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breastfeeding Q&A

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Breastfeeding Q&A

Breastfeeding helps you give your baby the best possible start in life. It may take a little bit of practice to get it right, but once you get the hang out it, you'll find it one of the most rewarding things about being a new mother. Don't be afraid to ask for advice - your midwife or health visitor can offer practical advice on how to make breastfeeding successful and enjoyable.

What are the benefits of breastfeeding?

Breastfeeding not only has health advantages, but also helps create a close bond between mother and baby.

Breast milk contains all the vital nutrients your baby needs to develop and grow into a healthy child. The vitamins, minerals, protein and fat content of breast milk are ideally balanced in a form that your baby can easily digest. By breastfeeding you are also passing on your antibodies to your baby. This helps strengthen the baby's immune system and promotes resistance to coughs, colds and stomach upsets.

It also has advantages for you: breastfeeding helps the uterus shrink back to its normal size and postpones ovulation and periods. There is evidence that longer-term breastfeeding may help to reduce postnatal weight and women who have breastfed may have a reduced risk of premenopausal breast cancer, ovarian cancer and hip fractures due to osteoporosis.

Recent evidence from the World Health Organisation has shown that breastfeeding is more than 98% effective as a birth control method if the mother is a full-time breastfeeder and feeding on demand day and night. However, most GPs would recommend that you also use a barrier method (such as a condom) to be on the safe side.

The closeness and comfort of breastfeeding is enjoyable for both mothers and baby. It is a great way to get to know your new baby, and makes your baby feel secure and content. Mothers can feel relaxed, peaceful and calm during and after breastfeeding. Remember you will be breast-feeding quite frequently in the early days and will welcome these peaceful moments where you can sit and relax with your baby and not worry about anything until after the feed is over!

Of course there are other benefits to breastfeeding; it is also convenient - breast milk can't spoil, it is always the right temperature, it needs no preparation, there are no bottles to wash and it's free!

mums tell mums: breastfeeding tips

Are there any reasons not to breastfeed?

Mothers with serious illnesses or infections, or those taking certain medications, may be recommended not to breastfeed. If in doubt, ask your GP, midwife or health visitor.

How long should I breastfeed?

There is no 'correct' answer to this question. You should breastfeed as long as you want to. Most mothers breastfeed anywhere from three months to 12 months and some for longer. It is up to you to decide. La Leche League suggests that breastfeeding for the first six months gives your baby the best start in life, and that it is up to you and your baby to decide when you should stop breastfeeding. It is, however, possible to begin introducing solids to your baby's diet at four months. UNICEF and the World Health Organisation recommend breastfeeding for at least the first two years, in industrialised countries as well as poorer parts of the world.

It is a good idea to begin breastfeeding as soon as possible after birth. However, if you can't breastfeed immediately, for instance if you have had a Caesarean, don't worry. The process will be just as successful if you start as soon as you can.

Just after birth, your breasts will produce a rich fluid called colostrum. Although it may seem to come in only tiny amounts it contains just the right nutrients and antibodies for your baby's needs in the days just after birth. This will begin to flow when your baby starts suckling. This suckling will also stimulate the production of milk and after a couple of days you will feel your breasts becoming swollen as your milk comes in.

How often should I feed?

Your baby will let you know when she is hungry and when she is full! Feeding on demand helps ensure your baby is getting adequate nutrition without overfeeding. It is more important for your baby to gain weight at the right rate than to stick to a rigid schedule. There is no advantage to making a tiny baby wait for a feed, they have very small stomachs. As you gain confidence and get to know your baby's moods, you will be able to settle into a reasonable schedule.

How do I know my baby's getting enough milk?

Most babies will regulate themselves, and take as much milk as they need at each feed. You will know your baby is getting enough if:

  • They are steadily putting on weight.
  • The urine is pale or clear.
  • They have at least 6 wet nappies a day.
  • They have regular, soft, mustard-coloured stools.
  • They are breastfeeding contentedly.

How do I express milk?

Expressing will probably take some trial and error. You can express before, during or after a feed, but most women find that they have more milk in the morning so it may be easier then. You can express milk by hand into a sterilised container. You could also buy a drip catcher, which collects milk that drips from one breast while you are feeding with the other, or a hand or battery-operated breast pump.

What can I do about engorged breasts?

Soon after you've had your baby you may find that your breasts feel swollen, tender, and even lumpy. Your breasts may feel hard and engorged, leaving you in discomfort and pain. One possible reason for this is that you're baby isn't keeping up with the amount of milk you're producing, so your breasts aren't emptying.

The engorgement shouldn't last long, but to help you feel more comfortable until your breasts soften, make sure you wear a properly fitted bra, even at night. You should also feed your baby as often as he wants: the more you feed, the more comfortable you are likely to feel. Finally, gently massage your breast as your baby is feeding from it: this should encourage milk flow and ease some of the discomfort.

What can I do about sore nipples?

Your nipples might feel sore or tender when you first start breastfeeding. You might need to adjust the baby's position when you are feeding - ask your midwife for advice. It may be that your baby is only sucking on your nipple and needs to open his mouth wider to actually take in more of the breast.

If your nipples become cracked, try using absorbent breast pads in your bra, changing them frequently, and try wearing cotton bras. Avoid using soap because this can dry out the skin on your nipples even more. You can try using petroleum jelly between feeds, or squeeze out some milk at the end of the feed and gently rub it into your nipples. If breastfeeding hurts, do ask for help straight away to put it right. If you know your baby is in a comfortable position and is latched onto your breast properly, it may be thrush causing the problem. In the meantime, try and be patient with breastfeeding and persevere. Many women get sore nipples, and in the majority of cases it is because the baby's position at your breast needs to be changed. With help from your midwife it should clear up within a few days.

What if I have a blocked duct?

Milk ducts can sometimes become clogged with solidified milk. This will show up as a red bump on your breast or a white spot on your nipple. Blocked ducts usually occur when feeding is stopped before the baby is finished, and the breast is not emptied completely. You should let your GP or midwife know if you have blocked ducts, especially if it becomes very painful.

If you have a blocked duct, feed from the affected breast first. If the baby doesn't empty the breast completely, try expressing the rest of the milk. Make sure there is no dried milk on the nipple after nursing; if necessary, wipe it with sterile cotton dipped in water that has been boiled and then cooled. A warm bath or shower before feeding may also help the milk flow smoothly.

A painful red spot on your breast, accompanied by a fever and swelling, may be a sign of mastitis. This occurs when the breast is not efficiently emptied of milk and is almost always caused by incorrect attachment. Ensure that your baby is positioned correctly at your breast and is latched onto your nipple properly. The inflammation that accompanies mastitis is difficult to distinguish from an infection, so you may be offered antibiotics. If you suspect you have mastitis, contact your GP immediately. It is best not to stop nursing while you are being treated for mastitis.

How does what I eat and drink affect breastfeeding?

Most foods and drink won't affect the quality or composition of your breastmilk. Alcohol and smoking should be avoided as they can affect your breast milk. Alcohol will make your baby drowsy, and large amounts can affect development. Cigarette smoke contains toxic substances that can enter the breast milk.

If you don't eat enough protein and calories it is your body that suffers rather than your breastmilk. Be sure to drink plenty of liquids (but limit your intake of high-caffeine drinks such as tea and coffee), and try drinking milk to boost your calcium intake. At first many women feel thirsty when they sit down to breastfeed, so it is a good idea to have water handy. You may also be hungry in the middle of the night or the afternoon - don't forget that you are still producing all your baby needs to keep growing, so it's no wonder you feel hungrier or thirstier than usual. Useful snacks include breakfast cereals, dried fruit and nuts, wholemeal toast and yoghurts. Some women take special vitamin supplements formulated for pregnant or breastfeeding mothers as an insurance policy against any deficiencies.

You may find that your baby reacts to certain foods you have eaten. Strong seasonings may flavour your breast milk but some babies seem to like this so keep an open mind. Garlic, onions and cabbage may cause your baby to have wind. If you have any questions about your diet while breastfeeding, talk to your GP or midwife.

Some medications can affect breastmilk, so be sure to check with your health visitor or GP if you need to take any medication while breastfeeding. This includes aspirin, cold remedies and other over-the-counter medicines as well as prescription drugs.

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