INFO SHEET

[Guest guest]

Here is a draft text for another NCT information sheet - any comments

gratefully received

if you want to adjust the text plse add text in CAPS and but bits you want

removed in (brackets)

plse copy you replies to me and Caroline Deacon ( who wrote it)

carolinedeacon@...

Making enough breastmilk

If you’ve decided to breastfeed, you’ve made the healthiest decision for

your baby. However, you’re probably feeling a bit worried; perhaps you know

someone who wanted to breastfeed but didn’t manage. One of the commonest

reasons women give for stopping breastfeeding is that they didn’t believe

they had enough milk. In fact nearly all women are able to make enough milk

to breastfeed their babies, given the right help and support.

The first milk - colostrum

From about twenty weeks of pregnancy, and for the first few days after your

baby’s birth, you make special milk called colostrum. Straw coloured, it’s

low volume but high in protein and antibodies, with a laxative effect to

help your baby clear meconium from his intestines. It is perfectly designed

for a baby who has just emerged from a safe womb into a world which his

immature immune system may find difficult to handle.

Mature breastmilk

After a few days of breastfeeding, your breastmilk will come in; the length

of time this takes depends on how often and how much your baby feeds. A big

hungry baby may feed more vigorously, telling your breasts to speed up the

production of mature breastmilk. A small or premature baby, with his weaker

suck and shorter feeds, will be telling your breasts to keep that

wonderfully sustaining colostrum going for longer. Human milk looks thin

and bluish compared to cow’s milk, but it is perfect to feed a human baby.

Once your milk comes in, each feed from each breast will start with fore

milk (milk which comes in before), dilute and thirst quenching, which

gradually thickens into hind milk (milk which follows behind) packed with

calories. So when your baby latches on, first he has a refreshing drink,

then he gets down to a satisfying meal of hind milk, which will help him to

grow. If you limit time at the breast, or swap sides too soon, your baby

may not get enough hindmilk, and will be hungry again very quickly. A baby

who is not positioned well at the breast will also find it difficult to

feed well enough to reach the hindmilk.

When your breasts start changing from colostrum to mature breastmilk, they

will fill with blood and may feel hot, uncomfortable and perhaps engorged.

You may feel weepy and depressed; the so-called " baby blues " . Don’t worry;

these feelings should pass within twenty-four hours. In the meantime the

best thing you can do is to keep feeding your baby to ease the engorgement.

Some women find that Savoy cabbage leaves put onto the breast can bring

relief.

Tailor made for all occasions

Not only does your milk change during each feed, it also varies from day to

day. For instance, in hot weather, breastmilk is more dilute, allowing your

baby to quench his thirst and replace lost fluids without having to resort

to bottles of water. The taste of your milk changes from day to day

depending on what you eat, letting your baby get used to your family’s

diet. Antibodies specific to your environment are passed to your baby,

whose immune system will take at least a year to mature.

Of course unwanted substances may pass through your breastmilk too. So just

as you did in pregnancy, you should think about what you are eating and

drinking carefully, and check that any medicines are compatible with

breastfeeding. Some contraceptives can affect your milk supply.

Often it is difficult to remember to eat yourself when you are spending so

much time feeding your baby, so try to eat nutritious snacks whenever you

can. It makes sense to take care of yourself by eating well, and by doing

so you’ll be taking care of your baby too!

How do I make enough breastmilk?

Your breasts have been preparing to feed your baby throughout your

pregnancy, and as soon as he is born, they contain enough milk for his

first feed. What your body is waiting to learn is how much milk your baby

is going to need in the coming months.

It’s quite simple to make enough milk, let your baby decide when he needs

to eat, and when he has had enough. Only he is capable of deciding how much

he really needs. The more you feed, the more milk you will produce - you

can’t run out. " Saving it up " for later will actually mean you will have

less than you need.

To get your milk supply going, start by feeding your baby whenever he

wants, using one breast until he falls asleep or lets go. You can then

offer the other breast – he may not always want to take it.

From the beginning

If you can put your baby to your breast soon after the birth, it may help

you get off to a good start, as most babies are tuned to breastfeed at this

time. If he is not in the mood, perhaps after a long delivery or pethedine,

then hold him so the skin on his body is touching your skin. This will

start to stimulate your milk supply.

Feeding your newborn baby will feel very different to how it will be in a

few weeks time. A newborn’s tummy is tiny; only the size of a walnut, and

he needs to feed little and often. As he hasn’t got used to day and night,

he will feed off and on through twenty-four hours, perhaps ten times or

more in that time.

Mild jaundice is common for new babies, and breastfeeding as often as

possible will help this pass. Research shows that extra fluids such as

water are not helpful to the jaundiced baby, in fact they may make it worse

by filling up his tummy so there’s less room for breastmilk. You will need

to wake him to feed often, however, as jaundice makes babies sleepy.

Avoiding problems

In the early days, while your body is finding out how much your baby is

going to need, it is quite easy to disrupt your milk supply. For this

reason, it is best to avoid giving baby other drinks, and to keep feeding

him as often as possible. Trying to introduce routines too early may give

your body the wrong message about how much milk to produce. It has been

found that babies who were given dummies in the early days are less likely

to be breastfeeding later on; perhaps because babies’ need to suck is

fulfilled with a dummy, reducing time spent stimulating mothers’ supply.

Growth charts

Whenever your baby is weighed, your health visitor will plot his gains on a

centile chart. Although these are being updated, many of those in use still

represent average weight gains for formula-fed babies. Breastfed babies

gain weight at different rates, although length and head circumference

should develop at the same rate, and it is equally, if not more, important

to plot these. If your baby does not seem to follow the pattern expected

from his weight centile chart, but is still making satisfactory gains in

length and head circumference, be assured that he is developing well.

Gains on weight charts are quite small – an ounce or two here or there, and

it is easy to get such minute amounts wrong – variations could be caused by

a wet or dry nappy, a large bowel movement before weighing, different

clothing, or different scales. It is also important to take into account

how much weight your baby lost initially. However, if your baby is

consistently slower than expected overall, or you are feeling worried, talk

to your health visitor, breastfeeding counsellor or family doctor and if

you are still not sure, ask to be referred to a paediatrician.

How can I tell if he’s getting enough?

Think about whether he:

· Settles contentedly after a feed

· Seems content and alert and interacts with you.

· Has several really wet nappies a day (five disposables, six to eight

washables)

· Has frequent, yellow and sweet smelling, bowel moments.

· His skin is soft and moist, and if pinched or pressed returns to normal

immediately.

· His eyes are bright and clear

· His cry is generally strong and insistent which stops when you attend to

him. These are all good signs. You need to worry if:

· His fontanelle is sunken

· Wet nappies are few and far between, or smell strongly of urine which may

be dark

· Bowel movements are green or explosive

· Your baby seems very placid, and rarely cries.

In the past, mothers were often told to introduce solids early to encourage

their babies to put on weight. We now know that this isn’t healthy, and

that all babies thrive on just milk for the first six months. Milk should

continue to be the main source of nutrition for the first year. Introducing

solids earlier than four months can lead to long-term health problems.

Recent evidence suggests that it may be beneficial waiting until your baby

is six months old before giving any solid food.

Increasing your supply

There are lots of ways to increase your milk supply:

Feed more often

Express between feeds

Have a " babymoon " – rest with your baby for twenty-four hours, feeding as

often as possible during this time

A baby who feeds a lot

If your baby feeds little and often, it doesn’t necessarily mean that you

don’t have enough milk. It is more likely that he is not reaching your

hindmilk:

Adjusting positioning may help in case he is not able to drain your breast

well

Try staying on one breast for the entire feed, or returning to the same

breast if feeding off and on.

If your baby is fretful or colicky– consider other options apart from

feeding. Perhaps he is tired or over-stimulated and just needs to rest.

If you are at all concerned about your milk supply, talk things over with a

breastfeeding counsellor.

National Childbirth Trust Breastfeeding line 0

Breastfeeding Network Supporters Line 0

La Leche League 0