Guide to Breastfeeding

Guide to Breastfeeding

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Contents Breastfeeding Your Baby

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Breastmilk How is Breastmilk made?

Colostrum Mature Milk

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Why is Breastfeeding important?

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Benefits to your baby Healthy for You

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Breastfeeding Techniques you need to know

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Milk Flow Response What is Latching?

Great Postions to Breastfeed How often do I feed?

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Baby and Dad

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How can Dad help?

Bonding Time

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2 Back to Work

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What is Weaning?

Baby-led Weaning Tips to Wean Expressing Milk Storing Milk

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First Tastes

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It's Time Pear & Apple Purèe Broccoli & Cauliflower Purèe Banana Purèe Carrot & Parsnip Purèe Avocado & Kiwi Purèe

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Healthy Eating for Mothers

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Garlic Milk Fennel Tea Ajwain Water Almond Milk Do Remember

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Myth Busters

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Drink lots of Milk Small Breasts Avoid certain foods Fasting while Breastfeeding

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Breastfeeding your baby

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Before your baby is born he is protected within your womb from all infections and after birth breastfeeding takes over the protection process.

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Breastmilk Your milk is made specially for your own baby. It is the right nutrition for the growth of your baby. It is easy to digest and it contains protective substances which help prevent infection especially loose stools. You can give it even when you are ill, pregnant or menstruating.

It is recommended that all infants should be fed exclusively on breastmilk until they are six months of age and continued to be breastfed till 2 years or beyond.

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How is Breastmilk made?

The process of breastmilk production starts during pregnancy. If you’re pregnant, you’ve probably noticed big changes in your bra cups. Those physical transformations i.e. tender, swollen breasts and darkened nipples and areolas (the circle of skin surrounding your nipple) ñ may be some of the earliest clues that you’ve conceived.

Another signal that your breasts are getting ready for nursing is when the bumps around your areola get bigger and more noticeable, often in the first trimester. These bumps are called glands of Montgomery or Montgomery’s tubercles. The oil they secrete lubricates your nipples and helps prevent drying, cracking, and infections when you’re breastfeeding.

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The hormone prolactin is needed for milk to be produced. Prolactin receptors, on the walls of the milk-producing cells of the alveoli, allow the prolactin in the bloodstream to move into the milk-producing cells of the alveoli and stimulate milk production.

As the alveoli fill up with milk they stretch, which changes the shape of the cells so they cannot absorb any more prolactin, therefore slowing the rate of milk production. The breast milk itself contains a protein gives the message to the cells to stop producing milk when the breast is full of milk.

The baby’s suckling stimulates the hormone to be released – oxytocin. Oxytocin causes the muscles around the alveoli to contract, squeezing the milk into the ducts, which swell behind the nipple, full of milk. The motion of the baby’s tongue as they suck, draws the milk into their mouth – though they must have a good mouthful of breast to be able to reach the ducts and feed effectively.

As the milk empties out of the alveoli, the prolactin receptors return to their normal shape, so the prolactin flows back into the cells and milk production starts again. The milk that is produced as the baby feeds is higher in fat and more satisfying.

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Colostrum The first few days of breastmilk : During the first few days after delivery you produce a special milk known as colostrum which is thick, sticky and yellowish in colour. It is easily digestible, contains anti-infective elements to protect your newborn against infections.

It stimulates your baby’s immature intestines to develop, in order to digest and absorb milk and to prevent the absorption of undigested proteins.

Colostrum also has a mild “gut clearing effect”, which helps your baby’s gut to pass the first, very dark stool called meconium. It also helps to prevent jaundice by clearing the bilirubin from the gut.

Although colostrum is secreted in small quantities (30-90ml), it is sufficient to meet the energy needs of a normal newborn during the first few days of life.

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Mature Milk During the two weeks that follow the colostrum stage, the milk increases in quantity and changes in appearance and composition as per your baby’s needs, the protein content decreases while the fat and sugar content increases. At this time,your breasts may feel full, hard and heavy.

Mature milk is thinner and watery but contains all the nutrients essential for optimum physical and mental development of the baby. The mature milk consists of hindmilk and foremilk.

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The milk which comes at the start of the feed is called Fore milk.

Foremilk, which is watery and bluish in color, has a low level of fat and is high in lactose, sugar, protein, vitamins, minerals and water. It satisfies your baby’s thirst and is produced in large amount than hind milk.You may sometimes worry that your milk is too thin.

Hindmilk, is the milk which comes later in a feed, is richer in fat and this extra fat makes it look whiter than foremilk. It satisfies the baby’s hunger and supplies much of the energy required. Therefore, it is important not to take your baby off the breast too quickly.

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Milk is never “too thin�. It is important for you to give both foremilk and hindmilk to provide complete meal and water that your baby needs.

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Why is Breastfeeding important?

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Benefits to your Baby Early breast milk is Liquid Gold Known as liquid gold, colostrum (coh-LOSS-trum) is the thick yellow first breast milk that you make during pregnancy and just after birth. This milk is very rich in nutrients and antiÂŹbodies to protect your baby. Although your baby only gets a small amount of colostrum at each feeding, it matches the amount his or her tiny stomach can hold.

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Your breast milk changes as your baby grows Colostrum changes into what is called mature milk. By the third to fifth day after birth, this mature breast milk has just the right amount of fat, sugar, water, and pro¬tein to help your baby continue to grow. It is a thinner type of milk than colostrum, but it provides all of the nutrients and antibodies your baby needs.

Breast milk is easier to digest For most babies – especially premature babies – breast milk is easier to digest than formula. The proteins in formula are made from cow’s milk, and it takes time for babies’ stomachs to adjust to digesting them.

Breast milk fights disease The cells, hormones, and antibodies in breast milk protect babies from illness. This pro¬tection is unique; formula cannot match the chemical makeup of human breast milk. In fact, among formula-fed babies, ear infections and diarrhea are more common.

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Healthy for You Life easier.

Breastfeeding may take a little more effort than formula feeding at first.

But it can make life easier once you and your baby settle into a good routine. When you breastfeed, there are no bottles and nipples to sterilize.

You do not have to buy, measure, and mix formula. And there are no bottles to warm in the middle of the night.

Breastfeeding can save money.

Formula and feeding supplies can cost a lot each year, depending on how much your baby eats. Breastfed babies are also sick less often, which can lower health care costs.

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Breastfeeding can feel great.

Physical contact is important to newborns. It can help them feel more secure, warm, and comforted. Mothers can benefit from this closeness, as well. Breastfeeding requires a mother to take some quiet relaxed time to bond. The skin-to-skin contact can boost the mother’s oxytocin (OKS-ee-TOH-suhn) levels. Oxytocin is a hormone that helps milk flow and can calm the mother.

Breastfeeding can be good for the mother’s health.

Breastfeeding is linked to a lower risk of health problems like Type 2 diabetes, Breast cancer, Ovarian cancer and Postpartum depression in women.

Experts are still looking at the effects of breastfeeding on osteoporosis and weight loss after birth. Many studies have reported greater weight loss for breastfeeding mothers than for those who don’t.

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Breastfeeding lowers health-care costs by reducing illness and deaths of children under five years of age because exclusively breastfed children are less prone to diseases. This also reduces the strain on the family budget.

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Breastfeeding techniques you need to know

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Milk Flow Response The Letdown reflex, also known as the Milk Ejection Reflex, is set off by the hormone, Oxytocin. It stimulates the muscle cells in your breasts to squeeze out milk. Oxytocin is released whenever your baby suckles in the first few days after she’s born. Later on, just thinking about feeding your baby can trigger this hormone release. Some mums find that their breasts leak when this happens.

Different women feel the letdown reflex in different ways. Some feel a slight tingling, some feel immense pressure and slight pain or discomfort and others feel nothing at all. As time goes by and you get used to breastfeeding, you’ll probably become less and less aware of it.

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For your baby to enjoy your milk, it must be released from the alveoli, a process known as Letdown.

Here’s how it happens: As your baby suckles, the sensation on your nipple causes another part of your pituitary gland to release oxytocin into your bloodstream.

When oxytocin reaches your breast, it causes the tiny muscles around the milk-filled alveoli to contract and squeeze, releasing milk.

Your milk moves along to the ducts just below the areola.

When your baby feeds, she presses the milk from the ducts into her mouth.

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What is Latching?

Scooping in a big mouthful of breast lets your baby draw your breast deeply into her mouth, creating a teat from which to feed. Your nipple will then be right at the back of her mouth, at the point where the hard roof of her mouth gives way to the soft area. With a mouthful like this, your baby will be able to use her tongue smoothly and rhythmically against the under surface of your breast, and remove milk from the ducts. This is called Latching.

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There’s a bit of technique to latching your baby onto your breast, but once you’ve got the hang of it, it should come easily to both of you.

Check your baby’s mouth is as wide open as possible as she comes onto your breast. Make sure her tongue, bottom lip and chin touch your breast first. Aim her bottom lip as far as you can from the base of your nipple.

These actions will help your baby to get a good mouthful of breast when she starts to feed. Then, her jaw will move up and down, following the action of her tongue, and she will swallow your milk as it flows to the back of her mouth.

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Great Positions to Breastfeed When it comes to breastfeeding, being comfortable and being able to get your baby to your breast easily are the two things that count.

Finding a position you are happy with will make it easier for you to latch your baby on to your breast. Whatever position you choose, make sure that your baby’s head is able to tip back slightly as she feeds.

33 1. Lying down with your bodies parallel.

2. Holding your baby across your lap, using the opposite arm to the breast she is feeding from.

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3. Holding your baby across your lap, supporting him with the same arm as your breast.

4. Holding your baby underarm.

5. Holding your babies in any combination, if you have twins and want to feed them together.

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How often do I feed?

In the early weeks babies are programmed to wake and feed frequently. A newborn baby will possibly spend the same time sleeping as she does awake. After the first few days, most young babies feed six to eight times a day, but these feeds will be spaced unevenly.

If you are breastfeeding so often she is undoubtedly building up your supply, as the more she feeds, the more milk will be produced. Check, however, that she is latched on well to ensure that she is getting the fattier hindmilk as well as thirst-quenching foremilk.

Your baby may well be reaching a growth spurt at five weeks and is genuinely hungrier.

It’s important to offer the breast when she needs it so that the quantity of milk you produce changes to match her requirements.

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While you canĂ­t supply the milk, there are things you can do to make breastfeeding easier for your partner. Helping her will allow you to play a more active role.

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Baby and Dad

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How can Dad help?

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Breastfeeding can be hard work at first, so be supportive and thoughtful towards your partner.

Do your share in chores and she will really appreciate you being an extra pair of hands. Studies have shown that the more supportive their husbands, the longer women breastfeed and the more confident they feel about their ability to do so.

Talk to your partner about the possibility of you feeding your baby a bottle of expressed milk. Donít pressure her, though, as some women find expressing milk, by hand or with a pump, uncomfortable and even painful. If you both decide that expressing is a good idea, it is important to wait a few weeks. This is so your baby has had the chance to get used to feeding at your partner’s breast before you introduce a bottle.

Try not to take it personally if your baby seems less than interested in taking a bottle from you at first. Teats on bottles come in all shapes, sizes and textures. You may have to experiment a little and be very patient before you and your baby discover the kind he’s happiest with.

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Bonding Time

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After your wife feeds your baby, you can burp him and put him to bed giving your wife much needed rest. This may make you feel more involved in caring for your baby and will help you bond with your baby.

Spend plenty of private time with your baby doing activities that involve skin-to-skin contact. Changing nappies, cuddling, putting the baby to sleep, bathing, and even just reading in a chair while the baby naps on your shirtless chest are all great relationship builders. Take her for walks in the pushchair, put her in a sling and go shopping, or do whatever you can think of to be together.

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These moments give you and the baby a chance to be alone together, and the more this happens, the more confident you will feel about your own abilities as a parent.

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Back to work

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What is Weaning?

It’s best to give your baby nothing but breastmilk for the first six months of her life. After that, you can start to give her different foods as well as breastmilk.

When your baby’s about one, she’ll be getting all the goodness she needs from food. So it’s around now you might decide to stop breastfeeding altogether. This is known as weaning your baby from your breast.

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Baby-led Weaning

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It’s best not to stop breastfeeding abruptly, as it can be upsetting for your baby and uncomfortable for you. It could leave you with engorged breasts and possibly Mastitis, a painful breast inflammation.A gradual approach is best which ensures your milk supply will slowly reduce as the demand drops.

This gives babies the chance to explore foods for themselves. It means they can cope with different food textures from the beginning of weaning. As long as your baby is ready, it’s important to give her foods with soft lumps for her to chew.

Babies who are given lumpy food later on, after they’re 10 months old, are more likely to reject the food. They may be less open to trying new textures and tastes as they grow.

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Ti ps to Wean Stage One Let your baby finish a full breastfeed, then offer her a small portion of food. At this point you are just letting your baby experiment with flavours and textures. She’ll still get most of her nourishment from breastmilk.

Stage Two Once your baby is eating well (you will notice changes in her poos if she is), you can switch things around. At some mealtimes, try offering food first, before you breastfeed her. Then you can start offering something to eat before every breastfeed.

Stage Three Eventually, offer your baby water in a soft-spouted beaker instead of a breastfeed.

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Expressing Milk Expressing is simply a way of taking milk from your breast without your baby suckling.

You can do this by hand, with a manual pump or with an electric pump. Once you’ve expressed your milk, you can store it in the fridge or freezer to bottle feed to your baby later.

Expressing means your baby can still have the benefits of breastmilk even if you are away from her. Whether you’re just out for a few hours, or have gone back to work, your baby can carry on enjoying your milk while someone else is caring for her. This will also stop your breasts becoming too full and uncomfortable.

If your baby is pre-mature, she may not be able to take milk straight from your breast at first. You can help her by expressing your milk. Expressing milk is also a great way to increase your overall milk supply.

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Storing Breastmilk It is best to put breast milk in plastic feeding bottles with secure tops to seal in freshness. You can also use plastic bags made especially for storing milk. Remember to write the date on the bottle or bag before putting it in the refrigerator or freezer so you’ll know how fresh it is.

To thaw frozen milk, place the bottle or bag in a bowl of warm water, run it under warm tap water, or defrost it in the refrigerator overnight.

Don’t use the microwave for defrosting or warming - it kills the nutrients in breast milk. When your baby is ready to be fed the breastmilk, gently shake the breastmilk to ensure even distribution of milk contents.

And don’t ever save partially drunk portions for later use as it may be vulnerable to bacterial activity.

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Once your baby is eating a wide range of foods you may find she cuts down on breastfeeding of her own accord. You could try these simple recipes to help your baby change.

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First Tastes

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It's Time!

It’s a good idea to wait until your baby is six months old before giving her solid food as well as her usual milk.

The Department of Health says it’s best to exclusively breastfeed your baby until she is six months old. After that, breastmilk on its own doesn’t give your baby everything she needs, in particular iron.

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Pear & Apple Puree This delicious mixture of fruits will provide your baby with plenty of vitamin C.

Ingredients 1 ripe pear, peeled and sliced 1 apple, peeled and sliced

Place the pear and apple in a small saucepan with one tablespoon of water and cook over a low heat, stirring occasionally, until the fruit is tender. PurĂˆe in a blender or mouli.

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Broccoli & Cauliflower Puree This combination of brassica vegetables is a good source of iron and vitamin C.

Ingredients 1 large floret broccoli 1 large floret cauliflower

Steam the vegetables until they are tender. Purèe in a blender or mouli and adjust the texture with boiled, cooled water or your baby’s usual milk.

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Banana Puree Bananas are often a favourite. They are easy to prepare, and are filling and tasty, as well as being a good source of potassium.

Ingredients 1 small ripe banana 1-2 tsps of baby rice 2 tbsps of breastmilk or formula

Mash the banana well until smooth. Mix the rice and milk, and stir into the banana. Adjust the texture with milk or rice to make a runnier or firmer purèe.

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Carrot & Parsni p Puree This tasty root vegetable mixture is a good source of betacarotene. In season, parsnips have a delicious natural sweetness your baby may love to taste.

Ingredients 1 carrot, peeled and diced 1 parsnip, peeled and diced

Steam the vegetables until tender. Purèe in a blender or mouli and adjust the texture with boiled, cooled water or your baby’s usual milk.

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Avocado & Kiwi Puree Your baby may really enjoy this refreshing, colourful combination. It is a good source of vitamin E and vitamin C.

Ingredients Half a ripe avocado 1 ripe kiwi fruit

Mash the avocado well. In a separate bowl, peel and mash the kiwi. Push the kiwi through a sieve to remove the pips, then mix with the avocado.

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Focus on eating whole grains and cereals, fresh fruits and vegetables, and foods that provide plenty of protein, calcium, and iron.

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Healthy Eating for Mothers

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As a new mum, you may often wonder what you need to eat or drink to increase the production of breastmilk. Certain foods are known to stimulate the production of breastmilk. They are also known as Galactagogue Foods.

While herbs such as fenugreek and fennel have been used for centuries to increase a nursing mother’s milk supply, little is known about how herbs affect a nursing baby. Do consult with your doctor before taking any herbal remedy.

Also increase your intake of water as it is a major constituent of breast milk.

It will help maintain your milk production. Ensure that you drink at least 10-12 glasses of water every day.

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Garlic Milk Garlic is believed to be an excellent galactagogue. Two studies have shown that the infants of mothers who eat garlic tend to feed for a longer time, and many babies seem to prefer a variety of flavour in breastmilk. Note: This is usually served as a morning/mid-morning beverage.

Ingredients: 2-3 garlic cloves finely grated

1 cup filtered water

1 glass milk

1 tsp honey/sugar/jaggery

Method Finely grate the garlic cloves and boil them in a cup of water till water is reduced to about 1/4th.

Add a glass of milk to the mixture and bring the milk to boil.

Simmer and add honey/sugar/jaggery, as per your choice.

Strain and serve warm.

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Fennel Tea Believed to increase lactation and aid digestion.

Ingredients: 1-2 tsp powdered fennel seeds (saunf) 2 cups water 1/2 - 1 tsp honey/sugar/jaggery (optional)

Method Boil the water in a pan and add the powdered fennel seeds.

Bring to a boil.

Cover and let the mixture stand for a five to ten minutes.

Strain and pour into a cup. Add honey/sugar. Serve hot.

Drink two to three servings of fennel tea per day

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Ajwain Water Believed to help in cleansing the stomach and uterus.

It also aids digestion.

Ingredients 1 tsp powdered carom seeds (ajwain powder) 1 cup filtered water 1 tbsp desi ghee 2 tsp powdered jaggery (gur)

Method Heat 1 tbsp ghee in a pan. Add carom seeds power and water and stir the mixture well. Bring to a boil and add powdered jaggery.

Stir the mixture till the jaggery dissolves. Simmer for another 2-3 minutes. Strain and sip it the warm drink.

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Almond Milk Helps boost milk production and immunity. Turmeric is believed to prevent breast inflammation.

Ingredients 5-7 almonds (badaam) soaked overnight and peeled 4 black pepper corn seeds (kali mirch) soaked overnight A pinch of turmeric (haldi) 1 glass skimmed/double toned milk 1 tsp desi ghee

1-2 tsp honey/ sugar/jaggery

Method Grind almonds and pepper corns into fine paste. In a pan, heat ghee and fry the paste till it turns golden brown. Add turmeric power. Fry for about one minute. Now add milk to the paste and stir. Bring mixture to boil.Add honey/sugar/jaggery to the milk.

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Do Remember Remember moderation is the key.

Exercise some caution when choosing herbs and spices.

Try a few different options first and see what works best for you and your baby.

You may also want to consider switching a certain beverage if you find it does not agree with your system or if your baby gets fussy.

Do ensure you make a fresh batch of the beverage each day - avoid the urge of making extra portions that last for several days.

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Myth Busters

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Drink lots of milk to produce breastmilk This is simply not true. Any type of food and fluid taken by you in adequate quantity is sufficient to produce enough milk. The production and quality of breastmilk is not dependent on the milk intake of the mother. The baby’s suckling on the breast is the key factor.

“More suckling makes more milk”.

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Small breasts will not be enough This is not true. Breast size and the quantity and quality of breastmilk produced are completely unrelated. Being able to breastfeed successfully does not depend on the size of your breast.

The size of the breast depends upon the amount of the fatty tissue layer under the skin. That is why different women have different breast sizes. This is not a part of the breastmilk producing mechanism.

Breastmilk, on the other hand, is produced by special glands in the breast that are present in all women. These glands are completely developed by the time of puberty.

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Avoid certain foods while breastfeeding No. you can continue eating most of your favourite foods during breastfeeding. If you are worried about a particular food, eat a small amount each time and see if it causes any problem to your baby. If it bothers your baby every time you eat it, you may consider avoiding that food.

Most breastfeeding mothers can eat and drink what they like. In a few cases, some babies seem to react with symptoms such as colic, fussiness, or excessive crying to foods in the mother’s diet. While some women swear that hot and spicy foods upset their babies, trial and error may be your best guide, as food-induced irritability differs markedly from one baby to the next.

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Fasting while breastfeeding Some of the calories required for breastmilk production are supplied by body fat reserves laid down during pregnancy. However, additional calories are needed over and above your pre-pregnancy intake to provide enough energy to supply the needs of your growing baby.

If you are breastfeeding, you are not expected to fast during Ramzan. Most Muslim scholars believe that women who are breastfeeding (and women who are ill, or travelling) have permission not to fast. Some even say it is wrong to ignore this act of kindness by fasting when you do not have to.

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This book is intended to be an introduction to breastfeeding for new mothers.For more information log onto www.babycentre.in. The information given here is based on educational research. However, it is always best to consult your doctor for advice and direction.

Printed by Breastfeeding Promotion Network of India.

Content Š Babycentre India.

Everything you need to know about breastfeeding your baby and more. We give you ti ps and tricks to keep your baby happy and healthy. Read on for great breastfeeding positions,reci pes for your little tot and how dad can help.

Published by Breastfeeding Promotion Network of India Content Š Babycentre India