As mentioned in yesterday’s post, a few key points stuck with me after antenatal class on Tuesday evening with regards to breastfeeding. I have had more friends who did not manage to breastfeed successfully for a variety of reasons than those that did manage it, and so I have witnessed the heartache and unjustified sense of failure that not being able to has brought.
The below are above and beyond the overwhelming number of opinions and pieces of advice you will no doubt receive from everyone you know – try to breathe through it and focus on what you want and know and trust your body and your baby to let you know when things are going well or going wrong. If you need help, support or guidance – ask a specialist, not a friend, because even with the best of intentions, everybody has a different experience and a different baby.
I really want to breastfeed and as a stay-at-home and later work-from-home mom, I am lucky enough to be able to give it a try for the long term. The midwife talked us through a few of the potential scare factors we would face in the first few weeks and I feel they are worth sharing – as a very important aside note that this is from my memory of the advice given and does not reflect an official medical opinion.
Your milk only comes in on the third or fourth day – this does not mean there is something wrong with you! Your breasts will produce colostrum in the first few days and this will provide more than enough nutrition and sustenance for your baby until the milk comes in. Unless there is something wrong, you should feed your baby ever 1-2 hours in those first few days and what you are producing should keep your baby satisfied and well fed. Also important to note, your baby’s tummy is only the size of a marble when born and will grow naturally in response to the amount of milk they get over time.
Engorged is a scary word – According to our midwife, as long as your milk is coming through your milk ducts easily, your breasts are not “engorged”. Engorged means that your breasts are overfull and blocked. There are loads of definitions on the internet that disagree with this assessment, but I believe what she means is that there is a difference between overfull breasts that are uncomfortable and a situation where you are unable to get the milk out of your breasts which can cause extreme pain and infection.
When your milk comes in, it comes in too much too fast – Between days 4 and 7, your breasts will produce more milk than you will need and although you will be uncomfortable, it is not dangerous and you should try to continue to breastfeed your baby every 2 hours.
However – when your breasts are overfull, it can cause your baby to have trouble latching. A baby is latched when their gums are on the areola where the milk ducts are, not the nipple itself. When your breasts are overfull, your breasts may be too tight to allow baby to latch properly. The temptation to express as much of your milk as possible may be very strong, but there is a very powerful reason not to – your breasts produce milk in response to what your body believes is needed – if you express all your milk, your body will simply produce more milk to meet what it perceives as a demand.
In our midwife’s experience, if you want the best chance at breastfeeding long term, you should not express your breasts completely, but lightly manually express just enough so that the areola softens enough for baby to get a good connection. This will mean that baby will get plenty of milk, easing the pressure on your breasts and will save you from extremely painful cracked nipples.
Very briefly on the topic of cracked nipples – there are two ways to potentially help heal faster: laser treatment that can be provided by your hospital and there are apparently those that will come to you at home as well; and creams. If you go the cream route, find one that is safe for baby to ingest as it will defeat the purpose of the cream if you have to remove it every time you feed. Cracked nipples are apparently extraordinarily painful and quite often the reason mothers tend to choose other methods of feeding.
All babies will lose 10% of their body weight immediately following their birth. If your baby is 3kgs at birth, within a few days they will be 2.7kgs – this does NOT mean your baby is not getting enough nutrition from you. Depending on the baby it can take anywhere from 2 – 3 weeks before your baby regains that weight. It is important that you do not let anyone bully you into top up feeding unless your baby is losing weight, but it is just as important that you do not put your need to breastfeed above your baby’s welfare. If you are unsure or unhappy with the recommendation to top up, take your baby to another doctor for a second opinion. If you do need to top up, try spoon or cup feeding as opposed to bottle feeding; this will mean that your baby will perceive it as an additional form of feeding and not a substitute for the breast.
Your body produces two seemingly different types of milk when you breastfeed. The first, foremilk, is thin and watery, low in fat but high in volume, and is there to simply quench baby’s immediate thirst – do not panic if your milk appears very thin! During the course of the feed, the milk will become thicker and richer in fat and as long as you feed baby til they are done and stop drinking on their own, they should get plenty of both kinds of milk.
To reassure yourself that your baby is getting enough of both, after the first week (when you feed very much on demand due to baby needs and alternate breasts throughout a feed to meet your own needs due to overproduction), alternate breasts at each feed, letting baby drink their fill on one breast and then do the same with the other breast at the next feed.
Don’t take every bit of advice on what you can and cannot eat – if you followed it all, you would starve to death. There are the obvious ones – alcohol, medication – that you should avoid because it is passed on to your baby through the milk; but if you continue to eat much as you have throughout your pregnancy, you and your baby should be fine – Everything in moderation. And don’t start dieting and trying to lose your pregnancy weight when you are breastfeeding! Breastfeeding should naturally help you to lose the weight fast, but you need to be very well nourished in order to provide your baby with everything they need.
And finally, don’t overthink it. One of the biggest culprits for struggling to breastfeed is stress. Try to take things as they come, be gentle with yourself, eat lots of food, drink LOTS of liquids, try to rest as much as you can when baby rests, get advice and support from the right sources and do the best you can.