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    A GUIDE TO THE FIRST FEW DAYS OF BREASTFEEDING

    Breastfeeding Newborns

     

    There are many words to describe those first few days after the birth of a baby. Exhilarating, emotional, joyous, exhausting, exciting, overwhelming. There are ups and there are downs. There are moments of incredible peace and joy. There are moments of great stress and anxiety.

    One of the main focuses of these first few days — and the cause of many of the emotions that go with it — is feeding your newborn.

    You may have read up on things you should know about breastfeeding while you were pregnant, but there’s still a whole lot to learn now that your baby is in your arms. It is also suddenly very real! You are now in charge of a tiny human being who relies on you completely. Whoa. Breathe …

    So what is breastfeeding going to be like in these next few days? What questions should you ask health care providers? What can you do straight away to help establish a good supply of breastmilk and successful breastfeeding in the future? And what are the common concerns among new mothers when they start breastfeeding?

    5 things to know about breastfeeding in the first few days:

    The first feeds and colostrum
    In most circumstances you will have fed your baby straight after birth. A newborn usually will seek out their mother’s breast if placed skin-to-skin straight after birth. Breastfeeding helps your uterus contract back into shape and the delivery of the placenta is what triggers your milk to come.

    The milk doesn’t usually come until day 2-3 and until that time your baby gets all the nutrients they need from colostrum, which is sticky, yellow-ish, slow-flowing and nutrient-dense. Your baby only needs a small amount of colostrum to fill their tiny belly and it gives you and the baby some time to practice attachment and positioning before all that milk comes flowing in!

    If you weren’t able to breastfeed your baby straight after birth it isn’t too late for skin-to-skin contact –there’s many advantages to this (for mum, baby and dad too!) and it can help to establish breastfeeding.

    How to know when baby is hungry?
    There are a few signs to watch for that will help you to know when your baby is hungry. It is best to watch for these signs before a baby becomes too hungry — as then they will be upset and unsettled, which means you’ll have to settle your crying baby before you feed them.

    Breastfeeding is easiest when a baby is hungry but still calm. Some of the early telltale signs are:
    • Baby’s mouth opens
    • Baby turns their head to the side, as if looking for your breast
    • Baby starts to move more
    • Baby might make sucking noises or suck on their fingers or fist

    How often should you feed your newborn baby?
    Newborns have small bellies and breastmilk is quickly and easily digested. This means they’ll need frequent feeds. Start to watch for the early signs that your baby is hungry and feed your baby when they are hungry.

    It is common for a new baby to have between 8-12 feeds in 24 hours and each may last up to an hour.

    Breastfeeding is about supply and demand so offering frequent feeds when your baby is hungry will send the right signals to your body so that it can produce the right amount of breastmilk for your baby. When you’re asked how long it has been since your baby’s last feed you count from when the feed started, not when it finished.

    All this feeding can be overwhelming at first. Sometimes it feels as though you’ve only just finished a feed and baby is already looking for another. Don’t fret. It is normal and beneficial in establishing a good supply — and it won’t last forever.

    Make sure you stay hydrated and rest between feeds.

    Attaching your baby to the breast – the correct latch technique
    It is difficult to explain correct attachment in words so it is important that you talk to midwives and lactation consultants when you can — while you’re in hospital or having home visits.

    An incorrect latch will mostly likely result in painful cracked or grazed nipples and your baby may not be able to drain the breast properly, which could lead to blocked milk ducts or mastitis.

    Signs of a well-attached breastfeeding baby:
    • the baby is help close to the mother’s body and facing the mother’s body
    • the baby’s mouth is open wide when attaching
    • the baby draws in nipple and areola
    • baby’s lips are curled outwards
    • baby’s chin is touching the breast and perhaps the tip of the nose (baby’s nose should not be squashed up against the breast)

    If your baby isn’t latching on properly make sure you take baby off the breast and try again. A trick to do this is to use your finger to push onto the nipple, near the baby’s mouth, to break the suction seal before removing the baby. If you feed when baby is poorly attached it will become painful. Sometimes there will be pain even when baby is attaching properly — this is just your nipples becoming used to the extra friction — but this should disappear if baby continues to attach well.

    Please remember to ask for advice from midwives and lactation consultants at each feed — the more tips the better, until you find something that works for you. Also ask them to show you a variety of ways to hold your baby when breastfeeding as a change in position can help cracked nipples to heal.

    When your milk comes in — and engorgement
    For many new mums it is quite obvious when their milk does come in! All of a sudden your breasts are full, so full you may not be able to roll over in bed! It can take up to six weeks before your body has worked out how much milk is the right amount for you to produce. Until then — and especially in the very early days — your breasts will often feel engorged.

    Here are some tips for when your milk comes in and dealing with engorgement:
    Keep feeding your baby when hungry, rather than to a strict feeding schedule.

    As you feed your baby walk your fingers across the top of the breast you’re feeding from. This mini-massage will help your breast to drain, will help you get to know what your breast should feel like and will help you to spot small lumps (potential blocked ducts) and massage them away.

    Sometimes a breast will be so engorged that your nipple is too tight for baby to attach properly. Try to hand express a small amount of milk from the breast so the nipple become soft again.

    You may need to express a small amount of breastmilk to relieve some of the pressure of engorgement. Remember that your body can’t tell if the milk goes into a breast pump or into your baby’s belly so it will assume that you need that milk and will respond by producing more milk so only express enough to make yourself comfortable.

    Make sure your baby is draining your breast properly. Have them drain one before offering the second and make sure they are attached properly as this will also help the breast to drain. If your baby doesn’t drink from the second for long, make sure you start on that side at the next feed. There are a few tricks to remember which side you’re up to (try a hairband or bracelet around that wrist! There’s even apps to help you remember!)

    You may need to wake your baby for a feed — especially in those first days if you’ve got a sleepy newborn (or one with a condition such as jaundice or low blood sugar). This will help to relieve engorgement. You might need gently stroke, or slightly tickle, a small baby to stop them nodding off mid-feed or take off a few layers of clothing so they’re not super warm and cosy (but not too many that they are cold either, of course).

    Some common early breastfeeding concerns
    It is hard not to feel anxious about breastfeeding at some point. It is all new to you and it can all be quite overwhelming at times. Make sure you ask as many questions as you can while you’re receiving help — in hospital or during home visits.

    If you aren’t receiving home visits find a midwife, lactation consultant or child health clinic nearby.

    Some common early breastfeeding concerns are:

    Sore nipples
    If you’ve had early latch issues (combined with all that extra friction on your nipples) you’re bound to be in some pain when feeding. You can take paracetamol while breastfeeding (take it 40 minutes before for it to have any affect) and you can also find creams, nipple shields or soothing breastpads in most chemists.

    Ask your midwife to show you some different feeding positions, as the change in position will stop the constant friction in the one spot and will help you to heal.
    Don’t wash nipples with soap as this irritates them further. Rub breastmilk on them after feeds and allow them to air dry if you can.

    If feeding your baby is far too painful to continue you can keep your supply up by using a breast pump and feeding expressed breast milk to your baby until you heal.

    Concerns about supply
    Many mothers worry that they’re not making enough milk for their baby. Remember that in the early days you’re making colostrum and baby only needs a small amount. Some mother’s try to use a breast pump to see if there’s enough milk but pumps aren’t as efficient as a baby’s suck and will not give an accurate idea of how much milk is there.

    Be assured that if your baby is having plenty of wet nappies they are getting enough.

    Also, if you’re used to feeling engorged and your breasts don’t seem as swollen any more it is usually a sign that your body is getting better at producing the right amount of breastmilk.

    The best way to build your supply is to feed when your baby is hungry (watch your baby not the clock). Breastfeeding works by supply and demand, so your body needs to know how much milk your baby drinks in order to produce the right amount.

    Remember also that all babies will lose up to 10 per cent of their birth weight in the first few days and then will begin to put on weight.

    However, if your baby isn’t putting on weight or having enough wet nappies, you should talk to your health care professional immediately.

    Conflicting advice, lack of support and zero confidence
    A lot of mums become confused and frustrated by the large amount of advice (sometimes conflicting advice) coming their way. The key is to learn as much as you can from trusted sources (midwives or lactation consultants or friends who have breastfed their own babies) then use that information as a base to filter all other advice and to find what works for you and your baby.

    From well-meaning relatives to random people in supermarkets — advice will be as fast-flowing as your breastmilk on letdown! And it won’t just be about breastfeeding — you might need to work on your ‘polite smile’ because becoming a parent suddenly opens you up to a whole new world of advice and sometimes judgement.

    Ask the right people for advice, do your own research so that you’re well informed about what is normal (the range of ‘normal’ when it comes to breastfeeding is surprising large), surround yourself with supportive friends and family, watch your baby and learn from them, and have confidence in your ability to be a parent.

    It’s just not working out
    Sometimes breastfeeding just doesn’t go as planned. Most women intend on breastfeeding but for many reasons things don’t always work out. If things aren’t going well, remember to ask advice and look for support. There are many issues that can be resolved, especially if they are addressed quickly, with good advice and loads of support.

    Some mothers feel guilty or feel a sense of loss if they’re unable to continue to breastfeed their baby. These are normal emotions and you should be kind to yourself during this time. It is OK to feel this way but remember that you did your best and every drop of breast milk your baby received benefited them.

    Feeding your baby is just one aspect of parenting — although it feels all-consuming when they are newborns. What is also very important is that you’re looking after yourself and that you’re a healthy happy mother.

    If you have any questions or concerns about breastfeeding contact your health care professional.

    This article was first published on bubhub, compiled using information from the Australian Breastfeeding Association.

    CLOGGED MILK DUCT? HERE’S WHAT YOU CAN DO!

    CLOGGED MILK DUCT? HERE’S WHAT YOU CAN DO!


    If you are a breastfeeding mama and you’ve had a clogged milk duct, you already know that they are no joke and can be extremely painful. Clogged milk ducts are quite common and I have a lot of experience dealing with them through my lactation clients and personally while I was breastfeeding my daughters. I’m going to share all my tips for recognizing a clogged milk duct, dealing with it as quickly as possible and how to make sure you never, ever have a clogged milk duct again!

    Clogged Milk Duct Symptoms – How Do You Know You Have A Clogged Milk Duct?

    Oh my goodness, you will definitely know you have a clogged milk duct! I woke up one glorious morning, my baby had recently started sleeping through the night and I felt rested, I felt ready to take on the day, I felt…a very painful lump in my breast! My happiness turned to dismay. I knew right away that I had a clogged milk duct.

    A clogged milk duct will feel like a tender or painful lump in one area of the breast. It is usually firm to the touch, can vary in size and will NOT be accompanied by a fever. If you have a fever and feel flu-like, you most likely have mastitis and will need to go to your doctor ASAP.

    Why Me?
    No, you aren’t being punished because your baby finally slept through the night, but it might have something to do with it. Clogged milk ducts are just what the name suggests, they are ducts that didn’t fully empty. When leftover milk sits longer it can thicken and block the duct, resulting in a clogged milk duct.

    What Causes A Clogged Milk Duct?
    Anything that prevents the breast from completely emptying can cause a clogged milk duct. Infrequent or skipped nursing sessions, a weak or ineffective breast pump, or pressure from a tight bra or clothing can all be factors that can cause a clogged milk duct. The remedy is to get that milk flowing again! This is easier said than done as many clients tell me they are avoiding nursing and pumping because it is too painful. Using Ibuprofen and hot or cold compresses can help alleviate the discomfort of nursing and pumping.

    How to Clear a Clogged Milk Duct - Use Heat
    I always recommend using heat to help loosen up the clog in the milk duct. Take a warm shower, use a warm compress, or take a nice hot bath (what mom doesn’t need a reason for a long bath). Using heat before and during nursing can be really beneficial. Here is a super cute one.

    Nurse and Pump A LOT
    You will need to nurse and pump, a lot! Nursing is usually more effective for clearing a clogged milk duct, but if that is not an option for you, pumping is absolutely fine. Try to nurse or pump every 2 hours. Always start on the affected side and make sure to completely empty the breast. If your babe isn’t nursing quite that often switch between nursing and pumping.

    Good, Good, Good Vibrations!
    Vibration and massage are a great way to help loosen the thick or congealed milk in a clogged milk duct. I often recommend an electric toothbrush or your phone on a vibration setting. There are also massage tools specifically for clogged milk ducts. Really, anything that vibrates is the perfect tool for this. Hold it over the clogged milk duct before and while you are nursing. If you don’t have anything that vibrates, you can massage the area by hand in a downward and forward motion. Use as much pressure as you can handle.

    Try Out Some Yoga Positions
    Nursing while on all fours, or dangle nursing, is a position that is very effective for alleviating a clogged milk duct. If you do yoga it would resemble the cow pose. If you don’t know what the cow pose is that’s alright! Position baby on their back on the floor. Get on all fours (hands and knees) above baby. Baby will be under you with your breast above baby. This position uses gravity to help fully empty the area where the clogged milk duct is. It sounds awkward, but it really does work!

    How Long Will This Take?
    A clogged milk duct should clear in 24-48 hours. Clearing the clogged milk duct quickly is important. If left untreated, a clogged milk duct can cause complications. Possible complications include infections (like mastitis), an abscess that may require surgical drainage and a significant decrease in milk production.

    What If You Keep Getting Clogged Milk Ducts?
    Most women will have one or two clogged milk ducts during their breastfeeding journey. If you have recurrent clogged milk ducts on the same side, I would recommend investigating a little further.

    First, check that baby has a good latch and notice how you hold your breast while breastfeeding. One mom I worked with always pushed down with her thumb in the same spot every time she nursed. Recognition of this and focusing on moving her hand positioning while nursing helped alleviate her persistent issue with clogged milk ducts.

    Check your breast pump!
    A weak breast pump is not only slow and frustrating, but it could be causing your clogged milk ducts. Things to troubleshoot on the pump would be to check the flanges (the part that fits over your nipple) and valves. Check that the flange fits you properly (not too big or too small). When checking the membranes or valves see if they show any wear or thinning. Valves tend to wear out quickly with frequent use and this can cause reduced suction and strength of your pump. A weak pump will not completely empty your breast and can cause a clogged milk duct. Replacement valves and membranes can be bought and changed easily.

    If you can’t find a reason for your persistent clogged milk ducts I would suggest going to see your physician. There could be an anatomical issue that is preventing a portion of the breast from emptying such as a cyst, lesion or scar tissue. There are also medications that can be prescribed in extreme circumstances to help with persistent clogged milk ducts.

    I hope these tips help you avoid a clogged milk duct or help alleviate one if you are currently battling one. Clogged milk ducts are definitely a nuisance, but with these tricks you should be back to normal very quickly. Take care Mamas!
     
    About the Author: Robin Forslund is a Registered Nurse, Lactation Counsellor and runs The Mama Coach in Edmonton, Alberta.

    MY FIRST BABY WAS TONGUE-TIED AND HAD PROBLEMS NURSING

    How a tongue tie can make breastfeeding a baby difficult

     

    Coming up to the birth of my first child I never considered the possibility that I would have difficulties breastfeeding her.

    I was very lucky to have a very fast, yet intense, natural birth and Baby B was placed immediately on my breast and she suckled straight away.

    After a sleepless night in a very busy public ward I was ready to go home the next day. As I had had no medication or issues with the birth of Baby B and she seemed to be latching on and feeding well, although with a bit of pain to me (which I was told was fairly normal for the first time), we were cleared to go home by that afternoon.

    I never thought that there would be any issues breastfeeding, my mother breastfed 9 children, two of my sisters have breastfed their 4 children with no problems as well as my sister-in-laws and friends. The only issues any of them had was lack of supply when their children got too big for breast milk alone.

    So you can imagine my feelings of inadequacy and hopelessness when one week after giving birth I was still in constant pain when breastfeeding B and the mere thought of feeding her would bring me to tears. My nipples started to crack and bleed to the point that it looked like the tip of my nipple was actually coming away from the base. It got to a point after two weeks of pain, tears and anguish that when I started to contemplate putting B on formula, I went and visited the lactation consultant at the hospital to see if she could help me.

    In hindsight I wish we had visited the lactation consultant as soon as I started feeling pain, but I was headstrong and didn’t want to admit that I was faltering at supposedly the most natural thing in the world, breastfeeding my child. Initially I thought a bit of pain was normal as nipples get a bit roughed up in the process of breastfeeding but as the pain quickly got worse and my nipples started to be torn apart my husband and I realized that something was wrong.

    I tried using nipple guards, which softened the pain, but would tire B out before she got a full feed, I then moved onto expressing as I really wanted B to get all the benefits of breast milk even if she had to take it from a bottle and not me. This meant I was up all night and day either expressing or feeding B the bottle, it was a very tiring and extremely emotional time.

    During the first visit to the lactation consultant we went through the latching on process and B seemed to be doing that properly. The lactation consultant recommended continuing with the nipple guards and expressing for some feeds in order to let my nipples heal, as B didn’t like the nipple guards I continued to express all meals until my nipples seemed a bit better and tried feeding B again, it only took a couple of feeds before my nipples were red raw and bleeding so we went back to the lactation consultant. By this stage the cracks of were more like crevices and I was in constant pain, I was still expressing milk and I was really not enjoying motherhood.

    During the second visit the lactation consultant still couldn’t understand why we were still having problems as B latched on with no problems the only sign that there was a problem was when I released her mouth from my breast, my nipple would come out all pinched and pointy instead of fat and round.

    It was at this stage that my husband mentioned B’s tongue-tie and asked whether this could be creating any issues. The lactation consultant said that yes it could definitely be creating problems. She told us about results she had read and the effect tongue-ties (ankyloglossia) have on the infant’s ability to latch on to their mother’s breast, depending on the severity of the tongue-tie.

    As B’s tongue-tie was quite far forward it restricted her tongue so much that she was unable to draw the nipple completely into her mouth which meant that my nipple was being “chewed” when she was trying to feed. It also meant that she was tiring out before getting a full feed and she wasn’t gaining weight as quickly as she could have.

    The lactation consultant recommended a GP who specializes in snipping tongue-ties (frenetomy). The procedure is quite simple, the Doctor simply clips the frenulum (the band of tissue that connects the bottom of the tongue to the floor of the mouth) to loosen it and allow the tongue it’s full range of motion. It takes less than a second, and because the frenulum contains almost no blood, there is usually only a drop or two of blood. The baby is put on the breast immediately following the procedure, and the bleeding stops almost instantly.

    Even though my nipples were still healing and quite sensitive I noticed a difference straight away when I put B on my breast straight after the frenetomy. The pain wasn’t shooting through my whole body it was only surface pain due to the cracks in my nipples. The relief was palpable I cried.

    After a couple of weeks of expressing and breastfeeding alternately to allow my nipples to heal, I was finally enjoying breastfeeding, I now understood what all those other mum’s meant when they said breastfeeding was emotionally fulfilling. Mostly I was really enjoying bonding with my child.

    Looking back, I really wish I had known before B was born that a tongue tie could create issues with breastfeeding as it would have been snipped at birth and I could have avoided all the issues.

    Disclaimer: The author of this article is not a Medical Doctor and as such is not giving advice or recommending any medical procedures. If you have any concerns about your child please consult your General Practitioner.