Breastfeeding Tips I – Getting Started

ImageThere are plenty of books and websites and resources on breastfeeding and you can learn all the ‘technical details’ from these places. Most hospitals have lactation consultations who can help you get started also.

Most baby or parenting websites cover breastfeeding very well. You can try the following websites as a start :

La Leche League International 

Singapore Breastfeeding Mothers Support Group

There is no doubt that breast milk is the best food you can give your baby. It is the most natural food to feed your baby and your baby’s digestive system is made to digest your breast milk, not cow’s milk. Formula are cow’s milk modified to be like breast milk. Although it does not mean that if you feed your baby formula, you are a bad mother, if you can, do try to breastfeed, even if it is only for a short period of time.

I think I don’t have to elaborate on all the benefits of breastfeeding. Even if you breastfeeding for only 1 month, you have given your baby a really good start in life. Even if it is only 1 week, it is better than nothing at all. So in spite of the fact that it is difficult to start, do at least start.

After answering many questions on breastfeeding, I have decided to organise this section based on the following main topics :

1.How to Start

2. Preparing to Go Back to Work

3. Coping at Work

4. Boosting Supply

{Note : When revamping this site, I decided to break this article up into 3 separate articles, based on the sections mentioned above.}

Tips on How to Start

1. Common Understanding between you and your husband

I feel that this is one of the most important factor. Even before your baby arrives, you and your husband should have a good discussion on how serious both of you are about breastfeeding. Both of you need a common position. Your husband has to stand by you and remind you (about your goal) and encourage you to keep you going towards the goal in the midst of troubles, problems, naysayer, and baby blues.

Most husbands are wonderfully loving people. When they see their wives suffering in their attempt to breastfeed, they cannot bear it and will start suggesting things like switching to formula, or supplementing with formula, so that their dear wives don’t have to suffer so much. They are supportive and encouraging but in the wrong way.

Hence, if you are serious about breastfeeding, let your husband know and let him know how you need him to support you to succeed in breastfeeding. His support and encouragement must be towards the correct direction, towards the ‘goal’. And when you feel like giving up, he should be the one to help you keep your eyes on the finishing line.

2. Set small targets

The minimum recommended period for breastfeeding is 6 months. You are encouraged to feed for at least a year, or until your baby self-wean. That’s what everyone ‘official’ will tell you. A lot of mothers-to-be are very gung-ho and enthusiastically aim to breastfeed their babies for at least 6 months to a year. I know because I was one of them. Then reality sets in when you really get started and realise how difficult and painful it can get. Plus, if you are a new mother, you may already be frustrated with your baby crying all the time, and you may be feeling blue because of the adjustments, the lack of sleep and your haywire hormones. 6-months target seems very impossible at this point in time, and from the looks of thing you probably won’t survive that long (breastfeeding, I mean), so why not just give up?

Well, there is a better way to do it. Set small targets. E.g. 2 weeks. Tell yourself, “I will breastfeed for 2 weeks first and decide after 2 weeks whether to go on or not.” That way you won’t feel so stressed about meeting such a daunting target as 6 months. It’s easier to tell yourself to do it ‘just for another day’ when you see your 2-weeks deadline approaching. After 2 weeks, if you think you can live with another 2 weeks of breastfeeding, set another small target of 2 weeks.

If you decide to give up after meeting your small target, at least you will feel like you have accomplished something – meeting your target – instead of failing at breastfeeding your baby for 6 months. Let me assure you again that having breastfed for a couple of weeks is still better than not doing it at all. So congratulate yourself even though it may only be 2 weeks and not 6 months.

After a couple of small targets met, say after a month, things should be easier for you already. Breastfeeding should be established and less difficult and painful for you. You have, in fact, overcome quite a major hurdle to breastfeeding. So instead of setting 2-weeks targets, it may not be so daunting now if you were to set a slightly bigger target, e.g. 1 month. Before you know it, you would have breastfed for 3 months and it won’t be a problem for you to breastfeed for 6 months. Again, the kind of targets set will vary from person to person. Every mother is different. Some may even want to set so small a target initially as 3 days. Some may have no problem with starting off with a 1 month target. Whatever it is, reward yourself each time you meet a target. Do something nice for yourself.

3. If necessary, set a feeding schedule

I have touched on scheduled feeding under ‘The Whole Truth about Breastfeeding’ so I won’t elaborate too much on it here. If you do not have some kind of a schedule, breastfeeding can be very tiring for you. Some ‘experts’ say that feeding your baby on a schedule may lead to under-feeding and dehydration. I beg to differ. Because I have done so and many others have done so.

To me, it is better to have a schedule (provided you exercise wisdom and discretion and vigilantly monitor growth signs) and succeed at breastfeeding, than to try to cope with ‘demand feeding’ and hate the whole experience (thus not able to enjoy your baby) and eventually give up breastfeeding altogether.

Sometimes, babies just want to suckle for comfort and if by allowing them to do so at your breasts, you are going to be burned out, then you have to exercise your discretion and do something about it. My record for feeding Dominic was one and a half hours. One of my friends actually breastfed her baby for 2 hours in one sitting.

Setting a feeding schedule will eliminate all these ‘uncertainties’ about breastfeeding. Sometimes, I find Breastfeeding experts’ advice hardly consider the well-being of the mother. Of course, I think it’s also the extreme cases (like a mother who is having problem coping with the ‘demands’) that are often ‘neglected’. In the initial months of having a baby, the well-being of the mother is very important. By having a feeding schedule, you will be less prone to fatigue and blues and generally will recover faster physically and mentally. Having said that, if you are ok with feeding on cue and enjoy the experience, by all means, do what suits you.

From my own experience, and from what I heard from other mothers, babies have a tendency to become ‘snackers’. In other words, they will be crying for your breasts every hour or two, just to suckle a few minutes. Of course, without taking sufficient food, they will be hungry again in another hour or two. And the cycle goes on. Your baby might end up with too much foremilk and not enough hindmilk. This might aggravate the problem for colicky babies. If you want to feed on cue, do encourage your baby to have a full feed each time. It may be very tempting for you to put your baby to sleep when he falls asleep after a few minutes of feeding (especially when you already have a hard time trying to get him to sleep). But it is better that you wake your baby up and get him to continue feeding.

The American Association of Paediatiricans actually issued a statement against scheduled feeding citing examples of parents who had following scheduled feeding and ended up with malnutritioned and dehydrated babies. Well, to me, it’s not the method that is wrong but the stupidity of the parents who had not monitored their babies growth and exercise flexibility and allowed their babies to suffer.

So will you under-feed your baby? I don’t think so. Of course, you should always exercise flexibility and not let the clock dictate you to the dot. Every 2 to 3 hourly feed should be sufficient for a full term baby. 2-hourly means from the start of the feed to the start of the next feed, eg. 2pm, 4pm, 6pm. It is important to get this right.

You will end up feeding your baby minimally 8-10 times within 24 hours. You should not feed your baby any less than that. You can start with 2-hourly feed for the first 2-4 weeks, then stretch to 2.5 hours, then 3 hours, etc. Also, be wise and monitor your babies’ growth. Monitor your baby’s output and weight gain. This is very important. If your baby is not thriving, you should consult the doctor ASAP.

Sometimes a baby goes through a growth spurt. He will need to be fed more. Therefore, you do have to exercise discernment and flexibility to ensure the well-being of your baby.

Another way of setting a schedule is to do ‘demand feeding’ for the first few weeks. For some babies, you will see a pattern emerging. Once you can see the pattern emerging, set the schedule according to the pattern and stick with it, but be flexible especially in times of growth spurt, teething or illness.

Another important factor to note is that Asian babies are prone to jaundice. To keep things under control and clear the jaundice quickly, you have to feed frequently during the beginning days. Jaundice is a separate issue altogether. For now, just remember that the more you feed, the faster it will clear. Hence, my recommendation is to feed on 2-hourly schedule during the early days.

4. Get Professional Help

When you are in the hospital, get the lactation consultant to teach you personally how to breastfeeding. Make sure she checks your latch. Ask all the questions you can. After you are discharged from the hospital, if you encounter any more difficulties, you should also go back to the LC or seek from from other professional LC.

Some LCs just come and ask how you are without actually going through the process with you. Don’t settle for ‘lip service’. Make sure she gets hands on with you.

Please note that normal nurses, although they may have some training, are not the ‘professionals’. They can only teach you the basics and sometimes cannot even do a good job at it. They may not be very knowledgeable about breastfeeding and may give you the wrong advice. To be on the safe side, always consult professional LCs. You will have to pay for their service but it is worth the money.

5. Deal with Problems Immediately

If the latch is correct, you should not experience a very bad case of sore nipples. But there are some people, like me, who will still get sore nipples even though there is nothing wrong with the latch. If you do have sore nipples, please make sure you do something to treat the problem ASAP. Untreated sore nipples may developed into more painful problems like cracked nipples. If you are not sure that the latch is correct, seek help from professional LCs. If there is nothing wrong with your latch and you still experience sore nipples, use lots of lanisoh cream to treat it. Apply after every feed. There is no need to clean the cream off before a feed. Avoid too much contact with water as water will dry the skin on your nipple and makes things worse. Air your breasts as much as you can.

If you have plugged duct, treat it before it develops into mastitis (an infection). Apply hot compress on the affected area before every feed and massage the area before the feed. Nurse as much as you can on the affected breast, as the baby’s sucking is the best cure for plugged duct.

In conclusion, treat problems as soon as they arise so that they do not develop into more serious and more painful conditions that will further affect your effort to breastfeed.

6. Doctors may not know everything.

This is an unfortunate fact in Singapore and many places in the world. Doctors do not know much about breastfeeding because they are not taught in medical school, I guess. A good LC knows more than your average doctor, including gynaecologists. It is commonplace to hear of doctors giving patients the wrong instructions. It is always good to check back with a good LC on whatever instructions you received from a doctor regarding breastfeeding. It is a sad fact that an ignorant doctor can greatly set you back in your effort to breastfeed.

7. Do not allow your baby to be bottle fed in the first month

Babies tend to develop ‘nipple preference’ or ‘nipple confusion’. I much prefer the term ‘preference’ because I don’t think they are ‘confused’ at all. Babies exposed to bottles tend to prefer the bottles because it is much easier work for them to suck milk. Also, the way they suck is different from how they latch on to your breasts and suck milk.

Do not allow your baby to be fed by a bottle in the first month. Generally, that’s how long it takes to get breastfeeding going on smoothly and successfully. Giving your baby bottles of milk, even expressed breastmilk, is going to create problems for you.

When you are in the hospital, you must give clear instructions to the nurses, especially those in the nursery, NOT to feed with bottle. You may have to keep checking on them because sometimes they do forget. If you want to be safe, you may want to room in with your baby so that you are in control of all the feedings.

Some people try to feed with a bottle so that they can ‘know how much the baby is drinking’. Don’t bother; it is unnecessary. What your baby gets from you directly is way more than what you can express with a pump. And why do you want to know how much your baby is drinking? Unlike formula milk, ‘sufficiency’ is not judged by the number of ounces drank. To know whether your baby is getting enough, you should check the output and not the input.

If you really need to feed your baby by external means, feed your baby with a spoon or a small cup, and do it only if absolutely necessary. During the first month, the more you latch your baby on directly, the better it is.

8. Do not Pump in the First Month

Do not attempt to seriously pump in the first month. You can pump if you need to relieve engorgement, or for further stimulation of your breasts. However, you should not pump in attempt to replace direct feed with indirect feed. The reason is because the suction of a pump, even a very good, hospital grade pump, will never match up with a baby’s sucking. Hence, every feed that you replace with an indirect feed means your baby is suckling at your breasts less, which in turn means that your breasts are not getting the stimulation they should be getting. Before long, you will see your supply dipping.

9. Do not Supplement with Formula

Whatever your confinement lady, or your mother, or your mother-in-law tells you, DO NOT supplement with formula. That’s a sure formula for failure. Your baby is able to get enough from you without having to take any formula supplement. In the first few days, your breasts only has colostrums, which is very little in quantity but very potent in terms of quality. It is ‘liquid gold’. Nowadays, there are health supplements made from animal colostrums! Do not worry that your baby will not have enough form the little colostrums. Feed more frequently. It helps to get your real milk in sooner too. Besides, your baby has enough ‘spare’ to survive on the small quantity for a few days.

Do not believe the myth of babies sleeping better if they are fed formula milk. If that is so, formula feeding mothers won’t have to wake up at night for night feeds. But the fact is that they still do wake up for night feeds. What’s worse is that they have to struggle to make a bottle of formula in their semi-conscious state. A breastfeeding mother only has to pick up the baby and feed straight away. Mothers who co-sleep with their babies only have to turn over and feed.

Supplementing with formula means that you are actually feeding your baby less. This means that there is not enough demand and therefore your supply will be affected. Instead of being the solution to your “perceived” insufficient supply problem, it is actually the contributing factor.

10. Drink More Water

A lot of people overlook this, but not drinking enough water will actually affect your supply. So drink more water! Having said that, please don’t over-do things.

11. Relax, relax, and relax!!

The whole issue is that you should not be stressed. If you are stressed, your milk supply will be affected, and you will end up being more stressed and it goes on. Remind yourself that nature has made you the way you are – having a set of milk-producing breasts to nurture your children – and naturally you will be able to breastfeed. Forget about housework, and every other thing you ‘need to do’ and just concentrate on getting breastfeeding going. Rest whenever you can, as much as possible.

12. The Last Question to ask yourself.

The ONE nagging thought all breastfeeding mothers have is ” Do I have enough milk?” That is the very last question you should ask yourself. You will have enough! If something is not going on right, e.g. your baby is crying all the time, explore other possibilities (is he colicky?) and let this question be the last one you ask yourself. It undermines your confidence and stress you up. Again, the whole issue is that you should not be stressed. There is no point asking this kind of question. Do every other thing right (e.g. the baby is latched on properly, sufficient demand is placed on your breasts, etc) and there won’t be a question of milk supply.

13. Join Support Groups and avoid naysayers

They give you positive reinforcement and encouragement and tips on how to deal with the problems you face. You are more likely to succeed at breastfeeding if you have a support system. Frankly speaking, I think in our society, we have more than enough naysayers. Avoid these people if you can. Turn a deaf ear to what they say if you can’t avoid them. Be persistent and perservere. Whether or not you succeed in breastfeeding depends a lot on your determination.

A good support group to join is the Breastfeeding Mothers Support Group. Another one is the Asian Parents Group.

Breastfeeding Tips II – At Work

Breastfeeding Tips III – Boosting Supply