There are multiple queries arise in mother’s mind about breastfeeding of the baby. Here are the answer to few such queries.
WHEN TO START BREAST FEEDING?
The baby must be put to the breast within half an hour after normal delivery or within four hours after cesarean sections. In the first 2-4 days, a small quantity (10-40ml) of colostrum (yellow milk), that is secreted is all that the baby needs. Colostrum is rich in protein immunoglobulins, protect babies from many diseases. The mother and baby should be relaxed and comfortably postured during breastfeeding. Rooming-in (keeping baby in mother’s room), Bedding-in (keeping baby in mother’s bed), Mothering-in (keeping baby with mother) should be practiced. These measures ensure mother-infant bonding.
WHAT IS EXCLUSIVE BREASTFEEDING?
Exclusive breastfeeding means giving breast milk only, and nothing else (no other milk, foods or liquids, not even sips of water), except for medicines prescribed by a doctor or nurse. Breast milk provides all the food and water that your baby needs during the first 6 months of life. Feeding your baby both breast milk and other foods or liquids, including infant formula, animal milk, or water (called ‘mixed feeding’) before 6 months reduces the amount of milk that you produce and can make your baby sick.
CAN I GIVE MILK SUBSTITUTE OR COW MILK TO BABY?
Breast milk substitute or cow milk (Top feed) should be avoided unless medically indicated. There are lots of benefits associated with breast milk. (Refer to advantages of breast milk). No breast milk substitute can match the physical composition, quality, and benefits of breast milk. Top feed lack the nutritional, immunological, neurological, psychological benefits of breast milk. Mixed feed (intermittent top feed with breastfeeding) or pure top feeding make the baby prone to infection, diarrhea, constipation, feed intolerance, and allergic illness. Top feed will decrease the stimulus for breast milk production.
CAN I GIVE BOTTLE FEED? WHY NOT?
Bottle nipple is soft, will provide easy milk to baby, while breast milk is difficult to suckle. Hence bottle feed leads to nipple confusion for the baby. It can lead to denial to feed on the breast by the baby. Sucking from the breast helps in milk production. Bottle feeding will lead to decreased production of milk from the breast. The bottle is a source of infection, which can lead to gastrointestinal infections like diarrhoea.
HOW OFTEN TO BREASTFEED?
There is no fixed schedule. Breastfeeding should be given on demand, at least 8-10 times per day.
If not getting awake after 3 – 3.5 hr, should be awakened for breastfeeding by rubbing or tapping on the sole. (Especially in the first months of life).
HOW LONG SHOULD I BREASTFEED MY BABY EACH TIME?
Breastfeeding should be continued as long as the baby desire to suck (until the baby finishes the breast and comes off on his or her own). During the newborn period, most breastfeeding sessions take 20 to 45 minutes. Offer the other breast and let your baby decide if he or she wants more or not. Withdrawing the baby from the breast before the baby releases it on his/her own, can leads to a sore nipple or crack nipple. Allowing baby to suckle till he/she desire will satisfy the sucking instinct of baby and will express hindmilk which is more nutritious.
Foremilk – Milk is expressed in the initial part of breastfeeding. It satisfies the thirst of the baby.
Hind milk – Milk expressed in the late part of breastfeeding. It fulfills the nutritional requirement of the baby. Also, its expression provides a stimulus for more milk production.
It is preferable to suckle the baby on both breasts. If had twin babies, feed on each side should be provided. If not adequate can give top feed. (Avoid cow milk).
HOW TO KNOW THAT BABY NEEDS FEED OR BABY IS HUNGRY?
A hungry baby will :
- Puts hands or things to mouth.
- Turns head towards mom’s breast or bottle.
- Make sucking noises or emotion.
- Puckers, smacks, or licks lips.
- Has clenched hands.
- Flex arms and legs.
IN WHAT POSITION SHOULD I BREAD FEED THE BABY? CAN I FEED IN LYING DOWN POSITION?
Feeding should be done preferably in the sitting position of the mother in full consciousness. Most of the time mother remains tired in the first few months of giving birth due to feeding, burping, and cleaning the baby after motion and urination. There fair chances of the mother getting asleep while feeding in a lying-down position. If the mother gets asleep while feeding and the baby did burp in a lying-down position, there is an increased chance of aspiration of milk in the lung. Also, the mother’s body or breast can lead to obstruction of the airway of the baby, if the mother got asleep while feeding. Both situations can cause a risk to the life of the baby. Hence it is advisable to avoid lying down position by mother while breastfeeding.
WHY PROPER ATTACHMENT OR LATCHING IS IMPORTANT? HOW TO LATCH THE BABY ON BREAST?
Good attachment or latching helps the baby to get an adequate amount of breast milk. It helps in the production of breast milk by ensuring proper suckling of the breast by the baby. It also helps to prevent breastfeeding related issues like sore or cracked nipples, and breast engorgement.
Steps to make sure your baby is attached or latched well:
- Sit in a comfortable position.
- The Baby’s body should be straight and turn towards the breast.
- Touch baby’s lips with your nipple.
- Wait until your baby’s mouth opens wide.
- Support breast from below.
- Quickly bring onto your breast from below, aiming your nipple up towards the roof of the baby’s mouth.
- The baby should take a big mouthful of breast.
The 4 signs of good attachment are:
- Baby’s mouth is wide open.
- You can see more of the darker skin (areola) above the baby’s mouth than below.
- Baby’s lower lip is turned outwards.
- Baby’s chin is touching your breast.
Other features of good attachment
- No pain while breastfeeding
- Baby’s cheeks are full, not hollow.
- Baby should do regular, slow, deep sucks.
HOW TO DO BURPING AFTER BREASTFEEDING?
Put on the left shoulder, head supported with the left hand, right arm support buttocks, with right hand gently pat on baby’s back. The baby should be kept in a burping position for 10-15 mins.
POSITION THE BABY AFTER BREASTFEED?
The baby can be kept in the right lateral position to prevent aspiration.
WHETHER BREAST MILK IS ADEQUATE OR NOT?
- Baby should pass 8-10 times of pale-colored urine.
- Should passing 1-6 liquid stools per day.
- Should sleep for 1.5 to 2 hr most of the post-feeding time. (Most of the babies remain awake in night hours for the first few months of life and demand the mother’s attention).
- Should gain weight. (Baby loses 10 % weight in the first few days of life. Regain the birth weight by around 10 days).
HOW TO PREVENT COMMON BREASTFEEDING DIFFICULTIES?
- Position and attach your baby correctly on the breast.
- If you develop cracked nipples, put some breast milk on them. Do not use any types of creams or ointments except when prescribed by a health care provider.
- Feed frequently to prevent your breasts from becoming swollen.
- If the baby misses a feed you should express some milk to keep your breasts soft.
- Keep expressed breast milk in a cool place, but not for longer than 6 to 8 hours. (For details refer to Breast milk storage guidelines.) Link.
- If one or both of your breasts become painful or hot to the touch, see a health care provider.
- Mixed feeding (combining breast milk with anything else) is not healthy for your baby before 6 months of age. Mixed feeding reduces the amount of milk that you produce and can make your baby sick.
- If you have trouble practicing exclusive breastfeeding, discuss your situation with a trained counselor.
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