Breast feeding

How is milk produced?

During pregnancy, the body produces a hormone called prolactin. This hormone stimulates the cells in the breasts to make milk. The amount of milk produced does not depend on the size of the breasts. The more the mother nurses the baby, the more is the production of milk. Another hormone called oxytocin stimulates the tiny muscle cells within the breasts to contract and squeeze milk down the milk ducts toward the nipples. This happens each time the baby is put to the breast.

When should breast feeding be started?

Breast feeding can start as soon after delivery as possible. Initially there may be problems, with the baby unable to suck well and the mother unable to nurse properly or to make enough milk. This first milk, called colostrum, is thick and yellowish and is packed with all the nutrients that the newborn baby needs. It also contains many substances to protect new babies against infections.

The flow of milk picks up in 2 to 3 days. Mothers who are relaxed and comfortable are more likely to have a normal flow. Touching the breast to the centre of the baby’s lips stimulates the baby to open her mouth widely. This is called the rooting reflex because the baby is identifying the nipple for future use. The nipple and much of the areola must be pulled well into the baby’s mouth. The baby’s lips and gums should be around the areola and not on the nipple. If the nipples are not sore, breast feeding should not be painful. If it hurts during feeding, then either the technique is wrong or there is a sore on the nipple.

For the first few weeks after birth, babies that are being breast fed do not require any supplements like water, sugar water, or formula feeds. A baby who is breast feeding regularly and effectively gets all the water and nutrients she needs.

How often should the baby be nursed?

Breast fed babies tend to feed more often than formula-fed babies because human milk is easy to digest. Initially, the newborn will probably need to be nursed whenever she cries. This is called 'feeding on demand'. By the end of the first month, the baby may start sleeping longer at night. Later on, babies usually settle into a 3 hourly feeding schedule. For timing the feed, the baby should be allowed to decide rather than going by the clock. Long gaps between feeds are uncomfortable for the mother as well, as the breasts become filled with milk. The baby must be put to both breasts during each feed. The latter part of the milk from the breast is very rich in fats and provides more calories.

How does one know if the baby is getting enough milk?

If the baby is not hungry for 2 to 3 hours after a feed and shows progressive weight gain, she is getting enough. Babies gain about 25 gram weight every day for the first 3 months. Also, if she has at least six wet diapers per day with pale yellow urine, and 2 to 3 stools every day, her requirements are being met. If the milk flow is inadequate, one of the reasons is an anxious mother or early introduction of the bottle. Sucking is the best stimulus for milk production. Minor ailments and fevers must not prevent the mother from feeding the baby.

Does one need to be careful about medication and food?

Most medications are safe to take during breast feeding, but there are a few that can be dangerous for the baby. To be sure, the baby’s doctor should be informed that she is being breast fed. Alcohol can pass through the milk to the baby and must be avoided. Even smoking must be avoided. Caffeine accumulates in the babies’ body because their bodies cannot get rid of it very easily. Too much caffeine taken by the mother may pass into the breast milk and cause problems such as poor sleeping, nervousness, irritability, and poor feeding.

Sometimes breast fed babies do not tolerate certain foods that their mothers eat. Babies may cry or have a colic. If the baby gets these symptoms every time a certain type of food is eaten by the mother, that item is best avoided. Some breast fed infants may be allergic to the cow’s milk in the diet. Symptoms appear soon after taking cow's milk and may include diarrhoea, rash, and gas.

What are the common problems of the breast during feeding?