Benefits of Breastfeeding and some Myths about Breastfeeding and some Sleep Facts

15- 09- 2017


Benefits of Breastfeeding

Importance of exclusive BF in first 6 months

  • Optimal nutrition
  • Bonding
  • Protection
  • Colostrum
  • Health of the baby
  • Health of the mother

BF continues to be important after six months once other foods are introduced

How to make sure you have enough milk?

If your baby shows the following signs then it is likely that you do have enough milk.

  • At least 6 to 8 very wet cloth nappies or at least 5 very wet disposable nappies in 24 hours. The urine should be odourless and clear/very pale in colour. Strong, dark urine suggest that the baby needs more breastmilk and you should seek medical advice.
  • A young baby will usually have 3 or more soft or runny bowel movements each day for several weeks. An older baby is likely to have fewer bowel movements than this. Formed bowel motions suggest that the baby needs more breastmilk and you should seek medical advice.
  • Good skin colour and muscle tone. Does she look like she fits her skin? If you gently ‘pinch’ her skin, it should spring back into place.
  • Your baby is alert and reasonably contented and does not want to feed constantly. It is however normal for babies to have times when they feed more frequently. It is also normal for babies to wake for night feeds. Some babies sleep through the night at an early age while others wake during the night for some time.

Wide variation exists in what is seen in a newborn's nappies. The following gives a general guide as to what might be seen.

The first bowel motions a baby has are black and sticky. This is from the

meconium present in the baby's digestive tract before birth. By day 2, the bowel motions should be softer but still dark in colour. Over the next few days, the bowel motions change to a greenish-­‐brown and then to a mustard-­‐yellow. As the colour changes they become less sticky and larger in volume.

A baby should have at least 1 wet nappy on day one, at least 2 on day two, at least 3 on day three, at least 4 on day four and at least 5 on day five. From day 5 onwards, the information above is relevant.

Over the first few days, salts of uric acid in your baby's wee may leave a rusty, orange-­‐red stain on the nappy. This is normal during this time. If you see this after day 4, consult a medical adviser.

How do you know if a baby is hungry?

Babies cry so their needs will be met. A baby's cry is her way of communicating to her parents that she needs something. If you are a parent trying to cope with a crying, fretful baby, you will know how distressing her prolonged crying is to herself, to you and to anyone nearby.

Learning about the things that upset a baby can help you cope. It's easier to be patient with a constantly crying baby when you understand she has a positive reason for her distress.

The breastfeeding mother immediately worries about whether it's her milk. Family and friends often recommend a change to formula. But breastfeeding is hardly ever the reason for the crying. It's a simple matter to eliminate problems like poor positioning and attachment, let-­‐down reflex not working, or hunger.

If your baby is having breastmilk only (no formula, solids or water) and is having six to eight really wet cloth nappies or five heavily wet disposables in 24 hours, and regular soft bowel motions; then you know plenty of milk is going in the other end.

It may be that you are expecting your baby to ask for feeds every four hours. This is an unlikely frequency for newborns and many older babies. It is common for young babies to want to breastfeed between eight and twelve times (or more) in 24 hours. Breastmilk is food and drink and comfort to babies. Your baby doesn't know that she's hungry or thirsty, she just knows she needs you. Your little baby has a tiny stomach which needs refilling very often. If she's hungry, give her more breastfeeds and discuss with an LMC whether you need to increase your supply.

How much milk do babies need?

In the early days, a newborn baby takes in very small amounts of colostrum per feed. Then when a mother’s milk ‘comes in’ after a few days, the volume of milk she makes, and that her baby takes in, increases rapidly, levelling out at anywhere from about 1 week post-­‐partum.

Research has shown that an exclusively breastfed baby between the age of 1 to 6 months drinks an average of about 750–800 mL in a 24-­‐hour period (though the range is less than 500 mL to 1000+ mL).

Once solid food has been introduced, the amount of breastmilk that a baby takes in depends on the amount of solid food that is offered. It is important to remember that breastmilk remains the most important source of nutrition for a baby’s first 12 months.

Breastfeeding with colic and reflux babies

Breastfeeding is just as important for babies diagnosed with reflux as it is for all other babies. Breastmilk provides all the nutrients that a baby needs to reach her full potential. Babies who are not breastfed, have increased risk of infection (eg ear, gastrointestinal and respiratory) and tend to have lower scores on tests of intelligence. Reflux is equally common in artificially-­‐fed and breastfed babies, but artificially-­‐fed infants have episodes of reflux more often than breastfed babies and they last longer. Artificially-­‐fed babies have less quiet (deep) sleep (when reflux rarely occurs). Artificial milk may also be more likely to cause problems if inhaled. Breastmilk is more nutritious and easily digested.

Some babies do better with smaller, more frequent feeds. This causes less pressure on the sphincter muscle. They may not want both breasts at each feed, or may do better if offered only one side, but more often.

However, as reflux episodes are worse in the first hour or so after feeds, some babies may prefer a larger feed less often. These babies may feed from both breasts at each feed, and go longer between feeds. You may like to experiment to see what helps your baby.

When can a baby sleep through the night, which is appropriate weight and age for that?

My personal perspective is that if a baby is gaining weight well and is over 12 weeks, you have a good milk supply and the GP is medically happy for your baby to sleep through the night at this point, then this is something that can be discussed with a sleep consultant.

Small babies need to wake in the night to feed. It is physiologically desirable for them to wake often to refuel. A newborn's stomach is about the size of your baby's clenched fist. It is also important that the breasts be drained well regularly to maintain the mother's milk supply. Bearing this in mind, some babies might need night feeds throughout the first year.

Baby reasons – comfort, connection, immunity, nutrition

Mummy reasons = maintaining milk supply. In the first three months after birth, there is more breast development happening – you are developing more prolactin receptors, which will encourage your ongoing milk supply. A mother with a large storage capacity has the room in her milk-­‐making glands to comfortably store more milk at night before it exerts the amount of internal pressure needed to slow her milk production. On the other hand, if the baby of the small-­‐capacity mother sleeps for too long at night, her breasts become so full that her milk production slows.”

If you are a mother with a smaller milk storage capacity (this isn’t necessarily related to the size of your breasts) or if you have a medical condition such as PCOS, Diabetes, Insufficient Glandular Tissue or Thyroid conditions that may make your milk supply more fragile, night feeds may need to continue for many months for you to maintain your milk supply and for your baby to thrive.

When should you seek medical advice?

If you are concerned at any time regarding your babies breastfeeding please seek medical advice.

Myths about breastfeeding

Truth: It is not normal for breastfeeding to hurt

Many mothers feel some nipple pain that ceases beyond the initial attachment in the early weeks. If pain lasts beyond the initial attachment or if there are signs of nipple damage, these things usually mean that a baby is not attached well to his mother’s breast. If your nipple becomes sore after a period of comfortable feeding, you may have a nipple infection. If breastfeeding hurts, get help as soon as possible.

Truth: Most mothers can produce enough breastmilk

Most mothers can make more than enough milk for their baby (or babies!). Indeed, having too much breastmilk is common. In many cases if a Mum has a low supply it is because the baby is not taking enough milk at the breast. Usually, feeding more often will increase supply, but you may find it helpful to talk to a lactation consultant.

Truth: Breast size has nothing to do with milk production

Breast size depends on how much fatty tissue you have. The larger the breast, the more fatty tissue and vice versa. It is the amount of glandular (milk producing) tissue in your breast that matters. Usually, if you follow your baby’s lead and breastfeed whenever your baby shows that she needs a feed (by squirming, grunting, mouthing her hands and nuzzling into your breast), you will have plenty of milk.

Truth: Night feeds are important for babies and mothers

Prolactin (the hormone that tells the breast to make milk) is highest at night, so night feeds are important for your milk supply. Babies have small stomachs that need to be re-­‐filled often, including during the night. Night feeds ensure that a mother and her baby have close contact around the clock.

Truth: You don’t need to wait for your breasts to fill up with milk

You don’t need to wait a certain amount of time before putting your baby back to your breast – there is always milk there. Your breasts are making milk all the time. The rate is related to how much your baby drinks. If she drinks more/less, your breasts will make more/less. So if your baby still seems hungry after a feed, you can put her back to the breast and there will be more milk there for a top up.

Truth: It is easy to tell how much breastmilk your baby is getting

There are ways to tell whether your baby is getting enough (eg plenty of wet and dirty nappies, gaining weight, meeting developmental milestones etc).

Truth: Soft breasts do not mean you have ‘lost’ your milk

or if they cannot feel their let-­‐down reflex. After the early weeks, your body adjusts to your baby’s needs. The full feeling that you may have had in your breasts in the early weeks disappears. This simply means that your milk supply is now 'in sync' with your baby’s needs. Some mothers never feel their let-­‐down reflex. Fortunately there are other ways to tell when your let-­‐down reflex occurs. Your baby’s sucking changes from a shallow, quick suck to a deeper, more rhythmic suck and milk may drip from the other breast

Truth: Your breast is more than a dummy

A breast cannot be a dummy, as the dummy (like the bottle teat) was invented to be an artificial breast! Babies don’t breastfeed just for food. This often comes as a surprise to parents, but babies go to the breast for many reasons — they may be hungry, thirsty, tired, hurt, over-­‐stimulated, bored, lonely, in the mood for cuddles, etc. All are equally valid reasons to breastfeed.

Truth: Milk supply cannot be measured by the amount of milk you can express or pump

The amount of milk you can express is a poor measure of how much milk you are making. There are many mothers who breastfeed their babies just fine but who can’t express much. A baby who is feeding well triggers your let-­‐down reflex and gets the milk from your breasts better than a breast pump can.

Truth: Breastfeeding a child past babyhood is normal

Anthropological research has shown that the natural age of weaning for humans is between 2.5 and 7 years of age.3 Breastfeeding doesn’t have to stop once your child gets teeth, can talk etc. Breastfeeding can and should continue for as long as both mother and child wish.

Truth: Formula is nothing like human milk

Human breastmilk is the biological norm for humans. It is what nature intended for our young. It is a living substance, so complex that scientists are still trying to find everything that is in it. Formula contains no antibodies, no growth factors, no living cells, no enzymes to help digestion. The proteins and fats in formula are very different from those in breastmilk. Formula does not vary from the beginning of the feed to the end of the feed, or from day 1 to day 7 to day 30. Your breastmilk is made as required to suit your baby and changes to match your baby’s needs as he grows.

Truth: You don’t need to worry about ‘foremilk’ and ‘hindmilk’ (If you have never heard of these, then don’t bother reading this one!)

True foremilk-­‐hindmilk imbalance usually only occurs when there is too much milk or where feeds are timed. Many parents are told by other people to worry about their baby getting the fatty ‘hindmilk’, but all breastmilk has some fat in it. Fat content of breastmilk naturally varies throughout a feed and throughout a day. Early in a feed, a baby gets breastmilk that is lower in fat. Towards the end of the feed, he receives breastmilk that is higher in fat. Simply put, the emptier your breast is, the higher the fat content and vice versa. In the early part of the day, if you have very full breasts, fat content will be lower. Later in the day, as your breasts soften, the fat content will be higher. If you follow your baby’s lead and breastfeed your baby whenever he is looking for the breast, your baby will get what he needs.

Truth: Breastmilk never loses its nutritional and protective value

Breastmilk changes to meet the needs of a child. It continues to provide excellent nutrition, immune and other health and emotional benefits for as long as a child continues to breastfeed.

Truth: Most mothers want to breastfeed

Most mothers start out breastfeeding, but the number exclusively breastfeeding drops off a lot during the first 6 months. Many mothers who stopped breastfeeding before they wanted to, did so because they ran into problems and didn't receive good information and support at the time they needed it. Always see an LC if you are having breastfeeding issues.

Truth: Many mothers do find breastfeeding hard at first

Breastfeeding is natural, but in today’s world it is often not easy. Mothers don’t fail at breastfeeding, but society often fails mothers. Some of the factors that make breastfeeding harder are birthing practices, poor breastfeeding information, marketing of formula products, lack of support and concerns about breastfeeding in public. Setting up a support network and getting good information before your baby is born helps. Mothers are not meant to breastfeed or bring up a child all alone, so don’t be afraid to ask to for help!

Truth: Babies sleep through the night when they are developmentally ready

Sleeping through the night is a developmental milestone and will occur when your baby is ready (they have the tendency to sleep well by 12 weeks if there are no weight gain issues). If baby starts sleeping more at night, you can always add extra top up feeds in daytime so that you are sure your baby intake is not going to decrease.

Age-Specific Breastfeeding

Age Feeding Frequency Approximate Duration of feed
0-3 Days 8-12 feeds/24hrs 5-60 min
3-14 Days 8-12 feeds/24hrs 15-45 min
14-21 Days 12+feeds/24hrs 15-40 min
21+Days 8-12 feed/24hrs 15-40 min
1-2 months 7-9 feeds/24hrs 10-20 min
2-6 months 6-8 feeds/14hrs 10-20 min
6-12 months 4-5 feeds/12hrs 5-20 min
12+ months 1-3 feeds/11-12hrs 5-20 min

Breastfeeding takes time!
if mom is to nurse 6-8 times per day ( and not at night ), should understand the time commitment.


Transitioning to day Feeds
  • Babies often dont't eat during the day because they've taken in too many of their colories during the night - so they're not hungry
  • Baby will eat when he's hungry!
  • He will eat in the morning if he hasn't eaten all night!
  • Cut down on simulation during the day if necessary
  • Hyperousal from lack of adequate sleep - poor nervous system function

Truth: A breastfeeding baby does not need extra water in hot weather

Breastmilk contains all the water a baby needs. In hot weather, just like adults drink more, it is common for a baby to want to breastfeed more often too.

Truth: A mother with an infection or mastitis should keep breastfeeding

With very rare exceptions, a mother will actually protect her baby if she continues to breastfeed when she has an infection. By the time the mother starts to show symptoms of an infection (eg fever, cough, diarrhoea, rash or vomiting etc) her baby has already been exposed to the bug. She will have produced immune-­‐promoting factors in her breastmilk, which will help to protect her baby from getting sick. If the baby does get sick, he will be less sick if he keeps breastfeeding. Sometimes it is the baby who has passed the infection on to his mother, even though the baby did not show any signs of illness. A breast infection (eg mastitis) is not a reason to stop breastfeeding. Indeed, mastitis will resolve more quickly if the mother continues to breastfeed from the affected breast. Keeping the milk moving is very important if you have mastitis. The milk is quite safe for the baby to drink.

Truth: You don’t need a perfect diet to breastfeed

In most cases a breastfeeding mother does not have to worry about what she eats. The breastmilk concentration of only a few nutrients can be affected by a mother's diet. Even mothers who have a very limited diet will usually make quality breastmilk for their babies. A mother should eat a wide variety of healthy foods for her own health and wellbeing, but her diet has very little, if any, effect on her milk supply. A baby who has allergies or intolerances to certain foods may react through breastmilk to something that his mother consumed. If you are concerned about this, seek advice from a dietitian who has an interest in breastfeeding (lactation) or infant feeding as well as food allergy and sensitivity.

Truth: It is better for a mother who smokes to breastfeed than formula feed her baby

In an ideal world, it would be better if the mother did not smoke. But if she cannot stop or cut down, then it is better for her to smoke and breastfeed than smoke and give her baby formula. Breastfeeding has been shown to decrease the harmful effects of cigarette smoke.

Truth: A breastfeeding mother does not have to completely abstain from drinking alcohol.

It is safest if a breastfeeding mother does not drink alcohol, in particular when her baby is a newborn. However, with some thought and planning, she can consume some in moderation.

Truth: Nearly all shapes and sizes of nipples and breasts are fine for breastfeeding

Mothers with various shaped/sized breasts/nipples can breastfeed. Babies breastfeed, they don’t nipple feed. Truly inverted nipples (ie where the nipples are completely stuck inwards) are very rare. Some mothers have nipples that don't stand out or nipples that take more 'coaxing' to come out. With good help and persistence, most mothers find that breastfeeding becomes easier and that their nipples stay out more and more as their baby gets better at breastfeeding. Even if your baby has problems at the start, he will eventually get the hang of it, as long as you maintain a good milk supply.

Truth: A pregnant mother can continue to breastfeed her baby

In most cases, if the mother and child desire, breastfeeding can continue throughout pregnancy. However, some mothers find their milk supply decreases due to the hormones of pregnancy and some babies wean themselves at this time. Some mothers continue breastfeeding the older child even after the new baby is born (tandem feeding).

Some Sleep Facts
  • If your baby is on growth Chart and having frequent wakeups for a feed which is more for a comfort than food, you can check with your GP and can help your baby sleeping through the night working with a Sleep Consultant with approach that suits your family needs.
  • Sleep deprivation can also affect your supply.
  • Setting up healthy sleep habits can actually affect whole family sleep issues. Most mothers go through PPD in initial months after delivery and mostly the issue can be Sleep.
  • Breastmilk contains tryptophan, an amino acid used by the body to make melatonin. Melatonin is a hormone that helps induce and regulate sleep. Tryptophan levels in breastmilk rise and fall according to maternal circadian rhythms. Breastfeeding can help develop babies’ circadian rhythms, and help them to settle to sleep better at night. In first 3 months, baby’s needs are more. But approaching a sleep consultant and working along and setting up routine you can reach sleep goals easily.

 

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