20/05/2023
Sharing again as I am teaching a lesson on this topic next week.
The real truth about breastfeeding and low milk supply and why you probably don't have it!
Ok so I am writing this as it has come to my attention as a mum who has successfully breastfed two kiddos and as a trainee ABM mother supporter (Association of Breastfeeding Mothers breastfeeding mother supporter for those who don’t know what the ABM is) that there is a lot of bad/misled/misguided advice out there for those of us who want to breastfeed our children. Misled as in how a breastfed baby should behave (its very different from a bottle fed baby) how much babies should sleep, how much they should feed and how breastfeeding actually works in. The misguided info often comes from health professionals. Although the NHS is fantastic from my experience the knowledge on breastfeeding isn’t that great, (not there fault it comes from lack of training). So I am going to get real and tell the truth about all of the above to knock some myths on the head.
Before I go on to myth bust, I just want to say that if you have not managed to successfully breast feed, you are not a failure and should not feel any guilt, you have been let down by the system and by our society in the west. I say this because although we are told ‘breast is best’ in the west we are given advice and guided by bottle fed babies and how they behave is seen as the norm. We are given advice by out mums, aunts, grandmothers, friends who bottle fed. Common things I have heard are the following:
· She shouldn’t be feeding that much
· She should be sleeping more
· How can you be sure you are producing milk?
· You will spoil him by holding him so much
I could go on; however I will just roll my eyes and say thanks for the advice but this is what I am doing…The thing is breastfed and bottle fed babies will behave differently and this I will go into more detail about shortly. I will also add that if you have not managed to exclusively breastfeed but tried you are definitely not a failure there is no shame in combo feeding, pumping and giving a feed in a bottle or bottle feeding exclusively. The single most important thing is that you feed your baby. Being a parent is hard enough as it is without feeling like a failure or judged by someone! However I'd you want to educate yourself on breastfeeding or get some reassurance that you are doing OK then you are in the right place.
Number one myth to bust…breastfeeding is easy!
Erm well there is a truth to this, however with my first baby this was not the case to begin with. I can remember being discharged from the birth centre after being told the latch was great (it was not) and thinking everything was going to be great (it was not). By day two my ni***es were sore, really sore, and by day 3 they were bleeding and my toes were curling with every feed, which at this point was every 30 -60 minutes (I will talk about this later). It was rough. I struggled on with formula in my cupboard ready for when I couldn’t take it anymore. The midwives would come out and say try a different position which I did but it didn’t help. I was also told that it was fine to feed with bleeding ni***es (great but it fu***ng hurt). I relented and got ni**le shields which you are told not to do. I didn’t care they fu***ng helped so I was using them. For four weeks I struggled on nearly crying at every feed still roughly every 60 minutes, even through the night (I will discuss this later) Then I was sent an angel in the form of my health visitor who luckily for me was a lactation specialist who had also breastfed. She asked how things were going I was honest and she was amazing. I remember her words to me “you think its going to be easy as it’s the most natural thing in the world, but its not. I know how you feel the toe curling with every feed and I am going to help you” (or something like that). She watched me feed. The latch was wrong, I was just putting my ni**le in his mouth so he was just sucking my ni**le which is why it hurt. She explained that they need to get a good mouthful of flesh to help it be pain free and showed me how to do this (tease ni**le on his top lip till he opened his mouth wide then shive as much b**b as you can in) you can also use the CHINS acronym to help prepare for breastfeeding (taken from B***s Salford)
Close- bring baby close to your body so they can reach your b**b easily
Head free to tilt- babies head should be free to tilt back so they can open their mouths wide to get a nice mouthful of b**b
In line- Check babies head and body are in a straight line facing the same way so they do not twist their necks
Nose to ni**le- move the babies nose to your ni**le so they can reach your b**b. They will tilt their head back as they root for your b**b and your ni**le will slip under their top lip and baby can get a good mouthful of breast not just ni**le
Sustainable- the position should comfortable for both mum and baby for the whole feed.
Once the latch was established it was bliss and I can honestly say that within a week I no longer needed the ni**le shields, my ni***es no longer bled and I did not dread feeding my baby anymore. Basically if it hurts then seek advice from a lactation specialist (see https://abm.me.uk/find-a-local-breastfeeding-support-group/
for a starting point, also check out B***s https://www.facebook.com/breastfeedinginsalford/
)
Myth busted number two…Babies should sleep!!!
Oh how I wish this was true and that my babies had got this memo!! They did not (arseholes) and it is a really common worry for parents when their baby doesn’t sleep through the night or for x amount of hours during the day, after all they are supposed too aren’t they?? Erm well no! you need to ignore everything you have been told and rewrite your expectations of what ‘normal’ is (I hate normal because there is no normal, and what works for you works for you and no one should tell you otherwise) as a society we are bombarded with books and articles (and friendly advice) that babies shouldn’t wake up at night when, in fact, babies were designed to wake up at night to feed and cuddle. Your baby will regulate their feeding needs over the 24 hour period and in that 24 hour period in the first few days you should be looking to feed 8-12 times
If our expectations for babies were not so different from our babies’ expectations for themselves, much of this “problem” might disappear (https://kellymom.com/parenting/nighttime/sleep/)
Obviously though as humans we still want to sleep we still have things we need to do during the day, so to enable us to be able to get sleep we look for ways to get it. I was adamant that my first baby was going to be in his own moses basket all night (I was deluded) however at week 5 I was feeding him and fell asleep but was so exhausted I was dreaming/hallucinating that I was awake and went to put him back in his moses basket...except I didn't I dropped him on the floor (mega mum guilt, but he was ok) because of this I looked into safe co sleeping as I needed sleep and wanted to feed loads in the night so after researching I found a safe co sleeping position and tried it, it was the best thing I ever did. Now co sleeping is one of those things that may be frowned upon by health professionals that you are given safe sleeping advice by for a good reason and I will say that please do not co sleep if you have drank alcohol, taken drugs (or meds that make you drowsy) or are a smoker and look at this safe co sleeping advice https://www.laleche.org.uk/safe-sleep-the-breastfed-baby
It is also perfectly ok to feed your baby to sleep, it is something that has been frowned upon as it will supposedly make your kiddo clingy and dependant on you. Well I will say that I fed my now 6 year old to sleep alot and he is now in his own room and own bed and yes he can be really clingy at times but he is 6. If you choose to co sleep and feed your baby to sleep it is your decision as long as you are ok with it then do what works for you and your family.
Myth busted number 3…I am not making any milk!
Ok so this is a valid concern and one that I myself had with my first baby, now there are times when a woman may not make enough milk however with the correct support milk supply can be established. So first lets look at why you might think this. Common reasons for thinking this are that the baby is not sleeping is constantly feeding and hungry and baby is screaming at my ni**le (fun right).
So lets look at how breastfeeding works (science bit). While you are pregnant (about half way through pregnancy) your amazing b**bies make colostrum, and the hormone(Lactogenesis I) Colostrum is an amazing thing its super rich in nutrients and gives your baby everything it needs.During pregnancy the hormone progesterone keeps the supply of colostrum down. During the birth process when the placenta is delivered and there is a drop in in progesterone/oestrogen/HPL levels. This abrupt withdrawal of progesterone in the presence of high prolactin levels cues Lactogenesis II (copious milk production). Other hormones (insulin, thyroxine, cortisol) are also involved, but their roles are not yet well understood. This is hormonally driven and is known as the endocrine control system. It happen whether or not you choose to breastfeed or not and milk will usually ‘come in’ (I dislike the term as it insinuates that there was no milk there before when there was just not milk as you think of milk as its colostrum, I prefer to say milk has changed) in 2-5 days (although research has shown that lactogenesis II happens 30-40 hours after birth you just can’t feel the fullness until 2-5 days) You will know when your milk has changed as your b**bs will often feel rock hard.
📷
Once your milk has changed, milk production switches to the autocrine control system and is known as the maintenance phase or lactogenesis III. In this phase milk production becomes more of a supply and demand process. You and baby will be establishing your supply. You will produce enough milk for your baby (yes even if it’s a big baby) as baby will feed on demand and you will produce the milk that baby needs. Baby feeds b**bs get emptied signals are sent to the brain to produce more milk…The more you feed the more milk you make (for the full on science of this and an introduction to prolactin and FIL see https://kellymom.com/hot-topics/milkproduction/
)
Science bit over for now…so how does breastfeeding actually work then? Why is my baby crying and constantly on my b**b wanting to feed, surely this means I am not making enough milk?
Ok so when a baby is born they have tiny tummies the size of a pea, yeah its super tiny. As its so small it gets filled up really quickly but also empties really quickly. A breastfed baby will only take enough milk to fill its tummy…but will get hungry again really quickly especially as breastmilk is easily digestible. This leads to lots of feeds (8-12 over 24 hour is recommended but more is fine) Often we are comparing how a breastfed baby is fed to that of a bottle fed baby who will have been given a certain amount of ounces of milk and will get its tummy stretched quicker than that of a breastfed baby to be able to hold more milk so may remain satisfied for longer. We are also told in our baby books that babies should go a certain amount of time between feeds, I know my aunty who breastfed my cousin nearly 40 years ago went 4 hours between breastfeeds (my poor cousin she will have been starving) there is now a move away from this for bottle fed babies to baby led feeding which is only a good thing.
At times babies may become fussy and cluster feed, (feed lots in a short period of time, often at night possibly in preparation for a longer sleep) it may seem as if they are screaming at your b**b and are going on then coming off it leading you to think that they aren’t getting enough milk or that there is something wrong with you. This is normal and has nothing to do with milk production. If you are wanting to exclusively breastfeed the worst thing you can do is give your baby a bottle at these times. Giving a bottle will mean you are not feeding and sending the signals that you need to make milk so don’t do it unless you have decided to combi feed which is also fine.
Sometimes you may also have a slow ‘let down’ I know now that I did for the first few weeks with my first. My b**bs were really full of milk so when he latched on they just wouldn’t let go of the milk so he would scream at my b**bs which was horrific as I thought he was getting no milk. To overcome this I hand expressed before I fed him so the let down happened before he got to my b**b so he would get milk immediately (see [https://kellymom.com/bf/got-milk/supply-worries/letdown/]
(https://kellymom.com/bf/got-milk/supply-worries/letdown/
) for more info)
While we are talking about not making enough milk lets look at signs that it is actually going ok…
· Your baby has 8 feeds or more in 24 hours.
· Your baby is feeding for between 5 and 40 minutes at each feed
· Your baby has normal skin colour
· Your baby is generally calm and relaxed whist feeding and is content after most feeds
· Breastfeeding is comfortable
· When your baby is 3-4 days old and beyond you should be able to hear your baby swallowing frequently during the feed
· Your baby is having the recommended wet and dirty nappies-
A baby should start to move their bowels within the first 24 hrs to pass meconium. A new born baby should be pooing every day and on days 1-6 we would expect them to be p*eing their age so day 1, 1 p*e, day 2, 2 p*es and so on...you will know if baby is p*eing from their nappies. After your milk has come in (around day two to five), we’d expect to see six wet nappies in 24 hours and three poos the size of a £2 coin or bigger. After week four, some babies poo rate can slow right down. This doesn’t mean anything is wrong. Some babies can skip several days between poos and this isn’t anything to do with the amount of milk they are getting or your milk supply. if your baby hasn't pooed for a few days and you are worried it is worth getting some advice from a lactation consultant or you health professional.
·Myth number four…if you have small breasts you can’t breastfeed
Not true in anyway, trust me I have small b**bs and my babies have had no issues with weight gain, growth and meeting milestones.
Myth number five…I can’t express much so I must not be making enough milk
Actually pumping and breastfeeding are not related at all. A breast pump removes milk form the b**b in a completely different way to a baby. Many women who have a healthy milk supply will have trouble expressing so do not go off how much you express to see how much baby is getting.
Myth number six…you can’t drink while breastfeeding or you have to pump and dump
Alcohol is present in breastmilk at the same level as in her blood: it rises and falls along with it. If you know your blood alcohol level, you know your milk alcohol level. Alcohol passes freely into breastmilk and has been found to peak about 30 to 60 minutes after drinking, 60 to 90 minutes when drunk with food.
Alcohol also freely passes out of breastmilk so there is rarely need to express milk and throw it away. If the alcohol has gone from her blood, it will have gone from the milk. It takes a 140 pound (10 stone, or about 63.5kg) woman about two to three hours to eliminate the alcohol in one serving of beer or wine from her body; the more alcohol that is consumed, the longer it takes for it to be eliminated. For example, if the same woman had four drinks, it would take nine to ten hours for her breastmilk to contain no alcohol.
Maternal blood alcohol levels must attain 300 mg/100ml before significant side effects are reported in the baby. (80mg/100ml fails the police breath test).
You don’t need to pump and dump except for comfort, I can remember being out (yes I got let out) and hand expressing in the sink in a club as my b**bs had become uncomfortably full, got some weird looks but I didn’t care I needed the milk gone! **Myth number seven...weaning a breastfed baby is more difficult. There is no evidence to support this. It is more likely that you are feeling the pressure of society to stop breastfeeding at a certain age. I know from my own experience that when my first baby turned one I had people asking when I was going to stop feeding and I did feel like I was wrong to continue. Comments like 'well he's not a baby now' and 'he can have cows milk' and 'you will make him dependant on you', made me question my feelings of not wanting to stop. I fed my first baby until he was 2 and I can honestly say that weaning was not a problem, I did get tougher with feeds and he only had 3 a day from 18 months to 22 months and then only a night-time feed to sleep feed for the last 2 months. He honestly just got it and when I said no to him he accepted it. He did still try it on tapping my b**bs and asking for milk but was happy with a drink of cows milk. There honestly is no age to wean from the b**b if you and baby are happy to continue to breastfeed then do it until you want to stop. Research points to natural weaning happening (in societies where it is allowed to happen) at between 3-4 years. It is not harmful to continue to breastfeed after a certain age. some mums do have to return to work when baby is around 9 months this doesn't mean you have to stop b**bie feeding, employers should give you pumping breaks and you can still feed baby when you are not at work they may just need expressed milk while you are not there. Weaning may appear difficult because unlike a bottle the breast is not just food and drink, it is also comfort and even after weaning your kiddo will still want comfort! se this article for more information https://www.laleche.org.uk/breastfeeding-beyond-infancy/
During the first 6 weeks breastfeeding with my first baby was tough, I had doubts but was given amazing support which sadly many of my friends have not been given leading them to believe they failed in some way as they were unable to breastfeed. I hope that if you read this you will gain a slightly better understanding of how breastfeeding works and will be able to continue your breastfeeding journey. And if you genuinely have any concerns please get support from an experienced lactation consultant
