The ABCs of breastfeeding

Breastfeeding can be a wonderful bonding experience, but many women encounter challenges with it. 

Initially, you might face issues with your breasts like engorgement, cracked nipples, or even mastitis. Also, some babies have trouble with breastfeeding, either not latching properly or refusing entirely. It can be frustrating and stressful for both mother and baby.

But remember that you’re not alone. With some patience and support, these challenges can be managed with guidance from hospital nursing staff or a lactation expert.

It’s always a good idea to start preparing for breastfeeding before your baby’s birth, advises Erica Neser, a breastfeeding consultant in Stellenbosch. “Although there’s no way to physically get your breasts ready for feeding, you may feel better equipped and more confident if you start learning about the basics ahead of time by watching YouTube videos and acquainting yourself with latching techniques.”

Erica recommends creating a support network that includes your partner, family and friends who have breastfed, as well as a lactation consultant for practical help. Your hospital will likely have a breastfeeding or lactation specialist as part of the nursing team in the labour ward who can offer support while you are in hospital. Sister Doriska Posthumus, a midwife and certified lactation consultant in Milnerton, advises that you find a consultant through South African Certified Lactation Consultants (SACLC) to provide support with breastfeeding once you are home. She also suggests spending time getting comfortable with your breasts to make latching easier when your baby is born.

It’s also important to stay calm. “Calm moms encourage calm babies,” says Sister Lynne Lane, a registered nurse at Mediclinic Louis Leipoldt. She suggests using LED lights and playing gentle music to create a soothing environment for breastfeeding. Also make sure you’re sitting or lying comfortably.

The next step is to trust your body, says Sister Doriska. “You trusted your body to carry the pregnancy and deliver a baby – now trust it to feed your baby. Breastfeeding is just a continuation of pregnancy – your breasts are made to feed your baby, and they’re designed perfectly for this function. Trust your instinct, too and don’t overthink things.”  

Sister Lynne cautions that it’s hard to latch a crying baby. Crying is usually a late sign of hunger, so keep an eye out for earlier cues like your baby putting their fists to their mouth. When you’re ready to feed, bring your baby to your breast instead of moving your breast to the baby.

“Don’t try to force your baby to latch; rather, offer the breast calmly and slowly when they show feeding cues,” says Erica.

If your baby won’t latch, try holding them skin-to-skin as much as possible, as this helps trigger their natural feeding instincts. If they still don't latch, get in touch with a lactation consultant right away and begin expressing milk every two to four hours to keep up your milk supply.

Erica advises that for babies younger than four days old, it’s best to express milk by hand. After that, you can use a pump. Your baby might feel hungry during this time, but try to feed them using a cup, spoon, or medical syringe instead of a bottle.

Don’t worry about the “quality” of the latch – Sister Doriska says that so long as your baby is getting milk and you’re not in pain, the latch is adequate. “There are some tips to help make latching easier,” she says:

• Ensure you’re sitting comfortably with your back straight and your feet flat on the floor or on a footstool.
• Bring your baby close to you, turning their body so it faces yours (tummy to mummy).
• Then, gently tickle their nose with your nipple until they open their mouth wide.
• While their mouth is open, help them latch onto the breast.

Sister Lynne says breastfeeding shouldn’t hurt. If it does, contact a lactation consultant for help. In this case, Erica recommends using the “four Ts” method: Turn your baby’s body so their whole front is against yours; tug them across your body so their nose lines up with your nipple; tuck their bottom in (you can lift your other breast so they can tuck under it if needed); and tip their head back, so their nose is away from your breast and their chin presses into it.

Worried you’re not making enough milk? Feed some more – at least every two to three hours. “Frequent feeding encourages milk supply,” assures Sister Lynne. Skin-to-skin contact should also help here.

According to Erica, the clearest sign that you’re not producing enough milk is if your baby isn’t gaining weight. Ideally, they should be gaining about 30 grams each day. Weigh your baby weekly initially – they should gain about 200 grams per week. If this isn’t happening, you can try gently squeezing your breasts in a rhythm while your baby is feeding to help the milk flow. You can also express some milk after breastfeeding and give it to them as an extra boost.

“If these strategies don't work, your lactation consultant can offer more ideas to make sure your baby gets enough milk while you work on increasing your supply,” says Erica. “In the meantime, don't stress about adding or removing things from your diet, like jungle juice or ginger beer. You know your baby best, and your body knows what to do.”