What to expect about the quantity of breastmilk – Am I making enough breastmilk?

For the first few days, don’t worry if your baby does not seem to get much milk. Your baby doesn’t need much now. But what’s important is that both of you get into the habit of feeding; nursing will get your milk flowing. More importantly, your baby will get colostrum which comes before the actual milk. It is a thick, yellowish liquid high in protein, vitamin and sugars. It is packed with antibodies and white blood cells that help fight bacteria and build up baby’s immunity. If your baby gets a good dose of colostrum, you’ve already given them the best part of mother’s milk. Sucking on colostrum for a few days can satisfy your baby’s appetite as it is so rich, while the sucking helps build up the supply of milk.

For some, the milk could come in immediately after delivery. If it doesn’t, be patient. On the third or fourth day after delivery, your breasts may become engorged (they feel hard, swollen and painfully tender) and the milk comes in for some. This is called transitional milk which is slightly creamy yellow in colour and comes after the colostrum. Mature milk is what finally comes in and continues - it is a thin whitish-blue liquid and although it doesn’t appear thick, it is packed with all the nutrients that growing babies need. 

How long should we feed?

The Indian Academy of Paediatrics recommends exclusive breastfeeding for six months, followed by gradual introduction of semi-solids and solids recommended up to around 2 years.

You also need to consider your own desire (how long you wish to) and your own personal situation (how long you can). If getting back to work or dealing with other children are your concerns, you can consider expressing milk .

If milk supply seems to be diminishing, you could professional seek help to stimulate milk production. As long as the demand is there, the supply should continue. A few circumstances like illness or another pregnancy could dry up your milk supply.

What is the Breastfeeding diet?

There is no real breastfeeding diet which you need to follow. Your body takes the nutrients it needs to produce milk. So your baby usually gets the right nutrition. But your own supplies of nutrients could be depleted, so make sure you eat a balanced diet, with some food from all the food groups. Avoid alcohol and smoking. Check with your doctor before taking any medication – they will be able to recommend medicine that’s safe while breastfeeding.

How to create the right ambience to help my baby latch well?

Breastfeeding is one of the best ways to bond with your baby - you and your baby can spend time alone, look into each other’s eyes, talk and cuddle. After nine months of togetherness, the time set aside to breastfeed provides ‘just you and me’ time again.

Though it may sound easy, breastfeeding could be difficult until you get into the groove. Spend the first few days or weeks getting it right. It will help your baby have satisfactory meals and help you avoid pain. Your time together is precious, so create the right ambience.

  1. Create a relaxed atmosphere.
    Tip: Dim the lights, put on some soft music, make yourself comfortable and then feed your baby.
  2. Keep interruptions to a minimum. They can be distracting and break the mood.
  3. Keep people out, stay off the phone and switch off the TV until you are both used to one another and the feeding process.
  4. Keep drinking water or other liquids nearby to quench your thirst. (Breastfeeding can be tiring and you need to keep replenishing the liquids you are losing while nursing. Breastfeeding can make you hungry too, so eat small, nutritious meals throughout the day.)

How will I know if my baby is hungry?

Watch your baby to learn the signals that say, “Feed me.” When you see your baby do these things, offer your baby your breast:

  • Moving her hands near her mouth
  • Clenching her fists
  • Making sucking motions with her mouth
  • Rooting (turning her head and mouth toward something that strokes her face)

Do not wait until your baby cries to start a feeding. A great time to offer your baby the breast is just as your baby is waking up. 

How to get the correct Latch to help my baby get better milk supply?

From the start, get your baby latched on correctly. Your baby must take the whole nipple and surrounding dark area called the areola in the mouth while suckling. If only the nipple is sucked, you could get seriously hurt and milk supply could be reduced. If you have sore nipples, incorrect latch could be the problem.

Once you are in a comfortable position, hold your baby close to you and cup your breast from underneath. Gently tickle the bottom of your baby’s lip with your nipple. As they start rooting around for your breast, move your baby closer in to you and hold the nipple down towards the lower lip. This will get them to open their mouth wide. You can then move their head towards your breast so that your baby can take the whole nipple and areola into the mouth. You must not move your breast towards your baby or force the nipple into their mouth. It could result in getting latched incorrectly or even make your baby very angry!

You will know that your baby is latched on properly when the tip of their nose and chin are both touching your breast. Make sure your breast is not making it difficult for your baby to breathe. If you feel this is happening, gently press on your breast in that area to give your baby room to breathe.

Getting Started: Self-attached Breastfeeding

New babies have a stepping-crawling reflex that can help them seek out the breast. Give your new baby many chances to self-attach in the first few days. Right after birth is a good time to start. Keep your baby on your chest skin-to-skin. Babies often nurse about 10 to 12 (or more) times in 24 hours when they are using the self-attached way to latch.

What are the different Breastfeeding Positions ?

Believe it or not, you do not have to be in pain while breastfeeding. Feeding should not cause pain or discomfort unless you have the positioning wrong. Of course, demand feeding will take its toll on you and stress levels may be high while you perfect the feeding process but getting latched on correctly and maintaining the right positions will eliminate sore, cracked or bleeding nipples. Ensure that you have adequate support for your back while nursing.

There are four main breastfeeding positions:

  1. Crossover hold
  2. Cradle hold
  3. Clutch hold
  4. Side-lying position

Sit in a posture where you feel comfortable, securely but gently holding the baby

Cross cradle (your baby is held in front of you, one hand is on the base of the baby’s neck and the body is supported with that same arm)

Football/clutch hold (the baby is held next to you with your hand on the base of the neck, baby’s legs toward your back)

Cradle/Madonna hold (baby is rested on your forearm, not in the crook of your arm, bring your forearm closer to put the baby to breast)

Side lying (you are lying on your side, the baby is in front of you on his/her side, the arm that is higher is the one that helps bring the baby to breast).This is not always recommended position.

Getting a good latch

  • Loosen your baby’s blanket so she can move her arms. Breastfeeding will work better for both of you if her arms are free to move and touch your breast.
  • Start with her nose opposite your nipple.
  • Be patient and wait until she opens her mouth very wide
  • Move her to your breast; don’t move your breast to her. Her chin should reach your breast first.
  • The nose and chin should be close to the breast but not pushed into the breast. More of the top of the areola will be showing and less of the bottom.
  • Your baby’s lips should make a seal around the breast and her mouth will look a little bit like a fish with the lips rolled outward and visible. You can help adjust her lips by pulling gently on the skin by her nose and chin in order to help the lips make a seal.

How often, how long?

Perplexed by how often and how long to feed? Don’t be daunted by the stories of babies suckling day and night, giving the hungry, tired mom no respite. Your baby and you will soon settle into a mutually satisfactory routine. In the meantime, here are some guidelines to help.

Initially, you will need to feed frequently in order to get the milk flowing (the demand leads to supply) and to meet your baby’s needs. Your baby needs to be fed every 2-3 hours, and when your baby is very small, you may need to awaken them for feeding. You might find yourself feeding 8 to 12 times a day.

Every time you feed, empty at least one breast completely. This is necessary because:

  • Your baby gets the hind milk as well as the fore milk. The fore milk is the milk which the baby gets at the beginning of each feed. It is thinner and less fatty. It mainly serves the purpose of quenching your baby’s thirst. The hind milk comes later and is well worth the wait! It is full of fat and nutrition and this is the part of the milk that helps in weight gain and satisfies hunger. If you cut a nursing session short or exchange breasts before the first one is completely empty, you will be depriving your baby of hind milk.
  • You remember which breast to give your baby for the next feed easily. A full breast is hard (engorged) and feels very full and heavy. You can tell your breast is empty when it gets soft.  When your baby has emptied it, the milk supply will reduce to a trickle and it will feel light and soft.

Tip: An easy way to remember which breast to offer next is by wearing a bracelet or a hair bobble (one that won’t hurt your baby) on the wrist of that side!

It is best to feed your baby on demand. The more you feed, the more easily let-down will happen and the milk will flow. A good amount of milk flow also means that your baby would get a full meal at your breast, reducing the time per feed at each breast as they get more out of each feed. This also increases the time between two feeds, which will be a relief to you.

Every baby spends a different amount of time on each feed, and to empty a breast. It’s better to let your baby spend twenty minutes per breast (or at least empty one breast per feed if you don’t get to the next one) than spend five minutes per breast which means your baby will only snack on each breast rather than have a full meal. Spending five minutes on a breast does not allow your baby to get to the hind milk. It would also mean that your baby would need to feed very often (maybe even more than 12 times a day) which could mean sore, worn nipples and an exhausted mom. Emptying one breast and maybe starting on the other means a full meal for your baby. Once milk starts more easily and let-down is instant, one breast might be enough for one feed. You can slowly get into a feeding routine with at least two to three hours between each feed.