Breastfeeding – common issues

This article was written by the fabulous Doula and Breastfeeding Counsellor Sarah Harcombe, with whom I help run a birth exploration group in Taunton. This woman knows her stuff so if you’re pregnant this is worth bookmarking. Link to original article here.

Recently, an article in the Lancet reported that the UK has some of the lowest breastfeeding rates in the world.
So why are more mothers not breastfeeding? Breastfeeding is the natural way to feed a baby – mothers have been feeding their babies in this way since mankind began – it can’t be that hard can it?
Or can it?
In 2010, 81% of mothers initiated breastfeeding at birth. After one week, the breastfeeding rate drops to 69%, and to just 55% at six weeks. At six months, just over a third of babies are still receiving breastmilk. Exclusive breastfeeding rates (i.e. just breastfeeding with no use of formula or solid foods) are even lower. The world Health Organisation (WHO) recommends exclusive breastfeeding for the first six months of life, and continuing to breastfeed into the second year of life and beyond. The Infant feeding Survey also tells us that the majority of mothers who gave up breastfeeding in the first few weeks would have liked to continue breastfeeding for longer.
So what is happening? It seems that mothers want to breastfeed but are not enabled to do so. Here are some of the key issues that mothers discuss at the breastfeeding drop-in group that I run.

Am I doing it right?

Some of the problems cited as causing mothers to stop breastfeeding are sore nipples and insufficient milk. Often, when a mother has become sore when breastfeeding, it can be due to the way that baby is latched. The latch is how the baby attaches to the breast to feed – there are many factors that can affect the latch but possibly most common is the positioning of the baby whilst feeding. There are a variety of positions to use, and in the early weeks with a new baby it is a case of experimenting to find what is most comfortable for mum and baby. You can find more information on positions to try here
Once your baby is latched you can look for signs of a good latch such as baby’s head tilted back slightly, mouth open wide, chin tucked into breast, cheeks full and rounded, and more of the areola (darker area around nipple) visible above rather than below mouth – see here for more info.
Ultimately feeding should be comfortable for mum and baby should be drinking (you may hear swallowing and see movement at your baby’s temple as he/she feeds)

How do I know if my baby is getting enough?

It can hard to feel confident as a new parent. Often when a breastfeeding mum encounters difficulties with her baby, it is her ability to produce enough milk, or milk that is of a good enough quality that is questioned. However our bodies are really very good at providing exactly what our baby needs, and contrary to popular belief, breastfeeding mums do not need to eat a specific diet, nor drink vast quantities of fluids to maintain a good milk supply (see here)
In fact the best way to ensure a good milk supply is to follow babies cues for feeding, and to feed for as long as, and as frequently as baby requires. Babies may cue for a feed for reasons other than just milk – it is comfort, reassurance and love all rolled into one. Feeds may not have a regular pattern, certainly in the early days, but a baby needs to feed 8-10 times in 24 hours to be able to receive enough milk.

As your baby feeds, your body is stimulated to make more milk. In fact our bodies make milk 24 hours a day; the rate increases whilst the baby is at the breast so a mother will not run out of milk if she is feeding according to her baby’s cues. It is very normal for babies to cluster feed, often in the evenings. Babies also go through growth spurts when they will feed frequently for a few days – this stimulates the mum to produce more milk to meet the baby’s increased needs. It takes a few days for our body to catch up with what our baby is doing, which is why the baby may seem unsettled until the milk production increases.
One way to tell if your baby is getting enough milk is to look at nappy contents. A baby who is under a week old should wee and poo every day. After this, some babies will poo less frequently, and some breastfed babies can go many days before passing a poo. Have a look here for more information.

I find it hard to position my baby

Babies need to learn to breastfeed, just as mums do. A wonderful way to learn together is to enjoy some skin to skin time. Babies love this contact with mums (it is equally important for babies to have skin to skin time with dads too). When you are in skin to skin contact your body produces lots of oxytocin, the hormone that drives breastfeeding, and also promotes bonding. Your baby’s oxytocin level also increases which helps them feel calm and relaxed, which in turn helps them to follow through on their own reflexes to breastfeed.

If breastfeeding is not going as smoothly as hoped, enjoying skin to skin time, in a relaxed position with your baby on top of your body so that you are tummy to tummy, can help take the stress out of breastfeeding and allow mum and baby to enjoy just being together. Have a look here for more information about using this position to help breastfeeding.

I need help!

Support plays a major part in a woman’s ability to establish and continue breastfeeding. Dads can be the first line of that necessary support. Dads can provide emotional support (telling her she is doing a great job and how proud he is of her) as well as practical support (simple measures such as making a snack or a drink for her whilst she is feeding can help the mum feel comfortable and able to keep breastfeeding). Sometimes it is the Dad who thinks to reach out for further support – ringing the midwife or health visitor, or a breastfeeding counsellor. It is very difficult to know what is normal when you have never experienced something, and new parents often have many questions concerning their care for their new baby. No health practitioner minds being asked such questions – and no question is too silly to ask.
Support groups can be a valuable source of information, and equally important, allow new parents to meet others who are very often going through similar experiences. This can enable the new parent to feel more relaxed knowing that what they are experiencing is common, and in turn may feel more confident in being able to meet their baby’s needs. I run a breastfeeding drop-in group at Cannington, Somerset and the mums often say how helpful it is to come along and chat with other breastfeeding mums. They enjoy the group describing it as ‘warm and welcoming’; that they ‘feel listened to’ and that support and information they receive is ‘very helpful’. One mother wrote ‘the Breastfeeding drop-in has been an oasis for us – somewhere to go for a hot cup of tea and be able to chat to other like minded mums’. Another wrote ‘If I had not had the support in feeding my two children I could not have continued’. Another mum said ‘the group was like a haven – I got a lot of benefit from the group for tips on sleeping’.

Support and information may also be sought from midwives, maternity care assistants, breastfeeding counsellors (try NCT, ABM or La Leche League) or lactation consultants, through telephone helplines, or breastfeeding clinics. To find your local breastfeeding group, you could ask your health visitor or midwife, or phone one of the national helplines listed below:

  • NCT 0300 330 0700
  • La Leche League 0845 120 2918
  • ABM 0300 330 5453

In this article I have only covered a small selection of tips that may be helpful to you whilst breastfeeding – if breastfeeding is proving a challenge or you feel that you are struggling, then please get the information and support to enable you to continue to feed for as long as you and your baby wish.

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