Obstacles to Exclusively Breastfeeding and ways to overcome them
“I want to breastfeed, but since I am going to work, I need to be able to formula feed, too.”
Attend a prenatal breastfeeding class (deserves equal time to birthing class education)
Get more information about milk expression and get a breast pump.
Consider a longer maternity leave, if possible.
Prepare to simplify life during the transition to parenting.
“My husband/partner and other family members will want to help feed the baby. Won’t they feel excluded if I only breastfeed?”
Fathers/partners can interact with their newborn by holding the baby skin to skin or taking the baby out while mom sleeps.
After breastfeeding is well established, others can feed the baby expressed milk by bottle
“I want to do combination feeding, or las dos cosas.”
It is important to frequent and exclusively breastfeeding during the early postpartum weeks for establishing mother's milk supply.
If eligible, enrollment in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) offers breastfeeding mothers a substantial food package, counseling, breast pumps, and peer counselors
“The yellow milk does not look like much. A little formula won't hurt, will it?”
The initial colostrum is potent and enough and there will be a rapid increase in milk production between 36 to 96 h.
“My friend says it is a good idea to ask the nurses to care for my baby at night so I can get some sleep.”
Advise a continuous rooming-in, where the mother can practice being with her baby in a controlled setting and learn to latch baby comfortably and effectively which allow the mother to learn to interpret her newborn’s feeding cues and breastfeed as often as baby wants; advocate for no routine formula use in the system of care.
“Now that we are home from the hospital, the baby seems to be feeding every hour. She or he doesn’t seem satisfied with breast milk alone.”
8–12 feedings in 24 h are typical and necessary to establish an abundant milk supply.
Newborns typically begin feeding more frequently the second night after birth, when the baby is at home.
Use a hand-pump or hand expression, so you can see that there is milk.
Once the breast milk comes in, the newborn elimination patterns (3–5 voids and 3–4 stools per day by 3–5 d; onset of yellow, seedy milk stools by 4–5 d) assure enough intake.
Try to distinguish between newborn “flutter sucking” or “nibbling” that results in only a trickle of milk at the breast versus “drinking” milk, with active sucking and regular swallowing.
“My nipples are sore and cracked. Can I take a break and give my baby a little formula?”
Sore nipples are usually attributable to incorrect latch-on technique and are a common reason that mothers discontinue breastfeeding early or start supplements.
To evaluate latch; consider a lactation consultant for one-on-one assistance with latch.
Proper Positioning and Latch link
“My baby is 2 weeks old, my breasts do not feel very full anymore. I’m afraid my milk went away.”
Although the mother’s breasts are less swollen than during postpartum engorgement, they should feel fuller before feedings and softer afterward which does not mean they have insufficient milk supply.
“My baby is one month old, is crying a lot, and I am tired and need sleep.”
Normal infant crying peaks at about 6 wk (3−5 h in 24 h)
If infant has gained weight appropriately, that is reassuring of the adequacy of your milk supply.
Use coping strategies for infant crying, including holding the baby skin to skin; the 5 S’sa ( swaddling, side lying, swaying, shushing, and sucking ). (however, swaddle with the baby’s hands up near the head to help assess feeding cues); use of an infant carrier; going for a stroller or car ride.
“Nothing seems to calm her/him except the bottle.”
If the infant drinks milk from a bottle that is offered,you may assume that your infant is not satisfied by breastfeeding.
Fact is, that sucking is reflexive, and drinking from an offered bottle doesn’t always mean that the baby is hungry; baby “can’t scream and suck at the same time,” so the bottle may appear to calm baby, just as a pacifier might
If you like to offer a bottle, use expressed milk as the supplement
Be aware of cluster feedings (late afternoon/evening) and upcoming appetite spurts, occurring at about 6 wk and 3 mo.
“I am going back to work and am worried that I do not have enough frozen stores of milk. Are there any herbs I can take to keep my milk supply strong?”
There is no harm in trying Fenugreek or Blessed thistle, they are not “magic pill” to increase the mother’s milk supply; the key to ongoing milk production is frequent, effective milk removal
(every 3−4 h) and avoid going long intervals without draining the breasts.
“My 4 months old baby seems to only eat for a few minutes, and when I try to put her/him back to the breast, she or he refuses.”
Explain that infants become more efficient at breastfeeding, and by 3 mo, they may drain the breast in 4–7 min.
“My 4 months old baby seems more interested in everything around him or her than in nursing at the breast.”
Distractibility is a normal developmental behavior at this age and that short, efficient feedings are common.
Nurse in a quiet, darkened room.
“My 6 months old baby is drooling and rubbing on her or his gums all the time. I do not think that I can continue to breastfeed because my baby might bite me.”
Infants cannot bite and actively breastfeed at the same time. Biting tends to occur if the breast is offered when the infant is not interested or at the end of the feeding.
If the infant bites, say “No biting,” touch the infant’s lips, set the baby down, and briefly leave the room
“My 6 months old baby has refused to breastfeed for almost a whole day now. Is she or he ready to wean?”
Some babies may suddenly refuse the breast between 4 and 7 mo of age for no apparent reason; common causes include upper respiratory infection, ear infection, teething, regular exposure to bottle-feeding, use of a new soap/perfume, maternal stress, or a decrease in milk supply.
Because many babies will nurse while asleep, try offering the breast when the baby is drowsy or asleep.
Regularly express milk if the baby won’t nurse, and feed the pumped milk until the infant resumes breastfeeding.
Benefits and Rewards of Breastfeeding
Breast milk is easier to digest for babies.
The cells, hormones, and antibodies in breast milk protect babies from illness such as Asthma, eczyma,
Type 2 diabetes, respiratory infections and Obesity (reduced risk for becoming obese later in infancy and during childhood).
Reduce the risk of Sudden Infant Death Syndrome "SIDS".
Breast milk provides the substances the baby's brain needs to develop and mature.
Makes your life easier with no bottles, sterilizing nipples, or buying, measuring, mixing and warming formula.
Breastfeeding can save you money .
The physical contact and bonding benefits both the mother and the newborn.
Breastfeeding reduces the mother’s chance of Type 2 diabetes, breast cancer, ovarian cancer, and postpartum depression .
Mothers who breastfeed lose their pregnancy weight faster than women who do not breastfeed
and their uterus and birthing canal recover way faster.
So... We can easily say " BreastMilk is BestMilk! "
Link for more on Benefits of Breastfeeding
How do you breast-feed?
Get ready for a feeding
Being ready for a feeding will help you relax. And being relaxed will help your let-down reflex, which occurs just before or soon after feeding begins. It's helpful to wear a loose blouse or a shirt that can be raised easily. If you want more privacy, use a lightweight blanket over your shoulder and chest to cover your breasts and your baby.
It is likely that you will have to breast-feed around other people, even strangers, when you are feeding your baby on demand. In many states and on federal property, your right to breast-feed in public is protected by law.
To get ready, you can also do things like:
Make sure the room is quiet and warm. Keep the room darkened. Bright light makes it hard for newborns to open their eyes.
Keep something to drink nearby. Most women get thirsty as they breast-feed. Drink enough to satisfy your thirst.
Use one or more pillows to support your arms and the baby. Support your back with a pillow, and use a stool to raise your feet. This will help you and your baby be more comfortable during feeding.
Make sure your baby is alert. This will help you get your baby to latch on. You may need to wake your baby.
Find a position
Breast-feeding in the proper position will help your baby latch on and breast-feed correctly. There are several breast-feeding positions, such as the cradle hold, the football hold, and the side-lying position.
As you start to breast-feed, try different positions to find those that are most comfortable for you and your baby. For example, use the cross-cradle hold at one feeding, and then use the football hold at the next. Feeding in different positions may reduce nipple soreness. Also, start each new feeding with the opposite breast you started with at the last feeding. This routine helps you to empty each breast completely.
Proper Positioning and Latch link
Get your baby latched on
A proper latch helps prevent problems such as sore nipples, blocked milk ducts, breast infections, and poor infant weight gain. An improper latch is painful and frustrating. It causes some women to stop breast-feeding.
The steps to get your baby latched on [lick here to see an illustration.] are about the same for all breast-feeding positions. Latching on in the cross-cradle position is an easy one to start with.
Make sure the baby's head and body are lined up straight, not turned to one side or tilted up or down while breast-feeding. For this position, you and your baby should be tummy to tummy. Your baby's nose should be right in front of your nipple.
Support and narrow your breast with one hand using a "U hold," with your thumb on the outer side of your breast and your fingers on the inner side. You can also use a "C hold," with all your fingers below the nipple and your thumb above it. Try the different holds to get the deepest latch for whichever breast-feeding position you use. Your other arm is behind your baby's back, with your hand supporting the base of the baby's head. Position your fingers and thumb to point toward your baby's ears.
You can touch your baby's lower lip with your nipple to get your baby to open his or her mouth. Wait until your baby opens up really wide, like a big yawn. Then be sure to bring the baby quickly to your breast—not your breast to the baby. As you bring your baby toward your breast, use your other hand to support the breast and guide it into his or her mouth.
Both the nipple and a large portion of the darker area around the nipple (areola) should be in the baby's mouth. The baby's lips should be flared outward, not folded in (inverted).
Listen for a regular sucking and swallowing pattern while the baby is feeding. If you cannot see or hear a swallowing pattern, watch the baby's ears, which will wiggle slightly when the baby swallows. If the baby's nose appears to be blocked by your breast, tilt the baby's head back slightly, so just the edge of one nostril is clear for breathing.
When your baby is latched, you can usually remove your hand from supporting your breast and bring it under your baby to cradle him or her. Now just relax and breast-feed your baby.
When your baby is done breast-feeding, you can break the latch by using your pinky finger. Place one finger into the corner of your baby's mouth. This will gently break the seal. You can also use your pinky to break the latch if you experience pain after your baby first latches on. Then you can start again. If you don't break the latch before you remove the baby from your breast, your nipples may become sore, cracked, or bruised.
Provide a complete feeding
Let your baby feed until he or she is satisfied.
Offer the other breast when the first breast feels empty and your baby sucks more slowly, pulls off, or loses interest. Usually your baby will continue breast-feeding but for less time than on the first breast.
To burp your baby, gently pat your baby's back to help him or her let out any swallowed air. After the baby burps, offer the breast again. Sometimes a baby will want to continue feeding after being burped.
If your baby falls asleep before finishing breast-feeding, you may need to stimulate him or her to finish the feeding. After a while, you will learn your baby's patterns and will know whether he or she needs rousing or has fed long enough.
Signs That Your Baby Is Getting Enough Breast Milk
Shows an eager desire and wakes up frequently to breast-feed.
Rhythmically sucks and swallows milk. The fronts of your baby's ears will move slightly, and you usually will hear swallows.
Breast-feeds at least 15 to 20 minutes on each breast at each feeding and is content when finished.
Feeds at least every 1 to 3 hours during the first 2 months. Wake your newborn every 2 to 3 hours for a feeding during the first few weeks, if needed. After 2 months, your baby will be able to empty the breast more quickly. Feedings will then occur less often and take less time.
Has regular dirty and wet diapers.
During the first few days of life, breast-fed newborns have about 3 wet diapers a day. After that, they have 6 or more wet diapers a day throughout the first month of life. The number of diapers a baby wets is sometimes hard to know, because disposable diapers work so well at wicking moisture.
Breast-fed babies usually have a small stool after every feeding for about the first 4 to 8 weeks. By the end of the first week, your baby may have as many as 5 to 10 stools a day. This number may go down as your baby eats more and matures during that first month. By 6 weeks of age, your baby may not have a bowel movement every day. This usually is not a problem, as long as the baby seems comfortable and is healthy and growing and as long as the stools are not hard.
Grows at a normal rate as judged by regular increases in weight, length, and head size. Your baby should appear healthy and happy with good muscle tone, healthy skin, and good color.
Most mothers become more confident that their babies are eating well after a few weeks of breast-feeding. It usually takes some time to establish a routine. You will learn to recognize and respond to your baby's feeding signals.
Dietary changes for mother and infant
Drink plenty of fluids, some sources may recommend a glass of water every time you breast feed
Continue taking a prenatal vitamin throughout the duration you breastfeed .
Newborns that are breastfed need an additional supplement of vitamin D .
Credits to : Noel Kutchey, CNA Mohammad AL Harastani, MD
Link for more information about Breastfeeding
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