What are the commonly asked questions about lactation in new mothers? Ms Loh Lee Lian, a Certified Lactation Consultant at Mount Elizabeth Hospital with 34 years of experience addresses these questions.
1. How often should I breastfeed? How will I know whether my baby is getting enough milk?
Breastfeeding should be by baby’s demand regardless of frequencies, but ideally, the baby should be fed every 2 – 3 hourly. Baby should get enough milk, if the baby latches and suckles well on each breast for about 15 – 20 minutes and about 8 – 12 times in 24 hours. 5 – 6 wet diapers and regular bowel movements a day indicate sufficient milk intake. Baby should be contented and alert after breastfeeding.
2. How do I prevent sore nipples?
Mother’s correct positioning on holding baby very close to body helps with latching. Ensure baby’s mouth is opened when moving baby to latch. Baby should be suckling on the areola instead of the nipple. Remove baby and re-latch if baby is sucking on the nipple. Prolong sucking on one breast may cause soreness. Offer both breasts each time and frequent and short feeding if nipples are sore.
3. Can I continue breastfeeding if my breasts hurt or if I have a cold or the flu?
Breasts tend to feel tender when milk comes in. Breast massage and warm compress before breastfeeding helps to stimulate flow and relief hardness. Continue frequent breastfeeding to avoid engorgement. Breast discomfort will ease when the breastfeeding demands and supply are more regular. Cold compress may be used after breastfeeding to relief discomfort. If mother has cold or flu, breastfeeding should be continued, as breastmilk has high content of antibodies that protect babies against infection.
4. Are there foods I should avoid eating while breastfeeding? What about alcohol or caffeine?
Breastfeeding mothers should eat well-balanced diet and allowed 500 calories extra daily. All food can be taken in moderation. As alcohol is not encouraged as it is also drying for the body and may be used in moderation for cooking. Basically, caffeine of about 200gms (100gm per cup) per day consumed is safe, but best to drink it soon after breastfeeding as generally caffeine takes about 1-2 hours to be absorbed and dissipated from the body.
5. Are there any medications that I should stop taking?
Generally, less that 1 percent of medications are not suitable for breastfeeding babies. Breastfeeding should be avoided if mother is on Chemotherapy drugs, sedations, antidepressant medication or radium therapy. Mothers who are breastfeeding should be highlighted to Doctors on prescribing baby-safe medications.
6. What should I look out for when searching for a good lactation consultant?
Basically, the Lactation Consultant should be trained and experienced, a practicing LC and currently registered with IBCLC (International Board of Certified Lactation Consultant).
7. I’ve heard that I can’t get pregnant while breastfeeding. Is this true?
Total breastfeeding, not missing any breastfeeds in some way prevents the onset of menstrual period, thus acts as a natural contraceptive measure. It is not totally a safe measure and may need a second contraceptive method.
8. How do I prevent my breasts from becoming engorged?
Engorged breasts are usually due to stagnant breastmilk, hence total and frequent breastfeeding day and night will maintain the flow. Breast massage and warm compress before breastfeeding may help to stimulate flow.
9. What happens when I have engorged breasts?
Engorged breasts will cause discomfort and fever. Mother may take analgesia to lower fever and relieve pain. When breast is engorged, it will be hard and difficult for baby to latch on and the flow will also be impeded. Breast pump may not be effective in milk removal when breasts are too engorged. Breast massage, warm compress, hand expression and with continue frequent breastfeeding will maintain smooth milk flow and supply. To be comfortable, cold packs may be used after feed.
10. When should I introduce a bottle?
Bottle feeding is best introduced after the 4th week in order to avoid ‘nipple confusion’. Suckling from the breast and drinking from a bottle require different techniques. If bottles are introduced too early, some babies may refuse to latch onto the breast or latch well.
11. What should I look for in a breast pump?
It is important to select the breast pump and accessories for individual situation. While manual breast pumps are great for stay-at-home mothers who are exclusively breastfeeding, electric breast pumps are the better choice for moms who are frequently separated from the babies because of work or health problems. Depending on the different models of pumps available and the frequencies of use, the breast pump should effectively remove milk in order to sustain supply.
TNAP recommends: Pigeon’s new range of Breast Pumps
12. How often should I pump when I go back to work?
To replace baby suckling on the breast, regular breast pumping every 3 hours should maintain the supply of breast milk and avoid breast engorgement.
Extra Fact: What does a midwife do?
As a midwife, job-scope in the maternity unit encompasses looking after mothers starting from when they are admitted for labour and delivery. Nursing care, on how to manage pain, support and advice are given continuously throughout for safe well-being of the mothers and babies in the process of labour and delivery.
After delivery, midwives are also responsible in the postnatal care, and that includes helping and teaching mothers the correct technique to breastfeed and to ensure that baby is feeding well. Mothers are also shown and taught on how to take care of baby (e.g. holding baby, change diaper, bathing, burping and swaddling). Physical and psychological well-being of mothers during postnatal period is maintained during their hospital stay.
For more information about the maternity ward services at Mount Elizabeth Hospital and to book a maternity tour, please call (+65) 6731 2000 or visit www.mountematernity.sg. A virtual tour of the rooms is available at www.mountelizabeth.com.sg/virtualtour/meh/orchard/single-room.html
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