association, which has helplines and runs support groups nationwide (contacts are listed below).

GETTING STARTED

Skin-to-skin time

Midwives recommend that you have your baby skin-to-skin with you for the first hour or so after birth. Being skin-to-skin encourages your baby to begin the process of finding your breast when he is ready to feed. The newborn baby has very strong abilities and reflexes which are designed to help you both to get breastfeeding off to a great start.

Once he has had a good feed you'll probably find that you will both be ready for a long sleep. If he doesn't suck straight away, don't worry, some babies need longer to get the hang of it. Ask for help if you need it. Your midwife may assume you're doing fine if you don't speak up.

Follow your baby's feeding cues

Your baby is the best judge of when he's hungry, so follow his cues. A newborn may feed for an hour at a time, but as your baby becomes bigger he'll be able to satisfy his hunger in as little as 10 minutes.

This flow chart can help you to tell when your baby is letting you know that he is hungry.

Is my baby getting enough?

The biggest worry for most breastfeeding mums is whether the baby is getting enough milk. You can't measure how much you're producing, but he should be wetting several nappies a day and putting on weight.

Is a comfort feed OK?

Most babies have a 'fussy' period and your newborn may want to feed more-or-less constantly at this time, which is normal. He probably wants the comfort of your breast as much as the milk itself.

Remember to eat, drink & rest to maintain your supply

It's important to look after yourself while you're breastfeeding. Poor nutrition, tiredness and anxiety can all affect your milk supply. It can be difficult to make time for proper meals, so make sure you have high-energy snacks on hand, like hummus and carrot sticks, fresh fruit or a healthy breakfast cereal.

You also need plenty of fluids and may get very thirsty while feeding, so have a drink handy every time you sit down to feed. And don't rush to start dieting after your birth. Just avoid junk food and concentrate on eating foods that pack a nutritional punch.

THE "OUCH" FACTOR!

Breastfeeding should not be painful! When a baby is well-latched, the nipple and part of the areola is taken to back of the mouth where it is protected. If you are experiencing pain here are the most likely problems:

Sore nipples:

If the nipple looks pinched or misshapen when he comes off then he has not taken enough breast tissue into his mouth.

Encourage your baby to open his mouth wide by stroking the area between his nose and upper lip with your nipple. His body should be fully facing you, his chin should be well into your breast and his nose should be clear.

Ask your midwife or health visitor for help. Remember though, even if they say he looks well attached, if your experiencing pain and the nipple is misshapen, then he isn't on properly.

Engorgement:

This is when your breasts are over-full and feel hard and painful. It may cause your nipples to flatten, making it difficult for your baby to latch on properly.

Expressing a little milk to soften the area around the base of the nipple, massaging the breast gently and applying some heat before a feed and using a cold pack after the feed can help.

Engorgement can be avoided by feeding your baby according to their nees. It is normal for young babies to breastfeed 7-12 times in 24 hours.

Remember that your baby's tummy is the size of a marble in the early days and can comfortably take 3-5ml of colostrum each feed. His capacity increases to about golf ball size around the second week after birth.

Blocked duct:

You may feel this as a sharp pain, and may notice a lump or a red patch on your breast. Keep feeding from the affected breast, and gently massage towards your nipple as you feed. Applying some heat to the area can help as well.

Mastitis:

Sometimes a blocked duct becomes infected - this is called mastitis.

You may have a swollen, red area on your breast, a high temperature, and feel really unwell. See your GP as you may need anti-inflammatories or antibiotics, but don't stop feeding from the affected side.

It is really important to keep the milk moving in that breast, either by the baby feeding and/ or expressing.

Medications for mastitis are safe for breastfed babies.

STEP-BY-STEP GUIDE:

Novice breastfeeder? Follow our six simple steps to fuss-free feeding.

1. Holding your baby

Support your baby so he is fully facing your body. His chin should be tucked into the breast and his nose free to breathe easily. His head will look slightly tilted back.

2. Rooting

Bring his chin into the breast and stroke his top lip and nose with your nipple to encourage him to open his mouth wide.

3. Latching on

With your baby's mouth wide open, aim your nipple at the roof of his mouth. He should take the nipple and a large part of the areola (the dark area around it) into his mouth. You should be able to see more areola above his mouth than below it.

4. Checking the latch

Think about how it feels once he starts sucking. Is it hurting? Try bringing him in a bit closer. Is it still hurting? If yes, gently take him off and have another go.

He gets the milk through a combination of sucking and creating a negative pressure in his mouth. You may feel a tingling sensation known as 'let down'. As the milk starts to flow you will notice that his suck/swallow changes to a more rhythmic action.

5. Continuing the feed

Your baby will suck quickly at first, then settle into a slower rhythm.

Young babies commonly doze off before they have had a full feed. Changing his nappy half-way through a feed will often remind him that he hasn't finished yet.

6. Finishing the feed

Your baby will usually stop sucking of his own accord and let go. If you need to unlatch him, gently slide your little finger into the corner of his mouth to break the suction. He'll soon let you know if he's still hungry!

WHAT THE EXPERTS SAY

Dr Jenni James (PhD) is a Clinical Lactation Nurse Consultant and reassures mums that breastfeeding takes some time for both mum and baby to learn.

"When the baby arrives all mothers face a steep learning curve. The skills needed by both mother and baby to successfully initiate and maintain breastfeeding are largely skills that require 'on the job' training.

"Each mother-baby pair will learn at their own rate and it is a rare occurrence that breastfeeding just happens! More often, it takes several weeks for mothers and babies to develop the skills and confidence to feel that breastfeeding is coming together and that life is starting to feel 'normal' again."

HELPLINES

For more information or help seven days a week, call the National Breastfeeding Helpline on 1800 686 268 FREE or visit the Australian Breastfeeding Association website.

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