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AVOIDING PROBLEMS
Sore Nipples:
?incorrect latch ?thrush
hindmilk on nipple/100% Pure lanolin/Sunshine
Engorgement-Day 2-5 Vascular
Feed on demand
Chilled Cabbage leaves, Heat, Supportive Bra
Hand express small amount if problems latching baby
Blocked Duct
Massage during feeding
Mastitis ?inflammation from blockage/stasis ?infection
Flu like symptoms, sore red area
Rest, fluids, Vit C, homeopathic, empty breast, may need Antibiotics but please talk to your LMC Midwife or Dr first.
Abscess- see your LMC
Supply:
Demand = supply ie the amount of milk removed is produced.
- Giving other fluids (water,formula) to baby will reduce your supply of milk
-Try to avoid artificial teats, nipple shields, dummies especially until breastfeeding established
-Feed on Demand 2-4hrly (8-12x in 24 hrs for newborn) let baby decide, if in doubt offer feed can not overfeed a Breastfeed baby
-Babies need feeds at night esp 1st 6wks, may take 6wks-1yr before sleep through the night. Keep night feeds quiet, dull lighting and don't talk to the baby it will wake them up too much and they will then want to play
- Let the baby finish 1st side wind/nappy change then offer the 2nd side. Alternate sides you start on, as usually they take the most of the first side.
- Early weeks may take total of 45mins to feed => baby will get quicker at breastfeeding, eg 10-30mins, with time
- Growth Spurts every 2wks for 1st 3mths, and at 6mths, and 1yr, during these times they feed a lot for 2-4 days
-If your breasts become soft it does not mean the milk has gone
-Signs that baby is getting enough = wet nappies 6-8 cloth, 5-6 disposable, gaining weight after initial weight loss (back to Birth Weight at approx day10-14) alert &well.
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ADVANTAGES
Advantages of Breastfeeding
To the Baby:
Nutrition
-species specific, human milk is different from any other animals
-easily digested, Breastfed babies are seldom constipated and have less digestive discomfort problems
-changes to suit the babies age, provides all a babies nutritional needs in 1st 6mths
-alters from beginning to end of feed, foremilk comes at the start of a breastfed, then comes hind milk which has more fat to help make your baby feel full and settled.
Immunity (passive immunisation)
-reduced chest, ear, urinary and gut infections
-reduced incidence of meningitis
Allergies
-are reduced eg eczema and hay-fever
SIDS(cot death)
-reduced incidence in breastfed babies
Chronic diseases
-reduced incidence of Diabetes, heart disease, liver disease, various bowel diseases.
-protection against lymphoma
Eyesight
-improved retinal development
Oral
-better speech
-reduced incidence of crooked teeth
Intelligence
Improved brain development =>higher intelligence test scores
Bonding
-closeness with mother and baby
-Babies are more settled
To the Mother:
Convenience
-always available
-No prep time esp important at night
-correct temp
-portable
Speeds recovery from Birth
-less bleeding
-uterus shrinks faster
-weight loss
Contraception
-average time to have no periods Postnatally is 10mths if breastfeed at least 6x/day
-increased prolactin levels prevent stimulation of ovary: exclusive (ie no milk substitues introduced) breastfeeding is 98% reliable 1st 6mths as a form of contraceptive if there is no periods.
Prolactin Hormone
-relaxing effect
Health
-reduced ovarian & pre-menopausal breast cancer
-reduced osteoporosis
Bonding
-once breastfeeding established most women find it pleasurable and enjoy the closeness they have with their child
Family:
Free natural resource
-1992 study showed saved $1000 /yr
-reduced Hospital visits: one USA study showed 1st 4mths of life 77 Hospital admissions for every 1000 bottlefeed infants verses 5 for every Breastfeed infants
-environment-formula production and cans cause waste
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ANTENATAL CARE
Avoid soap- areola (brown area around the nipple) glands secrete oil
Talk to your Midwife if you have any worries re breasts/nipples eg previous surgery, inverted nipples. For inverted nipples may be able to use nipple formers (shells, Niplette) to help with this.
Bras leave till 36wks, have fitting, buy2-3
Breast pads may be needed if you leak a lot
As your breasts get larger you may need a supportive top or Bra for in bed, & to hold pads in place if leak at night
Avoid underwire bras =>can cause blocked ducts
Knowledge is the best preparation
Breastfeeding is a natural process but a learnt skill
Resources and help:
Books/videos
Lactation consultant
La Leche League
LMC (Midwife)
Plunket Parent Centres
Partner
May like to try practicing positioning before the baby is born eg with a doll of teddy
Steps:
Mother comfortable
Unwrap baby
Arm of baby out of way of breast
Babies chest to your chest, babies chin to breast
Support breast with C hold of your hand
Tickle lips of baby with your nipple for the rooting reflex, if the baby is opening it's mouth.
Baby needs a wide mouth like a yawn
Bring the Baby to the breast
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LATCHING
Signs of a good latch:
Most problems caused by incorrect latch
Wide open mouth
Lips curved out over areola
Chin against breast, Tip of nose touching breast
Sucking rhythm changes to long sucks and swallows
Sometimes can hear baby swallow, see movement of jaw
NO PAIN, initial tenderness 1st few days due to hormonal changes
If painful take baby off, breaking suction by putting your finger gently into the side of their mouth and try again.
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MILK PRODUCTION
Colostrum
-produced during late pregnancy & 1st few days = early milk
-high in antibodies and protein, low volume
After the birth
-hormonal changes and baby sucking brings in mature milk about day 3
-breasts feel fuller ie engorgement
Supply & Demand
-more milk removed=>more made (Prolactin)
Let down reflex
-sucking also releases oxytocin =>muscle fibers around breast glands (alveoli) tighten => milk pushed out
-tingling feeling
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PREPARATION
-Signs of baby wanting a feed: hand to mouth movements, fussiness, sucking action or sounds, cooing or sighing and nuzzling at breast
-Organise yourself before you begin to breastfeed- phone and water near by
-Tri-pillows are helpful
-May need to wear a breastfeeding bra for support, including to bed
-You may leak breastmilk and need breast-pads
- If you are going to away from your baby for any period of time consider buying a breast-pump to express milk off for baby
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TERMS USED
DEMAND FEEDING: letting the baby feed when they want to. Babies may feed between 6-18 times in 24hrs, newborns usually feed 2-4 hrly.
AREOLA: the dark area around the nipple
LATCHING: the baby is positioned on the breast ready for a feed
LET DOWN: milk is going from the milk cells into the ducts. May feel a tingly or a tightening sensation. Is caused by oxytocin hormone release when the baby sucks and sometimes when you think about your baby.
COLOSTRUM: the milk which is produced in the first few days after birth of your baby.
It is concentrated and high in antibodies which help fight infections
FOREMILK: milk at the start of a breastfeed
HINDMILK: milk at the end of a breastfeed which is higher in fat content
ENGORGEMENT: Fullness of the breast
EXPRESSING: using your hand or a pump to remove milk
MASTITUS: breast inflammation causing pain, swelling and flue like symptoms
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