1. Incorrect latching and position
How to tell if correct positioning & latcing-on have been achieved:
i) Mother's position must comfortable for both mother & baby. Mother can be either lying down or seated. If baby struggles or cries, it is usually a sign that baby is uncomfortable. Soothe baby first before continuing. Do try other position.
ii) Baby must be fully turn to face mother - baby's stomach must touch mother's stomach.
iii) If necessary, support baby's head with a pillow so that baby reaches mother's breast.
iv) Tease the baby's lips with the nipple until baby's mouth opens wide, as if yawning.
v) Once mouth widely opens, gently push baby's head towards the breast (Important: move the baby to the breast not the breast to the baby). Aim baby's gaping mouth at the nipple, making sure that baby's mouth close around a good part of the areola (coloured area surrounding the nipple). It is unnecessary for baby to take in the entire areola. However, mother should never let baby suckle on the nipple alone as this will lead to cracked nipples & irritation.
vi) Let the baby suckle until the baby has had enough & unlatches. If mother needs to stop midway, gently break the suction by inserting a clean fingertip into baby's mouth. Then, slowly pull the nipple out.
If baby is correctly latch on to mother's breast, the mouth will be wide open, lips flared out (like fish lips). Baby will also have as much of mother's areola in the mouth as possible.
2. Low milk production
Almost all mothers go through a period of questioning whether their milk supply is adequate, especially when they begin breastfeeding. But according to many experts, true milk insufficiencies are rare.It can happen if you stop feeling a strong letdown reflex or lose the feeling of fullness in your breasts or if milk stops leaking from your nipples - but these are actually natural, a common sign that your body has adjusted to your baby's feeding requirements.
A mother's milk supply may decrease temporarily because of infrequent feedings brought on by sore nipples, stress, emotional lethargy or a poor latch-on technique. Estrogens containing birth control pills or an illness can also affect milk production. For a few women, biological or physical conditions such as hormonal disorders or breast surgery can cause their milk supply to be low. If you start giving supplementary feeding or bottle-feeding can also lead to minimal milk production.
First, rule out false alarms about your milk supply. Here is how to tell if your baby is getting enough.
i) Newborn will typically lose between 5 and 10 percent of their birth weight in the first few days before gaining it back. Weight gain is the way to make sure your baby is getting enough milk.
ii) Baby nurses frequently - every two to three hours for a total of at least eight to twelve feedings a day.
iii) You hear him swallow and you sometimes notice milk in the corners of his mouth.
iv) He appears healthy and active
v) He wets approximately five to eight diapers a day. Essentially it is easy to monitor this by cloth diapering, most suitable for newborn is prefold or the traditional square mueslin cloth (kain lampin)
If you feel you are not producing as much milk as you (and your baby) would like, try the following technique:
i) Make sure that you are not stressed and think breastfeeding is a tedious task. Remind yourself the purpose of this journey is purely out of love.
ii) Feed your baby often. Frequent nursing session will stimulate your body to produce milk.
iii) Get the best latch-on possible. Check for proper positioning at the breast.
iv) Improve your diet by eating more body building foods (eg. fish, chicken, meat, eggs, nuts, seeds, beans) and protective foods (eg. fruits and vegetables)
A sleepy baby may need to be awakened and encouraged to nurse more vigorously (thus stimulating your glands to produce more milk). To arouse baby, try switching sides frequently and alternating positions. Mothers who determine that their milk output is actually low may want to have their thyroid levels checked. Low thyroid levels are known to impede milk supply. Please consult your Lactation Consultant.
3) Drop in milk production
These could be the reasons on low milk production:
i) Mother's body has adjusted to a schedule. Stress and tiredness will impact milk supply. This is likely to happen to mother's who are returning to work after confinement.
ii) Baby is given supplement other than breast milk. If baby is given formula or water along with breast milk, it will affect mother's milk production.
iii) If baby starts taking solid from 4 to 6 months of age, his demand for milk will reduce and mother's body will adjust too.
iv) Mother may want to check on her food intake. Some food groups can be the cause of low milk production.
v) Reduction in pumping or expressing milk may affect the milk supply.
If any of the above is confirmed, mother may want to resolve the situation using the techniques below:
i) To maintain milk supply, mothers must either breastfeed or express milk every three hours. Therefore, continue to breastfeed baby whenever mother is home (after work, at night and when the mother is not working). Mother also must express milk at the workplace.
ii) Mother may try tandem nursing-simultaneously express milk from one side when the baby is feeding on the other side.
iii) Some foods like barley and herbs like fenugreek (halba) have been proven effective in increasing milk supply. Do consult your Lactation Consultant to check whether it is advisable.
To be continued: Part 2 : Breast engorgement, inverted nipple and leaking breast