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Feeding your baby

Pregnancy is an exciting time in your life and as you prepare for the birth of your baby, it’s important to think about not only how to prepare for labour and birth but also about feeding and caring for your baby.

Breast milk is perfect and uniquely made for growing baby’s needs. Breastfeeding makes a big difference to both your baby’s health and yours – the longer you feed your baby mum’s milk, the longer you and your baby will benefit.

South West Healthcare midwives and nurses will respect your right to choose how to feed your baby, whilst being committed to the protection, promotion and support of breastfeeding. South West Healthcare also have International Board Certified Lactation Consultants (IBCLCs) working in the Infant Feeding Support Service to support your feeding goals.

Rooming in

During your hospital stay, we encourage you and your baby to stay together day and night. By rooming in you will get to learn your babies feeding cues and behaviours. This will enable you to respond to your baby’s needs. It has been shown that staying together helps to establish your milk supply and helps you sleep better when you know your baby is close by.

Demand feeding

Breastfeeding on demand means feeding your baby without limits to how often or for how long. Demand feeding has been found to help your milk supply establish faster and also prevent problems such as engorged breasts. It also allows your baby to feed according to their own need.

How often to feed

Your baby needs and will want to feed frequently, until your milk comes and this is considered to be normal. Feeding this frequently helps to bring your milk supply in. There should not be long gaps of over 4 hrs between their feeds in these early days. With frequent feeding milk should come in anywhere between day 3- 6 after birth. You know your baby is feeding well when they:

  • In the initial days after birth, you should observe:Day 1:  1 wet nappy and 1 black tar like poo (meconium)Day 2:  2 wet nappies, poo changing in consistency and easier to wipe from baby’s bottom

    Day 3:  3-4 wet nappies, poo colour can begin to change to dark green in colour

    Day 4:  4-5 wet nappies increasing in frequency and volume. Poo can now be a brighter green and “seedy” in appearance.

  • After your milk comes in your baby should have 6-8 wet nappies and mostly yellow soft or liquid poo 3 or more times in 24 hours.
  • Your baby is settled after most feeds. (Some episodes of frequent/cluster feeding & unsettled behaviour in a 24-hour period is considered normal for newborns)
  • Your baby is alert, active and mostly content when awake

Poos and wees – Raising Children Network

Your baby should be back to birth weight by two weeks of age. Normal weight gain is between 20 and 30 grams per day, or between 150 and 210 grams per week.

You know your baby is feeding correctly when:

After some initial short frequent sucks to stimulate milk flow, your baby begins to swallow. Sucking becomes slower, deeper, and more rhythmic with rest periods between each sucking burst. As the feed progresses the sucking bursts become shorter and the rest periods longer. You can hear or see your baby swallowing.

You may develop problems breastfeeding if you:

  • restrict suckling time at the breast
  • give infant formula to your baby without medical advice
  • use dummies in the early weeks.

Breastfeeding

About breastfeeding

Your breasts begin to prepare to feed your baby early on in your pregnancy. From week six of pregnancy they may begin to feel fuller, heavier and more sensitive. Not all breast tissue is involved in making milk as much of it is fat and supporting tissue, so the size of your breast doesn’t equal your ability to breastfeed. Later on in your pregnancy, you may notice the nipple and areola (the area around your nipple) becoming darker. Some women also experience leaking of colostrum from the nipple during late pregnancy.

Position and attachment

Steps for good attachment:

  1. Make sure you are sitting comfortably, and you are well supported.
  2. Hold your baby close to you, facing your chest.
  3. Position your baby on their side with their nose opposite your nipple.
  4. Support your breast from underneath.
  5. Position your fingers well back from the areola/nipple so your baby is able to take a big mouthful of breast tissue.
  6. Touch your baby’s nose with your nipple and the fuller rounder part of the breast to their lips to encourage your baby to open their mouth wide.
  7. Make sure your baby’s mouth is very wide (like yawning), before bringing your baby quickly to the breast, with their chin leading
  8. Attach so your baby’s bottom lip is well down over the areola.

Some discomfort from the initial stretching of the nipple is normal, but should not last.

If your nipple is squashed or pinched in appearance, it is likely that your baby does not have enough nipple & breast tissue in their mouth, try again for a deeper latch.

Continue to support your breast until your baby is sucking and swallowing in a deep rhythmic pattern.

If you experience pain when your baby starts swallowing, take your baby off the nipple and re-attach.

Good attachment  video- Raising Children Network

 

Frequently asked questions

  • What position should I use?

    There are lots of different positions for breastfeeding. You just need to check the following:

    • Are you comfortable?
    • Are your baby’s head and body in a straight line? If not, your baby might not be able to swallow easily
    • Are you holding your baby close to you? Support your baby’s shoulders and back. Your baby should be able to tilt their head back easily and shouldn’t have to reach to feed
  • How will I benefit from breastfeeding?

    Your milk is perfect and uniquely made for your growing baby’s needs. Giving your milk to your baby makes a big difference to both your baby’s health and your health. And every day counts; the longer you feed your baby mum’s milk, the more they benefit. The World Health Organization (WHO) recommends that you exclusively breastfeed up to six months of age, with continued breastfeeding along with the introduction of solid foods up to two years of age or beyond.

    Breastfeeding is emotionally and physically rewarding and it can help enhance the bond between you and your baby. It also helps you by keeping your uterus contracted and reducing bleeding. It can help you return to your pre-pregnancy weight.

    Breastfeeding can reduce your risk of premenopausal breast cancer, ovarian cancer, diabetes and other illness later in life.

  • I can’t seem to get this attachment right! Why can’t I do it?

    Remember that breastfeeding is a learned skill for you and your baby. It takes plenty of practice and patience.

    When trying to breastfeed ask the midwife caring for you for some guidance.

    You may be shown many different ways to breastfeed, choose the one most comfortable for you and stick with it – persistence will pay off.

  • Whenever I feed I get contraction type pains, why is this happening?

    These are known as after birth pains, and though not common with your first baby, they are very common with your second, third, etc.

    After birth pains are due to a hormone called oxytocin which stimulates the let down or release of your milk and also causes your uterus to contract.

    Ask for a hot pack or pain relief if you require it. The pains should settle in two to three days.

    You can also seek support from our Infant Feeding Support Service.

  • Which breast should I offer each feed?

    Always offer both breasts at each feed. Start with the opposite breast you started the last feed with.

    A nappy change after the first breast will help to wake a sleepy baby for the second breast.

    At times your baby may not feel like the second side especially when your milk first comes in. If the breast that baby does not feed from is full and uncomfortable hand express a small amount of breastmilk off and then begin on that breast next time.- Do not pump off as this will increase supply further, your baby should regulate your supply, not a pump.

  • My nipples are very tender, especially when the baby first attaches to the breast. Am I doing something wrong?

    If the discomfort persists beyond the first minute of the feed, detach your baby by breaking the seal of their mouth with your finger and ask for guidance.

    It is important to check your nipple shape as soon as the baby lets go of the breast. If the nipple is a normal shape, then what you are feeling is normal tenderness. This will settle in a day or two.

    Your baby has not been well attached if your nipple is an odd shape or in any way discoloured, grazed or cracked.

  • Yesterday my baby slept most of the time. Today he/she has hardly slept at all and seems to be constantly hungry, am I doing something wrong?

    In their second to third day of life babies do become very frequent feeders. This is normal behaviour to increase the milk supply.

    Feed whenever your baby displays hunger signs, and rest when they sleep.

    Dummy use should be avoided as a baby showing sucking signs should be fed in order to help establish you r milk supply

  • My baby doesn’t seem to burp very much. How important is it to burp him/her? Are hiccups normal?

    In the first few days when your baby isn’t drinking large amounts of milk, they may not burp after a feed.  During this time babies are only taking about one teaspoon of colostrum each feed. Give your baby the opportunity to burp by holding them upright with their back straight for a few minutes.

    It is not necessary to try to burp them for a long period of time.

    Hiccups are common to most newborns, and don’t seem to bother them. They may be relieved by re-offering the breast.

  • My breasts are very full. They feel tight and sore. How long does this last?

    When your milk comes in (anywhere between day 3-6 after birth), your breasts often produce too much milk.

    The tight, full feeling starts to settle after 24 hours and feeding your baby often will help.

    The use of cold packs on your breasts after feeds may also help these symptoms.

    Management of full breasts – The Royal Women’s Hospital

  • We just seemed to have got the feeding right and now my baby is having trouble attaching to the breast. What has happened?

    The fullness of your breasts has made the areola (brown area) very firm, so your baby is now trying to latch onto what is more like an inflated balloon.

    It can help to express a small amount of milk until this area becomes much softer and easy to shape.

    You will probably need to do this for the next day or two until your supply starts to settle.

    Keep this in mind if your baby sleeps for longer than usual and your breasts have become overfull again.

    Management of full breasts – The Royal Women’s Hospital

  • How do I know if I have got the attachment right?

    Your baby will take plenty of the areola (brown area) into their mouth.

    Once attached and sucking there should be no pain.

    You will be able to hear your baby swallowing milk regularly.

    When your baby releases the breast from their mouth the nipple will be the same shape as when it went in.

    Your breast will also feel much softer.

  • What is the ‘let down’?

    The ‘let down’ is a hormonal response to nipple stimulation (either from your baby or when expressing).

    It involves the tiny muscles in your breast contracting and pushing milk down the ducts toward the nipple.

    Some women may feel a tingling sensation in their breast, milk leaking from the other breast, thirst or nothing at all. All are perfectly normal.

    The only way to really know you have had a let down is the change in your baby’s suck from short shallow sucks to longer drawing sucks and swallowing can be heard.

    You will have several let downs in each feed.

    Let down reflex – Australian Breastfeeding Association

  • How often and how long should I expect my baby to breastfeed?

    Every baby has its own feeding pattern.

    How often a baby feeds depends on how much milk your breasts can store, and your baby’s size and appetite. It is important to allow the breast and baby to work it out between them. Not limiting their time at the breast will give your breasts the best message about how much milk they need to produce. This is how supply equals demand. This is how milk supply becomes established.

    Most babies will breastfeed between six and 12 times over a 24 hour period. The spacing between feeds will also vary greatly. From long breaks, to feeds with very little space between them (cluster feeds).

    If you are concerned about the frequency of feeds or length of time it takes to feed your baby, seek guidance from your midwife, Maternal and Child Health Nurse or IBCLC.

  • How and why do you express breast milk?

    There are many reasons why lactating mums wish to express their breast milk and/ or store it.

    Sometimes a mother is separated from her baby or finds it difficult to breastfeed. Other reasons may include concerns about breastfeeding in public; as a temporary approach while trying to increase breast milk supply or when planning return to work.

    Why express milk?

    If you express milk, your baby will still be able to have mum’s milk even if somebody else is feeding them. This may be useful if you are away from your baby or returning to work.
    It’s best to wait until your baby is a little older before regularly expressing milk for your partner to feed your baby, so you have a chance to get feeding going well first.

    How to express milk by hand

    1. Wash your hands
    2. Gently stroke the breast toward the nipple to stimulate the letdown reflex
    3. Place fingers underneath the breast so that the 1st finger is just below, and the thumb is just above the area around the nipple
    4. Gently squeeze the fingers and thumb pads (not fingertips) together, back towards the chest wall into the breast tissue, then release the pressure
    5. The fingers should be well back from the nipple, don’t squeeze or pinch the nipple
    6. Repeat the action in a rhythm like a baby’s sucking
    7. When colostrum or milk drips easily start collecting it in a syringe or clean container
    8. When milk ceases to flow, rotate the position of the fingers
    9. Swap to the other breast when flow slows down

    Expressing with a breast pump

    It will depend on the reason you need to use a pump as to which type is suitable, so ask for information to compare them.

    Be sure to wash equipment after each use with hot soapy water, rinse well and dry on a clean surface.

    If your baby is unwell or premature ask for advice about sterilising the equipment.

    Expressing breast milk – Royal Women’s Hospital

  • How do I complete lymphatic massage to help prevent and resolve inflammatory breast conditions?

    The aim of lymphatic massage is to encourage drainage of fluid behind blocked ducts to help prevent and resolve inflammatory breast conditions such as mastitis.

    Key points:

    • Breast massage should never be painful
    • Use light pressure like “stroking a cat”
    • Best completed lying down with arm on affected side raised overhead on pillow.

    Technique:

    • This technique is best performed directly on skin or through light clothing without a bra.
    • Stroke breast in long sweeping strokes towards arm pit:
      • Outside or below nipple “lump”- sweep towards arm pit
      • Inside “lump”- sweep towards breast bone/sternum in centre of body or up to collar bone
      • Above nipple “lump”- sweep towards collar bone or out towards arm pit.
    • Repeat stroking motion 10-12 times

     

    • Deep breathing can help to activate the lymphatic system. Utilise the following breathing technique before, during or after completing self-massage:
      • Take a deep breath in through your nose so that your lower ribs and tummy expand.
      • Hold for 4 seconds
      • Then release slowly breathing out through your mouth
      • Repeat 4 times

     

    Additional techniques to utilise as advised by your physiotherapist:

    • Gentle circling motion to the arm pit whilst completing deep breathing exercise. Complete 10 circles in an anticlockwise motion and 10 circles in a clockwise motion.
    • Pick up and squeeze pectoral muscles in arm pit and feel it loosen from the chest wall. Complete several times.
    • Muscle pump:
      • Hands in ‘prayer position’
      • Breathe in through your nose and press palms of hands together to activate pectoral muscles.
      • Breath out and relax hands
      • Complete 5-10 times.
  • Where can I go for more support?

    Infant Feeding Support Service

    Australian Breastfeeding Association 24 hour help line 1800 686 268

     

Managing problems

Many common problems associated with breastfeeding will resolve themselves in the early weeks after giving birth.

  • Sore nipples

    Nipple soreness and damage is often a result of your baby not being attached well to the breast. It is important to seek advice and guidance about correcting the problem so that breastfeeding becomes pain free and comfortable. If your nipples do become sore, express some milk onto the nipple after feeds and allow them to air dry.

    Advice can be sourced from an IBCLC in the SWH  Infant Feeding Support Service.

     

  • Localised breast inflammation

    This occurs when there is narrowing in the milk duct/s preventing milk from moving through the breast. This can develop into localized breast inflammation, sometimes called ‘blocked ducts’.

    Causes

    • Inadequate breast drainage due to poor attachment or suckling, often accompanied by sore/damaged nipples
    • Sudden enlargement due to a change in your baby’s feeding patterns (sleeping through the night, rapid weaning)
    • Incorrect fitting of your bra
    • Fatigue or stress

    Signs and symptoms

    You may experience flu like symptoms such as a high temperature, shivers and joint aches. It is important to get medical advice or help at this stage, as you may need antibiotics. It is important to know that quick and effective treatment of the breast may stop mastitis developing further.

    Relieving an inflamed breast
    Start treatment as soon as you notice any signs of inflammation in your breast with the following these steps:

    • Gently massage the breast in long strokes toward the nipple then walk your fingers back up the breast while you are feeding your baby
    • Offer this breast first at each feed until the blockage clears
    • Offer the affected breast twice each feed to the baby to help drain the breast well
    • Apply a cold pack after the feed to help reduce any inflammation
    • Try hand expressing in the shower or bath if not resolving

    If you begin to feel unwell with a high temperature and flu like symptoms, mastitis may be developing and you need to seek medical attention.

    Localised breast inflammation – Australian Breastfeeding Association

  • Infective mastitis

    Infection caused by common bacterial organism staphylococcus aureus (sometimes called a staph infection)

    Causes

    • Delayed or inadequate resolution of inflammatory mastitis or not correcting a possible cause
    • Cracked nipples
    • Chronic oversupply
    • Incorrect positioning or attachment
    • General poor health (stress, fatigue, poor nutrition, anemia)

    Signs and symptoms

    The breast is red, swollen, hot and painful and the skin will look tight and shiny.

    You may well have an elevated temperature, flu like symptoms such as body aches and pains and feel unwell.

    Treatment of mastitis

    • Consult a Lactation Consultant, G.P or midwife
    • Continue to breastfeed as normal– this will assist in draining the breast and prevent the condition worsening
    • Avoid over emptying that breast by increased feeding or pumping as this may increase supply and worsen symptoms
    • Gentle massage toward armpit/lymph nodes (as if stroking a cat) of breast lumps. Firm massage/pressure NOT recommended
    • Antibiotic therapy and ensure the full course is taken
    • Take adequate oral pain relief/ alternate Nurofen and Panadol
    • Cold packs applied to the affected breast will decrease inflammation, assist milk flow and provide comfort
    • Rest and drink lots of fluids
    • Accept help from family & friends

    If you are thinking of weaning your baby, it is better to wait until the mastitis is resolved.

    Seek support from an IBCLC from the Infant Feeding Support Service and if recommended you can hire a hospital grade breast pump from SWH supplies shop).

    Mastitis – Australian Breastfeeding Association

  • Low supply

    Many mothers have times when they feel their breast milk supply is not enough. It is one of the most common reasons for early weaning. Feel confident that your body can make enough milk for your baby. Remember that supply equals demand, so if you swap breastfeeds with formula, your breasts will make less milk.

    If you feel your milk supply is low, you can increase your milk supply by:

    • Offering extra breastfeeds
    • Making sure your attachment and positioning of the baby is correct
    • Having extra rest and looking after yourself for a few days
    • Expressing your milk as soon as you can after you breastfeed

    If the above measures do not result in your supply being enough for your baby’s needs, seek professional guidance with an IBCLC.

    Increasing supply – Australian Breastfeeding Association

  • Difficulty attaching

    Breastfeeding is a learned skill for you and your baby and it is common for women to have difficulty attaching, particularly when breastfeeding for the first time. It takes plenty of practice and patience. Be reassured that this becomes easier with assistance and time, and there are many resources available to help.

    Mother-led attachment video – Australian Breastfeeding Association

  • Medications and breastfeeding

    Most medications are quite safe in breastfeeding mothers.

    If you are concerned about the safety of any medicines you are taking while breastfeeding, seek the advice of an IBCLC. You can also speak to a pharmacist who is supportive of breastfeeding.

    Medicines in breastfeeding – The Royal Women’s Hospital

  • Tongue tie

    Tongue tie or ‘Ankyloglossia’ is when the thin piece of skin under the tongue (the lingual frenulum) is very short and restricts the movement of the tongue.

    Tongue ties are present at birth and can range from mild to severe. Approximately 5% of babies are born with a tongue tie.

    What are the symptoms?

    A tongue tie may not always be obvious and symptoms will depend on severity. Features of tongue tie can include:

    • Inability to poke the tongue out past the lips.
    • Inability to touch the tongue tip to the roof of the mouth.
    • A flat, square, notched or ‘heart shaped’ tongue tip.
    • Difficulties moving the tongue into the corners of the mouth.
    • Feeding difficulties, such as slow weight gain in baby and low milk volume or a reduction in initial supply.

    It is not always about the appearance of a tongue tie/ oral restriction it is more to do with the function or the effect it is having on your feeding.

    If a tongue tie is suspected a thorough examination needs to be completed. Examination and a full feeding assessment can be completed by an IBCLC.

    More information

    Tongue tie – Raising Children Network

    Tongue tie – The Royal Women’s Hospital

    Tongue tie – Better Health Channel

  • Alcohol

    There is no safe level of alcohol intake for breastfeeding so avoiding alcohol is the safest option.

    Alcohol is passed through to breast milk and may reduce the supply or cause poor feeding and sleep disturbance to your baby. It is recommended that mothers avoid alcohol when breastfeeding.

    Alcohol and breastfeeding – Australian Breastfeeding Association

Bottle feeding

There are some important things to know if you are planning to bottle feed your baby, whether you are using expressed breast milk or formula. You will need bottle feeding equipment including a number of large bottles, rings and caps, and several teats. Which vary in size and shape, generally according to baby’s age. No one is better than the other. Choose bottles that are simple and easy to clean, and try teats with bigger or smaller holes until you find the one that you and your baby are happy with.

New babies immune systems are not yet fully developed to, protect them from infection. That means all bottle feeding equipment needs be properly cleaned and disinfected before and after use until your baby is around 12 months of age.

You will also need access to good quality fresh water, which needs to be boiled before use some type of sterilising equipment to keep everything clean.

Guide to bottle feeding – UNICEF

Bottle feeding – Raising Children Network

Facts about formula – Australian Breastfeeding Association

If you are also breastfeeding, it is suggested to use a “Paced bottle feeding method”.

Paced bottle feeding – Australian Breastfeeding Association

Page last updated: 2 January 2024

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