Some generalities
There is little doubt that breastfeeding is the best choice for your child in almost all cases. Its advantages are well known. There is no better milk for your baby. This is because breast milk contains all the necessary nutrients, such as sugars, minerals, proteins and vitamins, all in the best proportions. Plus, breast milk contains antibodies that give your baby extra protection against all kinds of infections.
But breastfeeding is not always straightforward. The new mother may find herself confronted with unforeseen difficulties. When you have just given birth, you are usually inundated with breastfeeding advice. Often, this abundance of information also raises new questions and can raise doubts. You can read up on it and talk about it with other people, it’s always helpful. It is important to be well prepared and well informed so that the breastfeeding period goes smoothly.
Frequent feedings, at the request of the child, are very important during the first days for the good progress of breastfeeding. They stimulate the production of milk.
Milk production follows several defined phases. The coordination and organization of these phases are regulated by hormones. At the time of birth, a mother’s breast produces a protein-rich and rather viscous liquid called “colostrum” which is sufficient to nourish the baby for the first few days of life. Your baby also has a good store of nutrients. After a few days, another hormone (prolactin) takes over and stimulates the arrival of milk in the breast. The more frequently you offer the breast “at your baby’s request”, the faster the start of this phase.
If your child is exclusively breastfed, you should also make sure that he is drinking enough. To do this, you can count the number of wet and soiled diapers. As a general rule, you can assume that your child needs to wet two diapers in the first 24 hours. For the first 4 days, the number of wet diapers increases to about 5. After 7 days, you should count about 7 wet diapers per 24 hours. A baby who is breastfed effectively has at least 3 bowel movements per 24 hours from the second day on.
Some tips for breastfeeding
Take care of yourself
You will breastfeed longer if you have a positive experience. It is therefore essential to take care of yourself. As a mom, make sure you get enough rest, eat well, and drink plenty (of water). Make sure each feed is as calm and relaxed as possible. Whatever the difficulties, skin-to-skin contact with your child is important.
Position
The position you adopt to breastfeed is very important. You can choose to sit or lie down. There are many good positions. In the beginning, you often have to do a little searching to find the most comfortable position for both the child and the mother. The young mother should be in a relaxed and comfortable position, which facilitates effective latching. Mother and child should ideally face each other (body / stomach) and be close enough. During the feeding, the mother supports the baby’s back and shoulders.
Correct latching
The child must seek the breast. He turns his head towards the breast and opens his mouth wide. Place the baby with the nose against the nipple. The child lifts the chin, grasps the nipple and areola deep in the mouth, and sucks vigorously. The baby’s lips should be pushed forward and the cheeks should not be too deep. If so, it means the baby has to suck too hard. If the baby is breastfeeding rhythmically, swallowing and breathing, you can continue breastfeeding. Breastfeeding does not have to be a painful experience for the mother.
Pacifier and bottle
In addition to nourishing it, sucking gives the child a feeling of pleasure. During the first few weeks, it is best not to use a pacifier to replace frequent feedings. In doing so, you stimulate the breasts less and, in the end, you also produce less milk. The sucking technique is different depending on whether it is, on the one hand, a pacifier or a bottle and, on the other hand, a breast. This is why the pacifier is not recommended until the child has acquired the correct sucking technique. So delay using the pacifier until your child has mastered the correct breastfeeding technique.
Breastfeeding difficulties
Breastfeeding sometimes gives rise to problems with latching on, the breasts or the child. If in doubt, consult the general practitioner or another specialist.
Breast problems
Nipple shape
There are two types of nipples: retracted or flat. Some nipples can be pulled out. Due to hormonal changes, this phenomenon sometimes corrects itself automatically during pregnancy. Certain exercises and devices put in place during pregnancy may also be sufficient to resolve this problem.
But there are also ‘really’ retracted nipples (nipples that curve inward without ever coming out). Where appropriate, advice on latching technique and positioning is extremely important. You can stimulate the nipple by massaging it or by applying pressure with your thumb and forefinger behind and around the nipple. A breast shield can be helpful.
Nipple pain
Pain may occur in the nipple early in the breastfeeding period. The nipple may be cracked or red, and even have a few blisters. This situation may possibly be due to an infection, but fortunately this is rarely the case.
Breast engorgement
Breast engorgement or congestion may appear a few days after your baby is born. The phenomenon generally corresponds to the so-called “rising milk” phase. The breasts are red, sore to the touch, and swollen. The young mother may have chills. Breast engorgement usually peaks, rarely lasting more than 24 hours, after which the situation gradually improves within two weeks.
Insufficient milk
The breasts should be sufficiently stimulated, either by breastfeeding or by pulling (at least 8 times a day).
What can you do ?
You can take care of your nipples by brushing them with a few drops of milk after feeding. You can also use a special nipple cream (lanolin), which does not need to be rinsed off before the next feed. If the skin is cracked at the base of the nipple, if a wet crevice forms or if breastfeeding becomes painful, it is advisable to wash the breasts after each feeding and dry them with a clean paper towel, for example. To repair the skin, you can regularly expose the breasts to air or wear a clean bra. The taking of painkillers should be reserved for really necessary cases, always after having discussed it with your doctor.
You can prevent breast engorgement by frequently breastfeeding your baby. The ideal is to start, using the right technique, within 24 hours of birth. The breast must be emptied. You can do this by breastfeeding the child (more than 8 times in 24 hours) or expressing your milk as often as possible (if the child is not breastfeeding). Expressing as little as 5-10 ml of milk can already relieve tension; the child will also be able to grip the breast more easily. Again, let us stress the importance of a good posture.
Cold compresses and fresh (or chilled) cabbage leaves can reduce the feeling of heat. A hot shower, the application of hot compresses and a breast massage promote the flow of milk. The taking of painkillers should be reserved for really necessary cases, always after having discussed it with your doctor.
Problems in the baby
Jaundice or jaundice
Some children (especially newborns) who are breastfed may develop jaundice due to breast milk. This problem is caused by improper removal of the substance called “bilirubin”. Fortunately, these children are generally healthy and responsive. Jaundice is usually not harmful and does not justify stopping breastfeeding. To rule out infections and other illnesses, however, it is advisable to have your child examined by a doctor. He will do a urinalysis and a blood test.
Breast refusal
Sometimes a child refuses the breast. This refusal can be due to many factors. Is your child sick and unable to breastfeed? Does your baby have a stuffy nose? Or maybe your child is having pain in their mouth, possibly because their tiny teeth are growing? It may also be that he has a yeast infection in the mouth (infection with a fungus).
What can you do ?
If your baby is sick and cannot breastfeed, it is advisable to express your milk. Make sure the feedings are calm and relaxed. Maintain skin-to-skin contact. If your child has a stuffy nose, you can rinse him out with a little saline. You will find it at the pharmacy.
Special situations
Breastfeeding twins
Breastfeeding little twins one at a time is very time consuming. You can save time by breastfeeding them at the same time.
Cleft (labio-) palate
An infant with cleft palate is often unable to grip the breast or a standard pacifier. A specially designed long pacifier usually solves the problem. You may be able to express your milk early to stimulate milk production.
What can your doctor do?
If breastfeeding is not going well, if you develop breast problems or if your child is ill, you are strongly advised to consult your midwife or general practitioner. He / she will work with you to find the root cause of the difficulties. The GP may ask you to show him how you breastfeed. They can examine your child to see if they are getting enough nutrition and, most importantly, enough hydrated.
If you produce too little milk, your doctor may prescribe medication. Medications for nausea may possibly stimulate milk production, but there is little scientific evidence to prove this.
In the event of mastitis (inflammation of the breast), with or without abscess, he may prescribe antibiotics.
If your child is sick, the doctor will examine him for the appropriate treatment.
Your child is at increased risk of hypoglycaemia (too little sugar in the blood) if:
- your child was born premature or ill;
- there has been talk of pre-eclampsia or high blood pressure during pregnancy;
- you have had gestational diabetes;
- your baby is too small or too big for the duration of the pregnancy;
- you have had twins with a weight difference of more than 25%;
- your baby had breathing problems during the birth;
- you are taking medicines for epilepsy;
- you are taking high doses of beta blockers;
- your baby suffered from dehydration shortly after birth.
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