Breastfeeding essentials

World breastfeeding week

World Breastfeeding week is celebrated around the world in the first week of August each year. This year, the theme is Supporting breastfeeding for a healthier planet.  To recognise the importance of sustaining the protection, promotion and support of breastfeeding, Mater Mothers’ Hospitals are focusing on skin-to-skin cuddles.

Skin-to-skin cuddles immediately following birth—and continued for at least one uninterrupted hour—encourages mothers to recognise feeding cues for when their baby is ready to breastfeed.

At birth, your baby receives a surge of stress hormones, which helps them to adapt to life outside the uterus. Skin-to-skin time for a mum and their baby, naturally counteracts this stress of being born, allowing you to respond to each other and connect for the first feed in a calm and nurturing environment while releasing hormones for breastfeeding.

Most of the care that you or your baby may need after birth can be done while you continue with skin-to-skin, or can even be delayed to allow time for skin-to-skin.

Continuing skin-to-skin with your baby while you transfer to the postnatal ward by bed or chair is also strongly encouraged, especially if your baby hasn’t yet breastfed.


Mater’s Parenting Support Centre

Mater’s Parenting Support Centre is available to support mothers throughout their feeding experience up to six months of age. The service offers sessions for both pregnant and postnatal women in hospital and also an outpatient service for once you go home, free of charge for women who birth at Mater and are Medicare eligible.

All services are run by qualified lactation consultants who are experienced in caring for newborn, premature and special needs mothers and babies.

Mater’s Parenting Support Centre is open from 8 am to 4 pm, Monday to Friday (excluding public holidays). For further information or to make a booking, call 07 3163 2229.


Hear from our Mater expert

Stacy has been a midwife for over 20 years, including 16 years as a lactation consultant. She is a proud mum of two teenage girls whom she was able to breastfeed for two and three years consecutively. At the time of her first daughter’s birth, breastfeeding didn't start out easily and this led her having a deeper appreciation for the struggles many new mums experience when developing this new important relationship with their baby. 

Stacy currently works with the breastfeeding team at Mater Mothers’ Hospitals in South Brisbane providing support in its postnatal wards as a lactation consultant, and also as a childbirth educator teaching parent education classes.

Is your baby getting enough breastmilk?

For new mums, breastfeeding is another new skill you’ll need to learn when your precious little one arrives. It is very common for mums to feel unsure about the various elements of breastfeeding such as timing, frequency, techniques and milk production. As with any new activity it can take some time to feel comfortable with breastfeeding. 

At Mater Mothers’ we deliver more than 10 000 babies each year and work closely with our new mums to help them become confident in caring for their baby. We share a range of tried and tested tips to help you learn about how your baby’s feeding behaviour, urine output and bowel movements to help you to know that your baby is getting enough breast milk.

While it is impossible to measure how much breast milk a baby drinks, it is possible to assess if your baby is feeding effectively. Breastfeeding should be comfortable for you and your baby. Your baby should have a deep, slow rhythmic sucking pattern; the slower the suck, the more milk that is drawn into your baby’s mouth. Your baby will appear more relaxed, and your breasts become softer, as the feed progresses.

Breastfeeding works on supply and demand. Every time your baby feeds, your body starts to make the next feed. The more your baby feeds, the more milk you make. You do not have to wait a specific amount of time for your breasts to fill up before feeding your baby again. If you have any concerns about your milk supply, please speak to your midwife, GP or a lactation consultant. 

If you require further assistance and support please get in touch with Mater mothers’ Parenting Support Centre on 07 3163 2999 to make an appointment with a lactation consultant.

Feeding cues—know when your baby is ready

There are so many new things to learn as a new parent; like bathing, changing nappies, feeding, sleeping, clothing (the list goes on). One of the most common fears of new mums is not knowing when to breastfeed. Fear not, we have all the information you need to ensure you know when bub’s tummy is grumbling.

Feeding cues

As a mum, you and your baby share a special bond. Your baby is born with incredible instincts and is able to communicate with you within the first hour of birth. Your baby has a unique way of communicating to you that they are hungry. Look for, and respond to early feeding cues that your baby displays including:

  • rapid eye movement
  • clicking or tongue sucking
  • squeaking noises or light fussing
  • opening their mouth and searching to suck on contact (also known as rooting)
  • hand movements to their mouth or sucking on their hands
  • increased alertness, awakening or changes in facial expression
  • movement of arms or legs
  • tossing, turning or wriggling.

Crying

Crying is a late sign of hunger so avoid waiting for this sign as your baby will be more difficult to latch to your breast. Occasionally, babies can move rapidly through the feeding cues to crying, or the situation may not allow you to immediately respond to their early cues. However, placing your baby skin-to-skin against your chest allows them to calm and they may then exhibit those early feeding cues again. A calm baby is easier to latch.

We all know how difficult it is to please a baby once they have reached the hysterical crying stage. When your baby has reached this point, it is almost impossible to attach your baby to your breast. Babies lift their tongue to the roof of their mouth in order to protect their airway when crying; therefore, it is impossible for your baby to receive the nipple in their mouth.

If your baby is crying and you do not respond to early feeding clues, your baby will become disorganised and experience more difficulty with latching. In this situation, they may suckle briefly before falling asleep which will start a cycle of incomplete poor feeding and short sleeping.

Tips to avoid crying:

  • Avoid changing your baby’s nappy before the feed if this upsets your baby. Instead, commence the feed and change your baby mid-feed once they become sleepy.

  • Place your baby skin-to-skin against your chest to allow their nervous system to calm. This will allow your baby to exhibit early feeding cues and improve their ability to attach.

Don't let you baby self-settle

One of your baby’s methods of communication is crying. This is how they talk to you. Beware of old fashioned people and books who tell you that your baby should be on a schedule until feed time or learn to settle on their own. This theory is not supported by evidence.

Letting a baby cry it out may be physiologically and psychologically harmful to a baby. Studies that have examined child attachment and development have found that babies who are responded to appropriately to when they display feeding cues are calmer, more attached and more independent children later in life.

Midwives and lactation consultants at Mater do not support popular parenting books which encourage routines and schedules. We actively discourage their use because of their detrimental impact on breastfeeding.

Introducing solids—when, what and how?

Australian guidelines recommend the introduction of solids should be considered when your baby is between four to six months of age. Solids should not be offered before four months as your baby’s digestive system and head control are less likely to be mature enough to cope with this new experience. Find out more about the best ways to introduce solid foods to your baby from our experts at Mater’s Health and Wellness Centre

Tips for pregnant women prepreparing for breastfeeding?

Become familiar with your breasts. Try expressing some colostrum to see what it looks like and feel where any lumps and bumps may be. Do you have flat or inverted nipples that may make early breastfeeding more challenging? Consider your wardrobe, what clothing will make breastfeeding more convenient. Be aware of support services in your local community, who can you call for help and support.

For those women who had difficulty feeding their first baby, engage with a lactation consultant and see if you can find out the possible reason for not meeting your breastfeeding goals. For example, was it physical or a medical issue, or a difficulty relating to babies ability to breastfeed, such as prematurity or tongue tie. 

My baby makes a clicking noise when he feeds sometimes—usually once during a feeding. I've read it's them taking air. Is there any way to help stop this?

There may be a number of reasons babies make a clicking noise while attached to the breast. It generally means the baby loses the vacuum or seal on the breast. It may be related to when the milk flow increases and you have a letdown and it’s your baby's way of coping with the flow. It could be a positional issue where the baby has difficulty staying on due to the symmetry at the breast or due to tongue dysfunction if it becomes more persistent and frequent. Checking your baby's symmetry and adjusting your positioning at the breast may help, sometimes using a more reclined position can help if the flow is fast, or having an assessment done by a lactation consultant or talk with your midwife if there is also nipple damage and poor weight gain.

Watch our breastfeeding video above.

What's your suggestion for one breast with very low supply whilst the other one is okay, to make both balance?

Many women have different sized breasts and the milk produced is also different. It is important to offer both sides, and for this reason especially timed feeds or restricting baby to only one breast per feed can be detrimental to your supply and your baby's intake with each feed. Usually offering alternate sides each feed to begin a feed will ensure each breast at a time will be well stimulated and production as even as possible.

How can I get my baby to latch perfectly on both sides, not just one?

To latch your baby well on both sides, you may want to adjust your position so baby is able to come directly in line with the nipple. This may change each feed depending on the fullness of the breast and what chair you are sitting in. Our breasts and nipples tend to be slightly or significantly different and this can make attaching to one harder or easier than the other. The same principles apply to both. Make sure you and your baby are comfortable and supported. Check symmetry of cheeks, nose and chin, then observe for signs of milk transfer. After a bit of practice most babies achieve success on the tricky side too.

Is a high fat (poly and mono fats) linked to a better milk quality (fattier milk)?

Eating a healthy diet is important for a breastfeeding mothers health, the amount of fat you eat does not change the fat content or ratio of fat in your breastmilk, however the type of fats you eat will change the type of fat in your milk. The more polyunsaturated fat you eat then that is the type of fat you produce in your milk. The fat content is actually determined by how full the breast is, the fuller the breast the lower the concentration of fat.

Is it easier the second time around (please say yes!)?

Most women find breastfeeding their second or third baby easier than the first, but not always, due to many contributing factors. Generally however you will be more confident/ coordinated and have a better supply earlier on to increase your chance of success. But don't forget you have an older sibling to worry about.

What are your best tips to help vasospasm?

Tips to prevent vasospasm would be to try and stay warm. Avoid cold exposure on your nipples, keep a warm cloth or heat pack close by. Close windows and avoid drafts. Improving baby's latch to avoid compression on the nipple may reduce vasospasm. Some women may find medication helpful. If simple measures don't help, consult your doctor or a lactation consultant.

How do you safely thaw-out frozen breastmilk?

Thawing frozen breastmilk is best done in the fridge, followed by slowly warmed in warm water when ready to use. Avoid rapid heating in the microwave. Once heated, the milk will need to be used or discarded after the feed.

Why is there so much conflicting advice between midwives?

Conflicting advice may occur for many reasons. Staff are regularly offered updates and education, however, there are many levels of experience and expertise among them, and there is a large range of tips and ideas that work for some women and not others. What's relevant for your situation may change from one day to the next and so the support and education may differ over time. We recommend listening to advice suggested and figuring out the best option that works for you.

No one would intentionally give you incorrect advice, if you have any concerns, please provide feedback to the manager of the ward, or the patient liaison officer.

I was told that once your baby is born, milk could take one to three days to come in. What will it feed on until then? Is colostrum enough?

Colostrum is present and available in the mother’s breast as soon as the baby is born; it is full of protein and antibodies to help your baby transition into the environment. Once the placenta is delivered, it sets in motion a surge of hormones and the next phase of lactation begins. A significant increase in the volume of milk becomes available around day three, until then colostrum is all a newborn healthy baby requires to drink.

However they also need warmth, love, connection and comfort, which they also receive skin-to-skin

Is feeding a full term baby different to a premature baby?

Premature babies may face some extra challenges when breastfeeding. Some have difficulty breathing, and may have low energy and muscle tone, this can make them tire easily and require more assistance with feeding. Expressing and feeding support is recommended and assistance from our lactation team will be available to all mums that delivery prematurely to create a feeding plan specific to their needs. Your breastmilk also adjusts in composition to the needs of your premature baby.

Is it true that your milk supply drops at four months post-partum?

Milk supply tends to increase steadily in the first six weeks, then stay at a similar volume for six months until solids are introduced. Breast milk is the main part of a baby's diet until around 1 year of age, it continues to be of many benefits for two years and beyond, as recommended by the World Health Organisation) for optimal health and development.

How do you keep your supply up as your baby nears 12 months?

Supply can generally be equal to babies' needs while demand feeding is continued. Night feeding is a common and important part of the relationship and will help keep your supply boosted. Stress, the return of your period and interrupting or scheduling is most likely to affect your supply.

Are there any potential problems with pumping when establishing breastfeeding?

It’s good to focus on gaining confidence with feeding directly from the breast first. You may not need to express at all. Comfortable sizing of the breast shield and correct use and cleaning of the pump will minimise potential problems with pump use. Pumping may help stimulate supply if you have concerns with this but if not needed may stimulate an oversupply. Direct breastfeeding will make knowing if you have enough for your baby by observing output and weight gain. Pumping un-necessarily, can make more work and upset the balance of supply and demand.

Is it true that some people just can’t breastfeed? Not enough milk, too painful, just unable to?

With good support and technique most women can successfully breastfeed. There are some rare health conditions, or physical development or a history of certain types of surgery that make breastfeeding more challenging. These women will benefit greatly from support and options to help them provide the most appropriate alternative or supplement to feed their baby. And to give them emotional support to help them accept this conclusion especially if it was unexpected.

Why do so many mums struggle with breastfeeding to begin?

Many mums struggle with breastfeeding due to lack of support and unrealistic expectations on their baby and themselves. Be kind to yourself and ask out team at Mater Mothers’ Hospital for help. 

Is it just comfort feeding after three years of age, with no health benefits for breastfeeding?

There is always a benefit to mum and baby for any amount of breastfeeding, from one day to four or five years. From nutrients to comfort and many health benefits for both.

How can I wean my one year old when he won’t take bottle or cup?

Weaning from the breast can be difficult for mother and baby no matter what age the baby is when you decide the time is right for you. There are many tips to help your baby take a bottle or cup, and each attempt should be undertaken with patience and support. Different flow speeds of teats can be tried and when at first you don't succeed, try again. Ask someone else to try, decrease distractions and take it slow.

Why is skin-to-skin so important?

Holding your undressed baby up against your bare breast immediately after birth will keep your baby warm and secure, and help them adjust to the outside environment. Babies who have uninterrupted skin-to-skin for the first hour after birth are much more likely to breastfeed in that time. If your baby doesn’t feed in that time, continuing skin-to-skin will encourage feeding when baby is ready. Skin-to-skin will also help you and baby to relax, connect and get to know each other. This can be especially helpful if your baby is sleepy, unsettled, premature or having difficulties working out what to do.

It’s recommended to keep your baby safely against your body as you move from birth suite—your midwife will help you with this.

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For urgent assessment at any stage of your pregnancy, please present to your nearest emergency centre or Mater Mothers’ 24/7 Pregnancy Assessment Centre in South Brisbane.

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