Long nipples with milk
Breastfeeding FAQs: Getting Started (for Parents)
Breastfeeding is natural, but it takes practice to get it right. Here's what you need to know about getting started.
When Will My Milk Come In?
For the first few days after your baby's birth, your body will make colostrum, a nutrient-rich "pre-milk." Colostrum (kuh-LOSS-trum) has many benefits, including nutrients that boost a baby's immune system and help fight infection.
For some women, colostrum is thick and yellowish. For others, it is thin and watery. The flow of colostrum is slow so that a baby can learn to nurse — a skill that requires a baby to suck, breathe, and swallow.
After 3–4 days of making colostrum, your breasts will start to feel firmer. This is a sign that your milk supply is increasing and changing from colostrum to mature milk. Your milk may become whiter and creamier, but this varies between women.
If your milk takes longer to come in, don't worry. This is normal and usually isn't a cause for concern, but let your doctor know. While babies don't need more than colostrum for the first few days, the doctor may need to make sure your baby's getting enough to eat. It can help to breastfeed often during this time to stimulate your milk production.
When Should I Begin Breastfeeding?
If possible, start nursing within an hour of your baby's birth. Babies tend to be alert in the first few hours of life, so breastfeeding right away takes advantage of this natural wakefulness. After this, newborns will sleep for most of the next 24 hours. At that point, it might be harder to get your baby to latch on.
When placed on your chest, your baby will naturally "root" (squirm toward the breast, turn the head toward it, and make sucking motions with the mouth). To breastfeed, babies latch onto the breast by forming a tight seal with the mouth around the nipple and areola (the dark part of skin around the nipple). Even if your baby doesn't latch on now and just "practices," it's still good for your baby (and you!) to get used to practicing breastfeeding.
In the first few days of life, your baby will want to feed on demand, usually about every 1–3 hours, day and night. As babies grow and their bellies can hold more milk, they may go longer between feedings.
How Can I Tell When My Baby's Ready to Nurse?
On-demand feeding means breastfeeding whenever your baby seems hungry. How can you tell? Hungry babies:
- move their head from side to side
- open their mouth
- stick out their tongue
- suck on their hands and fists
- pucker their lips as if to suck
- nuzzle against mom's breasts
- show the rooting reflex (when a baby moves their mouth in the direction of something that's stroking or touching their cheek)
Crying is a late sign of hunger. So try to nurse before your baby gets upset and harder to calm down.
To calm a crying or fussy baby before a feeding, try soothing "skin-to-skin" time. Dress your baby in only a diaper and place your little one onto your bare chest.
How Do I Get My Baby to Latch?
When you your baby shows hunger signs, follow these steps:
- Make a "nipple sandwich." Hold your breast with your hand, and compress it to make a "nipple sandwich." An easy way to remember how to hold your hand: Keep your thumb by your baby's nose and your fingers by the chin. (The thumb and fingers should be back far enough so that your baby has enough of the nipple and areola — the darker circle of skin around the nipple — to latch onto.) Compressing your breast this way lets your baby get a deep latch. Your baby's head should lean back slightly, so their chin is touching your breast.
- Get your baby to open wide. Touch or rub your nipple on the skin between your baby's nose and lips. When this happens, your baby should open wide (like a yawn) with the tongue down.
- Bring your baby to your breast. When your baby's mouth is open wide, quickly bring your baby to your breast (not your breast to your baby). Your baby should take as much of the areola into the mouth as possible. Your baby's nose should almost touch your breast (not press against it) and their lips should be turned out ("flanged").
When your baby is properly latched on, you may have a few moments of discomfort in the beginning. After that, it should feel like a tug when your baby is sucking.
To make sure you're doing it right, it's best to be observed by a lactation consultant, or someone else who knows about breastfeeding.
How Do I Know My Baby Is Getting Enough to Eat?
Your baby's diapers can help you tell if your little one is eating enough. The more your baby nurses, the more dirty diapers you'll see.
Pee
Because colostrum is concentrated, your baby may have only one or two wet diapers in the first 24 hours. After 3–4 days, look for:
- 6 or more wet diapers per day, with clear or very pale pee. Fewer wet diapers or darker pee may mean your baby's not getting enough to drink. If you see orange crystals in a wet diaper, call your baby's doctor. They're common in healthy, well-fed babies and usually not a cause for concern. But sometimes they're a sign that a baby isn't getting enough fluids.
Poop
A newborn's poop is thick and tarry at first, then more greenish-yellow as mom's milk comes in. After 3–4 days, look for:
- 4 or more yellow, seedy poops per day, usually one after each feeding. After about a month, babies poop less often and many may go a few days without pooping.
Your baby probably is getting enough milk if he or she:
- feeds 8–12 times a day
- seems satisfied and content after eating
- sleeps well
- is alert when awake
- is gaining weight
If you're worried that you baby isn't getting enough to eat, call your doctor.
I'm Having a Hard Time. What Can I Do?
Nursing takes time and practice. In fact, it can be one of the most challenging — and rewarding — things you do as a new mom.
While you're in the hospital, ask for help from a lactation consultant, the nursing staff, your baby's pediatrician, or your OB-GYN. When you get home, see if there's a lactation consultant in your area. You can search online at:
- United States Lactation Consultant Association
- International Lactation Consultant Association
The pediatrician will want to see your baby 24–48 hours after you leave the hospital. During this visit, the doctor will check your baby's weight and your feeding technique. If you have trouble or questions before then, call the doctor.
Whatever you do, don't let it get you down. With a little patience and some practice, breastfeeding is likely to get easier.
For more help or if you have questions, talk to a lactation consultant, your doctor, or someone who knows about breastfeeding.
Sore Nipples | Breastfeeding Challenges
There may be times when breastfeeding is challenging. Never ignore any issues you may have – talk to your health visitor, midwife, GP or breastfeeding specialist as soon as possible, they will be able to help you sort it out quickly.
Here are some common breastfeeding issues, and tips on what to do.
- Colic
- Constipation
- Mastitis
- Milk supply
- Reflux
- Sore nipples
- Thrush
- Tongue-tie
Sore nipples
When you first start breastfeeding, you may have sore or sensitive nipples. This is very common in the first week of breastfeeding, and is usually because your baby is not latching on (positioned or attached) properly. If you do have nipple pain, speak to your midwife, health visitor or breastfeeding specialist as soon as possible – breastfeeding should not be painful!
What causes sore nipples?
The most common cause of nipple pain is when your baby does not latch on properly. It's very important that you correct this as soon as possible – ask your midwife, health visitor or breastfeeding specialist for help, they can show you how your baby needs to be positioned when feeding. Have a look at our step-by-step guide to latching on
Whatever you do – do not stop breastfeeding! Breast milk is created on a supply and demand system, so the less you feed, the less you produce. If you are finding it really painful to breastfeed try expressing your breast milk to keep up the supply.
Breastfeeding Friend from Start for Life
The Breastfeeding Friend, a digital tool from Start for Life, has lots of useful information and expert advice to share with you – and because it's a digital tool, you can access it 24 / 7.
Other possible causes for sore nipples
Tongue tie
When the strip of tissue under your baby's tongue (attaching the tongue to the floor of the mouth) is shorter than normal – this can prevent them from latching on properly.
Thrush
Thrush (or 'candida') is an infection that can occur when your nipples become cracked or damaged. Symptoms are usually severe pain in your nipples after breastfeeding (it's described as burning or shooting pains) lasting up to an hour. Your doctor can prescribe treatment for you and your baby.
Tips for soothing sore nipples
- Some women find rubbing breast milk onto their nipples can be soothing.
- Products like Vaseline or lanolin can help with dry or cracked nipples (although there's little evidence to show what really works well).
- After each feed, let your nipples dry before getting dressed – change your breast pads after every feed.
- Avoid using soap, as this can dry out your skin.
- If possible, only wear cotton, non-underwired bras.
- It's best to avoid using nipple shields and breast shells – these will not improve your baby's attachment to the breast.
- Try not to shorten feeds – doing so will not ease the pain and may reduce your milk supply.
Videos
What can I do about sore nipples??
How do I know if my baby is properly latched on?
Breastfeeding with pierced, flat or inverted nipples
The shape and size of nipples can vary greatly from woman to woman. Our practical tips will help you make breastfeeding easier, no matter what your nipples are.
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Most women's nipples protrude, enlarge and swell when touched, but some have flat or even inward nipples. In addition, some women pierce one or both nipples. Usually flat, inverted or pierced nipples do not cause problems when breastfeeding, but in some cases additional help may be needed.
“Don't panic if you have flat or inverted nipples. As a rule, this does not interfere with breastfeeding in any way,” says Shawnad Hilton, a lactation consultant, health visitor and newborn care specialist who has worked with Medela in the UK for more than a decade. “Remember that your baby takes into his mouth not only the nipple, but also part of the breast.”
However, in the early days, when the baby's mouth is still very small and suckling skills have not developed, inverted or flat nipples can make feeding difficult, especially if the baby is unwell or born prematurely.
“Flat or inverted nipples may not reach the baby's palate and therefore not trigger the sucking reflex,” Schoned explains. “That is, the baby may have trouble grasping and holding the breast in the mouth, and the baby will not get enough milk.”
How to tell if you have flat or inverted nipples
Flat nipples 1 do not protrude much from the areola (the darker
area surrounding the nipple) even when stimulated.
Inverted nipples seem to be recessed in the center. They may look like this all the time or only if they are stimulated. Sometimes inverted nipples are on the same level with the areola, and sometimes even sink deep into the breast tissue.
This feature may occur on one or both nipples. It is estimated that approximately 10% of nulliparous women have at least one retracted nipple. 2 If you're not sure what type of nipples you have, try a simple pinch test: Gently squeeze your breast with your thumb and forefinger on both sides of the areola. The nipple should come forward. If your nipple hides inside, creating a depression, then it is retracted.
Preparing inverted and flat nipples during pregnancy
You may have noticed that during pregnancy your breasts have changed and your nipples have become more protruding. If this does not happen and you are worried that the shape of your nipples will make breastfeeding difficult, try using nipple formers* in consultation with your doctor. These are soft and flexible silicone discs that are discreetly placed in the bra and slightly squeeze the nipples, helping to pull them out.
“In a normal pregnancy, nipple formers can be worn from 32 weeks,” advises Schoned. - Start wearing them for an hour a day, gradually increasing the time to eight hours. If you have an incompetent (weakened) cervix or are at risk of preterm labor, check with your healthcare provider about when you can start using shapers, as nipple stimulation can trigger contractions.”
“Nipple formers can continue to be worn after childbirth,” adds Schoned. “Try to put them in a bra 30 to 60 minutes before feeding.”
“I have inverted nipples, and after two or three weeks of constantly trying to latch on, I almost switched to formula,” recalls Nina, a mother from Germany. “I turned to La Leche Liga for help, and one nice woman came to me and supported me to continue to feed. She suggested trying nipple shapers and they really helped me. Somehow my baby began to understand what to do! Breastfeeding went well and I nursed him until he was 21 months old.”
How to help your baby latch on to flat or inverted nipples
If your baby enjoys sucking on your thumb but isn't as interested in your breast, chances are your nipple isn't reaching the palate. The baby may become nervous, push off the breast and cry or even fall asleep on your chest. If this happens, ask a lactation consultant or healthcare professional to check the grip.
There are several tricks you can use before every feed to make your nipples more comfortable to latch on to. Schoned recommends the following:
- twist the nipple between thumb and forefinger so that it protrudes better;
- place fingers in a "V" or "C" shape and squeeze the breast just behind the areola to push out the nipple;
- apply a cold compress or ice cube to the nipple to push it forward;
- Express milk manually or with a breast pump for a couple of minutes before feeding so that the nipple comes out more.
“I had a flat nipple, but I only found out about it when I noticed Austin was having trouble suckling on that side,” says Jennifer, mother of two in the UK. “From an anatomical point of view, there is nothing abnormal in this, it’s just that my nipple does not protrude so much, and this requires some skill when feeding. Before giving this breast, I always pinched and squeezed the nipple a little and tried to put it into the baby's mouth. It was a little difficult at first, but over time I learned.”
Using nursing pads
If none of the above work and your baby still has difficulty latch-on, your lactation consultant or healthcare professional may recommend that you breastfeed with a nursing pad*. They are thin and flexible nipple-shaped silicone funnels with holes at the tip through which milk will flow.
It is easier for the baby to put the feeding pad in his mouth, as it is larger and more rigid. In addition, such an overlay will reach him to the sky, causing a sucking reflex. Do not use nursing pads for a long time. If you experience pain or other problems, contact your lactation consultant or healthcare professional to check that your baby is latching on properly with a breastfeeding pad. You will also need to monitor your baby's weight gain to ensure that milk production is meeting his needs. 3
Over time, as your baby learns to suckle properly and your nipples get used to breastfeeding, you will be able to breastfeed without breast pads.
“My nipples are rather flat. The doctor advised me nursing pads, and I was successfully able to feed my two babies,” says Ann-Sophie, mother of two from Sweden. “My secret is to make them adhere better to the skin, I lightly wet the edges before use. ”
Breastfeeding with pierced nipples
Many women with pierced nipples find it does not affect their ability to breastfeed. However, jewelry must be removed before feeding, as the child may choke on them or injure their tongue, gums or palate.
“I had a nipple piercing, but I got it off a year later when I got pregnant because my breasts were very sensitive,” says Kelly, mother of three from the UK. “I breastfed my daughter exclusively, and then her two younger brothers, and never had any problems. And the pierced nipple was my favorite!”
Some women report that milk can leak from piercings, while others believe that piercing scars reduce milk production 4 - but this has not been well researched.
“You can't predict how a piercing will affect breastfeeding until milk production begins,” Schoned explains. - If you are concerned, talk to a lactation consultant or healthcare professional. And remember that one breast may be enough for babies to get the nutrition they need if there are problems with the second. ”
What to do if you can't breastfeed with flat or inverted nipples
If you've tried all the options and still can't breastfeed, you still shouldn't deprive your baby of breastmilk.
“Mom and baby's health is the most important thing,” says Schoned. “Maybe you should switch to full pumping and feed your baby only expressed milk. You can also try the supplementary feeding system** where the baby continues to feed at the breast while receiving additional expressed milk through a tube. That is, the baby will still suck on the breast and stimulate the production of milk, which, in turn, will help you pump even more.
“I have inverted nipples. After the disastrous experience of breastfeeding my first son with my second, I decided to get my way after all,” says Babettli, mother-of-two from Italy. - On the advice of experts, I tried nipple formers and nursing pads, but everything was unsuccessful. In the end, pumping with the Medela Symphony*** Double Electronic Clinical Breast Pump proved to be the best solution for us. I fed exclusively on expressed milk for up to four months.”
Care for different types of nipples
Flat or inverted nipples may require extra care as the baby may squeeze them harder and they may become inflamed at first. Tips on how to care for sore nipples can be found in Nursing Nipple Care.
If your nipples become inverted after a feed, any moisture can lead to inflammation and increase the risk of infections, including thrush. Blot your nipples dry after each feed before they have time to hide inside.
With swelling of the mammary glands, when even protruding nipples can become flat, flat or inverted nipples can be difficult. Read the helpful tips in the article on breast swelling.
The good news is that continuous breastfeeding or pumping can change the shape of your nipples and breastfeeding will become easier over time. With the arrival of the next child, you may not have to face this problem at all, as happened with Leanne, a mother of two from the UK.
“The second feeding was like a fairy tale,” she says. “After almost four months of pumping for my first son, my flat nipples were so extended that with my second son I no longer had to use breast pads - he was able to suck directly from the breast. The youngest is now nine months old and I still breastfeed him.”
Literature
1 Pluchinotta AM. The Outpatient Breast Clinic. Springer International Publishing ; 2015. - Pluchinotta A.M., "Treatment of breast diseases on an outpatient basis". Springer International Publishing. 2015.
2 Alexander JM, Campbell MJ. Prevalence of inverted and non-protractile nipples in antenatal women who intend to breast-feed. The Breast . 1997;6(2):72-78. — Alexander JM, Campbell MJ, "Prevalence of inverted and intractable nipples in pregnant women who intend to breastfeed." Ze Brest (Chest). 1997;6(2):72-78.
3 McKechnie AC, Eglash A. Nipple shields: a review of the literature.Breastfeeding Medicine. 2010;5(6):309-314. — McKechnie A.S., Eglash A., "Nipple Covers: A Review of the Literature". Brestfeeding Medicine (Breastfeeding Medicine). 2010;5(6):309-314.
4 Garbin CP0106 , Rowan MK , Hartmann PE , Geddes DT . Association of nipple piercing with abnormal milk production and breastfeeding. JAMA, Journal of the American Medical Association. 2009;301(24):2550-2551. - Garbin S.P., Deacon J.P., Rowan M.C., Hartmann P.I., Geddes D.T., "Nipple piercing and its impact on abnormal milk production and breastfeeding", JAMA (Journal of the American medical association). 2009;301(24):2550-2551.
Read instructions before use. Consult a specialist about possible contraindications.
* RC No. FSZ 2010/07352 dated 07/19/10
** RC No. FSZ 2010/07353 dated 07/19/10
*** RC No. FSZ 2010/06525 dated 17/03/2021 Prejudice related to 900.3 breastfeeding
Instead of an introduction, I would like to say that the ideas of modern women about breastfeeding are a collection of prejudices. They are so common that in many books for expectant mothers and in magazines for parents, it is actions based on prejudice that are described as correct and necessary.
“Breastfeeding is something incredibly difficult, almost no one is able to feed for a long time, everyone always has a lot of problems and one continuous inconvenience”
There is nothing easier, more convenient, more pleasant for mother and child, and, by the way, cheaper, than proper breastfeeding. But for that to be the case, breastfeeding needs to be learned. The best teacher in this matter may not be a book or a magazine for parents, but a woman who has been breastfeeding her child for a long time, more than a year, and receiving positive emotions from this. There are women who breastfeed for a long time and perceived it as a punishment. For example, one mother fed a child for 1.5 years and for all these 1.5 years she pumped after each feeding, and when she decided that she was enough and decided to wean the child, she had mastitis due to wrong actions. Now she tells everyone that breastfeeding is hell. She didn't feed her baby properly for a single day.
"Breastfeeding spoils the shape of the breast"
It is true that breastfeeding does not improve the shape of the breast, but the breast changes during pregnancy. It is then that it increases and becomes heavier, and, if its shape contributes to this, it “sags”.
Breast changes during lactation. Approximately 1-1.5 months after birth, with stable lactation, it becomes soft, produces milk almost only when the baby suckles. After the end of breastfeeding, 1.5-3 or more years after the birth of the baby, involution of the mammary gland occurs, lactation stops. Iron "falls asleep" until the next time. Under natural conditions, the end of breastfeeding always coincides with a decrease in the baby's need for breastfeeding. The chest remains soft, inelastic. The shape of the breast largely depends on the presence of adipose tissue in it, the amount of which decreases during prolonged breastfeeding. After the end of breastfeeding, adipose tissue is gradually restored. If a woman does not feed a child, the involution of the mammary gland occurs within the first month after childbirth. The shape of the breast still does not return to its pre-pregnancy state. And if you think about it and figure out why a woman has breasts at all? It's for breastfeeding.
"Breastfeeding spoils the figure"
Many women are afraid to gain weight while breastfeeding. But usually a woman gains weight mainly during pregnancy, and not when she is nursing. Moreover, if before pregnancy she tried to meet certain fashionable standards, for example, 90-60-90, during pregnancy she returns to her weight, her genetically incorporated physiological norm (and it may be far from fashionable standards) + the well-known 7-10kg per uterus, fetus, amniotic fluid, increased volume of circulating blood and a little bit more for various little things. Weight gain during pregnancy can be significant. Many women begin to lose weight after 6-8 months of feeding, and gradually, in the second, third year of feeding, she “drops” everything that she has accumulated. It turns out that the figure from breastfeeding often just improves.
Very often it turns out that a woman, having stopped breastfeeding 1.5-2 months after giving birth, begins to gain weight. Perhaps this is due to the resulting hormonal imbalance, tk. no woman is designed for such a rapid cessation of lactation.
"You have to prepare the breast for feeding." And then various recommendations follow, from sewing hard rags into the bra to advice to the husband at the end of pregnancy to “dissolve the ducts” of his wife
There is no need to prepare the breast for feeding, it is so arranged by nature that by the time of birth it is quite ready to feed the child. Cloths, for example, can cause skin irritation. Any manipulation of the nipple at the end of pregnancy can lead to very undesirable consequences due to the stimulation of the oxytocin reflex: stimulation of the nipple - release of oxytocin - contraction of the muscles of the uterus under the influence of oxytocin - the uterus is "in good shape" - and, as the worst option, stimulation of premature labor. And in general, has anyone seen a cat with a rag in a bra, or a monkey doing a hardening shower massage?
“With a flat, let alone inverted nipple, breastfeeding is impossible”
Strange as it may seem to people who have never breastfed, a baby's nipple is just a point from which milk flows. If the child sucks in the correct position, then the nipple is located at the level of the soft palate and does not participate in the actual sucking. The child sucks not the nipple, but the areola, massaging, decanting it with the tongue. A breast with a flat or inverted nipple is difficult for a baby to hold in his mouth while suckling and it is more difficult for him to suck on it. Mom should show patience and perseverance in the first days after the birth of a child. Any child is perfectly trained to suck even the most uncomfortable, from our point of view, breast.
The nipple changes shape during sucking, stretches and takes on a more comfortable shape for the baby, usually in 3-4 weeks. There are also various devices called "nipple formers". They are put on immediately after feeding, when the nipple is slightly extended by the efforts of the child and worn until the next application. The nipple formers hold the nipple in an extended position. But even without these things it is quite possible to do.
It is very important for a mother with flat or inverted nipples to ensure that her baby never suckles anything but her mother's breast after birth. The child of such a mother, having sucked on a bottle or a pacifier, quickly realizes that this is a more convenient object for sucking and begins to refuse the breast. In this situation, mom will need even more patience and perseverance.
"You can't keep a newborn at the breast for more than 5 minutes, otherwise there will be cracks"
The child should be kept at the breast for as long as he needs. Feeding ends when the baby himself releases the breast.
If we talk about cracks, then there are only three groups of causes that lead to their formation
- Mother washes her breasts before each feeding. If she does this (and even with soap, and even anoints with brilliant green after feeding - a favorite pastime in Russian maternity hospitals, for example) - she constantly washes off the protective layer from the areola, which is produced by special glands located around the nipple, and dries the skin. This protective lubricant exists just to prevent the loss of moisture in the delicate skin of the nipple, it has bactericidal properties and inhibits the growth of pathogenic microorganisms and, which is especially important for the child, smells about the same as amniotic fluid. The sensitive skin of some women cannot tolerate such exposure for a long time and begins to crack, even with proper attachment of the baby.
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Causes related to the incorrect position and behavior of the baby at the breast: the baby is not properly attached and sucks in the wrong position. And if this is true, then 5 minutes after 3 hours is enough for the formation of abrasions, and then cracks. The baby may latch on correctly, but in the process of suckling, he may perform various actions that can lead to cracking if the mother does not know that these actions need to be corrected and not allowed to behave like this. It must be remembered that the child has not suckled before, and does not know how to do it (he knows only the general principle of sucking). Unfortunately, most mothers also do not know how a baby should behave at the breast; they have never, or almost never seen it. What shouldn't a child be allowed to do? "Move out" to the tip of the nipple. This happens especially often if, during sucking, the child does not stick his nose into his mother's breast. If the mother feels that the grip is changing, she should try to press the baby with her nose to her chest. Very often this is enough for the child to “put on” correctly.
If this does not help, the nipple must be removed and re-inserted correctly. The baby should not suckle the breast incorrectly for a single minute. He doesn’t care how to suck, he doesn’t know that he hurts his mother, he doesn’t know that the wrong position does not allow him to suck out enough milk, he doesn’t know that with the wrong position there is not enough stimulation of his mother’s breast and there will not be enough milk production. You can not let the child play with the nipple. A child who has learned to slide down on the tip of the nipple sometimes begins to pass the nipple back and forth through the parted jaws. Mom, of course, it hurts or is unpleasant, but in most cases, mothers allow this to be done “If only he sucked ...” they say ... Why? It often happens that children who do not feel the touch of the breast with their nose during sucking, or do not feel it very well, begin to make search movements with the nipple in their mouth. Here you need to gently press the baby to your chest so that he understands that he is already in place and there is nothing more to look for. Sometimes, especially if the mother has long and large nipples, the baby grabs the breast in several steps, “climbing” up in several movements. This also happens in cases where the child has already sucked on the pacifier and does not open his mouth well. The nipple is injured so very quickly. To avoid this, it is necessary to properly insert the nipple into the wide-open mouth, bringing the nipple itself past the jaws, as deep as possible. Moms don't know how to breastfeed properly.
A typical picture for maternity hospitals with separate stay is as follows: a baby was brought to the mother for 30 minutes, the baby held everything correctly and sucked well for these 30 minutes, he would still suck, but they came to pick him up and the mother pulls (slowly or quickly) his nipple from mouth. Six such pulls per day is enough for the development of abrasions. You can take the nipple only after opening the jaw with the little finger (quickly insert the tip of the finger into the corner of the mouth and turn it - it does not hurt at all and no one suffers).
Diseases of the skin of the nipples. Most often, mothers are faced with a fungal infection of the skin of the nipples - "thrush". In this situation, the skin most often looks "irritated", it can peel off, itch, cracks may appear, even despite proper application, there may be pain during and after sucking, piercing pains along the milk ducts. This problem is usually solved with the use of specific treatment and also has nothing to do with the topic of preparing the breast for feeding or the time the baby is at the breast.
“While there is no milk, it is necessary to drink more water”
The first day after childbirth, liquid colostrum forms in the breast of a woman, on the second day it becomes thick, on 3-4 days transitional milk may appear, 7-10-18 days - milk become mature. Colostrum is scarce and thicker than milk. This is the main argument in most Russian maternity hospitals in favor of supplementing and feeding the child (otherwise he allegedly suffers from hunger and thirst).
If a child needed large volumes of liquid immediately after birth, then nature would arrange the woman in such a way that she would be flooded with colostrum immediately after childbirth. But the child does not need extra water at all. All he needs he gets from colostrum and milk! The water that is given to the child while the mother has colostrum literally “washes away” the colostrum from the gastrointestinal tract, depriving the baby of the action of colostrum necessary for him. Water is given from a bottle, which leads to "tangled nipples" in the baby and may lead to refusal of the breast. Water causes a false feeling of fullness and reduces the need for suckling in a child. If we give a child 100 g of water per day, he sucks 100 g less milk (this applies not only to a newborn). The kidneys of a newborn are not ready for a large load of water and begin to work with overload. The list of arguments against can be continued, but these are enough.
“While there is no milk, it is necessary to supplement the child with formula, otherwise he will lose weight, starve”
The child is not designed to receive anything other than colostrum and milk. In the first days after birth, one colostrum is enough for him. Weight loss in the first day of life is a physiological norm. Newborns lose up to 6-8% of their birth weight in the first two days of their lives. Most children regain their weight or begin to put on weight by 5-7 days of life. Supplementary feeding with a mixture in the first days of a child's life is nothing more than a gross interference in the functioning of the baby's body. You can call this intervention a metabolic catastrophe. But in most Russian maternity hospitals, this is completely ignored!
In addition, the introduction of supplementary feeding is carried out through a bottle, which very quickly leads to "tangled nipples" and the baby refuses the breast. Sometimes one or two bottle feedings are enough to stop a baby from breastfeeding! The mixture causes a feeling of fullness, lingers in the stomach for a long time, the child has a reduced need to suckle the breast, which leads to a decrease in breast stimulation and a decrease in milk production.
“I feed my baby on demand! He demands from me in 3. 5 hours!”
Feeding on demand means putting the baby to the breast for every disturbance or search. The baby needs breastfeeding around every sleep, he falls asleep at the breast and when he wakes up, he is given the breast. A newborn child in the first week of his life can indeed be applied relatively rarely - 7-8 times a day, but in the second week of life, the intervals between applications are always reduced. During wakefulness, the child can ask for a breast up to 4 times per hour, i.e. every 15 minutes! Usually a child fed on demand is applied in the first month of life 12 or more times a day, usually 16-20 times. If a child in the first months of life is applied less than 12 times, then the mother either does not notice his modest requests, or ignores them (meaning a healthy, physiologically mature child).
In the overwhelming majority of cases, at the moment when the child begins to ask for a breast more often, the mother decides that the child is starving and introduces supplementary feeding. And the child asks for breasts not at all because he is hungry. He constantly needs a sense of confirmation of physical contact with his mother. During his life in his mother's belly, he is very used to the following: warm, crowded, I hear my heart beating, my lungs breathe, my intestines growl, I smell and taste amniotic fluid (filling the baby's nose and mouth), almost all the time I suck a fist (studies suck). Only in these conditions the baby feels comfortable and safe. After childbirth, he can get into such conditions only if his mother takes him in her arms, puts him on her breast, and then he will again feel cramped, warm, he will hear familiar rhythms, start sucking and feel the familiar smell and taste (the smell and taste of milk are similar to the taste and smell of amniotic fluid). And a newborn child wants to get into such conditions as often as possible. And a modern mother is waiting, she can’t wait, when the intervals between feedings will increase, when will the child start eating in 3. 5-4 hours, when will he stop waking up at night ??? Hurry!!! And, usually, to the timid attempts of the child to ask for a breast, he answers with a pacifier, a rattle, gives some water, talks, entertains. The child is most often applied to the breast only when he wakes up. And he quickly agrees with this position. The child always takes the mother's position. But here a “pitfall” awaits mother and baby - insufficient breast stimulation and, as a result, a decrease in the amount of milk.
“Feeding on demand is a nightmare! It is impossible to sit and feed the child for days!”
That's what mothers who can't breastfeed say. With properly organized feeding, mom is resting! She lies, relaxed, hugs the baby, the baby sucks. What could be better? Most women cannot find a comfortable position, they sit, they hold the child awkwardly, their back or arm numbs, if they feed lying down, it usually “hangs” over the child on the elbow, the elbow and back become numb. Moreover, if the child does not take the breast well, it hurts the mother . .. What kind of pleasure can we talk about here? In the first month - one and a half after childbirth, when the child is applied chaotically, without a pronounced regimen, sucks often and for a long time, the mother can feel good only if breastfeeding is organized correctly, it is convenient for the mother to feed, she knows how to do it standing, lying down and sitting, and even moving.
“After each feeding, you must express the rest of the milk, otherwise the milk will be wasted”
No, you do not need to express after each feeding if breastfeeding is properly organized. If you feed your baby 6 times a day and do not express, indeed, milk can disappear very quickly. If you express after each feeding, then you can support lactation for some time. The terms are different, but rarely it is more than six months, cases of feeding on such behavior for more than a year are isolated.
When feeding a baby on demand, the mother always has as much milk as the baby needs and there is no need to pump after each application. In order for the newborn to completely suck out the breast, it is applied to one breast for 2-3 hours, and to the other for the next 2-3 hours. Somewhere after 3 months, when the child is already applied relatively rarely, he may need a second breast in one attachment, then the next time he is applied to the one that was last.
There is one unpleasant “pitfall” in regular pumping after feeding, which even most doctors are not aware of. It's called lactase deficiency. When a mother expresses after a feed, she expresses just the “hind” fatty milk, which is relatively poor in milk sugar, lactose. She feeds the child mainly with the anterior portion, which accumulates in the breast between rare feedings. There is a lot of lactose in the anterior portion. The child is fed "only lactose", the gastrointestinal tract of the child after some time ceases to cope with such volumes of lactose. Lactase deficiency develops (Lactase is an enzyme that breaks down lactose - milk sugar, it begins to be missed). This is one of the reasons for the development of lactase deficiency; the second, for example, is this: the mother gives the child two breasts in one feeding. But about this separately.
“You should give your baby two breasts at one feeding.”
No, it is not necessary to give two breasts. A newborn baby can be applied for 1.5-3 hours to one breast. Then 1.5-3 hours to another (for example, the baby woke up, sucked a little and didn’t want to anymore, but after 30 minutes he wanted to suck a little more. After 20 minutes, he sucked longer and fell asleep; all these attachments were from one breast; when the baby wakes up, you can offer him another breast). We need this so that the baby sucks the breast to the end, and receives "front" and "hind" milk in a balanced amount. If the baby is transferred to the other breast in the middle of feeding, he will receive less fat-rich hind milk. He will suck mainly the front portion from one breast and add the same from the other. Foremilk is rich in lactose, and after a while the baby can no longer cope with the load of lactose. Lactose intolerance develops.
Transferring a baby from one breast to another can cause hyperlactation in some women, and if the mother also expresses both breasts after each feeding ... There are such mothers. Curtailing excess milk is sometimes more difficult than adding missing ... In some cases, feeding at one feeding from two breasts is necessary to stimulate lactation when there is a shortage of milk. A growing baby, most often after 3-4 months, may need two breasts in one feeding. Then the next application begins with the breast that was last.
“The more liquid you drink, the more milk”
There are mothers who try to drink as much as possible, sometimes up to 5 liters of liquid per day. And a nursing mother should drink only as much as she wants. By thirst. Mom shouldn't be thirsty. And if water is drunk on purpose, and even more than 3-3.5 liters per day, lactation can begin to be suppressed.
“Sucking the fist is very harmful”
The whole end of pregnancy the child sucked the fist, so he learned to suck. Fist sucking is one of the inborn habits of a newborn. After childbirth, the baby begins to suck on the fist as soon as it enters his mouth. At 3-4 months, the fist is the first thing that the baby can put into his mouth on his own. He can do things on his own!!! This is amazing! And at this age, many babies begin to actively suck their fingers and fists. There is nothing wrong with this. Mom only needs to watch the baby a little. If a baby plays with a fist, then he sucks, then he stops, he can not be distracted from this activity. If the baby begins to actively suck the fist, then the baby wants to suck for real, offer him a breast. If the need to suckle the baby is fully satisfied by the breast, then the baby stops sucking the fist by 5-6 months. (Then, at 6-7 months, he begins to “look for teeth”, but this is a completely different behavior). The cam baby sucks almost the same as the breast, opening its mouth wide. Some babies have a very funny behavior when, having stuck to the chest, the baby tries to put his fist in his mouth . ..
"My baby needs a pacifier"
The baby is not designed by nature to suckle anything other than the breast (and the fist, in a pinch). A child is always taught to use a pacifier. There are children who immediately push out the pacifier with their tongue. And there are those who begin to suck it. There are mothers who hold the pacifier with their finger so that her child does not push it out. Usually, the first time a baby gets a dummy is when he showed concern and the mother does not know how to calm him down. To calm down, the child needs to suck on the breast, well, they didn’t give him a breast, they gave him something else, he will have to suck what they give ...
“A child often asks for breasts, which means that he is hungry, there is not enough milk for him”
As mentioned above, a newborn child asks to be breastfed often, not at all because he is hungry. He wants to suck, he wants to mom. He constantly needs confirmation of psycho-emotional and physical contact with his mother.
“Sufficient milk or not, we will find out on control feeding”
We will not learn anything on control feeding (the child is weighed before and after feeding, the difference is calculated and find out how much he sucked for feeding). Because:
- A baby who feeds on demand constantly sucks different portions of milk. In one application 5 ml, in another - 50, in the third - 150. You can get 5 ml. (Once I weighed my daughter after 30 minutes of suckling. She gained 14 g. In the first month of her life, she gained 1200 g - and what would the district pediatrician tell me if this was control feeding in the clinic?)
- The newborn is designed to receive small portions of milk, but often. The vast majority of newborns in the conditions of feeding 6-7 times a day still suck out small portions of milk, and not 6 times 120 ml. And of course they don't eat. They start gaining poorly or stop gaining weight, or lose weight altogether.
Whether or not enough milk is available can be determined in two ways:
Wet diaper test. (This is a test for wet diapers, not for used diapers, because you need to know exactly the number of urination). If a child older than 7 days pees more than 6-8 times a day, his urine is light, transparent, odorless, then he receives a sufficient amount of milk. Usually the child pees during wakefulness every 15-30 minutes. If a mother uses diapers, but wants to find out if there is enough milk or not, she needs to remove the diapers from the child for three hours. If the baby pees 3-4 times or more in three hours, then you can not count further. If you peed 3 times or less, we count for 6 hours. If in six hours he peed 4-5 times or more, you can not count further, if less than 4, we count further. And so on… Weekly weight gain (for a child older than 7 days) should be between 125 and 500 g.
“If applied frequently, the baby will suck everything out quickly, the breast is soft all the time – there is no milk. It is necessary to “save” milk for feeding”
When feeding a child on demand, the breast becomes soft about a month after the start of feeding, when lactation becomes stable. Milk begins to be produced only when the baby suckles. The breast is never “empty”, in response to the sucking of the child, milk is constantly produced in it. If the mother is trying to fill her breasts for feeding, waiting for the breasts to “fill up”, she gradually reduces the amount of milk by such actions. The more mother attaches the child, the more milk, and not vice versa.
“The stomach needs to rest”
But the child's stomach doesn't work very well. Milk there only curdles and is quickly evacuated to the intestines, where the actual digestion and absorption takes place. This is the prejudice from the old song about feeding according to the schedule after 3 hours. The newborn does not have a clock. No mammal makes even intervals in feeding its newborns. The body of the child is adapted to the continuous flow of mother's milk, and he does not need to rest at all.
“After each feeding, keep the baby upright for 20 minutes”
Do not hold the baby upright after each feeding, especially if the baby has fallen asleep. Most of the time the baby lies on its side. If he burps a little, then the diaper just changes under his cheek. It is necessary to hold the artificial man vertically so that he does not spill the 120g poured into him. And we are talking about babies who are fed on demand and receive small portions of mother's milk. In addition, the cardiac sphincter of the stomach needs training, which it can only receive if the child is lying down.
“You need to sleep at night”
At night, you need to not only sleep, but suck your breast. Most newborn children are so arranged that they sleep from 10-11 pm to 3-4 am, then they begin to wake up and ask for breasts. In a child of the first month of life, applications in the morning hours (from 3 to 8) are usually 4-6. Night feedings with properly organized breastfeeding look something like this: the baby got worried, the mother put it to the breast, the baby sleeps sucking and the mother also sleeps, after a while he lets go of the breast and sleeps more soundly. And such episodes happen in a night 4-6. All this is easy to organize if the mother sleeps with her child, and for this she needs to be able to feed lying down in a comfortable position.
If the baby sleeps separately from the mother, in his own bed, then he stops waking up for morning feedings, sometimes already a week after birth, sometimes by 1.5-2 months. Most modern mothers take this with relief, because. for them, finally, the night running back and forth, nodding while sitting in a chair or on a bed over a sucking child, and some also pumped at night ... And here they are waiting for a pitfall called insufficient stimulation of prolactin and, as a result, a decrease in the amount of milk . A mother and her child are a wonderful self-regulating system. While the baby has a need to suck in the morning, his mother produces the maximum amount of prolactin, just from about 3 to 8 in the morning.
Prolactin is always present in the female body in small amounts, its concentration in the blood increases significantly after the baby begins to breastfeed, most of all it is obtained in the morning hours from 3 to 8 in the morning. Prolactin, which appeared in the morning, is engaged in the production of milk during the day. It turns out who sucks at night, stimulates his mother's prolactin and provides himself with a decent amount of milk during the day. And whoever fails to suckle at night, he can quite quickly be left without milk during the day. No mammal takes a nightly break from feeding its young.
“I lost my milk because of my “nerves””
Milk production depends on the hormone prolactin, the amount of which depends on the number of times the baby is latched on and nothing else. The experiences of the mother on any occasion do not affect him. But the release of milk from the breast depends on the hormone oxytocin, which is engaged in the fact that it contributes to the contraction of muscle cells around the lobules of the gland and thereby contributes to the flow of milk. The amount of this hormone is very dependent on the psychological state of the woman. If she is frightened, tired, in pain or in any other discomfort during feeding, oxytocin stops working and milk stops flowing from the breast. A child cannot suck it out, a breast pump does not express it, and it cannot come out with its hands ...
The manifestation of the “oxytocin reflex” was observed by every breastfeeding woman: when a mother hears the crying of a child (and not necessarily her own), her milk begins to leak. The body tells the mother that it is time to apply the baby. In a situation of stress or fear, nothing like this is observed. (Relationship to the ancient instinct of self-preservation: if a woman runs from a tiger and she smells of leaking milk, the tiger will find and eat her faster, so while she runs in fear through the jungle with a child under her arm, the milk will not leak when she gets to the safety of the cave - and calmly settle down to feed the child, the milk will come again.)
Modern stressful situations work like those tigers. In order for milk to flow out again, you must try to relax during feeding, think only about the child. You can drink soothing herbs, shoulder massage, calm conversation helps well. Anything to help you relax. And most modern mothers are not able to relax during feeding, it is uncomfortable for them to sit or lie down, it can be painful to feed - all this prevents the manifestation of the oxytocin reflex - milk remains in the breast, which leads to a decrease in lactation.
"The baby is too fat, it is necessary to limit the number of feedings and give water"
A breastfed child gains 125 to 500 g per week, or 500 to 2000 g per month. Usually, by 6 months, a child born with a weight of 3-3.5 kg weighs about 8 kg. The rate of gain is very individual, there is never any talk of "overfeeding", children who are actively gaining weight grow rapidly in length and look proportionate. Children who gain 1.5-2 kg per month in the first half of life, usually sharply reduce weight gain in the second half of the year and can weigh 12-14 kg by the year. There is never a need to limit the number of feedings, much less to give water.
“Baby lacks nutrients, needs complementary foods from the age of 4 months”
The need for other food manifests itself in a child of about 6 months of age, when he begins to actively wonder what everyone is eating there. And if a mother takes a baby to the table with her, he begins to actively take an interest in the contents of his plate. This behavior is called active food interest, and it indicates that the child is ready to get acquainted with new food and can begin it. Nevertheless, breast milk remains the main food of the child in the first year of life, and in many cases even at the beginning of the second, contains absolutely all the nutrients the child needs and much more.
"A nursing mother should have a strict diet"
Food should be habitual. It is preferable not to use exotic foods in the diet that are not characteristic of the "native" climatic zone. A breastfeeding mother may have interesting nutritional needs, and they must be met in the same way as the desires of a pregnant woman. A woman should eat according to her appetite, and not stick food for two into herself. And, of course, you need to try to eat healthy food. Do not use products containing preservatives, dyes and other unhealthy substances.