Gentle First Year: The Essential Guide to Mother and Baby Wellbeing in the First Twelve Months. Karen MacLeod Swan

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СКАЧАТЬ to mummy: lay the baby across your lap, with the baby’s tummy lying next to your tummy. The baby should be supported high enough so that her face is at breast height. A C-shaped breastfeeding pillow is ideal as it is long enough to curl around you, support the full weight of your baby and bring her up to the right height for you. This will help you to sit comfortably without having to bend over, preventing neck and upper back strain.

       Nose to nipple: Move the baby towards the breast and stimulate your baby’s rooting reflex by brushing your nipple on your baby’s upper lip. This will encourage the baby to open her mouth. (Never move your breast to the baby – it must always be the other way round.)

       When the baby’s mouth is open very wide, place the baby on the breast so that her bottom lip is curled back and her chin is pressed into the lower breast area (her chin should touch the breast first). In ratio terms, her mouth should cover the areola above the nipple one part to three parts below the nipple.

       The nipple should be directed at the back of the mouth, as far away as possible from the baby’s tongue, as the baby doesn’t actually suck the nipple itself, but stimulates the wider areola for milk release (the NCT says pertinently: it’s breastfeeding, not nipple-feeding).

       Sit centrally. This is vital for back care.

       If your baby is particularly windy, modify this technique by sitting the baby into a more upright position. Each time the baby naturally breaks off, wind gently.

       To break the latch, never just pull the baby off, as they get a powerful suction going! Put your little finger into the corner of her mouth first to break the suction.

      Breast and Nipple Protection

      In the early weeks, your breasts and nipples are naturally going to feel sensitive, even sore, until they adjust to breastfeeding. The most important preventative measure is to make sure the baby is latching on properly (see above). Some mothers like to use a barrier cream such as Lansinoh (which is pure lanolin) or Kamillosan after every feed for the first few weeks until you adjust. It is not strictly necessary to wash it off before the next feed, but I do advise it, as the commercial varieties do contain some preservatives.

      An alternative way to treat sore nipples is to express and rub a little of your milk onto them and allow them to air dry. Equally, if the nipples are very bad, or bleeding, some midwives recommend applying Vaseline before putting on the lanolin barrier creams. I have had mothers swear by it. If your nipples are too sore to feed, latex or plastic nipple guards are available at most pharmacies and can tide you over for a few days whilst the nipple heals. But if it is getting to this stage, please see a breastfeeding counsellor or lactation consultant for advice. They may also recommend that you express your milk for a couple of days and feed from a bottle (remember to express 30–45 minutes before the feed is due, so that the baby is fed on time).

      If your breasts feel hot and tender when engorged in the early days, savoy cabbage leaves from the fridge naturally cup the breast and provide an instant cooling balm, or just drape over a cold wet flannel. Equally, you can buy gel-pads that you leave in the freezer. They are breast-shaped and can be placed reasonably discreetly inside the bra.

      Although it is normal to feel a slight sharpness in the early days, breastfeeding should be comfortable. If you experience any sharp ‘cut glass’ shooting pains (indicative of thrush, see homeopathy for third-degree tears) or redness of the breast tissue, lumps or feverishness (indicative of mastitis, see mastitis) see your breastfeeding specialist or health visitor immediately. Mastitis can be treated with Bowen treatments and massage (see massage technique for blocked milk ducts) or in some cases antibiotics. Thrush can be treated with antifungal creams/tablets.

      massage technique for blocked milk ducts

      The following light massage technique clears the breast lymphatics and reduces the incidence of blocked milk ducts and mastitis. Using the middle three fingers, gently massage in ever-increasing clockwise circles from the edge of the areola to the upper breast and armpit area. Perform eight to ten times, twice a day.

      bowen technique for all grades of mastitis

      Bowen moves can be performed around the breast in an elliptical pattern, and I can vouch for the fact that mothers experience almost immediate relief. You can treat yourself whenever you feel your breasts are becoming sore or engorged.

      THE SECOND STAGE

      After three to five days (usually five days for Caesarean mothers), when most of the placental hormones (oestrogen and progesterone) have left the mother’s body, prolactin is produced and the main milk ‘comes in’.

      Most textbooks on breastfeeding explain that the breast milk flows in two stages: the fore milk and hind milk. Whilst I respect this viewpoint, I reject the concept that there are two types of milk. I am also sceptical of rigid feeding times in the first two weeks. Some babies are better than others at breastfeeding, and their skill can make a big difference to how long a feed takes. Another important factor is how quickly the mother ‘lets down’ her milk. Again, some are faster than others, which determines how long the baby is on the breast. I therefore advise my mothers to relax if their baby stays on an individual breast for just 20 minutes.

      Breastfeeding Problems in the Second Stage

      This second stage of breastfeeding is characterized by engorgement and leaky nipples, and mastitis is most common at this point. This is because it takes a few weeks for the milk supply to even out. Mastitis occurs when residual milk becomes compacted and the surrounding tissues inflamed. If you suffer from mastitis but are leaving the baby on for 40 minutes or more, check the baby’s latch (see box, correct latch technique and tips). Poor latch technique is incredibly common and can lead to prolonged and inefficient feeding. Sometimes the difference between a good and poor latch can be a matter of millimetres, so I strongly recommend seeing a specialist/counsellor at a breastfeeding clinic who can analyse and correct your latch. (Your midwife/health visitor will be able to give you details of your local clinic.)

      Mothers sometimes get into a habit of feeding their baby in one position, or they favour one side over another. Vary your routine, but always start each feed on the same side you finished the previous feed. Some mothers keep a notebook next to their feeding chair to remind themselves of whether it’s left or right this time, but you can also try reminding yourself by pinning a ribbon around the front clasps on your breastfeeding bra or wearing a hair band on the corresponding wrist. I laugh that you can always tell the more practised breastfeeding mothers – they’re the ones who absent-mindedly cup their breasts (one side will be heavier than the other) or gently press the upper breast area in the café or in the park. They become so fine-tuned to the subtle difference between breast swell and heaviness, they check their breasts unconsciously!

      Introducing a Feeding Routine

      This is also the time to introduce more of a feeding routine, rather than baby-led demand feeding. I recommend a schedule of feeding every three to four hours in a 12-hour day. I have noticed that when babies are introduced to breastfeeding within an hour of birth, they naturally seem to want to feed at more regular intervals and sleep for longer intervals between feeds.

      THE THIRD STAGE

      By four months, into the third stage, the leaky nipples and feeling of engorgement/heaviness have gone. It is common for many mothers to think their milk supply is drying up and so stop breastfeeding. This is usually an incorrect assumption. Often the lack of engorgement is just a case of the milk supply being highly regulated – both in quantity and timing – as the breasts adapt very quickly to their natural role. They’re СКАЧАТЬ