Samiksha Choithani

The first yellow milk (fluid) produced in the breasts is called colostrum. It is the first stage of breast milk production. Colostrum is thicker than your usual breast milk. Colostrum/yellow milk lasts until the transitional phase or mature milk is produced i.e. till the second or fifth day after the birth. Colostrum is like a child’s first immunisation, it is full of antibodies, white blood cells and other immune properties. Benefits of Colostrum for the baby are:Builds a strong immune system.Creates a tough layer on baby’s stomach and intestines to fight with germs that cause illness.It serves as a laxative that helps your baby pass the first dark stool/poop.Prevents jaundice.It is a perfect blend of nutrients to make the child’s brain, eyes and heart strong.Prevents low blood sugar in newborns. A baby should take 1-4 tablespoons of colostrum per day. Note: Do not give honey or any other food substance during birth, the first yellow milk is a great source of nutrition.

Colostrum has multiple benefits for a baby's health and should be the first food give to a baby after birth.

Colostrum and its benefits for Babies

Babies sometimes have their favourite side, and only prefer to take feed from one breast. At times it is because that particular side produces more milk or sometimes it is the side that produces less. The baby might avoid the most productive side as (s)he may not want the milk to gush out quickly that forces them to gulp fast.<ul><li>You can try offering one breast first, and then the second. Pump on the side that is not preferred by the baby as the baby might get frustrated if you forcefully offer both sides.</li><li>Keep a track of urine, stool and weight of the baby, if that is on track, let the baby feed on his/her preferred side and you can pump the other side.</li><li>If the baby isn’t gaining weight, try to feed the pumped milk from the other breast or try new positions to make the baby feel comfortable on both sides.</li><li>If the problem is with nipples, the baby may prefer to latch the one that is fully engorged. Try to talk to your gynaec, they will help you to pull the nipple on the other side (it is little painful) but once done, baby and mommy will be comfortable throughout the breastfeeding journey.</li></ul>

Many babies have a favourite side to feed on. However, if you are experiencing a problem with that, the situation can always be improved.

When baby prefers one breast!

Ravina Sewani

Milk production is in abundance during the early days, which is good. But as soon as the baby settles in – in most cases – the flow regulates on its own. Sometimes though, the breastmilk volume may still be high and there may be a very forceful spurt of milk with a forceful let down. This may cause problems for you and your baby. Usually babies develop a breastfeeding pattern within the first month. If after a month, your baby is still restless during the feeding, or pulls off your breast, coughs, chokes, gulps quickly, has painful cries, holds on to your nipple with a bite like hold, oversupply might be the issue here. You, on the other hand, might experience engorgement, have bouts of mastitis, or you may feel a strong let-down, and leaking breasts. Due to oversupply, a condition called Milk Ejection Reflex occurs in which the milk is released from the milk ducts in a forceful and in an almost explosive manner. Oversupply could be either due to your body making more milk, or when you don’t empty your one breast fully before offering the other, or thyroid. You can handle this situation by trying a reclined position while you breastfeed, you can try using nursing pads, and express little milk before feeding. You can use breast pumps and store the milk. Just be careful that your child does not choke while breastfeeding. If none of the methods work, you should consult your lactation consultant.

It is possible to have an oversupply of milk.

Oversupply of breastmilk

Try the following and see which one works out the best for you and your child: Laid back breastfeeding: Laid back breastfeeding is also known as biological nurturing which means that your baby's natural instincts will guide your position.You just need to make yourself comfortable, support your back, shoulder, neck and arms with pillows and bring your baby close to your skin. Rub your nipple on your baby's lips and your baby will open its mouth widely and start to latch. This is a natural instinctive way of nursing and you will be able to do it with ease. ﻿Cradle hold: Hold your baby in one of your arms wherein his/her head rests in the crook of your elbow and support rest of his/her body with the same arm. Cup your breast with your other hand and using your thumb and index finger, place your nipples along with areola into your baby’s mouth and ensure that the baby latches properly. To be specific, position your thumb on top and fingers below the nipple. The entire areola (dark circle around the nipple) should be in the child’s mouth. Football hold (Clutch or underarm hold): This position is especially useful if you have had a C-section, large breasts, premature baby or twins. This is a position where you hold the baby on the same side as the breast you are nursing from, tucking your baby’s legs under your arm just like a football. Hold your baby’s head in your palms and support his/her body with your arm. Cup your breast and latch your baby the same way you would do for the cradle hold. Sleeping or side-lying: Lying position is comfortable for mothers who have had C-section. Use your arm to comfortably position the baby’s head and hold the baby’s buttocks in the palm. Use the other hand to your breast. Use a blanket to cover the little one and your breast to help the child feel warm and safe.

For starters, most mothers find it difficult to stick to one position for breastfeeding. But with time, it gets better.

Breastfeeding positions

If your baby has green, foamy or frothy, explosive stools and pain, it might be a case of lactose overload. Lactose overload can happen when your baby gulps a very large quantity of breastmilk either due to a long gap between the feedings or due to an oversupply of milk. Healthy babies are able to break down the lactose in normal volumes of milk. The presence of fat in the milk ensures the slow movement of milk through the gut. But if your baby consumes a lot of milk that is relatively low in fat, it can rush through the digestive system without being digested. This can cause the problem of gas causing pain and frothy stools. If you suspect lactose overload, try to check your baby's latch. Try different positions to feed your baby if you have a problem of oversupply of milk. Try frequent feeds as your baby to avoid build up of watery low fat milk. If the problem persists, you know what to do, head straight to your doctor.

Lactose overload happens when the milk is not digested properly.

Lactose Overload

Breastfeeding after having a C-section delivery can be difficult due to the painful wound. Your healthcare provider will guide you about the positions that are most comfortable for you. Breastfeeding positions which you can try are the under-arm hold where your baby lies on your side under your arm. In this position, support your back and the side with cushions. Another position which you can try is side-lying hold, where you lie on one side, support your head and back with pillows with your baby closely tucked to you and facing you. You can read about these positions in detail in our Breastfeeding positions article. While breastfeeding, use a pillow over the wound to protect it and then ask someone to pass the baby to you. Make the best use of your hospital stay to get the needed guidance to breastfeed your baby effectively.

Breastfeeding after having a C-section delivery can be difficult due to the painful wound.

Breastfeeding after a C-section

When moms start feeding the newborns, the nipple often turns red and pointy instead of round and smooth. This could be due to the problem in latching technique, insert your finger into the corner of your baby's mouth to stop feeding for a while when you feel pain -- and then try latching on again. Ideally, your baby should take at least one inch of your areola (entire circle surrounding the nipple) into the mouth. Measures to treat sore nipples:<ul><li class="ql-align-justify">When you take bath, clean the area with water and do not apply any soap. Your areola secretes oil that keeps your nipples moist. If you use soaps, these protective oils might be removed.&nbsp;Air-dry your nipples and do not rub them harsh. There is no need to clean your breasts before breastfeeding, offer your breasts as such. The microbes on your breast surface will help in the development of your baby's gut bacteria. You need to only clean your breasts before feeding if you have an infection.</li><li class="ql-align-justify">Apply few breast milk drops. Massage a few drops of breastmilk before and after the feed to heal your nipples.</li><li class="ql-align-justify">Your doctor might sometimes prescribe you creams to apply on your nipples.</li><li class="ql-align-justify">If you need instant relief after nursing, use hydrogel pads.</li><li class="ql-align-justify">Sometimes the pain is also due to blocked milk duct, massage your breasts with warm water. This will help to unplug ducts and clear the lumps, milk gets released and there is a relief in pain. Note that breastfeeding is the best way to unclog ducts, do not stop breastfeeding due to the pain.</li></ul> These are only temporary relief solutions. You will have to work on the cause of your soreness like poor latch or baby's tongue tie etc. A lactation consultant will be able to help you better. Some women face nipple structural challenges as well. Some of them have flat nipples or very large nipples. In any case, there is no need to worry as generally newborns can nurse on all types of nipple structures. Just ensure that there is a proper latch during the breastfeeding and that the baby is gaining adequate weight. However, here are a few things which might help you if you are facing a lot of trouble:<ul><li class="ql-align-justify">If you inverted nipples, they will naturally protrude out as the pregnancy progresses. Even if this does not happen, your baby will be able to latch on and feed properly. If the baby is facing some troubles, a nipple shield will be very helpful in this case. Consult your doctor or a breastfeeding specialist to help you accustom to the use of nipples.</li><li class="ql-align-justify">If you have flat nipples, they will raise with stimulation. If they don't, do not worry as long as your baby holds on to the areola apart from nipples. If along with flat nipples, you have engorged breasts, your baby might struggle with the latch. In this case, use your fingers to pull the nipple towards your baby's mouth. Your doctor might suggest you to use breast pumps in this case.</li><li class="ql-align-justify">If you have large nipples, it will take your baby a few days to have a proper latch. But if you have adequate milk supply, your baby will get enough milk and gain wait adequately. You can try football hold if you have large nipples.</li></ul>

Breastfeeding can sometimes get overwhelming, not just emotionally, but physically too. Nipple care is very important for the first few months of feeding.

Nipple care

In mastitis, your breasts might become tender, warm to touch, breast may get swollen, get a breast lump, skin redness, experience burning sensation continuously or while breast-feeding. Mastitis is an inflammation of the breast due to ineffective draining of milk. Mastitis is known to happen in only one breast but sometimes it can happen in both your breasts. Mastitis requires medical advice right away. When you are breastfeeding, milk production is a continuous process and if you do not empty your breasts, the pressure around the breasts increases and the milk builds up in the surrounding breasts tissues. This build up of milk causes redness and swelling. If the milk enters into the blood stream, your immune system might respond with fever or with chills and heat alternatively. Mastitis sometimes is also caused by bacteria entering your body through your cracked nipples or milk ducts. The risk of mastitis increases there is poor draining of milk, sore or cracked nipples, inefficient nursing, or if you wear a tight-fitting dress restricting your milk flow, if you smoke or have a poor nutrition compromising your immunity. If left untreated, mastitis could lead to abscess. Mastitis can be prevented by ensuring drainage of the milk from your breasts while breast-feeding. This can be done by allowing your baby to fully feed from one breast before offering the other.The usual treatment for mastitis includes prescription of antibiotics. Mastitis can recur if you do not treat the cause. You need to drain your breast totally during every feed. Continue to breastfeed through your bout of mastitis as this may help you. If you do not do this, you run the risk of another infection.

Mastitis is an inflammation of the breast due to ineffective draining of milk.

Mastitis in mothers

Thrush is a fungal infection that causes severe pain in both nipples and breasts after feeds. If the pain lasts even up to an hour after every feed, it is the sign of thrush. If not taken care of, your baby can also develop this infection in the mouth. This infection is caused when you have cracked nipples that give the fungus an entry into your nipples. If you are on antibiotics for some reason, do not stop taking them fearing the thrush infection. Always do as advised by your doctor. Because your baby breastfeeds, (s)he has chances of developing this infection. Check if your baby has white spots or patches in tongue, gums, roof of the mouth or inside the cheeks. Try wiping them gently and if it does not go away, it indicates thrush. Other indicators of thrush include baby’s unrest when feeding, nappy rash, a white film on lips. It is important to maintain hygiene as the infection can spread to others in the family as well. Properly wash your hands carefully after nappy changes and use separate towels to prevent spreading of infection. You need to also wash and sterilise the toys your baby puts in mouth. Wash your bras at high temperature. Pain in the breast and thrush are two different things. Always seek medical help for the right diagnosis.In case you or your baby both have thrush, both of you will be treated simultaneously. Your doctor will usually prescribe a topical cream for you and an antifungal gel or liquid for your baby. Thrush can be treated, and you will be back to your days of breezy breastfeeding experience.

Thrush is a fungal infection that causes severe pain in both nipples and breasts after feeds.

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