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Registered health visitor and international board certified lactation consultant Addy Henderson answers your breastfeeding questions.
In the first one to two weeks of your baby's life this can be a normal feeding pattern. He only has a very small stomach, about the size of a marble, and so will need to feed little and often. Some ways you can help increase the amount of time he feeds for are by ensuring he has a really good attachment so that he is getting the milk quickly and efficiently, and is staying interested. If he is falling asleep too quickly try feeding him skin to skin or with less clothes on him. Swap breasts more often during feeding. Breast compression is also a useful technique for helping to increase the amount of milk he takes at a feed. The way to do this is:
To cup your breast with your free hand, thumb on one side of your breast and fingers on the other, well away from the nipple and areola.
When your baby becomes sleepy, or his sucks are less active, compress your breast, not so hard it hurts, but firmly enough to squeeze the milk into the ducts, so that your baby starts sucking deeply again.
Keep the pressure up until you baby stops sucking actively, wait a short while, if he does not start sucking again, repeat.
When he no longer sucks deeply, even with compression, swap sides.
These should only be temporary measures to keep your baby interested in feeding for longer, and hopefully increase the length of time between feeds.Do not necessarily expect your baby to space his feeds evenly during the day. This is quite normal for the breast fed baby. Sometimes he just wants a drink and sometimes a full meal!
This is a question most mothers ask at sometime during breast-feeding. If only breasts were transparent!
The signs that your baby is getting enough milk are:
That he is growing and putting on weight. It is normal for him to lose weight in the first five days as he comes “with a packed lunch” board of extra fluid, but this should not be much more than 10% of his body weight. After this during the first three months of life he should gain between 5 to 7 ounces (140-175 grams) per week. Between three and six months he should gain 4 to 5 ounces (113-142 grams) per week.Cont.
He needs to have regular wet and dirty nappies: a minimum of six to eight heavy wet nappies and two poos, which should be soft and yellow, or mustard like, in consistency. Some breast-fed babies only poo two to three times a week after the first six to eight weeks.
During feeds he should be relaxed, but sucking actively and rhythmically with short pauses. After feeds he should appear drowsy, full and sleep, or be content, for two to three hours on average, although it is normal for babies to “cluster feed” in the evenings and sleep for one longer period, hopefully, at night.
The most important and effective way of improving your milk supply is to make sure your baby is well attached to the breast during feeds. He needs to have a good deep mouthful of breast tissue and after a few moments of rapid sucking, be sucking deeply and strongly. The only noise you should hear is swallowing. Check the positioning and attachment guidelines on the websites for further help, or have an experienced breast-feeding advisor or lactation consultant watch you feed your baby. In order for your breasts to make more milk they must be emptied frequently. Thus, ensuring your baby is feeding efficiently and often will increase your milk supply. If he is not doing this, expressing your milk at least six to eight times in twenty-four hours will have a similar effect.
Other methods that can help increase your milk supply include keeping your baby close to you and giving him lots of “skin to skin” contact and expressing your milk after feeding. There are some drugs and herbal remedies that can help boost your milk supply known collectively as Galactagogues, but you will need to seek expert help before trying these.
It is quite common for babies to favour one breast and this usually depends on the side, which you feel most comfortable holding your baby to feed. You may sometimes overcome this by positioning your baby underarm, or as it is sometimes called, the “rugby ball” hold, on his least favourite side, or by offering him that breast first, while he is really hungry.
You can still make enough milk for your baby as your breasts work independently, so the favoured breast will make more milk. If you are concerned that your baby is not getting enough you can express from the least preferred breast after feeds and give the expressed milk as a supplement.
You now enjoy all the foods you would normally eat. There is no need to avoid anything, unlike during pregnancy when you were advised to cut out certain foods. Indeed it is important that you have a varied, well balanced diet, containing protein, fats, carbohydrates, fruit, vegetables and plenty of fluids. You may find that you feel thirstier when breast-feeding, so have a drink nearby, but there is no need to drink more than you wish to. Contrary to popular belief this will not make more milk! You will burn extra calories while breast-feeding, so if you eat sensibly there will be no need to diet. Tea, coffee and other drinks containing caffeine are fine in moderation, but some babies may become unsettled and restless if excessive caffeine is taken, so limit such drinks to five or six a day.
A few babies, especially if suffering from Gastro-intestinal reflux, may improve if cow's milk protein is eliminated from their mother's diet, but it is important to seek further advice from your doctor or a qualified lactation consultant before doing this. As a lactation consultant myself, you might like to speak with me direct, please feel free to do so via Greatvine.com
You do not have to cut out alcohol for the duration of breastfeeding but again moderation is key.
If you wish to have a glass of wine or other alcohol it is best to have it just after you have fed your baby. It takes on average one hour for one unit (small glass of wine) to be metabolised by your body. If you do have a special occasion to attend when you will be drinking more, you will need to express and discard your milk for several hours. It would be a good idea to express some milk ahead of this time and freeze it so that you have a reserve for your baby
View the full list of Experts who can offer advice on breastfeeding.
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