Q. I have just been discharged from hospital after having my first baby. I seem to be having a hard time feeling comfortable with breastfeeding, in particular the positioning. While in hospital I received many different opinions & ideas and seemed to have established a good system. However, at home I'm feeling a bit lost without having a midwife to see me every time I feed.
A. Gain some follow up advice from your local Child and Family Health Nurse who may be able to direct you to your local breastfeeding support group or clinic or offer some 1 to 1 support. Experiment with different holds to find a position that suits you and your baby. Remember with practice you and your baby will find the position which bests suits you. The main thing to remember is to ensure your baby is well attached with plenty of breast tissue in her mouth. For more information on attaching your baby to breastfeed, you can download our breastfeeding information brochure on the Karitane Website.
Q. Sometimes my baby wants to keep feeding and other times falls asleep after a short feed. How do I know if he is getting enough milk?
A. Signs to watch for are at least six wet nappies in 24 hours and adequate weight gains. Weight gains should be calculated as an average over 4 weeks and be around 150-200grams/week for birth to 3 months; 100-150 grams/week from 3 months to 6 months; 70-90 grams/week for babies aged 6 to 12 months. Feeds should be led by your baby, allow baby to indicate when and how much she needs. Some feeds will be long and others are of shorter duration - this is normal. Like you and I, your baby will be more hungry at some times than others. You will usually be able to hear her sucking and swallowing on the breast. She should also be content between most feeds. Babies usually have at least one unsettled period in the day. They may also demand more milk in hot weather or if she is having a growth spurt. If you have concerns about your feeding talk to your Child and Family Health Nurse/Karitane Careline(1300 227464). You can also obtain more information about breastfeeding from our information brochure on the Karitane Website.
Q. My nipples are becoming sore from breastfeeding. What can I do?
A. Some pain is Normal for the first few weeks. A cause of sore nipples can be incorrect positioning of the baby at the breast. If you have sore nipples and you cannot improve the positioning yourself, obtain help and support from your Child and Family Health Nurse or contact an Australian Breastfeeding Association counselor, or Lactation Consultant as soon as possible, to ensure baby is attaching to the breast correctly. You can find more information about managing breastfeeding difficulties in our information brochure on the Karitane website.
Q. I have changed how I attach my baby to the breast but my nipples are sore from her previous attachment. Should I buy any creams to heal them?
A. To help heal sore and cracked nipples after feeds express a few drops of breast milk, gently spread on the nipples and allow to dry. Leave nipples uncovered or loosely covered between feeds and avoid using soap on the nipples. The breast milk contains natural antibodies to help guard against infection and helps lubricate the nipple. For more information on attaching your baby when breastfeeding and managing sore nipples you can download our breastfeeding information brochures on the Karitane Website
Q. Sometimes I worry that I don't have enough milk. I had so much milk at first and now my breasts do not feel as full. How do I keep a good milk supply?
A. The more milk your baby takes, the more milk you make. Baby's sucking stimulates your breasts to produce more milk. Your breasts will settle down from the early days of feeding and might not feel quite as full. This is normal in most women and not necessarily an indication of low supply. You can be assured your supply is adequate if your baby is passing at least 6 wet nappies, is gaining average weight for age and is reasonably settled. Breastfeeding mothers need three meals a day, plus snacks and adequate fluids. Drink when you are thirsty. Water is the best drink. Try to rest and relax as much as possible. Babies cry for many reasons, not just when they are hungry. Ensuring your baby has access to breastfeeding and sucking to meet his/her needs will help maintain a good milk supply. For more information about signs that your baby is having enough breast milk, go to our information brochure on the Karitane Website.
Q. I need to go out and want to be able to leave my baby and miss a feed. How can I store expressed breast milk?
A. Put the expressed breast-milk in a sterilized plastic container with a tight fitting lid. It will keep at room temperature (26C or lower) for 6-8 hours and in a fridge for up to 3 to 5 days. Milk should be stored in the back of the fridge where it is coldest. Expressed milk will keep in the freezer box in the refrigerator for 2 weeks, 3 months in a separate door fridge/freezer, or deep freeze for 6 months. Once thawed, use the expressed milk immediately. Throw away any milk that is left over after your baby has fed. DO not refreeze or reheat the milk as this is not safe.
Q. My daughter is 5 1/2 months old and has always been breastfed but I would like to get her to take a bottle of formula so I can leave her for short periods of time. So far I have been unsuccessful in getting her to take a bottle of formula or breast milk and so has my husband. She will play with the teat and let the milk run out of her mouth but will not suck and swallow. I have tried stimulating her sucking reflex with my finger and then substituting for the teat but still no go. Do you have any advice for me?
A. Many breastfed babies take a little while to adjust to feeding from a bottle. When trying to introduce a bottle it is best to not put too much pressure on yourself or your baby. So give yourself and your baby a few weeks to get used to a bottle. When trying to encourage a baby to take a bottle the following may be helpful:
1. Offer the bottle at a usual feed time (instead of a breastfeed).
2. Hold her as if you were going to breastfeed her i.e. in your arms close to your chest.
3. Hold the bottle so it is resting on your chest and facing towards the babies mouth.
4. Gently move the teat across the baby's lips.
5. Let baby turn her head towards the teat. Many will turn away, cry but then turn back and look at the teat again. Don't try to force or follow the baby with the bottle.
6. Offer reassuring sounds like 'shh shh, it's OK'.
7. If your baby is crying and wriggling to get free for a few minutes put her down and give a 5 minute break.
8. Re-offer again - repeat over a 20 - 30 time span. If there is no success, offer the breast and try again at the same feed time the following day.
It may be helpful for another family member to introduce the bottle initially.
If you are needing to offer bottles on regular basis and the baby is refusing to feed, contact your Child and Family Health nurse or call Karitane Careline on 1300 227 464 for additional support and guidance.