Breastfeeding, what you need to know

Breastfeeding is one of the best and worst parts of being a new mum. We all know breast milk is liquid gold. Its immune properties and nutritional value cannot be replaced by anything else. The skin to skin and bonding between mother and baby during breastfeeding is priceless. And the practicality of a free supply of milk that is available anytime, anywhere is magical. So for those women to whom breast milk supply isn’t an issue, the latch is painless and whose baby grows well, then it really is a dream.

But for many of us, myself included, it isn’t so easy. It can lead to a downward spiral of grumpy baby and exhausted mum. There are a number of factors that lead to this and knowing what to expect can sometimes help. Here are some key points to consider; the main take home – it can be hard, you are not alone and you are a great mother regardless of how your baby is fed.

Expect it to be difficult

The one phrase I hear the most when speaking to struggling mothers is “no one told me that breastfeeding is this hard”. Babies are not born with a manual and there is no one size fits all approach. Even Midwives and Lactation Consultants who have taught breastfeeding for years can struggle. Know that it likely won’t be easy and that’s ok. Easier said than done, but remembering that it is in no way a reflection of your ability as a mother is the single most important thing to remember. Setting up a happy bonding feeding experience regardless of how the baby is fed is key

Make it convenient

Forget the visitors, forget keeping the place tidy – make it easy for you. Have a comfy area, have a view that you like looking at, have pillows everywhere if you need to, use a stool, have your favourite podcast ready to go. I got great advice to make little baskets in the main feeding areas with a few face washers, chuck cloths, a bottle of water, sweet treats, Lansinoh.. so handy!

Don’t put up with pain

Breastfeeding can be uncomfortable, but it shouldn’t be painful. If it is painful – seek help. The Maternal Child Health Nurse or your birth team should be able to let you know of local resources. The Australian Breast-feeding Association also has a 24 hour hotline! With the advice you are offered, take on what works for you and discard what doesn’t. There will be many people who want to give their opinion, but ultimately only you know what feels the best for you and your baby (this goes for everything not just breastfeeding!)

From personal experience, don’t push on if it’s starting to hurt too much. Pausing for a few minutes, a whole feed, or even a few days if you have to can make a world of difference. When you start to dread a feed or it hurts so much you cry – you need a break. If you don’t have expressed milk give some formula. The baby will be fine and you will feel so much better for it. When there is the vicious cycle of angry baby / frustrated mum, it needs to broken and pausing is the only way that bodes well

Low supply

Most women take a few days after the delivery to have their supply come up, sometimes longer following a Caesarean section. Day 2 is usually the worst when Bub is almost programmed to cluster feed to build up the supply. The first 48-72 hours will put you through your paces. If there is low supply beyond the first few days this will often lead to a hungry cranky baby and a tired cranky mother.

Medically, we see babies with slow weight gain or dropping weight (it is normal for newborns to lose up to 10% of their birth weight in the first few days, in general we like them to be back at their birth weight by two weeks of life) Other issues with significantly low supply can be low blood sugars in the baby and jaundice (yellowing of the skin).

Low supply often leaves mothers feeling helpless and hopeless. There is so much pressure on mums, either internally or externally, to be able to feed their baby enough to grow, and when it doesn’t seem to work it is hard to not take it personally. I have been counselling mothers about this for many years in my work but I was still one of those self blaming mums when I had a lot of trouble in the first few months.

Important things to note about low supply:

It is so common
It is not your fault
It does not make you a bad mother
There are ways to help
Expressing can help increase supply. Boobs are clever. They work by supply and demand. Simply put, the more milk you remove, the more you make. So pumping regularly can boost supply in many. This can be exhausting though. Between finding the time, buying / hiring the pump, washing all the parts regularly it is a time and energy consuming process. But it can be a game changer
There are medications that can help boost milk supply. As with all medications they can have side effects but it is worth speaking to a GP about as they can really help
At the end of the day, if none of this works, there is a perfectly satisfactory alternative – formula. Formula shaming needs to be a thing of the past. Breast is best, but fed is better and nothing is more important that a happy mum and bub unit
If still pregnant, ask your Obstetrician if it is suitable for you to do antenatal expressing (expressing in late stages of pregnancy) This can help build up some colostrum which can be used in the early days until supply comes in
Repeat points 1 – 3 over and over

Dr Nelu

Paediatric Doctor I Presenter