Planning to breastfeed? Preparation can help you meet your goals
Are you expecting a baby and wondering how to prepare for the breastfeeding journey? It's easy to get caught up in the excitement of the birth and forget about the post-birth period. But here's the thing: preparation can make a big difference in helping you meet your breastfeeding goals. According to Pamela Douglas, a breastfeeding medicine GP and educator in Brisbane/Meanjin, many new mothers don't anticipate the challenges they might face with breastfeeding.
While 96% of mothers in Australia start breastfeeding, by the time babies are five months old, exclusive breastfeeding drops to 15%. Knowing what to expect before your baby is born can increase the chances of meeting your breastfeeding goals, explains Charlotte Fielding, the assistant branch president of the Australian Breastfeeding Association (ABA) in Tasmania. "Really getting good, accurate, evidence-based information … that is really key to getting breastfeeding off to a good start."
Before we dive into what information can help, let's acknowledge mothers who couldn't breastfeed for whatever reason. The benefits of continued breastfeeding are well-documented, and the national infant feeding guidelines recommend babies be exclusively breastfed for six months. They also recommend breastfeeding continue with appropriate complementary foods until 12 months of age and beyond, for as long as the mother and child desire. The World Health Organization (WHO) recommends breastfeeding continue for two years and beyond.
When babies are breastfed, especially exclusively and for longer durations, they have a lower risk of a range of health problems, including gastrointestinal, respiratory and ear infections, as well as obesity and childhood cancers. Mums benefit, too. Women who breastfeed — especially for longer — are less likely to experience certain health conditions, including breast and ovarian cancers.
But why do so many women stop breastfeeding? While some mums find breastfeeding comes easy, others experience difficulties. Research shows those who stop breastfeeding altogether, or start mix feeding, in those first few months cite reasons including "not enough breastmilk for child," "baby was unsettled," "child was not attaching properly," and "too painful."
"They are the most frequent reasons breastfeeding mothers phone the [ABA support] helpline for — a lot of people have concerns about that, and those things can be addressed by getting the right information beforehand," says Ms. Fielding. "If you educate yourself beforehand, you learn what is normal," she says, adding that knowledge can also help you address any issues you have with breastfeeding easier and faster.
Here are some breastfeeding basics.
How often should I feed my baby?
Ms. Fielding says parents are often surprised about how frequently their baby will need a feed, and "the evidence shows understanding how your breasts produce milk can really help with getting breastfeeding established." In the early weeks, hormones play a role in your breastmilk supply, but breastfeeding also works on supply and demand, says Dr. Douglas. In other words, the more milk that is removed from the breast, the more milk you will make.
"We make milk by removing milk," Dr. Douglas says, adding "frequent and flexible" feeds help to build breastmilk supply. "Bubbies need, right from the start, [to have] frequent access to the breast, and it doesn't have to be long. It's not about every breastfeed having to be a meal. I say 12 times in each breast in a 24-hour period. Some women don't need that often, but that is normal." She says it's about giving babies "lots of opportunity" rather than "forcing or coercing" them into feeding.
Ms. Fielding says it's important not to "delay feeds." "Keep your baby close and respond to the first indicator they might be getting ready for a feed."
How do I know if my baby is getting enough breastmilk?
It's common for mothers to worry about whether their baby is getting enough breastmilk, says Ms. Fielding, but nappies can tell you a lot. By five days old, your baby should have at least five wet disposable nappies or at least six very wet cloth nappies in 24 hours, she says. "Poos are also important. They need to do three poos a day until baby is six weeks old."
Growth, including weight gain and increased head circumference, is another sign your baby is getting enough milk. Other signs include looking healthy (with good skin colour, for example) and being alert when awake. Sometimes your supply might drop, for example if your baby has formula, breastfeeds less often, or if you or your baby is very unwell. Reading more about breastmilk supply can help you navigate this.
Should breastfeeding hurt?
While it's common to feel some nipple tenderness or discomfort when starting to breastfeed, if the nipple pain lingers or becomes severe, it can be a sign something isn't right. "A lot of the pain settles down, but we don't know which women will move into ulcers and bleeding nipples," says Dr. Douglas. To help with nipple pain associated with attachment issues, she recommends the gestalt breastfeeding method. It allows the baby to explore the breast in a "comfortable, reclined "deck chair" position for efficient latch, milk transfer, and positive neurodevelopment." Dr. Douglas says making "micro-movements, millimetre by millimetre" when positioning the baby for feeding can help.
What are the other benefits of breastfeeding?
Aside from hydration and nutrition, breastfeeding also offers babies physical and emotional comfort. "It's a whole sensory motor wrap-around experience of love," Dr. Douglas says. "The act of sucking lights up huge amounts of the infant brain," she says, adding "it's not specifically about milk at all in those first few days." Dr. Douglas says women who don't breastfeed can also achieve this bonding and attachment in other ways, by holding their baby for each feed, for example.
Seeking support
Ms. Fielding recommends expectant mothers seek out evidence-based resources like those from the ABA to learn more. "Talk to your maternity providers and tell them you plan to breastfeed." She says partners and loved ones should also be informed so they can support you. And seek support early if you have any concerns, Ms. Fielding says.
