Breastfeeding – a special gift only you can give your baby

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This is an article from our “Doctor’s Corner” series, brought to you by Samitivej Hospital. Make sure to read the entire series!

Welcome to motherhood! This article is written to provide helpful information on breastfeeding. Learning to breastfeed can take time, patience, and practice. However, most mothers who persevere find that the experience and the benefits of breastfeeding far outweigh any challenges.

Breastfeeding encourages mom-infant bonding, it’s free, there is no need to mix formula, and it is known to provide protection against respiratory and gastrointestinal infections, obesity, type diabetes 2, and breast cancer. Moreover, as the baby changes in age, the amount and the nutritional content of your breastmilk will adapt to meet your baby’s changing needs. The American Academy of Pediatrics recommends exclusive breastfeeding for approximately six months and then continued breastfeeding with the introduction of solids up to one year. The WHO recommends continued breastfeeding for up to two years and beyond.

Before the birth

During pregnancy your breasts grow and change in preparation for the birth of the baby and the need to breastfeed. Milk production and nipple suppleness will develop naturally during the pregnancy, so there isn’t anything physically that you need to do to prepare. However, it is a good idea to research products that support breastfeeding such as breastfeeding bras; breastfeeding T-shirt, breast pad etc.

Positioning the baby

One of the most important things about breastfeeding is positioning. Before beginning to breastfeed, make sure you wash your hands and that you are sitting comfortably with your back, arms, and feet supported. There are different positions and you will find the one that suits you by trial and error.

“Cradle” Position: Place your baby facing you on his/her side, “tummy to tummy” at nipple level. Cradle the head with the crook of your arm and support the back with your forearm and the bottom/upper thigh with your hand. The advantage of this position is that you have a free hand to guide and support your breast.

“Football (Clutch) Hold” Position: Sitting comfortably, place one or two extra towels at your side. Rest baby’s bottom against your back support and support the baby’s back and neck with your forearm and the head with your hand. The baby’s body should be close to you and should be directly facing your nipple/areola. This position is particularly good for nursing mothers who have had a C-section as the baby’s weight is off the tummy. Also, it leaves free space on your other side if you need to attend to a toddler.

Lying Down Position: Lying on your side, use pillows to support your head, back, and between your bent knees. Lay the baby on his/her side directly on the bed or sofa next to you. The baby’s head should be face level with your nipple and areola. This position is very comfortable especially after a C-section or if you are very tired.

On your back: Lie on your back with pillows under your head. Place your baby across your chest and tummy with the head level at your breast. Support the baby’s head and body with your arm. Feeding a baby in this position may help to slow down a fast milk flow that may overwhelm a baby who is learning to breastfeed.

“Cross Cradle” Position: Support your baby’s head in your left hand and support the back with your forearm. Support your right breast with your right hand. Hold your baby “tummy to tummy” and offer your right breast. This position will give you a free hand to support and control a newborn’s wobbly head.

Additional Resources

If you have any problems breastfeeding and need further advice, please contact:

The Lactation Clinic (visit website)
Location: Well-baby Clinic, Samitivej Hospital, Building 2, 2nd Floor.
Hours: Open Tuesday and Wednesday 9 am – 12 pm
Telephone: (+66) 02 711 8238

Breastfeeding Help line
Hours: 24/7
Telephone: (+66) 02 7118345

Latching

It is important to make sure that the baby latches onto your breast well, otherwise your nipples may become sore and your baby may not get enough milk.

  • Position the baby to breastfeed, chest-to-chest and nose to top lip opposite your nipple.
  • Wait until the baby’s mouth is opened really wide.
  • Once the mouth is gaping open, move the baby onto your breast so that the bottom lip touches the breast as far away from the nipple as possible with the nipple pointing towards the roof of the baby’s mouth.

You will know that the baby has latching on well when:

  • You see the mouth opens wide
  • The baby’s mouth is covering the majority of the areola
  • The chin is touching the breast
  • The sucking pattern changes from short sucks to deep long sucks with pauses during the feed
  • It does not hurt

How do I know if the baby is getting enough?

  • The baby will initially nurse 8-12 times per 24 hours
  • The baby will have at least 6 wet diapers per 24 hours
  • The baby will have at least one stools per 24 hours in first month
  • The breasts will feel softer after feeding

How to care for yourself

  • Only use water to clean the nipples when bathing
  • Air dry nipples after feeding
  • Avoid soaps, sprays, and creams (with the exception of lanolin) on the areola and nipples
  • Avoid nipple shields
  • Eat a variety of foods
  • Drink to satisfy your thirst
  • Rest often – nap when baby naps

Expressing your milk

Expressing your milk can reduce discomfort from full breasts. You can express your milk manually or by using a hand held or electric pump.

  • Manually – this is a cheap and easy way of expressing milk. After washing your hands make sure you have a clean, sterile container to collect the milk. Place your first finger under the breast towards the areola with your thumb on top of the breast. Keeping your fingers and thumb in the same place gently press backwards. Maintaining the gentle backwards pressure, press your thumb and first finger together to move the milk towards your nipple. Release the pressure to allow the ducts to refill and repeat. Rotate your fingers around the breast to ensure milk is expressed from all ducts. Do not squeeze the nipple, as this is not effective and will be painful.
  • Hand Pumps – These are easiest to use when the breasts are full.
  • Electric Pumps – These are useful if you need to express for an extended period of time e.g. if you are returning to work and wish to bottle feed with expressed milk or you are taking medication for a short amount of time that can enter breastmilk and need to express and dump the milk to maintain the supply.

Samitivej, We Care!

For further information, please contact:

Child Health Institute
Samitivej Sukhumvit Hospital
2st Floor, Building 2
Tel: 66 (0) 2711-8236-7
Call Center: 66 (0) 2711-8181
E-mail: info@samitivej.co.th
Facebook: www.facebook.com/samitivej

Photo Credit: Robert Whitehead via Compfight cc

Samitivej Hospital

Samitivej Hospitals are world class international health care facilities located in Bangkok, Thailand.

Fully equipped with the state-of-the-art technologies, our innovative Women's Health Center at Samitivej Sukhumvit Hospital provides comprehensive gynecological and obstetrical service for women of all ages.

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