PRACTICAL BREASTFEEDING TIPS
We continue Breastfeeding week with Practical Breastfeeding tips out of the pen of Jannike Vlok, Registered Dietitian:
In this section we focus our discussion on the practical implementation of breastfeeding< starting from initiation to expressing milk.
The initiation1:
- Start breastfeeding within 1 hour of giving birth1,3
- Remain in skin-to-skin contact with your baby until the first feed is accomplished
- The first milk available after birth is called Colostrum; it is higher in protein than mature milk that develops later
- Within 48-96 hours after birth your breast will become fuller and firmer as the breast milk volume increases
- Practice, patience and perseverance!!!!
10 Step to practical breastfeeding technique1:
1. Find a comfortable position
2. Support with your hand the lower position of the baby’s head, neck and shoulders
3. Keep the baby close to your body
4. Make sure the baby’s arm is not between you, but is stretched towards your back
5. Align the baby’s nose opposite from your nipple
6. When the mouth opens wide, bring the baby’s body to the breast; aiming the nipple to the back of the baby’s mouth
7. The chin should indent the breast and the nose may touch the breast
8. Feeding time should not be limited
9. To remove the baby from the breast: Place your finger in the corner of the baby’s mouth until suction in broken à it will prevent nipple trauma
How often to feed1:
- On demand(whenever the baby wants to drink) or when showing feeding readiness by lip smacking, rooting, sucking movements of the mouth1,3
- Feed your baby 8-12 times per day (every 3 hours), day and night1,3
- Establishing a routine will support the baby to follow the routine of sleeping and drinking patterns
- Feed at least 20-30 minutes on the same breast and alternate the breast for feeding at the next feeding time
- Remember feeding time is the time mother and baby interacts and bonds!!
Breastfeed exclusively:
- Breastfeed the baby without giving the baby anything else to drink or eat (exclusively); for the first six months1,3
- Do not give the baby water, animal milk, tea, baby formula or porridge1,3
- It contains all the food and water that the baby needs, even on a very hot day3
- Do not give the baby feeding bottles or dummies1,3
When you are away from your baby:3
- Express your breast milk by hand:
o Cup your breast with the palm of your hand
o Then place your thumb just above your nipple
o Compress and release the nipple until milk begins to flow
o Do this for about 5 minutes or until the milk flow stops, on each breast
o Then go back and repeat again
o Collect your milk in a sterile container, remembering to label it with the date and time
- Express your breast milk by using a pump:
o Sterilise all parts of your breast pump before each use
o Assemble the pump according to the manufacturer's instructions
o Start to express slowly at first, ensuring that the pump is in the correct position and comfortable
o Pump for 5 minutes or until the milk flow stops on each breast
o Repeat the cycle again on both breasts
o Collect your milk in a sterile container, remembering to label it with the date and time
- Storage of breast milk:4
Breast milk | Room temperature | Refrigerator | Freezer |
Freshly expressed into a closed container | · 6-8 hours at less than 26⁰C If refrigeration is available store milk there | · 3-5 days at 4⁰C · Store in back of refrigerator where it is coldest · For the hospitalized baby – 2days | · 2 weeks in the freezer compartment inside a refrigerator · 3 months in freezer section of refrigerator with separate door · 6-12 months in deep freezer at -18⁰C |
Previously frozen and thawed in refrigerator (but NOT warmed) | 4 hours or less | Store in refrigerator for 24 hours (if milk has not been warmed) | DO NOT refreeze |
Previously frozen and thawed outside of the refrigerator (but warmed) | Only for this feeding | 4 hours or less | DO NOT refreeze |
Infant has begun feeding | Only for this feeding then discard | Discard | DO NOT refreeze |
- If someone else will feed the baby, a cup should be used and not a bottle:
When can a mom NOT breastfeed, when infant formulas are indicated2:
- Infants with Galactosemia(is a rare genetic metabolic disorder that affects an individual's ability to metabolize the sugar galactose [present in breast milk] properly) - Mother with active untreated tuberculosis
- Mother taking certain medications:
o Anti-metabolites
o On chemotherapy or chemotherapeutic agents
- There are medical conditions where infants need specialised commercial formula. Before any decision is made to use a commercial formula, a health care provider should be consulted for advice:5
o Breast milk fortifier for low birth weight infants
o Infant formula for low birth weight infants
o Soy protein based commercial formula
o Anti-reflux commercial formula
o Semi-elemental commercial formula
I hope you have learned a few new things on breastfeeding. Remember if you won’t be using the information just jet; be sure to pass it on to a friend (who will certainly benefit from it).
References:
1. Mahan L.K and Escott Stump S. Krause’s Food and Nutrition Therapy. 12th Ed. Saunders Elsevier: Canada; 2008
3. Department of Health, South Africa. Mother, child health and nutrition booklet. 2008
4. National Health and Medical Research Council (NHMRC - Australia). Guidelines for infant feeding. 2003
