Babies

Two mothers share their journeys, and a lactation specialist provides expert advice for moms who are struggling with breastfeeding.

“I remember sitting in excruciating pain those first few nights wondering what I was doing wrong,” says Jacky Smith, mother to David. “I had tender nipples and my first attempts at breastfeeding were hard. I felt like a failure as a mom.  However, I kept remembering my antenatal class teacher telling us that the first few feeds would be tough, but the benefits to your baby – if you manage to push through for even just six weeks – would be immense. It was that thought that prompted me to reach out to a lactation specialist.”

Common breastfeeding issues

The most common issues many women face, says Erica Neser, a lactation consultant at Mediclinic Stellenbosch, are tender nipples in the beginning and concern around milk supply.

“A lot of mothers worry about milk supply,” Neser says, “especially if their baby feeds more frequently than expected. We don’t measure the milk supply, but as a guide we may review whether the baby is gaining enough weight (200g or more per week), so we recommend weighing baby weekly up to six weeks.”

Other signs your baby is getting enough milk are:

  • Your breasts feel fuller before and softer after feeds
  • You can hear baby swallowing actively during feeds
  • Baby feeds at reasonable intervals (eight to 12 times in 24 hours)
  • Baby seems content most of the time during and after feeds
  • Baby (over five days of age) has three or more (yellowish) stools per day, and six or more wet nappies a day (with very pale yellow or invisible urine)

The main mechanism of increasing milk supply is increased stimulation, Neser explains. “Mom has to feed more frequently and/or express some milk between feeds to signal to her body that more milk is needed. This can take time and dedication, and it’s important to have realistic expectations. The supply usually doesn’t increase overnight.”

You can also speak to your doctor about prescription medications or herbal remedies that could work.

“Mom should follow a normal, healthy, balanced diet, without restricting certain foods. And she should drink fluids according to her thirst,” Neser adds. Research has shown that foods and drinks like ginger beer, milk stout, lactation cookies, bars, teas or ‘jungle juice’ do not have a significant or direct effect on milk supply.”

Neser explains that getting a deep latch is the key to preventing sore nipples. She recommends mothers focus on the 4 Ts when breastfeeding:

  • TURN your baby towards you
  • TUG them towards their feet
  • TUCK their hips into your body
  • TIP their head back slightly

She also mentions there are many factors that can affect latching and it’s important to consult a lactation specialist, paediatrician or nurse to rule out tongue ties or breast or nipple infections. “Treatments could include adjusting the latch, laser therapy, medications, and/or referral to a medical doctor for further treatment.”

The emotional pain of being unable to breastfeed

“I struggled for a week before consulting Erica,” Smith shares. “And, by the time I did, David had lost more weight than was ideal. My heart still breaks for him and for me, a struggling first-time mom, when I see photos of us in those early days. Fortunately, one nipple was less damaged than the other, and I fed him on one side while I did laser therapy and pumped on the other side to maintain my supply. And after a few days, both breasts were healed and producing sufficient milk. I went on to breastfeed David until he was 18 months old – something I never thought I would do. I was just so proud of our journey and how far we’d come, I didn’t want it to end.”

The value of a support system when learning to breastfeed

Neser also highlights the importance of a support system when new moms leave the hospital. Ideally, moms would have their partners, parents, in-laws, relatives and friends around to help with cooking, cleaning and other household tasks, as well as to provide physical and emotional support, she says. You can also call on a breastfeeding consultant or nurse if there are any problems – get help sooner rather than later, Neser advises. If there are medical concerns, visit your Mediclinic gynaecologist or paediatrician.