What tips do you have for someone who is attempting to breastfeed for the second time?
Go in with a positive mind. Every baby and pregnancy is different. Talk with your partner and family and chat about how important this is for you and having their support especially in the early days will really make a huge difference. When you are starting out and about having another person with you to have a cup of tea and moral support is really valuable as more often than not the only people who realise you are nursing are mums who are of have nursed and would love to give you a thumbs up and words of encouragement but as a new mum those early out and about feeds fills us with apprehension.
Look back at your early few weeks after the birth of your first baby and reflect would you change anything. Many mums will use this previous experience knowing that the sore and tender nipples are to be expected and that breastfeeding can be painful but that it can be improved with early support and tweaking things. Sometimes you will look back and identify that there was a feeding difficulty with a tongue tie or shallow latch or that you had mastitis, you may have got the support you needed and resolved these problems but it also may have led you to stop breastfeeding earlier than you wanted and this time round with that experience you can seek help and support a lot earlier.
If you had a positive experience and all is well because you had support at the hospital, your baby just knew what to do that is great , however every baby and birth experience is different and you may find second time around you will still need as much support as you did first time round.
Find a local breastfeeding group to go with your toddler whilst you are pregnant, enjoy meeting mums who are there and share your worries and look at how to minimise those early blips with the support of a friendly face and good peers.
You know that those early weeks are really important to help both you and your baby to learn how to breastfeed , so that you get lots of practice and get breastfeeding off to a good start. Ask family and friends to help out before birth if your toddler is attending nursery/ school so that this is one less rush in the morning – plan a rota if this helps.
Be confident, go by your gut mothering instinct, babies have their own biological clock and need a lot of flexibility. Babies can’t read the parenting books, these are current societal trends and you will never spoil your baby or develop bad habits. Babies need to be held, soothed and fed to feel warm safe and secure – knowing mum is there to protect and feed. We’ve done this for thousands of years.
If wanting to do a combination of expressing and direct breastfeeding is there a certain time when I should start? I've heard about waiting a couple of weeks until you attempt to express but is this just hear say?
Breastfeeding and milk supply does take a few weeks to get established and if there are no problems with feeding or unwell baby it is best to wait for around 4 weeks after your baby’s birth to start expressing. This is because you both need to get a lot of practice and your baby will have 2-3 growth spurts around 3 days, and 3 weeks and will have lots and lots of frequent feeds to meet this need. If you are expressing you could limit the available milk or actually contribute to an over supply which brings its own difficulties with engorgement, leakage and potential mastitis.
In the early days you can hand express as your milk comes to volume or use a pump just to soften the breast to help baby latch on , but be cautious not to do this too often.
If you are experiencing feeding difficulties, sleepy baby, jaundiced, tongue tie, engorgement, mastitis and baby unable to effectively remove milk you can support effective breast emptying with expressing after each feed to help with establishing your supply until baby is more alert , and able to feed more effectively. This means that you will have supported you milk production when your baby wasn’t quite there yet. With the support of your midwife you can discuss this further.
Ideally wait until 4 weeks and you may find a routine of every alternate day or a similar time daily for you to express. Start with only pumping one breast just in case little one wakes earlier than expected and once you get to understand your baby’s feeding routine and frequency you can tweak it to when it suits you both.
What are fool proof ways to boost supply?
Unfortunately there are no fool proof ways but getting it initiated well in the first few days after birth really makes a huge difference. Your breast milk cells are activated with the birth process and that first week of milk coming to volume gives each of these individual milk sacs the blueprint for your supply, production and storage capacity.
Rather than wait, start as you mean to go on. Frequent feeds every 2-3 hours and effective breast emptying as the more you drain the more milk you make. We look at milk volumes over a 24 hour period and some mums have a smaller storage capacity but feed 12-16 times a day and produce volumes > 700mls a day and other mums make as much milk but with less frequent feeds. What is normal is a great fact sheet to assist mums to understand the ranges of milk production per feeds and per day when babies are well , developing and growing.
If things are slowing down you can boost milk production by increasing the feeding frequency to 2-3 hours during the day. If you are night nursing no longer than 4 hrs if production is a little slow – so increase night feeds or reintroduce if these have stopped. If your baby isn’t interested in the other breast you can express at the same time, and pump after each feed to take any additional available milk to help with that breast emptying. If you are combining breast and bottle feeding it could have an effect even if its expressed milk in a bottle – some babies experience nipple teat confusion with a conventional teat and modify their sucking so that they get a little lost at the breast, or if you are using formula they are missing the opportunity to breastfeed and your body will down regulate your milk supply if you are not emptying the breasts as frequently.
The usual tips are always important:
· Good latch and comfortable positioning
· If it doesn’t feel right – seek help and support early
· Keep a feed diary – jot down time and length of feed, look and listen for lots of sucking and swallowing of milk, jot down what the nappies are - lots of heavy wet nappies and stools that are soft yellow mustard are indicators of lots of milk and good hydration.
· Have your baby weight length and head circumference jotted occasionally – there is no need for going to baby clinic every few weeks unless your health visitor advises you – babies grow at different rates and a steady weight with lots of wet nappies and a baby that is alert and happy is fine
· Soft breasts don’t indicate a reduced milk volume – its just that you make what your baby needs after 4-6 weeks many mums don’t have that fullness
· Eat and drink regularly, rest when you can and if you are tired and exhausted your body needs time to recuperate – delegate ironing and household chores to family, plan and freeze meals in batches, have lots of little mini nutritious snacks, and drink what your body needs – minimise the caffeine, diet and soft drinks and opt for water
· Sleep – even though you are waking for night feeds those breast feeding hormones provide you with deeper sleep to help you repair and refresh.
· If dad is giving expressed milk in a bottle pump at the same time so you regularly empty the breast and avoid huge gaps between feeds which may lead to engorgement and down regulation of your supply over time.
· If you are experiencing low supply – and this is confirmed by your health professional
o Increase feeding frequency
o Check the latch and positions
o Express if baby not feedingo You can take a galactogogue with the advice of your breastfeeding specialist and GP , there are some herbal remedies but these do need to be taken with a consultation.
Do you have any breastfeeding stories you would like to share with me?
- Wrote in partnership with Medela