BREASTFEEDING (Part 2)

BREASTFEEDING - (Continued)

Many articles are written on the benefits of breastfeeding for the baby. But there are also many benefits to the mother too. Apart from the obvious benefits such as convenience and financial (formula feeding costs approximately £450 per year where as breastfeeding is free) there are also benefits in the early postnatal period. As soon as the baby is born the body expels the placenta. Sometimes this can be retained due to several reasons.

Putting your baby to the breast and feeding at this this time encourages your uterus to contract and the placenta to separate and deliver. This means that you won’t have to go to the operating theatre for a Manual Removal of Placenta.

This also reduces the risk of having a post partum haemorrhage, which is common with retained placenta. Breastfeeding also helps your womb to involute (or shrink) in the days following the delivery, and because it uses up to 500 calories per day it can help with weight loss and getting back to your pre-pregnancy weight/figure.

Also when you breastfeed, your brain releases a hormone called Oxytocin into your body, this helps you to relax and aids bonding.

Breastfeeding also causes some common problems.

As your milk comes in, on day 2-3, your breasts will become engorged and you may feel discomfort. It is important that you feed your baby regularly to ease this discomfort and ensure that your milk supply continues to increase. You may take simple analgesia such as paracetamol to ease this discomfort or you could express some milk for temporary ease.

The major common problem caused by breastfeeding is sore nipples caused by the suction. This is why correct latching is extremely important as the baby needs to insert as much of the nipple and areola as possible. You can buy nipple creams to ease this soreness or gently squeeze a little breastmilk onto the nipple and allow it to dry in the open air.

You can also contract thrush on the nipple which may cause the nipple to crack and bleed. Your GP will prescribe treatment for this condition. Another fairly common problem is a blocked milk duct. This causes the breast to be swollen and inflamed, and the pain may increase when you feed your baby due to the pressure of the build up of milk behind the blocked duct.

A blocked duct may clear up quickly by feeding your baby more frequently. Or you may want to massage your breast gently while feeding to ease the milk to pass the blockage. If this duct becomes infected it may develop into Mastitis. This is due to bacteria getting into the milk ducts through a sore or cracked nipple.

The breast may swell and become hard and red which becomes extremely painful. You will get symptoms of infection ie. Raised temperature and feel generally unwell.

You will need a course of antibiotics to treat Mastitis, therefore if you suspect that you may be developing this complication you need to see your midwife or GP. Feeding from an infected breast will not harm your baby although the build-up of milk may become very painful therefore you may hand express to ease that pain.

A small amount of antibiotic may be present in your breastmilk but this will not harm your baby although its stools may be a little runnier. You may take simple analgesia to relieve the pain.

If you get a collection of pus inside the breast – you will have a breast abscess. You will feel a firm, tender red lump, and may feel unwell like Mastitis. If you do suffer from a breast abscess, this will have to be treated. You may need it draining and be given a course of antibiotics.

You will be advised not to feed from the infected breast. If your breasts become engorged , you should express and discard the milk from the infected side.

One of the most common worries when breast feeding is that mothers feel they cannot see how much milk their baby is receiving unlike formula milk. You can look for signs for reassurance. Firstly, is your baby latched on correctly, can you see them sucking and swallowing when feeding? Secondly do your breasts feel lighter and more empty after a breastfeed?

What about dirty nappies? By the end of the first week you should see about 6 wet nappies and 3-4 dirty nappies per day. Look for the changing stool. The first couple of days – the baby will pass Meconium, this is a black tar like substance. It will then change colour to a yellowy-mustard colour. When your baby becomes slightly older, it may become normal for them to go up to a week without passing a stool.

Within the first couple of weeks after birth, your baby may lose up to 10% of its birth weight. This will be checked by the midwife, and the relevant advice will be given. They will probably start gaining weight by two weeks old. Generally though, if your baby is alert and happy, and wetting and dirtying nappies, they are usually getting enough breastmilk.

So to ensure that baby is latched onto the breast correctly make sure that their head and body are in a straight line, this enables your baby to swallow easily. Hold your baby close to you and support their neck, shoulders and back. Make sure you are in a comfortable position. Use plenty of pillows and have access to a drink. You may be there some time!!

Start by holding your baby with his nose opposite your nipple. Let his head tilt back so he can open his mouth wide. Your baby’s bottom lip and chin should touch your breast first so that he can put the underneath part of your breast in his mouth first.

If you feed from the left breast, cup your breast underneath with your left hand. Keep your fingers away from the areola and nipple. Rest your thumb on top of your breast. Do not press. Your nipple should then be lined up with your baby’s nose.

Before putting your breast to your baby’s mouth make sure he has opened it wide to allow an ample amount to be inserted. When he opens his mouth wide, swiftly attach the breast. Ensure that his bottom lip has made contact well away from the base of the nipple. Then use your thumb to slide or roll the nipple forward under the roof of his mouth.

As soon as your baby is latched on and sucking well, slowly release your hand from your breast. The more breast the baby gets into his mouth – the better the intake of milk and the more comfortable the feed.

If his mouth is wide as he starts to attach and some of the areola is seen above the baby’s top lip, his nose is free and his chin is pressed into the underneath of the breast, he is probably latched on well.

He will take long sucks and swallows and pause on a regular basis. His cheeks should not be sucking in when he sucks. All these are signs that the baby is latched on and feeding well.

Remember breastfeeding is a skill. It doesn’t always feel as though it is natural although it should do over time.

For further advice or guidance please see your midwife or breastfeed support worker.

Baby Friendly: www.babyfriendly.org.uk

La Leche League – 24 hour helpline on 0845 120 2918: www.laleche.org.uk .

Breastfeeding Network (support line) on 0844 412 4664: www.breastfeedingnetwork.org.uk

National Childbirth Trust (breastfeeding line) on 0870 444 8708: www.nct.org.uk

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