Edie and Amy

Breastfeeding

Breastfeeding Struggles: Mastitis


Have you ever experienced mastitis?

It’s a situation where part of a woman’s breast becomes warm, very painful, and swollen because of inflammation.

Sometimes it’s associated with fever and chills and later develops into a collection of pus (an abscess) as the body tries to contain it.⠀⠀⠀⠀⠀⠀⠀⠀⠀


Mums who stop breastfeeding abruptly due to latching issues or weaning and later develop blocked ducts or engorgement are at risk of mastitis. Infected nipple cracks, sores, and smoking are also risk factors.⠀⠀⠀⠀⠀⠀⠀⠀⠀

Mums who stop breastfeeding abruptly due to latching issues or weaning and later develop blocked ducts or engorgement are at risk of mastitis.

Dr Ijeoma Idaresit, The Edie & Amy Company


Don’t be fooled by this calm fancy write-up. Mastitis can make you feel like your breasts are on fire.

How can mastitis be prevented?

⠀⠀⠀⠀⠀⠀⠀⠀⠀
1) Always drain your breasts of milk after each feed or express whenever your breasts are engorged.⠀⠀⠀⠀⠀⠀⠀⠀⠀
⠀⠀⠀⠀⠀⠀⠀⠀⠀
2) Avoid nipple cracks by ensuring that your baby has a good latch during breastfeeding ⠀⠀⠀⠀⠀⠀⠀⠀⠀
⠀⠀⠀⠀⠀⠀⠀⠀⠀
3) Ensure you are using the right size of breast shield (flange) in your breast pump. The wrong flange can mar your pumping experience. ⠀⠀⠀⠀⠀⠀⠀⠀⠀
⠀⠀⠀⠀⠀⠀⠀⠀⠀
4) If you do develop nipple cracks or blisters please keep them clean or seek medical care as soon as possible if they don’t heal within 3 days.⠀

⠀⠀⠀⠀⠀⠀⠀⠀
5) Adopt a gradual approach to weaning your baby off breast milk to reduce the risk of engorgement.⠀⠀⠀⠀⠀⠀⠀⠀⠀
If you develop mastitis ensure you keep hand expressing milk from the affected breast and apply cold gel pads.

The wrong flange can mar your pumping experience.

Dr Ijeoma Idaresit, The Edie & Amy Company
Breastfeeding struggles: mastitis

⠀⠀⠀⠀⠀⠀⠀⠀⠀
Visit your doctor to get an examination and a prescription of painkillers and antibiotics as well. Learn more about dealing with common breastfeeding challenges here.

“A good latch prevents nipple cracks.” Our chat with IBCLC Titi Med

WEANING: CARING FOR YOUR BREASTS AND YOUR BABY

Weaning in every child always comes with its own unique changes and challenges
Source: Shutterstock

Baby Fola was already 6months old. Her parents loved and adored her so she never lacked anything. Her mother, Sade, was able to take some time off work so she could breastfeed her little one exclusively. Sadly, Sade’s break had come to an end and she had to go back to work. She had to start giving Fola solid food, but was uncertain about how to go about weaning.

Source: Shutterstock

Was Fola even old enough to be weaned? Sade didn’t know where to begin.

What Is Weaning?

Weaning is the introduction of solid food into a baby’s diet, while gradually stopping breastfeeding.

When Does It Start?

The WHO recommends children be fed breast milk till the age of 2 years. Milk should form a major part of your child’s diet within the first year of life. It has several benefits for mum and baby such as reducing the risk of breast cancer and obesity.

At first, breast milk is all your baby needs. However, after 6 months, your baby requires more nutrients that breast milk cannot provide. At this point, you need to introduce solid food. Keep on breastfeeding even after you introduce solid food.

This gives your baby time to adjust to the new diet.

Reasons For Weaning

Reasons for wanting a breastmilk production to stop could vary from :

  • having to go back to work,
  • reaching your breastfeeding target,
  • You are tired and just wanting your body back (personal),
  • having a baby or mother with a medical condition that is incompatible with feeding breastmilk or
  • unfortunately if a mum looses her baby.

How To Start

Weaning can be either natural or planned.

Natural weaning is also called “child-led weaning”. In this case, your child determines the time and pace of weaning. It starts when your baby gradually begins to accept different types of food, while still breastfeeding. It’s best to start gradually, with one ingredient meals. We’ll discuss this in another article.

This continues till breastfeeding completely stops. This method of weaning might take some time, till your baby is about 2 years or more.

Feeding Baby
Source: Shutterstock

On the other hand, planned weaning or “mother-led weaning” is based on the mother. She chooses when to start the process. However, you should still wean gradually.

Begin by alternating solid food and breast milk. Introduce one food at a time. As your baby begins to adjust, you could then add a variety of meals.

How Can I Tell If My Baby Is Ready For Solids?

This usually coincides when your baby is around) months old but it varies from child to child. The signs of readiness to look out for include the following:

  • They can sit up without support.
  • They start showing interest in the food they see being eaten by others around them
  • They loose the extrusion reflex; the tendency to push food out using the tongue instead of rolling it in and to the back of the mouth

Next Steps

  • Gradually drop take off one feeding or pumping session every 2-3 days replacing this for baby with your desired semi solid meal. This tricks your baby and your body. For kids who are “aware” ie. over 1 year old you can substitute these sessions with healthy alternatives such as yoghurt or fresh fruit smoothies.
  • Increase the time in between each feeding or pumping session eg. If you pumped or fed every 2 hours, increase the interval to 4 hours.
  • Shorten the duration of each session. If your feeding or pumping sessions usually last 20-30 minutes, cut it down to 10 or 15.
  • Gradually your baby should loose interest. This doesn’t mean your milk supply will dry up immediately. This will come with time.

Drastic measures

You can stop Breastmilk production more abruptly using specific medication( diuretics or prolactin inhibitors). A doctor can prescribe this for you

How Can Weaning Affect You?

When you stop breastfeeding, your body experiences some physical and emotional changes. Some of these include;

  • Mood swings
  • Return of your periods
  • Decrease in breast size

Additionally, your breast will continue producing milk for some time. Weaning gradually allows your breast milk supply to reduce little by little.

This is necessary to prevent your breast ducts ( which transport milk) from getting blocked and causing an infection.

How Can You Care For Your Breasts When Weaning Starts?

Your breastmilk supply obeys the laws of demand and supply after your baby turns 1 month old. The best way to reduce and finally stop your milk supply is to drain as little of your milk as possible. However, your breasts may become engorged with milk, your ducts may clog up and get blocked, causing discomfort and pain.


Reasons for wanting a breastmilk production to stop could vary from having to go back to work, reaching your breastfeeding target, being tired (personal), having a baby or mother with a medical condition that is incompatible with feeding breastmilk or unfortunately if a mum looses her baby. for wanting a breastmilk production to stop could vary from having to go back to work, reaching your breastfeeding target, being tired (personal), having a baby or mother with a medical condition that is incompatible with feeding breastmilk or unfortunately if a mum looses her baby.
Weaning gradually can prevent complications from engorged breasts

If this happens to you, you could try;

  • Using warmth to help loosen up the clogged duct. This is done by taking warm showers, use hot compresses or a hot water bottle to massage your breasts. Please wrap in a towel before applying to your skin to prevent burns.
  • Hand-expression or pumping to temporarily drain milk in the affected breast. This will help clear your ducts. You can do this with a silicone breast pump.
  • Wearing a looser bra. Bras that are too tight especially those with underwires can lead to clogged ducts. We stock some comfort ones from Biamo designs.

If left untreated, a blocked duct could cause an infection called mastitis. This may need treatment with antibiotics. Your doctor may also recommend paracetamol or ibuprofen to help with the fever, pain and inflammation.

Learn about mastitis

Once the blocked duct or mastitis is treated, you can resume not draining your milk. With time, your breast will decrease its milk supply till it eventually stops.

Do you….

Whether you are breastfeeding directly or pumping exclusively, the decision as to how and when to begin to WEAN your baby off breastmilk is yours.
Tricking your body to stop producing milk is another matter altogether. If this process isn’t handled well it could lead to undernourishment in your baby or complications from breast engorgement for example.

We’ve written on 10 Nigerian meal ideas you can try for weaning. Meals like pap and Tom Brown are mixed with soya bean powder are great once your baby gets the hang of your starter one ingredient purees.

It would be a big change for both of you physically and emotionally. So do what you think is best, in your own time. Seek support from family and friends when needed.

You’ve  got this mama!

References
  • Arpana M. Naik 2015, Pregnancy and Parenting, Healthy Women, Viewed on June 22, 2020, <https://www.healthywomen.org/content/ask-expert/1286/clogged-milk-duct>.
  • Caring For Kids 2018, Weaning Your Child From Breastfeeding, Caring For Kids, Caring For Your Kids, Viewed on June 22, 2020, <https://www.caringforkids.cps.ca/handouts/weaning_breastfeeding>.
  • First 1000 Days 2020, What Is Weaning & How To Get Started, First 1000 Days, Viewed on June 22, 2020, <https://www.first1000days.ie/what-is-weaning-how-to-get-started/>.
  • Jessica Madden 2020, Engorgement, Mastitis + Thrush: What They Are and How To Treat Them, Motherly, Viewed on June 22, 2020, < https://www.mother.ly/life/engorgement-mastitis-thrush>.
  • Medela 2019, Weaning; When and How To Stop Breastfeeding, Medela, Viewed on June 22, 2020, <https://www.medela.com/breastfeeding/mums-journey/weaning>.

How To Select A Baby’s Bottle Teats

As a breastfeeding mum, sometimes you may need to delegate feeding your baby to someone else. This may be so you rest or return to work outside the home when your maternity leave ends. Delegating means your expressed milk needs to go in a bottle.

Adanna, like most new mums preferred to breastfeed her baby. She planned to do so for 6 months. However, having to go back to work and life schedules were forcing her to consider the bottle feeding option .

Now here’s the problem; Adanna’s son hates being fed from the bottle!

What Is A Baby’s Teat?

A baby’s bottle teat is also known as a nipples. It is the part of the bottle that goes into the baby’s mouth during feeding. It comes in different shapes and sizes in order to suite your baby’s needs.

Why Would A Baby Reject A Bottle

The nature of your baby’s bottle teat is just as important as the food you’re giving them. It goes directly into his/her mouth and if the texture is strange or the flow is different from the way milk is let out from your breast, your baby is sure to reject it.

Sometimes the solution is as simple as selecting the right bottle teat.

What Are Bottle Teats Made From ?

Bottle teats are made mostly from silicone or rubber. Each of these materials has its own unique features.

baby teat

Rubber (or latex) is a natural material which is softer and more flexible than the silicone option. Rubber teats are stronger, more water absorbent and effective. In addition, the softness of the rubber material makes it easier for your baby to adapt to it. However, the rubber teat tends to break easily.

On the other hand, the silicone teat is clear, firm and more resistant to temperature. Furthermore, it is more stretchy, durable and able to retain more liquid as compared to the rubber material.

The silicone teat can undergo several rounds of sterilization without developing cracks. Silicone is relatively inert. There a chance that your baby may be allergic to latex.

Tips For Selecting Your Baby’s Bottle Teats:

Choosing bottle nipples/teats for your baby when you are baby shopping could be a bit confusing as a new or expecting mum.

  • For younger babies, choose a teat that is close to the shape of your nipple. For older babies, choose one that is consistent with the appropriate flow of milk required.
  • Start with the teat with the slowest flow for newborns and then increase as the he/she grows. It’s important you select age appropriate teats. Most brands have different flow nipples to mimic the amount of milk and speed with which a baby is able to draw out milk from the breast during feeds hence the terms fast and slow flow nipples. Avent, for example achieves this by the number of holes at the end of the teat; these increase from 0-6months.⠀Manufacturers usually indicate the age on the packaging
  • Silicone teats are not suitable for babies who are teething. This is due to the softness of the material. It can be bitten off. This increases their risk of your baby being choked.
Choose a bottle teat that looks  similar to your nipples
  • The teat hole should allow an age appropriate/ slow release of milk. This helps to decrease the risk of choking and nipple confusion.
  • We suggest you don’t buy a full set of a particular brand’s teat at once. Get teats of different brands to see which one your baby will prefer.
  • Bottle teats should be changed every 2-4 months or once there’s any sign of damage. Change rubber teats when they become opaque or when they swell up.
  • Once your baby’s teats begins to look worn, sticky or cracked; change them. This would prevent the growth and spread of harmful germs.
A baby who’s used to the ease and fast flow from a particular teat may fuss whenever you then want to breastfeed directly. This is termed nipple confusion.
Change rubber teats once they become opaque

For mums who want to breastfeed exclusively, please note that it’s best to wait to your comfortable with latching and breastfeeding is established before introducing bottles and pacifiers. This usually takes 2-4 weeks max.⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀

Despite all these measures your baby may still refuse the bottle. Some babies just don’t like bottles and that’s totally normal. Read our guide on alternative ways of feeding your baby .

References
  • Judith Kotowski, Cathrine Fowler, Christina Hourigan, Fiona Orr (2020). “Bottle‐feeding an infant feeding modality: An integrative literature review.” Maternal & Child Nutrition. Accessed on 19th October, 2020 from https://onlinelibrary.wiley.com/doi/full/10.1111/mcn.12939
  • Angel Moral, Ignasi Bolibar, Gloria Seguranyes, Josep M Ustrell, Gloria Sebastiá, Cristina Martínez-Barba and Jose Ríos (2010). “Mechanics of sucking: comparison between bottle feeding and breastfeeding.” BMC Pediatrics. Accessed on 19th October, 2020 from https://bmcpediatr.biomedcentral.com/articles/10.1186/1471-2431-10-6
  • Jessica Appleton, Rachel Laws, Catherine Georgina Russell, Cathrine Fowler, Karen J. Campbell and Elizabeth Denney-Wilson (2018). “Infant formula feeding practices and the role of advice and support: an exploratory qualitative study.” BMC Pediatrics. Accessed on 19th October, 2020 from https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-017-0977-7
  • Sharon Lisa Perrella, Kathryn Nancarrow, Michelle Trevenen, Kevin Murray, Donna Tracy Geddes, and Karen Norrie Simmer (2019). “Effect of vacuum–release teat versus standard teat use on feeding milestones and breastfeeding outcomes in very preterm infants: A randomized controlled trial.” Plos One. Accessed on 19th October, 2020 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430377/#__ffn_sectitle

Nipple Confusion: My Baby Prefers Bottle Feeding

Do you know that the texture of the teat and flow of the milk during bottle feeding or while using a nipple shield is usually quite different from the way your breastmilk flows from your own nipple during breastfeeding?

Nipple confusion, nipple contact shield
Nipple shield

Your baby will have to do a bit more work in sucking to get milk out at the same quantity and speed when feeding directly from you. Shields are usually introduced to help breastfeeding with flat or inverted nipples or dealing with nipples sores which make breastfeeding painful.

Nipple confusion in breastfeeding, feeding bottle

As a result, babies on the bottle or using a shield tend to get frustrated whenever they are breastfed. They may eventually lose interest in direct breastfeeding. This is called nipple confusion.

We can avoid nipple confusion by :

  • Making sure proper latching and direct breastfeeding your baby is fully established before introducing a bottle/shield. This also one of the steps to ensuring your baby gets enough milk.
  • Always check that you are using the right teat for your baby’s age. As your baby gets older, the number of holes in the teat of the bottle increase from 1 to 3 and so on. A 3 week old has no business with a teat that has 3 holes.

If nipple confusion already exists consider…

  • Ensuring you feed baby on demand… follow baby’s early hunger cues and not the clock.
  • Consider pumping or hand expressing before putting your baby to breast to encourage milk let down . Milk let down is the initial flow of milk. This way, your baby does less work to suckle.

Dear Mama, not being able to breastfeed your baby directly does not make you less of a mother. Some mums have to pump their breast milk exclusively to feed their babies and so on and that’s totally fine. It’s just a different way to go.


Check out our previous posts on alternative ways of feeding baby breast milk and as well as tips on how to wean your baby off a nipple shield.

How To Wean Your Baby Off A Nipple Shield

Dear Mama, you had a challenge with breastfeeding that required a nipple shield.

You got the right size shield.

The challenge has over time been solved / corrected. Your baby no longer has a tongue tie, your flat or inverted nipple is now corrected.

Your baby is currently feeding adequately (i.e. gaining weight, peeing and pooing as expected etc).

How then do you transition smoothly to directly breastfeeding your baby?

We’ll share some tips on how to wean baby off the nipple shield :

Follow your baby’s early hunger cues

  • Breastfeed your child on-demand to prevent the baby from getting impatient and upset at feeding times.
  • Try pumping or hand expressing to encourage milk let down before baby latches.
  • Ensure your latching technique is on point and baby opens her mouth wide for a deep latch.
  • Try starting the breastfeeding session with the nipple shield then unlatch baby and take the shield off to continue breastfeeding directly . Gradually keep reducing the time you spend feeding with the shield per session.
  • Experiment with different breastfeeding positions.


Please…

Don’t cut the top of the nipple shield while weaning as some advise. It will create dangerous sharp edges that can hurt your baby’s mouth.

Ensure your nipple shield is made from high-grade silicon. If all else fails, don’t stress yourself, Mama. Weaning may take longer for you and your baby than some other mums.

Please be patient.

How To Feed A Baby Who Hates Bottle Feeding

Your maternity leave is about to end. Maybe you need to go on a trip without your baby. You’ve been breastfeeding directly all this while. Time to switch to bottle feeding and your baby outrightly rejects the bottle at your first attempt.

The clock is ticking and your baby still doesn’t want a bottle.

Your resumption date is fixed or your flight ticket has been booked. In fact work has started coming in , in anticipation of your arrival at the office.

Nope.

This isn’t the opening narration of a horror movie. Neither is it the work of your enemies. It’s legit the reality of some working mums in Nigeria.

How do I getback to work and continue feeding a baby that's rejeting the bottle?

How do I get back to work and continue feeding a baby that’s rejecting the bottle????

First things first. Please read our guides to selecting bottle teats and how to know if your baby is getting enough milk.

Done?

Now let’s continue the discussion below.

As a mum who want to breastfeed exclusively it’s advisable to delay bottle feeding till your baby is 4 weeks old and you have established breastfeeding properly (gotten your latch right etc etc).

That said…..


Sometimes, you may need to delegate feeding to rest or return to work outside the home when maternity leave ends.

For this, consider selecting a bottle with teats that look similar to your nipples when you are doing your baby shopping.


Despite your best effort, some babies just don’t like bottles .

some babies do notlike bottlefeeding despite your best efforts

In this case, consider feeding with any of these alternatives to bottle feeding:

  • Cup and spoon
  • Small Syringe (without the needle please, ejo, mbok, biko )
  • Feeding cup

These methods require that your baby is held a bit upright and fed patiently to avoid choking.
Please delegate this task to someone who is diligent and careful .

If you liked the tips in this article, you’ll love our guide to exclusive breastfeeding with a 9-5 job.

7 Signs your newborn is hungry
How to increase your milkk supply and buid a stash for work with Maryam from Breastfeedingng

GLANDULAR HYPOPLASIA AND BREASTFEEDING

“Maybe you just need to give it a little more effort”

“Have you tried drinking more water?”

“I heard fenugreek helps mothers like you”

Many mothers who have difficulties with milk production receive this sort of advice countless times from family and friends (well, most have good intentions).

While most women produce more than enough milk for their babies, a small percentage of mothers find breastfeeding to be quite challenging.

Why Can’t I Make Enough Milk For My Baby?

Some mothers feel that they can not make enough milk for their babies because they have small breasts.

However, this is not true.

The size of a woman’s breast does not influence how much milk she can produce in anyway. A more reasonable cause for insufficient milk production is insufficient glandular tissue (IGT).

Glandular tissue is the milk-making tissue in a woman’s breast.

Therefore, breast milk production will be low if the glandular tissue present is insufficient to produce enough milk. Women with insufficient glandular tissue struggle with producing enough milk for their babies, even after practicing good breastfeeding management.

A word of caution!

Insufficient glandular tissue is a diagnosis of exclusion. Other factors that can affect breastmilk supply must be investigated first by your health provider or lactation consultant and found to be absent. Some of these include:

  • Hormonal imbalances (eg. thyroid or due to retained placenta)
  • Previous breast surgery
  • Issues with the baby’s ability to suckle and drain the breast (latching, tongue tie, cleft lip)
  • Not putting baby to breast enough.

Physical Signs of Insufficient Glandular Tissue 

Signs In Mother

It is important to emphasize that the size of your breast has no bearing on your glandular tissue or ability to breastfeed.

Women with small and large breast can suffer from glandular hypoplasia

Women with small and large breast can suffer from insufficient glandular tissue. Some physicals signs that can indicate insufficient glandular tissue are;

  • Asymmetric Breasts; In this case, one breast being much larger than the other
  • Breasts that are tubular shaped (narrow at the base and long instead of round, quite like bananas)
  • Very large and bulbous areolae; The areola is the dark skin around your nipple. When this occurs. the areola may look as if they are a separate structure from the breasts.
  • Wide-spaced breasts (The gap between both breasts can be up to 4cm )
  • No breast changes during or after pregnancy. This is something that should be taken note of during your antenatal. We expected your areola to darken, breasts to become larger and so on.

The more of these signs a woman has, the greater her chances of having insufficient glandular tissue. 

Signs In Baby

In the setting of glandular hypoplasia, the baby will show signs they aren’t getting enough breast milk. Some of these include:

  • loosing more than 10% of birth weight,
  • failure to return to birth weight by 2 weeks,
  • having less than the required number of wet or poopy diapers for their age,
  • gaining less than 20g of weight daily between 2 weeks old to 3 months old.

What Can You Do? 

Some mothers who have difficulty breastfeeding can easily adapt to using other measures like formula feeding.

With glandular hypoplasia , the reality of being unable to breastfeed can be a very hard pill to swallow.

However, for a mother who anticipated breastfeeding as an important part of her mothering journey, the reality of being unable to breastfeed can be a very hard pill to swallow.

Fortunately, there are some things these mothers can do to preserve the breastfeeding experience.

1. Use A Breastfeeding Supplement Tool

One thing some mothers with insufficient glandular tissue can try is using an at-breast supplementing tool.

A mother using a supplemental nursing system (SNS)

This tool is made up of a small, thin tube with one end attached to the skin around the mother’s nipple. This is the end that goes into the baby’s mouth. The other end is connected to a container that contains the feeding supplement.

This supplement could be the mother’s own expressed milk, milk from a donor, or infant formula. The amount of supplement required will depend largely on the amount of milk the mother is able to produce on her own. With this method, it is possible for mother who has difficulty with milk production to still experience breastfeeding.

2. Prescribed Medications

Some mothers with insufficient glandular tissue may still be able to breastfeed and produce most of the milk their babies will need.

Certain approved medication can greatly increase their milk supply and reduce the need of supplements to just once or twice a day. Before considering this option, remember to consult your doctor.

3. Bottle Feed First, Breastfeed Later

This is also an effective method of maintaining a breastfeeding relationship with your baby.

Since your body can not produce enough milk, you can feed your child with infant formula first. Then once she is beginning to have her fill, you let her finish at your breast.

Nigerian food that help increase breastmilk supply

A Final Note

No matter how little milk you may be able to make, it is still very precious and valuable to your baby.

Thankfully, most mothers with insufficient glandular tissue find that their breast milk supply improves with subsequent babies. This is because each pregnancy and breastfeeding experience causes an increase in glandular tissue.

With support from a lactation specialist many mothers with insufficient glandular tissue can still enjoy fulfilling breastfeeding experiences.

We understand that being unable to produce enough milk to breastfeed your child may be difficult to accept.

However, all hope is not lost.

With support from a lactation specialist many mothers with insufficient glandular tissue can still enjoy fulfilling breastfeeding experiences.

REFERENCES

HOW CAN I TELL IF MY BABY IS GETTING ENOUGH?

“Is my baby getting enough milk? ” New mums all over the world are constantly asking this question. Newborn feeding constantly leads to friction between new mothers and their mothers and mothers-in-law in Nigeria.

Is my baby getting enough? is a constant source of arguments

The anxiety this causes tempts us to introduce water or formula in the first few days of life when our actual goal was to breastfeed exclusively.  

Anxiety and fearof starving the baby causes mums to introduce formula

These conflicts stem from:

  • Ignorance of individual and general signs of hunger and feeding patterns in newborns
  • Lack of knowledge of the normal progression of weight gain/ fluctuations
  • Not knowing the signs that a baby is being adequately nourished.
  • Poor infant feeding practices or alternatives when challenges arise

What are the general signs of hunger in newborns?

Babies are usually good communicators.

The trouble is we don’t often pay attention or know what to look out for. The following are common signs that your baby is hungry: 

  • Baby keeps opening the mouth
  • Sticking out the tongue
  • Making sucking movements 
  • Your little one is constantly bringing their hands up to their mouth
  • Moving their limbs as though crawling or cycling in the air
  • Turning their head towards the chest or breast of whoever is carrying them
  • Crying and being irritable. When they cry, it is a late sign of hunger. Some may get so worked up that they won’t want to latch onto your breast or teat of the bottle! Alternatively, they could latch onto your nipple in their haste and annoyance.

This, I assure you, will bring you exquisite pain while breastfeeding

Are Preemies Different?

When preemies are hungry they could lick their lips, become restless, stick out their tongue or flutter their eyes.

Conversely, when they have had enough they relax, and their color changes if they are light-skinned). Some of them may change the rhythm of their nursing and they may touch the breast.


7 Signs your baby is hungry

A satisfied baby is relaxed with inactive limbs. The baby may turn away from your chest, lets go from breast or bottle feeding and fall asleep.

Baby’s tend to cluster feed at times when they are experiencing rapid growth. Cluster feeding is characterized by showing signs of hunger more frequently than usual.

This is often observed by mothers who schedule their baby feeding times at intervals (as opposed to feeding baby on demand). A baby who usually feeds every 3 hours may demand food every 2 hours for a span of 3 days. For breastfeeding mothers, it’s nature’s way of increasing your milk supply. Demanding more milk from you in response to your baby’s next stage of growth is characterized by the need for larger quantities of milk. Growth spurts can be observed at 2 days old, 3 months old, and  6- 9 months old

How much milk does my baby need?

Your newborn’s stomach size is really small at first.

At the first to the third day of life, your baby’s tummy is the size of a cherry or 1 grape and can only hold a teaspoon of milk ie. 5-7 mls per meal. By day three to five, it is the size of a table tennis ball or walnut.

From six days old up to 3 weeks old baby’s stomach is the size of an egg and so on.  Knowing this should restrain you from overfeeding your baby which could cause undue discomfort and distract you from the real cause of why our child may be fussy.

All babies lose no more than 10% of their body weight within the first 5-7 days of life before returning to their birth weight by week 2. Baby’s weight should increase by 50% at 6-8 weeks old and double his/her birth weight at 4-5 months old.

This topic, weight gain, is another source of anxiety and potential conflict with loved ones as far as a first-time mum is concerned. Look out for these variations and verify during your first well-baby visit after childbirth. Make sure you use an appropriate infant weighing scale.

Any deviation from this may then prompt investigation of your baby’s nutrition or breastfeeding practices. The weight and length measurements for your baby should be entered in a chart which usually comes with your immunization card. Each entry is benchmarked against the normal range for baby’s age within our environment which is also indicated on the chart. This forms a more objective view of if your baby is being adequately nourished.

Signs That Your Baby Is Being Adequately Fed

A well-fed baby will :

  • Have 4 -6 wet diapers (urine) and 3-4 poopy diapers daily. Note that exclusively breastfed babies can go up to 3 days without passing stool at 3 months old. Also, formula-fed babies can get easily constipated if you fail to follow the instructions for proportions of water to formula while preparing their meal.
  • Gain weight in accordance with the normal range for his/her age and race as entered in the growth monitoring chart mentioned above

Is there a need for vitamin supplements in infants? Formula-fed babies do not need multivitamins. However, babies being exclusively breastfed are required to get vitamin D drops. There apparently isn’t enough vitamin D in breast milk and babies and mums don’t get as much sunlight as needed.

What Can I do When Challenges Arise

The bedrock of a breastfed newborn getting enough milk from its mother is ensuring your little one is draining the breast adequately. Next mother has to have an adequate supply.

Your infant will drain your breast if he/she latches on properly ie. your nipple and most of the areola complex are in baby’s mouth with the areola in contact with baby’s hard palate and tongue.

If your breast is constantly being drained by the end of each feeding session, the initial increase in milk production and supply which is governed by demand and supply feedback will be activated.

Nigerian foods that help increase your supply

Some structural challenges such as tongue-tie in the baby or a mismatch between the size of their mouth and your nipple-areola complex can hinder adequate feeding. It is important that these are found early and addressed by a trained health professional or lactation specialist.

As mentioned above, it is important that the exact instructions for preparing a baby’s formula are followed. This prevents them from developing hard stools that are difficult to pass out (constipation). Constipation will come up from a concentrated mix of formula. On the other hand, a formula mix that’s too dilute will result in their not getting enough calories.

What if my baby doesn’t like feeding on a bottle?

This is a question that worries mothers who may need to return to work or leave their baby in the care of others for a few hours. If they refuse to breastfeed or accept a feeding bottle, the following alternatives are viable feeding options:

  • Cup and baby spoon 
  • A small syringe (without the needle)
  • Feeding cup 

Feeding a newborn as a first-time mum can seem daunting. It is important to arm yourself with the right information to avoid common mistakes. Furthermore, information gives you the confidence to push back and advocate for yourself and your little one when the need arises. These are tips you should learn during an antenatal visit or birthing and breastfeeding class.

References

Wagner C. Counselling the Breastfeeding Mother. Emedicine. February 2015 Accessed September 9th 2019
https://emedicine.medscape.com/article/979458-overview

How to increase your supply and build a stash of breast milk

Is It Possible To Breastfeed Exclusively With A 9-5 Job?

As mums, we’ve all heard of the amazing benefits of exclusively breastfeeding our babies. The list ranges from building baby’s immunity, protection from diarrheal diseases to breastfeeding being relatively easier on the pocket compared to breastmilk substitutes.

Going back to your 9-5 job after childbirth.


Breastfeeding is challenging. If exclusive breastfeeding is your goal, the thought of keeping up with it and going back to your 9-5 job can seem daunting. It’s my hope that a few of these tips can help you navigate this.


Building a stash of milk

Start preparing now or at most two months before you are due to return from maternity leave.

Pump a little each day.

I advise you to store your milk in labeled bags or bottles with ice packs in a large plastic container in your freezer to protect it from power outages.

Find out how much milk your baby normally takes at each feeding. This, of course, will vary as your baby gets older.

For our demonstration, let’s say the baby drinks 50mls of milk with each feed. If you are going to be away for 8 hours every day and your baby eats every 2 hours that means your baby will feed 4 times while you are away. Add an extra 50mls (just in case there’s a spill). That means your baby will need 250mls of milk ((4x 50mls) +50mls).

Breast pump to help working moms breastfeed exclusively
You’ll need to figure out how much milk your exclusively breastfed baby takes per session

So, to build up a stash that will last 5 workdays you’ll need (5x250mls). That comes to a total of 1250mls of milk.

Storage bags working mums use to aid exclusive breastfeeding
It’s important to label your breastmilk storage bags to indicate the date and time you expressed the breastmilk

Ensure your bags or bottles are labeled with the date and time pumped as well as the amount of milk in each bag or bottle. Make sure they are then sealed properly for storage.

Make sure your breast milk storage bags are sealed properly when you are done
Make sure your breast milk storage bags are sealed properly when you are done


How long can I store breastmilk for with the weather in Nigeria ?

In our environment, breast milk can last up to:

  • 6 to 9 months in the chest freezer,
  • 6 days in a fridge and
  • 4 -6 hours out of the fridge at room temperature and
  • 24 hours in a cooler with an icepack.

So if you pump milk at work and store it in a cooler bag with an ice pack you are good till you get home.

Please note

Breast milk separates when stored with a layer of fat at the top. Once thawed gently swirl (don’t shake) the bag or bottle to mix.

What guidance do I give my baby’s carer about thawing breastmilk ?

Breastmilk is liquid gold.

It’s alive. It has infection-fighting cells, protective proteins as well as nutrients. Thawing it the wrong way can destroy all that good stuff. For milk from the freezer, bring it out the night before to thaw in the fridge. Alternatively, dip it in a bowl of tepid water. Please don’t microwave or put your milk in boiling or hot water. Breastmilk stored in bags thaws faster than milk in bottles.

It’s best to store your milk in serving-sized portions that your baby will finish at a go. Any bit of milk left can be stored in the fridge but must be consumed within 24 hours.


Can breastmilk turn sour?

I’ve had mums worry about being engorged by the end of a workday or after a trip out of town but reluctant to breastfeed their babies.

They were told by relatives that their breast milk would have gone sour by then. I’ve also been told of some babies who reject stored milk or mums who noticed that the taste of their milk changed compared to when it was first expressed.

The taste of your breast milk depends on several factors:

  • Your diet
  • The action of enzymes found in breastmilk
  • Where you store it
  • What you store beside it in the fridge or freezer.

Milk that is fed to your baby directly from your breast even after a break away from the baby is still good and cannot have “gone off”. Secondly just because the milk that has been stored properly tastes funny at a given point in time does not mean it’s gone off. The only issue is that some babies may reject breast milk at that time because of a change in taste.

Let’s break it down

One of the enzymes (lipoprotein lipase) in breast milk breaks down triglycerides into several fatty acids when it’s stored.

The levels of this enzyme in breast milk are higher right after you have had a meal, especially a high-fat one. These fatty acids can give your milk a soapy, musty, goaty, or metallic taste.
Further breakdown (by oxidation) can give your milk a metallic taste.

Some babies don’t care about this, some do.

5 Things you can do about this change in the taste of your breastmilk

  1. Freeze your milk once it’s expressed instead of putting it in the fridge.
  2. Thaw your frozen milk gradually in the fridge instead of in warm water.
  3. Some advocate scalding your milk at 82 degrees C before storage. This works but destroys protective antibodies in your milk.
  4. Adding antioxidants such as Vit E and C to your diet.
  5. Cutting down on polyunsaturated fats in your diet.

Exclusive breastfeeding is challenging. However, it can be an immensely fulfilling experience for mums who can pull through. There are situations where it is absolutely impossible to breastfeed or have a good supply, e.g. glandular hypoplasia. These challenges faced can potentially put a mum’s mental health at risk. In such cases be rest assured that as long as your baby is being fed enough (breast milk or formula) all will be well. 

Your ability to breastfeed does not in any way reflect on your ability to be a good mother.

Why breatsfeed?
References

Nichola Singletary. 2019. “Funny Tasting Milk: Biochemistry and Clinical Applications of Human Milk Oxidation”. Lecture delivered at 2019 Gold Lactation Online Conference

HOW TO PREPARE AND STORE YOUR BABY’S FORMULA

Babies grow at a remarkable rate from the moment they are born. Mothers often worry about selecting the best formula to meet their babies’ needs. Once chosen, you may feel a bit nervous about how to prepare and store this formula safely.

Mothers often worry about selecting the best formula to meet their baby's needs.

A lot of nutrients are required to support the amazing growth rate of babies. The best way to provide your baby with these nutrients is through breast milk. However, some situations where challenges to breastfeeding exist necessitate formula feeding. It’s also become increasingly popular in recent times.

In plain terms, this is the feeding of an infant or toddler with a prepared formula. This formula can be used to feed your baby on its own or to supplement breast milk.

What Nutrients Are Present In Formula

Whether from breast milk or formula, some basic nutrients and vitamins that your growing child needs to stay healthy are:

  1. Calcium: For strong teeth and bones.
  2. Fat. Provides energy and protection against infections. Also helps with brain development and maintenance of healthy skin and hair.
  3. Folate. Helps in growth and development.
  4. Iron. This aids brain development and building of blood cells.
  5. Protein and Carbohydrates. Serves as a source of energy and fuel for your growing baby.
  6. Zinc. Encourages cell growth and repair.
  7. Vitamins: Vit. A, B1, B2, B3, B6, B12, C, D, E and K are essential for healthy skin, hair, vision, blood cells, brain, immune system, bones, teeth, muscles, e.t.c.
baby formulas are fotified with nutrients some of the nutrients your baby needs

Although most infant formulas are gotten from cow’s milk, they are enriched with the necessary nutrients. Whether your situation makes the use of formula from the start necessary or to introduce it to your baby later on, you will likely have a lot of questions.

How do I choose the best formula for my baby?
How do I prepare and store my baby’s formula?
What formula is right for my baby’s age?
Is my baby getting enough milk?

In this article is all the information you need to know about infant formula. Determining your baby’s hunger and satiety cues will also help to make this journey easier.

Always follow the instructions on the label when making formula

 Types of Infant Formula

The three main types of infant formula are:

1. Cow Milk Protein-Based

This is the most common type of infant formula available as most formulas are made from cow’s milk. These formulas have been fortified to contain the right amount of nutrients that would support your baby’s growth. In addition, they are formulated to make it easier for your baby to digest. However, some babies are allergic to the proteins in cow’s milk and thus need other types of formula.

2. Soy-Based

These are perfect for babies who are allergic to cow’s milk formula. Occasionally, a baby may be intolerant of both cow’s milk and soy milk as well. In this case, another kind of formula is needed.

3. Protein Hydrolysate Formulas

Protein hydrolysate formulas are best suitable for babies who have a protein allergy and cannot digest either cow or soy milk. The proteins in this formula have been broken down into smaller components that such babies can tolerate.

Apart from these 3, there are special formula preparations for infants who are born preterm or have special health conditions.

How are they sold?

There are 3 preparations of infant formula that you can choose from based on what suits you best. These include:

Powdered Formula

This is the most common and affordable. It comes in powder form that needs to be dissolved with water.

Concentrated Liquid Formula

Even though it’s in liquid form, this formula preparation is also required to be mixed with water before feeding your baby.

Ready-to-Use Formula

Just like the name implies, this is ready-to-use to feed a baby. It does not need to be prepared with any water. It is the most convenient type of infant formula. However, it’s also very expensive. 

AGE SPECIFIC FORMULA

Based on age, infant formulas can be classified into 3 stages;

Stage 1 ( 0-6 Months)

This infant formula is creamy and attempts are made to make it similar to breast milk. In addition, contains starch as well as lactose and would keep your baby full.

Stage 2 (6 Months Onward)

You may notice that this formula is creamier than stage 1 formula and contains more energy. You are to begin this formula when your baby is ready to start eating baby food. Depending on your preference, it can either be fed to your baby alone or used to supplement baby food. This formula will leave your growing baby more satisfied with his/her food.

Stage 3 (10 Months Onward)

This final formula is contains more starch, nutrients and energy to suit your growing baby’s needs.

How to Prepare Your Baby’s Formula

  • Remember to wash your hands well before preparing your baby’s food.
  • Clean and sanitize the area where you plan to make your baby’s food.
  • Wash and sterilize your baby’s bottles and other feeding utensils.
Always wash your hands before preparing formula
  • If you are using powdered formula:

1) Use water from a safe source to prepare your baby’s formula. It is advisable to use distilled or boiled water. Please, do not use sachet water.

2) Check the instructions on the formula container for the quantity of water to use. Most feeding bottles come calibrated and can be used to get an accurate measurement. Please use the exact amount stated because:

  • Too much water can make the preparation too dilute and unable to meet your baby’s nutritional needs.
  • Too little water can make the preparation too concentrated. This would cause your baby’s organs to work extra hard, leaving your baby dehydrated and or constipated.

Storage

Use the prepared formula quickly or store it immediately.

  • Unopened infant formula should be stored indoors in a cool and dry place. Do not put your baby’s formula in your vehicles, garage, or any other place outdoors for a long period of time.
  • Always make sure you check the expiry date on the container of the infant formula before you use it.
  • Use it within 2hours after you prepare it or 1hour after you start feeding your baby. Do not leave your prepared formula out at room temperature longer than this. It would get spoilt.

If you are mixed feeding, follow this link to learn more about storing breastmilk.

How do I decide on what formula to use?

Finally,

  • If you do not plan on using your prepared formula within 2hours, store it in the fridge immediately and use within 24hours.
  • Use warm water to heat up your baby’s formula. You can place it for a few minutes under running warm water, or place it in a bowl of warm water. Never use a microwave to warm your baby’s formula.
  • Before you feed your baby, pour a few drops on the back of your hand to make sure it is not too hot.
  • Get rid of any remnant formula after feeding your baby and wash the feeding bottle immediately. The combination of the formula and your baby’s saliva can allow bacteria to grow, making it unhealthy for your baby’s consumption.
  • Make sure you clean and sterilize the feeding bottles before each feed.

Although no formula can truly replicate breast milk, modern formulas provide a close alternative where a mother chooses not to breastfeed or breastmilk from a mum or a donor is unavailable.

Bottle feeding moments are amazing opportunities for you and your baby to get closer and to know each other more.

Also, bottle feeding allows your partner and other family members to help you with some of the feeding sessions so you can rest or return to work. If for any reason your baby doesn’t like bottles, you can learn about alternative ways of feeding baby

REFERENCES
7 Signs your baby is hungry