Midwife & Breastfeeding Consultant

What are the advantages of breastfeeding?

Breastfeeding is a pleasure and a joy to do!

One of the great things about breastfeeding is that it is such a pleasure to do; it is a wonderful way to connect and bond with your baby all the while providing the absolute best nutrition possible.  Breastfeeding facilitates all the lovely nurturing mothering behaviours of holding, cuddling and caressing which promote bonding and help the mother feel empowered in her ability to care for and provide for her baby. 

It is important to realise though that most new mums find the first few weeks of breastfeeding a bit overwhelming on as they get to grips with both breastfeeding and being a new mum.  But usually after the first few weeks most first time breastfeeders start to find breastfeeding easy, relaxing and a joy. 

Breastfeeding is really really convenient!

You are going to be feeding your child for many years to come (at least 18!) and it will never be as easy to provide healthy, nutritious and free food as it is with breastfeeding.  When you  breastfeed there is no cost, no shopping, no preparing, no worrying if it is healthy enough, no worry if the amount is enough or the temperature is right or if the baby will like it and there no washing up afterwards!  All you have to do is hold your baby and latch him or her on anywhere, anytime! In the years that come after breastfeeding you will look back and sigh wistfully and remember just how easy it was to feed your baby such a wonderful food  - it really is the most convenient of convenience foods.

Breastfeeding provides numerous scientifically proven health advantages over formula feeding for baby and mum!!

Research has shown that when a baby is not breastfed for the first three months of life they are five times more likely to be admitted to hospital with diarrhoea, two times more likely to be admitted to hospital for breathing problems (asthma, chest infections) and or ear infections and twice as likely to develop eczema and five times more likely to develop a urinary tract infection. 

According to research done in Ireland last year babies who are breastfed for 3 – 6 months are 38% less likely to be obese at nine years of age and children who are breastfed for 6 or more months are 51% less like to be obese a nine years of age.  Breastfeeding also protects the baby from high cholesterol and diabetes in later life.

Breastfeeding has also been shown to protect the child from acute lymphoblastic leukaemia and acute megaloblastic leukaemia, crohn’s disease, ulcerative colitis and rheumatoid arthritis and breastfed children have been shown to have a higher IQ.

Breastfeeding also protects mum from, high blood pressure, heart disease and diabetes in later life also ovarian and breast cancer.

Breastfeeding saves money!

Research done in 2012 in the UK has shown that up to 31 million pounds per year could be saved on health care costs if more women chose to breastfeed.  The savings to be made are because breastfed babies are so much healthier than formula fed babies and go to the doctor less and are hospitalised less.

From an individual household perspective there are savings to be made because by breastfeeding a family is not spending money on bottles, sterilisers and formula. The average cost of formula feeding can range from €600 to €800 a year depending on the price of the equipment and formula brand.  Adding this cost to the possible increased medical costs it makes good financial sense to breastfeed.

Click here more information on the benefits of breastfeeding. 


 

What are the disadvantages of breastfeeding?

Breastfeeding can be a bit tricky to get the hang of

To be honest I think there are very  few disadvantages to breastfeeding but it is only fair to point out that breastfeeding is a skill that needs to be learned and mastered and it can be a bit overwhelming in the first few weeks if you feel like you don’t know what you are doing. 

The best way to prevent feeling overwhelmed and stressed by breastfeeding in those early days is to take a class about breastfeeding before the baby arrives, this way you will know the basics and be able to approach breastfeeding with confidence.  It is best that the class is taught by an International Board Certified Lactation Consultant (IBCLC) and is at least 3 to 4 hours in length and that your partner or support person can attend with you.  Click here for more information on my Preparing for Breastfeeding Class.

Also breastfeeding support can be of invaluable help for the new mum so find out where your local breastfeeding support groups are so they are easy to access afterwards and don’t be afraid to reach out for help and support, there is plenty of breastfeeding support available.

Breastfeeding can be stressful if  there are problems

When a new mum experiences breastfeeding problems such as sore nipples or concern over her babies weight gain she can, of course, find breastfeeding stressful.  It is vitally important that when any concerns or worries arise with breastfeeding that you access skilled breastfeeding help.  The help can be in the form of breastfeeding counsellors either from La Leche League or Cuidiu, or her local HSE breastfeeding support group (in the community or hospital) or she can visit an IBCLC in private practice.  With prompt appropriate support and help the vast majority of breastfeeding problems can be easily and quickly resolved and breastfeeding can get back to being the joy and pleasure it is meant to be.

Some women worry that breastfeeding in public might be a bit daunting

The issue of breastfeeding in public would be one of the main concerns most new mum’s have about breastfeeding.  In countries where breastfeeding is more popular and the norm women don’t have this issue at all but in Ireland it is still a major concern. However, Ireland has very clear laws about breastfeeding in public and women can breastfeed wherever and whenever they want to and no one is legally allowed to ask them to stop.  But the law is not the problem, the problem is that breastfeeding mothers think that breastfeeding in public is difficult and potentially embarrassing but the reality is that it isn’t, not at all. 

Once you get used to breastfeeding after the first couple of weeks you will realise how easy it is to do and that it can be done quite discreetly and the convenience of breastfeeding out and about far outweighs the any concerns you have about breastfeeding in public.  I have been helping mum’s with breastfeeding for over ten years in Ireland and not once has any breastfeeding mother ever told me about having a negative experience breastfeeding in public – in fact the opposite is often true, if anyone notices at all they often just smile at the breastfeeding mum as a form of support.  So as I said the problem is a problem in our imagination mostly and it most definitely is not a reason to choose not to breastfeed. 


 

I really want to breastfeed my baby, what steps can I take to ensure that I will be able to breastfeed successfully?

Take a Preparing for Breastfeeding Class while you are pregnant

A Preparing for Breastfeeding Class taken while you are pregnant will give you the  information you need to ensure that you will be able to get off to the best start.  In the class you will learn about latching, how often your baby will need to feed, how long feeds will be, what the feeding cues are and how to know your baby has had enough milk plus much much more.  There should be a practical component to the class, practicing latching and holding the baby (a doll) etc... Also your partner should be encouraged to attend the class because his support is an important component to the success of breastfeeding.  Click here for more information on the Preparing for Breastfeeding Class.

Involve your partner and your family support

Partner support is vitally important as he will be the person who is with you most of the time after the baby is born.   Encourage him to attend the Preparing for Breastfeeding Class or take time to explain to him how breastfeeding works and that you will need his help and support in the first few weeks after the birth while you are getting breastfeeding established.

Learn as much as you can

There is a lot of excellent and up to date information available in books and on the internet and it is a good idea to read up about breastfeeding while you are still pregnant because you most likely won’t have the time or energy to do it once the baby arrives! 

Locate your local support groups

Another important aspect of breastfeeding is support and you can start by developing a support network of women who have breastfed, this can be just friends, or family members or if that isn’t available to you then accessing the support groups such as La Leche League or Cuidiu (Irish Childbirth Trust), or Friends of Breastfeeding is a good idea. Ask other breastfeeding mothers what helped them in the early days, try and get a realistic picture of what new motherhood is like for the first weeks and months.  Other breastfeeding mothers have a wealth of experience to offer and share. 

Labour and Birth – keep it simple

This may seem like a big ask but it is a good idea to aim to have as little intervention as possible during the labour and birth.  Labour and birth are designed to be the primer for breastfeeding with all the wonderful hormones your body produces during the labour helping the baby breastfeed when he or she is born.

Induction, epidural, pethidine, forceps, vacuum extraction and caesarean section have all been shown in research to have a detrimental effect on breastfeeding to varying degrees.  Basically a baby who has had a normal labour is more likely to come out eager and ready to feed. I am not saying don’t have an epidural at all, or don’t be induced or whatever the intervention is being suggested because there is a time and place for these interventions but it is important to know that you may have to work a little harder at getting the breastfeeding up and running if this is what is necessary for you.

Immediate Skin to Skin contact after the birth

Skin to skin is where the baby is placed on the mother’s abdomen or chest immediately after the birth.  Immediate skin to skin contact allows the baby to recover from the process of the labour and birth and helps the mother bond with her baby. Usually after 20 to 40 minutes the baby will spontaneously start looking for the breast to feed and this is an important first step in the breastfeeding process.

Feed the baby whenever the baby wants to feed 

Newborn babies don’t have a “routine” (they didn’t have a routine in the womb, so why would they have one within days of coming out)  Newborn babies have small stomachs that fill up quickly, breast milk is then quickly and easily digested and so they get hungry and need want to feed again.  In the first few weeks they need to feed quite regularly, at least every two hours or so, they need to do this because they are growing loads and putting on the pounds!

Babies show hunger signs by bringing their hands to the mouth, licking their lips, latching on to anything that is close by and finally by crying.  If the baby looks even remotely interested in feeding put him or her to the breast – only the baby knows if he or she is hungry.  The frequent feeding ensures a good milk supply and that your body will recover more quickly from the birth and helps the baby recover from the birth as well as providing nourishment and calories for baby. 

Make sure baby has latched on correctly to the breast –

The latch is how the baby attaches onto the breast and is essential that the baby latches well so your nipple doesn’t get damaged and also so that the baby will have a fulfilling feed.  The Preparing for Breastfeeding class will show you how to ensure you have a good latch and what to do if you are experiencing problems with latching on.  There is more info about latching under the heading “How do I know my baby is latched on and breastfeeding correctly?”

Take time to rest and recover from the birth and to learn the skill of breastfeeding

I have a saying, “Mum breastfeeds the baby and somebody else does everything else!”    Labour and birth are exhausting, having a new baby is demanding – a new mother does not need to do any else for the first 4 weeks other than recuperate from the birth and learn about her baby and how to breastfeed.  Women really struggle with this recommendation but in my  years of  experience in helping new mum’s I know it is the cornerstone to ensuring successful breastfeeding and a happy confident mother. 

Surround yourself with support

Connect with other breastfeeding mothers, by phone, by internet and by going to support groups.  Although in Ireland breastfeeding mothers are still in the minority there is plenty of help and support so don’t be afraid to access it – as many mothers say to me it is a lifeline to talk to women who have babies and are going through similar experiences.

If you are having problems access skilled breastfeeding help promptly

International Board Certified Lactation Consultants (IBCLC) are the health professionals who specialise in resolving breastfeeding problems.  Most hospitals in Ireland have IBCLC’s on staff to help many hospitals also have clinics that you can attend.  There are also IBCLC’s who work in private practice either in clinics or as a home visit. Click here for  more information on my private practice in Cork or click here for other IBCLC’s around the country.

 

How do I know my baby is latched on and breastfeeding correctly?

It shouldn’t hurt

The best way to know that a baby is breastfeeding correctly is that the breastfeeding should not be painful – at all.   It is a common myth that when you start out with breastfeeding that it is ok for breastfeeding to be painful while your nipples “toughen up” for a few days to a couple of weeks, but this belief is incorrect.  There should be no pain, just a gentle tugging.  A few women may have a 30 second sensation of “ooch!” when the baby latches initially but then it should just become a gentle sensation of tugging or no sensation at all and definitely not continuous pain and the nipples should not be sore or damaged in any way after feeding. 

Baby should have a wide open mouth 

When a baby is latched onto the breast correctly, his or her mouth should be wide open taking in as much of the areola as he or she can, also the upper and lower lip should be folded out (fish lips), this will enable the nipple to be placed right at the back of the baby’s mouth and for the tongue to come forward over the lower gum and protecting the nipple from the hard gum.

Baby should be actively sucking for at least ten minutes for each feed

The baby should suck actively for at least ten minutes before going to sleep, often babies will feed for as long as 30 to 40 minutes and this is normal too but it is important to know that baby needs to feed for at least ten minutes for it to be counted as a feed.  Go to “How do I know my baby is getting enough milk” to understand more about feeding times.

After the first three days you should be able to hear gulping and swallowing

After the third day after the birth you should be able to hear gulping and swallowing as the baby drinks the breast milk.  The baby will feed for anywhere between ten to forty minutes and then fall contently asleep on the breast. The baby should be having three to five golden mustard coloured poos a day and six to eight wet nappies a day.

If there is pain with breastfeeding

With correct latch on the baby will be able to get lots of milk, gain weight and breastfeeding feels comfortable for the mum.  If there is pain with breastfeeding, then that is a sign that something is amiss.  Often the baby just has to be taken off the breast and re-latched and all will be well. However, if breastfeeding remains painful then it is very important that the mother get expert breastfeeding help as soon as possible because there can be several reasons why the breastfeeding is painful.  The best breastfeeding help is from an International Board Certified Lactation Consultant (IBCLC) – many of the hospitals run breastfeeding clinics that are staffed by IBCLC’s or you can go and see an IBCLC in private practice.  It is the IBCLC’s job to assess the latch and ascertain what the problem is and help you resolve it, often the problem is sorted out quite easily and then breastfeeding will become easy and comfortable.

 

How do I get a good latch?

There are many different ways to latch a baby onto the breast.

Cradle hold

Cradle the baby in your arms and snuggle him or her up close to you, stroke the baby’s top lip with your nipple and wait for a wide open mouth (as wide as a yawn) and then bring the baby onto the breast. Then wait and see how it feels, if it is painful after about 30 seconds take baby off and try again and you may need to do it a few times to get it right.

Cross cradle hold

Another method is to use a breastfeeding cushion and lay baby facing towards your breasts. Bring your arm along the baby’s back and support the neck and shoulders, with your other hand hold your breast with your fingers away from the areola and then gently stroke the baby’s top lip with your nipple and watch for the wide open mouth and then bring baby onto the breast. Then wait and see how it feels, if it is painful after about 30 seconds or so take baby off and try again.

Laid back nursing position

Another method is for you to lie back in a semi-reclining position and place baby tummy down onto your torso with his head on your breast. You will see baby “head bob” up and down (like a woodpecker!) and work his way over to your nipple. You can help baby locate the nipple by moving your breast so he can access it easily, the baby will head bob over to the nipple and latch on himself. Then you just put your arm around baby to cradle him, you may need a pillow under your arm to support it. This is a very comfortable position to feed your baby and requires very little “expertise” from mum. If you are having a problem with latching on – don’t stress over it, sometimes there are other issues going on that need to be looked at so just find an IBCLC to come and help you as soon as possible. Most latching issues are easily resolved with skilled breastfeeding help.

 

How do I know when my baby is hungry and needs to feed?

Watch your baby for feeding cues

Your baby will provide you with feeding cues to let you know that he or she is getting hungry (maybe they should be called feeding clues!). Look for baby bringing the hand to the mouth, opening the mouth as if the latch on, sticking the tongue out, turning the head towards the breast or trying to latch onto your finger or chin or nose! These are all early feeding cues – baby is letting you know that he or she is getting a bit peckish. Crying is a feeding cue that comes last and is often one you can’t ignore, however if you pick up the early feeding cue your baby probably won’t need to cry.

 

How often will my baby feed and how long will each feed last?

Often & oftener! 

A breastfed baby should feed at least 8 – 10 times in a 24 hour period and the feeding pattern does not happen at regular intervals, it is normally erratic with some feeds being 30 minutes apart and other feeds being a couple of hours apart. Also the length of each individual feed varies too, some feeds will be for ten minutes and others for forty minutes.    The reason for feeding so often is because your baby has a very small stomach, about the size of an almond, so it fills up quickly with milk and then because breast milk is easily digested it empties quickly.  This means that in the first few weeks it is normal for a breastfed baby to feed at least every two hours, but sometimes it can be much more frequently than that, even every 20 minutes or so – often and oftener!

 There is no routine feeding pattern  (so don’t expect one!) 

It is normal for a breastfed baby to feed for a different amount of time and at different times every day because the baby feeds when he or she is hungry and this varies from day to day.  Your baby has an inborn instinct to know when he or she is hungry (just like you do) and because newborns are growing at an amazing rate they need to feed A LOT.  Another factor affecting the frequency of feeding is that because their stomach is so small they can only take in small amounts at each feed.  In the first few days of life the volume taken in would normally be less than half an ounce (15 mls) per feed and this increases after the milk comes in around the third or fourth day but the frequency of the feeds will remain  the same for the first six weeks or so. 

Frequent feeding is normal in the first few weeks

It is important to understand the frequent feeding is NORMAL, when a baby feeds frequently he or she not only is getting food but they are also communicating with your body about how much milk to produce for your baby.  EVERY BABY HAS THEIR OWN UNIQUE FEEDING PATTERN, there is no routine as such, your baby will instinctively know when he or she needs to feed, just like an adult.  (Adults don’t have a rigid feeding routine, when we eat and how much we eat varies from day to day depending on what our needs are – your baby is just like you in this regard).

The length of an individual feed will vary from feed to feed 

As well as the feeding pattern varying from day to day (but at least 8 to 10 feeds in a 24 hour period) the length of each feed will vary, some feeds will only be 10 minutes of active sucking and others could be as long as 40 minutes.  It is also normal for the baby to pause during the feed, the baby will take a little rest for a minute or so and then start sucking again.  The different feed times  is completely normal, again your baby knows when and how long he wants to feed for (just like you do) so your job is to sit back and enjoy holding and cuddling and breastfeeding your baby!

Trust your baby!! 

Your baby is born with incredible instincts to know when and how long to feed and provided your baby is actively sucking for ten minutes a feed for at least 8 to 10 times a day (keeping track with a notebook is a good idea in the first week or so) then you can just relax and trust that your baby knows what is best for him or her.

As your baby grows older a feeding pattern will emerge

As your baby grows a feeding pattern will emerge and usually by 8 - 10 weeks most mums will have a good understanding of their own baby’s feeding pattern.  The normal pattern for at this time will be feeding every three or so hours and feeding for about 10 to 20 minutes, but again there will be some days when the baby feeds more frequently especially when he or she is going through a growth spurt.  Usually by four to five months of age the baby will be very efficient at breastfeeding and the feeds will probably be around every three to four hours and lasting about ten minutes. 

 

How do I know my baby is getting enough milk?

Keep an eye on the weight gain

Monitoring how much weight the baby is gaining is a good indicator of how the breastfeeding is going.  The problem with this though is that it isn’t convenient or that easy to do as you have to go to your GP or public health nurse to get the baby weighed.  Because of this I have given you other methods that you can use at home as form of daily reassurance that all is going well but it is good to understand what a breastfed baby weight gains should be.   

The baby will be weighed at birth and this weight is the basis from which all the other weights will be measured.  The baby will then be weighed at three days old and usually most babies will lose up to 7% of their birth weight  -  this is normal and expected as they are poo-ing and peeing  a lot and only taking in small amounts of colostrum.  The baby will then be expected to return to birth weight by the second week (14 days). 

The public health nurse will weigh the baby when she comes to do the home visit after you are discharged from hospital and this is usually around day 5 – 7, so this will give you an idea that your baby’s weight is moving back to the birth weight. 

After your baby has regained the birth weight the weight gain is usually around 5 – 7 ounces a week or about an ounce a day.  In grams; 140gms – 200gms a week or around 20gms a day.  This weight gain pattern is expected to continue until about 3 to 4 months.

The clue is in the poos!   

Montoring your baby’s  bowel movements is a convenient and handy way to ensure that baby is getting enough breast milk.  Because we can’t measure how much a baby is drinking with breastfeeding it is necessary to have an easy guide to reassure us that baby is getting enough, one way of doing this is to monitor the output – the poos and pees!  In the first few days after the birth the baby will poo a dark green tarry substance called meconium.  Usually the baby will do one or two poos of meconium each day for the first three days.

After the first three days the mature breast milk will be reaching the baby’s intestines and then the baby is expected to poo about 3 – 5 times in a 24 hour period and the poos should become a golden yellow colour.  The baby should also be having about six to eight wet nappies a day – what the output shows us it that the baby is getting enough in to grow and put on weight and also enough to produce bowel movements and urine.

Feeding often and oftener! 

Your baby should be feeding at least 8 times in a 24 hours period with each feed being at least ten minutes of active sucking.

Baby should be active and alert

Your baby should have periods where he or she is active and alert. In each 24 hour period there should be several  5 to 10 minute periods when your baby is awake and  alert, these periods called are called a “quiet alert state” will become more frequent and last longer over the coming weeks .

Baby should be filling out and growing longer 

You will start to notice that your baby is growing out of his or her new born baby clothes.

 

How do I know when my baby is finished a feed?

Baby will fall asleep on the breast after breastfeeding

It is normal for a newborn (up to around six weeks of age)to breastfeed for as long as he or she wants to (10 to 40 minutes) and then fall asleep on the breast at the end of the feed. There is a hormone in your breast milk that makes your baby feel sleepy when the stomach is full so you will start to see the sucking slowing down and become sporadic and eventually stop all together. It is perfectly normal to let your baby fall asleep while on the breast and is in fact the best way to help your baby get to sleep – once you see your baby in a deep sleep you can then move him or her if you want to - or you may just want to stay and cuddle up with baby. And don’t worry about your baby falling asleep on the breast - you won’t be creating bad habits by allowing the baby fall asleep on the breast – it is where the baby is meant to fall asleep in the comfort of your arms and the breast is the best pillow there is!!

Around 6 weeks the baby will also start to come off the breast independently when he or she has had enough.

As they baby gets older and has more awake time you may notice that they actually come off the breast by him or herself – if you offer the breast again they may have a few sucks but then come off again. So follow your baby’s lead and let them decide when they have had enough – trust your baby!

 

How do I know when my breasts are empty?

The breasts are never empty  

The breasts never run out of milk, the body is continually making milk while the baby is feeding so although they may not be as full as they are the beginning of a feed they are actually never completely empty.    Initially there will be a lot of milk at the beginning of the feed and there is quite a fast flow of milk and then as the feed continues the milk flow slows down and there is less milk.  The amazing thing though is that the body compensates for the slower flow by making this milk higher in fat content, so although the baby may be getting less milk it is quite high in fat content.

 

How do I know when to move the baby to the other breast?

Watch your baby for signs that he or she wants to move

Allow your baby to feed on one breast for as long as he or she wants to.  A newborn will usually feed for around 10 t0 40 minutes on one breast and then fall asleep on the breast – this is normal and expected.   Then when the baby needs to feed again offer the other breast, so you then alternate breasts for each feed. 

Around 2 – 4 weeks some babies will start to show signs of not being satisfied with just one breast per feed, they show their dissatisfaction by head butting the breast (!) or tugging on the nipple and coming off and crying a little and then going back on again and sucking for a few seconds and then coming off again. The baby is trying to tell the mother that they want the other breast, so follow their lead and switch the baby to the other breasts.

 Every baby has their own unique feeding pattern

Some babies will always want both breasts for a feed and others will only feed from one breast per feed and others will do a bit of both so remember every baby has their own unique feeding pattern and it is easiest (and requires less thinking) to just watch your baby  for the signs.

 

 

I want my baby to have breast milk but am anxious about breastfeeding so I might just express and feed my baby by bottle – is this a good idea?

Expressing is not intended to replace breastfeeding entirely

Expressing is meant for situations where the mother can’t feed her baby such as when the  baby is in the special care baby unit, in this situation it is necessary to establish the milk supply and to provide breast milk to the baby until such a time that the baby can breastfeed.  The other use of expressing is for periodic use to enable the mother to leave the baby for short periods of time.   

Expressing milk is a LOT of work and not much fun

Although this method of feeding may seem to alleviate the issues with breastfeeding it is in fact about double (or triple) the amount of work.  The process of expressing your breast milk takes up a lot of time, then the baby needs to be fed and then the equipment needs to be cleaned, then it often time to start all over again.

Your body will most likely not produce enough milk with expressing only

The first three days after the birth are crucial for establishing your milk supply, the skin to skin with baby and the frequent breastfeeding are all important elements to get the milk supply up and running.   To mimic this with a pump is very difficult and therefore it is unlikely that you will be able to establish a robust milk supply.

As time goes on your baby will do cluster feedings that precede a growth spurt, these cluster feedings are crucial to increasing the milk supply.  This synchronistic relationship between the baby and the mothers’ body cannot be replicated with expressing and so will result in a lower milk supply.

It is much easier and more enjoyable to breastfeed

Once you have mastered breastfeeding , around 4 to 6 weeks, it just gets easier and easier and more and more enjoyable.  One way of looking at breastfeeding is that it is mother nature’s reward for all the work of the pregnancy, labour and birth – it is an easy, pleasurable way to feed your baby and it enriches your relationship with your new baby.

Learn as much as you can about breastfeeding before the baby arrives

It is ok that you may be a bit anxious about breastfeeding, a lot of women feel this way but take the time during pregnancy to learn as much as you can about breastfeeding , take a class, talk to friends, read books and find where your local breastfeeding support groups are.  By taking these steps you will become much more confident about breastfeeding and greatly improve your chances of success when the baby arrives.

 

 

Thank you for a fantastic class today, really enjoyed it, got so much reassurance from you & reinforced my decision to keep breastfeeding!

Liz

With Clare's support I have managed to feed my son exclusively and he is now over 8 months old. Thanks Clare.

Yvonne