Having successfully breastfed 2 children and having learnt more about the reasons people struggle to breastfeed I thought about some tips and pointers for women who want to use natural medicine principals as a guide. So if you do end up having problems, you can solve these with your midwife, Plunket and us alongside, to find solutions before your baby ends up dehydrated and hungry and before you end up having a love hate relationship with this beautiful and simple process.
Our little babies have in them an instinct to survive. Millions of years of mammalian evolution has led to feeding our young milk as a form of survival and babies begin practicing to suckle in the womb! The current recommendations are to place the baby on the breast within half an hour after birth if you can. However cesarean birth and the epidural have been shown to interfere with the establishment of breastfeeding and lower rates of successful breastfeeding at 6 weeks post-partum (1). So whether you end up having a vaginal birth or a cesarean birth and you plan to successfully breastfeed – make sure you and your midwife have the understanding that you want baby placed on your chest as soon as possible to allow baby to start feeding soon after birth, and be sure to seek out extra support.
Colostrum is the first stage of milk that comes through – often it is there at the end of pregnancy. It is rich in easily digestible sugars for baby’s immediate energy needs and it has special immune enhancing antibodies to start building baby’s immune system straight away. It may not appear as though they get much in the first day or two but feeding as often as possible is crucial so that baby can practice his latch and get these important sugars into them over the next few days. This also opens up the milk ducts and lets your body know how much milk to produce. The size of your breasts doesn’t matter – small or large breasts can both create the right amount of milk, it’s simply the amount you feed that determines the quantity of milk you make.
On day 2 and 3 your milk will arrive with a bang. It builds over the second day and by the third night your breasts are fully engorged, even shortly after a feed. Using your stretch mark oil on your breasts at this time is a good idea too. It seems that you will be like this forever but the best thing to do is feed as often as needed in order to empty them and make it comfortable. Those first few days are the time when expressing some off to make it more comfortable can do wonders for your sleep those first few nights. Initially your body just makes it all the time – which is great because baby needs to get his weight up after the first few days, but in another few days it will settle and they won’t be so engorged as the brain learns to down regulate in order to maintain a steady supply to your baby. Nature knows best by making up for this initial weight loss with a catch up session before settling down to a routine and eventually your breasts will feel as though they are empty most of the time, only filling up when baby feeds.
In the first few days and weeks it is very important to have a good nipple balm on hand. After every feed use the balm to prevent sore and cracked nipples. If it’s your first time feeding your nipples will need to harden up – baby’s suckle is quite strong and they need to desensitize (don’t worry they will re-sensitize after you finish feeding!). Initially for the first time feeder they can be sore for up to a week, and then this should subside. If it doesn’t, and you’re using a nipple balm, talk to your midwife as this can be a sign that baby’s latch isn’t quite right. Your midwife should be your first port of call for breastfeeding advice. They should be showing you how to hold baby, how to create a latch and don’t be afraid to ask for advice, especially if your milk didn’t arrive with a bang.
On day 3 when your milk comes in, feeding follows a ‘let down’ pattern – baby suckles, after a minute the milk starts to flow, the pressure is high at first (like a hose that you have your finger over), then as baby takes the milk the pressure reduces and after 10-15 minutes the breast is empty and baby may comfort suckle or take himself off. It does take a few weeks to get used to things – how best to hold baby, how to feed lying down, how to tilt baby’s head so she can suckle easily. If you find you have plenty of milk and baby is struggling, it is ok to take the pressure off with a breast pump just before you feed baby. If you still create a lot of milk as you continue to breastfeed, you may find that baby spills some after every feed – it can be a mistake to think this is reflux – it may simply be that you produce a lot of milk and baby’s stomach just can’t hold it all, called posseting. So keep siphoning some off as you go if you need to and donate milk to a local milk bank near you. Signs of reflux include baby showing signs of discomfort while spilling up milk.
If you find that your supply is actually reducing – baby isn’t putting on weight – come in and ask for our Spilt Milk tea – it is a natural galactogogue which means the herbs in it help to increase the production of milk. Remember the biggest factor when not producing enough milk is stress and anxiety so set up a routine where you grab a book and a cup of tea and enjoy the process, or simply watch baby an admire them from this special angle.
If baby gets trapped gas and is ‘colicky’ try our Happy Baby Happy Mum tea. It works wonders for baby’s tummy as it goes through the milk.
Nutrition advice – Eating well for breastfeeding requires good nutrition on your part – everything goes through the milk to a certain extent. B vitamins are extremely important so eating foods such as brewers yeast, rolled oats and molasses are good old fashioned milk tonics, and I continue to take my pre-natal multivitamin. You may feel like you are attracted to more carbohydrate laden foods, and just more food in general! Most of breastmilk is energy (40-50% fat, 40-50% carb and 5-10% protein) so its nearly 100% pure energy going though you and into baby. That’s why we feel the need to eat slightly more. In regard to fats – the fats you eat on the day are going to go through your milk so be careful not to eat fried fats and stick to your natural fats instead such as nuts, seeds avocado and animal fats and a source of omega 3 such as sardines, salmon and flaxseed oil for baby’s brain development.
In terms of fluid your body will give you the thirst signal if you aren’t keeping up but they say an extra 1 litre of water on top of your own requirements is what you need, so be sure to keep up with demand.
Did you know that the breast has its own set of bacteria living in there? These go through to baby when you feed and help establish his own gut microbiome. If you think about it, the nipples act as an entrance to the body as well as an exit for tiny bacteria so be careful where you swim and what you expose your breasts to when you are breastfeeding as these portals are more open than normal. We have reason to believe that bacteria can make their way in as well as out when feeding and this means taking probiotics has a special role to play in preventing and treating breast problems and helping to keep the breasts healthy for baby and you during feeding.
Breastfeeding can be so enjoyable and once you have the hang of it is is super easy and very relaxing and enjoyable for both you and baby – and in the end it’s only a short time that they completely rely on you for support, its free to do, and doesn’t require any work on your part except to relax and enjoy it – so good luck and remember to seek help if it is not seeming easy for you – there may be a mechanical/medical reason that needs attending to or that you need to work out how to get around.
This blog does not replace expert advice but lets you know what to expect. If breastfeeding isn’t working for you then you need to find help fast or your baby won’t be getting the fluid and food she needs. One sign is that your baby won’t settle and relax after a feed. Seek out a local lactation consultant or La Leche League – a women’s breastfeeding support group which is free. Ask your midwife or Plunket nurse for urgent advice and don’t fret if you need to use a bottle to supplement. Just offer the breast first and the bottle after baby has suckled for 10 minutes on each side. You can build up your supply again so long as baby suckles (or you pump) regularly.
Remember we can help with most breastfeeding, post-partum & baby issues. Mastitis is easily solved if treated early – so at the first sensation of a bruised breast – come in and talk to us and we can help fix it without antibiotics. We prefer to have these as a last option, not a first. For information on our Pregnancy Wellbeing Clinic click here