At a Glance:

Breastfeeding may seem to be a very simple and natural approach to give your baby all the nutrition. But then there may arise a few situations when you are clueless or feel less confident. With this article, we try to reduce all the breastfeeding issues a new parent may have.

Basics of breastfeeding for the new mom

The American Academy of Paediatrics (AAP), recommends breast milk as the best nutrition for infants, exclusively for the first 6 months. Formula feeding is the next best option for nourishing your baby.

Breast milk includes all the nutrients that a newborn needs. It is loaded with the calories in the form of carbohydrates, fat and protein, along with cholesterol, calcium, sodium, phosphorus, vitamin C, magnesium and iron.

Colostrum, the first-formed milk is thin and is low in fat and carbohydrates. Colostrum is yellow due to rich (10 times more than is found in mature milk) and essential beta-carotene. It also contains elevated levels of vitamin E and zinc. Thus, it is essential to breastfeeding the newborn as immediately as possible after birth.

During each breastfeeding session, the composition of milk varies from the beginning till end. The initial portion is usually thin which is helpful in quenching the thirst of the baby. The hind milk that the baby receives at the end is actually richer in fat and other nutrients. So, it is important to allow the baby to feed enough before shifting to the other breast (premature breast-switching).

The quality of breast milk may be further enhanced by following proper breastfeeding and diet habits. Here are a few tips for the new mothers:

• Taking prescribed prenatal vitamins
• Avoid skimping on protein
• Limiting saturated fats
• Increasing DHA intake
• Breastfeeding on demand
• Letting your baby take his or her time at each breast, avoid premature breast-switching.

Breastfeeding problems: Breastfeeding can be a happy yet stressful experience for the new mother. Although breastfeeding is beneficial for both the mother and child, there are several challenges such as

1. Any problem in expressing and storing the milk
2. Oversupply or low supply of milk
3. Breast engorgement (expansion and pressure exerted by the synthesis and storage of breast milk)
4. Sore, tender or sensitive nipples
5. Mastitis, inflammation of the mammary gland due to infections via a damaged nipple.
6. Pain during breastfeeding. If the pain does not subside in a few seconds, it is not normal and you must seek help.

It is important to consult your gynecologist/obstetrician if the pain that persists or worsens, infections and related fever.

1. Breastfeeding vs. formula feeding:

Benefits and advantages of breastfeeding for the baby:

• Natural protection: The natural antibodies will ensure that your baby is well protected against infections such as conjunctivitis (eye infection), ear infections, etc.
• Easy digestion: Breast milk is easy to digest and thus reduces the chances of constipation and gas.
• Better infant health and growth: The baby is at reduced risk for sudden infant death syndrome, in the first year from birth.
• Better health prospects as an adult: Breastfed babies are at reduced risk of developing asthma, diabetes, obesity, etc.

Benefits and advantages of breastfeeding for the mother:

• Reduced risk of breast cancer & ovarian cancer
• Reduced risk of bone diseases such as osteoporosis
• Reduced risk of heart diseases
• Reduced risk of diabetes
• Faster burning of extra calories
• Reduced uterine bleeding after birth
• Faster reduction of the uterus to pre-pregnancy size

Benefits and advantages of formula feeding:

• Flexibility and convenience
• Bonding experience for both mom and dad
• Easy to schedule the feeding
• Mother’s diet does not affect the baby’s nourishment and growth

Although breastfeeding and formula feeding have their respective pros and cons, doctors encourage the new parent to try breastfeeding for it has better health prospects for the infant. While making a choice between breastfeeding and formula feeding, it is important to make sure that the baby is well nourished and well cared-for.

2. Types of breastfeeding positions

Breastfeeding is all about proper position and perfect latching. Here are a few breastfeeding positions you can try:

• Cradle-hold: This position offers deeper latching for the baby while you are comfortably seated on the feeding chair. Hold the baby as close as possible to you while he lays sideways belly facing your chest and head on top of the same arm as the breast you are feeding him with.
• Cross-cradle hold: This position is similar to the cradle-hold and is best used for premature babies and small babies who need support for latching. Use the hand on the side of the breast being used to feed the baby, while supporting his neck and support him latch well with the palm of the other hand.
• Football-hold: This position works well for mothers with larger breasts or C-section mothers. Use your palm to support the baby on his neck and nestle the baby close to your body.
• Side-lying position: Both you and your baby can lay on the bed sideways facing each other. This breastfeeding position is a favorite of the many mommies for the night time feeding, while both mom and child can co-sleep.
• Back-lying position: This is a position that is comfortable for both you and your baby. While you lay on the bed, put your baby on top of yours, so the baby’s head is upright and milk moves against gravity, helping slow the flow.

3. Pumping breast milk

Even if you are breastfeeding, due to many reasons you may want to pump the breast milk for your baby. Breast pumping really helps when you are not around (working mommy), the baby is not able to latch or feed directly from the breast, you don’t want to feed directly or you want to increase your milk supply, you are suffering from mastitis and need to alleviate pressure or need to drain your breast to help healing, etc.

Using a quality breastfeeding pump is necessary for successful breast pumping. Read the instructions carefully before using it. Talk to your breastfeeding consultant to help you with further guidance. Wash your hands with soap and water. Bring a snack and a drink before you sit and begin pumping.

When is the best time to pump breast milk?

• Morning is the best time as most mothers get the most milk first thing in the morning.
• Pump between breastfeeding, or 30 to 60 minutes after nursing, or at least an hour before breastfeeding.
• If your baby wishes to drink just after breast pumping, it is okay, let them! Some babies tend to drink longer to get the milk they need.
• Each mom and baby is different; it is okay to work around the above points to suit what is best for you.

How much to pump and reach full milk production?

If you are exclusively breast pumping, plan to pump 8 to 10 times per day. (Full milk production ranges from 750 to 1035 ml per day). Try and maintain full milk production. It usually takes a few days to reach full milk production, so do not expect to achieve it on day one.

Preterm babies and sick babies cannot feed directly from the breasts. So, when you are breast pumping reach and maintain full milk production. Here are a few tips to do it:

From birth to day 4: How long and how much to pump?

• Start within 6 hours from birth.
• Expect to pump only a little colostrum in the beginning.
• Double pump to save time.
• Pump 8 to 10 times a day
• Pump for 10 to 20 minutes, until the milk comes on day 3 or 4. Then, hand express to drain the breast completely.
• Fully drained breasts produce milk faster.
• Early morning, between 1 to 6 am, is when hormone levels increase and more milk is produced.

From day 4 to full production: How long and how much to pump?

By day 4, the milk production increases from drops to milliliters.

• Continue pumping, two minutes after the last drop of milk or until your breasts no longer feel full.
• Do not worry about the time interval between each pumping. Ensure you pump 8 to 10 times every 24 hours.
• Do not allow more than one 5-hour period to pass without pumping during the first 2 weeks from birth.

After achieving full production: How long and how much to pump?

• When you reach full production you have met your goal, you can then pump fewer times each day and maintain full production.
• Pump for a shorter duration, 10 to 15 minutes.
• Keep a track of milk pumped so you know when the production drops.

What can you do to increase milk production?

• Pump more (8 to 12 times a day) and 2 minutes after the last drop.
• Hand express after pumping.
• Ask your breastfeeding consultant for further information on increasing milk supply.

Weaning: When and how to stop breast pumping?

A few ways to wean breast pumping are:

• Drop one daily pumping at a time, while giving your body 2 to 3 days’ time to adjust. And leave another

• Keep the number of pumping same but pump for a shorter period of time. For example, reduce the amount of milk pumped from 120 ml to 90 ml.

Either way, you must allow your body 2 to 3 days’ time to adjust before weaning any level further.

Father’s role in Feeding

Feeding your baby need not mean you lose your baby time. Though you can’t actually breastfeed the baby, you can be an integral part of your support. Apart from feeding the baby, there are great ways you can spend time with your baby – bathing, nappy changing, massage, cuddling to sleep and playing.  

• Learn how breastfeeding works so you can support your partner in early difficulties if any.
• Breastfeeding can be slow and more frequent. Most newborns feed eight to twelve times a day.
• Breastfeeding may be uncomfortable for the first-time mothers. If the pain or discomfort does not subside after a minute, it is not normal and your partner needs assistance.
• Babies tend to sense the smell of milk and yearn for it even if not hungry. At such moments, a dad can settle baby more easily than a mom.
• Expressed milk (milk obtained from expressing or pumping the milk from the breasts) is equally beneficial for the baby. So, once a good breastfeeding system is established between mom and baby, you can occasionally bottle feed your baby. When done right, it is a good way to improve your bond with baby while your partner takes a break.
• Support your partner with an extra pillow and other things she may need while breastfeeding or pumping. For night-time feeding, you can help by taking the baby from the cradle to her.

Health experts believe breast milk is the best nutritional choice for infants, but breastfeeding may not be possible for all women. Formula milk is the best substitute for breast milk and also provides babies with the nutrients they need to grow and thrive and mothers must remain guilt free and not feel too much pressure if they are not able to breast feed as long as the baby is being fed and getting the required nutrients.

References:

Nutrients and calories in breast milk: A guide for the science-minded. Available online at
https://www.parentingscience.com/calories-in-breast-milk.html

Breastfeeding vs. Formula Feeding. Available online at
https://www.webmd.com/baby/breastfeeding-vs-formula-feeding#1

A dad’s guide to breastfeeding. Available online at
https://www.pregnancybirthbaby.org.au/breastfeeding-for-fathers

Breast pumping guide: When and how long to pump. Available online at
https://www.ameda.com/milk-101-article/when-and-how-long-to-pump/