Is the
milk suitable?
If a
baby is gaining weight slowly but steadily, is contented and developing well,
you can be sure that however thin and watery-looking your milk is, it is
adequate. The quantity may be small, but
the quality is always right for each individual baby. It is obviously more
difficult with breast- feeding than with bottle-feeding, to determine the amount
of milk that the baby takes at each feed. One way of establishing this is to
test-weigh the baby before and after each feed.
Test-weighing
Test-weighing is a useful procedure if there is any doubt or anxiety about how
much milk the baby is receiving. The principle of test-weighing is very
simple—all that is required is an accurate set of scales (which you do not need
to buy—they can be hired). The baby is weighed immediately before a feed and
then immediately after he has finished the feed. If he soils or wets his nappy
during the feed, this must not be changed until after he has been weighed for
the second time. The difference between the before and after weights will show
the amount of breast milk he has taken.
Supplements
From
the time they are one month old, breastfed babies need vitamin A, D and C
supplements. Dried milk supplements may also be necessary for one reason or
another if the mother's milk supply is slightly insufficient—perhaps after a
bout of influenza, for example.
Care of the breasts
A
little lanolin cream applied to the nipple area will help to keep this soft and
supple. A well- fitting bra should be worn both night and day during the whole
period of breastfeeding.
General health
Breastfeeding does not necessitate drinking vast quantities of fluid, neither
does it preclude a mother from eating her favorite foods, although some foods,
such as onions or prunes, for example, may make a baby restless. Alcohol in
moderation does no harm. The doctor will ensure that the mother is not given any
drugs which may be absorbed into the breast milk and thus affect the baby. The
one thing that a mother must ensure is plenty of rest—and this means rest from
mental and emotional anxieties as well.
Breastfeeding problems
The
most common time for breastfeeding problems is immediately after the return home
from hospital. This is when the world—in the shape of cooking, housework and,
perhaps, other children —rushes in. Your rest periods are eroded, and you feel
tired and tense when the time comes to feed the baby. It needs a determined
effort to ignore all the interruptions and relax at feed- times, but this is
really essential.
Engorgement of Breasts
Engorged breasts are enlarged, swollen and hot and tender
to the touch. This condition most commonly occurs in the first day or two after
the milk comes in. Frequent sucking, or expressing the milk, will do much to
relieve this. If the engorgement becomes severe, the doctor will prescribe small
amounts of oestrogen to reduce the milk supply a little.
Cracked Nipples
The
cause of this painful condition can be an over-eager baby who chews on the
nipple instead of grasping it properly around the areola. The treatment for a
cracked nipple is rest for that breast for at least twenty- four hours, plus
expressing the milk in order to ensure a continuation of the supply. If the
condition is allowed to worsen it may cause a breast abscess.
Breast Abscess
This
occurs when an infection creeps in through a cracked nipple and affects a
section of the breast. The breast then becomes swollen, red and painful. Urgent
medical attention is necessary. With rapid antibiotic treatment the condition
can be resolved, without the necessity for discontinuing breastfeeding.
Inverted Nipples
Inverted nipples can cause difficulties at the onset of breastfeeding as the
baby is unable to grasp the nipple firmly. Treatment during pregnancy by easing
the nipple out with the fingers and by wearing plastic breast shields under a
bra will correct all but the most inverted nipples.
Menstruation
The
time of return of monthly periods is very variable after the birth of a baby,
and can be anything from three weeks to six months. Breast- feeding usually
inhibits the menstrual flow, but successful breastfeeding can, and does, take
place with normal menstruation. Do remember that `menstruation' means
'ovulation', and that breast- feeding is no bar to pregnancy. Adequate pregnancy
precautions are, therefore, necessary. If you want to use a contraceptive pill
whilst breast- feeding, you will need medical advice as to which one is the most
suitable.