Feeding

Feeding Baby and trying to get some type of 'rhythm' to it during the early weeks can take up much of your day ... something that most mums are really unaware of! But these weeks pass and on the whole, the feeding gets easier as you and Baby get into the swing of it. Importantly, this routine is not just about physically nourishing Baby. It is also part of bonding by providing emotional 'nourishment' as Baby nestles comfortably in your arms and feels secure regardless of whether you are breastfeeding or bottle-feeding.

Developing a Feeding Routine

As with all the caregiving routines, you need to BE CALM in preparing yourself and talk reassuringly to Baby, tell her what is about to happen and comfort her with your smiling face and gentle use of touch ... even if she is screaming for a feed!

Below is a suggested guide to your interactions with Baby in establishing a daytime feeding routine during the early weeks. At all times ensure safety is practiced during feeding (see Babies' Safety → During Caregiving Routines):

• Anticipate Baby's hunger

It is easier for you and Baby to commence feeding when she is not screaming. Anticipate her need for a feed before she gets frantic. (OK, it won't always happen but you do get better at judging when hunger will be calling!)

• Calmness as you get organised

Talk to Baby, smile and reassure her. And, have as few distractions as possible. This way all the focus is on feeding and establishing what works best for you and Baby.

• Comfortable positioning for you and Baby

Getting advice from midwives/lactation consultants about how to position yourself and Baby is important. Other mums can also offer suggestions. Then, getting to know what is comfortable for you and Baby takes some adjusting. If breastfeeding, you might need to try different positions. Depending on Baby's size and the size of your breasts some lactation consultants suggest to begin by placing Baby on a pillow on your lap so her head is level with the breast as you support her - either with Baby to your side or across you as shown in the photos.

The pillow will also support your cradling arm whether you are reclining in bed or sitting in a comfy chair. Discovering what works for you both takes practise. If you are bottle feeding, cradle Baby in a semi-upright position supporting her head in one arm and holding the bottle in other hand making sure the milk fills to the nipple/teat. This way Baby is maximizing on the milk intake and not sucking in air.

 

• Encourage Baby during feeding

Such words as well done, that's it will help to settle Baby into the feeding pattern. While cradling her, your gentle touch such as stroking her face can be comforting. Your eye contact is reassuring.

• Watch for Baby's signals

Ensure she is sucking and swallowing rhythmically. She may pause momentarily - a sign she is taking a little break - and then gets back to it. Sometimes she may 'spit up' or hiccup so sit her up and give her a slow, gentle back rub. If breastfeeding, when she has finished one breast, give her some 'burping time' (although some babies don't burp!) before the next breast.

• Spend 'calm time' with Baby at the end of the feed

By holding Baby and giving time for the milk to settle is all part of bonding ... remember, this time is important for you and Baby.

As far as the night-time feed goes ... a young baby needs to be fed regularly and this will include during the night in the early weeks. However, the night feed is just for feeding (and maybe a nappy change). Then it's back to bed. As the middle of the night is not a time for play and stimulation keep your voice to a soft whisper with a low pitch so you don't excite Baby, and keep the light to a dim glow (Sleep-time is discussed further on in Caregiving Routines).

Feeding Difficulties

Difficulties can arise just by rushing into the feeding and being uptight, as Baby will 'feel' your tension. If this tension continues to be a repeated pattern, Baby learns to anticipate the feeding routine as being a stressful situation. Consequently a cycle of tension between you and the baby can start, instead of the feeding routine being a time of exchanging pleasurable interactions. Babies' temperament (discussed in Bonding and Beyond → Infant Temperament) may also add to the tension. If a baby is difficult to soothe, this 'fussiness' can bring on parents' stress and a feeling of helplessness. Importantly, parents' calmness and reassurance will help their baby to adjust. Research has found that parents having skin-to-skin contact with the baby (called Kangaroo Care) soothes and comforts newborns especially babies born premature and can help with feeding difficulties.

There is a 'long list' of other possibilities causing feeding difficulties e.g. babies having underdeveloped sucking reflex, difficulty in attaching to the breast, aversion/dislike to the texture of the nipples (as recent research has discovered), sensitivity to the taste of formulas, a mother's difficulty in producing/sustaining her supply of breast milk or having an oversupply, sore nipples and mastitis and, there is even evidence showing that babies can be sensitive to the smell and taste on the breast of soap/bathing gel that mothers' wash their skin with and moisturizing lotions. Some babies also suffer from reflux where their food is 'regurgitated' into the oesophagus causing acid burn and discomfort but usually subsides within the early months.

Breastfeeding

It cannot be ignored that breastfeeding provides babies with the nutrients they need for healthy growth and development. The World Health Organisation (WHO) recommends babies be breastfed exclusively up to 6 months of age. However, the task of breastfeeding is one of the most common problems that new mothers experience. Many mothers have high expectation about their need to breastfeed and the sheer intensity (both physically and emotionally) associated with it can cause much stress and anxiety to Mum and Baby. Importantly, take in as much advice and support that is needed - from midwives/lactation consultants and other mums, and reading - then work out what is best for you and Baby.

Without a doubt, getting it 'right' takes time and perseverance - and it is easier for some mums than others. During the first few days after birth while producing the protein-enriched colostrum that is thick and yellowish your breasts are still reasonably subtle so breastfeeding for most mums seems to be 'manageable'. Then as the white/creamy milk 'comes in', the breasts fill ready to nourish Baby. It is then when mothers may experience some discomfort from the breasts being full ... so be prepared. But by relaxing and getting Baby to attach to the breast correctly to begin with is the first step to relief!

Below are some common tips that midwives use to help mothers begin breastfeeding. However, these are ONLY tips and should not be relied on as comprehensive information:

• When you and Baby are positioned comfortably, (as discussed above) cup your breast in your hand and brush Baby's mouth with the nipple stimulating him to open.
• As he opens wide, aim the nipple area toward the roof of his mouth so he is able to take as much of the areola into his mouth as possible - the nipple is in the centre of his mouth and the tongue is under the nipple. By doing this Baby should not be sucking only on the nipple. The sucking is on the areola with the nipple toward the back in his mouth.
• Baby's chin should be resting on the breast, his lips rolled out and his nose just slightly cleared of the breast for easy breathing as shown in the photo
• Baby should start a sucking rhythm, as the milk goes into the mouth and is swallowed with the occasional pause. This is a sure sign that he is sucking properly.
• You will feel a pulling sensation of the breast but should not be feeling an 'abrasion' of the nipple.

If Baby is not attaching properly, your nipples are likely to be taking the full 'force' of Baby's sucking. Ouch!!! And, Baby will not be maximizing on his milk intake. Continuing will lead to your pain and Baby not being satisfied. So, try again. To take the breast out of Baby's mouth:

• Slide your finger gently in the side of his mouth to break the suction. He may cry because of 'losing' his comfort but don't get frustrated. Just calm yourself. Some babies are soothed with sucking a finger while mums are 'taking a deep breath'. 
• Then, when comfy, try again.

Other than your local maternal and infant health service, the following organisations provide comprehensive information and some with helplines and a support service:

• Australian Breastfeeding Association provides a helpline and information at: https://www.breastfeeding.asn.au
• The Association of Breastfeeding Mothers in the UK provides a helpline and information at: https://abm.me.uk
• The American Academy of Pediatrics has an information website at: https://www.aap.org/breastfeeding
• La Leche League is a worldwide organisation that provides information and breastfeeding support within most countries at: https://lalecheleague.org