Breastfeeding Basics

Category: Birth & Beyond

As a new mother, you may wonder, doesn’t breastfeeding come naturally? Isn’t it instinctive… or a learnt skill? MH explores this, offers tips on latching your baby and lays out the basics of breastfeeding.

WORDS ANITA DAUBARAS

All mothers have natural tendencies to nurture and respond to their infants’ needs. However, we live in a high-tech world and many of us are not tuned into our mammalian instincts. We may not have grown up being surrounded by other breastfeeding mothers and babies. Or we may be influenced by our culture’s attitudes about breastfeeding.
Breastfeeding requires getting in touch with our natural hardwiring. Our biological tools, together with the skills we learn from classes, instructional guides, and other nursing mothers mean that almost all women can breastfeed successfully!
 

Before Baby Arrives

Your Attitude

Your breastfeeding success depends largely on your beliefs about breastfeeding and your attitude. Breast milk is the normal food for your baby; your baby is biologically primed to breastfeed. Trust that your body is designed to produce high-quality milk to nurture your baby.

Become Informed

“For mothers who want to breastfeed, 80% of the work is done prenatally, and the remaining 20% is the practical aspect,” says Ms Ginny Phang, birth and postpartum doula and Baby-Friendly Hospital Initiative (BFHI) National Coordinator at the Association for Breastfeeding Advocacy (Singapore) (ABAS).
Becoming knowledgeable helps you start breastfeeding well. As breastfeeding becomes established, understanding how breastfeeding works helps you align your expectations and decisions with your breastfeeding goals. Your background knowledge helps you troubleshoot if challenges arise.
The Womanly Art of Breastfeeding by La Leche League International, Breastfeeding Made Simple Seven Natural Laws for Nursing Mothers by Mohrbacher & Kendall-Tackett and The Breastfeeding Book by Sears are good reading choices.

Build your Breastfeeding Community

Speak to your spouse to find out his views regarding breastfeeding. Spend time with breastfeeding mothers and seek out breastfeeding support groups; observe how mothers fit breastfeeding into their daily lives.

Plan your birth

The physical effects of your birth and the confidence you have as you emerge from birth affect how breastfeeding begins. Facilitate breastfeeding by:

  • Participating actively in a non-medicated labour & birth
  • Nursing your baby for the first time, within 30 minutes after birth
  • Holding your newborn skin-to-skin to you
  • Rooming-in after birth
  • Withholding artificial nipples/supplements from your breastfeeding newborn, until four to six weeks of age

Phang shares, “I usually suggest that parents prepare a Birth Plan to communicate their preferences, and a Baby Care Plan for the postpartum period. When we start working on the Baby Care Plan, it gets parents thinking about how they need to prepare for breastfeeding.”


Breastfeeding – In Action

Mother-led Latching

New mothers are often taught to breastfeed by following a series of steps to encourage and direct their babies’ efforts at the breast. 
This involves:

  • Position yourself upright or slightly reclined in bed or on a chair, using pillows for support behind your back, under your knees, behind your elbow and on your lap
  • Position your baby with his body facing you (tummy-to-tummy); his ear, shoulder and hip should be in a straight line, he should be at nipple level and his nose should be at your nipple
  • Offer your baby the breast, using your fingers to form a ‘C’ or ‘U’ hold, with your thumb on one side of your areola and your four fingers on the other side. Your fingers should be away from the areola.
  • You can also press your breast gently, to form a ‘breast sandwich’ for your baby to latch onto a big mouthful of breast
  • Touch your baby’s lower lip lightly; when he opens wide as a yawn, roll him onto the breast chin-first, so that his lower jaw is far back on the breast (an asymmetrical latch).

In Breastfeeding Made Simple Seven Natural Laws for Breastfeeding Mothers, Mohrbacher and Kendall-Tackett say that breastfeeding works best when your nipple reaches the area in your baby’s mouth where his palate changes from hard to soft, nearer the back of the mouth.

 

The Signs of An Effective Latch are

  • Nipple & most of the areola drawn into baby’s mouth deeply
  • His lips are flanged out
  • Rhythmic jaw movements as he sucks & swallows

 

The Signs of An Ineffective Latch are

  • Baby has a shallow latch or keeps slipping off & rooting for the nipple mid-feed
  • His lips are pursed or his cheeks seem sunken, as if drinking through a straw
  • Odd clicking sounds during a feed 

Baby-led Latching

Many researchers, paediatricians and lactation professionals believe that all mothers and babies inherently possess the reflexes and instincts they need to breastfeed; these evolutionary instincts are the foundation of baby-led breastfeeding.
Biological nurturing involves making the breast available to the baby. You lie in a semi-reclined position with complete support for every part of your body, allowing you to relax fully. Your baby is positioned on you (tummy-on-mummy), his cheek against your breast. Baby self-attaches in his time. Biological nurturing is flexible and simple for a new mother; there are no steps to remember! 
International board-certified lactation consultant (IBCLC) Jani Combrink explains, “In Biological Nurturing, we trigger the baby’s parasympathetic nervous system through skin-to-skin contact. The work of maintaining body temperature, breathing, regulating heartbeat and maintaining metabolism is taken over by the mother’s body, reducing neonatal stress. This allows the baby to channel energy to feeding efficiently, enabling effective milk transfer.”
Generations of breastfeeding mothers have used a combination of mother-led and baby-led latching styles. “It is important to note that with all breastfeeding positions, the one that is most comfortable for a specific dyad is unique,” adds Combrink.

The 3 Rs of Breastfeeding
① Respond to your baby’s cues to decide when and how long to feed for
Observe your baby for cues that he wants to breastfeed.
Early Cues - Stirring, rooting
Mid Cues - Stretching, increased body movements, raising hands to mouth
Late Cues - Crying, agitated body movements - calm baby before feeding

Feed your baby at the first breast for as long as he wants. When he is done, he will let you know by falling asleep, slipping off the breast or letting the nipple go. Burp him, change his diapers, snuggle a little, and then offer the other breast. He may or may not want to feed more. At the next feeding, offer the second breast first.

MYTH: Mothers are sometimes told to breastfeed at fixed intervals of time, maybe 3-hourly, for a fixed number of minutes at each breast.

Individual babies have different needs; some babies may need to feed more often than others. Mothers also have different breast storage capacities; some mothers may be able to store greater volumes of milk to give to their baby all at once, while others may need to feed more frequently. Getting to know your own baby will help you determine his particular needs.
The fat content of breast milk varies as the feeding progresses. Hind milk is the creamier milk with a higher fat content that your baby receives as the breast empties. Feeding for a fixed number of minutes at a breast may mean your baby is switched to the other breast before he receives enough of this high-calorie milk, resulting in gassiness or low weight gain.

② Removal of breast milk means greater production.
Milk production is driven by how much milk your baby removes from your breasts. The emptier the breast is kept, the greater the rate of milk production. This means that frequent feedings keep up your milk supply.
Moreover, the frequency and amount of milk removed in the early weeks determines how much milk is produced later on; frequent feedings early on mean a greater supply later!

MYTH: All newborns are able to switch between breast and bottle-feeding comfortably.

Different jaw and tongue movements are needed for sucking from the breast and from a bottle nipple. Introducing bottles to a breastfeeding newborn means he has to learn different sucking techniques. Many babies have difficulty with this.
Milk flow from a bottle nipple also differs from flow from the breast. Your baby may come to prefer the steady flow from the bottle.

MYTH: Breastfeeding directly during the day and asking a caregiver to bottle-feed at night so that mother can get longer stretches of sleep does not affect breastfeeding.

Prolactin levels are higher at night; levels also surge higher in response to your baby’s suckling, at night. Nighttime feedings encourage milk production.
Many mothers express breast milk at night to maintain their milk supply, while the baby is bottle-fed by someone else. Breastfeeding a baby is very different from removing breast milk with a pump; breastfeeding works best with baby’s direct suckling.

③ Rhythms change as your nursling grows
Your newborn’s stomach capacity is that of a marble at birth, a golf ball at 3 days of age and a large chicken egg at 10 days of age. The volume of milk your body produces corresponds with baby’s stomach size. The immune-boosting, nutrient-packed first milk, colostrum is produced in small amounts while transitional milk is produced in larger amounts after Day Two. 
As your baby grows, he may nurse more frequently during growth spurts. When solid foods are introduced, teething begins, another pregnancy begins or you return to work, breastfeeding patterns change – flexibility is key!
    Breast milk has many scientific advantages for infants. However, breastfeeding is more than a way of delivering food to your baby. It is a means of nurturing and connecting. Breastfeeding is about meeting your baby’s emotional needs, it is about your mother-baby relationship. Surround yourself with others who understand your approach to breastfeeding!

Thanks for sharing!

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