Did you know double pumping is more efficient than single pumping? This means if you’re expressing regularly – perhaps because your newborn is unable to feed directly from your breast, you’re going back to work, or you need to increase your milk supply – double pumping could be the best way to ensure your baby can continue to have your breast milk.

Why double pumping is so effective

While it may be obvious that double pumping saves time, our research team knew there were also studies that suggested this method helped mums express more milk.^1,2 We were keen to figure out why, so assessed a group of mums during a double pumping session and then again during a session when they pumped each breast in turn.

It prompts an extra let down

What we found was fascinating: the double-pumping sessions did indeed yield significantly more milk – 18% on average.³ We also discovered why: the double stimulation was more efficient at getting the milk-releasing hormone oxytocin flowing, so the mums had an additional let down.

Of course, babies are the experts when it comes to getting mother’s milk. But double pumping gets closer to what they can do. One theory is that even though a baby drinks from just one breast at a time, he normally has lots of close contact with his mum while doing it, which is great for releasing oxytocin. Perhaps because double pumping involves double the contact and stimulation, it works in a similar way, prompting additional oxytocin release and consequently more milk.

It’s important to note that although double pumping improves expressing’s effectiveness, it doesn’t mean that mums using this technique are on the path to creating an over-production of milk. Also, our study doesn’t suggest double pumping is better than a baby – it’s more that single, sequential pumping is not as good as a baby, and double pumping gets closer to that gold standard.

It yields milk with a higher fat content

Another amazing discovery was that the milk mums expressed during double pumping had higher fat content than when they were single pumping each breast in turn. Why? Breast drainage is the key.

During feeding or pumping, the fat content of the milk increases steadily. Because double pumping results in an extra let down and 18% more milk, the breasts are drained more completely. So the higher fat content is simply a sign that the breasts are well emptied during double pumping, more so than single pumping. For babies who are born early and can only take small volumes of milk per day, this higher calorie content can be especially helpful.

Double pumping’s effectiveness is also important because a well-drained breast tells your system to produce more milk, whereas milk that’s left behind after ineffective pumping signals that more milk is not required.⁴ That’s why frequent and effective milk removal is so crucial for your milk supply.

Choosing the right double breast pump for you

We’ve established that double pumping makes sense if you need to pump regularly – but which breast pump should you choose? Medela makes a variety of double breast pumps that you can use at home, work, or on the go, as well as Symphony, the hospital-grade double electric breast pump that you’ll find in many birth facilities, or you can rent one for personal use. For help deciding which one is right for you, read How to choose a breast pump.

Hands-free pumping: Perfect for busy mums

For ultimate convenience, you can use your double breast pump with a specially designed pumping bra, such as Medela’s Easy Expression Bustier, which holds the breast shields in position and keeps your hands free while you express. As well as making it easier to operate the breast pump controls, it’s ideal if you want to do other things while you express, such as playing with your baby, eating, reading, or using your phone or computer.

For more advice, check out our website’s introduction to your breastfeeding journey section.

Relevant videos

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1: Practice makes perfect

If you’re feeling anxious about breastfeeding in public for the first time, try practising at home in front of a mirror so you can see what you look like while feeding. You’ll probably notice you’re not exposing as much of your breast as you might have imagined, as your baby’s head is covering it.

You may find breastfeeding in public easier if you do it in a supportive environment for the first few times. Visiting a mother and baby group or a cafe with a friend may be better than going to a crowded shopping mall or on a train by yourself.

2: Dress for the occasion

When it comes to what to wear when breastfeeding in public (and for breastfeeding in general), there are lots of options. If breastfeeding goes well and you intend to continue, it might be worth investing in a few items of nursing wear to make life easier.

“My nursing top was very convenient and easy to use. I could breastfeed discreetly outside, even in winter, as I didn’t have to remove my top. You just place your baby’s face in the opening and there you go. Anywhere, any time!” Caroline, mum of two, France.

However, it’s not necessary to buy specific breastfeeding clothing – you can simply layer up two of your normal tops. “What worked for me was wearing a stretchy camisole, which I could pull down on one side so it hooked under the breast I wanted to feed from, under a looser top that I pulled up. The looser top covered my chest and the camisole concealed my belly. As well as being subtle it meant I didn’t show my wobbly post-birth tummy or get chilly when feeding out and about.” Susannah, mum of two, UK.

Alternatively, for easy access, wear tops and dresses with buttons or a zip at the front, dungaree-style straps or side-openings. Or try wrap-around styles, or cowl or shawl necklines that you can pull down.

“I found wrap-front cardigans a lifesaver while breastfeeding in public,” shares Natalie, mum of one, UK. “I just untied one side then draped it over my baby feeding, so I could cover up easily and instantly when she was hungry or crying, without having to find something from the change bag.”

3: Do your research

Before venturing out with your newborn, make a list of good places to breastfeed in public near you, so you don’t have a last-minute scramble to find somewhere. Shopping malls, department stores and babywear shops often have baby-feeding rooms, which are quiet and private with a comfy chair and changing facilities. Many cafes and hotel lounges also welcome breastfeeding mothers.

“If you’re a bit nervous, look up feeding-friendly locations before you go out so you know where you can have a pit stop. Breastfeeding is not always easy at first, but you get better and better at it, until you’re so quick and subtle nobody realises you’re doing it anyway.” Rachel, mum of one, Maldives.

Other places to try include department store changing rooms, furniture stores, community centres, libraries, museums and parks. Ask other local mums for advice on the best places for public nursing nearby. 

“I live in the UAE, where children have a right under law to be breastfed until age two. There is a lot to encourage breastfeeding here, with fancy nursing rooms in malls and respect for breastfeeding mothers in public places, such as restaurants.” Faye, mum of two, UAE.

4: Consider a breastfeeding cover 

Some mums like to use a nursing cover up for privacy when feeding their babies in public, and there are lots of styles to try. From simple shawls and ponchos to specially designed wraps or aprons with a semicircle of wire in the top so you can still see your baby while she feeds, there should be something to suit you both. There’s also the option of feeding your baby while she’s in a sling or carrier, which will support her, as well as giving you privacy.

“My tip is to buy a baby carrier,” says Caroline, mum of two, US. “With a little practice you’ll be able to breastfeed while walking around and getting on with your day.”

Ultimately, however, you may find your little one makes the decision for you. Some babies hate being covered while feeding, while others get distracted if they aren’t. “Neither of my babies liked shawls draped over their heads while breastfeeding, so I just relied on their heads blocking the view,” says Esther, mum of two, UK.

5: Know your breastfeeding rights

In many countries you’re legally entitled to breastfeed in any place open to the public, and there are laws to protect breastfeeding mums. If you’re unsure about what the breastfeeding in public laws are where you live, try doing some online research – government or public health websites are a good place to start – or speak to your healthcare professional. Otherwise, you could ask local mums or nearby friends and relatives about what their experiences have been. Their responses may surprise you. 

“Breastfeeding is widely accepted in Australia and it’s perfectly acceptable to wop one’s breast out while ordering a skinny latte from the friendly male cafe waiter!” Amy, mum of two, Australia.

If you’re breastfeeding your baby in public and someone complains, you could politely remind them of your legal rights. If you feel that a business, such as a shop or cafe, has discriminated against you by asking you not to breastfeed, you may be able to make an official complaint, again depending on how you feel and the laws where you live.

“I was feeding at the table in a diner after I’d finished eating (having established there was no feeding room), and a blushing junior manager was dispatched to ask me if I’d be more comfortable in the ladies’ room. Er no, I said, would you eat in there? ‘Would I consider moving to a side booth?’ No again. I didn’t go anywhere until we were done!” Maya, mum of two, Spain.

“My advice is try not to worry. I was apprehensive but regularly breastfed in public – everywhere from urban to very rural areas – and never had any negativity, comments or looks. Obviously not everyone will be so lucky, but I breastfed for a year so there were lots of opportunities for people to be horrible, but nobody was. Not in the slightest. So your fears might turn out to be totally unfounded.” Tiffany, mum of one, UK.

The post 5 tips for breastfeeding in public appeared first on Medela South Africa.

Did you know the World Health Organization recommends feeding your baby breast milk up to two years and beyond? Extended breastfeeding can support your baby’s growth and brain development, lessen the likelihood of infections, and provide lifelong protection against type 1 diabetes and obesity. And the benefits aren’t all for your baby. The longer you produce breast milk, the less likely you are to suffer from cancers of the breast, uterus and ovaries, high blood pressure, heart disease and stroke. We tell you the amazing truth about breast milk’s benefits after six months, and why every breastfeeding mum should consider it.

The post 6 months and beyond: Long-term benefits of breastfeeding appeared first on Medela South Africa.

Nursing accessories for beginning breastfeeding

The first few days with your baby are usually quite hectic, so it pays to prepare. Whether you’re home soon after the birth or have to stay in hospital for a few days, there’s some kit you may want to have ready:

• nursing bras, night bras and nursing vest tops
• nursing nightdresses or pyjamas
• breastfeeding pillow
• disposable or washable nursing pads
• muslin cloths
• nipple cream for sore nipples 
• nipple formers if you have flat or inverted nipples  
• a book about breastfeeding
• contact details of a lactation consultant, breastfeeding specialist, or helpline

If breastfeeding doesn’t quite go to plan, a lactation consultant or breastfeeding specialist may advise you to use the following:

• Nipple shields if your baby struggles to latch on, or possibly if you’re suffering from sore nipples. In general nipple shields should be considered a short-term solution. If problems or pain occur, consult your lactation consultant or breastfeeding specialist.

• A breast pump to relive engorgement and/or help establish your milk supply.
• Some mums also find that cooling hydrogel pads can be soothing in the days following the birth, especially when their milk starts coming in.

What mums found most useful 

“Cushions are helpful for back, leg and arm support. Also nursing pads for leaking breasts, and a breastfeeding bra and loose tops for easy access (I had good-quality bras converted into breastfeeding bras so I had more support). And we used a sling all the time.” Zariya, mum of two, South Africa.

“My number one, couldn’t-be-without product was hydrogel pads. I was given these in my first few days of breastfeeding and I never had a cracked nipple or even much soreness. I swear by them and buy them for everyone who is even considering breastfeeding.” Camilla, mum of one, Australia.

“A must-have was someone to bring me a glass of water, because I kept forgetting to get one before I started breastfeeding!” Mag, mum of two, France.

“A flask so I could have hot drinks while I was stuck in bed. Decent food and snacks – my mother-in-law made awesome beef stew and flapjacks (I needed to eat a lot!). A pillow to support my baby, as I was exhausted. A comfy chair, a night light for night feeds, and a cushion to sit on as I had stitches – ouch!” Felicia, mum of two, UK.

“A sympathetic partner, friend or grandma to bring you cups of tea and all the other things you can’t get for yourself while you’re sitting breastfeeding. Oh, and a Kindle so you can read a book easily with just one hand!” Julie, mum of one, Spain.

Nursing equipment while breastfeeding gets established

As the first couple of weeks progress, hopefully you and your baby will gradually start getting the hang of breastfeeding. Feeds will be pretty frequent and time-consuming. Here are a few things that should make life easier and more comfortable while your breast milk supply is getting established, and beyond:

• nursing chair
• breastfeeding app 
• disposable or washable nursing pads
• breast milk collection shells 
• plenty of healthy snacks, drinks and things to help pass the time.

At some point you’ll want to leave the cosy cocoon of your home and go out with your baby. Read ‘Breastfeeding in public‘ for more tips on feeding your baby when you’re out.

What mums found most useful

“My essentials were breastfeeding bras, disposable nursing pads, and big muslins to wipe up spillages and to help cover my baby or boobs. Also lanolin cream was an absolute must for cracked nipples, and loose tops and cardigans helped with easy feeding.” Tatjana, mum of three, Switzerland.

“The most useful product was a good U-shaped breastfeeding pillow. I also had a rocking chair that, at a certain angle, I found really comfortable for feeding my baby. I always listened to music to relax me.” Violeta, mum of one, Romania.

“A sports-type water bottle that doesn’t leak even when open, so you can have it lying on the sofa or bed next to you. Also, an app to track feeds and remind me which boob my baby took last.” Francesca, mum of one, UK.

“Milk collection shells that you put in your bra to catch any leaking milk. I had such an oversupply, they were a lifesaver.” Lisa-Maria, mum of two, Switzerland.

“I loved my feeding cover with a D-ring, which gave my baby privacy and minimised distractions when we were out and about. An Ikea Poäng chair with a slight bouncing motion was a cheap alternative to crazily overpriced gliders. I found washable breast pads really absorbent, and muslin cloths have a thousand uses. The product I wish I’d bought was the Medela Easy Expression bustier – it would have made expressing so much easier!” Camilla, mum of one, Australia.

Baby feeding accessories for expressing milk

At some stage on your breastfeeding journey you may need to use a breast pump to express milk for your baby. The type of pump you’ll need depends on your situation and how much milk you want to express. Depending how often you’re planning to pump, you might also need:

• a steam or cold-water sanitiser, or microwave sanitising bags
• breast milk storage bags
• a hands-free pumping bra
• a cooler bag

The post What breastfeeding accessories do I need? appeared first on Medela South Africa.

Like any breastfeeding mum, you need to understand the basics, such as supply and demand, and getting the right position and latch.

Added challenges when breastfeeding multiples include time (or lack of!), sustaining your energy levels and finding the best feeding pattern. Accepting help can make these easier.

How can I prepare for breastfeeding twins?

Getting things ready before birth is key. Even if you’ve breastfed before, take expert advice on twin feeding.

There are dedicated antenatal classes and lactation consultants or breastfeeding specialists who can teach you the basics of nursing twins and answer any questions. Also seek out other mums of multiples and find out about twins’ groups locally and nationally, as these often offer meet-ups, publications, helplines and other valuable support services.

Enlist family and friends ahead of your due date to help around the home. Passing responsibility for any cooking, cleaning and shopping you usually do will allow you to focus on breastfeeding – something Robin, mum of four, Canada, found invaluable: “My mother-in-law stayed with us for the first two months,” she says. “I don’t know what we’d have done without her!”

Manage your expectations, too. Breastfeeding twins will take time to learn, sleep will be rare, and you might be largely housebound initially.

“It’s very full-on at the beginning, so expect life to be feeding, feeding, feeding,” says Helen Turier, who, in addition to being Support Services Manager at the UK’s Twins and Multiple Births Association (Tamba), is a qualified nurse and mum of three children, including twins. “Your breastfeeding journey may be longer, especially if your multiple babies have been in special care.” 

How do I start feeding my twins?

Having skin-to-skin contact with your babies as soon as possible after the birth is the best way to get breastfeeding off to a good start.¹ So put this in your birth plan and discuss your intention to breastfeed with your birth partner and healthcare professionals in advance, including considering what will happen if your babies are premature or need to spend time in special care.

Ideally you’ll be breastfeeding as soon as possible after the birth, even if you’ve had a c-section. The healthcare professionals should bring your babies to you and assist with latching. Ask for help if they don’t, and ensure your partner is involved so he or she knows how to support you.

“I think a major reason why I was successful breastfeeding twins, when I had previously struggled with my son, was because I got expert help in hospital during those crucial first days,” says Zoe, mum of three, UK.

Will I produce enough milk for two babies?

Yes. This is because the more your babies feed, the more milk you make. Research shows breastfeeding mums of triplets can produce three litres a day²– bearing in mind the average male baby drinks 831 ml (29 fl oz) a day.³

Your breasts should make enough colostrum – the nutrient-rich first milk – to feed your newborns for the first two to four days. After that supply and demand starts to come into play.

Follow a baby-led approach. Breastfeed whenever either baby shows early signs of being hungry – such as stirring from sleep, poking their tongue out, turning their head, making cooing noises, or sucking their lips or hands – to help build a sufficient supply.

What I can do to make breastfeeding twins easier?

It will be trial and error for you and your babies – remember they’re also learning. One baby may find feeding easier, need more frequent feeds, or gain weight more quickly, so treat them as individuals. Take expert advice on how to tackle any concerns.

“A midwife friend spent a long time helping with positioning and latching technique, something one of my girls really struggled with initially,” says Anna, mum of two, UK. “In the first month I really needed someone with me when feeding, just to pass me the babies. It’s hard to manage two at once, especially when they’re so tiny.”

Bear in mind that the early weeks are the toughest – it won’t always be this time-consuming and exhausting. And remember that any amount of breast milk has wonderful health benefits for your babies.

If you’re doubting your ability to breastfeed exclusively, or your babies aren’t thriving on your breast milk alone, discuss your feeding options with a healthcare professional, lactation consultant or breastfeeding specialist, and your partner too, so you can make the best choices for your family.

Good attachment and being comfortable are vital. A specifically designed twin breastfeeding pillow can help with positioning and take the strain off your wrists, arms, back and shoulders.

Although you’ll be focusing your energy and attention on your babies, don’t neglect your own nutrition and wellbeing.

Bethan, mum of two, UK, advises: “Try to sleep when you can. Do online grocery shopping and book delivery for when you have a friend or partner there. Prepare a big bottle of water and drink every time you feed. And ask someone to take your babies out afterwards so you can rest.”

What if my twins are unable to breastfeed?

Should one or both babies need to stay in hospital for a time, or arrive prematurely, feeding directly from the breast can still be possible, but it may not be established until later. If either baby can’t latch, you can express in the meantime. This will help initiate and build your milk supply and enable your newborns to have all the benefits of your breast milk, whether it’s fed to them from a syringe, feeding tube or another method with the support of a healthcare professional. You’ll need to pump as often as a newborn would normally breastfeed, which means every two to three hours, for at least the first month or so.⁴

“My twin girls came at week 30 by caesarean and were in the neonatal intensive care unit for many weeks,” remembers Monika, mum of three, Switzerland. “They couldn’t breastfeed until 34 or 35 weeks. So for the first month I was pumping every day, at least eight times a day. This felt like the most important thing I could do for them.”

You may have one baby who’s strong enough to feed from the breast, while the other still needs expressed milk. In this situation, mums often find it’s easiest to pump for the weaker twin while breastfeeding the stronger one.

Breast milk is proven to lower the risk of some serious health problems that premature babies are more prone to, including necrotising enterocolitis (NEC) and sepsis.⁵ So if your multiples are able to take some of your expressed breast milk, you can take comfort knowing you’re giving them the best start.

Should I feed my twins together or separately?

Each method has its merits. You might feed individually while you sort out the basics, then move to time-saving tandem breastfeeding (nursing both babies together).

There are various twin breastfeeding positions you can try, such as the double rugby ball (with a baby under each arm), the parallel hold (with your babies lying across your body in the same direction), or the laid-back position (with both babies lying on your tummy). Ask a lactation consultant or breastfeeding specialist to show you how to do these. You may find one suits you better, or that different positions work in different situations.

“I found it easier to feed my twins simultaneously,” says Zoe, mum of three, UK. “I did the same at night. If one baby woke for a feed, my husband would wake the other.”

Alternatively, you may prefer to feed each baby on demand or to wake the second to feed after the first one has finished. Or you might mix and match.

While tandem feeding in public might be tricky, you can buy special covers to help make you feel less self-conscious.

“Tandem feeding is not for everyone though. Often once one baby had latched on, the other would fall off,” recalls Robin, mum of four, Canada. “I ended up being a sweaty, frustrated mess. I switched to feeding them one after the other, sacrificing time but saving my sanity.”

When it comes to choosing which breast to feed each baby with, some mums allocate a breast to each twin. However, it’s a good idea to alternate in case one breast produces more milk than the other. This can be an issue in the early days, especially if one baby is a weaker feeder. Alternating breasts would allow the stronger feeder to stimulate milk production for the weaker feeder and help build an even supply on both sides.  

I’m struggling with breastfeeding multiples: What should I do?

Don’t be afraid to ask loved ones to look after you so you can look after your babies. “Coping well can mean saying no to things you can’t manage,” advises Bethan, mum of two, UK.

Seek professional and emotional support, no matter what stage you’re at in your breastfeeding journey.

“I lost my confidence at six weeks in,” recalls Billie, mum of four, UK. “I called a helpline and went to a breastfeeding group where I got suggestions for better positioning. I never looked back.”

Crucially, don’t be too hard on yourself if you have down days. Breastfeeding multiples can feel like an overwhelming responsibility at times.

“Breastfeeding one baby takes a lot longer than you think to master. Perseverance pays off,” says Olivia, mum of four, Australia. “Breastfeeding two is a whole new level of patience. But it’s so worth it.” 

The post Breastfeeding twins or multiples appeared first on Medela South Africa.

Breast milk has antibacterial and antiviral elements.² Depending on how long you breastfeed for, you’ll be lowering your baby’s risk of contracting colds and flu, ear and respiratory tract infections, sickness and diarrhoea.¹ Scientists are even investigating breast milk’s potential for treating conditions ranging from conjunctivitis to cancer.^3,4

Should I breastfeed my sick infant?

Yes. Breastfeeding a sick baby gives her a great chance of a speedy recovery, as well as helping to comfort her. Your breast milk contains antibodies, white blood cells, stem cells and protective enzymes that fight infections and may help with healing.^1,5,6 It also has a constantly adjusting balance of vitamins and nutrients, supporting her to get better as quickly as possible. And that means fewer sick days and visits to the doctor for both of you.⁷

“Breastfeeding provides everything your baby needs if she’s poorly – it’s her medicine as well as her food, fluid and comfort. It’s the best thing on the planet for her,” says Sarah Beeson, a UK-based health visitor and nurse.

Amazingly, the composition of your breast milk changes when your baby is ill. If you’re exposed to a bacterial or viral infection, your body makes antibodies to combat it; these are then transferred to your baby through your milk.⁸ The levels of immunity-boosting cells, called leukocytes, in your milk also rise rapidly whenever your baby is unwell.⁵

And because breast milk is very easy to digest, it’s also the ideal food for babies with upset tummies.

“My daughter contracted norovirus when she was 12 months old, and breast milk was the only thing she could keep down,” remembers Maya, mum of two, Spain. We had weaned naturally to one breastfeed a day at bedtime, but the supply-and-demand effect of breastfeeding her more often again was quite astonishing. Within 48 hours, I was at dairy levels of production! It saved my baby girl being put on a drip.”

Bear in mind that you may have to alter the way you breastfeed your baby while she is sick. For example, a baby with a cold may want to feed more often, but for shorter periods, both for comfort and because a blocked nose may make it harder to stay at the breast for long. If your baby has a stuffy nose she might also prefer to feed upright, so you could experiment with different breastfeeding positions. 

What if my baby seems too unwell to breastfeed? 

Sometimes when a baby is feeling really ill she may not have the appetite or energy to breastfeed. If you’re struggling to get her to feed, contact a healthcare professional, lactation consultant or breastfeeding specialist for advice to prevent her becoming dehydrated.

They may advise you to express some milk to feed to your baby from a syringe, cup, or other method that you’ve found requires the least effort from her to drink from. Expressing when you would normally breastfeed will also keep your milk supply steady.

If you have any concerns about your baby’s health or milk intake, always seek medical advice quickly.

Can I still breastfeed when sick?

It may be the last thing you feel like doing, but it’s best to keep breastfeeding through almost any common illness. If you have a cold or flu, fever, diarrhoea and vomiting, or mastitis, keep breastfeeding as normal. Your baby won’t catch the illness through your breast milk – in fact, it will contain antibodies to reduce her risk of getting the same bug.

“Not only is it safe, breastfeeding while sick is a good idea. Your baby is actually the person least likely to fall ill with your tummy upset or cold, as she has already been in close contact with you and is getting a daily dose of those protective antibodies from your milk,” says Sarah Beeson.

However, being sick and continuing to breastfeed can be extremely tiring. You’ll need to look after yourself so you can look after your baby. Keep your fluid levels up, eat when you can, and remember your body needs extra rest. Book a seat on your sofa and snuggle up with your baby for a few days, and ask family or friends to help with caring for your baby when possible so you can focus on recovering.

“Don’t worry about your breast milk supply – you will keep producing it. Just don’t stop breastfeeding abruptly as you’ll run the risk of getting mastitis,” Sarah adds.

Good hygiene is important to minimise the risk of spreading the illness. Wash your hands with soap before and after feeding your baby, preparing and eating food, going to the toilet or changing nappies. Catch coughs and sneezes in a tissue, or in the crook of your elbow (not your hands) if you don’t have one with you, and always wash or sanitise your hands after coughing, sneezing or blowing your nose.

Is it OK to take medicines while breastfeeding?

It’s fine to take paracetamol, ibuprofen and some antibiotics while breastfeeding,^9,10 as long as you discuss it with a healthcare professional and follow the dosing instructions. Remember ibuprofen has contraindications for asthmatic mums.

Previously mums were advised to avoid aspirin, but a recent study indicated low doses are likely to be safe while breastfeeding.¹¹ However, high doses have been linked to a rare but serious condition called Reye’s syndrome in infants,¹² so it’s best to discuss the use of aspirin with your healthcare professional.

Stronger prescription painkillers, such as codeine and tramadol, aren’t recommended.¹⁰ Since guidelines and recommendations are continually updated, your healthcare professional or pharmacist will be able to give you more information on specific medicines if you have any concerns.

Some cold, flu and cough remedies contain decongestants or expectorants, and these could reduce your milk supply. Steer clear of those that have phenylephrine, phenylpropanolamine or guaifenesin listed in their ingredients.⁹ Medicines that cause drowsiness are best avoided when you’re breastfeeding too.

“Check the packaging and if you’re still uncertain, ask a healthcare professional,” Sarah advises. “And if your baby was born prematurely, at a low birth weight, or has a medical condition, you should check before taking any medications while breastfeeding – even paracetamol.

“Whenever you go to a doctor or a pharmacist, for any reason, always make it clear you’re breastfeeding and ask for the best option,” she adds.

How about long-term medication?

If you’re on long-term medication for diabetes, asthma, depression or any other chronic health condition, the benefits of breastfeeding can outweigh the risks. “Breastfeeding is often still possible with nearly all illnesses, except for a few rare conditions,” says Sarah. “You’ll be familiar with your regular medications and should have an opportunity to discuss them with your doctor or specialist while pregnant. There is guidance available for all healthcare professionals on the safety of different drugs.” In any event, you should discuss this issue with your doctor or healthcare professional.

I was on a high dose of medication for my epilepsy but breastfeeding was still possible,” says Nicola, mum of one, UK. “I was monitored by my neurologist to get a balance between safety for my son and keeping my risk of a seizure low. Seizures can be triggered by lack of sleep and I was feeding day and night, but I took good care of myself, as did my husband. It’s been a positive experience.”

What if I have to go into hospital?

Whether you need planned or emergency treatment, there are ways to ensure your baby continues to receive the benefits of breast milk, and that you can continue breastfeeding once discharged.

“Express and freeze your breast milk so a caregiver can feed it to your baby. Have a practice ahead of time, and make sure you tell healthcare professionals you are a breastfeeding mum when you’re booked in, and again when you’re admitted,” suggests Sarah.

“If your baby is small, they may let you have her with you. Ask whether there’s a hospital lactation consultant or breastfeeding specialist you can see too – they’ll be a great advocate for you, especially if you’re on a general ward. If it’s an emergency, make sure the healthcare professionals know you have a baby – it’s not something they might think about otherwise.”Having surgery under local or general anaesthetic doesn’t mean you need to stop breastfeeding, or to ‘pump and dump’ your breast milk. By the time you feel well enough to hold your baby after an operation, the amount of anaesthetic in your breast milk will be minimal and it should nearly always be safe to breastfeed.¹⁰ However, you should seek the advice of a healthcare professional, lactation consultant or breastfeeding specialist in any of these circumstances.

Should I ever not breastfeed?

There are a few situations in which it’s safest to stop breastfeeding temporarily and pump and discard your milk to keep up your supply until treatment is complete. These include if you have radiotherapy or chemotherapy for cancer, herpes lesions on your breast, or infections such as tuberculosis, measles or septicaemia, that could be transmitted through your milk.^13,14 Seek expert medical advice about your condition and whether it’s best to continue or interrupt breastfeeding.

The post Breastfeeding while you or your baby are sick appeared first on Medela South Africa.

Now you and your baby are settled into a routine and know what you’re doing, any breastfeeding difficulties might feel like a distant memory. But there may still be a few surprises in store. Here’s my advice on tackling potential breastfeeding problems that could lie ahead.

Challenge 1: I have to spend time apart from my baby

Whether it’s for a social occasion, travelling, or medical treatment, at some point you may need to be away from your breastfed baby for a while.

Solutions

• Pump milk so a caregiver can feed your baby. Now breastfeeding is established, you can express then store your breast milk in the fridge or freezer. You may have to experiment to find the best time to slot expressing into your routine – some mums find pumping in the morning after their baby has slept for longer more effective. For others the best time is 60 minutes after a breastfeed, but remember everyone is different. Don’t be disappointed by the amount you collect at first – you’ll probably need to pump two or three times to get enough for a single feed. Just as with breastfeeding, it can take time for your body to become efficient at expressing.
• Take a breast pump with you if you’re going to miss a breastfeed. You’ll need to remove milk if you’re going away for more than a couple of hours, even if you’ve left some for your baby. Express as often as she would feed to maintain your supply and prevent discomfort. Be sure to do this regularly throughout the day and avoid waiting until your breasts are really full before pumping.¹ Most electric breast pumps can also be battery-operated so you don’t need access to an electrical socket.

Challenge 2: How do I breastfeed now that I’m returning to work?

If you’re returning to work, you’ll probably be away from your baby for longer, more frequent, periods, so it’s even more important to find ways of managing breastfeeding and pumping to suit you both. As described above, you can build up a stock of expressed milk before you go back to work and then pump regularly while there to maintain your supply, prevent discomfort, and ensure your baby has plenty for the next day. Many workplaces are set up for expressing, and modern breast pumps are efficient and reliable. If you work regular hours or are part-time, you might still be able to breastfeed your baby directly before and after work, as well as at night.

Solutions

• Express as often as your baby would feed, as this will help maintain your milk supply, as well as prevent discomfort and reduce the risk of blocked ducts, mastitis and engorgement.¹
• Try double pumping. As well as halving the expression time, double pumping removes 18% more milk on average than expressing from each breast in turn. The milk has a higher fat and calorie content too.²
• Put together a kit that includes a breast pump, milk storage bags, plus a hands-free pumping bra if you want to use one, to take to work. You’ll also need a cooler bag to transport expressed milk in.
• Know your rights. Many countries have laws giving women the legal right to pump and store their breast milk safely at work. Discuss expressing facilities and logistics with your employer before returning so you’re both prepared.

Challenge 3: I think my baby’s just sucking for comfort

You may sometimes feel your baby is using your nipple as a soother, rather than to get milk. Remember breastfeeding isn’t just about food, it also comforts your baby. ‘Non-nutritive sucking’ (where she sucks at the breast without taking milk) helps calm and relax her. Be aware that sudden more frequent or longer feeding sessions may signify a low milk supply – although if your baby is gaining weight and producing the expected number of wet and dirty nappies per day this is unlikely.

Solution

• Be patient. Your baby needs your reassurance, so go with the flow and give her that support. This period of sucking for comfort doesn’t usually last too long, and it will help your baby feel secure and loved – the very best thing you can do for her.

Challenge 4: I want to move from mixed feeding to exclusive breastfeeding

Because breast milk has so many benefits for you and your baby, it’s certainly worth trying to make the move, although if you haven’t been breastfeeding frequently your supply may be low. If you’ve only been mixed feeding for a couple of weeks you may be able to increase your supply – speak to a lactation consultant or breastfeeding specialist to help guide you through this process. This is a very individual journey and depends on many factors. However, don’t be disheartened as every drop of breast milk you feed your baby is precious.

Solutions^1,3

• Boost your milk supply. Encourage your baby to feed from the breast often, as the more milk she consumes, the more you’ll make. You can also do some additional expressing, as explained above – double pumping in particular can help increase your supply further.
• Enjoy lots of skin-to-skin. Just like when your baby was a newborn, close contact helps the hormone oxytocin flow, which in turn triggers your milk supply. An added bonus is it makes you both feel calm and relaxed.
• Cut formula feeds gradually. Resist the temptation to stop using formula suddenly. If you’ve been doing a top-up after every feed, go to every other feed while your breast milk supply increases. Keep a close eye on your baby’s nappies and weight gain during this transition period. You may find she’ll want to feed more frequently at first, which is perfectly normal.
• Work with a lactation consultant or breastfeeding specialist. They will be able to guide you and build your confidence that your baby is getting what she needs.

Challenge 5: My baby has lost interest in breastfeeding

If your previously enthusiastic baby suddenly refuses the breast for no apparent reason, it’s called a ‘nursing strike’. You might assume she’s ready for solids or that your milk is not satisfying her, but this is unlikely. Instead, her developing eyesight may mean she’s more distracted by the world around her. Or perhaps she’s been startled during a feed, is reacting to a disrupted routine, has a stuffy nose, or has sore gums from teething. What you think is lack of interest could just be your baby becoming more efficient at breastfeeding, so she isn’t feeding for as long as she used to.

Solutions

• Be patient. It may take a few days but most nursing strikes are temporary. In the meantime, make sure your baby is receiving all the nourishment she needs by feeding her expressed milk.
• Retreat to a quiet place with minimal distractions. Your baby may be more likely to have a good feed if she’s able to concentrate and is feeling relaxed.
• Check your feeding position. If your baby is uncomfortable or cannot move her head to breathe during the feed, she may refuse your breast.
• Keep up your milk supply by pumping. You can try feeding your baby the expressed breast milk using a Medela Calma teat.
• Don’t introduce formula feeds or early solids. Topping up with formula could mean your milk supply dwindles, making the situation worse. As long as your baby is having regular feeds of expressed milk, is growing well, and pooing and weeing as expected, try not to worry. If she’s under six months, don’t introduce solids, as her delicate digestive system may not be ready for them.
• Never force breastfeeding. Try to relax with your baby and enjoy lots of skin-to-skin contact and cuddles, offering the breast often, and letting her try to attach herself. The oxytocin boost from being close will also help you express milk.⁴

Read on: Breastfeeding: What to expect after one month

The post 5 breastfeeding challenges after one month – solved appeared first on Medela South Africa.

The World Health Organization (WHO) and other health bodies recommend that babies are fed entirely on breast milk for their first six months of life and continue having their mother’s milk alongside other foods – known as complementary foods – until at least the age of two.¹

This is because breast milk isn’t just food. A natural comforter if your child is worried or tired, it also contains immunity-boosting components that increase dramatically in number whenever she’s ill.²

Anthropologists estimate the natural age for humans to stop breastfeeding is even higher than two. Looking at factors including tooth development, body weight, comparison with other primates and historical evidence, some say it could be two to four years, while others believe our ancestors might have been breastfed until the ages of six or seven.³

Today, more than 60% of mums in developed countries give their baby some formula or complementary food before the age of six months,⁴ even though WHO guidelines don’t recommend this. 

When’s the right time to start weaning my baby?

Weaning is the process of stopping feeding your baby with breast milk. Ideally, the first step towards weaning your baby is introducing complementary foods alongside your breast milk around the age of six months. The weaning process continues until breast milk is completely replaced by other foods and drinks.

“After six months, your baby begins to need higher levels of certain nutrients – such as iron, zinc and vitamins B and D – that she can’t get from your breast milk or her own reserves alone,” explains UK health visitor and nurse Sarah Beeson.

“But solid food will only complement your baby’s milk intake to start with, and replace it gradually. Breast milk will remain her major source of nutrients for many months to come.”

A typical seven-month-old still gets 93% of her calories from milk. Even at 11 to 16 months, milk may still provide around half her daily calorie intake.⁵

“Mums sometimes think breast milk isn’t important once their baby has started eating solids, but in fact there’s no better milk for her, however old she is,” says Sarah.

Indeed the entire weaning process can take as long as mum and baby want it to: “When to stop breastfeeding is your choice,” says Sarah. “Don’t feel pressured by what friends are doing or what family members – or even strangers – say. All that matters is what feels right for you and your baby.”

How to stop breastfeeding

Whenever you decide to start weaning your child off breast milk, it’s best to do it gradually. Stopping breastfeeding suddenly could put you at risk of engorgement, blocked ducts or mastitis, as well as being an abrupt change for your baby’s digestive and immune systems to cope with. It may also be difficult for you both emotionally.

Do I need to stop breastfeeding?

Sometimes mums mistakenly think they need to stop breastfeeding when they don’t. If you’re returning to work, breastfeeding can be a great way of maintaining intimacy during a big change in both your lives. You can express milk for your baby at work and keep nursing sessions as a special time together at the beginning and end of the day. Or if you need to travel without your baby, you could express milk to take or send home.

If you get ill, it doesn’t always mean you need to stop breastfeeding either – read our advice on breastfeeding while you’re sick and be sure to consult with your healthcare professional.

Stopping breastfeeding before six months

If you feel unable to continue breastfeeding until the six-month mark and want to try mother-led weaning, start by cutting out one breastfeed a day and replacing it with a bottle of formula.

“Ideally, start with the mid-day feed. Babies are remarkable and can identify the scent of their mother’s milk nearby, so ask your partner or a relative to give your baby the bottle while you are in another room,” says Sarah.

“Be mindful of good hygiene when preparing feeds. It may be that your baby takes fewer feeds of expressed breast milk than from the breast during a 24-hour period. Don’t force her to take more milk than she wants.”

You’ll probably notice your breasts feel full and tender as your body adjusts to producing less milk. If this becomes uncomfortable, try expressing a little breast milk – just enough to relieve the discomfort without stimulating your body to make more.

Once your body is used to this new volume – usually after a few days – cut out another feed each day. Repeat until you’re no longer breastfeeding and your baby is fully weaned.

“I had complications after my first birth which meant I lost a lot of weight very quickly and I also suffered with mastitis. My supply was low and at three months, I needed to stop,” says Jennifer, mum of two, UK. “I swapped one feed at a time so didn’t struggle too much physically, but I found it hard mentally.”

If you want to maintain the intimacy and health benefits of breastfeeding, but need to cut back, try partial weaning, where only some of the feeds are replaced with formula.

Stopping breastfeeding after six months

As your baby starts to have solid foods at around six months, you will find that her breastfeeds naturally become less frequent over time. Within a year she will probably be down to a couple of feeds a day, complemented by meals and healthy snacks.

However, if you’d like to cut back further, do it gradually, dropping one breastfeed at a time and offering your baby formula milk instead if she is less than 12 months old. Cow’s milk should wait until she is at least a year old.

“My son was down to three breastfeeds a day and having three meals plus snacks when I decided to start weaning him. I gradually replaced each feed with a bottle of formula – leaving the night one until last, at 11 months,” says Ruth, mum of one, UK. “The slow pace meant I had no problems, just a little fullness for a few days.”

There are various ways to distract your child from the change in her feeding patterns. Some mums offer a drink and a snack instead, which you could share to bring a feeling of closeness. You could also alter your daily routine, play a favourite game, or replace a feed with a cuddle from you or your partner.  Some children will take longer than others to feel happy with the change, but things will get easier over time. If you’re having any difficulties with weaning, it’s always helpful to seek support from your healthcare professional.

Stopping breastfeeding naturally over time

If you choose to let your toddler decide when to stop breastfeeding (known as baby-led weaning or natural-term breastfeeding), the weaning process is likely to be slow and gradual. Over the months, her feeds will probably become shorter and less frequent, while some mums report their child simply losing interest one day.

“My daughter self-weaned at four,” says Sarah, mum of one, UK. “She gradually slowed down and hardly fed at all from three-and-a-half. Then she seemed to forget when we were on holiday. Six months on, she sometimes wants to latch on, but knows the milk is gone.”

Your body should have plenty of time to adapt, so you’re unlikely to experience any uncomfortable engorgement. You may find it tough emotionally, though, so make time for plenty of cuddles and bonding moments.

“Baby-led weaning was right for me because my son had never had formula or a bottle. I didn’t want to stop suddenly and deny him,” says Kelly, mum of one, UK. “He lost interest at two-and-a-half. It was the best scenario for us, although I was quite emotional.”

What if I need to stop breastfeeding quickly?

Although it’s best not to stop breastfeeding abruptly, sometimes it’s necessary for health reasons, or because you and your baby can’t be together.

If your baby has been breastfed until this point, you’ll almost certainly need to express milk to avoid your breasts becoming uncomfortably engorged. Some women find a breast pump easiest for this, while others prefer to do it by hand. Again, only express enough to ease any discomfort – you don’t want to encourage your body to produce more milk.

While your breasts may feel swollen and tender at first, they will adapt. Your breast milk contains something called feedback inhibitor of lactation (FIL). When your baby stops breastfeeding, FIL tells your body to slow production, but it may take a few days or even weeks for your breasts to adjust.

Taking paracetamol or ibuprofen can help to relieve any pain (although ibuprofen has contraindications for those with asthma). Always follow the manufacturer’s and pharmacist’s guidance and consult a healthcare professional about any medications you need to take.

“I had to give up breastfeeding suddenly when my daughter was eight months old because I needed to take strong painkillers,” says Peggy, mum of one, Switzerland. “I found it very hard – she kept looking for my breast and crying. I held her tightly against me for reassurance while giving her a bottle. After a month, she seemed OK with it.”

Can I continue breastfeeding if I want to get pregnant again?

While breastfeeding is a natural contraceptive, it’s not foolproof. And it’s unlikely to be effective after six months, or if you’re not exclusively breastfeeding. This means you could conceive while still nursing your child.

Pregnant breastfeeding mums sometimes receive conflicting advice about whether to wean. Tandem feeding two children of different ages is certainly possible and when your new baby arrives, your body will produce milk to fit each of their needs.

Some mums find that their older child weans naturally during the pregnancy or drops certain feeds. This may be due to changes in the composition of your milk during pregnancy, which mean that it tastes different and less sweet.⁶ If your breastfeeding child is under a year old when she starts to wean, keep an eye on whether she continues to gain weight.

You should take advice from your healthcare professional if you want to continue breastfeeding while pregnant if you have previously had a premature birth, a miscarriage or are suffering any bleeding.

If you need medical help to conceive, you may find that doctors will not administer certain fertility drugs or treatments if you’re breastfeeding. Discuss all the options before making a decision on weaning.

The last word on baby weaning 

Whenever and however you stop breastfeeding, be gentle with yourself and your baby. It’s a big shift physically, hormonally and emotionally for you both, so do it with thought and care.

“While my body coped with weaning fine, I felt very emotional. It was something we’d shared for so long and it had come to an end,” says Jane, mum of two, USA. “I was working long hours, five days a week, and breastfeeding made me feel very relevant in their lives. But when that stopped, we soon found other ways to bond.”

The post Weaning: When and how to stop breastfeeding appeared first on Medela South Africa.