A wife of noble character who can find?...She speaks with wisdom and faithful instruction is on her tongue...Her children arise and call her blessed; her husband also, and he praises her. Proverbs 31:10, 26 & 28

Wednesday, November 9, 2011

Breastfeeding: The Nitty Gritty (or: why I think I have never had mastitis)

I've decided to keep the breastfeeding theme going. If you're a guy reading this I'll probably get a little personal so you might want to stop reading this post now.

Either I've got really good genes or was given some great advice when I was new to breastfeeding. I think it was more the advice so I thought I'd share that advice here.

Firstly I'd like to say that I am NOT a lactation consultant and if you really need advice and are having problems you NEED to talk to one. In Australia we have the Australian Breastfeeding Association that you can ring. I'm only passing on the information that I've learned on my breastfeeding journey.

Of course it hasn't always been a smooth road but really the only times I've had trouble while breastfeeding is when I've been too tired to pay too much attention to how well the baby has latched on. The first thing that you need to learn is how to latch the baby on to your breast properly. Don't be afraid to ask the nurses in hospital to help you until you feel you've got it down to a fine art. You're only in there with their experience for a short amount of time. With my second child I would call someone in every time I felt he needed a feed and get the nurse to help me get him to latch on. With my newborn I make sure I'm sitting up nice and straight and comfortable, the baby is normally resting on a pillow on my lap. This allows me to use both my hands to position the baby's head and my breast. I'll normally hold the baby's head in one hand and my breast in the other, then I tickle their mouth with the nipple and when their mouth is wide open pretty much shove them on (very descriptive, I know). Make sure their bottom lip is near the edge of your areola, this should mean that your nipple is in far enough.

More often than not even if you don't get cracked nipples, or mastitis, you may still get grazes or just be sore. I don't really recommend using anything except breast milk on your nipples as the idea is to keep them as dry as possible in between feeds and most products out there have harmful ingredients in them. When I first started having children the big thing was putting lanolin on your nipples to moisturise them and yes it might have been 'natural' but the sheep the lanolin came from were dipped in chemicals so there was every chance that these chemicals were in the lanolin. Anyway I think if you keep them dry enough in between feeds, changing your nursing pads when they get wet from leakage, you can do without these moisturisers. Plus do you really want your baby swallowing these with their feed? There's even no need to wash your nipples with anything special, just water will do. This will keep them as natural as possible for your baby.

So you think you've gotten the whole breastfeeding thing down pat and then your milk 'comes in'. What joy! (only kidding). It can be quite a shock when you're new to this, and these days they send you home from hospital before your milk comes in and if you do not have a good support system with good advice in place you may be at a loss. This is where most new mums get into trouble, they're milk supply is in excess of their baby's needs and the breasts aren't getting drained enough. There are a few things that you can do to help with this until things settle down, that won't affect your milk supply.

I've mentioned in a previous post that I have never used a breast pump. I'm not against them, I just never needed to, but I have hand expressed. When you're full to bursting and you're baby is already satisfied and it's no good trying to make them drink more hand expressing will give you some relief. Position your thumb above your nipple, on you areola and two fingers under and gently press. You won't get anything squeezing your nipple, it needs to be the areola. You can express into a sterilized container and keep it for baby or into a cloth nappy or rag, I've even heard of someone expressing straight into the bath to be washed away.

Change baby's position when you feed him or her. Where the baby's chin is is where your breast gets drained the most so it's useful getting comfortable with other feeding positions such as the football hold and laying down. Just make sure that the baby's chin is towards the sore part of your breast. Also as you feed gently rub your breast towards the nipple. This will help dislodge any blockages that might be building up and help with the release of milk from that part of your breast.

I don't hear this technique very often and it can be misused and start to dry up your milk but it can be useful for really engorged breasts if you use it the right way. That is cabbage leaves. You only need to use a part of a clean leaf tucked into your bra against the sore part of your breast. Don't leave it there for long and don't use this too often as you don't want it to affect your milk supply. This is more for if the other techniques just aren't doing their job and I would suggest that you get more professional advice than mine before trying this technique. I don't know the science behind this, though I am sure that you could find out if you googled it, but it does work.

When your milk first comes in it may feel like it will stay that way forever but it will soon sort itself out as your body comes to learn how much milk your baby needs.

Make sure that each breast is drained before moving onto the next one. I remember being told to feed 10 mins on one side and then 10 mins on the other. This is BAD advice! I only feed on one side per feed and if the baby falls asleep before I think he or she has finished and wants more a 1/2 hour later I'll offer the same breast back. This will make sure that the baby has had the more filling hind milk and not just the fore milk and will make sure that your breast is drained, leaving less of an opportunity for blocked ducts. If you have a problem remembering which breast you fed the baby on last, which is a reality for a sleep deprived new mum, I keep a clean tissue in the bra cup that I did not feed the baby on. This tissue is not replacing the nursing pad but just tucked in as a reminder that I did not feed the baby on that side. On the other hand if you think that baby has drained that particular breast but is still looking for more then do change sides (this especially happens when baby is having a growth spurt or you haven't rested enough or drunk enough water), don't forget to offer the second breast first for the next feed.

I've probably left a lot of other information out but the Australian Breastfeeding Association has a great informative website and if that doesn't have the information you're after I highly recommend that you ring one of their Lactation Consultants.

1 comment:

Jen's Busy Days said...

Mastitis and blocked ducts was one of the reason I tandem fed. My first helped to drain me fully when his little brother who was a reflux type kid wouldn't feed well.

I did end up with mastitis pretty bad a couple of times when the second was the older child of the two I was feeding. Obviously he wasn't a good "drainer".

When the third was the older child of the two feeding I managed to avoid bad mastitis. TG!

In my case stress, tight clothes or bra not well fitting, a bump from an overactive toddler or me not eating well were also factors in my cases of mastitis.

Something I feel that was very important too when breastfeeding is to drink a glass of water every time the baby fed and have a healthy snack. I had a fig with pecan slice that I loved. It had rolled oats in it and was so filling.

Hope all is going well.

Best wishes
Jen in NSW