Breastfeeding // My Breastfeeding Hopes & Fears (with Baby #2)

Those of you who have been long-time Make, Do & Push! Readers may remember that my breastfeeding journey with Busby was a short-lived, frustrating, tense period of time, which ended before it had really begun. I’ve always felt disappointed that I didn’t breastfeed for longer; I was in so much pain (bleeding nipples etc) and had such a daily difference of opinion and care, that in the end switching fully to bottle feeding seemed the best solution for both my sanity and for Busby’s health.

This time round I’m more determined to make breastfeeding work for us. I definitely feel more prepared; I know what to expect and I know it probably won’t be a breeze, as I thought it should be last time. However, I also know that if it doesn’t work out then that’s fine too – Busby is an intelligent, thriving Toddler who certainly hasn’t suffered from only being breastfed for a month!

I would love to be able to breastfeed for longer, to be able to have the confidence to feed Peppercorn in public (which should be considerably easier this time round as it will be June, rather than December/January, so less clothes!) and to be able to crack this breastfeeding malarkey and feel proud of myself for doing so.

I’m overjoyed to announce that I will be working with fantastic, breastfeeding product manufacturers Medela during my postpartum period. Thankfully, and very luckily, working with Medela means that I’ve been able to ask their fantastic Lactation Consultant, Sioned, some questions that have been bothering me – I hope these will also be useful for other Mamas out there:

1) I suffered from problems breastfeeding with my first child – my nipples cracked and bled a lot, and I had issues with milk supply – which resulted in me combination feeding, and finally stopping breastfeeding a month into Motherhood. How would you recommend for me (and other Mums) to help control the worry that something similar might occur this time too? And does worry/anxiety affect milk supply?

“It is normal to be a little apprehensive whether it’s your first or second baby. Every pregnancy and baby is different and just because last time you had some difficulties it doesn’t mean that this time you will find the same challenges. Your previous experience is valuable and great that you are already thinking ahead to be prepared and positive.

Start now, find out where your local support group is and go along to a drop in group to meet other mums – I’m sure you will get a very warm welcome and great tips from the mums and the midwives and peer supporters to help you. Best beginnings DVD and the NHS leaflet off to the best start also gives you tips about what to expect and what a good latch should look and feel like so get your hands on this to read and watch at your convenience.

When baby is born start with skin to skin for as long as you both want. To begin with your baby’s tummy is very small and you only produce small amounts of colostrum. The more you feed the more both of you practice and it’s great to have the help at hand if you need a little assistance with positioning and checking the latch.

Latching on well is key to good milk removal and this is how a good supply is established with effective drainage of the breast milk. Lots of feeds 8-16 feeds is normal for the first few weeks as your milk supply comes to volume, it changes from colostrum to mature milk.

If it hurts then take baby off and try again.

If little one is a little sleepy your midwife will show you how to hand express and get you established on a breastpump if Little One isn’t feeding well to help bring your milk to volume. This is important to discuss with your midwife if baby is sleepy, jaundiced, nappies are dry or if you are worried.

Yes, worry and stress does affect how breastfeeding works, adrenaline inhibits the oxytocin response so having positive thoughts is one way of reducing this, apprehension and pain can stop the milk let down reflex from triggering so it is important to relax. Having support is essential to making breastfeeding easier so take your mum, mother in law , your partner along to groups, it may help to get some of their questions answered too so that they are giving you advice that us current and consistent.”

2) What top tips do you have for increasing milk supply?

“It starts in the antenatal period when your breasts start to change in preparation of making the milk cells and ductal network. Some mums find early breast changes, other later and some very little breast changes.

The key to establishing a good supply is to get it right in the first week after baby is born. This is the critical window where the milk cells are activated by a drop in the pregnancy hormones with the delivery of the baby and placenta and this switches on the breastfeeding hormones oxytocin and prolactin. A few tips:
– getting off to a good start is key
– find a good support group and drop in before baby arrives to chat about your worries
– Get your baby to latch on well – if it hurts take baby off and try again
– lots of skin to skin time and cuddles with your baby
– feed to your baby’s feeding cues so lots of nursing opportunities
– in the early days it is normal for your baby to feed frequently every 1-3 hours night and day.
– night feeds are essential so no longer than 4-5 hrs between feeds at night.

What you are doing in this first week is give your breast the recipe for making milk and your breastmilk storage capacity long term so have a breastfeeding honeymoon and put all the other things on hold for a few weeks.

It is normal after 4-6 weeks for the breasts to feel soft and this doesn’t mean that your milk supply changes it just means that you have finely tuned your supply to meet your baby’s needs rather than feel uncomfortable and full a lot of the time.

If you feel supply is dipping:
– keep a feed diary and note how often and how your baby feeds, one or both breasts , night feeds, use of a dummy etc.
– every time your baby cries and shows feeding cues feed rather than put the dummy in
– increase the frequency of feeds
– wake baby up for feeds
– night feeds are important so wake baby or express
– if baby is only taking one breast express off both to stimulate the milk and drain the breast well.
– check your latch and seek advice
– try not to worry stress will inhibit your milk letdown reflex so will stop milk from flowing, try breast massage before feeding/ expressing. Smell an item of your baby’s clothing as your brain sensory receptors will pick these up, have your baby close, nurse and wear your baby in a sling.”

3) What remedies would you recommend for sore, cracked nipples? Is there any way I can prepare my breasts prior to the baby arriving?

“Unfortunately there is no way to prepare your breasts before baby arrives in relation to minimising sore nipples. Your nipples are similar to your lips and if you think that when the lips are exposed to the environment – cold, wind and heat they become dry, sore and we lick them more stripping the natural moisturiser. The same is with the nipples when you start to breastfeed.

Good breast health is important; having a daily shower and minimise using soaps that may dry the skin.

The Montgomery glands secrete the moisturiser to keep nipples soft but as baby feeds frequently this sometimes isn’t enough. What is amazing is that human milk has anti-infective properties that help keep natures balance of good bacteria to keep the breast healthy; it also contains antibodies and growth factors to help with healing. So applying a little expressed milk onto the nipple is a good thing to do.

You may also choose to use a nipple cream such as PureLan that is hypoallergenic and safe to ingest by the baby so that you don’t have to remove and wash the nipple before feeding. Use this after every feed and will also help with healing and moisturising the nipple.”
Hannah