Problem 1: There’s a painful lump in my breast

There are various reasons for lumps and bumps in a lactating breast. One of the most common is a blocked duct, clogged by milk, causing a hard lump that may be sore and tender.

Solutions^1–3

• Massage the affected area, especially when feeding or expressing, to help release the blockage.
• Gently press a warm flannel on your breast, or try a warm bath or shower before a feed to help ease the discomfort.
• Continue to breastfeed normally to avoid the risk of milk build-up, which can lead to mastitis.
• Try pumping from the affected breast after feeds to ensure good milk drainage and to help remove the blockage, allowing the duct to work again. You can explore Medela’s full pump portfolio and choose one that meet your needs.
• Ask about therapeutic ultrasound treatment. If you suffer with recurrent blocked ducts your lactation consultant or breastfeeding specialist may recommend this procedure, which can help get milk flowing again. It is performed by a physiotherapist.
• See your healthcare professional if you notice signs of infection (a red, painful breast, or flu-like symptoms such as a high temperature, aches and pains, or headache), or you think the lump isn’t related to breastfeeding.

Problem 2: My breasts are red and painful

If one or both of your breasts are red and painful, and it isn’t a blocked duct, it’s likely you have mastitis. This is a condition where the breast tissue becomes inflamed. Signs include a red and hot area, tenderness, flu-like symptoms – being hot and cold with aching joints, and a temperature of more than 38.5 °C (101.3 °F). If you’re experiencing these symptoms, seek medical advice straight away. Mastitis needs to be treated quickly, as it can worsen in just a few hours.³

The causes of mastitis can be:

• an untreated blocked duct
• bacteria that have entered you breast via cracked or damaged nipples
• poor attachment to the breast
• leaving long periods of time between feeds
• having breasts that are too full
• wearing a bra or clothing that is too tight and ‘cuts in’ to your skin
• weaning your baby from breastfeeding quickly
• an oversupply of milk

Solutions³
In addition to seeking medical advice, you can also try the following self-care tips:

• Take paracetamol or ibuprofen (not aspirin) to relieve the pain, as instructed on the packet or by a pharmacist.
• Keep breastfeeding or pumping frequently. Your milk is still safe for your baby to drink. Flowing milk will help clear any blockage and prevent further painful build-up. Stopping suddenly could exacerbate symptoms. You may need to express any leftover milk after feeds.
• Offer your baby the affected breast first. This may help your baby to drain it adequately. If this is too painful, start on the non-affected side to get the milk flowing, then switch.
• Rest, drink and eat well. Make sure you’re having plenty of fluids and eating nutritious foods.
• Massage the area in a warm bath or shower, or compress with a warm flannel or heat pack to help release the blockage and ease symptoms before feeding or expressing.
• Use a cool pack after feeds to reduce inflammation. 

Problem 3: I’m feeling exhausted

Breastfeeding can feel tiring and relentless at times during the first weeks. Your baby will likely be feeding every few hours, day and night, while you’re still recovering from the birth.

Solutions

• Look after yourself. It may be easier said than done when you have a newborn, but get as much rest as possible, try to eat healthily and regularly, and drink plenty of water. Get help from your partner, family and friends – even paid help if you can afford it.
• Feed lying down. This may feel more relaxing and place less pressure on any sore spots, stitches or caesarean scars.
• Don’t skip feeds. A well-meaning loved one may offer to give your baby a bottle while you rest. Although this can be tempting, it’s recommended that you establish milk supply over the first four weeks by breastfeeding. Once breastfeeding is established, you can try giving your baby an expressed milk feed, but until then, ask family and friends to do other jobs so you can concentrate on breastfeeding.

Problem 4: How can I produce more breast milk?

It’s easy to lose confidence in your breast milk supply, especially when your baby has developmental spurts, common at three to four weeks. You may worry she’s increased her feeds because you’re not producing enough breast milk, but if your baby continues to have her regular number of wet and dirty nappies – see breastfeeding: what to expect in the first month – she’s most likely breastfeeding more frequently for comfort. It’s easy for her to become overwhelmed by all the new sights and sounds around her, and breastfeeding makes her feel safe.⁴

Solutions ^4,5

• Avoid top-ups feeds of formula, unless healthcare professionals are concerned about your baby’s weight gain or levels of hydration. Keep offering your baby the breast to increase your supply naturally – it’ll soon catch up.
• Don’t use a feeding schedule. Breastfeed your baby on demand to ensure your supply matches her needs.
• Use a breast pump to increase breast milk production, in addition to continuing breast feeds.

Problem 5: I’ve got too much milk 

Hyperlactation, or an oversupply of milk, can cause breastfeeding difficulties for you and your baby. While you suffer from swollen breasts that are leaky and uncomfortable, she may struggle to latch on, start choking on your fast flow of milk, and may not be able to finish a feed properly.⁶

Solutions

• Remove a little breast milk at the beginning of a feed to reduce the force of your let down. Don’t express too much as this could make your oversupply difficulties worse – just enough to relieve any discomfort. Try hand expressing, or use a breast pump (check out our range of breast pumps to find one that meets your needs).
• Use a towel or muslin to soak up any excess milk, or pop a milk collection shell on your other breast while you feed to catch leakage.
• Ensure your baby feels supported. Hold her firmly (it makes her feel secure) and in a comfortable position where she’s able to move her head. Talk her through the initial fast flow, so she’s less likely to be surprised and pull away from your breast.
• Consult a lactation consultant or breastfeeding specialist, who will take a look at you both and may suggest one-sided feeding or block feeding as ways to regulate your supply.
• Be patient. Problems with milk production usually improve after a few weeks.

Problem 6: My breasts are lop-sided!

You may find your baby prefers to latch on one side, or that one breast produces more milk than the other, which could make them different in size or shape. This is very common and shouldn’t cause any problems when breastfeeding. If it’s not bothering you or your baby, there’s no need to do anything about it, but there are things you can try if you feel self-conscious.

Solutions 

• Offer the least-used breast first at every feed, as your baby will usually suck more vigorously at the start.
• Use a breast pump to help increase lactation in the less-efficient breast.
• Don’t neglect the fuller breast. You’ll need to keep feeding from the larger one, too, to avoid blocked breast ducts and mastitis.
• Seek medical advice. Sometimes an ear infection may cause your baby to only feed on one side. This is because certain positions can cause discomfort – a more upright hold can help with this. In addition, if you have a breast infection this may change the taste of your milk and put her off.

Problem 7: There’s a blister on my nipple

The demands of frequent breastfeeding can sometimes cause a painful friction or blood blister on the breast, nipple or areola.⁷

Solutions

• Ask a lactation consultant or breastfeeding specialist to check your baby’s latch. A shallow latch can cause nipple or areola blisters.
• Take paracetamol or ibuprofen (not aspirin) up to an hour before you feed your baby to ease pain during breastfeeding.
• Try different feeding positions to avoid pressing on the painful area.
• Use ultra-pure lanolin cream to soothe the soreness.  
• Wear breast shells to stop clothing irritating the blister and aid healing via air circulation, or try cooling hydrogel pads to ease pain and encourage healing.
• Try pumping. Using a breast pump may be an alternative way of getting milk without aggravating the blister. Make sure you use a correctly sized breast shield so your nipple can move freely and doesn’t rub against the breast shield tunnel.
• Don’t pop the blister, as this could lead to an infection.
• Seek medical advice if the problem persists and is painful.

Problem 8: I have a painful white dot on my nipple

When the opening of a milk duct becomes blocked with thickened milk, or a thin layer of skin grows over it, this can create a tiny white or yellow spot on the nipple tip. These plugged milk ducts – sometimes known as milk blisters or blebs – can cause localised pain for some mums, especially during feeding or expressing. Others don’t experience any discomfort. White blebs can persist for days or weeks, lasting until the skin eventually breaks and the hardened milk can escape.⁸

Solutions

• Follow the advice above for dealing with friction blisters.
• Loosen the blockage if you see the milk plug protruding – try to pull it out gently with very clean fingernails.
• Keep breastfeeding or expressing to try to get the duct working normally again. It won’t harm your baby if the duct unblocks while she’s feeding.
• Apply a hot, wet flannel to the bleb immediately before feeding or pumping to encourage the blocked duct to open. Also try rubbing it briskly with a clean, moist flannel.
• Hand express before feeding to try to push out hardened ‘strings’ of milk. If this doesn’t work, feed or pump as normal. Repeat several times a day.
• Soak a cotton wool ball in olive oil and leave it in your bra next to the nipple with the bleb. It may help to soften the skin.
• Seek medical advice if it persists. A healthcare professional, lactation consultant or breastfeeding specialist can remove the plug with a sterile needle. This should be done after feeding so the bleb is at its most prominent.

Problem 9: My nipples hurt when I breastfeed

It’s normal for your nipples to feel tender, or even sore, in the early stages of breastfeeding, but this usually subsides after a few days. If you’ve had your baby’s latch checked by an expert and the soreness persists, or you experience nipple pain every time you breastfeed, you might need medical help to resolve the problem.^2,7

If you have any of these symptoms and signs in one or both breasts, during feeding or afterwards, you could have either a bacterial infection or thrush:

• nipples that burn, itch or sting, either mildly or severely
• nipple pain made worse by wearing clothes that touch your breast
• nipple pain that continues despite making adjustments to how your baby attaches  
• nipples that are tender to touch
• stabbing, shooting, burning or deep aching pain
• breast pain that lasts throughout the feed, as well as up to an hour afterwards
• nipples that look bright pink
• a change in the areola’s colour or texture – to bright pink, darkened, dry or flaky
• a white rash on the areola or breast

Also look out for these symptoms and signs in your baby:

• thick, white patches or coating on her tongue
• white spots on her cheeks that you cannot rub off
• a bright red rash with spots on her bottom that does not clear with nappy rash creams

Solutions⁷

• Seek medical advice. Your healthcare professional will probably want to take swabs of your nipples to find out if there is an infection and, if so, what sort. Bacterial infections are treated differently to thrush (yeast) infections, so getting the right treatment as soon as possible is best. There are other issues that could cause similar nipple pain, including eczema, psoriasis or vasospasm (narrowing of blood vessels) in mums, or a poor latch or tongue-tie in babies, so it’s important to get an accurate diagnosis.
• Practise good hygiene. Wash your hands before and after breastfeeding, applying any treatments, and nappy changes too. Change breast pads frequently, wash your bras, tops and towels at a high temperature, and thoroughly clean breast shields and any items that make contact with your baby’s mouth, such as teats.
• Allow your nipples to dry after feeding, as infections thrive in warm, moist environments.
• Go back to your healthcare professional if there’s no improvement after several days. Don’t leave the problem to get worse.

Read on: Breastfeeding: What to expect in the first month

Breastfeeding: What to expect after one month

Breastfeeding challenges after one month

The post 9 breastfeeding problems in the first month – solved appeared first on Medela South Africa.

How often can I expect to feed?

Your newborn has a small stomach that grows rapidly, from the size of an apricot at week one to the size of a large hen’s egg at two weeks, to perfectly accommodate your growing milk supply.^1,2 Allowing your baby to take what she needs, when she needs it, will help her regain her birth weight and continue growing.

“You can expect to feed every two to three hours during the day. At night you might get longer gaps, like three to four hours, or maybe even five,” says Cathy Garbin, an internationally renowned lactation consultant. “But remember each day is different and so is every baby. Some babies are speedy feeders and are full in 15 minutes, whereas others can feed for up to an hour. Don’t compare your feeding pattern to those of others – they’re likely to be completely different.”

At each feed, allow your baby to take as much milk as she wants from one breast, then offer the other, which she may or may not want. When she’s full, she’ll detach naturally and seem relaxed and content – so much so that she might fall asleep. Next time offer the opposite breast first. You can use an appto keep track of which side you’re feeding from.

Why does my baby want to feed all the time?

This first month is usually the most demanding when it comes to breastfeeding. But just because your baby appears constantly hungry and is feeding really often – perhaps every 45 minutes – don’t assume that you don’t have enough milk.

Babies need to feed frequently in order to initiate and build your milk supply during this first month. This lays the foundations of a good milk supply for the future too.³

Don’t forget that babies also want to be in almost constant contact with their mums – the bright lights and sounds of the outside world can seem scary at first and your baby needs your contact to stay calm.

Sara, mum of three, UK, agrees: “Crying isn’t always a sign of hunger – sometimes my babies just wanted to be with me or suck for comfort. Use a sling. Get a bedside crib. Don’t look at the clock. Rest whenever possible. Cleaning does not matter. Make people look after you. Not for three days – at least six weeks! Enjoy the cuddles and cosiness, and never doubt your body.”

Does my baby need a breastfeeding schedule?

Your baby is too young for a routine, so forget following a breastfeeding schedule – let her guide you instead.

“You can read books about how to get a baby on to a schedule, but babies don’t read and don’t understand them,” says Cathy. “Each baby is an individual. Some may conform but many don’t. Most will find their own schedule over time.”

Some mums say a set routine was best for their baby – but these babies were probably among the small percentage who would naturally feed every four hours anyway! Adults generally don’t eat and drink the same things, at the same times, every day, so why should your baby follow such a strict routine?

Instead, offer your baby your breast whenever she shows signs of being hungry. Crying is a late sign, so look out for earlier cues, such as her licking her lips, opening her mouth, sucking her hands, or turning her head open-mouthed – known as ‘rooting’.⁴

What is a let down?

At the start of each feed your hungry baby will suck rapidly on your nipple, prompting the ‘let-down’ reflex that pushes milk through your milk ducts.⁵

“Nipple stimulation triggers the brain to release the hormone oxytocin,” explains Cathy. “The oxytocin goes through your body and causes the little muscles around the milk-making glands in the breast to contract. It also dilates all the ducts that the milk comes through, so the milk starts to flow.

“If you don’t get a let down, the milk won’t flow freely. It’s a hormonal response and being stressed can stop it happening or working properly. That’s why it’s really important to be supported and comfortable during a feed.

“Research has found that every mum has a pattern of let downs throughout a breastfeed,” she continues. “Oxytocin is a short-acting hormone and might only last in the body for 30 to 40 seconds. Your milk will flow and your baby will drink. Then the oxytocin will dissipate, you’ll get another let down and she’ll feed again, and so on. This is why babies stop and have short rests throughout a breastfeed – it’s nature’s way.”

The let down might cause a strong whooshing or tingling sensation in your breasts, although studies suggest 21% of breastfeeding mums feel nothing,⁵ as Cathy explains: “Many women will feel the first let down, but not subsequent ones. Don’t worry if you don’t feel a let down – if your baby is feeding well it may be that you simply don’t recognise what it is.”  

How do I know if my milk is satisfying my baby?

Because you can’t see how much milk your baby drinks when breastfeeding, you may worry she isn’t getting enough. Try to trust in your body and your baby.

As the milk starts to flow you may notice your baby slows her sucking rhythm. Some mums can clearly hear their baby gulping down the milk, while others may not. Your baby will tell you if she’s had enough, so watch her cues. Many babies may take one, two or three sittings at the breast before they are finished.⁶

“When your baby gets a good feed she will usually seem ‘milk drunk’ immediately afterwards. She’ll be relaxed and her body language will show you she’s satiated,” says Cathy. “Remember her nappies are also a good indicator that she is getting enough milk. At this stage, your breastfed baby will have five or more wet nappies a day and at least two soft, yellow poos – usually more.”

From one month onwards your exclusively breastfed baby’s poo should look the same every day (yellow, seedy in texture, loose and watery) until you start to introduce solids from around six months. Your baby may poo daily, or only poo every two to three days, or even less frequently than that.⁷

When should my baby regain her birth weight?

 Most newborns will lose weight during the first few days after birth. This is normal and nothing to worry about. Most lose around 5 to 7% of their birth weight, but some may lose up to 10%. However, nearly all babies are back up to birth weight by day 10 to 14. In the first three to four months the minimum expected weight gain is 150 g (5.5 oz) per week on average. But remember babies can have really fast weeks of growth, as well as slower ones, so your healthcare professional will be looking at your baby’s overall wellbeing and growth continuously.^7,8 

If you’re concerned – or your baby shows signs of dehydration, such as dark-coloured urine, no poos for more than 24 hours, a sunken fontanelle (the soft spot on her head), jaundice, lethargy, floppiness, and not wanting to feed (i.e. going four to six hours without a feed) – seek medical advice quickly.⁷

What is cluster feeding?

When a baby wants to breastfeed very frequently over the space of several hours, this is known as cluster feeding.⁶ It often peaks in the evenings between 18:00 and 22:00, which coincides with when many babies are unsettled and want to be held a lot. Mums most often report this happening during two to nine weeks after birth. This is a very normal, common behaviour for babies who are otherwise content during the rest of the day, feeding and gaining weight well, and generally healthy.⁹

Your baby may be cluster feeding because she’s having a developmental spurt and needs to feel secure, reassured and loved. She may be finding it hard to switch off due to all the stimulation her growing brain is receiving, or she may simply feel overwhelmed by it.⁹ Young babies who are overtired can find it hard to calm themselves and need someone to help. And what better way to be calmed than having a breastfeed, which is not just a source of food, but also a pain reliever and happy hormone giver?¹⁰

“No one had spoken to me about cluster feeding, and 10 days in I was beside myself, convinced my milk supply wasn’t meeting my baby’s needs,” remembers Camilla, mum of one, Australia. “It was a confusing time. I was told to pump and ‘top up’, until I called the Australian Breastfeeding Association. They explained what was going on and that it wasn’t a supply issue.”

Remember this is a temporary phase. Try preparing your evening meal at a time in the day when your baby is sleeping well, so you can just reheat it and eat quickly during the cluster feeding period. If you have support, share holding and rocking your baby to give you a break. If you don’t have support and feel it’s all too much and you’re not coping, place your baby safely in her cot and calm down for a few minutes before coming back to hold her again.

Enlist your partner, family and friends to help with chores, meals and any older children. If you have the resources, you could consider paying someone to help around the home. Try to have plenty of rest, eat well and stay hydrated.

“My daughter would sleep a lot during the day and then want to cluster feed from about 23:00 to 05:00, which was exhausting,” says Janelle, mum of one, US. “My husband tried to lighten the burden wherever he could: cleaning, making food for me, doing laundry, changing diapers, letting me sleep whenever possible, and always reassuring me that we were doing the best we could.”

If you’re concerned about the intensity of breastfeeding, it’s worth seeking help. “You need to see a lactation consultant or breastfeeding specialist, to find out if there’s an underlying problem,” explains Cathy. “Don’t fall into the trap of topping up with formula (unless advised to by your healthcare professional) until you get to the root cause. It could be that you’re not producing enough milk, but it might be that your baby is not able to get the milk effectively.”

When will breastfeeding get easier?

This early phase is short and special, and although it sometimes feels relentless it will get easier! By the end of one month, your breast milk supply will be established, and your baby should be stronger and more effective at feeding.^2,3 Any issues with your baby’s latch are likely to be sorted, and your body will be more efficient at making milk, so any soreness or leaking should start to subside.

“The first four to six weeks are the toughest, then it starts to settle down,” says Cathy. “And when you get to three months, breastfeeding gets really easy – way easier than cleaning and making up a bottle. Just hang in there!”

And the longer you continue breastfeeding, the more you’ll enjoy the benefits – from saving money on formula and having better sleep,^11–13 to boosted immunity for your baby¹⁴ and enhanced protection against certain cancers for you.¹⁵

“When you think you can’t go on, take it feed by feed and day by day,” advises Hannah, mum of one, UK. “I was sure I’d never make it to eight weeks. Now it’s almost 17 weeks and (dare I say it) easy.”

Find out about the next step on your breastfeeding journey in Breastfeeding after a month: What to expect

The post Breastfeeding in the first month: What to expect appeared first on Medela South Africa.

Before your baby’s birth

test123 Attending an antenatal class is a good idea. You’ll learn how important skin-to-skin contact is in initiating your milk supply, and you’ll probably receive other breastfeeding advice too. Your course leader may give you a list of local lactation consultants, breastfeeding specialists, or support groups. If not, make a note of local experts and a breastfeeding helpline, and find out if any groups are held nearby.

Also remember to include breastfeeding and having early skin-to-skin contact with your baby in your birth plan. This will help ensure the healthcare professionals looking after you know your wishes.

Who can give breastfeeding support?

If you need help after your baby is born, seek advice straight away. A minor problem can worsen rapidly, but most issues are quick and simple to fix if caught early.

Healthcare professionals, such as midwives, nurses and doctors, often have standard training in breastfeeding support. If you have more complex needs it’s worth seeking professionals who’ve had additional training. These fall into two broad categories – breastfeeding specialists, which include peer supporters and counsellors, and lactation consultants:

Peer supporters or peer counsellors

These are mothers who breastfed their babies and are trained to help with everyday problems. They can tell you whether your baby is well latched on and taking in enough milk. If your baby isn’t latching well, they’ll be able to help you find a better way to position him. If they spot a problem they can’t help with, they will be able to refer you to someone who can.

Breastfeeding counsellors

Breastfeeding counsellors (such as La Leche League leaders) have a deeper level of knowledge and can help with many of the trickier problems, such as a baby who isn’t gaining sufficient weight or who is refusing to latch.

Lactation consultants

A lactation consultant is needed for more complex problems, such as diagnosing low milk supply and helping mums with premature babies. They have IBCLC after their name, which means they’re members of the International Board of Certified Lactation Consultants and have had extensive training – visit its website to check if someone is registered.

What problems can an expert help with?

Here are outlines of some of the most common breastfeeding problems, with links to further advice.

A baby who won’t latch

Ideally, your newborn will latch within the first few hours. If he doesn’t, or the latch is uncomfortable, a midwife or peer supporter can check it. Don’t be afraid to ask for his latch to be rechecked, even if it was done at your birth facility. If your baby is still not latching after 24 hours, and you’re no longer in your birthing unit, an IBCLC lactation consultant can offer further support. Read more on getting a good latch.

Sore nipples

Almost always caused by your baby not being well latched, a peer supporter or counsellor can help you adjust his position. If the pain is severe or persistent, even after adjustments, an IBCLC lactation consultant can check for a cause that may have been missed before. Read more on sore nipples.

Breast engorgement

The best way to avoid engorgement – breasts that become uncomfortably full and hard when your milk ‘comes in’, usually around days two to four – is to feed your baby frequently. A breastfeeding specialist can show you how to massage your breasts and hand express or pump to relieve the pressure. If your baby cannot breastfeed because of the engorgement, you’ll need to see your midwife or a lactation consultant. Read more on engorgement.

Concerns about supply

Many mums worry about their milk supply over the first few days. A peer supporter or your midwife or nurse can reassure you it’s usual for your baby to feed every hour or two at this time. As long as he is producing plenty of wet and dirty nappies and gaining sufficient weight, all should be well. Read more about what to expect the first week of breastfeeding.

If your baby isn’t gaining weight, a breastfeeding counsellor or lactation consultant will be able to devise a feeding plan to ensure he is nourished and your supply is protected. Read more on low milk supply.

It’s good to talk 

Sometimes you may just want to be reassured that your baby’s behaviour – such as feeding very frequently or waking often at night – is normal, especially if you’re a first-time mum. In this case it can be comforting to talk to someone who has breastfed their own baby and knows what to expect, such as a peer supporter or counsellor.

The important thing to remember is that, although it can be tiring at first, with the right preparation and support, breastfeeding can be plain sailing. And if problems do arise, getting expert help early can steer you back on course.

The post How to get breastfeeding support appeared first on Medela South Africa.

Discover 11 different breastfeeding positions and find out what is best for you and your baby:

1. Laid-back breastfeeding or reclined position
2. Cradle hold
3. Cross-cradle hold
4. Rugby ball hold
5. Side-lying position
6. Laid-back breastfeeding after a c-section
7. Upright breastfeeding or koala hold
8. Dangle feeding
9. Nursing in a sling
10. Double rugby ball hold
11. Dancer hand nursing position

Whichever breastfeeding position you choose, remember:

• Gather everything you need, such as a drink, snacks, your mobile, TV remote, book or magazine, before you start feeding. And don’t forget to have a wee first – you may not be able to get up again for some time!
• Make sure your baby is comfy. Whatever position you’re in, your baby should be stable and supported, while his head, neck and spine should not be twisted.
• Ensure you feel relaxed and comfy too. Use cushions, pillows or rolled towels to support your back or arms if you need to.
• Check your baby is latching on correctly. A good latch is vital for comfortable breastfeeding.
• If your baby struggles to latch or breastfeeding makes you sore, seek support from a lactation consultant or breastfeeding specialist. They will also be able to show you how to support your baby to help you feed more comfortably.

1: Laid-back breastfeeding or reclined position

The laid-back breastfeeding position, also known as biological nurturing,¹ is often the first mums try. If your baby is placed on your chest or tummy as soon as he’s born, all being well he’ll instinctively work his way towards one of your breasts and attempt to latch on – this is known as the ‘breast crawl’. Skin-to-skin contact helps stimulate his feeding instincts, while gravity helps him to latch on well and keeps him in place.

However, laid-back breastfeeding isn’t just for newborns – it can work well with babies of any age. It may be especially useful if your baby struggles to latch in other holds, he doesn’t like his head being touched as he feeds, if you have a forceful let down, or if your breasts are large, as mum-of-one Isabel, UK, discovered: “The combination of my big boobs and a small 2.7 kg (6 lb) baby made positioning tricky at first. It took me a few weeks to realise there was no position I ‘should’ be in. In the end I mainly breastfed lying down with my baby balanced on top of me.”

You’ll probably be comfier if you’re reclining gently rather than lying flat on your back. Use cushions or pillows so you’re supported and can see your baby.

2: Cradle hold

This is the classic position most of us picture when we think of breastfeeding. It involves you sitting upright, with your baby positioned on his side, his head and neck laying along your forearm and his body against your stomach, in a tummy-to-mummy position.³ Although it’s a very popular position, it’s not always easy with a newborn because it doesn’t give your baby as much support as some other holds. A pillow or cushion behind you and a breastfeeding pillow across your lap propping up your baby or your arms may give you more support, and avoid strain on your back or shoulders. If you use a breastfeeding pillow, make sure it doesn’t lift your baby too high – your breasts should remain at their natural resting height to avoid sore nipples and a strained latch.

“I used the cradle hold because it worked! It felt comfortable and I liked sitting there just looking at my baby,” says Rachael, mum of two, Italy.

3: Cross-cradle hold

This looks similar to the cradle hold but your arms switch roles so your baby’s body lies along your opposite forearm.³ The aim is to support your baby around his neck and shoulders to allow him to tilt his head prior to latch. This is a great newborn breastfeeding position and is also good for small babies and those with latching difficulties. Because your baby is fully supported on your opposite arm, you have more control over his positioning, and you can use your free hand to shape your breast.

Julie, mum of two, UK, likes the flexibility of this position: “I normally do the cross-cradle with my newborn. It gives me a hand free to tend to my toddler at the same time.”

In the early days, don’t hold your baby around his head as you might push his chin on to his chest. This can result in a shallow latch (as your nipple hits the base of his tongue rather than his palate) and sore nipples for you. As your baby gets bigger this technique becomes much easier, and you can rest your baby’s head in your hand (as shown in our gallery image above).

4: Rugby ball hold

In this position (also known as the underarm or clutch), you sit with your baby resting along your forearm. His body tucks alongside your side, with his feet towards the back of the chair, or whatever you’re sitting on.³ This is another helpful early nursing position because it supports your baby well, while giving you plenty of control and a good view of his face. Being tucked in closely alongside your body will help your baby feel safe too. Mums who’ve had a c-section, twins, or a premature baby, along with those who have larger breasts, may also like this position.

“With my first daughter I had very large K-size breasts that were double the size of her head,” remembers Amy, mum of two, Australia. “I placed a rolled-up towel underneath each breast to help lift them up as they were so heavy, and fed her in a rugby ball hold, but more upright so she wasn’t overwhelmed by their size. This position was also good as I had a c-section wound and couldn’t rest her across my body.”

5: Side-lying position

Ideal for relaxed night feeds and breastfeeding in bed or on the sofa, side-lying can also be more comfortable than sitting if you’ve had a caesarean or stitches.³ You and your baby need to lie on your sides next to one another, belly-to-belly.

“I struggled to sit up in bed during countless night feeds, partly due to having had a c-section, partly due to exhaustion,” says Francesca, mum of one, UK. “Then I discovered I could feed my baby lying on my side and relax at the same time.” 

“Maisie couldn’t attach any other way than the side-lying position due to her tongue-tie. A lactation consultant showed me how to do it. It seemed like she could handle the strength of my flow and hold on better in this position. When her mouth grew bigger she became much better at attaching in the regular way,” says Sarah, mum of two, Australia.

6: Laid-back breastfeeding after a c-section

If you’ve had a caesarean delivery and can’t find a comfortable breastfeeding position,³ this may help. Reclining with your baby’s body across your shoulder will let you nurse comfortably without any weight or pressure on your wound, or you could also try side-lying.

7: Upright breastfeeding or koala hold

In the upright or koala hold, your baby sits straddling your thigh, or on your hip, with his spine and head upright as he feeds.⁴ You can do this hold with a newborn if you give your baby plenty of support, and it’s also a convenient way to feed an older baby who can sit unaided. The upright or koala hold is often the most comfortable breastfeeding position for babies who suffer from reflux or ear infections (who often prefer to be upright), and it can also work well with babies who have a tongue-tie or low muscle tone.

“When my baby was older I often used the upright hold because it was comfortable for both of us and I could still feel her body close to mine,” says Peggy, mum of one, Switzerland. “It was also discreet when we were feeding in public.”

8: Dangle feeding

This breastfeeding position involves your baby lying on his back, while you crouch over him on all fours and dangle your nipple in his mouth.⁴ Some mums say doing this for short periods helps if they have conditions like mastitis and don’t want their breasts to be squashed or touched; others claim that gravity helps unplug blocked milk ducts, although there’s no scientific evidence to support this yet. You can also dangle feed while you’re sitting, kneeling up over your baby on a bed or sofa, or almost lying down but propped up on your arms. You may need to use cushions and pillows to support yourself so you don’t strain your back or shoulders.

“I used the dangle feeding position a few times when I had blocked ducts and other methods of easing out the lumps in my breasts hadn’t worked. It seemed to help – I think because gravity was in my favour, and because the angle and position of my baby were so different to our normal breastfeeds that she drained my breast differently,” says Ellie, mum of two, UK.

Dangle feeding is probably not a breastfeeding position you want to do regularly, but it might just help if you need to mix it up.

“I used a dangle feeding position when my baby was struggling to latch,” says Lorna, mum of two, UK. “It wasn’t the most comfortable way to breastfeed, but at the time I’d do absolutely anything to get him to latch. It worked – and we’re still breastfeeding eight months on!”

9: Nursing in a sling

It may take a little practice, but breastfeeding your baby in a sling can be convenient when you’re out and about, looking after older children, or even doing light chores.

It’s also handy if your baby dislikes being put down or feeds frequently, as Lindsay, mum of two, US, found: “I used a front carrier often with both my babies. When we were out I tied a sarong around my neck and draped it over the carrier so it worked as a cover. They would nurse like this until they fell asleep.”

This method usually works best if your baby is an experienced breastfeeder and can hold his head up by himself.You can breastfeed in all sorts of slings, including stretchy wraps, ring slings and front carriers. Whichever you choose, make sure you can always see your baby’s face and his chin is not pressed against his chest.

10: Double rugby ball hold

The double rugby ball hold (also known as the double clutch) is a great breastfeeding position for twins, as you can feed them in tandem while having your hands relatively free.⁴ You’ll probably need to use a specially designed twin breastfeeding pillow while feeding like this, especially in the early days. This gives extra support to get both babies into position, and also minimises pressure on your belly if you’ve had a c-section. You may also find that with your hands freer, you can tend to one baby without disrupting the other’s feed.

“When my twins were born they were tiny and needed feeding every two hours, day and night. I soon realised for me to achieve anything other than feeding, I needed to tandem feed,” says Emma, mum of two, UK. “I used the double rugby ball hold with a breastfeeding cushion.”

Other breastfeeding positions you could try with twins include two cradles crossed across one another, one twin in a rugby ball hold and one in a cradle hold, and double laid-back or double upright breastfeeding positions.

11: Dancer hand nursing position

If your baby struggles to stay latched on or has low muscle tone – perhaps because he was born prematurely, has a condition such as Down’s syndrome, or has an illness or disability – try this hold to support both his head and your breast.⁴ Start by cupping your breast with your hand underneath, fingers on one side and thumb on the other. Then edge your hand forwards so your thumb and index finger form a ‘U’ shape just in front of the breast. Your three remaining fingers should continue to support the breast underneath. Rest your baby’s jaw on your thumb and index finger as he feeds, with his chin at the bottom of the ‘U’, your thumb gently holding one of his cheeks and your index finger the other. This hold gives your baby plenty of support and you control over his position, as well as a great view of his latch.

The post 11 different breastfeeding positions appeared first on Medela South Africa.

Mature milk is live

Soon after it reaches maturity, your milk starts to contain higher quantities of some components that protect your baby against bacterial and viral infections.¹ It’s probably no coincidence that this stage of breast milk production coincides with the time she starts grabbing objects and putting them in her mouth.

But the biggest fluctuation occurs if you or your baby pick up an infection. Then the proportion of white blood cells in your milk will rocket to fight it off.²

Like all stages of breast milk, mature milk is a living fluid. Even if we knew exactly what it was made of, and what all those things did (which scientists are still working out), we still wouldn’t be able to copy it exactly, because each mother’s milk is calibrated to her baby’s requirements.

“Breast milk is made from components that are brought to your breasts in your blood,” explains Professor Peter Hartmann, an expert on breast milk production, based at The University of Western Australia. “The milk-producing cells extract the components they need – and they’re pretty fussy about what they take!”

It’s nutrition, protection, body-builder and taste-former, all in one. And yet you never have to think about it, because your body produces the formulation your baby needs.

The difference between foremilk and hindmilk

At the start of each breastfeed your mature milk looks thinner and is commonly known as foremilk – although Professor Hartmann prefers the term ‘pre-milk’. As you nurse, your milk gradually becomes fattier, and is referred to as hindmilk or ‘post-milk’.

“The fat content relates to how full or drained the breast is,” explains Professor Hartmann. “The fat increases over the feed, until about 30 minutes afterwards, and then decreases as the breast refills. The concentrations of fat in pre- and post-milk depend on how much milk the baby has taken from the breast. So at one time of day the pre-milk could have a higher fat content than the post-milk at another time of day.

“Once a mother’s breast milk is mature, she will give about the same amount of fat to her baby over a 24-hour period, regardless of how often the baby breastfeeds,” he adds.  

Mature milk is more than just nutrition

Although your baby needs to start eating solids when she’s around six months old, breast milk can still make up half her daily calorie intake – alongside other foods – well into her second year.³ And your amazing milk continues to play a role that goes far further than simple nutrition.

“We believe mammals initially started secreting milk to protect their young, and the nutritional function evolved later,” Professor Hartmann explains. “So most of the compounds in breast milk that have a nutritive role are also protective in some way. It means there’s an awful lot of value in breast milk, but it makes things complicated when you’re researching it!”

He gives a few examples: alpha-lactalbumin, the major protein in breast milk, has antibacterial properties and helps stimulate your baby’s immune system.⁴ Lactoferrin, a protein that transports iron in the body, also has antifungal effects.⁵ And the fatty acids in human milk are antiviral and antibacterial too.⁶

Gut, immune system and brain development

All milk contains the sugar lactose, but breast milk also contains more than 200 human milk oligosaccharides.⁷ These complex sugars help create and protect a healthy gut, and develop the immune system. There’s nowhere near this number of oligosaccharides in cow’s milk or formula, and researchers are still working out their roles.⁸

Similarly, all milks contain fats, but the blend of fats in mature human milk is uniquely complex. Our brains are more complicated than other animals’ brains and, as more than half the human brain is made of fat,⁹ it stands to reason that we need custom-made fatty ingredients to help build that complexity.¹⁰

Humans are born at an early stage of development compared to other mammals, but during our first six months, our brain mass almost doubles.¹¹ So it’s not surprising that our babies need more protection and brain-boosting nourishment during their early months and years.

“Your breast milk will be always better for your baby than any milk you can buy in the shops”

Proteins are complex molecules that play many important roles in our health. Some act as building blocks for growth and repair, while others help to bring about the essential chemical reactions taking place in our bodies. Your mature breast milk contains more than 1,000 different proteins¹² that support your baby’s brain and immune system, alongside helping her grow.¹³

Mature breast milk is also rich in micronutrients: vitamins, minerals and trace elements, from calcium to cadmium, to support her development and wellbeing. The balance of these changes throughout the day to meet your baby’s needs.¹⁴

Some of your breast milk’s constituents might surprise you. “Mature milk has a high cholesterol content. It’s high in sugar, in the form of the simple carbohydrate lactose. And the proportion of protein is extremely low – it forms only 7% or 8% of a breastfed baby’s energy intake, compared to around 12% when she grows up,” reveals Professor Hartmann. “It’s not what we think of as suitable for adults but it’s ideal for babies – and shows how breast milk is tailored specifically to their needs.”

Breast milk ingredients that can’t be copied

Some elements of mature breast milk can’t be replicated because they’re unique to your own body. Nearly a third of the helpful bacteria in your baby’s gut come from your breast milk, and another 10% from the skin of your breast itself.¹⁵ 

Breast milk also contains stem cells, the ‘miracle cells’ that can renew themselves and change into other types of cell.¹⁶ Researchers are still working out their role in your milk and your baby’s development.

There are hormones in your mature milk too, including some that aid appetite control and the way your baby processes insulin.¹⁷ This may be one reason why children who were breastfed as babies are less likely to become overweight than those who were formula-fed.¹⁸

And because the food you eat affects the taste of your milk, your baby also gets to experience different flavours every day¹⁹ – something else formula can’t replicate.

“The differences between breast milk and formula are huge. One could spend all day going through the dissimilarities between the milks and the difficulties in actually trying to artificially produce a milk for babies,” says Professor Hartmann. “For example, the concentration of salt in cow’s milk, used to make formula, can be toxic to babies, so it needs to be highly processed.”

“However long you continue to breastfeed, your breast milk will always be better for your baby than any milk you can buy in the shops, or that scientists can create in a lab. It’s also a very convenient and cost-effective way of feeding your baby, and has wonderful health benefits for you as well as your little one.”

When it comes to feeding your baby, mother’s milk is truly the crème de la crème.

Interested in finding out more? Read our free ebook The Amazing Science of Mother’s Milk

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