Give Your Child a Headstart
Breastfeeding Your Baby
Congratulations! Now that your baby has arrived, perhaps one of the most immediate decisions for you is whether to breastfeed.
At KK Women's and Children's Hospital, we are committed to promoting breastfeeding because of the benefits for both mother and child.
Breastmilk is the best food for your baby as it contains all the nutrition that your baby needs in his first 6 months.
Furthermore, through your milk, your child will acquire the immunity which you have developed against certain illnesses.
More significantly, breastfeeding enhances the bond between you and your baby. Mothers who breastfeed often feel a strong sense of closeness towards their babies and vice versa.
To help you enjoy these benefits, we have prepared this guide to help you breastfeed successfully. We hope that you will find it helpful and we welcome your feedback.
Benefits For The Baby
Complete nutrition. It contains all the nutrients babies need for the first 4 to 6 months of age.
Counters risk of infection. Colostrum, the early milk produced after birth, is rich in antibodies. These antibodies help the baby fight against infections e.g. diarrhoea and respiratory infections. Breastfed babies are also less prone to allergies, colic and constipation.
Comfort and security as your baby feeds from your breast.
Benefits For The Mother Convenience
There is no need for bottles, sterilisation or temperature check.
Cleanliness
Breastmilk is free of germs and washing your nipples with water once daily is sufficient.
Cost saving
Breastmilk does not cost money and saves you paying for formula feeds.
Contraction of the womb
When baby suckles, this reduces the chance of severe bleeding and speeds up the return of the womb to pre-pregnancy size.
Confidence
It builds the mother's confidence as she fulfills the child's emotional and physical needs.
Child spacing
Breastfeeding delays the return of menstruation and can help you plan your family if you are fully breastfeeding for the first 6 months.
Cancers
Risk of breast cancer is reduced in women who breastfeed.
Calories
During breastfeeding, calories are used up and the fat stored around the hips and thighs during pregnancy may be lost if a sensible diet is followed.
Preparation For Breastfeeding
You should be prepared physically, mentally and emotionally.
Physical preparation
- Maintain a well-balanced diet during and after pregnancy. Increase intake of meats, vegetables and fruits.
- Have a breast examination by your doctor / midwife to check if you need help.
- Prepare your wardrobe for breastfeeding. Get a good support nursing bra by the 7th month of pregnancy. Acquire loose blouse / T-shirt or 2-piece clothing.
Mental and emotional preparation
- Read updated materials on breastfeeding
- Plan how long you would breastfeed your baby.
- Attend a breastfeeding talk with your spouse as early as possible.
- Know where to source for help if needed.
- Have a positive attitude and be confident that you can and will succeed.
Tips For Successful Breastfeeding
Your baby's first feed should be as soon as possible after delivery, ideally within the first hour of birth.
Feed your baby according to his needs and allow him to feed for as long as he wants. A healthy baby usually has 8 - 10 feeds in a day or, once every 2 - 3 hours. Total breastfeeding with no supplement helps to establish your milk supply and reduce the chance of engorgement.
Some mothers may experience difficulties in breastfeeding such as attaching their babies or pain in the nipple. These can be reduced by ensuring that your baby is held correctly and attached in the appropriate manner.
Technique Of Attachment When Breastfeeding
The following is a step by step guide to attaching your baby to your breast.
- Support your baby at your breast level with his body turned on the side and his mouth facing your nipple.
- Support your breast with 4 fingers below and the thumb by the side, away from the areola.
- Tease your baby's lower lip with your nipple to get him to open his mouth.
- Bring your baby to the breast when he opens his mouth wide.
- Make sure that your baby grasps as much of the areola (the dark ring surrounding the nipple) as possible.
You are holding your baby correctly if you observe the following signs:
- Your baby's head and body are supported as your breast level.
- Your baby's chin is touching your breast.
- Your baby's mouth is wide open, covering the areola.
- Your baby's gum is covered by his tongue.
- Your baby's lips form a seal on your breast with the lower lip turned out.
Below are 2 other positions which you may adopt when you breastfeed:
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Side lying position
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Football position
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Signs of correct sucking:
- No pain or discomfort in your nipple
- Your baby's jaw is moving rhythmically
- You are able to see or hear him swallowing the milk
- Your baby's ears are wiggling
- No clicking sound from your baby
- Your baby's cheeks are not drawn in
Feeding
You are encouraged to allow your baby to finish his feed from the first breast and letting him detach himself. Refrain from terminating the feeding by actively removing your baby from your breast. Finishing a feed from each breast is satisfying for your baby because of the high caloric content of hind milk. Always offer the 2nd breast to your baby. Alternate your breasts for subsequent feeds.
Burp your baby after a feed from each breast. Your baby may have swallowed some wind if he cried before the feed.
A baby who has enough is contented and wets about 6 - 8 nappies in 24 hours. Although during the first 2 days after birth, your baby may only wet 2 - 3 nappies in 24 hours. The number of wet nappies will increase by the 4th and 5th day with the increase in milk supply. Your baby may have 3 - 8 stools (usually loose and soft) per day.
Caring For Your Breast
You are encouraged to clean your breast at least once a day for hygiene purposes. However, avoid using soap on your nipple and areola as this may cause dryness to the area.
Air dry your nipples after each feed before putting on your clothes. Change the wet nursing pad frequently.
Breastfeeding After A Caesarean Birth
Early initiation of breastfeeding after a caesarean birth is as important as it is after a normal delivery.
Breastfeed your baby as soon as possible after you have regained consciousness.
If you are on an intravenous drip, ask for assistance when holding and positioning your baby. Having your husband or a family member around would be helpful too.
Prop yourself up on your bed or lie on your side to breastfeed your baby.
You may sit up on the 2nd day of the operation. You are encouraged to adopt the football hold position when you breastfeed. This will help to keep your baby from causing discomfort to your wound.
If your baby cannot be breastfed for certain reasons, express your breastmilk to prevent engorgement and to initiate lactation. This will ensure that the valuable colostrum can still be given to your baby.
Expressing Breastmilk
In instances when you are not able to breastfeed your baby directly, you can still provide your baby with breastmilk if you express your milk and store it for use. Expressing helps to initiate and establish lactation when direct feeding is not possible. It also helps to relieve blocked ducts which prevent milk flow.
If your breast is engorged, you may feel some tension around your nipple. Expressing some milk will help to relieve the discomfort and enable your baby to grasp the areola properly.
Ideally, the number of expressions a day should be the same as that of normal breastfeeding. That is, approximately 8 - 10 times a day.
Preparation for Expressing Breastmilk
- Ensure that the equipment is sterilised before use.
- Think about your baby to help stimulate milk flow.
- Adopt a comfortable and relaxed position.
- Apply a warm towel over your breast to increase circulation.
- Massage your breast using a circular motion.
- Stroke your breast in a downward manner, from the top of the breast towards the nipple.
- Shake your breasts.
Ways Of Expressing Breastmilk
You can choose to express your milk by hand or by using a pump, which you can purchase or rent. You are encouraged to adopt the method that best suits you.
Expressing by hand
Place your forefinger and thumb at the edge of the areola and press back firmly against your breast. Bring your fingers together and compress the areola using the finger pads. You are encouraged to compress your breast following a rhythm when expressing milk.
Expressing by hand pumps
You are advised to use the piston-type pump, which gives you control over the suction.
Ensure that the flange of the pump is placed over the areola to form a complete seal, as your baby's mouth would when you breastfeed.
Pump continuously for 5 minutes, alternating each breast and massaging your breasts in between.
Each session should not last more than 30 minutes in order not to tire yourself.
Expressing by battery-operated or electric pump
If you choose to use the battery-operated or electric pump, remember to begin with the minimum power before increasing the intensity to the point which you are comfortable with.
Storing Expresed Breastmilk
Expressed milk can be stored in a separate-door freezer for 3 - 6 months. You can keep it for up to 48 hours in a refrigerator at a temperature of 4 degrees Celsius. Breastmilk can also be left at room temperature (25ºC) for up to 4 hours.
When storing expressed milk, always remember to use a sterilised bottle. You should also label all the containers with the date and time of collection. Store the milk in feed size amounts.
Thawing expressed breastmilk
For quick thawing of frozen breastmilk, allow it to stand in warm water for 10 minutes.
Alternatively, you may choose to thaw the milk in the refrigerator. Milk thawed this way can be stored up to 24 hours if placed in the refrigerator.
You should warm the milk by standing it in a bowl of warm water before feeding your baby.
Shake the container before feeding.
Do not boil the milk or warm it in the microwave oven.
Excess milk left in the container after a feed should be discarded. Never refreeze milk that has been thawed.
Transportation Of Breastmilk
Carry the bottles of expressed breastmilk in a cooler box with ice packs. Once you reach your destination, transfer the bottles into the refrigerator.
Sterilisation Of Storage Containers And Breast Pumps
Ensure breast pump, storage container and cap are washed and sterilised before each use. This is important to prevent infection to the baby.
Cleaning the utensils
Ensure that the flange of the pump is placed over the areola to form a complete seal, as your baby's mouth would when you breastfeed.
Wash the breast pump, storage container and cap with soapy water using a brush and rinse thoroughly.
Method Of Sterilisation
Boiling method
Submerge washed breast pump, storage container, cap and a pair of tongs in a container of clean water. Cover container and allow the water to boil. Let water boil for another 10 minutes.
Allow water to cool after boiling before discarding water form the container. Leave the sterilised utensils cover in the container.
Wash your hands with soap and water before picking the sterile tongs from the container.
Use the sterile tongs to remove and assemble the utensils. Avoid touching the inner parts of the breast pump, cap or storage container with your hand.
Soaking method (chemical sterilisation)
Wash your hands with soap and water.
Use a plastic container with lid that can hold all the breast pump, storage container and caps. Follow the manufacturer's instructions on the use of the sterilising agent and prepare the solution.
Submerge washed breast pump, storage container, cap and plastic tongs in the covered container with sterilising solution. Soak all utensils for at least an hour, without adding anything in.
Wash your hands with soap and water before picking the sterile tongs from the container.
Use the sterile tongs to remove and assemble the utensils.
Avoid touching the inner parts of the breast pump, cap or storage container with your hand.
Drain utensils well before use.
Remember! After each use, wash and soak utensils again before using.
Change the sterilising solution everyday.
Working And Breastfeeding
You may adopt one of the following options to continue with breastfeeding while working.
Total breastfeeding
Express your milk while at work so that it may be given to your baby the next day. And you can breastfeed your baby directly when you are with him.
You may start introducing a bottle of expressed milk to your baby at about 4 weeks after birth. Gradually increase the number of expressed milk feeds at about 2 weeks before you start work.
Partial breastfeeding
Give your baby formula milk when you are at work and breastfeed him directly when you are with him.
About 2 weeks before you start work, gradually wean off the breast feeds which you will not be feeding your baby and replace with formula.
Solutions To Some Problems In Breastfeeding
Sore Nipples
This often occurs when you first start breastfeeding. To prevent having sore nipples, ensure your baby is positioned correctly.
- After feeding, express a little milk on your nipples and let it air dry.
- You may want to go without a bra for a while everyday.
- If soreness continues, express your milk by hand 5 - 6 times a day and give this milk to your baby.
Full Breasts
The early fullness usually subsides within a few days. If your breasts are very full, your baby may have trouble attaching to your breast. You may have to:
- Massage your breasts
- Express a little milk to soften the areola before feeding your baby.
Engorgement
This is the accumulation of milk in the breasts resulting in hardness, over distension, discomfort or pain.
Engorgement may be minimised by demand feeding, including night feeding and early feeding from birth.
You may adopt the following techniques to reduce the discomfort caused by engorgement:
- Massage your breast, areola and nipple area to clear any blockage.
- Apply warm towels over your breast only when your milk is leaking.
- Otherwise apply cold towels or cabbage leaves on the breasts in between breastfeeding to reduce the swelling.
- Express a little breastmilk before and after each feed to relieve the tension.
- Analgesic (e.g. Panadol) may be taken to relieve the pain.
Blocked Milk Ducts
This occurs when the milk is not being 'emptied' efficiently. Blocked ducts may cause part of your breast to feel lumpy, hard or sore. To unblock the ducts:
- Gently massage the affected area before and while baby is feeding
- Take a hot shower or apply a warm towel over your breast
- Change your feeding position e.g. to football hold
If any part of your breast is red and/or painful, and/or if you feel shivery or feverish, seek medical attention immediately. There may be a breast infection. Continue breastfeeding to empty the affected breast and to maintain your milk supply. In most cases, you should be able to continue to breastfeed your baby. If in doubt, consult your doctor or a lactation consultant immediately.
Consulting A Breastfeeding Consellor
You should find breastfeeding a fulfilling experience as it enhances your relationship with your baby. Many women who breastfeed find that they are closer to their babies. You are encouraged to consult a breastfeeding counsellor if you have any enquiries or if you notice the following:
- Your nipples are sore and painful
- Your breasts are hard and painful
- Your baby is extremely agitated when you breastfeed him
For more information, please call:
- Ask-A-Nurse Service
1900-KK-Nurse/1900-556-8773
08:00 - 00:00 midnight
Monday - Sunday, including public holidays
(This service is chargeable at 80 cents a min)
- Breastfeeding Mothers' Support Group(s)
+65 6339 3558
- Joyful Parenting and Breastfeeding Hotline
+65 6488 0286