Breastfeeding

 
Breast milk is perfectly designed to meet the baby's nutritional needs. Mother Nature has even been so thoughtful as to allow the composition of breast milk to change throughout infancy in order to better meet the shifting needs of the baby. For these reasons, breast feeding has long been the preferred and recommended means of infant nutrition. There are great benefits to breast feeding during the first 6 months of pregnancy for both the mother and the baby. The baby receives that vital nutrition that he requires to grow at such a rapid pace, and the mother is aided in maternal weight loss.

Nearly as soon as pregnancy begins, the mother's mammary glands begin to ready her breasts for the production of milk. By the 5th or 6th month of pregnancy, her breasts are ready to produce. Birth releases a hormone knows as prolactin which initiates the production of milk. By the fifth day after birth the mother's breasts will begin to feel 'full', lumpy and hard as the glands fill with milk.

Engorgement

Engorgement is a common occurrence in lactating women. When breast milk fills the breast too quickly, the mother's breasts can become so firm that it is difficult for the baby to grasp and suckle. The swelling - engorgement - also causes congestion in the breasts and milk flows at a slower rate meaning that even if the baby is able to suckle, his hunger will not be satisfied.

Engorgement should not frustrate or discourage the mother. The problem is easily solved by using either a breast pump or manual stimulation to expel excess milk. Breast pumps will be discussed later in this section. Manual release can be achieved by applying gentle pressure on the breast towards the nipple. The thumb and forefinger are then placed above and below the nipple respectively, and behind the areola. The breast is then gently squeezed forward by the fingers, expelling milk. Once the breast feels less full, the baby should be able to freely feed. During feeding, the mother can help by further massaging her breasts to aid the movement of milk. The mother can also help prevent engorgement by having lengthy nursing sessions with the baby which empty the breast. These sessions should last between 10-20 minutes on each breast, and should be done every 2-3 hours.

Breast Milk Composition

As previously mentioned, breast milk is designed specifically to meet the baby's complete nutritional needs and is easily digested. As was also mentioned earlier, the composition of breast milk changes as the baby ages in order to meet his new needs. The composition of milk even changes during feeding. At the beginning of feeding the milk is rich in protein, which aids in the baby's growth. As the baby feeds for longer periods, the composition of the milk becomes fattier, providing him with an easily digested energy source. The fact that breast milk is easily digested is important to remember. This means that the baby will be ready to feed again with in a number of hours of his last meal.

Breastfeeding will come naturally to some mothers and children, and others will struggle and require help to initiate the process. Some babies will take to the nipple immediately, and others will need to be encouraged and taught to suckle. In the first days or weeks after birth, many babies are very tired from the ordeal of labor. Their fatigue often means that they will need to be encouraged to breastfeed, rather than sleep. If the baby seems too tired to breastfeed, the mother can encourage eating by trying gentle techniques which arouse him. For instance, tickling the baby's feet, talking to him, removing some of the layers of clothes or blankets from him, and stroking his face all serve to alert the baby's senses, making him more likely to eat.

For many new mothers, finding a comfortable position in which to breastfeed is difficult. Comfort during breastfeeding is important because feeding sessions can be quite long. Maneuverability is also a concern; the mother will find breastfeeding more enjoyable if she is able to move while feeding without disturbing the process. There are a number of feeding positions that the mother can try:

- Cradle Position: The mother should begin by sitting up straight in her chair or bed. She may want to place a pillow behind her lower back for greater support. The mother should now cradle the baby in one arm, with his head resting in the bend of her elbow. The mother's forearm will support the baby's neck and her hand will be held under his buttocks. The mother should then turn the baby so that his stomach is against her stomach and he is facing her breast. With her free hand, the mother should support the breast that the baby is feeding from and gently apply pressure to aid the feeding process. If the baby is not taking the nipple, the mother should touch her nipple to the baby's mouth or cheek. If the baby is hungry, this should spur him to take the nipple. The baby's positioning on the mother's breast is correct if the mother has no pain when he suckles, and when the baby's nose and chin are both contacting the breast. Once the baby has begun feeding, the mother should be able to relax the arm that is supporting the baby without disrupting feeding.

- Cross-Cradle Position: This position is similar to the cradle position with one difference. Instead of holding the baby with the arm on the same said of her body that the baby is eating from, the mother will hold him with the opposite arm under his body, and her other hand under his head.

- Football Hold Position: In this position, the mother is to hold the baby at her side with one arm under him - much like the way a running back holds a football. The hand of the mother's supporting arm should be cradling the baby's head face up, level with her breast. The mother should use her free hand to stimulate feeding just as described in the cradle position. Mothers whom are recovering from a cesarean section find this position best because their child is not pressed against their stomachs. It is also used quite often by mothers of twins, because it is the only feasible way that they can be nursed at the same time.

- Lying Position: Many women chose to breastfeed while lying on their side because feeding sessions can be long. This position provides comfort as well as the opportunity for both mother and child to doze while feeding. The mother can feed this way by lying on her side and lying the baby on his side, facing the mother. The mother can now use the hand of the arm she is lying on to position the baby's head to her breast. The mother may find this position most comfortable if a pillow is used to prop up her head.

Taking the baby off the Breast

If the mother must take the baby off of her breast, either because feeding must stop for some reason or to switch the baby to the other breast, the mother should slip a finger between the baby's lips to break the suction. Pulling the baby off of the nipple while he is sucking will hurt.

How does Breastfeeding Feel?

It is not unusual to feel apprehension when beginning to breastfeed for the first time. It can be a slightly uncomfortable experience at first. When a hungry child first latches on firmly to a nipple, the suckling sensation will feel as though the nipple is being stretched - this is actually what is happening. This pain is not something that cannot be overcome. With time the pain will diminish, and eventually disappear. It should be said that not all women experience pain when breastfeeding. Many find it as relaxing as the baby does.

The baby's Feeding Style

Babies are all different, as has been said before. Their feeding styles are not an exception to this rule. Many babies are fast, thorough eaters, while others are slower and take a more grazing-like approach. Whatever the baby's feeding temperament is, the mother's approach to feeding must be tailored to his preferences and style. Essentially, the feeding styles of babies can be categorized into three groups:

1. Passive Eater: This baby may not eat enough when feeding, choosing to end feeding before enough milk has been consumed. Usually this type of eater dozes off while feeding and does not finish. He may also sleep through daytime feedings. If the baby falls into this category of eaters, the mother can take a number of steps to help the process along. Encouragement and commitment on the mother's part is necessary. She may need to wake the baby up regularly to feed him and keep him awake while feeding. Typically this type of feeding style subsides in the first month or two after birth and more regular feeding patterns will emerge.

2. Average Eater: This type of eater typically does not have any trouble awakening to eat or finishing feeding sessions. The average eater is not completely problem-free, however. He still may fall asleep while eating and it may be difficult to tell if he is crying due to hunger or something else.

3. Active Eater: Active eaters are quite aggressive when it comes to feeding time. They may be quite anxious to feed and will show this by bawling loudly when hungry. When they are fed, active eaters will be gluttonous - gulping milk as fast as possible and often taking in air as well as milk. Active eaters have a tendency to overeat and then spit up. These babies may be more temperamental and seem more irritable when they have not eaten. Active babies can be handled by feeding them regularly and ensuring that they are burped thoroughly after feeding.

Frequency of Feedings

Infants need to be fed often and regularly. Breastfeeding gratifies the baby's need for nourishment as well as his desire to suckle. Regular feedings also boost the mother's supply of breast milk by increasing production.

The common conception that infants should be fed every 2-4 hours of the day is deceiving. It must be reiterated that all infants are unique and as such will have unique feeding schedules and feeding demands. The baby may want to eat more frequently than every 2-4 hours, or he may want to eat less often. Really the best feeding schedule is to allow the baby to eat whenever he feels like it. He may eat more often but eat less at each feeding; or he may eat less frequently but eat large amounts at each feeding. This may mean that the mother has to feed the baby 12 or more times a day, or perhaps, as few as 6 times.

As well, the mother should not be surprised if every so often, the baby diverges from his regular feeding routine. The baby will experience growth spurts every so often, meaning that his need for nutrients increases. During these spurts it is likely that the baby's feedings will increase in terms of both frequency and duration. It will seem like the baby cannot get enough milk. The increased feedings should only last 1-3 days.

Is the baby Getting Enough Milk?

It would not be unusual for the mother to be concerned that the baby is not receiving enough to eat when breastfeeding. Many mothers worry about their child's nutrition, and whether they are taking in adequate nourishment. There are numerous signs that the mother can watch for that will signal to the mother that the baby is receiving enough milk. One sign that the baby has eaten well is the state of the mother's breast before and after eating. If prior to eating, the mother's breast feels firm and full, and after eating it is not, the baby has eaten well. The mother will also be able to see and hear the baby swallowing milk while he feeds. Typically, the baby will turn away from the mother's breast when he has had enough to eat.

Weight gain is also a telltale sign that the baby is getting enough to eat. Most babies initially lose weight after birth, but regain it after 1-2 weeks. If the mother's instincts are telling the mother that the baby is not eating enough, and is malnourished, she should trust those instincts and see a physician. Some babies will need special attention and encouragement when it comes to eating.

A final way in which to ensure that the baby is receiving adequate nourishment is by examining his stool and urine patterns. Typically, infants urinate 6-8 times per day and will have two or more bowel movements. If the baby is under or over these guidelines, the mother should seek medical advice on the situation.

The mother's Needs during Breastfeeding

It should now be clear just how important breastfeeding is to the growth and development of infants. For this reason, it is crucial that the mother takes adequate steps to ensure that she is producing enough, high-quality breast milk. There are a number of steps that the mother can take to remain healthy, allowing for the production of a good supply of milk.

- Nursing Bra: Nursing bras are vital because they provide much needed support for milk filled breasts. Adequate support will help prevent milk leakage and back aches.

- Nutrition: The mother's nutrition while breastfeeding does not need to differ from any other time as long as she is eating a healthy and well balanced diet. Eating regular meals that contains all food groups is crucial. The mother should also pay special attention to ensuring that she consumes enough fluids - eight to 12 glasses of water a day.

- Sleep and Rest: Rest and enough sleep are essential to being healthy and producing enough milk. Being rested will make the mother more energetic, eat better, and enjoy the baby more. Sleep and rest promote the production of breast milk by augmenting the production of breast milk producing hormones. The mother can even use the time that she is feeding the baby in order to rest. Feeding can have a tranquil effect; she should not be afraid to use this time to her advantage.

Introducing Breast Milk in Bottle Form

Once the mother has established a healthy milk supply and a regular feeding schedule for the baby, she may decide that occasionally using a bottle to feed is alright. The use of a bottle to feed will not interfere with the mother's supply of milk, or her production. When a bottle is used to feed, the mother should provide a full bottle and allow the baby to eat as much as he wants. Just as with breast feeding, the baby will stop eating when he has had enough. If he stops, it may be because he needs to be burped. The mother should thus offer the bottle once or twice after the baby has stopped eating to ensure that he is in fact full. Feeding from a bottle is much easier for the baby. Thus, when he returns to breastfeeding, he may be lazy and have slight trouble getting milk from the mother's breasts.

Breast Pumps

If a mother wants to or must occasionally bottle feed, but does not yet want to introduce formula, a breast pump can be used to extract milk and feed it via bottle. Milk is pumped, collected and stored for feeding at a later time. Breast pumps will also allow the mother to keep her production of breast milk going if there is a period in which the baby cannot breastfeed for whatever reason. Breast milk should however, not be used if it has sat for more than six hours at room temperature, been refrigerated for more than five days, or been frozen in a freezer for over two weeks.

To ensure that breast milk is properly and safely collected and stored, there are a number of steps that the mother must take:

- the mother must wash her hands before pumping

- Avoid nipple lubricants or creams; there is no need to wash breasts and nipples prior to pumping

- Pump milk directly into bottles

- Label each bottle according to date and time

- Do not combine milk from different pumping sessions into one bottle

- After each use, wash each part of the apparatus in hot, soapy water. Avoid using a dishwasher

- If possible, the mother should refrigerate freshly pumped breast milk immediately

- If pumped milk is not going to be used in 48 hours, freeze it

Final Breastfeeding Guidelines and Tips

- the mother should follow the baby's feeding cues carefully

- the mother should feed the baby quickly in response to his cues

- the mother should talk to and smile at the baby during feedings

- Do not rush the baby during feedings; he will prefer a relaxed manner of feeding

- the baby will take natural pauses during feeding. the mother should anticipate and allow for such pauses

- the mother should allow the baby to set the pace and amount of feeding

- the mother should hold the baby securely to reassure him

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