Knowledge of breastfeeding is essential towards successful and rewarding breastfeeding journey.

The journey will be much easier once there is better understanding of the potential issues that one may encounters. This is particularly true for the first-time mothers.

Understanding what breast milk is

What is colostrum?

The milk that first flow out from your breasts right after delivery is called colostrum. Colostrum is thick and yellowish in colour. It is rich in protein and antibodies and is easily digestible. By around third to fourth day after birth, you will begin to produce mature milk that will gradually replace the colostrum.

What is foremilk and hindmilk?

At the start of your breastfeeding session, your breasts will produce what we call foremilk. It's thinner and contains many proteins and vitamins. As your baby nurses on, hindmilk will be produced. It's creamier in colour and texture because it contains more fat.

What are the benefits of breastfeeding?

Breastfeeding benefits both the mothers and babies

Benefits of breastfeeding for babies

• Breast milk offers ideal nutrition and has perfect combination of protein, vitamins, and fats. Breast milk contains essential nutrition for your infant growth and development.
• It is easier to digest compared to infant formula milk.
• Breast milk contains antibodies that help to fight off bacteria and viruses.
• Babies who are breast fed have lower risk of skin allergy, asthma, breathing problems, ear infections and diarrhoea.
• Babies who are breastfed are more likely to gain the right amount of weight and thus, less likely become overweight.

Benefits of breastfeeding for mothers

• Breastfeeding helps you shed the pregnancy weight quicker as it burns calories.
• Hormone Oxytocin that is released when you are breastfeeding, helps the uterus to return to its pre-pregnancy size and reduce blood loss after delivery.
• Breastfeeding is linked to lower risk of ovarian and breast cancer and osteoporosis.
• Breastfeeding saves money as you do not have to spend on infant formula.

What are the correct positions for breastfeeding?

To ensure successful breastfeeding session, your baby should be positioned properly to the breast. Correct positionings include:

• Holding your baby close to your chest, with your baby's body turning towards you, facing you and your breast
• Baby's head and body in a straight line
• Firmly support your baby's back and buttock with your arm or a pillow
• You may nurse your baby in a sitting or lying down position

• Touch your baby’s mouth with your nipple. Wait until your baby opens his / her mouth widely
• Bring your baby to the breast (not the breast to the baby). Move your baby’s whole body toward the breast, not only the head. Make sure he / she takes as much as possible of the brown area (areola) around the nipple
• You can help your baby latch on by holding the breast with your free hand. Keep your thumb well back from the areola and make sure it does not press down on the breast

Why is proper attachment important?

Poor attachment may impair flow of milk and eventually leads to breast engorgement.

Therefore, here’s what should go on inside your baby's mouth when he's attached and feeding properly.

1. Nipple
2. Areola and breast tissue, with underlying milk ducts
3. Baby's tongue
4. Breast
5. Baby's throat

Signs of poor attachment include:

• Your nipple looks flattened or striped at the end of the feed
• Pain over the nipples during and after feed

Is your baby feeding well?

Many mothers who breastfeed are worried if their babies are getting enough breast milk. After all, you could not really measure how much milk your baby is taking in, unless if you are expressing and feeding from a bottle.

If your baby is feeding well, they should:

• Be content for one to three hours after each feed
• Have a minimum of diaper change about six times a day by the time they are a week old
• Your baby’s urine should be clear or pale in colour
• Not lost over 7percent of their birth weight in the first week they are born

The following are also features that your baby is most probably feeding well:

• His mouth opens widely during feeding
• His chin gently touching the breast
• His lower lip curled outward
• His nose lies against your breast
• He suckles, pauses, and suckles again in slow and deep sucks
• You may hear your baby swallowing
• Your nipple and areola are completely within the baby’s mouth during the feeding

How to deal with breast engorgement?

It is normal for your breasts to become fuller, heavier and a little sore as they begin to produce more milk.

Breast engorgement occurs when you are unable to nurse frequently or empty your breasts completely.

Regular feeding helps to prevent engorgement. Even though you may only be producing a small volume of milk right after delivery, it still helps to clear as much of milk as possible from your breasts by increasing nursing frequency or expressing it out.

When your baby is not feeding as much, express the milk at least every three hours helps to avoid painful breast engorgement.

If you feel very engorged and yet have difficulty expressing the milk, apply a hot pack around your breasts. Warmth helps to encourage milk let-down and prevent clogged ducts, while a cold pack is useful to relieve swelling and engorgement.

What are the best practices for breastfeeding?

Milk expression schedule

If you are a working mother, have a milk expression schedule and stick to it. Routine helps you to have your work life balance besides your pumping duties while ensuring continuous milk supply to your baby. It is also helps to prevent breast engorgement while you are away from your baby.

How to store your breastmilk

Proper milk storage is important:

• After thawing the milk, it cannot be restored again for future use
• Use container made of glass or BPA-free plastic
• Fridge is good for short term storage while freezer is best for long term storage

Instead of washing the breastfeeding kit every time after used, you can wash it once a day with hot soapy water. Rinse well and sterilise it before use.

How long should you breastfeed your baby?

The World Health Organization (WHO), recommends all mothers to exclusively breastfeed their babies up to six month-old and continue breastfeeding with appropriate food up to two years.

Healthy lifestyle tips for breastfeeding mothers

• Eat a balanced healthy diet – a little dietary adjustment can go a long way for the health of your little one.
• Avoid smoking and alcohol consumption
• Stay calm and avoid stress. Just do what you can. Avoid comparing yourself with other mothers. Understand that every woman is different. Your milk supply is not indicative of how you are as a mother.
• Be kind to yourself. If you are not getting it right the first time, take a step back before you try again. Patience pays off and a positive mindset soothes the soul.

What are the challenges faced by breastfeeding mothers?

Several problems are commonly encountered during breastfeeding. These include:

• Sore nipples
• Dry or cracked nipples
• Inverted nipples
• Breast engorgement
• Blocked milk ducts
• Mastitis (Breast infection)

Mothers need to know that you are not alone when they face challenges during their breastfeeding journey. Many mothers have similar difficulties too.

The reality is that breastfeeding is not always a bed of roses. You need to work on it, and it may not be easy for some women. In fact, most may struggle a little at the beginning. Nevertheless, practice makes perfect. With practice, experience and time, the whole journey will become much easier.

It is normal not to have a lot of milk in the initial period. Do not worry and stress. Continue breastfeeding and keep going. Breastfeed your baby on demand; as the more you feed, the more milk will be produced.

Once you get into the routine, you will become more accustomed to it. With familiarity, comes confidence. Eventually, you will find yourself looking forward to the nursing session.

Make an appointment at Pantai Hospital

If you are facing challenges and need help with breastfeeding, do make an appointment with the Consultant Obstetrician and Lactation Consultant at Pantai Hospital today.