Like you, all mothers have a lot of concerns about their babies. This is a special chapter to assist you to answer some of your own questions. Some common questions asked by the mothers are:
Q. When should breastfeeding be started?
- Breastfeeding should be started immediately after the baby is born. The naked baby (after baby is mopped gently and made dry) should be held by the mother, close to her breasts for skin to skin contact.It stimulates smooth flow of milk and keeps the baby warm besides helping emotional bonding. After this start breastfeeding.
Q. Why breastfeeding should be started early?
1 Baby is most active in first 30 to 60 minutes.
2 Sucking reflex is most active at that time.
3 Early start ensures success of exclusive breastfeeding. Colostrum, which is the first yellowish secretion from the breast, is full of substances which protect the baby from getting any infection and acts to prevent infection like a vaccine.
4 It prevents breast swelling and pain, reduces post delivery bleeding.
Q. After Caesarean- section delivery, can I breastfeed my baby successfully?
- Yes. This operation does not affect your ability to successfully breastfeed your baby. You can start breastfeeding after 4 hrs. of operation or when you are out
of the effect of anaestheia. You can tilt your body to one side in the lying-down position and start feeding ,or you can put the baby on your abdomen and then feed the child. All mothers who have caesarean section deliveries are successful in breastfeeding their babies with assistance for the first few days.
Q. Can I feed my baby in lying down position?
Ans. Yes. You can feed your baby in any position comfortable to you and your baby. It may be lying down, sitting or reclining.
Q. I give gripe water and/ or ghutti to my baby- is it desirable or not?
- No. Use of ghutti and gripe water is an unscientific practice.It is better not to use them. These preparations sometimes contain medications which are harmful and may induce sleep which is not natural.
Q. Does my baby needs vitamins?
- Usually not. A baby who is exclusively breastfed for first six months does not need tonics or vitamins.If not exclusively breastfed, then yes.
Q. My milk looks thin and watery . Is it alright?
- Yes. Milk at the start of breastfeed(foremilk)is thin and contains less fat. Hindmilk(near the end of feed) is thicker and full of fats. A baby needs both. Feed the baby in an unrestricted fashion to ensure that baby receives both foremilk and hind milk.
Q. Should I breastfeed from both the breasts each time I feed my baby?
- One breast must be emptied out fully before the second is offered, so that the baby receives both foremilk and hind milk. When the baby releases one, breast other should be offered. If the baby is still
hungry he will feed from the other breast. Alternate breast should be offered at each feed.
Q. My baby is preterm. Can I breastfeed successfully?
Ans Yes. you can breastfeed a preterm baby successfully.
Q. How long can I continue to breastfeed?
- You should breastfeed your baby exclusively for first 6 months and continue breastfeeding well upto 2 years or beyond.
Q. My milk leaks from breast after feeding the baby. What should I do?
- It is a temporary problem and quite normal. If you notice the milk is leaking , press your elbows firmly against the outer margins of your breasts. This will slow down the flow.
Q. I don’t have enough milk . What should I do?
- Sign of getting adequate milk supply is the baby passing urine 6 times (or more) in 24 hours and baby gaining weight 500gms per month. The feeling of inadequate milk is usually apparent and not true as it comes from the mother believing that she is not producing enough breastmilk or if the baby asks for feeds more frequently or cries a lot. What you should do is put your child more often at your breast. Increased suckling frequently will increase “prolactin” production and in turn increase your milk supply. Also, avoid tension which inhibits the milk flow.
Q. I have pain in the nipples while feeding the baby.What should I do?
- The cause of pain, probably is that your baby is suckling in an incorrect position. If the baby is suckling only at the nipple, it causes sore nipple, which is painful. The treatment is to feed your baby in the correct position. Once your baby starts suckling in the correct position, pain will immediately disappear. Applying any cream or lotion is not recommended. You can put few drops of your own breastmilk over the damaged area and allow it to dry.
Q. My baby is passing frequent loose stools.Do I need to worry?
- An exclusively breastfedbaby sometimes passes frequent loose stools. It is normal.
Q. I am sick, can I still breastfeed my baby?
- Yes. You can continue breastfeeding even if you are sick. Most of the diseases do not affect the baby even typhoid, malaria, tuberculosis, jaundice or leprosy don’t call for stopping breastfeeding.
Q. I am taking medicines.Can I continue breastfeeding my baby?
- Yes. Most commonly used drugs don’t cause any harm to babies For further advice consult your doctor.
Q. Should washing the breast before and after each feed be done ?
- No. Daily bathing is all that is required. Avoid applying soap on your nipples. Frequent washing or cleaning of the breast is likely to remove the antibacterial lubricating oil produced by the special glands present in the areola.
Q. Some of my friends give fruit juices and soups during early months of life. My baby is 3 months old.Should I start giving these to my baby?
- No. From birth till 6 months your child should be given only breastmilk. Any other food or drink given may be harmful for your child and also increases his chances of getting diarrhoea. Giving these would deprive your baby of adequate amount of breastmilk.
Q. I want to start bottlefeeding so that baby does not refuse to accept it later. What do you think?
- There is no need to give bottlefeeding and it should be avoided. If necessary, child can take milk from a cup.Even atfer six months if needed your child should be fed with a cup and a spoon.Bottle feeding is not necessary.
Q. What is the harm of using one bottle-feed a day when I am boiling the bottles carefully?
- Starting bottlefeed leads to three major problems
- Baby starts refusing the breast due to nipple confusion.
- It will reduce your own milk supply.
- The baby becomes more prone to infections because of bottle. Inspite of boiling the bottle the chances of infection are higher in the babies who are bottlefed than who are not given bottles.
Q. In case I need to give artificial milk, how should I give?
- If the baby has to be given artificial milk it should be given with a cup or a spoon and not with a bottle. Any mistake in the process of preparing a bottle-feed can lead to infections.
Q. Does smoking affect my milk and my baby?
- Yes. Smoking can reduce your milk supply. It may also make your child more prone to respiratory infections and asthma.
Q. Some mothers give fruit juices and soups during early months of life. Is it advisable?
No. From birth upto about 6 months a child should be given only breastmilk. Any other thing may be harmful. Giving these would deprive the baby adequate amount of breastmilk and also increases chances of getting diarrhoea.
Q.Most mothers use gripe water and/or Ghutti,-is it desirable?
No. Use of Ghutti and gripe water is an unscientific practice. it is better not to use them. These preparations sometimes contain medications that may induce sleep that is not natural. Also babies should not be given what is not desirable.
Q. Does my baby need vitamins?
Usually not. A baby who is only breastfed for first 6 months does not need tonics or vitamins. Bottle fed babies however may need vitamins. Ask your doctor, he may be the best judge in this case.
Q. My baby is passing frequent loose stools, do I worry?
An exclusively breastfed baby passes frequent, some what loose stools. It is normal. However the baby should be passing urine as frequently should not be given anything other than breastmilk. But if it is bottle fed baby, it is worrying.
Q. My milk leaks from breast after feeding the baby. What should I do?
It is a temporary problem. A little pressure over the breast will stop that. You can put a soft cotton cloth pad inside bra if you are going out doors.
Q. I am taking medicines. Can I continue breastfeeding my baby?
Yes. Most drugs don’t cause any harm to babies. Ask your doctor, he may be the best judge in this case.
Q. I am sick. Can I still breastfeed my baby?
Yes. In case you are sick you can continue breastfeeding. Diseases like typhoid, malaria, tuberculosis, jaundice or leprosy don’t call for stopping breastfeeding.
Q. My milk looks thin and watery. Is it all right?
Yes. Foremilk (at the start of breastfeed) is thin and contains less fat. Hindmilk (near the end of a feed) is thicker and full of fat. A baby needs both. It has a unique quality of changing with the baby’s needs. Feed the baby in an unrestricted fashion to ensure that the baby receives both fore and hindmilk.
Q. I don’t have enough milk, What to do?
Most mothers can produce adequate breastmilk for their babies. If you feel that you don’t have enough milk, you should check the points listed in the correct positioning of the baby during breastfeeding. See if you are following a demand schedule or not.
The feeling of inadequate milk is usually apparent as it comes from the fact that the baby asks for feed more frequently. “My baby keeps on crying after my feed”, “My baby sleeps well after an artificial feed” and “My friend or mother tells me that I don’t have enough milk” are some of the reasons given by the mother. After listening to these problems, a family members, friends or health worker concludes that mother’s milk is inadequate for the baby and he needs a supplementary feed.
What you can do is increase suckling frequency of your baby to increase ‘prolactin’ and thus the milk production. Avoid hurry and be confident.
Most mothers can increase their own milk supply by allowing the baby to suckle more often. “More suckling makes more milk” is true for all mothers. Sign of getting adequate milk supply is the passing of urine 6 times (or more) in 24 hours. You are the best judge of yourself and your baby.
Q. How can I start breastfeeding immediately- It seems difficult in a hospital?
Talk to the staff of the hospital where you are going to deliver the baby about your determination to breastfeed. Ask for the baby to be near you as soon as he is delivered and let the baby remain with you as long as you stay there.
Q. If I have a caesarian section delivery can I breastfeed my baby successfully?
Yes. This operation does not affect the ability of the mother to successfully breastfeed her baby. After a few hours of surgery when you are out of the effects of anesthetic drugs you can manage to keep the baby and start breastfeeding. You can tilt your body to one side in the lying-down position, get in front of the baby with the help of a pillow and start feeding. It is a little difficult in the beginning but most mothers who have C-section deliveries are successful in breastfeeding their babies with assistance for the first few days. You will need practical support from a health worker, relative or a friend.
Q. Can I feed my baby in lying down position?
Yes. You can feed your baby in any position comfortable to you and your baby. It may be lying down, sitting or reclining.
Q. I have pain in the nipples while feeding the baby. What should I do?
One of the most important factors is the baby suckling in an incorrect position. If the baby is suckling only at the nipple, it causes trauma and sore nipples which is painful. The treatment is to feed the baby in the correct position. If breastfeeding, is painful, the baby is in an incorrect position, put your finger in his mouth and break the suction. Then take out the nipple and try again.
Once the baby starts suckling in the correct position, pain will immediately disappear. Feed at frequent intervals. Don’t apply any creams or lotions. It is not recommended. You can take a few drops of your own milk and put it over the damaged area. Allow to dry.
Q. What should do if the breasts are full and firm?
You can have this feeling in case there is delay in feeding the baby or missing breastfeeds. It can be relieved by unrestricted feeding to the baby along with hand expression of milk.
Q. How to prevent breast infection or abscess formation?
Unrestricted feeding in the correct position usually prevents this. But in case sore or cracked nipples develop, and are followed by engorgement, it may lead to swelling, pain and redness on the side of the infection. It is to be treated by the doctor with drugs. If an abscess develops it has to be removed surgically. Mother can continue to breastfeed from the same side even after surgery.
Q. How long can I continue to breastfeed?
You can continue to breastfeed, well into the 2nd year of child’s life. Breastmilk can take care of the milk requirement of baby even during 2nd year.
Q. I want to start bottlefeeding so that baby does not refuse to accept it later-What do you think?
There is no need to start bottlefeeding for this reason. A child can take milk from a cup or glass even when he is as small as a newborn. Bottle is never required by the baby.
Q. What is the harm of using one bottle-feed a day When I am boiling the bottles carefully?
Starting bottlefeeds leads to three major problems
1. Baby starts refusing the breast due to nipple confusion.
2. It will reduces your own milk supply.
3. The Baby becomes more prone to infections even though bottles are boiled because your baby misses protection of your milk. Also, since many things are involved in preparing a bottlefeed e.g. spoon, sugar, sugarpot, milk, bottle, caps, nipple and your own hands, a minor mistake at any step could lead to a major infection.
Despite this, if you must start bottlefeeding we shall advise you to boil all the material for 20-25 minutes. Wash your hands with soap before you handle the bottle. Don’t put your finger into the milk to check its temperature.
Q. My baby is preterm- Can I breastfeed successfully?
Yes. However babies delivered preterm i.e. before completing their gestation are usually small in size and weight. They may not be able to suck. In such circumstances these babies may have to be kept in special care units. Your own breastmilk can be used to feed such a baby. For this you should learn the method of expression of milk by hands. Expressed breastmilk can be given through a tube or with a cup and a spoon. It is always preferable to avoid bottle. When the baby starts sucking he should be allowed to be breastfed.
Q. If I have twin babies- Can I feed both?
Yes. They can be breastfed simultaneously using one breast for each feed and alternating the breasts for next feeds. Breastmilk production is usually sufficient to meet with the requirements of both the babies. If required fresh milk can be used with cup and spoon.
Q. Should I breastfeed from both breasts each time I feed my baby?
Let your baby decide that. Take your hint from him. He may prefer to have milk from one or both breasts at each feed.
Q. Is there any drug that may increase the milk supply?
Yes. Some drugs have been reported to increase supply, But frequent suckling at the breast and avoiding bottle feeding is more important to ensure adequate supply of milk than medicines to increase your milk supply. The medicines have their inherent side effects as well.
Q. Would washing the breast before and after each feed and application of any cream or ointment help in the prevention or treatment of sore or cracked nipples?
No. Daily bathing is all that is required. Avoid applying soap on your nipples. Frequent washing or cleaning of the breast is likely to remove the antibacterial lubricating oil produced by the special glands present on the areola. The application of creams or ointment available in the market for prevention or treatment of sore or cracked nipples may actually make the problem worse.
Q. Exclusive breastfeeding for first 6 months: What does it mean?
Giving only breastmilk to babies during this period without addition of any other supplementary fluid, food or milk is called exclusive breastfeeding.
Mother’s milk is sufficient to meet all the baby’s needs for about 6 months. Recent research has shown that exclusively breastfed babies don’t require water even during very hot season. If a baby is passing urine 6 times during 24 hours it means he is getting enough food & fluids.
Q. In case I need to give artificial milk:
Breastfeeding takes care of the milk requirement of a baby even upto 2 years. These milks are usually not required. If the baby has to be given these milks they should be given with a cup or spoon and not with a bottle. Your baby does not need bottle at any age.