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Breastfeeding

Alternate Names

  • breastfeeding positions
  • nipple care when breast feeding
  • nursing frequency
  • nursing

Definition

Techniques and advice for successful breastfeeding are detailed below.

Information

The breasts get ready to make milk during pregnancy. Milk production is controlled by hormonal signals in the body. Successful breastfeeding depends in part on the mother's confidence in her ability to breastfeed. This involves having the proper environment to nurse and being prepared emotionally and physically for the experience. If the mother is pain free, relaxed and supported by family and others, success is more likely.
Proper nipple care, positioning and nursing frequency may help to prevent some common breastfeeding problems. Babies who are breastfed have fewer infections and allergies during their first year of life than babies who are fed formula. Breast milk is free and convenient. Nature's best food is a mother's own milk.

Some common breastfeeding questions include:

Frequency of feeding

The baby should be fed in the delivery room if the mother and baby's health are adequate. The next feeding should be 4 to 6 hours later or after the baby has awakened from a deep sleep. It may take up to 2 weeks to establish a good milk supply. Most babies will gain weight if they are fed on demand or at least every 1 1/2 to 2 hours.

Waiting more than 2 hours may cause the breasts to become engorged and painful. This decreases milk production. The goal of good nursing is to extend the time to about 30 minutes total. A baby should be nursed for 10 minutes on the first breast and then switched to the other breast and allowed to nurse for as long as he or she wants. Over 90 percent of the milk is obtained by the baby in the first 10 minutes. Nursing should not be rushed.

Amount of milk

By measuring a baby's output it is possible to make sure the baby is getting enough milk. Four or more bowel movements and six or more wet diapers a day is normal. All babies lose some of their birth weight but return to that weight by 1 to 2 weeks of age. This is why the pediatrician weighs the baby at this return visit.

Supplementary feedings

If a breastfeeding mother offers any bottles during the first 4 to 6 weeks after birth. her milk supply may decrease. Using supplementary bottles prevents complete drainage of the breast, takes away from sucking time and may reduce the baby's appetite.

After 6 weeks, a breastfeeding mother may want to offer a bottle of expressed milk or water once a day. The baby can get used to an artificial nipple. This provides some free time for the mother to leave the baby with a sitter or family member. Babies usually do not need extra milk even if they have a fever or the weather is hot. Milk provides enough water, presuming the infant is not ill and is feeding well.

Nipple care

Nipples can become dry and cracked. Soap or alcohol should not be used to wipe the nipple because they remove natural oils. Loose clothing should be worn. Nursing pads can absorb excess milk leakage. Nipples should be exposed to the air when possible.

Correct positioning of the infant is important for preventing nipple soreness. The baby's whole body should face the mother rather than just the head. The baby's shoulders should be rounded forward to maximize head and tongue control. The baby should take in to his or her mouth most of the dark part of around the nipple. If the baby latches on only to the nipple, the nipples can become sore.

The mother may find that changing positions may prevent uncomfortable pressure points. Three common positions are:
  • side lying (mother's stomach to infant's stomach)
  • sitting (cradling the infant, with pillow support to prevent mother having to bend)
  • football hold (baby's legs and body underneath the mother's arm).
Properly removing the infant's mouth by from the breast will prevent little nicks or tears. This can be done by inserting a clean finger into the baby's mouth to break the suction.
Let-down reflexSome mothers feel deep, shooting pains during feedings. If the let-down reflex is inadequate or incomplete, this may cause breast pain. The mother should create a comfortable environment in which to breastfeed. Using warm compresses before feeding may decrease the discomfort.
In severe cases of inadequate let-down, an oxytocin nasal spray may be applied 1 minute before feeding begins. Breastfeeding gives substantial health benefits to both mothers and babies. Breastfed infants have a lower incidence of allergy, stomach infections, middle ear infections, lung infections, and pneumonia.
Women who breastfeed have a reduced risk for premenopausal breast cancer, ovarian cancer and osteoporosis in their later years.
A woman who desires to breastfeed but has difficulty getting the baby to latch on, getting the schedule "in sync" with the baby, or having enough milk for each feeding, should consult a professional with experience in lactation, or a support group for breastfeeding mothers, before giving up. Sometimes a few simple adjustments will make a positive difference.
However, if breastfeeding is not successful or possible, a mother should not feel guilty about bottle feeding. If there is a strong family history of allergies, a mother should consider using a formula which is less likely to cause allergies, such as a partially or fully hydrolyzed formula. If goat's milk is used, one should make sure that it has been pasteurized and supplemented with folic acid.
It is every woman's right to choose her feeding options, and should be encouraged to have a strong bonding relationship with her infant.

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