As an obstetrician and gynaecologist, I felt fairly calm and prepared throughout my first pregnancy. I knew what lay ahead, I was familiar with common issues I may face and was prepared and ready to deal with them. One thing I was absolutely not ready for in any way, was the challenges of breastfeeding.
It is a part of modern medical school training that seems to be vastly lacking; basic education in how breastfeeding works and how to troubleshoot issues.
Therefore, having now done extensive reading around the topic, and breastfed 2 babies of my own, I wanted to share my tips about what I wish I had known for those first week of breastfeeding.
I now sound like a broken record when I do my postnatal ward rounds, but I wish I could be a cheerleader for every woman who wants to breastfeed! It’s HARD and doesn’t come as naturally as it sometimes looks, but with help and support it usually gets easier with time.
I have written this post in collaboration with bbhugme, creators of my absolute favourite nursing pillow, which helped me immeasurably in the early days!
I use it non-stop for all feeds at home, but also as a comfy supportive nest to rest my baby on.
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How to prepare for breastfeeding
1. Education and reading
Breastfeeding is a new world to most mothers, and comes at a time when your world has already turned upside down and you are recovering from birth, which may or may not have gone to plan.
If you can do some reading and understand about how breastfeeding works and the basics of getting your baby to latch, you will be more relaxed to begin with.
I really recommend the brilliant “The Baby Feeding Book” * by Vanessa Christie. As well as practical tips, she has amazing advice about getting into the breastfeeding mindset.
Antenatal classes that include some sessions about feeding your baby can be really useful, and it’s invaluable to meet other new mums who will be going through things at the same time as you.
2. Colostrum harvesting
Colostrum is the first milk the breasts produce. It is produced in the breasts from as early as 16-22 weeks, although you may not notice this production during pregnancy.
Many women find they can use their hands to gently express this colostrum towards the end of pregnancy, and you can collect this milk in syringes and store it in your freezer.
You may find that knowing you have this store can help relax you if breastfeeding takes some time to establish, or you become separated from your baby. You can know that if there is any concern meaning you cant give your baby enough milk directly from your breasts, you can give them your own colostrum as a temporary measure.
I wrote more about the technique for hand expressing in this blog post.
How breasts work
The most important thing about breastfeeding is understanding that the process functions on a supply-demand basis.
Every time the baby suckles at the breast, this triggers a ‘letdown reflex’ which ejects the milk from the nipples. The more frequently baby drinks from the breast/ the milk is expressed, the more the brain gets signals to produce more milk.
If the breasts get reduced stimulation eg not enough milk is removed from the breasts because baby is having occasional bottle feeds, or baby hasn’t latched well enough to remove milk efficiently, this can lead to a fall in milk production.
Positioning and attachment
The position of your body in relation to your baby’s can be really important in terms of making sure you can feel comfortable and relax into the feed. It also means ensuring that the baby is at the right angle and position to feed most efficiently.
There are a number of different options for positions, which are helpfully explained here.
Whilst the commonest position is the cradle hold, other positions can be useful for different situations such as side-lying for feeding during the night, or after a C section.
Regardless of which position you choose, there are some tips to help you get comfortable:
- Consider using a breastfeeding pillow. You will be most comfortable if you line baby up so their nose lies opposite your nipple. A pillow can support your arm and help adjust their height
- Tuck the whole body in close to yours, ideally with their skin against your skin. This will help provide them with stability and warmth, and also enhance your own milk production.
- If possible, ask your helper to hand you the baby once you are in a comfortable position.
- Once baby has latched on, check your positioning again and consider adjusting your pillows around you to be able to relax as much as possible.
Attaching or latching baby onto your breast:
The acroynm CHIN can be helpful to learn the steps to latching baby:
Close – Baby needs to be close to mum so that he can scoop enough breast into his mouth
Head free – Baby needs to be able to tilt his head back when attaching to the breast as they open their mouth wide. Hold your breast with one hand and support below their neck with your other hand. You can therefore control their head as you bring it towards your breast. This allows the chin to lead as he comes on to the breast.
In line – The baby’s head and body need to be in a straight line so that he doesn’t have to twist his neck. This makes swallowing easier
NOSE TO NIPPLE – Mum’s nipple should be just below babies nose so that as he roots and tilts his head backwards the nipple will slip under his top lip upwards and backwards to rest on the baby’s palate
Encourage him to open his mouth wide, and hold baby patiently with their nose close to the nipple until they do so. As they open, bring them onto the breast quickly, filling their mouth with as much breast tissue as possible, rather than just the end of the nipple.
To know if the latch is successful:
- Chin touching breast
- Mouth wide open
- Lower lip curled back
- Cheeks full and rounded
- Minimal areola visible
- Rhythmic suck / swallow with pauses
- Feeding should be pain-free
The early days
Finally, here are some things I wish I had known about the early days of breastfeeding:
- Ask your midwife to check your baby’s latch at each feed until you feel comfortable. It can be much harder to get timely support when you get home!
- The first day after birth, baby will give you a longer sleep. After the first feed they may not wake to feed for several hours. Take it as a chance to rest!
- Try to latch the baby every time they wake/ cry. This will help your milk to come in and also help settle the baby and bond
- Don’t worry about the length/ frequency of the feeds. You don’t need to try to stretch the baby to feed a certain way.
- Your baby is likely to be sleepy. Help them to take a full feed by trying to gently wake them if they fall asleep at the breast. You can take their feet out the babygro, blow on their face or gently tickle their cheeks.
- De-latch as soon as it feels painful. Don’t allow baby to feed at the tip of your nipple as this will lead to pain and cracks! Instead insert your little (clean!) finger in the corner of their mouth to break the suction and try again.
- Prepare for cluster feeding. It’s normal for baby to feed almost constantly for several hours, especially in the evenings whilst they build your milk supply and prepare for a longer sleep at night.
- Keep a breastfeeding box topped up with supplies – I include snacks, wipes, nipple pads, lanolin, a breastfeeding cover, a muslin, the TV remote, a phone charger, painkillers for any post-birth pain and a big bottle of water.
This blog post has been sponsored by bbhugme. For more information on their products, head over to www.bbhugme.com
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