Samiksha Choithani

There is nothing wrong in using breast pumps. Breast pumps are useful and come handy when you are travelling or for a working mother or when a child is having difficulty to latch on the breast. If you have decided to use a breast pump, follow these simple instructions:<ol><li>Clean all parts of the breast pump.</li><li>Wash your hands.</li><li>Find an isolated place where you can sit in peace and pump.</li><li>While you start pumping, think about your child, this will trigger hormones and will help to generate sufficient milk.</li><li>Make sure the shield of the pump is centred over the nipple.</li><li>Once you start pumping it may take a couple of minutes to start the flow.</li><li>Switch the breasts every 5 minutes; ensure each breast gets a total stimulation of 15 minutes.</li><li>After using the pump wash it with warm soapy water.</li><li>The milk extracted using a breast pump is safe for 4 to 6 hours at room temperature.</li></ol> In case after using breast pumps, you are experiencing problems such as - less milk supply or sore nipples, it is better to consult a doctor.

Using a breast pump is a personal choice.

Using Manual Breast Pumps or not?

Ravina Sewani

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

Reduced milk production can be due to pain through breast pump, infection, or poor latching, any breast surgeries you’ve had, stress, high blood pressure, insulin dependent diabetes, obesity, or thyroid. If your baby was born prematurely, it might be a while before your little one gets the knack of proper feeding. And because your baby takes a while to adjust to breastfeeding it too impacts your milk supply. Do not feel guilty about low milk supply as most of the factors are out of your control. Following are the ways which will help you to increase your breast milk production: <ul><li>Evaluate Your Baby’s Latch: Make sure the baby is latching on your breasts correctly.</li><li>Continue to Breastfeed: Your body works on the principle of demand and supply. As you keep feeding, it will produce enough milk. If your milk supply is low, try to express at least 8 times in 24 hours and at least once overnight. Milk producing hormones are secreted the highest at night, so do not skip the night-time expressing.</li><li>Stimulate Your Breasts: Use a breast pump or a hand expression technique to stimulate your breasts after you finish breastfeeding your baby. The extra stimulation will tell your body that you need more breast milk.</li><li>Use a formula supplement: When the milk flow is low or slow, the child may refuse to suck so you can use a formula supplement.</li><li>Make Healthy Lifestyle Changes: Smoking, taking a combination of birth pills, stress and fatigue can also adversely affect milk production.</li><li>Breastfeed Longer at Each Feeding: Your newborn should be breastfeeding for at least 10 minutes on each side. If (s)he falls asleep, try to wake him/her up gently to continue nursing. The more time your baby spends at the breast, the more stimulation you're getting.</li><li>Breastfeed From Both Breasts at Each Feeding: During the first few weeks, breastfeeding from both sides during each feeding will help to build up a stronger supply of breast milk.</li><li>Try to Keep Your Baby Awake During Feedings: Yes! When you are feeding your baby try to keep your child awake and actively sucking so that there is stimulation which helps in milk production.</li><li>Spend Some Time in Direct Skin-to-Skin Contact: The&nbsp;kangaroo care technique that is skin to skin connection between the newborn and mother stimulates their bodies and has a very positive impact on the baby and the mother.</li><li>Eat Well: Eat some milk boosting food such as oatmeal (porridge or upma), spinach, fenugreek, garlic, apricot.</li><li>Drink Plenty of Fluids: Breast milk is made up of about 90 percent water. Drinking about 6 to 8 glasses of water or other healthy liquids such as milk, juice, or tea proves beneficial.</li><li>Try to Get Some Rest: Exhaustion and stress can have a negative effect on your milk supply. Try to take a nap when the baby is sleeping, and know that it's OK to ask for help.</li></ul>

It is very rare that mothers have to deal with less breastmilk production. Nevertheless, there are always ways to deal with it.

Low Breastmilk Supply

Palak Vyas

Feed both of your babies at the same time, it will save your time too. However, babies are individuals, so one twin may want to nurse every three hours, and the other, every two hours. Tips to feed twins at the same time:<ul><li>Consider a nursing pillow: There is a specially designed pillow available in the market for nursing twins at the same time. You can also use two regular pillows or rolled-up towels.</li><li>Find the right nursing position. Try positioning both babies in the football hold (along your side) or the cradle hold (across your chest), using the pillow to support their heads. Or combine the cradle hold and the football hold, again using the pillow for support. You can use trial and error method until both you and your babies are comfortable.</li><li>Alternate breasts:&nbsp;Switch breasts for each baby at each feeding to stimulate both breasts equally. Keep alternating breasts with babies, so the babies get equal eye exercises and stimulation. By practising this method, equal amounts of milk is produced in both breasts.</li><li>Focus on your latch. With twin babies, there are much more chances of sore nipples due to continuous nursing. Soreness is usually caused by a poor latch. So if your nipples are extra tender, try a prescribed cream to ease the pain and spend extra time working on your latch with each baby.</li></ul>

For the first few weeks, infants need to breastfeed eight to 12 times per day. That is once every two to three hours, day and night.

Breastfeeding twin babies

Some mothers&nbsp;produce more milk than their breasts can hold, which makes the breasts feel rock hard and uncomfortably full – a condition called engorgement.This condition might last temporarily for 24 to 48 hours. However it can be painful. What do engorged breasts feel like?The breasts feel large, hard and lumpy. The skin of your breasts look shiny and feel stretched, and your nipples becomes hard and flat. Breast engorgement can cause breastfeeding difficulties – which can, in turn, worsen the problem. Your baby might struggle to latch if your nipples are flatter and your breast tissue is harder,&nbsp;causing sore nipples. Causes of breast engorgement:<ul><li>Engorgement usually occurs because the baby is not feeding frequently enough (at least eight times in 24 hours).</li><li>Those women who doesn’t feed their babies or who can’t, due to any reason for example either they are working or too busy with chores due to large families, these women can develop breast engorgement. It can also cause when the woman produces more milk than her baby can have.</li><li>Engorgement can also happen if you suddenly cut on breastfeeds, maybe, because your baby is sick,&nbsp;either (s)he keeps sleeping longer, starting solid foods and other liquids, or going into childcare, which keeps him away from you for longer time.</li></ul> Treating engorged breasts:<ul><li>Breastfeed your baby for minimum 8 times in 24 hours.</li><li>Check that your baby has a good breastfeeding latch.</li><li>Try breastfeeding in different positions.</li><li>You can also massage your breasts gently while feeding to help the milk drain effectively.</li></ul>

New mothers might worry about breast engorgement but there is nothing to worry about much.

Understanding Breast Engorgement

Cleft is a split in the lip that can be immediately identified during the birth of a baby. A cleft lip is a split in the lip. Cleft lip and cleft palate can affect one or both sides of the mouth. Cleft lip and cleft palate can occur independently of each other or can occur together. A cleft lip is caused due to many reasons - it can be hereditary, exposure to substances like cigarettes, alcohol or medications, diabetes or obesity during pregnancy. Babies having cleft lip can breastfeed comfortably, however babies with a cleft palate may have difficulty in sucking.&nbsp;Consider this while feeding a baby with cleft lip (Without cleft palate):<ul><li>The baby may find it difficult to seal nipple with the mouth. If there is a hissing sound, it indicates that air is entering in the mouth.</li><li>Try to reposition the breast and baby’s mouth to form a vacuum.</li><li>The nipple should be behind the tongue; this will help the baby to hold the nipple in its mouth.</li><li>You can adjust and change positions to identify the one that works the best for your baby</li></ul> A cleft palate is a split or opening in the roof of the mouth. A cleft palate can involve the hard palate (the bony front portion of the roof of the mouth), and/or the soft palate. Consider this while breastfeeding a baby with cleft palate:<ul><li>Hold your breast in such a way that baby can get a good grip and latch properly.</li><li>The cleft can be repaired with surgery after 6-12 months but before that do not stop breastfeeding your child.</li><li>Breast milk is very helpful as it does not cause irritation on delicate tissues of the nose and throat and can help to reduce ear problems. Try to avoid formula milk.</li><li>Take help from nurses or specialists to feed the baby with a cleft palate. There are alternate methods like bowl and spoon-feeding, use a breast pump to get the milk in a bowl and feed the child with a spoon.</li></ul>

A cleft occurs because the tissues of the baby’s face and mouth don’t fuse (link) properly.

Breastfeeding a child with cleft lip/palate

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

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

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.

breastfeeding problems health concerns

Following article(s) will help solve your concern.