Questions on Breastfeeding
Happy Parents. Happy Baby’s Jasmine and Imogen are both neonatal nurses and lactation consultants who support families on their feeding journeys.
They have answered some of your key questions about breastfeeding.
What do I need to buy before baby arrives?
There are no essential pieces of kit you definitely need to rush out and buy before your baby arrives. The parenting market is flooded with products, there is no way of knowing how your breastfeeding journey is going to go until you start. Remember that every breastfeeding journey is different so what works for one family may not work for you. Instead of buying stuff you could spend that money on an Antenatal Workshop or great book that will help you prepare and familiarise yourself with what breastfeeding looks like in the early days and weeks.
Do I need to hand express before my baby arrives?
Your body starts producing colostrum from around the midpoint of your pregnancy. It is yellow, thick, high in antibodies and very easy for your baby to digest. Colostrum provides everything your baby needs in their first few days.
You can start hand expressing from about 37 weeks, but please always check with your midwife first. Your midwife should be able to give you the syringes and caps for collecting and storing colostrum.
You may find that you are not able to collect colostrum before your baby arrive, this is ok. Not everyone can express antenatally. Not being able to express and collect colostrum antenatally does not mean that you will not have milk when your baby is born. Being familiar with the technique is still a great idea though as it can be used in many situations such as
- After your baby has arrived hand expressing can help if you are engorged,
- If you have a fast let-down
- you are separated from your baby for a period of time.
I’ve got flat nipples - will I be able to feed?
You may have been told that you won’t be able to breastfeed because you have flat nipples/inverted nipples. Remember that it is BREASTfeeding not nipple feeding. Your baby will only know your breasts, they don’t know that supposedly there is a “perfect breastfeeding nipple”. Supporting your baby to have a big mouthful of breast not just nipple is what will encourage & support your baby to stay attached and drink well from the breast. Getting skilled support with how you hold your baby and how you bring them to the breast to attach will ensure that the two of you are working together, ensuring that your supply is stimulated and that your baby will gets the milk they need to grow and thrive. The size or shape of your nipple should not prevent your baby from feeding.
If you are finding attaching and breastfeeding difficult please reach out for skilled specialist support.
In hot weather does a breastfed baby need to be given water?
Breastmilk is constantly changing to suit your baby, even in response to the weather! This means that if you're exclusively breastfeeding your baby, you don’t need to give them water as well as breast milk. In hot weather a thirsty baby may want to breastfeed more frequently but for shorter periods.
Do I need to establish a feeding routine?
Try and remember that your baby is a little person. And just like us will not do and eat the same things at the same times every day. Every baby is different, some will want to feed more regularly than others. It will take some time to find a rhythm and for you to establish your supply according to their demand.
Babies breastfeed for so many reasons, not just because they are hungry. Your baby will feed if they are thirsty, for comfort, if they are tired, in pain & also if they are feeling unwell. It is developmentally appropriate for babies to continue to feed frequently throughout the day and night. Their tummies are tiny and your breastmilk is digested quickly. Breastfeeding throughout the night is also a form of protection against SIDS.
Try & “watch your baby and not the clock”
In the beginning it is important to offer the breast frequently (at least 8 times in 24 hours) this will help to establish your supply and make sure your baby is getting the milk the need to grow and thrive. Also, it is important not to limit time at the breast or “stretch” time between feeds. Keep your baby close so you can recognise those early feeding cues - such as bringing their hands to their face, licking their lips, opening their mouths and looking around. Crying is a late cue – by now your baby is very very hungry and will most likely need you to settle them before breastfeeding.
How long they breastfeed for and how many times in 24 hours will changes but we know that this should be at least 8 times in 24 hours and somewhere between 5-45 minutes.
Should my partner do a night feed so I get a bit more sleep?
There are so many ways that your partner can support you and be involved, connected & bond with your baby that don’t involve feeding. Some other ways to support you other than feeding can involve:
- Burping
- Cuddling
- Walking
- Taking care of bath time
- Massage
- Settling your baby to sleep
- Nappy Changes
- Cleaning
- Cooking
This will give you time to rest in between feeding. It’s important for your supply that you avoid long gaps between feeds. The more often you breastfeed the more milk your body will make – in the early days and weeks this is really important for establishing your supply. Expressing and sterilising is one more job that if you can avoid until about 6 weeks will give you time to settle into your new role, your supply will be settled and you and your baby will most likely have got the hang of breastfeeding.
If you are wanting to introduce a bottle before this please ask for a plan to support your supply from those providing your postnatal support.
Will I be able to feed if I have insufficient glandular tissue (IGT) or hypoplasia (underdevelopment of breasts)?
There is no way of knowing what your supply will be before your baby arrives so it’s important to do some research beforehand. A good place to start would be finding out about antenatal hand expressing, where you can get skilled support from in the early days, some basics of positioning and attachment & how to know if your baby is getting enough milk. Discussing your concerns with a specialist before your baby arrives will help you make a plan to optimise your supply in the early days after birth and give you confidence in recognising if your baby is feeding effectively.
Some books you may find helpful:
Finding Suffucuency – Breastfeeding with Insufficient Glandular Tissue - Diana Cassar-Uhl
Making More Milk 2nd Edition - Lisa Marasco & Diana West
Can I feed if I have had breast implants or augmentation?
Once again there is no way to know for sure before your baby arrives. You won’t know until you start, consider finding some specialist support, ideally before your baby is born to discuss things to look out for and how you can maximise your supply.
Some things to think about - the size and type of implant you’ve had and where it was inserted. Was there any damage to the nerves and breast tissue. Also, how much breast tissue was there prior to the surgery.
https://www.bfar.org/index.shtml
How can I stop my baby biting me?
There are lots of reasons why a baby might bite you such as teething or getting bored at the end of a feed. Watch out for a pattern of when the baby is doing it and any signals such as them getting distracted or wriggling and try to take the them off before it happens. You may have to remove your baby by inserting your little finger into their mouth and then re-latching them. If they are a bit older you might want to gently say ‘no biting’ and praise them when they feed well. It’s not malicious and they don’t know that it’s hurting you. It might be a game for them so you need to tell them it hurts.
Is clicking when feeding normal?
Clicking is a generally a sign that the seal or suction is breaking when your baby is breastfeeding. Try and look at what else is going on when your baby is clicking. Is it at the beginning of the feed? During a letdown or is it constant? Are you in pain or discomfort? Some of the reasons for clicking are a fast let down, engorgement, poor positioning, oversupply or sometimes because of a tight lingual frenulum/tongue tie. If you are not in pain and your baby is gaining weight and you have no issues with breastfeeding then clicking is not causing a problem. However, if you are in pain or there are concerns about your baby’s weight then please find specialist breastfeeding support. They will be able watch a feed and assess whether there are any issues with the position or latch.
How do I know if my baby has a tongue tie?
If despite optimising positioning and attachment you are experiencing ongoing pain, your nipples are sore and damaged, your baby is not gaining weight or you have any of the other symptoms associated with tongue tie then please ask for a specialist oral assessment by an appropriately trained professional. Assessing and performing a frenulotomy requires specialist training. Not all Drs, GPs, midwives or Health visitors have had this training. If you suspect your baby may have a tongue tie then please ask to be referred to an appropriately trained professional for assessment. Your health visitor or GP can refer you to your NHS trust which may have an infant feeding clinic who can assess this for you and organise treatment or you can find a private practitioner here https://www.tongue-tie.org.uk/
Breastfeeding support resources:
https://abm.me.uk/breastfeeding-information/
https://www.nhs.uk/conditions/pregnancy-and-baby/breastfeeding-help-support/
