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Frequently Asked Questions

Milk production

You start to produce milk immediately your baby is born. This milk is called colostrum. A few days after giving birth to your baby, the colostrum starts to thin out a bit and become much whiter in colour. It is advisable to feed your baby between 8 and 12 times every 24 hours to stimulate milk production.

Colostrum is the thick (and slightly yellowy) milk that comes from your breast in the first few days after delivery. It is referred to as “liquid gold” it is low in fat and high in carbohydrates, protein and contains antibodies to keep your baby healthy. You don’t produce so much of it, however, the little amount that is produced is enough nutrition to sustain your baby in his/her first few days of life.

Colostrum is very important because it provides the perfect amount of nutrition as well as contains a large number of living cells that help in protecting your baby from harmful agents. It helps to and reinforces the immunity of your baby. Essentially, colostrum will also help to prevent jaundice and seal up their gastrointestinal tract. It is like an all-natural vaccine. 

If there is no engorgement, your milk supply isn’t necessarily low. To confirm, hand express some milk into a cup, if you can do this, then there is milk supply. But if you are worried, you can increase your supply by encouraging your baby to feed longer and feeding more frequently during the day and night. You can also add one extra pumping session to your day to stimulate your breast for increased milk production. However, you must ensure your baby is properly latched to access the milk effectively. 

Answer: If your baby seems very tired as a result of low energy. If your baby takes too little or too much time at the breast. If your baby has not regained his/her birth weight by 10-14 days old or the weight gain is slower than expected i.e. less than 155 grams (<5.5 ounces) in a week. If your baby is not stooling often as they should (babies should have 3-4 stools per day at about four days old). Also, if your baby’s urine is not pale, or you see reddish-brown colouration in the diaper. All of these and more could indicate your baby might not be getting enough milk. If this is the case, visit your health care centre or SMS BREAST to 45156

Take your baby off the breast if he seems to be gulping milk too fast or struggling to cope with the flow. To naturally slow the milk flow, lean back and let your baby face the breast directly with the belly toward your belly.

Sore nipples, biting and other problems

This is called sore nipples and it may occur in the first 20 or 30 seconds of feeding, after which the pain subsides. It is a sign that your nipples are adjusting to their role. The level of pain is subjective and varies mom to mom. If the pain becomes unbearable and your nipples are injured, you will need further intervention.

Bruised nipples could be a sign of improper latch resulting in baby biting on the nipples. In the early days with your baby, you need to master a proper latch. If you don’t practice and master this step from the onset of your breastfeeding effort, it can cause bruising, cracked nipples, blisters and bleeding.

A baby may bite during a nursing session for many different reasons – distraction, teething, or ear infection. It may be hard for your baby to swallow while breastfeeding if he/she has a blocked nose). If you experience a bit from your baby, it may cause you to be tense or fearful at the next feeding. You may start to think that it is time to wean your baby. No, weaning is not the remedy when your baby bites. The following strategies are recommended by La Leche League: 

• Proper positioning: Review how your baby latches. Ensure you position your baby so that the nipple is aimed at the roof of his mouth and wait for a wide-open mouth before quickly putting the nipple in his/her mouth. If your baby is latched on correctly and is feeding actively, getting enough milk and swallowing, it’s physically impossible to bite. 

• Act fast: Try and watch for a hint that your baby is about to bite which comes usually after the initial hunger has been satisfied; you will feel your baby pausing and her jaw tensing, quickly break her suction by sliding your index finger into her mouth and between her gums, gently remove him/her from the breast. Pulling your baby straight off may cause damage to your nipple. 

• Comfort: Your baby doesn't know it hurts you. He may be surprised and unhappy that you have stopped the feeding. Cuddle with a firm "no bite" Thereafter; offer the breast again if your baby is still interested in feeding. 

• Expression/compression: Keeping breast milk flowing can help. Baby can’t bite if she is actively sucking. If your baby seems to be slowing down he/she may not be getting enough milk flow. You can do breast compressions to increase flow which will help him/her to suck and swallow. You can also express a bit to start flow at the opposite breast and quickly move baby there to continue feeding. 

• Distract: Talk to your baby. Say his name. Play a game to get him to laugh for a quick please from the breast.

Engorgement is a common occurrence in the early days of the arrival of the baby. The good news is that it is easily resolved. The following remedies are proposed by the La Leche League:

• Keep your baby with you; on your chest, in your arms and at your side. Body contact is very helpful as it makes frequent nursing more likely.

• Nurse your baby or express your milk at least every 2 hours, and at least twice during the night. The more milk that collects in your breasts, the stuffier they get and the harder it is for fluids to move.  

• Move your breasts around gently and massage them; this will help shift excess fluids.

• Lie back, to keep your breasts higher than usual so that the fluids will follow gravity.

• Use a bag of frozen vegetables as a cold compress. Wrap it in a towel and put it on your breast(s) for about 20 minutes, then take it off for about 20 minutes.  

• Use cabbage leaves to help bring down swelling. Discard the outer leave, peel off one or more leaves, tear out the hard vein if you like, crumple each leaf gently in your hand, and put the leaves on your breast (not over your nipple). They should feel nice and cool and can be held in place with a bra or shirt. Leave them on until you get tired of them, and repeat as often as you like. 

• Stand in a shower and get a nice warm shower. You may even find your breast milk already leaking in the shower. 

Proper Positioning

Sit on a comfortable chair with proper back support to achieve a good breastfeeding latch. By using a pillow, position your baby so that he/she is tummy to tummy with you. Then guide your baby to the breast, by first facing his/her nose to the nipple, and then guide your baby to your nipple. Another method is to create a "C" hold. This is done by placing four fingers under the breast that you are feeding on, set your thumb on top and bring your nipple to your baby. Your hand should look like it is in the shape of the letter C.

Your baby latches correctly if his/her mouth closes around your nipple (and a little bit of your areola, too) and he starts to suckle steadily. In the first few days of commencing breastfeeding, you may feel pain on your nipples as your baby gets attached to your nipple. The pain should normally be over in a few seconds. If you feel the pain beyond that first minute or so, the baby may not be properly latched. You should take your baby off your breast and start again.

If you are worried and are not getting the latch right, Please SMS BREAST to this number 45156, and a BF expert from WBA will attend to you promptly. 

Frequency of Feeding

You should breastfeed your baby about 8–12 times per day in the first few weeks. Breast milk digest easily, so your baby will make the cues for feeding often. Frequently feeding your baby will help to stimulate your milk production. When your baby is 1–2 months old, feeding frequency may reduce to 7–9 times a day and may have a more predictable feeding pattern.

Calculate the time between feedings from the time your baby starts to feed,( not at the end of a feeding session) to when your baby starts to feed again.

Try to belch your baby when he finishes feeding on one side, before putting him/her to the other breast. Sometimes, the movement alone can be enough to cause a baby to belch. If your baby drips up a lot, try to belch him/her more often. It is normal for your baby to drip or spit up a small amount after feeding or during belching, but he/she should not vomit after feeding. If your baby vomits all or most of feeding, there could be a problem that needs medical care. You may need to visit the health centre.

Belching helps to get rid of the air that babies swallow during feeding. If your baby swallows much air while feeding and he/she is not belched, it can make him/her to drip or spit-up. To belch your baby, gently pat the back repeatedly while holding your baby against your chest, or Holding him/her sitting up on your or laying him/her on your lap on his or her belly. 

There is no specific amount of time that you should breastfeed your baby per nursing session, though at least ten minutes per breast is recommended. However, you must take the signal from your baby. If he is actively sucking, let him keep feeding. When he pauses or stops sucking, put him/her to the second breast.

Hind milk is the milk that comes toward the end of feeding usually 10 – 15 minutes into a feeding session. It is high fat and calorie-rich milk and it is essential for your baby's overall health and growth. At the beginning of a feeding, your breast milk is a bit thinner and more watery (foremilk), but as your breast starts to empty, the amount of fat in your milk increases. This is why it is ideal to allow your baby to drain one breast before moving him/her to the other breast to ensure your baby gets the hindmilk.

The soiling of the diapers is a good sign. In the first 6 weeks, you should expect at least 5 – 6 wet diapers with 3 – 4 stool soiled diapers a day. Weight gain is another sign. The average breastfed new-born will gain about 170gms a week.

The side you choose to nurse from is up to you. However, it is advisable to alternate which side you start on since your baby’s suck is stronger at the beginning of the feeding. This will ensure the breasts are drained equally.

A nursing bra usually comes with extra padding and easy access to your breast for feeding in a hurry. While it is not a necessity, it gives a measure of convenience and comfort. You can use a regular bra, just be sure it is not too tight but soft enough to prevent pressure on your breasts. Also, you should avoid the use of bra with underwire to prevent the risk of clogged ducts and mastitis.

For breastfeeding comfort, you may consider a breastfeeding pillow to rest your baby on while feeding. You may also want to consider Lanolin cream which can help to relieve your sore nipples. A nursing cover; apparel with built-in nursing panels is another thing you may want to consider. It is not essential but it is handy for feeding in the public. You may also need breast-pads for use in soaking leaking milk. 

It is common to make more milk than your baby needs especially in the first few weeks. This will result in milk leaking from your breasts. Buy a set of washable breast pads that can soak up any leakage so you don’t get your dresses soiled.

This depends on you and your work schedule. If you are a work at home mom, and you have your baby with you at all times, you may not need a breast pump. If you are a student mom or needs to return to work while your baby is still exclusively being breastfed, you may need to get a breast pump to express your milk. In this case, you will also need to get the accessories that go with it such as the cup for feeding, breast milk storage bag, breast pump wipes to clean up in between session and a cooler packs for easy transport.

When breastfeeding, aim to take in extra 300 to 500 calories a day since you are passing much food (in calories) to your baby and burning energy while doing it. However, it is important to let your appetite be moderately satisfied to avoid overeating and subsequently gaining excessive weight.

Expressing Breastmilk

You should start to pump as soon as you want to. However, it is advisable to wait for at least a couple of weeks so your baby has enough time to get comfortable with latching and feeding from the breast. Therefore you may start to pump around the third week as long as your baby is latching well. Pumping your breastmilk will increase your breast milk production.

Depending on the type of pump you have or purchase, open up the box and sterilize all the parts. Afterwards, use the dishwasher with soapy and warm water to wash everything and drain.

After breastmilk expression, sterilize any bottle that comes in contact with your breast milk. Keep the breastmilk in a tightly closed container. You can store freshly pumped breast milk in the fridge for between 4 - 8 days. If you have pumped more than you know you will use that for 1 week, you can store it in the freezer immediately after pumping, for up to six months. 

When storing in the freezer, divide the milk into 60ml or 120ml portions for storage, so that when you thaw it for use, no milk will be wasted. When it is to be used, thaw breastmilk at room temperature. After breast reaches room temp, it should be fed to your baby within two hours. Defrosted breast milk can only be kept in the refrigerator for up to 24 hours. It should never be put back in the freezer. The table below summarises how to effectively store breastmilk.

To thaw the frozen breast milk, place milk container in a bowl of warm water or run warm water over it. Also, you can thaw it in the fridge overnight. Do not microwave breast milk.

You may combine freshly expressed milk with milk you have expressed the day before as long as both containers have been chilled in the fridge. However, don’t add body-temperature milk to already cooled milk.

The fat in breastmilk always rises to the top, which is why your breast milk looks separated after it has been in the fridge. This is normal. When you want to feed the milk to your baby, gently swirl the bottle to mix it; do not vigorously shake it, to prevent the breakdown in the nutritional value.

If you are not uncomfortable, you can sleep too, and skip the pumping session. Breastfeeding is all about supply and demand, and your body will adjust as your baby goes longer stretches without feeding.

This describes a situation where you pre-empt your baby’s need for feeding somewhere around the midnight by picking your baby up to feed even while still asleep. Most babies seldom sleep through the night until six months or so. This way your baby will load up on calories, and be able to sleep through to morning.

You should pump every 2 - 3 hours in the beginning since you are exclusively breastfeeding your baby breast milk. However, if you are supplementing with formula, it is fine to pump less often. Try to imitate the feeding schedule you follow at home. Each session which could last 15 – 20 minutes should empty the breasts.

Missing a pumping session once in a while should not reduce your supply as long as you pump or feed your baby as soon as you can. However, many missed feedings or pumping could cause your milk supply to diminish. Therefore, keep your breastfeeding schedule as much as possible.

Cleaning uses soap and water to physically remove germs from the bottle. Sanitizing is an extra step to kill more germs on the items that have been cleaned. Sanitizing feeding items provides more protection against all infections to keep your baby safe.

Clean the bottles and the feeding items after every feeding. If your baby does not finish the milk in a bottle within 2 hours, discard the unfinished breastmilk. Germs can grow quickly if breast milk is added to a partially used bottle, or if a used bottle is only rinsed, rather than cleaned.

If your baby is less than 3 months old, was born prematurely, or has a weakened immune system due to illness (such as HIV) or other medical condition sanitize the feeding items daily. Daily sanitizing of feeding items may not be necessary for older, healthy babies, provided the items are cleaned carefully after each use. Sanitizing every 2 days will be sufficient.

You can clean the brushes and bowls in a dishwasher if they are dishwasher-safe, or by washing using hand with soap and hot water. They can be sanitized by boiling, steaming, or soaking in a bleach solution. 

Air-drying your baby’s feeding items on a clean dish towel or paper towel is probably more hygienic than using a drying rack. Drying racks may trap moisture, allowing germs to grow, and be difficult to clean. If you prefer using a drying rack, use it solely for your baby’s feeding items. Make sure you regularly wash it, sanitize it, and allow it to dry thoroughly to reduce contamination.

Special Circumstances

Tongue tie is when the baby's tongue is tied to the base of his/her mouth, causing a lack of motion. This situation can hinder a proper latch. Usually, the situation will be detected at the hospital and will be addressed by the health care personnel. The signs a baby's tongue is tied include small blisters on the baby's lips as that is their mechanism for holding on to the breast. Also, there could be the clicking or nipping sounds during breastfeeding. If it is not detected at the hospital, talk to your doctor or paediatrician at the hospital and they will suggest necessary treatment. Treatment includes using surgical scissors to release the tongue or waiting a bit for the tongue to stretch out.

Mastitis is an inflammation of the breast tissue that indicates an infection. Symptoms include breast pain, swelling on the breast and fever. If you experience any of these signs, make sure to see your doctor for treatment. Make sure you drink plenty of fluids and get some rest. Continue to breastfeed to maintain your milk supply. Also, it is advisable to be taking a hot shower and massaging your breasts to speed up recovery. 

Yes, you should continue nursing even if you have a cold, sore throat, fever, flu, diarrhoea and more. However, be sure to remind your doctor that you are breastfeeding so that the prescribed medication will be breastfeeding compatible. It is only on a very rare illness that would cause you to stop breastfeeding and you will be guided by your doctor in that circumstance. 

Complementary Feeding

The WHO recommends that infants be fed exclusively on breastmilk up till 6 months and afterwards complementary feeding should be given with breastfeeding for up to years. 

Solid foods are to be introduced to your baby gradually. Over time it will make up about 25 per cent of your baby's diet. Your milk supply will not reduce as you continue to breastfeed your baby while feeding him solids. A good rule of thumb is to breastfeed, then feed with solid an hour later. Your baby will naturally start to balance his/her milk intake with solid foods.

When your baby is 2 years or more and you are ready to stop him or her from breastfeeding, do it by a gradual process. Eliminate one feeding at a time every 3 – 7 days. The reason for this is to allow your milk supply to gradually decrease, to reduce fullness and discomfort. When you drop a feeding, replace it with a snack as a distraction. Feeding at naptime, bedtime and in the morning should be the last to go.

Yes. However, you may also experience smaller breasts than you had before childbirth as many women did.

General Questions

You may avoid fish that is high in mercury such as swordfish, king mackerel and tilefish, to prevent mercury in your breast milk. Also, reduce or avoid spicy foods that can make your baby produce gas. It is advisable to minimise or avoid the intake of alcoholic drinks especially in the first few months of your baby's arrival. Though less than 2% of alcohol reaches the mom's blood and milk, it can impact the baby's cognitive development.

The colour of your breastmilk can change based on what you eat. For example, if you eat a lot of squash or carrots, your milk might take on a tinge of orange. If you eat a lot of spinach, you might have a tinge of green. If it's red, pink, brown or black, you should contact your doctor as that could be a sign of blood.