Birth Health Life


Saturday, 27 August 2016

Common Breastfeeding challenges: We Love snacking...and so does your baby!

We love snacking!  So does your baby!!
I am so excited to be going back to the post natal ward this week after my summer hols, and honing my skills at delivering the 11 0 clock Stop information to new parents before they go home with their new baby.  Honestly I have no formal experience of talking to a group of people in this way, and it's a bit daunting sometimes.  I know that it's just like working in the clinic, where at first I used to panic a bit and feel out of my depth and worried about how I could be of useful support to mums, but I just kept going along and practising and learning and eventually I relaxed into the role a bit.  On the post natal ward, the emphasis is on giving the parents information that will get them through the next few days of breastfeeding their baby at home.  If they haven't had much breastfeeding education before having their baby, there can be a lot to take on...sometimes turning a 180 on their assumptions and what they've managed to glean from our bottle feeding culture and the ideas we have about normal baby behaviour.  The trick is to give out useful information without overwhelming them. 

One of the things I always speak about is parents worrying about their baby's milk intake, enough to consider giving an artificial feed. There are three main reasons for this worry, and one of them is frequent feeding. I include in this so-called 'snacking' and non-nutritive suckling. 

Our bottle-feeding culture leads to expectations that the normal pattern for their baby will be a substantial 'feed' every three or four hours, between which times their baby will display the kind of behaviour which will indicate that he or she is full and satisfied. This tends to be 'going down' for a sleep, and be 'settled'.  These are the kind of words parents use when talking with me, to indicate that they feel that their baby is communicating that all is well, and that the mum's milk is satisfying her baby.  The truth of the matter is that babies don't always fall asleep after a feed, aren't always happy with being put in their crib, and don't always take a massive four course meal type feed, but actually they do often want to suckle frequently, without 'settling' or sleeping in between. They may want to feed for shorter periods sometimes. 

 This totally normal behaviour can be perceived by anxious new parents as their baby being 'unsettled' or unsatisfied by the mum's beautiful milk. But this is how breastfeeding works! Babies are just like us and expect to be able to have snacks and drinks frequently...especially in this hot weather! Not every feed is a four course dinner, and sometimes it is about comfort and not food at all...which is totally normal, natural and actually necessary for your baby's physical and psychological health. The proper name for comfort suckling is non-nutritive suckling, and it supports healthy brain development as well as bonding. It is also a really important part of establishing your long-term lactation, which is one of the reasons that you will be advised to not use a pacifier at least in the first six weeks of breastfeeding when everything is being calibrated.  Your breasts need that valuable stimulation that the dummy would be getting instead.

Babies are still programmed to behave pretty much as they were in Stone Age times, expecting to be carried everywhere not ever really 'put down' and able to feed as and when they want, very frequently, for varying lengths of time.  Its our cultural expectations of babies that have changed, mainly due to the introduction of artificial milk.  I do always reassure parents that they can't overfeed their fully breastfed baby, and it's never wrong to feed your baby...he or she will definitely agree!  You always have the reliable indicator of wet and dirty nappies to let you know that sufficient milk is getting into your baby.

Urine output: Wet nappies increase each day. 1 on day 1, 2 on day 2, 3 on day 3, 4 on day 4. From day 5, at least 6 wet, heavy, soaked nappies in 24 hours

Stool output: Day 1 meconium. Day 2 meconium , Day 3 green, Day 4 brown, Day 5 onwards, at least 2 bright yellow stools in 24 hours. (think dijon mustard, korma yellow...sorry!)

What goes in, must come out, and this is how to be reassured that your baby is getting enough milk.

 If you're ever concerned about your baby's frequent feeding, and especially if this concern is accompanied by unsatisfactory weight gain and or reduced urine and stool output, or sore nipples, or mastitis/engorgement/blocked ducts, you need to seek out proper breastfeeding help. If you're in Great Britain, click here to find your local International Board Certified Lactation Consultant.  If you can't afford to pay out to see a Lactation consultant, there's always your midwife in the first 10 days, and local breastfeeding drop in clinics where you will find breastfeeding peer support volunteers like me, Infant Feeding Advisers, Health Visitors, and if your're not in Mid Sussex you may be lucky enough to find a Breastfeeding Counsellor at the drop in, and/or a Lactation Consultant, also called an IBCLC. 

 There are also four national, free helplines where trained, experienced Breastfeeding Counsellors will listen, advise and signpost if necessary. These, and the Breastfeeding Network, are the organisations that train Breastfeeding Counsellors. They are:

La Leche League (you will be put through to someone local to you) 0845 120 2918
National Breastfeeding Helpline 0300 100 0212
NCT 0300 3300 771
Association of Breastfeeding Mothers 0300 330 5453

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