“Breastfeeding shouldn’t hurt” is a mantra new mums often hear. But many find the reality is rather different in the early days.

For starters, during pregnancy most women’s nipples become larger and more sensitive. And when your newborn starts feeding from them he creates pressure and suction unlike anything they’ve ever experienced before (well, if you’re a first-time mum at least).

Breastfeeds can take a long time too – sometimes up to an hour – and your baby may feed up to 13 times a day.¹ All this new suction, pressure and saliva can result in sore nipples.

Think about lips that get sore or cracked from the wind or sun. The more you wet them by licking them, the more dry and damaged they get – so you moisturise to soothe and protect them and to help them heal. It’s the same with your nipples.

However, soreness shouldn’t last long as you and your baby should become accustomed to breastfeeding during the first couple of weeks. Treating problems promptly is essential for preventing further damage. So if your nipples crack, start bleeding, or are excruciatingly sore, speak to a lactation consultant or breastfeeding specialist as soon as you can.²

However, prevention is better than cure – so read my troubleshooting tips below.

Check your baby’s latch

The key to pain-free breastfeeding is a good latch. When your baby is latching on, aim your nipple towards the roof of his mouth. This should help him latch on to the nipple, as well as some of the areola (the circle of darker skin around the nipple) beneath it. Having both the nipple and some of the breast tissue into his mouth like this will help him feed properly.³

Get your baby’s latch checked by a lactation consultant or breastfeeding specialist in the first few days. They’ll give you advice on overcoming any problems and may suggest alternative breastfeeding positions to help you feed your baby as painlessly as possible.

Watch out for tongue-tie

Tongue-tie (ankyloglossia) affects 4 to 11% of newborns.⁴ It means the strip of skin that attaches the tongue to the bottom of the mouth, called the lingual frenulum, is too short. A tongue-tied baby may not be able to open his mouth wide enough to take in plenty of your breast when he feeds, and his tongue probably won’t cover his lower gum while he sucks. The result can be sore nipples for you and frustration for him.

A healthcare professional, lactation consultant or breastfeeding specialist needs to assess your baby to confirm a tongue-tie. It can be treated with a simple procedure called a tongue-tie division if necessary. Carried out by a healthcare professional, this doesn’t usually require anaesthetic and may help resolve feeding problems immediately.⁵

There is a similar, but rarer, condition called a lip-tie, where the frenulum attaching the upper lip to the top gum is too short. Tongue-ties and lip-ties aren’t always picked up in neonatal checks, so if you think one of these could be causing your nipple pain, seek advice quickly.⁴

Breastfeeding nipple care tips

• Only wash your breasts with water when you bath or shower. The little bumps (Montgomery glands) on your areolae produce an oil that moisturises and protects your nipples. Soaps and shower gels can strip this natural oil, causing dryness and irritation.⁶
• Air-dry your nipples or dab them gently with a towel. Women used to be told to rub their nipples to toughen them up, but this isn’t advised any more – thank goodness!
• There’s no need to clean the breast or nipples before breastfeeding. In fact, bacteria from the surface of your breast can help develop your baby’s gut microbiome.⁷
• Fresh breast milk can help heal damaged nipples,⁸ so try massaging a few drops into them before and after feeds.
• Change nursing pads frequently if they become damp to reduce the risk of bacterial or fungal infections, including thrush.⁶
• Avoid increasing the gap between breastfeeds to ‘rest’ your nipples. Your baby needs to feed on demand to stay healthy and grow well. Remember, frequent feeding builds and maintains your supply, so keep feeding through any soreness.⁹

Useful nipple care products

• Nipple cream made from ultra-pure lanolin – a natural product obtained from sheep’s wool. This moisturises and supports healing. It’s harmless for your baby, so there’s no need to wash off lanolin before breastfeeding.
• Hydrogel pads can be placed on sore nipples to offer instant breastfeeding pain relief, as well as creating ideal conditions for healing. You can even keep them in the fridge for cooling comfort.
• Breast shells fit inside your bra. They’re great for stopping clothing rubbing against sore nipples, and have holes in so air can still get to your nipples to help them heal.
• Nursing bras made from either a breathable material like cotton, or a fabric that dries quickly and wicks excess moisture away from damaged nipples.
• Nipple shields are silicone covers that fit over your nipples, with small holes for your breast milk to flow through as you breastfeed. They protect the skin underneath and can give a baby with a poor latch something firmer to attach to. In general nipple shields should be considered a short-term solution. If problems or pain occur, consult your lactation consultant or breastfeeding specialist.

When to seek medical help

Once your baby and your nipples are used to breastfeeding, it’s true it shouldn’t hurt. It’s worth reiterating that the number one cause of sore nipples is a poor latch. If one breastfeeding expert hasn’t been able to resolve your nipple pain, try another, and another if necessary.

If your nipple pain persists or you notice unusual symptoms, see a lactation consultant or breastfeeding specialist. White spots or flakiness on your nipples could be thrush, whitish or blueish nipples could be caused by a circulatory disorder such as Raynaud’s disease (vasospasm), and pus or hot redness are signs of infection.²

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Giving your baby his first breastfeeding within the first couple of hours of birth gives you the best chance of establishing breastfeeding, as well as giving him the chance to enjoy all the benefits of colostrum – the first milk you produce – as soon as possible. One way of helping to ensure this happens is to include breastfeeding in your birth plan.

Think of a birth plan as a wish list of your options during labour, birth and the time directly afterwards. It might include things like your preferences regarding pain relief and birth position, what should happen in the event of a caesarean section, what to do if complications arise, and, of course, breastfeeding.

Ideally, you should write your birth plan well before your due date so you have a chance to show it to your birth partner and the healthcare professionals who’ll be looking after you.

You can write it any way you like, but it’s probably easiest to start with a simple list that you can expand on after doing a bit of research. Your birth facility may have some samples or templates that you can use, or you could look at birth plan examples online.

Why is it important?

A birth plan provides clarity. It will help guide conversations and build trust between you, your birth partner and healthcare professionals. This is especially important during labour, when you may have other things on your mind! In addition, if there’s a change in staff shifts during labour, a birth plan can help the new staff get up to speed with your history and wishes.

Preparing for breastfeeding

If you’re keen to breastfeed, discuss your plans with your birth partner and healthcare professionals during your pregnancy. Your midwife will make your intentions clear in your medical notes and should be able to suggest useful local sources of breastfeeding support.

Writing a birth plan also provides you with a good opportunity to discuss your breastfeeding wishes in general with your partner, if you haven’t already. Explain that you’d like them to be your breastfeeding advocate, helping your baby to have your breast milk even if the delivery doesn’t go to plan or you’re not actively able to breastfeed straight after the birth. Ask them to have skin-to-skin contact with your newborn if you’re not able to, as this will help your baby feel comforted and calm.¹

Writing your birth plan: What to include

 When it comes to the breastfeeding section of your birth plan, start by simply stating your intention to breastfeed exclusively. Explain that you want the healthcare professionals to do all they can to help you breastfeed your newborn, or give him your expressed breast milk if feeding from the breast isn’t possible, so you can still initiate your milk supply.

Here are examples of the type of statements you can put in your birth plan to make your breastfeeding wishes clear and give you and your baby the best chance of a good start:

• I’d like skin-to-skin contact with my baby directly after the birth, before he is weighed or washed, as long as there are no medical concerns.
• If I’m not able to hold my baby straight away, please place him skin-to-skin with my birth partner instead.
• I’d like support to give my baby his first breastfeeding within the first hour after the birth if possible.
• I’d like my baby to be encouraged to self-latch, or given gentle support to latch.
• If my baby is poorly or we need to be separated, I’d like help expressing my colostrum and feeding it to him from a syringe or cup.
• If my baby is unable to breastfeed for any reason or is not feeding well in the first few hours after birth, I’d like help with double pumping within the first three hours and with feeding him my expressed milk.
• If I need to continue to pump, I want to achieve eight sessions in 24 hours to help initiate my milk supply.
• Please don’t give my baby formula milk without my or my birth partner’s consent, and then only if medically necessary.
• Please don’t feed my baby from a bottle teat or give him a dummy/pacifier without my or my birth partner’s consent.
• I’d like support with breastfeeding from a qualified lactation consultant or breastfeeding specialist, if available.

What if the birth doesn’t go to plan?

Even with the most carefully considered birth plan, it’s impossible to predict how your baby’s birth will unfold. This is why it’s also important to be open to changes.

Bear in mind some medications and interventions administered during labour and birth could affect your baby’s ability to breastfeed at first. It’s worth asking a healthcare professional about the effects of different types of pain relief and assisted delivery on you and your baby, as well as any impact they might have on breastfeeding, so you or your birth partner can make informed decisions.

And if you and your newborn aren’t able to breastfeed in that first hour, don’t be disheartened. Many mums and babies manage to establish and continue breastfeeding, despite not having an ideal start. Get as much support as you can from the healthcare professionals around you, and contact a lactation consultant or breastfeeding specialist quickly if you need help getting breastfeeding back on track.

The post Why breastfeeding should be in your birth plan appeared first on Medela South Africa.

Like many other questions, there’s not a black or white answer to this one either. The use of a dummy can have a lot of benefits for your baby when used responsibly, following certain guidelines and the instructions for use. 
If you’re about to make up your mind about whether to use a dummy or not, keep on reading! We have collated some science-based information and myth busters regarding the use of dummies. Additionally, you can learn how and when a dummy can help your little one and on which occasions you may want to consider holding the offering of a dummy.

A dummy can offer comfort when your baby is crying and/or agitated – Truth
Dummies can be very helpful to offer comfort to your little one during times of distress, as the action of suckling helps babies soothe themselves.¹

Dummies can be given to a breastfed baby – Truth
Dummies can be given to a healthy baby from birth. Studies have shown that the use of a dummy in healthy breastfeeding babies, started from birth or after lactation is established, did not impact significantly the frequency or duration of exclusive and partial breastfeeding up to four months of age.² However, you may want to consider introducing the dummy when you and your baby are already comfortable with breastfeeding. It is important that a dummy shouldn’t be used to replace or delay feeding time. 

Dummies may help reduce SIDS risk during napping and sleeping time – Truth
Scientific research has shown that the use of a dummy during sleep may offer protection against Sudden Infant Death Syndrome (SIDS).³ However, if your little one loses the dummy during sleep, there’s no need to put it back in the mouth.⁴  

Dummy affects teeth – Myth
When used responsibly and within the recommended time limits, dummies should not cause problems with dentition or misaligned teeth. Expert literature recommends limiting the time of use of the dummies to a maximum of six hours per day.⁵ Every child’s mouth and teeth develop differently. The use of dummies for children older than 24 months should be a decision made by each parent, based on consultation with a medical or dental healthcare provider. The American Academy of Paediatric Dentistry recommends that weaning should start at the latest by three years of age.⁶ We recommend choosing a dummy shape that supports oral development, usually signalled by the word ‘orthodontic’.  

Dummies can aid your baby with pain relief – Truth
Scientific evidence has shown that dummies can help babies better cope with distress and discomfort during minor painful events.¹ When babies get a vaccine or blood taken, the act of suckling on a dummy can help them calm and soothe themselves. When teething, your little one might feel very uncomfortable and experience aches and soreness. The dummy can offer some relief to the discomfort. Just pay attention to the condition of the dummy and replace it if it begins to look worn out.

Dummies cause colic – Myth
The cause of colics is still unknown, but there are some theories such as an immature digestive system, lactose intolerance, allergies, or changes in the normal bacteria of the digestive system. Swallowing additional air during feeding can aggravate the situation.⁷ It is often difficult to calm babies during a colic episode, they cry intensely and long, often with clenched fists and curled-up legs. Symptoms usually start to improve around 10–12 weeks of life. One tip to help soothe your baby is to offer a dummy,⁸ as suckling can be soothing and help regulate your little one’s emotions.¹

Weaning can be difficult – Myth and Truth
Some babies have no problem giving up their dummy while others need more time to say goodbye. As a dummy provides comfort, babies can become attached to it. Weaning will be learning and compromising the experience for you and your little one. But with love and some patience, you will manage to help your baby reach this life milestone. Find helpful tips and ideas about weaning in our Dummy guide for parents.

You now have a lot of useful information about dummies. If you feel that a dummy is a good option for your little one, start considering what the best one may be for your baby. There is a wide range of dummies available nowadays. They come in a variety of shapes, sizes, and materials, such as a special size for newborns, one-piece dummies, 100% made of silicone, and dummies for day or night time. Check out our Dummy Selector and find the perfect match for your baby.

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The health benefits of breastfeeding

As well as nourishing him, breast milk protects your baby. Breast milk is full of live ingredients, including stem cells, white blood cells and beneficial bacteria,² as well as other bioactive components, such as antibodies, enzymes and hormones,³ which all help fight infection, prevent disease, and contribute to normal healthy development.

Babies who are breastfed exclusively for their first six months are less likely to suffer from diarrhoea and sickness, gastroenteritis, colds and flu, ear and chest infections and thrush.⁴ And compared to formula-fed infants, exclusively breastfed babies are half as likely to be victims of sudden infant death syndrome (SIDS or cot death).⁵

Of course, breastfed babies do get poorly sometimes but breastfeeding when your baby is sick has even more benefits: “If a baby gets an illness, or his mother does, the protective components in her milk tend to increase,”⁶ explains Professor Peter Hartmann of the University of Western Australia, an internationally renowned expert on lactation and breastfeeding. “A breastfed baby is likely to recover faster than a formula-fed baby because the mother’s body will produce specific antibodies against whatever infection he’s picked up.”

And it’s not only about nutrition and immunity – breastfeeding when your baby is sick or upset comforts and soothes him, which is not to be underestimated as an important benefit. In fact, studies have shown that breastfeeding reduces crying and provides relief when babies are having vaccinations.⁷

Breast milk benefits for premature babies

Feeding your preemie your milk offers the best protection against potentially fatal conditions including sepsis, chronic lung disease and necrotising enterocolitis (NEC).⁸ Premature babies who are fed breast milk are also more likely to come home from hospital earlier.⁹

“Feeding your premature baby breast milk is the most beneficial thing you can do for him,” Professor Hartmann points out. “Every drop counts.” In fact, healthcare professionals view breast milk not just as nutrition, but as a medical intervention. Read more on how important breast milk is for premature babies.

How breastfeeding benefits your baby’s sleep

You might have heard that formula-fed babies sleep longer, but it seems that’s a myth. Research shows breastfed and formula-fed babies are just as likely to wake for milk during the night.¹⁰ But the difference is breastfed babies get back to sleep sooner. The oxytocin produced in your baby’s body when he breastfeeds makes him feel sleepy afterwards. And other hormones and nucleotides in your milk help your baby develop healthy circadian rhythms (sleep-wake patterns).¹¹

Breastfeeding and baby brain development

Your baby’s first six months are a busy time for his rapidly growing brain – its mass almost doubles during this crucial period.¹² A US study showed that toddlers and preschoolers who’d been exclusively breastfed for at least three months had brains with 20 to 30% more white matter – which connects different regions of the brain and transmits signals between them – than those who’d had no breast milk.¹³

The importance of breastfeeding for baby brain development is reflected in research across the globe. In a UK study,¹⁴ 16-year-olds who’d been breastfed for six months or more as babies were more likely to get higher grades in their school exams. And Brazilian researchers found people who’d been breastfed for at least a year tended to earn more money by the time they were 30.¹⁵

Even when results are adjusted to take factors such as household income and mother’s education into account, it seems infants who are breastfed exclusively are more likely to have higher IQs than formula-fed babies.¹⁶ “There are a few ideas about why this is,” says Professor Hartmann. “One relates to the long-chain fatty acids that are present in breast milk, such as DHA, which has a positive effect on the brain and brain development.”¹⁷

And the latest research suggests breastfeeding has behavioural benefits too. In a study of 10,000 children, those who were breastfed for more than four months were 30% less likely to show problem behaviour at the age of five.¹⁸

The lifelong benefits of breastfeeding for your baby

Breastfeeding doesn’t just benefit your baby for the first six months. The longer he continues to have breast milk, the more advantages there are – especially for his health.

Every nursing session raises the level of oxytocin – the ‘love hormone’ – in both your bodies, encouraging bonding.¹⁹ This can form a firm foundation for future relationships, and may even help your little one cope with stress in later life.²⁰

Research also shows children who were breastfed as babies are less likely to suffer from cancers such as leukaemia and lymphoma,²¹ and tend to have better eyesight,²² and straighter teeth²³ than those who had formula milk. Breastfeeding also helps to lower your baby’s risk of becoming obese or developing type 1 or type 2 diabetes^24,25 as an adult.

So if you’re wondering when do the benefits of breastfeeding end, the answer is they last a lifetime. And the longer you continue to breastfeed, the more health benefits there are for you too.

For more information, read our free ebook The Amazing Science of Mother’s Milk now.

The post What are the benefits of breastfeeding for your baby? appeared first on Medela South Africa.

The post Top tips and advice on breastfeeding for new mums appeared first on Medela South Africa.

When is the best time to start giving a dummy to your baby?

Dummies can be given from birth to any age, you can even start giving your little one a dummy if he or she is already three or six months old. With many shapes and designs, there are even dummies that are specially developed for newborns, like our NEWBORN dummy, shaped to accommodate their tiny mouths and to protect their sensitive skin.

If you are breastfeeding your newborn, you may choose to wait and introduce a dummy after your baby has learned to latch correctly and breastfeeding is well established between you two. Studies have shown that the use of a dummy in healthy breastfeeding babies, started from birth or after lactation is established, did not impact significantly the frequency or duration of exclusive and partial breastfeeding up to four months of age.¹
With that in mind, it is recommended to hold the use of the dummy when it is close to the feeding time and not to use the dummy as a mechanism to delay the feed. Instead, when your baby is giving you cues that they are hungry, enjoy this feeding moment to hold your little one in your arms and engage in the magical bond that unites the two of you.

Whatever timeline you prefer to follow, keep in mind that each baby is unique and may react and adapt differently to this new experience being introduced into their life.

So, how can I get my baby to take a dummy?

Every baby has their own preferences and rhythms, and introducing a dummy is no different. Try the following steps when helping your little one discover a dummy for the first time:

• Be sure to thoroughly clean and sterilise the dummy before it is introduced to your baby.
• Hold the dummy, and gently touch the skin around your baby’s lips and cheeks with the teat. Allow your little one to feel the dummy’s material against their skin. This will help trigger the rooting reflex and your baby will turn their face towards the stimulus.
• Observe your baby’s behavior. If your little one opens the mouth, it means that they are searching for something to suckle on. Place the dummy gently on the lower lip or the front part of the tongue, and wait for the suckling reflex to start. 
• If the first introduction is successful, your baby will eventually begin to explore and suckle on the dummy.

Of course, be gentle with your baby and don’t force the dummy as this may cause a negative response. If it seems as though your little one is rejecting the dummy at first, it’s instead often an indicator that he or she just needs more time to explore and discover. Give your baby plenty of time to learn, explore new feelings and sensations, and become familiar with their dummy on their own terms. You’ll know as your baby begins to enjoy suckling the dummy – for example, you’ll see it from their content expression and calm behavior.

Like all people, your baby has individual preferences and interests and you may even find that he or she doesn’t want a dummy. By carefully observing their reaction upon introduction, you can make the determination as to whether your baby is ready for a dummy – and he or she will likely let you know too.

Discovering the dummy is a learning experience. Your little one will learn all about it through their senses and by using their tongue, lips, and natural suckling instincts to explore with this brand-new object. In time, they will likely perceive and recognise their dummy as a pleasant object that allows them to suckle, relax, and perhaps even calm themselves.

The post When and how to introduce a dummy to a baby appeared first on Medela South Africa.

Congratulations – you’ve made it through the first crazy month of breastfeeding. Your breast milk is now fully mature,¹ your supply is beginning to calm down, and your breasts won’t leak as much, or at all, any more. Don’t worry, you’re not losing your supply – your breasts are just getting more efficient at making and storing milk.² At six weeks, you’ll start seeing your baby’s first gorgeous gummy smiles, and by two months you’ll have 500 to 600 feeds under your belt. Hopefully any latch issues will be resolved, and now it’s a case of maintaining breastfeeding and enjoying the convenience and ongoing health benefits.

When does breastfeeding frequency slow down?

The range of ‘normal’ breastfeeding for babies aged one to six months is wide – some only feed four times in 24 hours, while others have 13 feeds a day.³

“After he’s about one month old, your baby will begin taking bigger volumes of milk at a feed and may start to go longer between feeds,” explains internationally renowned lactation consultant Cathy Garbin. “His stomach is growing so he can take larger feeds, plus your mature milk keeps him fuller for longer.”

Feeds can last anything from 12 minutes to nearer an hour – there really is that much variability between babies!³ But if your baby is gaining weight and has a feeding pattern that fits into these ranges, you have no cause for concern.

Amazingly however, no matter how often your baby feeds, he’ll consume roughly the same quantity of milk per day at one month old as he will at six months, when you start introducing solid foods.⁴

“Having said that, you’ll invariably get some days when he wants to feed a bit more or less, especially if he’s not feeling well, and you should just go with it,” says Cathy.

Does my baby really only need breast milk for the first six months?

Yes. Breast milk provides your baby with everything he needs for the first six months of life – if he’s exclusively breastfed, he doesn’t even need water!⁵ In fact, his digestive system is not able to cope with solid foods until around six months, and he won’t be able to drink cow’s milk until he’s a year old.

Breastfeeding throughout this stage also prepares your baby for the exciting milestones ahead. It exercises his mouth muscles and helps develop his jaw and align his teeth,^6,7 which are all important for eating and talking. And because the flavour of your breast milk can be influenced by what you eat or drink, it means your baby can experience new tastes before he even starts solids.⁸

Not only that but if he gets ill, your body will produce antibodies that go into your breast milk to help fight off the infection.⁹ This means it will continue to protect him as he grows and gets more active over the months to come.

Once you hit your stride, carrying on breastfeeding is also incredibly convenient, as Claudia, mum of two, UK, discovered: “Not having to sterilise loads of bottles, make up formula, cart it all around, then heat it up, made breastfeeding the easy option – especially as my babies got a bit older and we went out more.”

When will my breastfed baby sleep through the night?

It’s normal for all babies to wake during the night. The majority of one- to six-month-old babies consume a fifth of their daily milk intake at night, so these feeds are important to ensure they get enough calories.³

“Really, it depends on what you call sleeping through the night,” says Cathy. “If your baby goes to bed at midnight and wakes up at 05:00, some people call that sleeping through and it’s certainly better than waking every two hours! I’ve known breastfed babies who’ve gone to bed at 19:00 and woken at 07:00 from six weeks, but plenty of others continue to wake frequently. Every child is different.”

A study of more than 700 babies in Wales showed that almost 80% woke at least once a night between six and 12 months, and 25% woke three times or more. There was no difference in frequency between breastfed or formula-fed babies.¹⁰

So, if you’re going to be waking up anyway, at least breastfeeding is a convenient option! As Minette, mum of two, Australia, agrees: “At night you barely have to wake up – just let your body and baby go on automatic pilot. No planning, measuring or sterilising. It’s all ready and at the right temperature in your boob. Perfect for me.”

My baby has started waking up more – is he hungry?

At around four months, your baby’s sleep patterns may change as he starts to cycle between periods of deep and light sleep, just like an adult. As a result, he may start waking more frequently at night. “At this four-month stage you may be dealing with a sleep issue not a feeding issue,” says Cathy. “It can wear you out, but try to go with the flow and ride through it.”

Some people refer to this as the ‘four-month sleep regression’ but a more apt word is progression. While it may feel like a step back, your baby is approaching an important developmental phase. He’s learning rapidly, becoming more aware of the world, gaining better depth-perception, and perhaps starting to experience separation anxiety. Crying for you when he wakes, feeding and being close to you is a way of seeking reassurance.^11–13

Don’t be tempted to give a ‘top-up’ of formula or introduce solids early in a bid to make your baby sleep longer. Your breast milk contains hormones that cause drowsiness and help both of you relax. And studies show mums who breastfeed actually get more sleep each night than those using formula or mixed feeding.¹⁴

How will teething affect breastfeeding?

Teething often starts from about four months. Your baby might become fussy and pull off your breast, crying with discomfort, if his gums are sore, which can be frustrating.

However, breastfeeding can also be soothing. A study showed babies who are breastfed during immunisations cry less and recover more quickly from the pain,¹⁵ and this calming effect could also help your baby while he’s teething.

An unwanted side effect may be that your baby starts to use your breast to try out his new teeth.“Occasionally some babies will have a little game and bite their mum playfully. If this is about to happen, you might notice a subtle change in your baby during the feed – he’ll have to move his tongue out of the way before he bites,” says Cathy. “It’s not usually a big problem and might only happen for a couple of feeds. Just stop the feed, tell him gently that it’s not good to bite, and he’ll soon cotton on.”

How can I continue breastfeeding if I’m away from my baby?

There may be occasions while you’re still exclusively breastfeeding during the first six months when you need to leave your baby for a couple of hours – or even longer if you have to return to work or go away for a day or two.

Don’t feel like you have to give up breastfeeding at this point. You can still continue giving your child the benefits of breast milk by pumping milk that can be fed to him while you’re not there, as Cathy explains:

“Express milk for a couple of days beforehand, taking small quantities – maybe 40 to 60 ml (1.4 to 2.1 fl oz) at a time – so you have a bank ready for whoever will be caring for your baby. By taking small amounts, you won’t affect your milk supply.

“If you’re returning to work, talk to your employer to get a plan in place. Many mums breastfeed their baby at night and do the first and last feeds. Then they express at lunchtime to ease any discomfort and provide milk for the next day.

“It’s usually much easier than people think it’s going to be, and many workplaces are set up for it these days,” she adds. “Breast pumps are efficient and will help you manage this juggling act easily.”

Natalie, mum of one, US, describes her routine: “I feed Dylan as soon as he wakes, and sometimes again before I go to work to get my supply going and have that connection. I pump twice at work for the next day (he has two bottles of breast milk while I’m at work) and then hurry home for his evening feed. At the weekends, I don’t pump and he goes back to just breastfeeding.”

Can I continue breastfeeding after introducing solids?

When your baby is showing an interest in food and sitting up unsupported, at around six months, he’s ready for you to start introducing solid foods. However, this doesn’t have to be the end of breastfeeding, as Cathy explains: “Your baby’s stores of iron, built up during pregnancy, have been used by six months and he needs to start getting more,” she says.

“Introduce foods around this time, but remember breastfeeding will remain more important as a source of calories and nutrients until your baby is around eight to nine months old. He’ll be eating a lot more food by that point, but you may still be giving breastfeeds four to five times a day, depending on your baby. By the time he gets to 12 months, you could be breastfeeding anywhere between two and six times a day. All babies are individuals and he could still be getting half his calories from breast milk.”

And don’t forget, your breast milk can also be added to your baby’s first solid foods, such as cereals and purees, so he can experience a familiar flavour at meals. If possible, use it freshly expressed (not defrosted) and mix in just before serving, so the live components and nutrients are not destroyed.¹⁶

You may feel social pressure to stop at six months, but the longer you breastfeed or express, the more benefits there are for you both.

How long can I keep breastfeeding for?

“The World Health Organization recommends giving toddlers breast milk alongside solid foods until they turn two and beyond, as it still has a vital role in supporting the immune system,” says Cathy. “It’s also an important way to offer emotional support when they’re feeling overwhelmed or poorly.”

At eight months old, you may be giving your baby four feeds a day but after he’s a year old, you could be feeding as little as twice a day. You can find a pattern that works for you both and fits into your lifestyle, as Jane, mum of two, US, found. She breastfed her children until they were around the age of two: “I’d feed when I was around in the evenings and at weekends, when they wanted to feel close to me,” she says. “It was a great help when they were sick, and my go-to method of comforting.”

“As my son grew older and became more adventurous, he’d often come back to me to nurse, as if to ground him and allow him to recharge,” remembers Amy, mum of two, Canada. “When he encountered bumps and bruises along the way, breastfeeding was a great comfort to him.”

If you breastfeed your baby into toddlerhood, other people may comment that he’ll never want to stop. But, given the freedom to choose, toddlers often self-wean between the ages of two and four years.¹⁷

“I never set out to breastfeed for so long but am still feeding my four-year-old and 22-month-old,” says Susannah, mum of two, UK. “I feed my youngest before and after work and pump during work trips. My eldest has a little comfort feed before bed or when she’s upset – it’s a great way to reconnect. When I’m exhausted or feeling touched out, I focus on the amazing health benefits and comfort I’m giving them. I’m now planning to follow infant-led weaning and let them stop when they’re ready.”

Find out more about what you can expect, along with lots of support and advice, in Breastfeeding challenges after the first month

The post Breastfeeding after one month: What to expect appeared first on Medela South Africa.

Breastfeeding isn’t always easy and if you’re experiencing difficulties you’re not alone. In fact a US study of more than 500 mums found that 92% reported breastfeeding challenges by day three¹. Thankfully, many early breastfeeding difficulties are simple to deal with – here are my solutions to the most common problems mums experience in the first week.

I have sore nipples what should I do?

Problem 1: Breastfeeding hurts!

Pain while breastfeeding is usually down to sore, tender nipples, especially once your milk ‘comes in’ around two to four days after giving birth.² Your baby will be feeding every couple of hours, which means the problem can worsen quickly, with some mums finding their nipples crack, bleed or become blistered. Ouch!

Solutions³

• Check your baby’s latch. Your baby not latching correctly is the most likely cause of breastfeeding pain. Your newborn should have a large portion of the lower part of the areola (the dark skin around your nipple) in her mouth when she feeds, with your nipple against the roof of her mouth, cupped gently underneath by her tongue.
• See a lactation consultant or breastfeeding specialist to make sure your baby’s mouth and body are positioned correctly and that there are no other latching problems. They can also check inside your baby’s mouth to see if there is a physical problem.
• Try different breastfeeding positions. A laid-back, cross-cradle, underarm (‘rugby ball’) or lying-down hold may take the pressure off the most painful areas of your breast.
• Wipe damaged nipples gently with several pieces of water-moistened cotton wool after feeding to remove any debris that could lead to infection.
• Air-dry nipples or dab with a very clean, soft muslin or flannel, as infection can flourish in damp conditions. Use either disposable or washable nursing pads to absorb any milk leakage, remembering to change them regularly.
• Soothe your nipples. Relieve soreness and any dry skin with ultra-pure lanolin cream or gently apply a few drops of your own breast milk – you won’t have to remove either before the next feed. You could also try hydrogel pads straight from the fridge. These nipple dressings cool and provide instant breastfeeding pain relief, while creating ideal conditions for healing.
• Protect your nipples. Breast shells prevent your clothes from rubbing against sore areas.
• Be patient. Soreness normally settles down after a few days as your body gets used to breastfeeding and your baby’s sucking becomes more efficient.
• Consult a healthcare professional, lactation consultant or breastfeeding specialist if the pain while breastfeeding doesn’t subside after a few days. Ongoing nipple soreness can be a sign of an infection that may require medication.

Problem 2: My baby is not latching properly

Some newborns just don’t seem to manage to get a great latch – perhaps because you both need a little more time to get breastfeeding coordinated, or because they were born prematurely, are uncomfortable after a difficult birth, or their mum has flat or inverted nipples.

Solutions

• Get support from a lactation consultant or breastfeeding specialist who can diagnose the cause of the problem and develop a plan to help you overcome it.
• Draw out inverted or flat nipples. Nipple formers fit comfortably inside your bra, and apply a gentle pressure that can help draw out your nipples to support breastfeeding.
• Adopt different holds to make things easier for your newborn. She needs to feel supported, comfortable, and able to breathe in order to feed effectively. Make sure you’re not holding her head or pushing it. A laid-back, baby-led feeding style encourages your baby to use her innate reflexes, making it easier for her to reach your breast and latch on.⁴
• Make tiny adjustments while feeding. Rather than take your baby on and off the breast, creating frustration for you both, try ensuring she’s well positioned and comfortable. Keep her body and bottom close to you, support her across her shoulder girth, and hold her firmly so she feels secure.  Let her head rest on your wrist so it can tilt back slightly and allow more space for her nose to breathe. Her chin should be close to your breast. If minor adjustments don’t seem to be improving your baby’s comfort, seek support from a lactation consultant or breastfeeding specialist.
• Feed through nipple shields. If your baby will not latch on, a lactation consultant or breastfeeding specialist may recommend using nipple shields to give your baby a larger, firmer target to attach to. In general, nipple shields should be considered a short-term solution.

The top 8 tips if your baby has lost too much weight

Problem 3: I do not have enough breast milk

Initially you’ll make a small amount of breast milk because the hormonal changes that trigger your milk production happen slowly, and won’t be finished until around day two to four.² This may cause you to worry your baby isn’t getting enough, but as her stomach is only tiny at first and she feeds frequently, it’s not a problem. During the first few days you only need to be concerned if your baby is losing more weight than expected and producing too few wet and dirty nappies, or is showing signs of dehydration. For a full explanation of how often your newborn should be weeing and pooing, read breastfeeding a newborn: what to expect in the first week.

Solutions

• Seek support from a lactation consultant, breastfeeding specialist or healthcare professional, who’ll be able to assess if you have a milk supply problem. The earlier you get help, the better.
• Feed on demand, not to a schedule. In the first week after birth your newborn will want to feed at least every two to three hours (maybe more!) throughout the day and night. This frequency helps to build your milk production.
• Look after yourself. It’s not always easy with a newborn, but try to rest when you can, eat well, and get as much help as possible with chores and any older children so you can focus on breastfeeding.
• Try expressing. If your baby is feeding often and still not putting on weight, a lactation consultant or breastfeeding specialist may recommend pumping to build your milk supply. If your milk hasn’t come in yet, the Medela Symphony hospital-grade double electric breast pump has an ‘Initiate’ program that mimics the way a newborn feeds in the first few days.

Problem 4: My breasts are really full and hard

When your milk comes in, your breasts will become fuller and firmer. If your baby is feeding well and frequently, this should pass without problems. However, some women’s breasts become rock hard, and they may also be tender, uncomfortable, even painful – a condition called breast engorgement. Engorged breasts may also feel fairly hot due to all the activity inside – it’s like a traffic jam in there! Although it’s only temporary, often lasting 24 to 48 hours, engorgement can also make it difficult for your baby to latch, as your nipples may become flattened.⁵

Solutions

• Feed your baby frequently. Aim to feed at least eight to 12 times every 24 hours. This is the primary treatment for this condition – for more tips and advice read our article on breast engorgement.^6,7
• See a healthcare professional, lactation consultant or breastfeeding specialist if the symptoms last more than 48 hours, you have a fever, or your baby is unable to breastfeed because of the engorgement.

Problem 5: My breasts are leaking

Leaky breasts are very common in the early days of breastfeeding, once your milk has come in. You may leak from one breast when you’re feeding your baby from the other, when lying on your front while sleeping, or when something stimulates your let-down reflex unexpectedly – like another baby crying in the supermarket. Leaking usually settles down after six weeks or so.

Solutions

• Protect your clothes by wearing disposable or washable nursing pads inside your bra day and night.
• Don’t waste a drop! Milk collection shells fit inside your bra to collect any leaked milk. They’re helpful when the leakage is too much for nursing pads, or if one nipple tends to drip while you’re feeding from the other. If you want to save the collected milk, you can, but only use milk you’ve collected during a breastfeed. Store in a sterile container and, if you’re not feeding it to your baby straight away, place in the fridge immediately and use within 24 hours. Don’t wear collection shells for more than two to three hours at a time.

Problem 6: I think I’m producing too much milk

Sometimes when your milk comes in, it really comes in! You may have a temporary oversupply for the first few weeks but it should settle down soon.⁷ Until then your breasts may feel painful and hard most of the time, even straight after a feed, and you might be leaking a lot of milk. Your baby may cough and splutter with the force of your let down, vomit as soon as she is moved after feeds, and have an uncomfortable tummy or explosive, frothy, greenish poos. All this suggests you may have too much milk, but this issue may resolve itself as soon as your breasts adjust to their new job.

Solutions

• Express a little milk by hand at the start of each feed to reduce the force of your let down.
• Try the laid-back breastfeeding position so your baby can better control the flow of milk. Or use the cradle position: holding her across her shoulders, ensuring your baby’s head is tilting back slightly and resting on your wrist. Her body will be resting on yours, sloping down diagonally.
• Be gentle and patient. Allow your baby to rest and digest her milk, both during and after a feed. Moving her around too much or too quickly could make her feel sick. As she grows, she’ll get better at coping with the flow, which is likely to slow in any case.
• Use a towel or muslin cloth to soak up the surge if your baby gets overwhelmed when your milk starts to flow, and put a milk collection shell on your other breast to catch any leaks.
• Seek advice from a lactation consultant or breastfeeding specialist if you’re still having difficulties after several weeks. They will assess you, and may advise on one-sided feeding or block feeding if you need to reduce your milk supply.

Read on: Breastfeeding difficulties in the next few weeks and breastfeeding challenges after the first month

The post 6 breastfeeding problems in the first week – solved appeared first on Medela South Africa.

When you first start breastfeeding your baby, your breasts produce colostrum in small amounts that gradually increase over the first few days. But after around two to four days they start making much larger quantities of milk – a change known as your breast milk ‘coming in’.¹

One of the signs milk is coming in is your breasts become fuller and firmer. This swelling is not just caused by the greater quantity of milk, but also by increased blood flow and extra lymph fluids in your breast tissue.²

For most new mums, if their baby is feeding well and frequently, these feelings of heaviness pass without problems. But some produce almost more milk than their breasts can hold, which makes them feel rock hard and uncomfortably full – a condition called engorgement. While this is usually only temporary, the 24 to 48 hours it typically lasts for can be painful.

What do engorged breasts feel like?

Engorgement can happen in one or both breasts. It may cause throbbing and swelling, sometimes extending as far as your armpit, and could make your breasts feel fairly hot or lumpy – this is because of all the activity going on inside. You may notice other breast engorgement symptoms, including the skin of your breasts looking shiny and feeling stretched, and your nipples becoming hard and flat. Engorgement may even cause your body temperature to rise to around 37.5 to 38.3 °C (99 to 101 °F).³

As well as being painful, breast engorgement can cause breastfeeding difficulties – which can, in turn, worsen the problem. Your baby might struggle to latch if your nipples are flatter and your breast tissue is harder, which can cause sore nipples. In addition, if your baby’s latch is poor she’s less likely to drain the breast well. This means that, if left untreated, engorgement can lead to blocked ducts, mastitis and reduced milk production.

What causes breast engorgement?

Engorgement usually occurs because a baby is not feeding frequently enough (at least eight times every 24 hours). It can happen to any new mum, but is more common in women who’ve had previous breast augmentation or other breast surgery.² Pressure from a badly fitting bra or tight clothing can make the discomfort worse, and may lead to blocked ducts and possibly mastitis.

Breast engorgement can happen to women who don’t or can’t breastfeed, as well as those who do. The hormonal changes that follow delivery of the baby and placenta, which cause an increase in milk production, occur whether you breastfeed or not. Engorgement can also happen if you suddenly cut breastfeeds, perhaps because your baby is sick, sleeping longer, starting solids, or going into childcare.

How can I treat engorged breasts?²

The most effective breast engorgement treatment is a hungry baby! You should try to empty your breasts as much and as often as possible to help keep milk flowing – so feed on demand, between eight and 12 times every 24 hours.

Keep your baby in skin-to-skin contact with your chest for as long as possible throughout the day, and when you’re awake at night. This way she can smell the tempting aroma of your milk, has easy access to your breasts, and you’re more likely to spot her early hunger cues so you can ensure she feeds frequently. Let her take as much milk as she wants from one breast before offering the other.

It’s also well worth getting your baby’s latch and positioning checked by a lactation consultant or breastfeeding specialist, to make sure she’s feeding effectively and draining your breasts properly. The tips below may also help relieve symptoms.

Tips for engorgement relief²

• Ensure you’re breastfeeding a minimum of eight times every 24 hours.
• Check that your baby has a good breastfeeding latch.
• Try breastfeeding in different positions.
• Massage your breasts gently while feeding to help the milk drain effectively.
• Express a little milk, either by hand or with a breast pump before breastfeeding to help soften your nipple so it’s easier to latch on to.
• If your breasts are still very firm and full after a feed, express again until you feel comfortable.
• If your baby is unable to breastfeed, replace the feeds with expressions. Pump your breasts until they feel much softer – a minimum of eight times every 24 hours.
• Try ‘reverse pressure softening’, a technique that can move excess fluid from the breast. A lactation consultant or breastfeeding specialist can show you how to do this.
• If your breasts are leaking milk, try a warm shower or applying a warm, wet flannel just before breastfeeding or expressing to soothe them and help milk flow. Don’t do this for more than a couple of minutes, as too much heat may worsen swelling.
• If your breasts aren’t leaking, apply a cold compress, chilled gel pad, or even frozen peas wrapped in a cloth, to your breasts for ten minutes after a feed to reduce swelling and relieve pain. 
• Tuck clean cabbage leaves inside your bra. Yes, really! Many mums find they help reduce swelling and discomfort, and there’s scientific evidence to back this up.⁴
• Take anti-inflammatory painkillers. Paracetamol and ibuprofen can be used while breastfeeding, although ibuprofen has contraindications for asthmatic mums. Always consult a healthcare professional and follow the manufacturer’s and pharmacist’s guidance. It’s generally best to avoid aspirin – for more on which medicines you can take while breastfeeding, read Breastfeeding while sick.
• Wear a properly fitted nursing bra and avoid underwires, or you may prefer not to wear a bra.
• Don’t skip feeds or stop breastfeeding suddenly as you could make the engorgement worse.

Seek medical advice if you develop a fever⁵ of around 38 °C (101°F) or above, or if your baby is unable to breastfeed because of the engorgement.

Finally, try to be patient. Your body is still getting used to making milk and feeding your baby. The engorgement should soon subside as you both get used to breastfeeding.

The post What is breast engorgement? appeared first on Medela South Africa.

Dr Jacqueline Kent and her team have spent years researching breastfeeding and have found that it’s different for every mum and baby.

Which of your findings surprised you the most?

The variability – there is such a broad range of ‘normal’. We were so used to textbooks saying a baby should feed eight to 12 times a day and should gain 150 g (5.3 oz) a week. But babies haven’t read the textbooks – they do their own thing! Some babies grow more slowly and some grow very rapidly.

Our studies of exclusively breastfed babies aged one to six months showed they typically breastfed between four and 13 times a day, and for between 12 minutes and nearer to one hour during each feeding session.¹

How much milk do breastfed babies drink?

Our studies showed that they can drink as little as 54 ml (1.9 fl oz) or as much as 234 ml (8.2 fl oz) of milk per feed.¹

Sometimes mums think their baby has had a good feed, but are surprised to discover he only had a very small amount of milk. Other times he can be slipping on and off the breast, only feeding for a few minutes, and yet take 100 ml (3.5 fl oz). So being fussy doesn’t necessarily mean he’s getting less milk overall.

All babies are different, but they all take what they need. Some will be ticking along quite nicely on 500 ml (17.6 fl oz) a day, some drink up to 1,356 ml (47.7 fl oz) a day!

And did you know, on average, boys drink 76 ml (2.6 fl oz) more than girls each day? As long as your milk supply is adequate, your baby will set his own agenda.

Should mums offer one breast or both?

I advise mums to offer the second breast after feeding from the first. If your baby accepts, then great, he obviously wants more. But if he says no, don’t worry. Let your baby decide – he knows how full his tummy is. Our research shows that 30% of babies take exclusively from one breast, 13% always take from both, but most (57%) do a mixture of the two.¹

How can a mum tell if her baby is getting enough milk?

In my experience, mums often feel guilty and worry they’re not producing enough milk. Ask yourself: Is my baby growing and putting on weight? Is my baby alert? Does he have good skin tone? Is he producing enough wet nappies and dirty nappies? If all of this is happening, then whether he’s having long or short feeds, be reassured you’re giving enough milk.

What’s the biggest misconception mums-to-be have about breastfeeding?

Mums tend to think that as their babies get older they will need more feeds and a greater amount of milk every 24 hours. They’re often very surprised when I tell them that between four weeks and 26 weeks, if everything is going normally, there’s no change in their total milk production.²

In the first few months, babies grow very rapidly and have a high metabolic rate. The milk they take in is mostly put into growth and maintaining their metabolism.

Then, from three to six months, their metabolic rate goes down and so does their growth rate, so the same amount of milk can satisfy them. This means your baby doesn’t need to increase his milk intake as he gets bigger. In fact, feeds start to become shorter and less frequent, and yet he’s still getting the same amount of milk as he feeds more efficiently.

Does your research show when breastfed babies start sleeping through the night?

Most babies feed at night. Their stomach capacity is not big enough to go all night without a feed, and breast milk is digested very rapidly. So of course, they wake up hungry in the night – and it’s likely to happen for at least the first six months. Night feeding is normal. When you’re awake at night feeding your baby, be reassured that other mums with babies the same age all over the world are probably doing the same thing – and hopefully it’ll only be for a few months.¹

What do mums worry about most in the first few weeks of breastfeeding?

The most common concerns are whether the baby is latched on and sucking properly, and if the baby is satisfied after a feed. It’s usual for mothers to be concerned about nipple pain too. The key thing is getting breastfeeding positioning and attachment correct from the beginning because, anecdotally, it makes a lot of difference to both milk transfer and mums’ comfort.

When should a mum worry that breastfeeding isn’t normal?

The mother should reach full milk production by two weeks. If a baby hasn’t started to regain weight by five or six days after birth, alarm bells should ring. Parents should seek medical advice, and healthcare professionals need to make sure milk is being produced and its composition is changing from colostrum towards mature milk.

If you could give a new mum breastfeeding advice, what would it be?

Have skin-to-skin contact with your baby as soon as possible after birth. Breastfeed within an hour if you can, or at least encourage your baby to latch on. Get your positioning and latch monitored and corrected as soon as possible to make sure there’s no nipple damage.

Feed often. New mums can’t always read their babies’ cues and cries. Definitely feed on demand rather than at regular, set, intervals. Offer the breast as soon as there are any signs of hunger – babies usually feed better if they’re calm. If your baby’s crying it can be harder for him to latch on. If in doubt, offer the breast. Your baby will soon tell you if he wants it or not.

For an overview of Dr Kent’s research findings, download the What is the range of ‘normal’ when it comes to breastfeeding? infographic or read it below.

The post What’s ‘normal’ when it comes to breastfeeding? appeared first on Medela South Africa.