*** Guest Post *** By: Lia Segall Pasternak, Lactation Consultant for Bangkok Breastfeeding Cafe
This article was first written in 2017 for Baby Blue in Bangkok, my pregnancy blog. However it remains so relevant that I wanted to share it with you again.
It’s really hard for me to summarize when it comes to breastfeeding, I am so passionate about the subject that each time I try I end up writing five pages and I hope that people will read it and get all the information they need, but in the bottom of my heart I know they won’t, which mom has time to read five pages?
Suddenly this morning I woke up inspired and it hit me, I finally found the way to write only the basics by thinking what are the top points that keep coming back with most of the mothers I work with, and I did it, I was able to downsize to six points! and here it is. I am hoping this quick article will help you avoid some struggles and understand the basics a little better.
1. Latch and position – The baby needs to open a big mouth in order to latch properly, and to be able to do so they need to be in a straight position, looking forward and up, same as we adults drink from a water bottle. To achieve this position try holding your baby from their upper back by supporting the head with your wrist (as if it is a shelve) and making sure there’s an imaginary straight line between the top of the head, the back and the bottom. Also, before the latch, the nose should be in front of the nipple, this will force the baby to look up and open a big wide mouth. (the theory is the same for any other position like football hold or vertical position).
2. How often and for how long to feed – Every time the baby shows hunger cues. It is a good practice to encourage often day feeding to avoid many night ones, especially because babies will eat 8-12 times a day and will compensate at night if they don’t receive their caloric need during daytime. Feeds should be active, as long as they are they should last between 20-40 minutes each. Skin to skin sessions help to motivate the baby and encouraging to feed more.
3. How to take care of the nipples – before the baby latches you can hold your breast besides the areola as a sandwich parallel to baby’s mouth, this will push the nipple inside baby’s mouth and help promote a better latch to protect your nipples. At the end of each feed you can express a few drops of breast milk and spread it over your nipple and areola to protect the skin. If some redness or soreness appear you may apply 100% lanolin after each feed, no need to wash or wipe before feeding your baby.
4. How to know the baby got enough – This is simple, starting from day 3 and until 6 weeks we expect 3 soiled diapers daily, 5 wet diapers, a happy baby who eats actively (you can hear the swallowing) every feeding session and a baby that wakes up to eat. If you’re still in doubt you can always check the weight gain, there should be no loss of more than 10% of the birth weight, by 2 weeks baby has to be back to birth weight and start gaining a minimum of 135 grams a week.
5. How to give supplementation when needed – When supplementation is needed a mother should give either expressed breastmilk or formula only, It is recommended to avoid bottles and give supplementation with a spoon, cup or syringe, if a bottle is needed then it is recommended to use paced bottle feeding technique to avoid nipple confusion, which means imitating as possible the action of the baby when suckling on the breast, the bottle should be in a horizontal position and the milk should cover half of the nipple only, the baby in an upward position will have to make an effort to extract the milk from the bottle, will be able to breathe better and take breaks as necessary, this kind of feeding will take longer, which is good and healthy.
6. Red lights and what to do – A lot of things can be rough or not go as expected, no matter what it is that you’re struggling with the first thing you should do is call for help from a lactation professional, do not try to figure it out by yourself, use Dr. Google, or ask friends or family since they don’t have the latest research based information and even with the best intentions they could cause some harm. Anything that doesn’t feel right is a red light, but here’s a list with some of the most common ones: Baby cannot open a big mouth, baby cannot latch, nipples are cracked and/or hurt, baby feeds for very long or very short periods, my baby isn’t peeing/pooping enough, baby isn’t gaining enough weight, baby isn’t waking up for feeds.
Well, that’s all for now, and if you have any questions, something isn’t clear or you just want to stay updated please feel free to like and contact me through my Facebook page
If you are struggling with breastfeeding, if something doesn't feel quite right, if anything about it hurts, or if you just want to ask some questions before the birth of your baby, please reach out for help. If will be one of the best things you can do for yourself and your child.
You can arrange a Breastfeeding Support session at your home with Kathy from Empowa. Should you wish to have Lia's expert help on hand, Kathy arranges virtual consults during her home visits to ensure you get the absolute best of care.
A note about Lia and I
I first met Lia at Bangkok Breastfeeding Cafe, she was relatively new to Bangkok and I was a brand new mum. Breastfeeding in public scared me, hell, just breastfeeding at all was scaring me. Breastfeeding, for me, will always be the most sacred, amazing, fulfilling but downright painful, difficult and at times heartbreaking thing I have ever done. My baby girl and I always found breastfeeding easy, her latch was good and my milk came in quickly but I've still had sore nipples, milk clogs, on clogs on clogs, I've had milk blebs, I've had mastitis...you name it and I think I've dealt with it, but I don't think I would have continued to breastfeed for as long as I did without the help of Lia. She's my boob angel, what she doesn't know about boobs isn't worth knowing. She's kind, gentle, passionate and selfless. She continued to attend Breastfeeding Cafe after the birth of her daughter, when she was only one week old, because Lia likes to help people.
See Empowa's About section for more information on Lia, and other partners with Empowa.