**This has turned into a really long post so you might want to go make a cup of tea first!**
Now, like most mums-to-be, I attended antenatal classes before my first baby and, to be honest, dismissed most of the information presented about cesareans and complications because that wasn't going to happen to me! And breastfeeding? Looks easy. Sounds easy. It's a totally natural process and I'm going to feed my babies for years. Right?
Well, it's very different when you've got your tiny baby's head in one hand and a boob in the other! No diagram in the world can truly explain it. So, why is it so hard for us intelligent, modern women to figure out? Mostly because we're not exposed to it. (Don't get me started on all this anti-nursing-in-public crap that fills my Facebook feed). The best source of support new mums have is other mothers. Things would be so much better for us if we could watch others birth and breastfeed.
I should mention that there are a few medical reasons (such as chemo, HIV, other medications) why you might not be able to and this is something to discuss with your health care professionals. However, most mums should be able to successfully start feeding and continue for as long they choose. At the same time, though, we need to avoid guilt entering these conversations.
A decade ago it was the norm to say "breast is best". This is because it is. Not only is it the best nutritionally for our babies it also does a whole host of things for their immune systems that we can't really replicate and probably a lot more 'amazingness' that we still don't fully understand. These days, however, if you say that then, apparently, your only motivation in saying it is to make mums who can't nurse feel guilty. Gah!
I see it this way: Mums worry. We're good at it. Gold medal worriers. And it starts pretty much the moment you find out you're pregnant. The zinger is that this worry ever so easily translates into guilt. We put it on ourselves! We do it! It's not about what other people say. We control that response. And we really need to stop being so down on ourselves. Accept what is and focus on the positive. Besides, there are plenty of things to worry out throughout this whole motherhood experience!
So, it seems that you're dammed if you say breast is best but, the other side of it is, that telling mums that "it may not work out and that's okay" isn't really great motivation either. Because it can be hard to get right and it is bloody painful in the beginning. And giving permission to quit is a bit wrong. We need to offer encouragement and support instead.
Feeding can be a different - and difficult - experience with subsequent babies too. It was for me even the fourth time around! I've heard it compared to dancing with a new partner. Even though I know all the steps - and baby has natural rhythm - we've still got a fair amount of rehearsing to do before we get it right.
So, bottom line, the one thing you really need for success is a determined attitude. Alright! Ready to give a good shot? Let's make a plan!
First, Get a Support team
This is probably going to be your partner. If not, a parent or close friend. Regardless, have a good chat about how important it is to you to succeed at nursing. Talk about ways they can help - offering encouragement, making sure you're comfortable and getting you a glass of water every time you feed is a great start.
Things like doing the cleaning or cooking so you can spend time focusing solely on baby and holding baby while you sleep sure help as well.
Sometimes you just need someone to talk you through it. I remember being so tired and my nipples being cracked and bleeding at the end of that first week (from Liam feeding for an hour every two hours!) that I begged hubby to go and buy bottles and formula. He said he would if he honestly thought that was what I wanted but that he knew how important this was to me. So, we decided to go to a Lactation clinic the next day and to give it our all for six weeks and reassess then. By that stage, all was healed and everything was going fine.
Then, Learn all you can
As I've said before, knowledge is power. Go to a class - some have a demo mum who expects you to look closely and ask questions. Visit a friend with a new bub (bonus tip: take her a home-cooked meal to stick in the freezer) and learn from their experience. Join the ABA. Watch videos. Be informed.
Now, Make your plan
Know what you want to happen after delivery. Immediate skin to skin is best and baby will pretty quickly start looking to latch on. Also, have a think about what you'd do in case special care is needed for you or baby. What do you want to happen if you have to have surgery? Or if baby needs a humidicrib and can't attach?
This template is a great starting point and has lots to think about... https://www.breastfeeding.asn.
And now here are My Top Tips for feeding success once your precious bundle has arrived..
1. Feed Baby Regularly
Before babies I'd always heard "never wake a sleeping baby" so I didn't with my first the first day or two and it meant a big delay in my milk coming in and baby getting dehydrated. Babies who don't wake for feeds should be woken every two to three hours. While you may not be producing milk yet, the colostrum they receive is liquid gold and all that suckling will stimulate milk production.
2. Proper Attachment is Key
The biggest tip for breastfeeding is get the attachment right. Nose to nipple, chest to chest. Get their mouth to open wide and take the whole areola. If it hurts while feeding, or your nipple comes out of baby's mouth flat, your attachment is wrong. Don't continue if it hurts. Dislodge them by slipping a little finger in to break the suction and try again.
Sometimes getting attachment correct is as simple as pulling their lip/s back or lifting them higher on your chest. Ask for help. Midwives are a great help (though, I've had a few cranky old bats in hospital who just made me confused and frustrated!) So too are lactation support groups. I went to one with Liam because, as I said, my nipples were so sore, I felt like I had no idea what I was doing and I was ready to give up on the whole thing. The consultant showed me how to do a football hold which worked better for us at the time and it changed everything.
3. Get in a Comfortable Position
You may be okay sitting on a bed, but a comfy yet supportive chair where your feet can sit flat on the floor is the best to begin. As you gain confidence you can try different holds and positions - lying down is my favourite first thing in the morning when I'm too sleepy to sit up...
I like my feeding cushion too. All that nursing can be hard on your neck and shoulders - mine are suffering really badly this time around. Heat packs, massage and physio are easing it.
4. Take Care of Your Needs
There'll be more of this in my general tips post, but the most important things relating to nursing are:
Water - drink a glass at every single feed. Even in the middle of the night. I have a full caraffe and a glass next to where I feed (because I hate drinking out of plastic bottles).
Nutrition - supplements can help but make time to eat healthy meals and snacks throughout the day. Prioritize salads and vegetables. Handfuls of nuts are great too. I took a jar of nuts and seeds to hospital with me too.
Also include galactogogues - which are substances that help increase milk production. Oats are a great source, plus they're good for you and porridge is easy to make and tastes yum. I've even found oats with minimal traces of gluten at my healthy food store which I don't seem to be reacting to.
Brewer's yeast and Fenugreek have them too but they are harder to incorporate into your diet. Try the cookies and tea mentioned here. Or this recipe.
Sleep - sleep whenever your baby does. Forget all housework that isn't absolutely necessary. Better yet enlist someone else to help out.
5. Treat Sore Nipples
My best tip for sore nipples is to express some milk and rub it in regularly, let them air and bask in indirect sunlight daily (morning sunbeams as they come in through a window are ideal). I found creams like Lansinoh provide extra soothing and protection when they're cracked and bleeding too.
6. Lumps Can Happen
Hard lumps can form in your breast and up in your armpits. For lumps in the breast, attach baby so that their chin is on the lump if possible. This helps to massage the lump and drain the milk buiding up in there. For other lumps, massage them in a hot shower and express a bit to drain them. They will eventually go away, but correct draining is essential to avoid mastitis. (Which I'm fortunate to say I've not experienced and therefore can't advise on. If you've got tips please comment below).
7. Know Where to Go to Get Help
Please, ask for help if you need it. Enough said.
8. Make a Note
Write down the time you started feeding baby and which side you started on. Tired brains forget. In my case, they forget pretty much everything. Ha! I use a little spiral notebook. This also means that hubby can read it in the morning, see if we've had a rough night and decide whether or not he wants to wake the bear or get the boys ready for school himself. (Which he does pretty much everyday because he's just awesome x).
9. Gather Everything You Need First
Before you sit down to feed make sure you have water, your notebook, feeding cushion, burp cloths, tissues, your phone/a book/the tv remote - whatever you might need. Also, go pee and/or wash your hands before you start too. Baby might cry a little but it's much easier to do it all before!
I prefer to feed sitting cross legged on my bed, so I keep everything on or next to my bedside table...
10. Offer Both Sides. Switch Each Time.
What has worked best for my babies is to feed them on one side, burp them, then offer the other. Then, next feed, start on the side I finished on. Some people offer one side at each feed and alternate but that always made me feel lopsided! Also, feed baby for as long as they want on each side but without them falling asleep! (Unless you're feeding a very tired and sad baby to sleep which can be a great strategy too).
11. Burp Baby Regularly
Always burp after each side. If baby is grizzly just after a feed it's probably because they have some gas needing to come up. If you experience a 'witching hour' - an hour or two around 5pm when they cry a lot - try burping more during every feed, say every 3-5 minutes. It really can help.
Finally, my advice is don't quit - even if you think it's not working! As mentioned, feed baby regularly (every 2-3 hours for the first week or two) to build up a good supply. Then whenever baby needs it. Often you'll find they cluster feed for a day or two and then sleep a lot for a day or two. This is in order to support their growth spurts and to stimulate you to produce enough milk to support that growth.
Give it a good run and if you and a professional think baby is not getting enough milk - which is usually about not putting on weight and not about how much they cry - then try expressing first. Express after a feed to help increase your supply and feed baby this extra milk with a syringe, cup or spoon. I've had limited success with expressing but found an electric pump to be more effective. They are available to hire too.
Be aware that overtime, your breasts get used to the amount of milk baby needs and won't feel as full. This doesn't mean they aren't as full. Once you introduce a bottle of formula it can be very hard to keep your supply up. Please, seek professional advice first.
13. Clothing is a Matter of Preference
Nursing bras are obviously essential. Get properly fitted before and after, if possible. Quality bras are a good investment if you're planning to wear them for a year or two. Nursing singlets - like these Bonds ones - are great in hospital as they make skin to skin contact easy. (So too do Bonds zippys on baby. Which I rave about here.)
Actual nursing tops are not necessary - you can just lift your shirt - but I like to wear them when I'm out in order to hide my belly, which I'm pretty self-conscious about at the moment. Button-up tops and dresses work too but I prefer having something over the top of my breast. It's entirely up to you.
Breast pads may be necessary if you experience leaking during letdowns or when your baby (or someone elses!) is crying. Sometimes a bra is enough and, usually, this leaking eventually stops. I hate sleeping in a bra but found a singlet with a built in shelf bra was enough to hold a nursing pad in place, (now) stops me from leaking, but is comfortable enough to sleep in. Peter Alexander make good ones.
14. Feed in Public
For the love of everything right in this world don't hide away to feed your baby! It's totally normal and should be acceptable to feed your baby whenever and wherever you need to. Be comfortable with it yourself, obviously, but don't take shit from anyone. In ten years of feeding babies I have never had one negative comment or dirty look and have only ever had people smiling at my cute baby while I feed. I prefer to find a nice cafe or coffee shops to get myself a calming drink too!
For breastfeeding counselling in Australia, please call the Breastfeeding Helpline on 1800 mum2mum or 1800 686 268 which is run by The Australian Breastfeeding Association (ABA). The Breastfeeding Helpline is available 7 days a week. It is staffed by trained, volunteer counsellors who answer calls on a roster system in their own homes. The National Breastfeeding Helpline is supported by funding from the Australian Government.