Getting Breastfeeding Off to a Good Start

Dr Rahmat Bagus, a General Practitioner at Mediclinic Louis Leipoldt, provides guidance on breastfeeding and how a new mother can enhance the experience with the most appropriate techniques. 

How do babies learn to breastfeed?

Newborn babies have instincts that help them to breastfeed. When newborn babies are born through the birth canal with an unmedicated labour and placed directly on their mother’s tummy in naked skin to skin contact, they will instinctively wriggle and crawl up to the breasts, lick and nuzzle, until they eventually latch on by themselves. This process may take 60-90 minutes.

• It is important to try to avoid disrupting this process. The smell of your areola, the dark area around the nipples, helps guide your baby during the breast crawl.
• In the crawling position, trigger points are activated on your baby’s hands, chest, legs and feet which help your baby with deep latching.
• The slope of your own body, ideally at a slant of about 45° helps your baby’s oxygenation and breathing.
• Your naked warm skin helps to keep your baby warm and helps prevent hypoglycemia and neonatal jaundice.
• On the comfort of your naked chest, your baby will learn to latch deeply and comfortably.

During and between breastfeeds keep your baby in skin-to-skin care for as long as possible.

How long should a feed last?

Just like we eat and drink differently throughout the day, breastfeeds will vary. Let your baby be the guide. He or she is the only one who can feel his own hunger and thirst. Watch for his early signals to latch him on. He may start moving in his sleep before being fully awake; this is often a good time to try latching him.

Breastfeeding is so much more than food. It provides powerful endorphins that combat pain (think birth trauma and needle pricks), contains digestive hormones, prebiotics and probiotics helping his immature gut and immune system, hormones to ease your little one to sleep, and so much more. When in doubt, put him back on the breast as that may be just what he needs to ease his fussiness.

How do I know that he’s had enough to drink?

Newborn babies tend to unlatch and fall asleep when they are satisfied. They may want to take a short (sometimes 10 mins) or longer nap (sometimes 1-2 hours) and want to feed again. A good indication that he/she is drinking enough will be apparent in your baby’s nappies – and the colour and consistency of the stool. In the first couple of days after birth, your baby’s poop will look blackish and sticky. This is called meconium. Between days 3-5, the poop will change and become lighter, brownish-greenish, and pasty. By the end of the first week, you can expect yellow, mustard-coloured poops that are more watery. They may contain some seedy-looking pieces. These are typical breastmilk stools. During the second week, you can expect a minimum of 3 large yellow poops per day. This is usually an indication that breastfeeding is going well. Some babies will pass a stool after every breastfeed during those early weeks. Usually after week 5, the stools will reduce to one or two a day.

Will my breasts work?

Breasts and nipples come in many shapes and sizes. Your baby has no one to compare to and will love your shape, whatever it is. Occasionally some mothers experience challenges with latching; reach out to an experienced breastfeeding counsellor for help early on.

Will breastfeeding hurt?

Pain is a signal from our bodies to guide us to change something to find a more comfortable position. In most cases, the baby is positioned slightly too far away, and needs to be brought in closer, hugging your body. Seek help from an experienced breastfeeding consultant for more comfortable positioning.

How can I increase my milk production?

Our bodies respond and make milk according to what our babies need.

During pregnancy our bodies start producing colostrum, the first milk, which is yellow, sticky and super concentrated in immune and growth factors to protect newborn babies after they have left the safety and comfort of the womb. Colostrum contains antioxidants, vitamins, hormones and growth factors that line the newborn baby’s gut preparing it for digestion, and immune regulation. It has a laxative effect aiding the passing of meconium (the black tarry-looking stool) from the gut, helping to prevent neonatal jaundice.

Your baby will obtain colostrum from the first 1-3 days of breastfeeds. Colostrum volumes come perfectly matched to your newborn’s tiny tummy. Keeping him in skin-to-skin care will allow him to get frequent opportunities to breastfeed. Over the next few days, you will notice that your breasts feel much fuller as your milk volumes increase.

Medically necessary supplements are rarely needed and when needed, can be given with a spoon or cup instead of a bottle. It can be risky to give a young baby a bottle (or even a pacifier) before they have had enough practice learning to breastfeed. Research shows that oxygenation levels are lower in bottle-fed babies and sucking on plastic teats disturbs muscle and bone development of the palate, face and skull.

Do I need special foods to make breastmilk?

Breastmilk is produced from your blood. There are no special foods, herbs or galactagogues needed to make your quality breastmilk. Your breastmilk adapts uniquely to the needs of your baby, changing by age, by exposure to the environment and from morning to night. Your baby’s skin against your own skin, and their saliva and mouth at your breasts, signal to your body to produce milk exactly according to their requirements.

What if my baby is separated and I am unable to directly breastfeed?

Life does not always go the way we would like, and unforeseen circumstances may make us feel overwhelmed and helpless at times. Providing breastmilk to your baby regardless of the circumstances can still be achieved by hand expressing or pumping.

It is important to know that there is much more milk in your breasts than what you can squeeze out in a few seconds or minutes. The milk glands in your breast release stored milk and make more milk in response to baby’s frequent suckling with a deep comfortable latch. Learning to extract milk by hand or with a breast pump may take some time; but comes more easily with some practice.