STEP THREE in Preparing Mentally for Having Your First Baby: Feeding: for most it’s not comfortable or easy! Be relaxed and take your time.

• Prepare for the possibility that breastfeeding may not happen easily,  immediately or at all.  The key is to try and be as relaxed as possible with baby and take your time.

When baby is born, one of the first things you are encouraged to do is get baby onto your breast.  Most mothers expect it to be second nature and for many it is.  However, for some it can be incredibly difficult or not possible at all.  I know women who, when they realised they could not breast feed, cried for days and felt horribly guilty.  It is so important to prepare for the fact that it may be difficult for you, because guilt is such a stressful emotion and one which can be avoided.  There are many fantastic formula milks on the market, which I will discuss in my next bog, and babies have been thriving for decades on formula.  So if you are one of those who cannot breast feed, you must not worry, your baby will be fine.

There is no denying that if you can get baby on your breast, it is a wonderful thing to seal the bond.  However, just being next to you, skin-to-skin, is bonding.  He’s used to being attached to you via the umbilical cord, so having that flesh-on-flesh contact while adjusting to being out of your body, is comforting and will help him regulate his body temperature.  Of course, suckling on the breast is very reassuring for baby but it is not possible for everyone.  If it does not happen for you immediately, don’t panic!  Try and be calm and let him take his time.

Women worry that if he does not feed straight away there is something wrong.  Do not worry.  Some babies take a little longer.  He has just survived birth and learned to breath, which are both massive achievements.  Feeding is next on the agenda, it just may take a little longer than you expect.  If he seems to want to feed but can’t latch on, try not to get frustrated and ask a midwife to help you.  Don’t worry if you feel like you don’t know what to do.  He doesn’t either!  You and baby are learning together.  Remember, even though he is no longer connected to you via the umbilical cord, he is still sensitive to everything you feel.  If you are nervous and stressed, he will be too.  So try and relax and be patient.  Together you’ll work it out and remember he does have one advantage over you: an intensely strong sense of survival.

It is understandable that you might be concerned if breastfeeding doesn’t happen within the first few hours.  Be assured however, that they are incredibly robust little things and the reason you are encouraged to breastfeed straight away is more about bonding than his survival.  Of course it is good to start all the fundamental processes as soon as possible but if it takes a little longer don’t worry.  The important thing is to try and relax.  Baby is completely in tune with you, as if you are one person (like you were when he was in the womb).  Any anxiety will be passed onto him.  So take your time.

• A reassurance:

When baby is born, about 5% of his body mass is made up of brown fat[1].  It is distributed over his back and its purpose is to prevent baby getting a chill or worse, as his nervous system is still underdeveloped and can’t respond quickly to temperature changes.  However, it also means that he has a fat reserve to keep him going.  He might get hungry but he won’t starve for quite a while!  Obviously you should not rely on this, and I’m not suggesting for a moment that you let your baby go hungry, but the message I am trying to get across is that you don’t need to worry if things do not happen immediately.  I know I am repeating myself a bit, but no matter what you say, there is so much anxiety tied up with feeding, if it isn’t easy for the mother, and I want to try to help to dispel some of that.  Baby has had a lot to learn already today and feeding is rather tricky!  Being relaxed with your newborn is the key.

• Mentally prepare for the fact that breastfeeding is difficult and not very comfortable.

Most babies are terrible at breastfeeding for days.  I had to help both of my boys latch on for weeks.  If it is agony try latching on again but don’t have any illusions that if they latch on right it feels nice.  It should not be excruciatingly painful but I’ve never met anyone who, initially at least, if not for extended periods of time, did not find breastfeeding really uncomfortable.  I certainly did, and from baby number two, you have uterus pains to go with it!  Even for mothers who are able to feed relatively easily, it’s not the dreamy experience you might imagine.  As well as being uncomfortable, it can be incredibly frustrating for both parties.

• If baby won’t latch on, but you are sure he is hungry, persevere.

One minute baby is perfectly happy, the next he is crying for food.  Leave it too long and baby gets so tearful that he finds it hard to feed at all.  For a new mother, who thinks her little one is hungry, but he doesn’t seem to want the breast, it can be very hard.  My second son was like this.  If he cried for food for more than a couple of minutes, I would have to just keep stroking his nose on my nipple until he calmed down enough to latch on.  He was hungry, but too frustrated to do anything about it but cry, sometime for 20-30 seconds, which can seem like an eternity.  When they are used to having food on-tap via the umbilical cord, waiting a few minutes for food can seem endless for them.  Another frustration was that he would sometimes only feed if I was standing up and slightly moving (babies are comforted when you replicate the womb environment[2]).  I would be sitting down, all comfy, when baby would start whining, but he didn’t seem to want the breast.  Confused I would stand up and start jigging him slightly, suddenly he would be feeding no problem.  Typical, I now had to watch my favourite TV show standing up!  Each baby is different and it is impossible to predict how yours will be.  It’s all just trial and error.  You’ll pick up tips about how others do it, and you’ll experiment to see what works for you.  If one thing doesn’t, then try something else.  If you are relaxed, it makes it all a lot easier.  Easier said than done, I know, but each day it will get easier, because each day you’ll get to know your baby slightly better.

• Get help if you need it and if it is sore act quickly, or it can get very painful very quickly.

If feeding does not seem to be working for you, but you really want to breastfeed, there are many professionals out there who can help.  Friends who found it agony, have used professionals and sware that they were worth every penny[3].  Don’t wait until it is almost to much to bear or under estimate how quickly issues with feeding can manifest into depression.  If your nipples crack and get sore, you can use creams such as Lansinoh.  I swear by the stuff.  My nipples would get slightly sore and engorged on occasion and I would apply the cream (which has a vaseline like texture).  If you don’t apply before your next feed, the nipple just gets worse and worse.  I know women whose nipples cracked and bled with every feed.  I can’t imagine the agony!  Don’t let them get this bad if you can.  You can try nipple guards as well.  I never did, but I know plenty of people who said it just gave their nipples a break when they got sore.

• Mastitis

Be aware, if one nipple is particularly sore, so you decide to give one breast a rest, you run the risk of getting mastitis[4], which can develop very quickly and is excruciatingly painful.  It’s when the milk ducts block creating lumps in the breast and the only way to get rid of them is by massaging the blockage away which feels like you are massaging a bruise – ow!  However, if you do not get rid of it, it can manifest into infectious mastitis which has flu like symptoms (see footnote 4 for NHS site link with information).  The key to all of this, as I’ve already mentioned, is, if you have a problem, sort it right away because it can only develop into something bigger and worse.

Some common feeding problems are when your milk doesn’t come in, or if you can’t produce enough milk or baby won’t or can’t latch on.  Here are some possible solutions:

• If your milk doesn’t come in you can use pumps.

If your milk doesn’t come in, there are powerful pumps you can use while still in hospital.  If you are determined to breast feed but this is your problem, please enquiry at the hospital.  The staff are very busy with babies arriving constantly so make them realise how important this is to you.  A friend of mine refused to leave hospital until she was breastfeeding.  They hooked her up to one of these machines and eventually her milk came in.  She went home breastfeeding, but it took a lot of perseverance.

• If you can’t produce enough milk.

You can try to improve the quality and quantity of your milk in a number of ways.  Here are a few things I tried:

1. Supplements.  There are many on the market and if you type ‘breast milk supplements’ into Google, there are a million options. I used a herbal supplement called Fenugreek[5].  It is incredibly good for you and has many properties, one of which is to increase your milk supply.
2. Rest.  The more rest you can get when you have just given birth, (sleep whenever baby does if you can) the better it is for your milk quality and quantity.  Some people do not have this luxury, but be aware of how energy intensive it is producing milk, so try to limit other very exertive activities.
3. Drink lots of water.  You can’t drink enough when you are breast feeding.  Try to drink water while baby is actively feeding.  Avoid caffeine if you can.
4. Eat plenty of carbohydrates.  No matter how much weight you put on during pregnancy, “breastfeeding isn’t the time to try that carb-cutting fad diet your friend told you about. Both you and your baby will benefit from eating healthy, complex carbohydrates during breastfeeding.”[6]  Eating well is incredibly important, check out the Health Journal (see footnote 6) for advise.  It is tempting to try to diet once baby has arrived but easier to try not to ‘eat for two’ while you are pregnant.  You don’t need to.  What you need to do is eat little and often, and focus on healthy foods with high nutritional value rather than puddings and cakes.  Getting rid of ‘baby fat’ can be very stressful when you are trying to regain your personal identity with a young baby.

• If baby can’t or won’t latch on you can express.

Another common problem is that even though you have lots of milk, baby doesn’t seem to want to, or be able to latch on.  I know many people who expressed milk for months, giving their baby the goodness and boosting their immune systems with the breast milk, feeding them from a bottle.  This is also a good solution, if you want to go back to work, while keeping up the breast milk feeds.  Do not underestimate how exhausting this can get, however.

There are many different breast pumps on the market.  Some people prefer manual pumps because they feel that they are easier on the breast and once you get the flow going, the expressing is a nicer experience.  (Some people blame electronic breast pumps for stretch marks on their breasts.)  I never used one, as I was advised to get the electronic Medela double pump and it worked for me.  The double pump means you can express from both breasts at the same time, so it takes half the time.  I really recommend it.  Breastfeeding isn’t enjoyable,however.  When I breastfed I felt like a cow (because baby spent so much time attached to my breast), but when I was hooked up to the electric breast pump, whirling away, I felt like a cow in a milking farm!  To add insult to injury, your nipples engorge in the pump for the duration which isn’t painful but looks like something out of Stanley Kubrick’s film ‘Clockwork Orange’.  Best to keep this sight away from your partner if you are trying to rekindle your sex life – nothing sexy about it!  None of this is a joyful experience, but can save you the even worse feeling of guilt which some people feel, for not providing the breast milk goodness.

Hopefully feeding will be a piece of a cake for you, and now that you know what to expect, it might be easier still.  Try and relax, listen to baby, and if you run into any problems, ask for help before you are in too much pain or experience any real stress.  Remember there is a solution for every problem.  Good luck!

Tiffany Newton