Breastmilk is perfect and made for your baby to thrive and grow.
Breastfeeding benefits for BABY
• Increased immunity – your baby is born from a sterile environment and has to build his/her own immunity. Breastmilk lines the newborn gut, enabling it to build immunity and protect against bacteria and viruses
• Releases endorphins/serotonin to self-sooth
• Develops jaw and mouth muscles • Promotes bonding • Hygienic • Complete feed for water and nutrition
• Lower incidence of obesity, heart disease and diabetes
• Easy to digest
• If your baby is born prematurely, then breast milk is commonly referred to as ‘liquid gold’ and is perfectly formulated for your baby’s gestational age. For example, a mom who is expressing milk for her 28-week premature baby will have very different milk to a mom who has a term baby. The milk is perfectly made with different fats and nutrients according to gestational age Breastfeeding benefits for MOM
• Helps uterus to contract
• Weight loss
• Convenience
• Economical
• Boost mom’s confidence
• Lower incidence of cervical cancer Key points for breastfeeding positions:
• Your baby must always be level with your breast
• Your baby’s ear, shoulder and hip must be in a straight line
• You and your baby must be tummy-to-tummy, skin-to-skin
• Assume a comfortable sitting position with back support and arm rests, and a standard or breastfeeding pillow on your lap, so that your baby is at your breast level. Do not lean forward with raised shoulders – try to relax Key points for successful latch:
• Hold your breast in a C shape with your thumb on top of your nipple
• Lift your baby’s nose with your index finger
• Your baby’s mouth must be opened wide, over your areola
• Your nipple must be deep in your baby’s mouth
• Your baby’s lips must be flanged and you must see the inside of your baby’s bottom lip • Try to rub the little hands or the crown of the head with your free hand to stimulate the sucking reflex if your baby is ‘sleepy’ on the breast Tips before starting to feed:
• First check your baby’s nappy; if dirty or very wet, it may upset the feed
• Do not delay the feed if your baby is desperate, as this will increase the winds before you start and he/she may gulp initially
• Drink water or ‘jungle juice’ with each feed. You cannot produce milk if you are dehydrated Feeding cues:
• Niggly and restless
• Tongue comes out
• Hands go to mouth
• Rooting reflex where head turns to side when cheek is ‘tickled’ Remember that suckling is a form of comfort and babies suck for comfort. Your baby’s nappy status:
• Your newborn baby will have 1 or 2 soiled nappies per day
• Once milk has come in, expect 4–6 wet nappies and 3–4 soiled nappies, but also bear in mind that each baby is different
• By Day 5, your baby’s stools should be yellow and substantial (at least one tablespoon). The stools will start as thick, black and sticky and are called meconium. Use lots of Vaseline when changing the nappy as this prevents the meconium from sticking to the skin Your baby is feeding sufficiently if:
• He/she is restful and sleeps for approximately 3 hours
• He/she is gaining weight (about 100–200 grams a week). The baby will initially loose about 10% of its birth weight, which it will regain by 7–10 days. It is important to initially weigh your baby weekly for about the first 6 weeks and then monthly thereafter Tips for winding your baby:
• Air travels up, so always keep your baby upright
• Your baby’s mouth and tummy should be in a straight line
• Apply gentle pressure with the palm of your hand to your baby’s tummy
• Gently rub your baby’s back in an upward motion Tips for waking up your baby to feed:
• Undress your baby
• Open and check your baby’s nappy
• Change the nappy if necessary
• Wipe feet with a lukewarm facecloth Tips for putting baby to sleep:
• Wind your baby
• Swaddle your baby if you are going to put him/her down, or alternatively place him/her skin-toskin and cover him/her
• Use your clean index finger for your baby to suck on, which will assist with self-soothing
• Read up on Dr Harvey Karp’s ‘5 S’s’ for soothing: ‘Swaddle’, ‘Side’, ‘Swing’, ‘Shush’ and ‘Suck’ Tips for storing expressed breast milk:
• Store in a sterilised container
• Store in a refrigerator or freezer in the coldest section – not in the door
• Date your breast milk and use the oldest expressed milk first
• Never microwave your expressed breast milk as it destroys all the nutrients and forms hot spots that can burn your baby’s mouth
• To warm up milk, place the container in a bowl or jug with warm water
• Always check that the milk matches skin-temperature warmth by allowing one or two drops onto the back of your hand to test the temperature Your baby may go through a growth spurt around:
• 2–3 weeks
• 6 weeks
• 3 months Allow your baby to feed often to stimulate your milk production to meet your baby’s increased needs. To increase your breast milk supply:
• Day 1: Drink 3 litres of jungle juice per day
• Day 2: Drink 2 litres per day
• Day 3: Drink 1 litre per day to sustain breast milk A jungle juice recipe has been included below, which will help with milk production (kindly note that this is not for diabetics):
• 2 Litres of Rooibos tea made with 4 bags of quality Rooibos that were ‘slowly brewed’ on low heat in a pot on the stove
• 60ml Schlehen Blackthorn Berry Elixir (available at pharmacies or health shops)
• Optional: Some apple juice, 1 Cal-C-Vita and a few drops of Rescue Remedy or Rehidrat® Diet:
• Balanced diet of fresh fruit and vegetables
• Drink between 6–8 glasses of water per day or until you are no longer thirsty
• Recommended juice: litchi, mango, sweet melon, pawpaw, guava and pear
• Eat in moderation
Avoid as much as possible or eat in very small amounts:
• Gas-forming foods like cabbage, beans, onions, Brussel sprouts, fizzy drinks and white bread • Sweets such as chocolate
• Steamed fruit
• Caffeine in coffee, tea and coke
• Sour foods such as mayonnaise, tomatoes, pineapple and citrus fruits
Helpful tips to prevent an incorrect latch: If you feel any pinching or pain or and there are lots of sucking ‘sound’ effects
• Break the suction with your finger (let the baby suck on your finger)
• Relatch the baby
• Make sure your baby’s mouth is wide open
• Make sure your baby takes a big portion of your areola
• Make sure your nipple is deep in your baby’s mouth
• Look for jaw joint movements and confirm that the bottom lip is slightly curled out/flanged Helpful tips to prevent cracked nipples:
• Use a good lanolin-based nipple cream
• Rub a few drops of your breast milk on your nipples and allow to dry naturally
• Expose your nipples to air and sunlight, but not in the midday sun
• For cracked and painful nipples consult a lactation consultant, baby clinic nurse or physiotherapist. You could also get a cortisone-based nipple cream on prescription from your gynaecologist Helpful tips to treat engorged breasts:
• Take a warm shower where water runs over your breasts (turn your back to the shower to avoid direct spray on breasts if tender) and massage your breasts gently to allow milk to flow out, which will relieve fullness
• Allow your baby to feed often
• Put cool refrigerated cabbage leaves in your bra (do not freeze cabbage) and do not cover your nipples (an excellent remedy which works very well)
• Allow the baby to feed and try not to express as this can make the engorgement worse Helpful tips to prevent thrush:
• Change your breast pads after each feed to keep your nipples dry
• Do not use breast pads with a plastic lining as this will keep the area moist
• If you suspect thrush, contact your doctor or baby clinic nurse as you and your baby may need to be treated. Do not end treatment until medication finishes, or the thrush may reoccur Feeding your premature baby: • Liquid gold (colostrum) is essential
• Expressed breast milk (Mother’s Own Milk – MOM) is HIGHLY beneficial and gives your baby everything he/she needs
• It is easy to digest, and can prevent serious gastrointestinal disease • It increases the baby’s health • It could reduce the time hospitalised and the cost of treatment as it reduces some gastric complications
• Please ask for as much help as possible when you have to express for your little one in the neonatal unit. You need to stimulate your breast by using a breast pump for 15 minutes on each breast, strictly 3-hourly; at night, you will also be expected to do this 4-hourly. You will have to set your alarm to wake up and express.
Do not give up – even a few millilitres of colostrum in the first few days is great and very essential for your baby Milk donation: Any mother considering expressing and donating milk for other babies can visit the South African Breastmilk Reserve (SABR) website: https://www.sabr.org.za/ Donor milk is needed for premature babies and can be used to save a life! After completing an online screening form from the SABR website, you will be contacted directly by SABR, who will arrange and pay for your blood tests. Once all tests have been concluded and approved, SABR will collect the frozen milk from you. The entire process is simple from start to finish.
Helpful tips if your baby has jaundice:
• Continue to breastfeed on demand if possible
• Baby may be sleepy and might have to be woken up to be fed
• Express your breast milk using an alternative method A helpful tip if you have twins:
• It is important to ask family and friends for assistance
• Try to feed simultaneously, or it could become very time-consuming
• Contact SAMBA – a multiple-birth support group – or a feeding consultant Help and support:
• Ask the nursing staff questions – they are there to assist you when you are in hospital • Ask your baby clinic nurse or breastfeeding consultant for assistance
• Call Mediclinic Baby’s helpline on 0860 233 333 How to be successful at breastfeeding your baby:
1. Keep the baby in direct skin-to-skin contact with yourself and allow the baby to drink as often as it wants to. Always try to minimise separation between yourself and your baby
2. Remember that colostrum is also milk; even though it is only a few drops, it is all the baby needs (5ml colostrum = 25ml of formula)
3. Breast milk production:
• The production process will initiate after the placenta is removed and the hormones change from pregnancy-supporting hormones to breastmilk-forming hormones. This changeover takes a few days and might only happen once you have been discharged
• When the baby smells its mother, the sucking reflex will be triggered
• The baby suckles on the breast and stimulates the milk ducts around the areola. This sends a message to your brain to produce more milk (more hormones form)
4. Be patient – the milk will come. The more you stress, the less milk you will produce. When you are stressed, your brain receives a message that you are in trouble and produces hormones to counteract the stress, which may oppose the good breast milk-forming hormones. The same happens when you are in pain, so please ensure that you manage your pain well. Take medication strictly as prescribed and do not wait until you are in excruciating pain. Always ask for medication if you are uncomfortable
5. The baby is in control now, not Mom! Listen to your baby and feed him/her when he/she shows signs of hunger
6. Breastfeeding is a ‘team sport’. Make sure you have lots of help and support. If you want to sleep in the first 24 hours, Dad can also comfort the baby and even do skin-to-skin. Dad should wear a buttoned shirt so baby can also lie skin-to-skin and close to his beating heart when cuddling. Talk and sing to baby to calm him/her
7. Although it is a natural process, breastfeeding is still an art that you and your baby need to master
8. If your breasts become fuller, remember the reverse BMW:
• W – Apply warmth to the breast: Warm shower, warm towels, infrared lamp, etc.
• M – Massage the breasts gently from the outside to the nipple until the lumps feels better
• B – Baby suckling will empty your breasts (Express with a breast pump or by hand if the baby is in the neonatal unit)
Expressing breast milk
• If you intend to use a bottle, introduce around 6 weeks for baby to become familiar with the rubber teat (just one feed intermittently)
• It is advisable to express after breastfeeding to collect the excess milk and allow the breast to fill up for the next feed
• Mornings are good as the volume is much higher • In the first week, the body produces 300–500ml of breast milk in a total of 24 hours
• Thereafter, 600–700ml will be produced within 24 hours in the next 2–3 weeks
• Expressing is about demand and supply – express when necessary Storage: • Expressed breast milk (EBM) should be used within 4 hours of expressing
• Place in the fridge within 1 hour of expressing if not for immediate use • EBM can be kept at the back of the refrigerator for up to 3 days
• If you have a fridge with a small freezer section inside the fridge, the EBM can be kept for up to 2 weeks in this compartment
• In a separate freezer, EBM can be kept for up to 3 months • In a deep freezer, EBM can be kept for up to 12 months at -18°C
• EBM quantity calculations: Take baby’s current weight, multiply by 150 and divide by the number of feeds baby has in 24 hours: e.g. 4kg x 150ml = 600ml/6=100ml/bottle. The easiest method is to always take it up to the markings on your bottles. So, if baby weighs 4.4kg, 150ml x 4.4 = 660ml in 24 hours or 110ml per bottle. If bottles are marked in 20ml up to 120ml, and/or in 25ml, then do 125ml.
Once you have worked out the initial volume, when baby constantly finishes that amount and wakes earlier, then move to the next mark on the bottle. Breastfeeding is both a wonderful experience and can also be quite challenging – women are able to feed their newborn baby with breastmilk that is perfect for it. It is on tap, just the right temperature and perfect in every way for your baby to grow and develop and to build its immunity.
Breastfeeding is also soothing for the baby and mother and is a time of bonding that cannot be replaced. However, as easy as breastfeeding is, it is also very emotionally driven, and many of your family and friends will give you tips and advice on how they did it, or how you should do it and what works best. Often, moms who are desperate to breastfeed their baby struggle, and moms who are indifferent and feel they will just give it a try have no problems. It is important to realise that both mom and baby are individuals, and you and your baby will work out what is best for you.
It is also important to remember that breastfeeding is time-consuming and may not always fit into a schedule. On some days, baby will want to snack all day; on other days, not so much. It can take more than an hour to feed your baby, and you need to relax and enjoy this time without being concerned about what needs to be done. We live in an instant society and are generally used to hustle and bustle, and getting a great deal done in a day.
Your baby needs your undivided attention, especially during the first six weeks of life. Relax and enjoy this time – sleep as much as baby allows you – bond with baby and allow yourself the freedom to do this. You and your partner need to get to know your baby and adjust to a larger family, sleepless nights, and this new and wonderful experience you have been waiting for.
If this is a sibling, you will need to adjust your time for all your children, and your partner. This can be quite difficult, as you might feel guilty for not making enough time for the older child, and your new baby might also be very demanding. Regardless, this is all normal and all siblings go through this. In time, you will all adjust. As breastfeeding is an intimate experience between you and your newborn, allow Dad to wind the baby, change his/her nappy, or bath him/her. He can also do skin-to-skin and bond with his baby. You need to breastfeed as often as your baby demands and allow sufficient time for him/her to feed. You have an abundance of milk, which is perfect and exactly what your baby needs, so try to relax and enjoy the experience.