Breastfeeding 101

There is always more to learn about breastfeeding – whether you are pregnant for the first time, a new mother, or even a mother who has breastfed her other children before.

So lets start at the beginning – 

Should I breast feed?

YES! The world health organisation recommends exclusive breastfeeding for the first 6 months. As an OBGYN I totally stand by that – breastfeeding is essential for baby and mother. However its not as easy as it looks but please please make that effort. Its totally worth it.
Breastfeeding is one of the most effective ways to ensure child health and survival.

Breastmilk is the ideal food for infants. It is safe, clean and contains antibodies which help protect against many common childhood illnesses. Breastmilk provides all the energy and nutrients that the infant needs for the first months of life, and it continues to provide up to half or more of a child’s nutritional needs during the second half of the first year, and up to one third during the second year of life. 
Breastfed children perform better on intelligence tests, are less likely to be overweight or obese and less prone to diabetes later in life. Women who breastfeed also have a reduced risk of breast and ovarian cancers. 

When should I start breastfeeding?

Ideally as soon as you deliver your baby, but realistically within half an hour of birth is great. So long answer short – ASAP
For the first month it is ideal to feed every 2 hours and then on demand.

How do I hold the baby while breastfeeding?

There are many ways to hold the baby while nursing but choose the most comfortable one for both of you – might take some experimentation.

1. Cradle hold – Lay baby lengthwise across your abdomen, using one hand to support his head and the other his bottom

2. Football hold – Place baby beside you face up and lengthwise. Lay him along your arm and guide his head to your breast.If you’ve had a C-section you may find this hold more comfortable.

3. Lying down – Lay baby next to you in bed, with you on your right side, he on his left. His mouth should be at the same height or slightly lower than your nipples. With your free hand, adjust baby’s mouth toward the nipple closest to the bed and circle your other arm around him.

You can use breastfeeding pillows as well or even place blankets around the baby for better positioning.

How do I get the baby to latch onto my breast?

Position the baby on its side and prop him up with a pillow and hold to your breast, don’t lean over the baby.
Place your thumb and fingers around your areola 
Tilt baby’s head back and place your nipple on her mouth till she opens her mouth
Help baby place her jaw onto your nipple and tilt her head forward till she takes the entire nipple and most of the areola in her mouth

The first milk is yellowish and watery. What do I do with that?

The first milk is called colostrum and its VERY good for the baby – please breastfeed your baby this. 

How do I know if my baby is feeding enough?

If your baby is passing stools and urine daily then you can be reassured.

Please contact your pediatrician if you notice – 

yellowing of skin
hard and dark stools
lethargic baby
baby stops feeding in 10 mins or less

My breasts are too engorged and now no milk is flowing. What to do?

Rocky and hard breasts are NOT a good sign. This can lead to fever and then eventual abscess formation which can damage your milk ducts.
Apply ice packs to ease the pain. Try freezing a cabbage leaf and putting it on your breast as well
Hot shower or hot water bag on your breasts helps loosen the milk – then express it out. Your breasts will always make more milk so you can either store this excess milk or throw it out but it is important to release it.

My nipples are hard and cracking and hurt. What to do?

Try an ointment for sore nipples (or just use vaseline!). Be sure to wash your breast before breastfeeding so the ointment does not go in the baby’s mouth.

I’m not getting any milk. What to do?

Consider these points before panicking –
Maybe your baby isn’t latching correctly
Maybe you aren’t breastfeeding often enough – ideally every 2-3 hours through the day AND night. More breastfeeding = more milk production
Keep getting your baby to latch on and keep trying – easy does it.
Skin to skin contact with baby also increases oxytocin (breastfeeding hormone) in your body

Can I get pregnant while I’m breastfeeding?

So lactational amenorrhoea (no periods during breastfeeding) does happen to be a method of natural contraception, its NOT reliable at all.

Storing breast milk

Breast milk lasts about 5 hours at room temperature, but looking at Indian weather maybe don’t keep it out for more than an hour or so.
Breast milk lasts in the fridge about 4 days but use it as soon as possible to prevent bacterial contamination 
Breast milk has to be rewarmed before giving to baby but ideally don’t microwave it. Use a bottle warmer or a water bath. 

TIPS

Hydrate yourself! Eat a healthy balanced diet! If you’re not well nourished how will you produce nourishment for your baby?

Don’t freak out – motherhood is hard, but you’ve got this

It can take time for your baby to learn to latch on correctly, or they might not be digesting well at the beginning and these things can be remedied. Your newborn can get used to it, or a specialist can help you both make the adjustments you need so breastfeeding is more enjoyable for Mom and baby.

Find yourself a great nursing bra. Something comfortable and also that 

If its really difficult for you to express milk maybe look into a breast pump

COVID AND BREASTFEEDING

Can COVID-19 be passed through breastfeeding?

Transmission of active COVID-19 (virus that can cause infection) through breast milk and breastfeeding has not been detected to date. There is no reason to avoid or stop breastfeeding.

Following delivery, should a baby still be immediately placed skin-to-skin and breastfed if the mother is confirmed or suspected to have COVID-19?

Yes. Immediate and continued skin-to-skin care, including kangaroo mother care, improves the temperature control of newborns and is associated with improved survival among newborn babies. Placing the newborn close to the mother also enables early initiation of breastfeeding which also reduces mortality.

The numerous benefits of skin-to-skin contact and breastfeeding substantially outweigh the potential risks of transmission and illness associated with COVID-19.

Can women with confirmed or suspected COVID-19 breastfeed?

Yes. Women with confirmed or suspected COVID-19 can breastfeed if they wish to do so. They should:

• Wash hands frequently with soap and water or use alcohol-based hand rub and especially before touching the baby;
• Wear a medical mask during any contact with the baby, including while feeding;
• Sneeze or cough into a tissue. Then dispose of it immediately and wash hands again;
• Routinely clean and disinfect surfaces that mothers have touched.

It is important to replace medical masks as soon as they become damp and dispose of them immediately. Masks should not be reused or touched in the front.

I have confirmed or suspected COVID-19 and am too unwell to breastfeed my baby directly. What can I do?

If you are too unwell to breastfeed your baby due to COVID-19 or other complications, you should be supported to safely provide your baby with breast milk in a way possible, available, and acceptable to you. This could include:

• Expressing milk;
• Donor human milk. 

If expressing breast milk or donor human milk are not feasible then consider wet nursing (another woman breastfeeds the child) or infant formula milk with measures to ensure that it is feasible, correctly prepared, safe and sustainable.

Here are some products I’ve curated that may be helpful while breastfeeding:

Nursing Bras

Mee mee maternity nursing bra

Triumph – this is underwired so has good support but still comfortable

Motherly

Thirdlove 24/7 classic nursing bra

Enamor

Breast Pump

Philips Avent – this is the best one but a bit expensive

Philips Avent manual – its a manual breast pump but value for money

Medela manual breast pump

Medela automatic

Nipple creams

Moms co nipple butter

Lansinoh

Vaseline

Breastfeeding Pillow

Kradyl

Babybee

Modern homes

Breast milk warmer

Philips avent

Trumom