• The Pinay Mom's Complete Guide to Breastfeeding Success

    The first step to breastfeeding success is having the right information.
    by Rachel Perez .
The Pinay Mom's Complete Guide to Breastfeeding Success
PHOTO BY iStock
  • Breast milk is one of the best first gifts you can give your newborn who is born with the reflexes to crawl to your chest and latch on to your breast. We kid you not! But breastfeeding can be demanding physically, emotionally, and mentally — it doesn't always come naturally. You need to be at your baby's beck and call almost 24/7. It can be hard, but most moms who think of giving it up always tell us they make it when they find out the problem. Sometimes, it's all about knowing the proper latch position.

    Why breastfeed

    There are several proven and valid reasons the medical community refer to breast milk as liquid gold. Breast milk is the only source of nutrition your baby needs until you introduce him to solids when he reaches six months of age. (You don't even need to give him water because your baby can easily digest breast milk.) Breast milk also serves as your baby's first immunization because it's packed with antibodies to help keep illnesses at bay.

    In many other ways, moms benefit from breastfeeding, too. It helps your uterus get back into its pre-pregnant size and aids in weight loss. If you nurse exclusively and have not gotten your period yet, it can also serve as a form of natural contraception for the first six months (you need to meet certain conditions). Studies have shown that breastfeeding can lower your risk for cancer, heart diseases, and hypertension. And the bonding it fosters provides you and your baby.

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    Aside from these health benefits and the unique bonding experience, breastfeeding is economical — it's free, after all. It saves you more money because you don't need to buy milk, baby bottles, sterilizer, or even bottled water.

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    How to mentally prepare for nursing

    A lot of the issues many nursing moms had to overcome can often be traced to misconceptions and mistakes during your first breastfeeding sessions with your newborn. It is why attending breastfeeding seminars helps, so you can adequately prepare yourself for a demanding and daunting task before your baby arrives.

    First, you need to establish these two key points to ensure you can breastfeed your child for the recommended first six months of his life (it is recommended up to 2 years old and beyond).

    You are enough, mom.

    Your body has been your baby's home for the past nine months, so when you finally welcome him, he'll need you. "A newborn has only three demands: the warmth and the arms of its mother, food from her breast and security and the knowledge of her presence. Breastfeeding satisfies all three," writes Dr. Grant Dick-Read in his book Birth Without Fear.

    You need a lot of support.

    While being your newborn's only source of nutrition, you will need your partner and your family to have your back. You need to get everyone — your doctors, household help, and even your mom and mom-in-law — on the same page when you choose to breastfeed. Yes, it is a family affair — don't try to do it all by yourself.

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    You will definitely need help, so ask for it. You need someone to take over some baby care duties while you take care of yourself — eat healthy and get some rest. It's how you can continue to feed your baby. Your circle of support will be your rock, especially when you start working to overcome any nursing issues that come your way.

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    Breastfeeding your newborn

    Make sure your birth plan has instructions that your newborn must receive the four essential newborn care practices: immediate drying, delayed cord clamping, skin-to-skin contact, and breastfeeding. Skin-to-skin contact is crucial as it helps initiate breastfeeding your newborn. Ideally, you should keep your baby on your chest until he latches on your breast and finishes his first feeding.

    Ensure your baby receives colostrum.

    As soon as the placenta detaches from your uterus, your body will start producing milk. In the first two to three days (sometimes five days) after giving birth, your body will deliver a thick, yellowish substance called colostrum. It's so thick that it comes out of your nipples only in the form of drops. If breast milk is liquid gold, think of colostrum as a potent concentrate of breast milk.

    Latching after birth is crucial. It's vital and indispensable for your newborn baby to receive colostrum for the following reasons:

    • It contains white blood cells and antibodies that help your baby build a robust immune system
    • It coats your baby’s stomach and intestines to help keep germs from causing illness.
    • It acts as a laxative to help baby pass meconium, of the baby's first poop.
    • It helps prevent jaundice.
    • It contains nutrients for baby's complete nourishment.

    You don't need a lot of milk in the beginning.

    Many new moms complain that they don't have milk, but they do in the form of colostrum. Don't worry, though; you'll produce the fluid, white liquid type breast milk, called mature milk, a few days after giving birth. Even then, you will only need to produce less than a couple of ounces every one to three hours of feeding your little one.

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    On Day 1, a newborn has a stomach capacity of a calamansi, which is about less than 1.4 teaspoons of breast milk. On Day 3, you little one stomach will be as big as a sineguelas, and he'll only need about an ounce of milk every feeding.

    After a week, your baby's stomach capacity will be as big as a tomato which may be filled up by about two ounces of breast milk. A one-month-old baby's stomach would have grown as big as a chicken egg and would require only about five ounces of milk max.

    "If your baby’s stomach capacity is that small and you are preparing four ounces right away, then we are stretching the baby’s stomach capacity, and then they want more and more and more and then it becomes difficult to regulate and catch-up,” explains Doula Noelle Pollack of the Pinay Doulas Collective.

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    Keep track of your baby's nappy changes.

    A common fear of nursing moms is their baby isn't getting any or enough milk. To ensure your baby is fed, count his soiled diapers. Your baby wouldn't be able to pee or poo if his body has no milk to digest and process as waste. Counting pee-filled nappies are good, but counting poop-soiled ones are better.

    On day one, your baby is getting colostrum, so if he soils just one wet diaper and one poop-soiled diaper, then your breastfeeding is on track! Your milk is still yellow and thick, but your little one may produce two pee-filled and two poop-filled diapers.

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    Expect at least two wet diapers and two dirty ones from your baby as your milk starts to change its consistency around day three to four. After five to seven days of breastfeeding, your little one can produce at least six wet nappies and two poop-filled diapers.

    proper latch
    Signs of a proper latch: Your baby's mouth should be wide open. His chin is touching your breast and his lower lip is curled.
    ILLUSTRATOR Vasilyeva Larisa/Shutterstock

    Make sure your baby latches correctly.

    A shallow latch means your baby may be able to efficiently suck from the breast, and end up getting only very little milk. An improper latch is also usually the cause of pain for the nursing mom.

    One sign of a good latch is the baby’s mouth should be wide open as if she's yawning when sucking on to your breast to ensure a deeper latch. Your little one should be taking into his mouth more breast tissue and not just the nipple. Position your nipple at the soft part of the roof of the mouth, so the baby’s tongue can freely move like a wave and feed properly.

    Another sign of a good latch is if your newborn's upper lip and lower lip are flanged out and wide open to accommodate the mother's nipple all the way up to the back part of the mouth. If the baby is having trouble latching on a large breast, hold the breast like a sandwich to be able to position it through the back part of the baby’s mouth.

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    Learn to decipher hunger cues.

    You have to feed your baby before she's starving and upset. "When the baby is stirring, putting his or her hand to the mouth, making a suckling effect, then offer the breast,” Pollack advised. You'll need to anticipate feeding time, so you need to observe your baby and recognize hunger cues.

    Early hunger cues include licking or sticking out their tongue and puckering the lips, or turning their heads and actively searching for the breast. Mid hunger cues involve movements such as sucking their thumb or sucking their entire fist, squirming a lot, or positioning himself to nurse.Crying is already a late hunger cue. Calm your baby first if he's already crying before you offer your breast.

    Possible nursing positions are (from left) the cradle hold, football/clutch hold and the cross cradle hold.
    ILLUSTRATOR Vasilyeva Larisa/Shutterstock

    Get comfortable while nursing.

    You're going to be breastfeeding every one to three hours, so find a comfortable position for you and your baby. The most common nursing positions are the cradle hold, cross cradle hold, clutch or football hold, side-lying and reclined. You can easily do these basic breastfeeding holds with or without the help of a nursing pillow.

    You can also adopt your nursing position. Take note of these guidelines when choosing or changing nursing positions:

    • Make sure your baby's tummy is touching yours.
    • Hold your baby close. Your baby's nose should touch your nipple. If your position is correct, there should be air pockets on the side of your breast that will allow your baby to breath.
    • Your baby's ear, shoulder, and hips should always be aligned. Your little one's spine should be in one straight line.
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    A breastfeeding mom's diet

    Nursing your baby is pretty much an extension of your pregnancy when it comes to nutrition, what can you eat or drink and what's not good for you and your baby. Your breast milk is what you eat, so you want to avoid food and drinks that may hurt your little one.

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    No food is technically prohibited for breastfeeding moms — yes, you can have spicy food, sushi, nuts, oily food, etc. Eating healthy while nursing is all about moderation. You only need an extra 500 calories to be able to produce milk, and you need to make sure those extra calories you take in is still a balance of go, grow, and glow foods.

    That said, you have to make it a habit of observing for and keeping a journal of any adverse reactions in your baby. Your body takes two to four hours to absorb food and pass on nutrients into breast milk, so any skin rash or change in behavior should manifest around that time if it's a reaction to something you ate.

    Of course, if you observe and adverse reaction in your child, you have to pinpoint which food or ingredient is that brought about that rash or is making your baby fussy. Once you're sure, try to limit your intake of that food or eliminate it in your diet.

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    Gassy foods

    One such type of foods you eat that can affect your baby are gassy foods. Just because you're breastfeeding doesn't mean your little one will never have gas. Too much air causes a baby's stomach to bloat, and it causes discomfort and cramping. For a breastfed baby, it could be due to his or her mom's diet.

    In breastfeeding a gassy baby, you may have to limit your intake of gassy foods which include raw broccoli, onions, Brussel sprouts, green peppers, cauliflower, and cabbage so better cook them first. Spicy food, it may also cause similar gas or colicky symptoms in a baby, but not all. Cow’s milk and dairy products, carbonated drinks like soda and high caffeine drinks such as chocolate, coffee, or tea are also common culprits.

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    If you notice that baby’s tummy produces a loud drum-like sound when you tap it gently, then your baby's discomfort may be due to gas rather than colic. Some babies can relieve themselves by clenching their first and pulling their leg up to release the excess air by giving out a loud burp or fart. You can also help by gently massaging his tummy.

    Alcohol and caffeine

    When we mentioned that nursing moms could have whatever they want, that's true, and yes, even breastfeeding and alcohol or caffeine can co-exist. Yes, you can give in to your wine or coffee cravings but with conditions — occasionally and always in moderation.

    Nursing moms can have their alcohol fix but no more than two ounces of hard liquor, eight ounces of wine, or two beers for an average 120- to 130-pound woman. Pediatrician and breastfeeding and lactation counselor Dr. Jamie Isip-Cumpas, M.D. suggests waiting for at least two to three hours before a nursing session. The general rule is if you're too intoxicated to drive, then you're too drunk to breastfeed.

    Coffee in breast milk affects babies differently. Some babies are sensitive to it and may become more fussy or irritable and difficulty in sleeping. Two cups of coffee a day is within a nursing mom's limit. Caffeine-laden drinks, however, are diuretics, and you need water to continue producing milk. You need drink two cups of water for every cup of coffee you have.

    If you've had too much alcohol or caffeine, you can pump and dump to relieve breast engorgement and continue to stimulate milk production. It does not, however, alter the levels of alcohol and caffeine in your body. You have to wait it out. Many breastfeeding moms schedule drinking wine or coffee right after a feeding session, so after two hours or by the time it's time for their little one to feed again, they're good.

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    Medications and herbal supplements

    When it comes to medications, nursing moms should never self-medicate. Certain drugs and medicines, such as combination birth control pills, are not safe for nursing moms for two main reasons: one, the meds could interfere and affect breast milk production, or two, one or some ingredients in the drug may be harmful to your baby if it's passed on to him or her via your breast milk.

    Herbal treatments and supplements may not also be safe for nursing mommas. These don't go through strict approval processes compared to medicine and information about its safety for nursing moms may not be sufficient. Always run a drug or herbal supplement by your doctor before using them. If a quick consult with your doctor isn't possible, you can check it's safe for you via a website called LactMed as a last resort.

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    Dealing with breastfeeding pain

    Even if you did everything right from the start, sometimes it's inevitable to face nursing challenges, the most common of these are having sore nipples, engorged breasts, clogged ducts and more. Whenever you encounter breastfeeding pains, remember that there's a solution and it usually doesn't involve giving up nursing.

    It's typical to feel pain or be really uncomfortable when nursing during your first few times, but it should eventually taper off. You shouldn't have to endure pain to be able to nurse. Sore nipples are quite common but not normal. Pain is often an indication that something needs improvement concerning the baby’s position and latch.

    Engorgement is when your breasts feel abnormally full, enlarged, and almost rock solid. Plugged ducts occur when the breasts feel sore, and the milk ducts are inflamed. It often happens when your baby was unable to empty your breasts properly. The only way to relieve you of the discomfort it to release excess milk from your breast.

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    Soak a face towel in warm water and put them over your breasts for a few minutes. You may also gently massage your breast to prepare them for hand-expression. A manual or electric pump will work, though it might be better to hand-express breast milk if you have engorged breasts so you can control the amount of pressure on your breasts.

    Expressing, storing, and thawing breast milk

    Once you've gotten the hang of breastfeeding your baby and you've established your milk supply, you can start building your breast milk reserves by expressing and storing breast milk. It can be handy for when you're away from your baby for more extended periods of time or when you're returning to work.

    Expressing breast milk

    Hand-expressing is the most preferred way by lactation counselors and the least likely way to contaminate breast milk. If you're using a breast pump, whether manual or electric, you need to make sure your breast pump, milk bags and containers, and other nursing paraphernalia are clean and dry before every single pumping session.

    Try to empty both breasts when expressing milk, but keep it breast milk in small batches, or just about how much your little one consumes in one feeding. Leave your milk bags or containers some room as milk expands when frozen. Make sure bag and container is sealed tightly, and label it with the date and time of milk expression.

    Storing breast milk

    Breast milk in a sealed container and placed in a bowl of cold water at room temperature for 10 to 12 hours. If it's in an ice box cooler, it's good for 24 to 48 hours. In the refrigerator, breast milk is safe to consume within three to five days. Breast milk in a freezer is good for three to six months, and in a chest freezer, it's good for a year.

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    Pediatrician and lactation consultant Dr. Teresa Maria Ribaño shares a more straightforward way to remember how to store breast milk: The "Rule of Three's" That is, three hours in room temperature, three days in the refrigerator, three months in the freezer.

    Place the milk in the ref or freezer in the far back where it's coldest. If you're using an icebox or insulated bag to transport breast milk, say from the office to your home, make sure ice packs are always in contact with the milk and try not to open the bag often.

    Thawing breast milk

    When taking frozen breast milk out, use the "first-in, first out" rule: Consume first the milk bag labeled with oldest date and time. To thaw it, you can leave the frozen expressed milk in the refrigerator overnight or hold the breast milk container under running water.

    Once thawed, place it in a bowl of warm water. "Once you thaw a bag of breast milk, consume it within 24 hours," Dr. Ribaño said. "Once the milk touches the lips or has the saliva of the baby, use it within one to two hours," she stressed.

    Never use the microwave to thaw breast milk. Also never re-freeze or re-thaw breast milk. It's the reason why you divided your breast milk into portions that your child usually consumes in one feeding.

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