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 Directions for Breast Feeding
 Different positions of Breast Feeding
 How to find out whether the baby is getting enough milk ?
 Why mother's milk ?
 What should Breast Feeding mothers eat ?
 Medication while Breast Feeding
 Problems faced during Breast Feeding
 Prevention of sore nipples
 Engorged Breasts
 
Directions for Breast Feeding

Most of the babies come into the world knowing how to be breast-fed. If you get them anywhere close, they nuzzle, get attached, and suck away. Some need a little assistance.

To breast feed properly, your baby needs to open its mouth wide enough to take in the nipple and about a centimeter or two of the breast beyond it.

Your free hand should be used to support your breast, keep it in the baby's mouth, and keep it out of the baby's nose. Use your fingers under the breast with your thumb on the top.

Hold the baby at your breast by positioning it on its side or tummy-to-your tummy with its mouth at nipple level. During the first breast feedings, it is often helpful to remove the upper clothing from both mother and baby to be skin-to-skin.

To help the baby get started, express the milk into its mouth. This encourages the baby to open wide, suck, and swallow.

As a general rule, you'll breast feed your newborn eight to twelve times per day. Breast-feed your baby on demand, not by the clock. You don't want to let your baby get overtly hungry, as it does not feed well if you do so.

Sucking does not equal eating. Check to see if your baby, who is sucking away furiously, is actually swallowing. Babies usually do some sucking to swallow the saliva.

Newborns usually suck one to three times, and then swallow. Thus a new born who is sucking 15 minutes per breast, but not swallowing, is not receiving enough feeds and may need to breast feed 20 to 25 minutes per breast to get enough milk. The more the baby breast-feeds, the more milk your body will produce. Newborn babies breast feed about every two hours. However, they often breast feed for many reasons other than hunger. Therefore, allow the newborn to breast-feed as often as he or she wishes. Make sure the baby is sucking effectively. Offer both breasts at each feeding. Your baby's nose may be touching your breast during nursing. Babies' noses are designed to allow air to get in and out in such a case. But if you're concerned that your baby can't breathe easily, you can gently press down on your breast near your baby's nose to give him or her enough room to breathe. 

Different positions of Breast Feeding

Breast-feeding is a very natural process. The mother's and baby's bodies are naturally suited for each other's needs. But, to identify and help the mothers to feed their babies properly, certain positions are explained here:
Cradle position : Place baby's head in the crook of your arm. Support your baby's back and bottom with your arm and hand. Your baby will be lying sideways facing you. Your breast should be right in front of your baby's face.
Football position : Tuck your baby under your arm like a football with his or her head resting on your hand. Support your baby's body with your forearm. This may be a good position if you're recovering from a cesarean section.
Lying down position : In this position lie on your side with your baby facing you. You can use pillows to prop up your head and shoulders. This is also a good position if you're recovering from a cesarean section or episiotomies.

How to find out whether the baby is getting enough milk ?

When your baby is hungry he or she begins to nuzzle against your breast, makes sucking motions or begins to cry. If your baby feeds for a very long time (say, 30 minutes on each side), he or she may be having trouble getting enough milk. If this is repeated every time you breast-feed, consult your doctor. Different babies have different feeding patterns. Many newborns nurse for about 10 minutes to 20 minutes on each breast. Your baby will let you know when he or she is satiated, by letting go of your breast. Most milk is sucked in during the first 5 minutes to 15 minutes of nursing. Signs that your baby is getting enough milk: ·
 
Acts satisfied after each feed.

Gains weight constantly after the first 3 to 7 days after birth.

Passes urine at least 6 to 8 times a day.

Passes stool 2 to 5 times a day at first and then may have two or less a day. Stools will be loose at first.

Why mother's milk ?
Research spanning many decades and experience of many mothers and babies over the years, have established that breast milk is perfectly suited to nourish infants and protect them from illness. The primary benefit of breast milk is nutritional.

Breast milk contains about 100 components not found in formula milk. It contains just the right amount of fatty acids, lactose, water, and amino acids required for human digestion, development of the brain, and for growth. The mother's natural antibodies against a number of diseases are transferred to the child through breast milk. About 80 per cent of the cells in breast milk are macrophages, cells that kill bacteria, fungi and viruses. A breast-fed baby's digestive tract contains large amounts of a good bacteria Lactobacillus bifidus, that prevent the growth of harmful organisms in the body.

No baby is allergic to their mother's milk, although they may have a reaction to something the mother eats. If she avoids it from her diet, the problem will be solved. Also, milk straight from the breast is always sterile, never contaminated by polluted water or dirty bottles, which can cause diarrhoea in the infant. Breast-fed babies are protected from a number of illnesses, including pneumonia, botulism, bronchitis, staphylococcal infections, influenza, ear infections, and German measles often suffered by bottle-fed babies.

Cow's milk contains a different type of protein when compared to breast milk with which infants can have difficulty digesting it. Bottle-fed infants tend to be fatter than breast-fed infants, but not necessarily healthier.

And finally, sucking at the breast helps good jaw development. It's hard work to get milk out of a breast than a bottle, and the exercise strengthens the jaws and encourages the growth of straight, healthy teeth. The baby at the breast also can control the flow of milk by sucking and stopping. With a bottle, the infant must constantly suck or react to the pressure of the nipple placed in the mouth.

Strong, early bonding of mother and child is another benefit of breast-feeding.

Studies have shown that breast-feeding facilitates the mother's postpartum recovery and lessens the risk of breast cancer. It helps uterus to contract back to normal size after having been stretched during pregnancy. It delays the return of the mother periods. And it helps the mother to develop an emotional and physical bonding with the baby.
What should Breast Feeding mothers eat ?
Nursing affects a woman's entire lifestyle. A nursing mother with baby-in-tow should eat a balanced diet with plenty of calcium. This means eating fruits and vegetables, whole-grain cereals and bread, eggs, meats or beans, milk and dairy foods like cheese. The mother needs to get enough calories--about 500 more per day than usual-and she need to drink plenty of fluids. A balanced diet that includes 5 servings of milk or dairy products each day will give you enough Calcium.

Certain food products are best avoided as these can appear in the milk. Before taking any tablets clarify with your doctor. Smoking should be avoided. Smoking during breast feeding is harmful for the baby and also decreases the milk secretion.
Medication while Breast Feeding

Usually, the medicines consumed by a breast-feeding mother do not cause any problem to her baby. Likewise, if a breastfed baby is given any vaccine or medicines, it will not interfere with feeding. Vaccines such as OPV or BCG will not cause any side effects to breast fed babies.
 
Even mothers who breast-feed their babies can take medicines for diseases such as epilepsy, diabetes, or high blood pressure. Taking the drug after feeding will always reduce baby's exposure to the medicines taken by her mother.

However, there are a few medicines, which have to be totally avoided by a breast-feeding mother. The medicines for Parkinson's disease with Bromocriptine component can reduce the milk production in the mother, drugs used for chemotherapy in cancer which destroy the cells in mother's body can harm the feeding baby, medicines with Ergotamine, used to treat a breast feeding mother for her migraine headaches may cause vomiting, loose motions or fits in babies. Other medicines with severe side effects are Lithium containing medicines given for manic-depressive illness.

If you are on any medication take it after breast-feeding the baby.

Problems faced during Breast Feeding

One can sight innumerable advantages and benefits of breast-feeding to the mother and the infant. But there are a few inconveniences caused to the feeding mother. In the first few weeks of breast feeding it can be painful and uncomfortable. A woman's nipples may become sore or cracked. She may experience engorgement of breasts due to clogged milk ducts, which can lead to mastitis, and a painful infection of the breast. Though, most nursing problems can be solved with home remedies, mastitis requires immediate medical attention.

There are three most common causes of breast tenderness or soreness: ·

Breasts that are too full of milk.

Feeding in a wrong position.
 
Improper sucking by the baby.

The main cause of sore nipples is when the baby doesn't suck properly. If the baby isn't positioned the right way. To take your baby off the breast, first release the suction by putting a finger in the corner of the baby's mouth between the gums and then gently take the baby's mouth away from the breast.

Don't limit the time of nursing the baby. This doesn't prevent sore nipples; it just keeps the milk ducts from completely emptying. This can lead to swelling and pain. Applying crushed ice compresses before nursing can ease the discomfort. Rubbing lanolin or vitamin E oil on the nipples is found to be soothing. But, wash off the oil before breast-feeding the baby.

Prevention of sore nipples

Make sure the baby is sucking in the right way. If the sucking hurts, place your baby in the right position.

Allow the nipples to dry between feedings.

Feed the baby, first with the nipple that is less sore. The baby's sucking may be less vigorous after the first few minutes.
 
Change nursing positions.

Wash the nipples daily with warm water and dry it properly.

Express milk until the letdown reflex occurs. This will help make the milk more available so the baby sucks less hard.

Mastitis is the inflammation of breast tissue. It can occur due to the cracked nipple or blocked ducts. If left unattended this leads to abscess formation, which may require surgical intervention. Untreated mastitis can cause other infections also which can be very painful. Feeding the baby and thus draining the breasts to prevent breast engorgement is the best way to prevent it. If any signs of it are noticed, consult your doctor immediately.

Engorged Breasts

In some women, a few days after delivery the milk supply comes on so quickly that the breasts become swollen, hard and sore. This is called engorgement. There is an increased supply of blood and other fluids in the breast as well as milk.


What will you notice in an engorged breast?
The breasts and nipples may be so swollen that the baby is unable to latch on and suckle. The soreness makes it difficult for the mother to relax and enjoy the feeding of her baby.

How are engorged breasts managed?
Feed the baby on demand from day one until he/she has had enough.

The first breast is finished completely. One side per feed is used rather than some from each breast. The second breast is offered if the baby is hungry.

A warm wash or shower before breast-feeding is advised as it softens the breasts and helps in free flow of the milk.

Avoid giving the baby other fluids.
 
Massage any breast lumps gently towards the nipple while feeding.
 
Apply cold packs after feeding and cool washed cabbage leaves (left in the refrigerator) between feeds.

If the breast feels uncomfortable or if the baby sleeps for more than four hours, the baby can be woken up for its feed.
 
Use a good comfortable brassiere.
 
Remove your bra completely before feeding.

For severe discomfort, contact your doctor - paracetamol may be taken with the doctors' consent.

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