Beginning to breastfeed
If you're planning to breastfeed for the first time, you might be worried that you won't be able to produce enough milk or that your milk won't be nourishing enough. Don't be anxious - you're not likely to have any problems. All women are equipped to feed a baby. No breast is too small and, in most cases, your supply of milk will automatically adjust to meet your baby's needs.
Feeding on demand
© DK
A baby can digest a full feed of breast milk in about an hour and a half to two hours (half the time it takes for a bottlefed baby to digest a full feed of infant formula). So breastfeeding on demand means frequent feeding, but this doesn't mean your milk supplies will run out. Research shows that mothers who breastfeed their babies on demand produce more milk than those who breastfeed at regular but less frequent intervals.
One study compared babies breastfed on demand with those fed only every three or four hours. The babies fed on demand got an average of nearly ten feeds a day, compared to an average for the others of just over seven. The more frequent feeding didn't mean that a daily amount of milk was being divided into more but smaller feeds - in fact, it was the opposite. The fed-on-demand babies got an average of just over 73ml (2 ½ floz) at each feed (725ml/25floz a day), while those fed at fixed intervals got only 68.8ml (2 2/
5 floz) each feed (502ml/17floz a day). As a result, after two weeks the babies who were fed on demand had gained more weight than the others - an average of 561g (20oz) compared to 347g (12oz).
Keeping up your milk supply for breastfeeding
Milk production can be affected by many things, including how you're feeling, how healthy you are, and what you eat. The change from colostrum to breast milk is triggered by changes in your hormones after the birth, but continuing supplies of milk depend on the sucking action of your baby. When he sucks, nerve endings in your areolae are stimulated, sending signals to a part of your brain called the hypothalamus. The hypothalamus in turn sends signals to your pituitary gland telling it to release prolactin, the hormone that stimulates milk production - this response to your baby's sucking is known as the prolactin reflex. Your pituitary gland also releases oxytocin, a hormone that causes the muscle fibres around the milk glands to contract, squeezing the milk from the glands into your milk ducts. This is called the milk ejection or “let-down” reflex. When your breasts are full, it can be triggered not only by sucking but also by your baby's hunger cries or even simply when he's near to you.
A good milk supply
The best way to keep up your milk supply is to feed your baby often, so that the prolactin reflex and the milk ejection reflex are triggered frequently. This will also prevent engorgement - swelling of your milk-producing glands by milk.
If the glands do swell, they won't be able to make milk efficiently. And you won't feel like feeding because it'll be painful. For these reasons, the reflex that promotes the release of prolactin diminishes and so your milk production slows down. If this does happen, you can relieve engorged breasts by expressing milk, and stop it happening again by feeding your baby often. It's also important to wait until your baby empties the first breast you give him before switching him to the other. This way he'll be sure to get not only the thirst-quenching, low-fat foremilk that comes from your breast first, but also the highly nourishing, fat-rich hindmilk that follows.
You'll need to eat well at this time, as your body has an even greater need for good nourishment than during pregnancy. You don't need to eat any special foods for breastfeeding, but it's best to have a balanced diet with plenty of protein, iron, and calcium, and lots of fluids, fresh fruit, and vegetables. Three good meals, with healthy snacks in between, will give you energy and keep you from getting too tired.
Refusal to feed
Occasionally, your baby won't want to breastfeed. This is most likely in the early days, when he may be too sleepy to be interested. If your baby refuses the breast, don't give up - express the milk he would have suckled and wait for him to want food. Babies feed better when they're hungry.
If you find that your baby tends to fall asleep soon after you've started feeding, try lying on your side, with him lying beside you. This way he'll find feeding less tiring. Your baby may also refuse to feed because he has difficulty latching on. This is usually because your breasts are engorged - the swelling makes it difficult for your baby to latch on. If you express some milk before feeding, he'll be able to latch on more easily.
Producing milk
Your breasts change during pregnancy to prepare them for producing milk. Your milk will begin to come in a few days after you've given birth.
A female breast has 15-20 groups of milk-producing glands, connected to the nipple by the milk ducts. When you're pregnant, the placenta and ovaries make high levels of the hormones oestrogen and progesterone, which stimulate the glands to make colostrum. Colostrum gives your baby water, protein, sugar, vitamins, minerals, and antibodies to protect him against infection. Your body stops making colostrum and starts making milk three to five days after your baby is born.
Expressing your milk
You may sometimes need to express milk from your breasts - perhaps so that your baby can be fed from a bottle if you have to go out for a while, you're returning to work, or if your breasts have become engorged.
You can express milk by hand, but it's quicker to use a pump. When you've expressed your milk, put the cap tightly on the bottle. Refrigerate the milk until needed; it will keep for up to 24 hours in the fridge at a temperature of between 2°C and 4°C, or can be stored for up to six months in the freezer.
Posted 16.11.2010
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