Breastfeeding is difficult for many new mums. From breastmilk supply issues and nipple pain to baby’s feeding routine, you can end up feeling very alone and deflated.
So, to help take some of the stress away from breastfeeding bubs, we asked the Australian Breastfeeding Association to help with your breastfeeding questions.
The Australian Breastfeeding Association (ABA) is Australia’s largest breastfeeding information and support service. It offers much-needed assistance to more than 80,000 mothers every year. The ABA also provides up-to-date information and continuing education for thousands of health professionals working with mothers and babies. So, without further ado, here are the answers to your breastfeeding questions from the ABA Breastfeeding Information and Research Team.
What can be done to help with milk supply issues?
At my son’s six-week check-up his weight gain was low, having only put on 70 grams. I began offering formula after each feed and, within a week later, he had put on another 60 grams. His behaviour and sleep also began to improve. Following each breastfeed, my son is currently taking around 150mls of formula but ideally I want to stop formula altogether. My doctor has put me on domperidone, but what else can I do to help my milk supply? — Chelsea
ANSWER: Many mothers worry about their baby’s weight gain and their milk supply. The good news is there are ways to tell if your baby is getting enough milk while breastfeeding. Plus, there are lots of things you can do to increase your supply if it has dropped.
Providing baby is latching well, the quickest and most successful way to boost your supply is to breastfeed more often. Offer a breastfeed every 2-3 hours during the day. Alternatively, increase the number of feeds by offering the breast in between your baby’s usual breastfeeds. Every time you drain milk from the breast, it is a signal to your body to make more.
Young babies usually feed around 8-12 times a day or more, and every feed stimulates and builds your supply. It may be helpful to see someone experienced in breastfeeding to watch a feed and give you some tips on improving baby’s latch and suckling. Also, breast compression and switching sides a few times each feed can help the baby to get more milk.
Your baby’s wet and dirty nappies are a great way to check if they are getting enough milk. At least 5 heavily wet disposable nappies (or at least 6 very wet cloth nappies) and at least three soft poos (although it’s common for older babies to have fewer) each day are good signs that your baby is getting enough.
Weight gain can vary between babies and even week to week. It should be used just as a guide and looked at over a period of weeks, rather than just one.
Lots of skin-to-skin time and increasing the number of feeds can help get you back to your breastfeeding goal. Indeed, you may need some support and guidance while you rebuild your supply and decrease your formula usage.
TIP: The ABA’s new app, Mum2Mum, allows new mums to create a baby care timeline, which can assist in keeping track of nappies on a daily basis. This may just offer you the reassurance you need to put your mind at rest. You can download the app for free on the App Store or Google Play.
For extra support, you can call the National Breastfeeding Helpline 1800 686 268, or use the ABA’s LiveChat service.
My son has a cleft palate. What can I do to increase my chances of breastfeeding?
We are currently trying to use a nipple shield but he often fusses and gets frustrated. How can I have more luck with breastfeeding? — Honey
ANSWER: The journey of breastfeeding a baby or toddler with a cleft palate is not easy. Positive breastfeeding support along this journey is certainly available, but sometimes it is hard to find. ABA’s website, as well as our specialised booklet, has some encouraging information on the journey of breastfeeding with a cleft palate.
Increasing supply and breastfeeding cleft bubs is a special situation that requires an assessment of all the things going on. Breastfeeding a baby with a cleft palate is likely to include assistive techniques, as the baby is unable to form a vacuum to draw milk out of the breast. However, they are able to swallow, so if milk is placed/squirted into their mouth they can swallow the milk – no sucking required. This may be done using breast compressions, like hand expressing, but directly into the baby’s mouth, or with consideration given to a supply line. For example, using gravity, a pressurised system with syringes of expressed breastmilk, carefully squirting little bits of milk in a nipple shield or providing breastmilk via a spoon, cup or special bottle.
Why is my baby now refusing the breast?
My bubs has started refusing the breast but will happily be bottle-fed (expressed milk or formula). What can I do to continue breastfeeding? — Chloe
ANSWER: Some babies go through periods of time where they do not seem to be happy at the breast and refuse to breastfeed. In these situations, it is important to take steps to maintain your supply by expressing frequently; particularly at the times that your baby would normally breastfeed. It is wonderful that you are still able to provide your baby with breastmilk and, with a little time and patience, babies will often come back to the breast.
Ensuring your milk is ready to go can be encouraging for your baby, as he or she is then rewarded with a big mouthful of milk from the very first suck. Try offering your breast when your baby is sleepy or asleep. Sometimes, it can also be helpful to offer the breast after the edge of hunger taken is off with the bottle or even after most of a bottle feed.
TIP: Support can be very useful in times like these. You can contact an ABA Breastfeeding Counsellor via the National Helpline (1800 686 268).
Is there anything I can do in the lead up to my next baby, to help my chances of succeeding breastfeeding the second time around?
With my first baby, I had supply issues as well as some nipple trauma and latching troubles and had to give up on breastfeeding. — Amy
ANSWER: It is such a great idea to seek support and information prior to the birth of your next baby if you had some difficulties with breastfeeding the first time around. Have you heard of our Breastfeeding Education Classes? These are a great way to gather all the information you need prior to the birth of your baby. Then, if you do face any hurdles you know some problem-solving strategies and where to go for further help.
Each breastfeeding experience is different. So, of course, the good news is that the issues you faced last time may not even happen this time around. To establish your milk supply in the early days, it is helpful to spend as much time as possible skin-to-skin with your new baby, allowing them unlimited access to the breast. This sends the message to your body to make milk. If you have any discomfort or pain seek support as early as possible. After all, if your baby’s breast attachment isn’t quite right it can lead to damage (as you know) and can impact supply.
When is the ideal time to express to keep supply up?
If milk supply is weak, should I express first thing in the morning, before feeding baby, or after baby feeds. Or maybe I should express twice a day after feeds? — Puja
ANSWER: It is quite common for mums to feel they may not have enough milk when, in fact, all is well. The best way to know your baby is getting enough milk is by their nappies and their growth (at least 5 heavily wet disposable nappies or 6 very wet cloth nappies, and at least three soft poos). It is common for older babies to have fewer than this.
ABA’s new app Mum2Mum features a baby care timeline. This allows you to track nappies, which may provide you with some reassurance. You can download the app for free via the App Store or Google Play.
If you feel as though your supply is low it can be helpful to express. However, as an alternative you could offer extra feeds to your baby – every time milk is removed, milk is replaced. It’s a good idea to touch base with an ABA Breastfeeding Counsellor or contact the National Breastfeeding Helpline or LiveChat to discuss your individual situation. With any supply issue, it is a good idea to work out why you have low supply and address it that way.
TIP: If you are expressing to increase milk supply, it is beneficial to express between feeds, as you will remove more milk compared to expressing at the end of a feed. You will often find that you will have more milk in the mornings than in the afternoons.
What is the best way to get a newborn (six days old) into a feeding routine?
Since we got home from the hospital and there is all the extra stimulation and things to do (school run etc), I’m just all over the shop. I’m also having supply issues – extra pumping and latching issues due to a tongue-tie (has been snipped) and damage to my nipples. — Leanne
ANSWER: Sorry to hear that you have been experiencing a challenging time with your new bub. The second time (or third, fourth etc.) can be a whole new ball game – just like the first. Is there support around you (partner, friends/family/neighbours)? Can anyone help with your older child while you get breastfeeding established with your new baby?
Hopefully, things settle after having the tongue tie snipped. If not, it would be a good idea to revisit your medical practitioner to discuss. Additionally, regular skin-to-skin contact is also useful for your milk supply and for your baby to attach well to the breast.
Little babies are such a great size to tuck into a baby carrier, like a stretchy wrap. At this age, they basically eat and sleep. In fact, so much so that it is often easiest to keep them on mum between feeds. Certainly, this allows you to get things done and keep baby happy. Many mums find a routine really starts to develop organically as baby grows and matures. Indeed, the easiest way to establish supply and bond well at this stage is to follow your baby’s lead and enjoy the snuggles!
TIP: Remember, the Breastfeeding Helpline is available on 1800 686 268 if you ever need support.
What tips can you offer to prevent nipple soreness?
Is there anything that can be done to prepare the nipples and how can soreness be addressed once breastfeeding? — Lola
ANSWER: There is no need to do anything special with your nipples to prepare them for feeding. The way in which your baby latches to the breast could be the cause of nipple pain and damage. Attending Breastfeeding Education Classes could be helpful, as they will discuss positioning and attachment.
If you do find yourself with sore, cracked or damaged nipples it is important to seek help from someone who is able to assess how the baby is latching to the breast. Your care providers (if still in hospital) or an International Board Certified Lactation Consultant (IBCLC) may be able to come to your home.
Again, attending a local group meeting is a fantastic way to seek additional support and reassurance. An ABA Breastfeeding Counsellor may very well be present and can watch you feed your baby, providing guidance if necessary. Alternatively, you can call our National Breastfeeding Helpline on 1800 686 268 or try our LiveChat service.
Breastfeeding is different for everyone and is quite likely to be different for every baby. It’s important not to compare yourselves too closely to others. We hope these breastfeeding Q&As offer you some assistance and useful advice. Feel you need further help and support? Don’t hesitate in contacting the ABA’s National Breastfeeding Helpline on 1800 686 268.