Kiddipedia
Midwife Cath Curtin
Establishing routine:
Newborns require lots of small frequent feeds in the first few weeks of life. Breastfeeding frequently in the early days and weeks is completely normal and benefits the mother by establishing lactation and providing the baby with breast milk to help with growth and development. The baby is receiving all of the nutrients they need, while helping to promote lactation, which may take 6-8 weeks to be established.
Breast milk is perfect for babies. Breastfed babies may feed up to 8–12 times in a 24-hour period – which is completely normal. Remembering all babies feed differently and all women (and each breast) lactate differently. This usually means that your baby will breastfeed on average every 2–3 hours around the clock (day and night). In time, there may be one longer stretch between feeds somewhere in a 24-hour period – this depends on the baby’s age (in weeks) and increasing weight.
The length of time between feeds can vary greatly from baby to baby. Feeding can take anywhere between 30 minutes 60 minutes (sometimes longer) and if your baby is well and has a wet nappy every time you change it, and is gaining weight, you don’t need to time how long you feed for. Simply respond to your baby’s needs as breastfeeding is a unique situation for all women. Babies are very clever – they will feed for a long time some feeds, and may have lots of quick feeds – both are normal, so trust your baby!
To wake or not to wake, that is the question?
In the first weeks the baby tends to sleep more during the day and wake more frequently overnight. This is normal. To help your baby sleep a little longer after midnight I encourage your partner to bath your baby at 10pm. This is not something required forever, just during the early days to help a baby who is waking overnight. Respond to your baby when crying with a breastfeed even if it was only 30 mins since you last fed. If your baby is premature, low birthweight, sick or jaundiced, a feeding plan is written with you after consultation with your paediatrician and / or midwife. It is important to be guided by your doctor or midwife in these situations. They will talk you through the reasons and ways to meet your baby’s needs and are always available for support. Wrapping the baby for all feeds and sleep can assist in helping your baby relax, keeping them warm, safe and supported.
How to position your baby for good attachment
Babies are very clever! They know exactly what to do from the very beginning – one of their strongest primitive and natural reflexes is to suck and that is so they can live. Yet, it can come as a surprise to some mothers when they discover breastfeeding isn’t always easy.
A baby is best positioned across the mum in a cradle hold so the baby can self-attach. This positioning and gentle introduction to the nipple will trigger the baby’s rooting reflex meaning the baby will manoeuvre itself around to find and latch on to the nipple. Two fingers in the ‘peace sign’ can be used to position the nipple in place. It’s important that the mother is relaxed and comfortable while feeding.
Feeling some pain or discomfort during the first few seconds of breastfeeding is normal as the baby works hard to find the nipple and suck the nipple into the right position. Often the pain will settle once the nipple is deep on the baby’s tongue. However, if the pain does continue you can try nipple shields – these help in protecting your nipples, and are great for flat, inverted nipples and sore and sometimes bleeding nipples. I prefer to use nipple shields as they keep the baby on the breast rather than taking the baby off and mum endlessly pumping milk which can become very stressful. Again, having the baby wrapped will help with feeding. If the baby is undressed they get cold very quickly and the baby’s arms can flail everywhere making breastfeeding a bit of a juggle. Mother nature wants our babies to feel safe, warm and loved when breastfeeding. One of my most important tips is to have only one voice in your head. All professionals have a different approach, and new parents find it confusing. Find a professional who can help you and listen to him / her.
Keeping up your milk supply
No cream, tea, food, cake, herbs, biscuits, medications or any over the counter medicinal fluids will help increase your supply. There’s only one little person that can help you with this, and that’s your baby. You many find the early days / weeks / months of breastfeeding long with many hurdles to jump over – the baby doesn’t seem satisfied, your baby feeds for hours, sleeps only short blocks and may cry a lot.
Keep it simple – keep your baby warm by keeping them securely wrapped. Feed your baby frequently, do tummy time for short periods during the day – I’d suggest about 10 times for a minute or two. This allows the baby time to move and stretch. Plus, tummy time can decrease the incidence of a flat head. The best and easiest way to keep the breast lactating is to keep your baby close and feed frequently. Lactation works on demand and supply. And, breastfeeding your baby frequently will certainly help increase the supply. It is important to remain well hydrated and well fed when breastfeeding – it really is thirsty work for both mother and baby. Basically, the mother’s body is giving energy, life and weight gain to her baby so maintaining a satisfying and nutritious diet, a multivitamin and if possible some rest for yourself, is absolutely essential.
Hygiene is important – for breasts and hands
You need to look after your breasts, they are working very hard to produce milk. The tissue is sensitive, so you don’t need to rub or massage them as this can damage your breasts. Keep your nipples clean by gently washing your them in warm water with a soft face washer. But, make sure you don’t rub or vigorously scrub, just gently dab them. It is also important to wash your hands well (only with soap and water) before every feed. This can prevent infection such as mastitis. Mastitis is a staph infection that usually ascends from a cracked nipple to infect the breast. Washing your hands prior to every feed and after every nappy change is of the utmost importance.
Switching sides
It is important to alternate breasts during a feed to keep the milk moving. The brain does not discriminate when the baby sucks the nipple to stimulate and allow the milk to let down. It does not go to just one breast, but both. Feed the baby one side, then unwrap and burp the baby and do some tummy time (on a clean wrap or quilt, on the ground and never leave a baby alone) just for a few minutes. Tummy time is safe and a well, term and healthy baby can commence this from day one. They are so clever. Let your baby finish feeding on one side until you feel your breast is soft or the baby has come off itself.
When the baby is ready for another drink, change the nappy and rewrap them, then feed from the other side if your baby is still hungry. And, alternate each breast from left to right.
How long should I breastfeed for?
It is recommended that babies are fed exclusively on breastmilk for the first six months of their life. It is all that they need to thrive and grow. The World Health Organisation recommends that babies continue to be fed with breast milk as well as solid food for 12-24 months. However, everybody’s breastfeeding journey is different. Talk with your midwife, paediatrician or healthcare professional – they are there to help guide you along the way.
In 2020 when COVID-19 put a pause on face-to-face appointments and resulted in the cancellation of antenatal classes, Midwife Cath partnered with Cell Care to create Tummy Talks – free online antenatal classes and education service that expectant parents could access from the comfort and safety of their home.
Midwife Cath does zoom consultations on pregnancy, birth, breastfeeding your baby and sleep issue you may have with your baby. The Pregnancy and Birth classes were so popular, Breastfeeding and Postnatal classes and Baby First Aid & CPR have now been added. Tummy Talks has grown to cover a range of topics all hosted by Midwife Cath. And, it’s completely free. For more information or to register for her class visit www.tummytalks.com.au
