Breastfeeding is something not many mums are prepared for during pregnancy. Women are told breastfeeding is natural – but that doesn’t mean it comes naturally. It is a learned skill; and the better prepared you are for it, the higher your chances of success.
I sat down for a chat with lactation consultant Elisabeth Aichinger to ask her for some tips every mum should know about. These are her recommendations:
Connect with a local breastfeeding counsellor while you’re still pregnant
According to Elisabeth, it’s a widespread problem that women are not given enough information about breastfeeding prior to the birth of their babies. “Only when the baby is already born and mum is struggling with breastfeeding she’s given the number of a lactation consultant – but by then it’s too late”, she says.
It’s very important to find a contact person during pregnancy, not after you’ve given birth, says Elisabeth. “I think when there are problems, when breastfeeding is painful, one of the most helpful things is if they already have a connection to a person who knows about breastfeeding, so that they don’t have to search for somebody, because contacting somebody you don’t know and you have never spoken to is a step a lot of mums don’t do. It’s easier for them to contact someone that they already know.”
It can be painful at the beginning
In the first few days breastfeeding can be really hard, and mums are not always prepared for that. “Many women don’t think that it could be so hard, and in my opinion lots of them give up very quickly”, says Elisabeth. “But if you really want to you will make it. It will work, but it could take some time. You shouldn’t give up too early. You should give your body and your baby a little bit of time, even if it’s painful. And if it’s painful, don’t wait to contact your breastfeeding counsellor. Contact the counsellor immediately if something is not going well.”
Feeding on demand is best
It’s normal for breastfed babies to feed often. They don’t just get hungry every two hours; hourly feedings are also normal. Feeding on demand (whenever the baby wants to feed) is best – but depending on who you speak to, and what training your health care professionals had, you might be told otherwise. According to Elisabeth, it happens that some midwives who don’t have special training in breastfeeding tell the mum “don’t feed too often”. After all, a few decades ago that was the official advice.
Nowadays all breastfeeding professionals will know that feeding on demand is best; but some doctors or nurses in the hospital who were never trained in breastfeeding might give mums different advice. “There could be someone coming into the room telling the mum ‘how are you breastfeeding, it will not work like that’ simply because this person has no special training in breastfeeding and they just don’t know”. When in doubt, it’s important to take advice from the relevant professionals – and when it comes to breastfeeding this is a lactation consultant or breastfeeding counsellor.
Feeding on demand is not only best for the baby, but it will also help you boost your milk supply. In Elisabeth’s experience, many mums who give up breastfeeding say they didn’t have enough milk – but she believes the real reason is that they didn’t have enough support to know how they can boost their milk supply. “If you only look at the clock and say ‘no, it hasn’t been two hours since you last breastfed, you should wait a little bit’, if you do this for a few days you won’t have enough milk. Perhaps during a growth spurt, when the baby is growing, they drink more because they need more milk. And this helps the breast make enough milk for the next feed. But if you look at the clock and say ‘oh no, you shouldn’t feed yet, it’s not time yet, we have to wait a little bit’ then the milk supply will not grow. You won’t have enough milk. I think this is one of the main problems.”
Stress is bad for breastfeeding
Ideally, the first 2-3 weeks after giving birth mums should rest in bed with the baby, says Elisabeth. “They should prepare that the first 2-3 weeks at home they don’t have to do anything, except staying at home with the baby and the dad, the three of them together and nobody else. Maybe someone who brings them food. Stay at home doing nothing except breastfeeding the baby, cuddling the baby, staying in bed with the baby. And that’s the best possible start.”
Try not to have too many visitors in the first few weeks. According to Elisabeth, nobody should come to visit a new family every day, except people who are there to help you. “Anything that makes stress is not good for breastfeeding – and when many family members come to visit that’s stress. You have to put a bra on, you have to do your hair, breastfeeding in front of your father-in-law, perhaps all the dirty clothes are laying around, you have to clean the house; it’s all stress. You should have no stress. Perhaps someone who is cooking for you or does the laundry can come, but the mum should only be there for the baby for the first 2-3 weeks.”
How can you tell if the baby gets enough milk
The easiest way to decide is to have a look at the nappy. As Elisabeth explains, healthy babies born full term and exclusively breastfed need to have a minimum of six wet nappies in 24 hours. “That’s one thing every mother can have a look at, six full wet nappies is the minimum. It can be more; but if there aren’t six full nappies, we have to have a look what’s going on. What can the mother do, how can the baby drink more often, is the baby attached well; a consultant needs to have a look what’s going on.”
As for dirty nappies, there are many possibilities with breastfed babies. The wet nappy is the most important thing with a minimum of six a day; but poo could be ranging from a few times a day, to only once in a few days. “There’s a wide range of possibilities of how the nappy could be, but at least one poo every 10-12 days minimum. But three times a day is also normal. But this is only for fully breastfed babies. If they get formula they have to have poo every day or every other day at least. So there’s a difference.”
There are also weight curves the baby has to reach, but there are many different kinds of curves, so weight gain is not the only indicator. As to how often babies should be weighed, Elisabeth recommends once a week, if the baby is otherwise healthy. “In the hospital babies will be weighed daily, but once you’re home weekly is enough for the first few months if we’re talking about a healthy baby. Later, even every 2-3 weeks is enough.”
Some people recommend weighing the baby before and after each feed, but Elisabeth advises against that. “That’s not a good way, and it’s very stressful. What if you change the nappy, the weight will change straightaway. It’s not good to check the weight every day either. I would say once a week. And if the baby is not growing enough then twice a week, but not more. This applies to babies who were born full term, healthy weight, healthy babies. Premature babies are different of course, you need to look at other indicators as well.”
Another thing you can check is whether the baby is swallowing. Sometimes the baby is only suckling, but not swallowing; and mum needs to check, because suckling doesn’t mean drinking. Apart from that, the baby has to have a good skin tone, look happy, perhaps fall asleep right after breastfeeding meaning they’re satisfied, perhaps some milk comes out of their mouth meaning their tummy is totally full. These are all signs that the baby is getting enough milk.
Dads can support mums
Dads should know that they can support mums. They can also learn about what’s normal and what’s not. Current breastfeeding advice is different from what it was a few decades ago; so for example, if everyone around them says what mum is doing is wrong, then the husband can support the mum and tell her she’s doing everything right. “If mum always gets told that she’s doing something wrong, and dad says ‘my mum also said you’re doing something wrong’, then mum is not going to breastfeed for long.”
Breastfeeding is a big responsibility, and for some women it can feel too much. “In our culture it is not so common that a woman is responsible for someone 24/7, and this is hard to learn”, says Elisabeth. “And for some women this is the point they’d like to go away. They would like to go back to work, or go to the hairdresser, or go shopping; which is also normal. But there can be ways where you can do both. You can pump a little bit and give it to the baby from a bottle. But of course this is not easy, you have to organise, you need to think ‘when will I pump, how much do I need to pump, where will I store it’, and the partner has to warm it up, so it’s not so easy as making a bottle from formula that you buy in store.” This is where the support of the partner becomes very important.
To summarise, prepare for breastfeeding in advance while you’re still pregnant, be realistic about what to expect, and familiarise yourself with local support available in your area – these things together will put you on the right path to successful breastfeeding.
Thank you Elisabeth for sharing these tips with us! ❤