Some Common Breastfeeding Questions
Q/ When can I expect my breastmilk to come in?
A mum’s first milk is called colostrum, which can begin storing in breast tissue from approximately 16 weeks of pregnancy. Some women may experience secretions of colostrum on their nipples towards the end of their third trimester of pregnancy (and sometimes earlier). Some women however, may only be aware when they actively hand express. Both are perfectly normal and healthy.
Active hand expressing to collect your colostrum is generally not recommended until you reach your 37th week of pregnancy. With the support and knowledge of your health care provider, it can be a wonderful skill to learn, and for many breast/chestfeeding parents, reassuring to have in the early days post giving birth to your little one. It is not paramount for every feeding parent to have this available prior to giving birth. Babies are born incredibly efficient at feeding, and with comfortable position and attachment, and effective milk transfer, your baby will easily receive all the rich, immune-protective benefits of colostrum.
Please refer to this resource from - The Australian Breastfeeding Association (ABA) for further education and understanding.
https://www.breastfeeding.asn.au/resources/antenatal-expressing
When you have unrestricted time with your baby from birth - placed skin-to-skin with you, and able to feed on demand regularly (ideally aiming for a minimum of 8-10 feeds in 24 hours, sometimes more), your breastmilk will change from the nutrient rich, high protein colostrum to wonderful ‘transitional milk’ (which is associated with breast fullness “my milk is in”) usually between day 2-5 after giving birth. You may hear the term ‘Mature milk’, which simply means our milk production from 2 weeks after giving birth.
Q/ Is it normal for breastfeeding to cause discomfort or pain?
The short answer is no.
It is also helpful and reassuring to share the normal and varied sensations that can be experienced by feeding parents:
“A feeling of tingling or pins and needles” - sensation in the breast/chest as milk begins to flow - often referred to as the ‘letdown reflex’, or the ‘milk ejection reflex’. It is also very normal for many breast/chestfeeding parents to not experience this sensation at all.
“Really firm pressure” on breast/chest and nipple that subsides once the baby has been actively sucking for approximately 15-20 counted sucks (or approximately 30 seconds), is a good and reassuring sign that your baby is deeply attached.
Others may describe the pressure on their nipples as “a tugging or pulling” when baby is actively sucking.
Our babies have the same palette as ours. If you place your tongue behind your front teeth, and trace it to the back of your mouth along the palette, you will feel a firm palette followed by a soft spongy palette - this can be described as the - junction of the hard and soft palette. It is here where we aim for our babies to take our nipple, breast/chest tissue for the duration of the feed.
firm & tugging pressure = normal
Stinging, burning, pinching discomfort = not normal (Reattachment of your baby is strongly encouraged)
Q/ How do I know if my baby is attached/latched correctly?
How it feels for you.
It is important to share that what can look like a deep and comfortable attachment to the observer, is no indication of how it may feel for the breast/chestfeeding parent.
Once baby has completed approximately 15-20 active sucks (or on average approximately 30 seconds), ask yourself - Is it comfortable with nil burning, pinching, or stinging sensations? If there is pain or significant discomfort, then it is important for you to detach your baby safely by gently inserting your finger into the corner of their mouth to break the suction. Reposition yourself and reattach your baby using the positioning and attachment techniques which promote effective milk transfer.
Look at the shape of your nipple when your baby detaches. Whatever shape your nipple is at the tip of your nipple, it should look the same as when your baby comes off the nipple at the completion of a feed. The best way to describe it is…if it looks misshapen, it’s likely your baby needs a deeper attachment to protect your nipples, milk supply and breast health long term.
Aim for your baby’s chin and both cheeks to be in full contact with your breast/chest. Your baby’s cheeks when well attached will appear full and rounded, with no noticeable dimpling of cheeks, or clicking sounds when actively sucking.
Also aim for baby’s nostril to be clear of breast/chest tissue (can be gently touching), so baby remains sucking at the breast for the duration of the feed. Babies are nasal breathers, so if your baby is regularly pulling off it is worthwhile looking at the alignment of your baby’s body against yours. ‘Chest-to Chest’ and ‘Tummy to Tummy’ with you, with their bottoms cuddled in close and their arms hugging you either side of your breast/chest - will allow for a good secure and comfortable position for baby - allowing their head to comfortably and slightly extend backwards enabling them to take a lovely large mouthful of breast/chest tissue into their mouth. The slight extension of a babies head is equivalent to how we as adults would drink a glass of water.
Some babies may pull off if mum’s milk flow is forceful and fast. Adjusting your position such as reclining back may be all that is needed to help your baby regulate comfortable transfer of your milk. As your baby grows, different positions will evolve as you learn together.
Q/ How will I know if I am making enough milk for my baby?
Baby is waking for feeds and demanding regularly from you over a 24 hour period. I will often say to the feeding parent - feel your breast/chest prior to attaching your baby to feed, and again post feed. If your breast/chest feels softer, then your milk has transferred beautifully to baby.
Your baby is settled in between breastfeeds
Your baby is gaining weight
Taking note of how many wet and dirty nappies you are changing in a 24 hour period. As a guide:
Day 1: 1 wet nappy + 1 stool (meconium - sticky, tar consistency)
Day 2: 2 wet nappies + 1-2 meconium stools
Day 3: 3 wet nappies + 3 greenish coloured stools
Day 4: 4 wet nappies + 3 mustard coloured stools
Day 5 onwards:
Once your milk is established and mature milk is flowing, good signs that your milk supply is perfect for your baby’s needs are indicated by:
At least 5-7 heavy wet disposable nappies and 6-8 soaked cloth nappies per day. Bowel movements for an exclusively human milk-fed baby can fluctuate, and some babies may go several days without a bowel motion.
If your baby, appears well, continues to demand feed from you (a minimum of 8 breast/chest feeds in a 24 hour period); is active and alert and settles post feed; there is no need for concern. If for any reason your baby’s bowel motions and wet nappies have suddenly changed from what you consider to be normal for them, don’t hesitate to reach out and seek help.
A Registered Midwife, International Board Certified Lactation Consultant (IBCLC); Maternal Child Health Nurse (MCHN) ; and your family GP are supportive and helpful resources to access.
Q/ How long should I breastfeed my baby?
For as long as you like.
Breastmilk is all the food and drink your baby needs for the first 6 months of age. There is no official time to wean for a breast/chestfeeding parent. Sometimes it is a family; a personal; or a babies decision to wean from the breast/chest. Each family will be on their own breast/chest feeding journey. However long you feed your baby, human milk is wonderful in every way.
The World Health Organisation’s supportive statement is:
WHO and UNICEF recommend:
early initiation of breastfeeding within 1 hour of birth;
exclusive breastfeeding for the first 6 months of life; and
introduction of nutritionally-adequate and safe complementary (solid) foods at 6 months together with continued breastfeeding up to 2 years of age or beyond.
https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding
