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Breastfeeding





Breastmilk is the food designed by nature for your baby. For their first 6 months babies require nothing other than milk to eat or drink. Breastfeeding is free and available 24/7, and your milk is packed full of the essential nutrients your baby needs to get a head start on a healthy future.


Most women can breastfeed without too many problems. Breastfeeding is not without its challenges, so always seek as much support and guidance as you need when you are starting out. Studies show that 9 out of 10 women start out breastfeeding their babies. Unfortunately, despite best efforts sometimes breastfeeding does not work out, and you can read our guide here for “When breastfeeding does not work out”.


Over the past several months you have watched and felt your breasts change and grow, as your body prepares to nourish your baby. You may have been looking forward to this for your whole life, or you may still be trying to come to terms with the whole process! However you approach Breastfeeding, having patience and determination and asking for help as much as you need it will help pave the way for a rich and wonderful experience for both you and your baby.


What are the Benefits?

Breastmilk is natures food for your baby. Breastmilk is a Superfood - containing over 400 essential nutrients, minerals, hormones, and disease fighting compounds. The World Health Organisation recommends that babies be fed breastmilk exclusively for their first 6 months. They also state that women are fine to carry on breastfeeding until the end of your baby’s first year and even beyond if you wish.


Breastfeeding has been linked to higher IQ’s in later childhood, and according to the AAP breastfeeding is thought to play a role in preventing SIDS (Sudden Infant Death Syndrome).


Breastfeeding will help you ‘bond’, the closeness of breastfeeding, the quiet and special time you share can be invaluable to your emotional attachment with your baby. Eye contact and skin-on-skin contact will make your baby feel loved and secure (and skin on skin contact is known to stimulate your milk flow, so its win/win!)


Aside from the nutritional benefits for your baby, breastfeeding has benefits for you too. The physical bonding between mother and baby during breastfeeding can help you develop a close and special relationship.


Breastfeeding benefits mothers as well – many women say it helps them lose their excess baby weight, and studies suggest that women who breastfeed can lower their risk of getting breast cancer before menopause. It can also help protect you against bone weakening (and associated diseases such as osteoporosis) as well as ovarian cancer. Breastfeeding produces and releases Oxytocin in women – a hormone which helps your uterus return to its original size and has been linked to reductions in uterine bleeding after birth.


When to Start Breastfeeding?

Almost every baby has a strong urge to suckle as soon as they are born. If you are both well enough you can both start breastfeeding right away, indeed most birthing professionals will encourage you to attempt to breastfeed within the first hour of birth, helping to establish the bond and connection and to make your newly born baby feel safe and secure.


How does your Breastmilk develop after Birth?

During the first few days your breasts will be producing colostrum, a source of milk commonly called “first/fore milk” which your breasts produce for up to 8 days before your “hind milk” comes through. Newborn babies have a very immature digestive system, and while colostrum is a highly concentrated source of nutrients it is delivered in lower volumes then hind milk. Your baby’s stomach is only around the size of a marble so they will only need small amounts over the first few days to fill them up. By the time your body begins to prepare to release your hindmilk, your baby’s stomach is already expanded and able to cope with the extra volume.


Colostrum has a mild laxative effect, which encourages your baby to pass their first bowel motion – called Meconium. This clears excess bilirubin, dead red blood cells which are produced in high volumes during birth, which plays a role in reducing the chance of jaundice.


Why is Colostrum so beneficial?

Colostrum is known to contain major components which make up the immune system, including immune cells, many antibodies, essential peptides, and growth factors. The antimicrobial factors stimulate development of the gut and help protect your baby against viruses, bacteria and disease. Colostrum is rich in proteins and vitamins but tends to contain lower amounts of carbohydrates, lipids and potassium than hind milk.


How to Put your Baby to your Breast, and get to the Milk

Your baby will instinctually find their way to your breast. Many women simply hold their babies to their chests and notice their newborn attaching or trying to attach on their own. This is referred to as ‘baby led attachment’.


While some babies will attach themselves, others may need some guidance from you. Holding your baby close to your skin with their chin against your breast and your nipple opposite your baby’s mouth may encourage your baby to latch on. Gentling touching your nipple to your baby’s lips may help them open their mouth, and always ensure as much as your areola (the darkened area around your nipple) is in your baby’s mouth. Your colostrum and milk will flow more freely if you are relaxed and comfortable. You may experience initial tenderness but experiencing pain is not normal and you may need guidance if feeding hurts.


Before your baby latches on, you can try gently massaging your breasts and rolling your nipples between your thumb and forefinger to stimulate milk flow. Breath slowly and deeply with skin on skin contact if possible, and be calm and comfortable so that your baby can relax and feed peacefully.


How to know if your Baby is getting enough Milk

This is common concern for many breastfeeding women. Even though it may seem tricky, it’s not as difficult as you may think to tell if your baby is receiving enough milk from you. If they are breastfeeding regularly (between 8-12 times over 24 hours), has had plenty of pale, wet nappies (around 6-8 cloth or at least 5 disposable) over 24 hours, has 2 or more soft bowel movements a day and is gaining weight and seems generally alert and happy.


How often should you Breastfeed and How to Increase your Supply?

The more your baby feeds, the more milk you will produce. When babies breastfeed, the sucking motion stimulates nerves which releases hormones into the blood, namely Prolactin and Oxytocin. Prolactin activates milk-making tissues, and Oxytocin causes the breast to let down the milk.


One of the most common concerns new breastfeeding mothers have, is whether they are producing enough milk. Its also one of the most common reasons mothers give for weaning their baby. There are some ways to help you work out if your supply is actually low, and some suggestions to help you produce more milk.


  • Breastfeed often and regularly. Many babies require between 8 and 12 feeds in 24 hours. This is classified by full feeds when the baby eats until he/she is satisfied. Overly slow and fussy feeders, or baby’s who don’t take a lot of milk during feeds may need many more feeds then this. If you produce a lot of milk and feel your breasts and sore or too full, you can express your excess milk either by hand or with a manual/automatic pumping machine. Feeding your baby regularly – either on demand (when they cry or fuss or seem to want to feed) or on a regular schedule helps maintain steady milk flow.

  • Letting your baby finish the first breast before beginning on the second will encourage your milk flow to refill to its best capacity. You will be able to tell when your baby is finished on the first breast as they may stop sucking and release your nipple. Then offer them the second breast. If they pull away or un-attach they may be full for now, just remember to start their next feed on the second breast. (Keep track of which breast and duration of feeds with our amazing Phoenix Diary App!)

  • As well as daytime feeds, you will need to be feeding your baby throughout the night. This constant regular feeding will help your milk flow as well as relieve your discomfort if your breasts are overly full.


When and Where can I Breastfeed ?

Babies have the absolute right to be Breastfed, and mothers have the absolute right to Breastfeed. Breastfeeding your baby is a normal and natural thing to do. It is within your legal rights to breastfeed wherever and whenever you like. Most mothers work out where and how they will breastfeed when they are out so that they are most comfortable. It is your right, to Breastfeed your baby in Public.


In our society today, some women are still be subjected to criticism by people in public if they are breastfeeding, sometimes with negative remarks or confronted with made up “rules” against public breastfeeding. Unfortunately the controversy associated with breastfeeding in public can imply that breastfeeding is unnatural or illegal. This is absolutely untrue. Luckily these incidents are uncommon but do still occur, and can be very confronting for a mother feeding her child, and any friends or family present.


Many women counteract the accusations either with truth about the law and/or their natural human rights. However you cope with this situation if it were ever to arise, try and remain calm and/or don’t respond if you don’t feel comfortable, and don’t respond to any aggressive behaviour, so the situation does not escalate. If you ever find yourself in a threatening situation, do not hesitate to call the police.


Will you be able to Breastfeed at work?

Legislation is in place in most States and Territories which guarantees that no employer may discriminate against individuals with family responsibilities. Many mothers are successful in combining work and breastfeeding. Work environments continue to evolve and change, and many workplaces are adopting flexible Breastfeeding options for women. Approaching the issue of Breastfeeding at work is generally still left up to the mother, and employers in most states and territories aren’t legally entitled to discriminate against a breastfeeding mother’s rights.


What is the Law regarding Breastfeeding?

Under Australian Federal Law, breastfeeding is a right, not a privilege. The Sex Discrimination Act 1984 states it is illegal in Australia to discriminate against a person, either directly or indirectly, on the grounds of Breastfeeding.


Each State in Australia has their own independent laws but in essence they all protect women against breastfeeding discrimination. Details vary from state to state so check with your State or Territory Government agencies.


General information about state laws can be found at the Australian Human Rights Commission Website - http://www.humanrights.gov.au/guide-australias-anti-discrimination-laws.


If you feel you have been discriminated against with regards to your breastfeeding rights in public, complaints can be lodged with your State or Federal agency, but usually not both. This is due to differences between the state and federal jurisdictions. You can receive free advice which might help at the General Commission, Phone 1300 656 419.


What Foods should you consume with care while Breastfeeding?

It is important that you are healthy and eating the right foods, as the quality of your milk will largely depend on your diet. A balanced diet and a high intake of food rich in vitamins, minerals and protein will help you be optimally healthy for you and your child. Likewise, there are certain foods and drinks which are best avoided or eaten with care while you are breastfeeding.

Foods to Consume with Care


Coffee – If you have abstained from Coffee for the length of your pregnancy, denying yourself your Caffeine hit at this point after so many months may be almost impossible. But its important to remember that your baby will be absorbing trace amounts of Caffeine through your breastmilk, which can cause irritability, crankiness and/or sleep disruption in babies. Try to keep your caffeine intake to a minimum - perhaps saving your cup of coffee until after you have nursed may help. (Tea also contains caffeine so limiting your intake of caffeine in general is a good idea if you notice it affecting your baby – keeping in mind it may not have any adverse affect at all).


Chocolate – The delicious sweet treat also contains caffeine, so be mindful of your intake and if you do enjoy the odd bar (or block) try to avoid eating it right before you breastfeed if you notice it affecting your baby. If you are a chocolate lover and you suspect its behind your baby’s irritability, cut down or remove it from your diet completely for a few days and gauge if there is any change in your baby’s behaviour.


Alcohol – Over-consumption of alcohol can have lasting negative effects on your breast-fed baby. Not the occasional glass of wine with dinner, experts agree that generally has no lasting effects on nursing babies. But if you are a moderate to heavy drinker and breastfeeding, it could pose risks to your developing infant. It may help to remember this – the amount of alcohol in your blood is the amount of alcohol in your milk. As a general rule, it takes on average 2 hours for a woman to rid her blood of the alcohol content in one standard drink. The time is taken from the start of drinking. The best way to responsibly enjoy a drink while breastfeeding – is to plan ahead.


Spices – Like other ingredients and food groups on this list, some may have no effect on nursing babies while others may cause your baby to be irritated and fussy for several hours. This includes Spices, Peppers and Chili. Some nursing mothers can add their much loved dose of chilli to everything and cause no problems for their nursing babies, while others may become irritable and fussy. Again, limiting consumption if you notice it may be causing your baby discomfort may help you figure out if its causing problems or not.


Peanuts –Many mothers eat peanuts and breastfeed without any issues but if you are eating peanuts and your baby shows signs of allergy or sensitivity – such as a rash, eczema or wheezing, seek advice and cease consuming nuts until you receive further information and/or have tests to determine any allergies.


Wheat/Gluten – If you enjoy your toast, sandwiches, pasta, cous cous and other wheat products but your baby develops symptoms such as signs of obvious pain, inconsolable crying or painful/bloody stools following feeds, you may wish reduce or eliminate your gluten intake for 2-3 weeks and gauge your baby’s response. Always speak with your doctor about your concerns before starting elimination diets.


Dairy Products – Very rarely, babies may be intolerant or allergic to cows milk formulas. Studies have found this to be highly uncommon – only around 2% of infants will develop an intolerance or allergy and congenital intolerances (intolerances from Birth) are even rarer. If your baby develops an allergy to dairy they may display symptoms such as colic and excessive vomiting, wheezing, eczema or rashes. If your baby is overly fussy (though what baby isn’t?) bear in mind it’s more than likely other contributing factors behind your baby’s change in temperament or general well being.


Elimination diets for two to three weeks may help you figure out the source of their discomfort, but always speak to your healthcare provider if you suspect your baby may have allergies or an intolerance. (Some babies are intolerant to Dairy alternatives such as Soy products too, so be mindful of this when discussing elimination diets with your paediatrician). Again this is extremely rare and most babies have no trouble with dairy products.


Fish/Shellfish – The same rules for fish and shellfish consumption during pregnancy applies when breastfeeding. While pregnant women are advised to eat on average two serves of fish a week, fish with high concentrations of metals in their systems (such as Mercury) are to be avoided. Fish such as tinned tuna, smaller ocean fish, freshwater/farmed fish etc are generally lower in Mercury concentration, while fish such as shark, swordfish, mackerel, tuna and more are best avoided during pregnancy and breastfeeding.


Medicines & Herbs – Although many medicines and herbs are safe to take while breastfeeding, most drugs will get into your milk to some degree and may affect your supply and your baby. Always get professional advice before taking any pharmaceuticals or herbal medicines while breastfeeding. It’s important to keep in mind that herbal remedies are not regulated by the Food & Drug Administration. This means there is no official classification as to their potency, effectiveness or adverse effects. Always seek advice to learn more about the effects of anything you wish to take.


Complications

Difficulties can arise in connection with breastfeeding, as it is a skill both mum and baby will have to learn and refine together.


It is important to receive enough support and guidance when you start breastfeeding – it is not without it’s challenges and there is no shame in needing help. An Australian Breastfeeding Association (ABA) counsellor may be able to help, or phone the National Breastfeeding Helpline on 1800 686 268.


Some common complications can include:


Sore Cracked Nipples

Nipple pain is probably the most common complaint when women start breastfeeding. It is common to have some tenderness which generally improves within the first week. Pain beyond the first week, or cracks in your nipples (fissures) or localized swelling is not normal and you should see your doctor for evaluation and treatment if required. Sore nipples are commonly due to your baby not latching on correctly, or incorrect use of an expressing pump. Nipple pain could also be a sign of an infection, so consult your doctor if you are uncomfortable or unsure.


Engorgement Some women have a build-up of milk and other fluids in their breast tissue, causing their breasts to become large, heavy and uncomfortable. This is normal for women whose milk is coming in, from around the second day after your baby is born. But some women find, even before they have their baby, their breasts may have become very hard, swollen and tender, and her nipples taut and flattened. This is painful for a woman and sometimes difficult for babies to latch on. Treatment of engorgement includes continued and frequent breastfeeding, while ensuring your baby is latched on correctly so that as much of your milk is released as possible.


Latching On

Many babies can have problems learning to latch on, and you may need to guide them so they are getting as much of your milk as possible, and to protect your nipples from cracking or pain. Some mothers use baby-led attachment, other mums attach their babies themselves. Speak to your GP or lactation consultant for support on tips on how to ensure your baby is latching correctly.


Nipple Infections

Infections such bacteria (staph) or thrush (candida) can cause pain, itchiness, burning and redness, and may coat your baby’s tongue in white mucous. Antibiotics or antifungal tablets or gels may be prescribed, or a combination of treatments.


Mastitis

Mastitis is inflammation of the breast which causes painful symptoms similar to nipple infections. Later stages of mastitis may result in infection, causing fever and nausea. Commonly, continued breastfeeding, plenty of fluids and rest are generally common remedies, but breastfeeding with such a painful condition can be very trying, so try to keep it up and stay positive! Hand pumping may be a less painful option, to relieve your symptoms as well as keeping up your milk flow.


Clogged Milk Ducts

Your milk may occasionally block your milk ducts, which may present as a sore lump in your breast around the nipple or areola. Frequent and continued breastfeeding will empty the affected breast and may ease your discomfort. A hot shower, warmed heat pack or compress or gentle massage may also help to break up the lump. Hand pumping may be a less painful option, to relieve your symptoms as well as keeping up your milk flow.


Inverted, flat or very large nipple

Inverted, flat or very large nipples may make it difficult for your baby to nurse successfully. Your baby will form a teat from not just your nipple, but your areola as well, so most inverted or flat nipples will not cause any problems. Breast pumping may draw out inverted nipples before putting your baby to the breast. Nipple stimulation or using a nipple shield may be useful techniques - talk to your lactation consultant about the techniques which may help you.



SOURCES

Australian Breastfeeding Association

www.breastfeeding.asn.au/bf-info/breastfeeding-and-law/legalright


Human Rights Commission

http://www.humanrights.gov.au/guide-australias-anti-discrimination-laws


National Breastfeeding Helpline

1800 686 268

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