POWERED BY MEDELA
Guest Editor Dr Danielle Prime [aka your new milk-making mentor] is here to answer the most common breastfeeding questions. It’s time to latch and load, mama!
This feature is Part 3 of our Milk Makers Series in partnership with Medela, deep diving into all things breastfeeding – from preparation through to weaning. Read Part 1 here, Part 2 here, and sign up to our newsletter for more.
Feeling like a bit of a noob when it comes to feeding from the boob? Don’t stress, we’ve all been there. New motherhood is a bit of a mind trip, because nurturing and nourishing our babies is something that we feel we should just ‘know’. You know?
Like somehow there is a mama manual pre-programmed into our brains that is activated when we’re pregnant – wouldn’t that be nice? Our sweet little bundles of love don’t come with a guide either. Which is why we call on those around us, who have come before us, and who know more than us, to help.
Because knowledge truly is power, and it is time we equipped every mother with it.
This is especially true when it comes to breastfeeding – a natural yet intricate process that often becomes a maze of unanswered questions and self-doubt. From latching techniques to milk supply concerns, the nuances of breastfeeding can be overwhelming.
If I plan to breastfeed, should I be collecting colostrum?
Hand expressing to collect colostrum during pregnancy has become a really hot topic. Most healthcare professionals say that if you are having a healthy pregnancy, then there should be no harm in trying hand expressing after week 36 of pregnancy. But of course, if you are at all concerned, check with your obstetrician or midwife to make sure it is the right option for you.
Why would I collect colostrum?
Any colostrum that is harvested before birth can be brought to hospital. And that colostrum can act as a little ‘reserve’ of milk that could be given to the baby instead of formula; if breastfeeding is not quite going to plan in those first days.
If you have a happy, healthy pregnancy and you don’t have any risk factors or indications that breastfeeding will not go to plan, then it’s highly probable any milk you collect won’t be needed.
What if I can’t collect any?
Don’t be disheartened if it doesn’t work for you. Being unable to collect colostrum before birth is not indicative that you will not be able to breastfeed, or that you won’t have enough milk. Only after your baby is delivered does your body naturally begin to turn on the milk-making cells in the breast.
So please don’t expect to be able to walk into the hospital with a full bottle of milk in a cooler bag!
How and when should I start?
Practice would begin from 36 weeks, around twice a day, beginning with massaging the breasts and then hand expressing to collect any drops into a collection container.
Your hospital may provide you with a collection kit, or you can use syringes that you can purchased at a pharmacy.
Note: The safety of the practice has never been tested with a breast pump so it is not advised to use a pump for antenatally expressing milk.
Will I have enough milk?
In order to talk about how much is ‘enough’, let us first step through the processes that your breasts go through to produce a full milk supply.
During pregnancy your breasts will have undergone a complex restructuring where you are developing milk-making cells and a network of milk ducts in order to be able to produce and transport milk to your baby.
The ‘initiation’ stage
This begins after birth. Not only do you deliver your baby, but you also deliver your placenta. The placenta, which has been helping your baby grow during pregnancy, has been producing a hormone called progesterone which has been blocking your breasts from producing milk.
This is why it is very normal to only be able to produce small volumes of milk in those first days after birth, until the progesterone leaves your system. Only then can the milk-making cells that you developed during pregnancy get to work.
The ‘build’ stage
The switching on of the milk-making cells is commonly referred to as your milk ‘coming in’. Now, the breasts are really able to start producing larger volumes of milk and you enter the ‘build’ stage.
Here, the more milk you take out of your breast the more milk will be signalled to be produced by the breast, and you should build up to a full milk supply between weeks two to four.
How do I know if I am producing enough?
In those first weeks after birth one of the best ways to know if you are making enough milk is to monitor the weight of your baby. Your midwife or someone from your hospital will help you to do this.
In those first three days it is normal that your baby will be feeding frequently – every two to three hours – and that they will lose some weight (5 to 7%). Ideally your milk ‘comes in’ around day three and babies begin to gain weight from day four to five onwards, reaching their birth weight again ideally between day 10 and 14.
To get off to the best start, make sure your breasts receive early, frequent and effective stimulation.
It’s also important to note that the following are not necessarily signs of a poor milk supply:
- Your baby wants to feed frequently
- They don’t want to be put down
- Baby is waking at night time
- Your breasts don’t leak or you have small breasts
Breast size is not an indicator of milk-making ability. The breast is made up of two types of tissue, the milk-making tissue and adipose or fatty tissue, and every mum has a different proportion of those tissues in her breasts.
So what that means is that you could have a very large breast but within it you have a really large proportion of fatty tissue and an average amount of milk-making tissue. Or you could have a mother who has a relatively small sized breast but her breast is jam packed with milk-making tissue and very little fatty tissue. So size is not an indicator of the ability to produce milk.
Is breastfeeding painful?
It is common for mothers to experience some discomfort, from sore and tender nipples, when breastfeeding in those first days after birth.
You, your breasts and your baby are all learning a new skill. The best thing you can do is to seek as much support as possible, as early as possible. Asking a specialist to check baby’s latch while feeding (making sure that their mouth and your nipple are working together in an optimal way) is a great start to avoid worsening discomfort. They will also give you some tips on positioning your baby’s body while feeding, and different holding techniques that can help make breastfeeding more comfortable.
That initial discomfort really should subside after a few days as your body becomes used to breastfeeding.
Persistent pain during breastfeeding is not normal. You shouldn’t feel pain throughout a whole feed or in between feeds, and your nipples should look in good condition. Lactation specialists are there to support you, and this is one of those occasions where the sooner you seek help, the better the outcome will be.
How often should I breastfeed?
How often you feed your baby will change as time goes on. But in general, plan to feed on demand and not to a fixed schedule. In those early days and weeks after birth, your newborn will likely want to feed every two to three hours. And this is normal, as feeding frequently helps to initiate and build your milk production.
Once you have established your milk supply, you and your baby will naturally find your feeding frequency rhythm. And this can be really different from person to person. Try not to compare yourself to others, if you and baby are comfortable and baby is growing, then your rhythm is right for you.
Is night feeding normal?
Feeding at nighttime is biologically normal. Research shows that the majority (64%) of exclusively breastfed infants will feed throughout the day and night between one-six months of age. These night feeds are not just a snack. These feeds contribute up to a quarter of the daily intake.
And remember, if your baby is not growing well or you are uncomfortable with your breastfeeding dynamic, be sure to consult a professional to help you get on track.
THE WONDER OF WEANING
How long should I breastfeed for?
International health organisations recommend that infants should receive only breastmilk for their first six months of life. After exclusively breastfeeding for those first six months, parents can then begin giving additional foods while continuing to breastfeed.
Health organisations do not recommend an upper limit to breastfeeding. Instead, they state that breastfeeding should continue alongside complementary foods for up to two years of age or beyond.
How do I wean?
Once you start to introduce complementary foods, your baby will start to take a little less breastmilk. And this begins the process of ‘weaning’. But this process can take as long as mum and baby would like it to. Keep in mind, that breastfeeding at two years will look a lot different to breastfeeding at two months. At two years perhaps it’s only a morning and afternoon feed.
At whichever time you do decide stop, it is best to start reducing the amount of milk you make gradually in order to avoid engorgement or potential mastitis. Your breasts work on ‘supply and demand’ so as you start to demand less milk, your supply will adjust accordingly.
No matter when you wean, be proud of however long you can provide your baby with the unique and fascinating components that exist in breast milk!
PUMP, PUMP IT UP!
When can I start using a breast pump?
Most healthcare professionals will recommend that you spend the first weeks after birth working together with your baby to initiate and build your milk supply. If you deliver a healthy baby and breastfeeding is going well, you won’t need to use a breast pump in those first weeks.
If, however, your baby is sick and needs to go to the neonatal intensive care, then the pump would be used to stimulate your breasts, just as your baby would have if you were not separated. In this situation you may be brought a hospital pump and asked to pump early (within the first hours after birth) and frequently (8x per day) until your baby is well enough to transition to breastfeeding.
When should I pump?
Pumps are very useful for whenever you are separated from your baby. Perhaps you have an important appointment, a social event, or you are returning to work. Pumping whenever your baby would have fed will help you to maintain your milk supply.
What if I don’t get much milk?
Don’t be disheartened if you try pumping and don’t get much milk. Your body may need a few pumping sessions to get used to the new stimulation. If you know that you will be needing to pump to go back to work, for example, it can help to be prepared. Begin pumping a few weeks before you need to in order to allow your body time to adjust.
If you’re trying to use the pump to increase your milk supply, be patient. Your body needs to adapt to that increase in demand. Also explore ways to optimise your pumping output with things such as:
- Double pumping
- The right breast shield size
- Using your maximum comfortable vacuum
How do I store breast milk?
You can store your milk in different ways, depending on when you plan to use it.
If you have just expressed and plan to use it in the next few hours, you can skip the fridge and keep it at room temperature for up to four hours. Remember, room temperature is defined as 16°C to 25°C. So keep that in mind in the warmer months.
If you don’t plan to use the milk until after a few hours, then the fridge is the next best option. Milk can be kept safely in the fridge for up to three days. Pop it in the back of the fridge where it is coldest. Rather than in the door or somewhere that temperature may fluctuate.
If you need to store for longer, then you can pop that milk in the freezer. Breast milk can be safely stored in a deep freezer (-18°C) for six months.
Important note: If your baby is unwell in hospital, the staff may provide you with some special, stricter, instructions for collecting or storing milk for your baby. Storing your milk safely is also dependent on collecting your milk safely. If you’re using any equipment to express your milk, read and follow all of the cleaning and sanitising instructions from the manufacturer.
Disclaimer: No material on this site is intended to be a substitute for professional medical or health advice, diagnosis or treatment. Always seek the guidance of your doctor or other qualified health professional. Please refer to our Medical and Health Disclaimer for further information.