Lactation

Lactation

The process of milk production. Human milk is secreted by the mammary glands, which are located within the fatty tissue of the breast. The hormone oxytocin is produced in response to the birth of a new baby, and it both stimulates uterine contractions and begins the lactation process. For the first few hours of nursing, a special fluid called colostrum is delivered; colostrum is especially high in nutrients, fats, and antibodies, to protect the newborn from infection. Thereafter, the amount of milk produced is controlled primarily by the hormone prolactin, which is produced in response to the length of time the infant nurses at the breast.

Difficulty in latching?

Latching on is the way your baby takes your nipple and areola into her mouth to suckle. It is absolutely the most important aspect of breastfeeding. Without proper latching on, your baby will not get the milk she needs and your breasts won’t be stimulated to produce more, initiating a vicious cycle of poor milk demand and poor milk supply. What’s more, your breastfeeding nipples may become cracked and mighty painful when the latch isn’t right.
How to help baby latch on, step by step

Here’s a guide to helping your baby on latch on and get the nourishment and comfort he needs:

  • Once your baby is in the right position, hold your breast with your free hand.
  • Place your thumb above your nipple and areola at the spot where your baby’s nose will touch your breast.
  • Your index finger should be in the spot where your baby’s chin will touch the breast.
  • Lightly compress your breast, giving it a shape more closely resembling your baby’s mouth.
  • Bringing your baby to your breast, stroke her cheek to allow the rooting reflex to kick in, and turn her mouth toward your breast; then tickle her lips with your nipple until her mouth is open wide (like a yawn).
  • Quickly bring her to the breast (without pushing or squashing her head), allowing her to take your nipple and areola into her mouth. (She won’t get the entire areola in her mouth, especially if yours is large, and that’s okay — as long as she grabs onto a good part of it.)

Best nursing positions for helping baby latch

How and where you breastfeed matters, for your comfort and your baby’s nourishment. Studies suggest new moms who try at least two breastfeeding positions are more likely to breastfeed for more than six months. Getting comfortable varying the way you nurse will make it easier for you to adapt your style to your baby’s feedings habits. Switching up positions may also reduce breast pain or discomfort.

Crossover
This position works especially well for newborns. Sit up in a comfortable chair or rocker and relax your arms. Now hold baby in the crook of your arm and rest his tummy against yours. Supporting his head, tilt him towards your breast until he latches on, then continue to cradle his head as he feeds.

Cradle hold
Instead of supporting your baby with the arm on the opposite side, you prop him up with the arm on the same side as the nursing breast. Some moms like to use a pillow or boppy for support in this position.

Football
The football hold positions your baby at your side, facing you, with his legs tucked under your arm (yes, like a football) on the same side as the breast you’re nursing from. This position is helpful if you have had a C-section (and don’t want any pressure on your belly), have a small or premature baby, have twins, or have large breasts.

Laid Back
The laid-back position is great for women with small breasts. You lean back and allows your baby to take the breast from any direction. Gravity, rather than your arms, will keep him close to you.

Side Lying
This position is great for middle-of-the night feedings. Both you and baby lie tummy to tummy, while you position the breast to his mouth. Make sure there is no loose bedding around your baby that could pose a suffocation hazard.

Prenatal planning

  • Many women choose to start pregnancy planning prior to conception so that they may minimize possible toxic exposures to the fetus.
  • Women or couples with an increased risk or family history of genetic (inherited) diseases may undergo genetic counseling as a step in pregnancy planning.
  • For the best outcomes, chronic medical conditions should be treated and under good control prior to attempting pregnancy.
  • Smoking cessation and avoiding alcohol or illicit drug use strongly improve a woman’s changes of having a healthy pregnancy and baby.
  • The amount of weight that a woman should gain during pregnancy depends partially on her pre-pregnancy weight.
  • As soon as a woman stops using birth control, she is able to become pregnant. Some long-term hormonal contraceptives may require a period of time for the hormonal effects to wear off.
  • Women who are planning to become pregnant should take folic acid supplements to reduce the likelihood of neural tube defects in the fetus.
  • Some types of fish may be high in mercury or other toxins and are not recommended for pregnant women.
  • Exercise is part of a healthy lifestyle and is recommended for most pregnant women with uncomplicated pregnancies.
  • It is important to review all medications, whether prescription or over-the-counter(OTC), with your health-care professional if you are planning to become pregnant.
  • Sexual activity is safe for most pregnant women.
  • Certain infections, including Zika virus, rubella, toxoplasmosis, and parvovirus B19 can pose risks for the fetus.
  • Women who do not have immunity to the rubella virus should be vaccinated before trying to conceive.
  • Women who have been infected with the HIV or hepatitis B viruses can receive medications during pregnancy or at delivery to reduce the likelihood of transmitting these infections to their newborn

Oversupply symptoms you may experience 

Mums with too much breast milk often experience uncomfortable feelings of engorgement and tension and constantly feel overfull. As we have seen, leaking breast milk is normal in the first six weeks or so, and not usually a sign of oversupply. But if you’re still getting soaked every time your baby feeds after this period, it may be an issue.

Because a baby can’t always drain a very full breast, it’s also common to experience blocked ducts or repeated bouts of mastitis as a result of oversupply. However, these problems may also have other causes.

How to decrease milk supply 

If you’ve established that you have too much breast milk and it’s a problem, here are a few simple measures that may help. For some mums these are sufficient:

  • Try laid-back breastfeeding. Feeding in a reclined position, or lying down, can be helpful because it gives your baby more control. He can set the pace and lift his head for a break if your flow is too fast for him. Remember to place a towel underneath you to catch any excess milk!
  • Relieve pressure. If your breasts are very uncomfortable you can hand express or pump a little milk to relieve them – but try to express the smallest amount possible. Each time you remove milk, you’re sending your breasts a message to produce more. So, while expressing can bring temporary relief, in the long run it could make the problem worse. If you need to express and store milk for times when you’re apart from your baby, it’s best to wait until you’ve addressed your oversupply.
  • Try nursing pads. If you’re leaking milk, popping disposable nursing pads super or milk collection shells inside your bra could help you stay dry. If your leakage is only light to moderate or you have leaking breasts during pregnancy, Ultra thin disposable nursing pads will help you feel confident in a discreet way.
  • Avoid lactation teas and supplements. If you’ve been drinking mother’s milk teas, eating lactation cookies or taking herbal supplements to encourage breast milk production in the early days, make sure you stop – these could now be part of the problem.

How to decrease milk supply 

If you’ve established that you have too much breast milk and it’s a problem, here are a few simple measures that may help. For some mums these are sufficient:

  • Try laid-back breastfeeding. Feeding in a reclined position, or lying down, can be helpful because it gives your baby more control. He can set the pace and lift his head for a break if your flow is too fast for him. Remember to place a towel underneath you to catch any excess milk!
  • Relieve pressure. If your breasts are very uncomfortable you can hand express or pump a little milk to relieve them – but try to express the smallest amount possible. Each time you remove milk, you’re sending your breasts a message to produce more. So, while expressing can bring temporary relief, in the long run it could make the problem worse. If you need to express and store milk for times when you’re apart from your baby, it’s best to wait until you’ve addressed your oversupply.
  • Try nursing pads. If you’re leaking milk, popping disposable nursing pads super or milk collection shells inside your bra could help you stay dry. If your leakage is only light to moderate or you have leaking breasts during pregnancy, Ultra thin disposable nursing pads will help you feel confident in a discreet way.
  • Avoid lactation teas and supplements. If you’ve been drinking mother’s milk teas, eating lactation cookies or taking herbal supplements to encourage breast milk production in the early days, make sure you stop – these could now be part of the problem.

Reasons for low milk supply

A small number of new mums have difficulty producing enough breast milk due to medical reasons, which include:

  • Excessive blood loss (more than 500 ml/17.6 fl oz) during the birth or retained fragments of the placenta can delay your milk coming in (which usually happens around three days after the birth).
  • A history of polycystic ovarian syndrome, diabetes, thyroid or other hormonal disorders. Mums with these conditions sometimes experience a low milk supply.
  • The rare medical condition mammary hypoplasia, in which there isn’t enough milk-producing glandular tissue within the breast.
  • Previous breast surgeries or breast trauma – although many mums who have had surgery go on to breastfeed successfully.

What to do if you have low milk supply

  • If you suspect your baby is not getting enough milk, see a lactation consultant or breastfeeding specialist. They will assess whether you have low milk supply and observe a breastfeed to see if your baby is latched on well and taking in enough milk. They may suggest adjusting your feeding position or your baby’s latch so she can feed more efficiently.
  • You could also try having more skin-to-skin contact with your baby before and during feeds to stimulate the hormone oxytocin, which gets your milk flowing. Or use relaxation techniques, such as listening to your favourite calming music, to reduce any anxiety that could be affecting your supply.
  • With support, most mums with low milk supply are able to partially breastfeed their babies, and some will manage to develop a full milk supply.
  • If your baby is not yet taking enough milk directly from the breast, perhaps because she was premature or has special needs, you may need to express to protect your milk supply, and your healthcare professional may prescribe galactogogues (medication to increase milk production).
  • If you’re not yet able to express enough breast milk for your baby, you’ll need to supplement her with donor milk or formula, under the guidance of a medical professional. A supplemental nursing system (SNS) can be a satisfying way for her to get all the milk she needs at the breast.

How to decrease milk supply 

If you’ve established that you have too much breast milk and it’s a problem, here are a few simple measures that may help. For some mums these are sufficient:

  • Try laid-back breastfeeding. Feeding in a reclined position, or lying down, can be helpful because it gives your baby more control. He can set the pace and lift his head for a break if your flow is too fast for him. Remember to place a towel underneath you to catch any excess milk!
  • Relieve pressure. If your breasts are very uncomfortable you can hand express or pump a little milk to relieve them – but try to express the smallest amount possible. Each time you remove milk, you’re sending your breasts a message to produce more. So, while expressing can bring temporary relief, in the long run it could make the problem worse. If you need to express and store milk for times when you’re apart from your baby, it’s best to wait until you’ve addressed your oversupply.
  • Try nursing pads. If you’re leaking milk, popping disposable nursing pads super or milk collection shells inside your bra could help you stay dry. If your leakage is only light to moderate or you have leaking breasts during pregnancy, Ultra thin disposable nursing pads will help you feel confident in a discreet way.
  • Avoid lactation teas and supplements. If you’ve been drinking mother’s milk teas, eating lactation cookies or taking herbal supplements to encourage breast milk production in the early days, make sure you stop – these could now be part of the problem.

What is supplementary feeding?

Supplementary feeding describes the method of giving additional fluids aside from breast milk to a breastfed baby because of breast milk supply issues or attachment issues. Supplementary feeding is also known as complimentary feeding.

When should you give supplemental feeds?

The most common reason parents give for starting supplementary feeding is that their baby still seems hungry straight after a feed. And while giving a little extra milk at the end of a breastfeed hardly seems like a big deal – particularly in the early days when breastfeeding isn’t yet established and the milk supply can be up and down – supplementary feeding can create complications of its own as a result of offering milk from a source other than the breast.

The best way to build your milk supply is to encourage your baby to drink often from the breast – if your baby can’t feed from the breast, try to regularly express milk to maintain your milk supply. Once your milk supply has increased, chances are that you’ll no longer need to offer a supplementary feed.