My article is addressed to those who want to breastfeed their baby. And especially for those who are afraid of making mistakes or have bad experiences with older children.
I'll start with a short story about myself.
My little son was born full-term, on time, however, the birth was not quite ordinary for our time - without pain relief and stimulation. I gave birth with my husband.
I didn’t prepare my breasts before giving birth.
No, don’t think that you didn’t know how. But all the girlfriends unanimously argued that these procedures were of little use.
My son was put to the breast about 30 minutes after birth. There was almost no colostrum. On the second day, in the evening, the nipples were “gnawed” into blood, the babies’ gums were strong. The baby could not grasp the breast correctly (the breasts had enlarged during pregnancy, and the nipples were small and inverted), the medical staff just shrugged their hands - teach them to grasp the nipple correctly... The nurse held a corner of a terry towel in her teeth so as not to scream in pain (childbirth compared to it was just a rough walk).
On the third day they warned me that milk should come and told me not to drink too much. But the milk did not appear. Feeding was very painful. They started feeding the baby with formula in the maternity hospital, despite my indignation.
On the fourth day I was discharged. The baby is screaming from hunger, there is amber-colored colostrum in the chest, even droplets, breasts with sore nipples, soft, the milk has not arrived. We bought silicone nipple covers. The baby didn’t like it right away, not the mother after all. But I felt a little better.
The “compassionate” grandmothers lamented that we would starve the baby to death, and bought formula. I steadfastly defended my point of view: I want to breastfeed and nothing more. You have no idea what I heard a lot in response.
The visiting nurse came. She stated the fact that there was no milk, advised to feed “on demand, but no more than once every 3 hours”, to pump the breast after each feeding until the last drop, to feed for no more than 20 minutes at a time, and generally switch to artificial feeding. However, I still didn’t understand how to combine it all. We are fighting. Before each feeding I massage (see appendix).
Day seven - hurray, the milk has arrived. We did it. We did it. We eat every one and a half to two hours. At night - three or four times. Thinking about sleeping together. In the first month the baby gained 1400 g.
The baby is a month old and screams after feedings. Everything suggested by the doctor does not give results. It turned out to be dysbacteriosis (something tells me that this is the result of supplementary feeding in the maternity hospital). This made some adjustments to the feeding schedule. We eat five to six times a day, one feeding lasts one and a half to two hours (total: 10-12 hours a day I lie with the baby hanging from the boob). We are being treated. We gain weight: in the second month 1300 g, in the third 1000 g (for those who don’t know, with dysbacteriosis, babies gain weight very poorly).
At the age of three months and a week, a lactation crisis began (read about it below), and it dragged on for a very long time. At four months they started giving him juice, at four and a half - soup. In the fourth month, weight gain was 300 g. And I was alarmed, and for good reason, it turned out that we were expecting a second child.
Despite all the doctors’ prohibitions, I didn’t stop feeding, I reasoned that if I carried to 7 weeks and fed 6-8 times a day for an hour and a half, then the threat would be less, I just decided to reduce the number of feedings to 4-5.
At the age of 5 months, we switched to mixed feeding: mother, soup, porridge, fruit puree. At six months they started replacing one feeding with formula. At 9 months, the baby suckled 2-3 times a day before bedtime. In the evening they gave me the formula, ate my mother and went to sleep, and in the morning at 4 o'clock they ate my mother again.
At 11 months (seventh month of pregnancy) they threatened to put me in confinement with the threat of premature birth. I refused the hospital. But, unfortunately, we had to sacrifice feedings. I simply explained to my smart boy that mom no longer had milk.
I stopped feeding my son when he was 11 months and 8 days old. During this time, I did not pump my breasts even once.
When Vanyushka was just over a year old, a daughter was born. The milk arrived on time and in large quantities, I didn’t even know that there could be so much of it. The nipples, despite recent feedings (about two months had passed), were cracked again, but I already knew what to do. Under no circumstances did she let me feed the baby.
The breasts were expressed until the tension was relieved and no more, only between feedings, or immediately before feeding, so that the baby would not choke on milk from an excess of milk. It turned out that this happens too. To my regret, during the break my son forgot how to suck his mother, he and I cried together, he applied himself to the breast and waited for the milk to flow...
Until six months, my daughter ate only her mother and she steadfastly ignored all my attempts to introduce at least some complementary foods (soup). We ate often: every one and a half to two hours in the first 2 months (and at night too), then less often, but most of all the baby loved night feedings, and until the last day of feedings at night we ate 8 (eight) times.
By six months, daytime feedings became more rare - every three to three and a half hours. At six months they started introducing complementary foods, soup, then porridge, etc. When the baby was 9 months old, I left for a session. I first strained the milk and froze it in the freezer. Unfortunately, my absences were quite frequent, although not long. When traveling, I pumped 3-4 times a day to maintain milk production.
When my daughter was ten and a half months old, I left again for 3 days, leaving behind a supply of milk. And when she returned, the baby did not want to breastfeed. This time there were grandmothers with her, who fed the bunny with my milk, but from a bottle with a nipple... Deciding not to torture the child with a spoon and a silicone sippy cup...
I stopped feeding my daughter when there was only a week left until she was 11 months old. There was a lot of milk. Read about how I managed to finish lactation painlessly in the appendix.
That's the whole story. Despite the fact that I fed both children only until they were 11 months old, I consider my feeding experience successful. I have learned and understood a lot and want to share my thoughts with you.
And now we have reached the most important thing. In order not to be unfounded, I present here WHO recommendations on breastfeeding. In the future I will repeatedly refer to them and refer to them.
My observations and thoughts about breastfeeding
- There is no need to prepare your breasts for feeding. All recommendations boil down to placing hard fabric in the bra, shower massage, and tugging and kneading the nipples. Any manipulation of the nipple reflexively causes the production of oxytocin and contraction of the muscles of the uterus, which can trigger premature birth. I'm not kidding. And to put a hard cloth under it - well, I don’t know, but what if irritation or inflammation occurs? Do you need this? After all, look around: have you seen a cat wearing a bra with rags or tugging at its nipples? If you have a flat or inverted nipple, it’s not a problem. First, your baby may learn to latch wonderfully from the start, and over time the nipple will stretch out a little. Secondly, you can use silicone pads, they were developed specifically for women with such special breasts. I had small inverted nipples. I used the pads constantly for a month, then slowly weaned off. At the beginning, she gave the breast while it was full, without a pad, then, when sucking became more difficult, she put on a pad, giving more and more bare breasts every day. I used the pads with both children.
- Human milk is not like cow's milk. You've probably read about the composition. I'm talking about color. You can’t imagine how many times I’ve heard from mothers that my child doesn’t get enough to eat—my milk looks like it’s diluted, not white, but blue. Dear, dear mothers, you are not cows. Your milk does not contain casein, which is what makes cow's milk white. Women's milk is divided into two types: “early” - released at the beginning of feeding, it is blue, translucent, there is a lot of water in it, the child does not get enough of it, but drinks, and “later” - released in the second half of feeding, it is fattier, white (not like cow milk), it can also be slightly yellowish, thick and high-calorie, it begins to be released after 25-40 minutes from the start of feeding, it is this milk that the baby eats up. Based on this, I remind you: if the baby ate one breast for less than 40 minutes, then it is advisable to start the next feeding again with this breast.
- Ask the maternity hospital to let you feed your baby right in the delivery room. Sucking the breast leads to gentle contractions of the muscles of the uterus, which prevents possible bleeding and helps to recover after childbirth. This is in accordance with WHO recommendations - not a single doctor will argue with this. This also promotes lactation in the future.
- Do not give your baby water or supplement with formula in the first days after birth. And it's okay if you don't have milk. It shouldn't exist. In the first days, you will feed your baby colostrum, which is very different in composition, color and calorie content from breast milk. And physiological weight loss in the first days after birth is not at all explained by the mother’s lack of milk, but by the child’s adaptation to new living conditions, the restructuring of his digestive and excretory systems. From the second, third or fourth day, your baby will definitely begin to gain weight.
- Feed your baby on demand. Babies cling to their mother not only to eat, but also to drink, communicate, and feel protected. If you feed your baby the way he requires, you will not need to express milk, and you will be less likely to develop milk stagnation, lactostasis or breast inflammation. Over time, the baby will switch to less frequent feedings. If the baby asks for the breast every hour, this is normal; if he asks every 20 minutes, then every 3 hours, this is normal. Your baby is special, don't you agree? Then why do you think he should suckle according to someone else's rules? Feed the baby on demand, put the baby to the breast for every squeak or searching movement. While awake, the baby can ask for the breast up to four times per hour, i.e. every 15 minutes! In the vast majority of cases, at the moment when the child begins to ask for the breast more often, the mother decides that the child is starving and introduces supplementary feeding. And the child asks for the breast not at all because he is hungry. He constantly needs the feeling of confirmation of physical contact with his mother. In your tummy, the baby constantly heard the beat of your heart, your breathing, he felt warm, he was surrounded by you on all sides, and often sucked his finger. Why do you think that, having been born, he is ready to give this up? And the mother is waiting for the intervals between feedings to increase, when will the baby start eating after 3.5-4 hours, when will he stop waking up at night? The child always takes the mother’s position, and if you deprive these moments of communication, he will agree, but with insufficient breast stimulation (especially in the first 3 months), the amount of milk decreases. Often, patronage nurses advise feeding no more than every 2 hours and giving the baby boiled water. My advice, ask why exactly after 2 hours, why not after 1 hour 40 minutes or after 2 hours 10 minutes? I also strongly advise you to ask how many children she herself breastfed, and until what age she breastfed. And regarding supplementation: re-read the WHO recommendations, point 8. I’ll also add that I read about a study that was conducted among volunteers in extreme heat. In the first group there were children who were artists, who, naturally, were fed extra food; in the second - breastfed children who were supplemented with water; in the third, children are exclusively breastfed. Children from the third group gained weight the best, they did not show any signs of dehydration, etc. Any additional feeding or supplementation leads to a reduction in milk production. You gave the baby 15 ml of water, next time he will suck 15 ml less milk - and then, along the chain, your brain receives a signal from the breast that there is an excess of milk and its amount needs to be reduced. Well, if you really want to give your child water, give it, but only from a spoon.
- Feed your baby for as long as he wants. Feeding ends when the baby releases the breast on his own. My babies did not want to part with the breast, even when they were fast asleep, so I carefully inserted my little finger into the corner of the mouth and gently pressed on the lower gum, after which I took the breast out. Cracks in the nipples do not form from long feedings (see point 10).
- The baby should suck milk completely from the breast. There is no need to offer him both breasts at one feeding. During the first couple of months, babies latch on frequently and unsystematically. Apply it to one breast for 2-3 hours (it can be applied from 1 to 6 times or more, it also depends on the duration of sucking) until all the milk from this breast has been consumed, the next 2-3 hours to the other. After three to four months or during a lactation crisis, the baby may need both breasts in one feeding, but only on the condition that after eating one breast (at least 40 minutes), he remains hungry. At the next feeding, place your baby on the last breast first. Here we return to the issue of early and late milk; the baby needs both one and the other. Without sucking late milk from the first breast, but replacing it with early milk from the second, the baby will not be fully fed. And soon he will want to eat again.
- There is no need to pump your breasts after every feeding. Lots of arguments. The baby did not suckle for long, what are you expressing? That's right, late milk, you already know about its meaning. The baby is full and you’ve only pumped the last couple of drops from your breast, what’s next? Your body will decide that there is not enough milk and will produce more of it. Don't shout hurray too early. What are you going to do with the excess milk? Your child will still not eat more than he needs. If you express the excess, this will again lead to an increase in lactation. If not, you may experience stagnation of milk, which is painful and requires additional effort on both your part and the baby’s. You can express if you feed your baby by the hour (6 times a day) - this will prolong lactation for some time, but about
Without fanaticism: when you can deviate from recommendations
However, even if a mother is determined to follow WHO recommendations for breastfeeding, sometimes situations arise when this is not possible:
- during a difficult birth or caesarean section, it is not possible to immediately put the baby to the breast - the mother may be under anesthesia for several hours or medical indications do not allow leaving the baby with her;
- not all maternity hospitals allow mother and child to be together around the clock. It is better to find out this moment in advance so that it does not become an unpleasant surprise;
- the mother is forced to go to work early and cannot feed the child for a long time. Of course, it is advisable to spend as much time as possible with the child and postpone the return to “society” for several years. A child under one year old needs the constant, even 24-hour, presence of his mother nearby, literally like air.
- the child himself refuses to breastfeed at the age of 1-1.5 years. In this case, of course, there is no need to force feed him, citing WHO. The baby himself knows how much milk he needs.
In any case, natural breastfeeding is always a dialogue between mother and child. It is very important, first of all, to learn to listen and understand your baby, then the process of adaptation to new conditions will be much easier and painless.
The culture of natural breastfeeding is gradually taking its rightful place in people’s minds, and WHO specialists have made a lot of efforts for this, creating and disseminating recommendations for breastfeeding. And although it is still quite common to find doctors of the “old school” who were brought up in different rules and try to impose them on young mothers, the situation is confidently improving and more and more babies are receiving mother’s milk, which is so important for them.
Tip 1. Breast massage and compress
In the first 2 months after giving birth, I did this massage before every day feeding. We massage the left breast like this: we place our right hand under the breast, with our left we make spiral movements from the periphery to the nipple, massage gently, and work through each lobe of the breast several times. The right one is the same.
If you feel a lump somewhere under your fingers, pay special attention to this area (and be sure to let your baby suck on this breast during the next feeding). But gently without much tension or pressure. A massage for one breast lasts 5-10 minutes.
If your breasts are full and painful, massage and express a little milk, just until you feel relief.
Compress: take a cabbage leaf, make a hole for the nipple, remember a little and scald it, place the still warm leaf on the chest, cover with compress paper or cellophane (don’t forget about the hole for the nipple), on top of something warm (terry cloth, wool blend, optional ). Wear a bra. If your chest hurts, you can “wear” such a compress from feeding to feeding.
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Tip 2. Diet for the first three months
My son was very sensitive to what I ate. And in general, some products, it seems to me, are not healthy for a nursing mother. All foods introduced into your diet should be suitable for your baby. For example, one of my friends could not eat potatoes or anything containing them, even a little bit, and her child became allergic. My son’s colic intensified from the large amount of potatoes I ate, which already tormented him for up to six months.
You can: everything boiled, steamed, baked in foil or without crust.
Not allowed: fried, salted, canned, smoked, spicy.
Can:
Vegetables: any, except cabbage. Introduce raw vegetables into your diet one at a time, carefully monitoring your child’s reaction. Onions and garlic, especially if you ate them during pregnancy, are okay.
Fruits: baked apples are best, 1 raw per day. 1 banana per day. Some fresh plums, peaches or apricots, pears, etc., whatever grows in your climate zone. It is better to avoid red fruits and berries - they are strong allergens. Exotic - it’s also better to wait, let the baby grow up.
Kashi: yes, yes and yes again. Any, with milk and dried fruits. But - boiled in water.
Fish: yes.
Meat: yes, but lean varieties.
Broth: no. The meat and fish were boiled and the broth was poured out. The broth contains many allergens that are digested from the meat. If you are interested in my personal opinion, this is not a healthy or baby food dish.
Bread: yes, better with bran, dark.
Oil: butter - yes, but a little, vegetable - yes.
Dried fruits: yes, but not dried or smoked, but dried.
Sweets: yes, but just a little.
Drinks: green tea, possibly with milk, black tea (weakly brewed), dried fruit compote, still mineral water, juices with pulp diluted with water (very carefully). Milk. Kefir is not recommended at first. Tea for nursing mothers.
Nuts: yes, but just a little (5 pieces per day).
You need to eat regularly, in small portions, without overeating. Don't eat for two. If you want to eat in the middle of the night, eat it, better not a bun with a thick layer of butter and the same cheese, but porridge or oatmeal cookies, crackers with tea.
If you really, really want something, eat it.
You must drink as you wish.
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New WHO principles
Gradually, WHO recommendations on breastfeeding are expanding, more and more new points are being added to them. In particular, it is recommended to maintain breastfeeding for as long as possible - up to 2 years and even more. This helps the child build full-fledged immunity, since mother’s milk contains immune bodies. In addition, it still contains a large amount of vitamins and microelements necessary for full development.
Also, according to WHO breastfeeding guidelines, it is better to refrain from weighing your baby frequently. This does not provide critical information about his development, but it often irritates the mother, who begins to worry that her baby is malnourished or gaining weight too quickly.
Specialized support groups for mothers are important, in which they teach proper latching and help establish lactation. Participation in such groups is necessary both during pregnancy and after childbirth. Before the birth of a child, a woman has a lot of time and effort to obtain the necessary information, so she should clarify for herself as many important points as possible. After childbirth, the moral support of like-minded people will be important, especially if a woman is “unlucky” with a pediatrician or relatives, and they actively suggest that she switch the child to formula.
The principles of breastfeeding a newborn also include completely emptying the breast before placing the baby on another. If the baby requires more abundant feeding and is fed from the second breast, it is important to carefully monitor his behavior and not remove him too early so that he receives “hind” milk from the first breast - fattier and more nutritious. If the baby stops sucking, but does not release the breast, it means that the milk continues to flow and he is simply resting. It should be transferred to another breast after the first one is completely emptied.
Tip 3. How to end lactation?
I promised to tell you how I ended lactation after my daughter gave up breastfeeding. I didn’t bandage my breasts, didn’t take medications, I didn’t feel unwell, had a fever, or had breast engorgement.
I simply pumped my breasts to a state of relief (and no more) as soon as the need arose. I will repeat in other words: I did not express my breasts completely, but expressed just enough so that the feeling of discomfort in my breasts would disappear. After a week, it was only 2 pumping sessions - in the morning and in the evening. After two weeks, I stopped pumping completely.
