Recommendations for breastfeeding
1. Exclusive breastfeeding is recommended for up to 6 months, and continued breastfeeding beyond that together with appropriate weaning should be practiced.
2. Early initiation to breastfeeding is important to the establishment of successful breastfeeding.
3. Skin to skin contact after delivery and breastfeeding within the first hour after birth are strategies that increase exclusive breastfeeding rates.
4. Parents must be mentally and physically prepared for the commitment. Although breast feeding is an act of instinct, it still requires practice. Mothers should attend breastfeeding courses and learn how to breastfeed properly.
Practical steps to breastfeeding
1. Shoulders and arms should be relaxed. Adopt a comfortable position. Use pillow to support if necessary.
2. Use your hand to support your breast by using “U hold”, then position your baby on his / her side, with his / her belly touching yours.
3. Tilt her head slightly back and gently stroke her lips with your nipple until she opens her mouth wide.
4. Her chin should touch your breast first, the nipple should be at the back of baby’s mouth. Remember to bring her to your breast and not your breast to your baby.
5. Make sure your baby takes a good mouthful, covering the whole areola, not just the nipple. Her nose should be clear of your breast so that she can breathe easily while feeding.
6. At first, she will do short and rapid sucks to stimulate the milk flow (let-down reflex).
7. Once the milk starts to flow, she will suck more slowly and deeply with pauses. The latch should not feel uncomfortable, it should be more of a tugging sensation. You should see her jaw moving and may also hear her swallowing. There should be no clicking sound when the baby is latched on properly.
8. If the latch is painful and uncomfortable use your “pinkie” finger to insert it between the breast and baby’s mouth push down the breast to unlatch and retry again.
9. Let the baby suckle until she is asleep. The baby will eventually let go of the nipple herself when she is satisfied.
Common questions on breastfeeding
Is your baby getting enough milk?
1. Your breast should feel less tender and softer after each feed.
2. Your baby will feel contented, settled and usually sleep after each feed.
3. Baby passes clear urine 5-6 times and the stool colour will gradually change from dark green to yellow colour.
4. Your baby's weight increases.
When to feed the baby again?
1. After 20-30 minutes of feeding, usually your baby will be satisfied and usually sleep.
2. Feed the baby frequently - either every 2 hours (10-12 feeds in 24 hours) or when the baby wants.
What can I do if I want to go back to work and still continue to breastfeed?
1. For working mothers, it is recommended to store enough breast milk (at least 8-10 bottles) in the freezer before you start work.
2. Prepare the steriliser or steamer to sterilise you breast pump equipment and bottles. Sterilise it before you bring to office.
3. Prepare a cooler bag with pre-frozen ice pack to store expressed milk from office.
4. Express your milk every 2-3 hours at workplace and transport it home in cooler bag with ice packs.
5. Label the date and time of expressed milk on the bottle.
6. Frozen breast milk can be stored up to 3 months. Breast milk stored in the refrigerator at 4°C can be stored up to 5 days.
7. Thaw the milk using a milk warmer or move it from freezer to refrigerator. Do not use microwave to thaw or heat up the milk. Warm the milk with milk warmer or use a bowl of warm water to warm the milk.
8. Breastfeed the baby directly whenever you are with the baby.
How to Increase breast milk supply?
1. The best way to increase milk production is through frequent stimulation via baby’s suckling. Oxytocin (milk releasing hormone) and prolactin (milk producing hormone) will be released in response to baby’s suckling. Therefore, frequent suckling promotes and stimulates more milk production. Prolactin level is produced most at night.
2. Galactagogues such as Fenugreek or Domperidone can be used if you do not have enough milk production.
3. You may also speak to a lactation consultant if you still do not produce sufficient amount of breast milk.