Born to Breastfeed: The First Six Weeks and Beyond

By Rowena Gray, Anne Hillis and Joanna McMillan

Breastfeeding and breastmilk provide all the nutrients and antibodies to give babies the very best start, with health benefits for babies and mothers. Research shows that as the backbone of early nutrition, breastfeeding is also a key influence on adult health, intellect and longevity.

The World Health Organization (WHO) recommends that every child should be exclusively breastfed for six months, with partial breastfeeding continuing until two years of age. Yet of the 136 million births worldwide each year, it is estimated that only 38 per cent of babies are breastfed for six months.

Born to Breastfeed fills the information gap. Taking the baby’s perspective, it draws on up-to-date, evidence-based research and midwifery practices during pregnancy, birth and postnatal care, explaining how mothers can respond to baby’s actions and needs to improve the health of future generations.

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Not only does Born to Breastfeed expertly explain the science and physiology of breastfeeding, clearly outlining the many benefits, it packs in all of the practical information a new mum needs to know. Every conceivable problem or worry is covered. I have no doubt that this will fast become the feeding bible for all new mums and I sincerely hope the end result is far more babies reaping the benefits of nature’s truly amazing first food.
Dr Joanna McMillan
PhD qualified dietitian and nutritionist, author and health presenter (drjoanna.com.au)

Breastmilk is nature’s perfect food for babies. It contains all the correct nutrients in the right proportions at the perfect temperature, and provides the foundation for lifelong health.
Born to Breastfeed is the ultimate guide for new mothers who want to give their children the best start in life.
Catherine Saxelby
Accredited nutritionist, best-selling author and founder of foodwatch.com.au

Born to Breastfeed is a wonderfully inspiring, easy-to-understand book that will guide women on their breastfeeding journey. Although breastfeeding is natural and all babies are born to instinctively breastfeed, many women encounter difficulties along the way. As a lactation consultant, I know how important it is for women to feel empowered to make the right choices … for themselves and their babies.
I highly recommend this book to all new mothers.
Sonja Svensson RN, RM, IBCLC

At last … a book about breastfeeding written by an experienced lactation consultant and mum who has breastfed and understands the family and community pressures on new mothers.
Born to Breastfeed is a passionate but practical guide that will help mums and babies to succeed on their breastfeeding journey. A definite ‘must buy’ for all new mothers.
Dot Platten RN, RM

• Language: English
• Publisher: Coretext Books
• Release date: Aug 1, 2015
• ISBN: 9780977502974

Book preview

Born to breastfeed

the first six weeks and beyond

Rowena Gray RN, RM, IBCLC

WITH NUTRITION CONSULTANT ANNE HILLIS DNFS, CERT DIET, DIP ED

Published by Coretext Books

43 O’Connell Street, North Melbourne VIC 3051

www.coretextbooks.com.au

First published by Coretext Books in 2015

Copyright © 2015, Rowena Gray and Anne Hillis

The moral rights of the authors have been asserted.

All rights reserved. No part of this book may be reproduced or transmitted by any person or entity, including internet search engines or retailers, in any form or by any means, electronic or mechanical, including photocopying (except under the statutory exceptions provisions of the Australian Copyright Act 1968), recording, scanning or by any information storage and retrieval system without the prior written permission of Coretext Pty Ltd.

Note to readers

Great care has been taken to provide accurate general information on breastfeeding. However, this book is not intended as a substitute for medical advice. Please consult a qualified lactation consultant or medical practitioner if you have any concerns about your baby’s health or your own wellbeing. The authors and publishers cannot accept legal responsibility for any issues arising from the contents of this book.

National Library of Australia Cataloguing-in-Publication entry

Gray, Rowena, author.

Born to breastfeed: the first six weeks and beyond / Rowena Gray with Anne Hillis.

ISBN 9780977502950 (paperback)

ISBN 9780977502974 (Ebook)

Includes index.

Breastfeeding – Australia. Breastfeeding – Immunological aspects. Infants – Nutrition. Hillis, Anne, author.

649.33

Cover image: Corbis Images / Aurelie and Morgan David de Lossy

Design by Mary Callahan

Illustrations by Toni Horne

Printed in China by Everbest Printing Co Ltd

For my husband, Daniel, whose support and understanding throughout our own breastfeeding adventures is something I wish every mum could have. And for our three beautiful daughters, Emily, Rebecca and Natalie, who taught me firsthand the joy, frustration, pain and sheer magic of being a breastfeeding mum.

Rowena Gray

For my husband Geoff, who supports me in my endeavours to promote good nutrition to parents to help raise healthy and happy children.

Anne Hillis

Contents

Foreword

Prologue

Introduction

Chapter 1 Baby’s first minutes

Welcome to the world …

Why skin-to-skin?

Oxytocin – the ‘love hormone’

What is breastmilk?

The benefits of breastfeeding

How labour and birth can affect breastfeeding

Pethidine

Morphine

Epidural

Forceps/vacuum extraction

Caesarean

Premature birth

Intravenous fluids in labour

Extended separation of mother and baby

Kangaroo care

Food for Mum

Eating in labour and after giving birth

Chapter 2 Baby’s first hours

Getting acquainted

What happens in the first hour?

The first feed

Ahhh … sleep at last!

Health problems and breastfeeding

Gestational diabetes

Obesity

Food for Mum

Chapter 3 Baby’s first days

Going home

Feeding and sleeping

Correct positioning and attachment

Pain equals damage

Baby’s hunger cues – how do I know when he’s hungry?

How do I know if my baby is getting enough milk?

How do I know if my baby isn’t getting enough milk?

What is the let-down reflex?

Dealing with sore nipples

Some tips to help relieve and heal sore, damaged nipples

Changing milk, changing nappies

Growth charts

Maternity bras – holding it all together

Food for Mum

Foods to avoid

Chapter 4 Baby’s first weeks

A mother’s story

How many feeds? Yes, overnight too.

Dealing with breastfeeding difficulties and nipple problems

Engorgement

Expressing

Storing your breastmilk

Low milk supply

Lactogenic foods and herbs that can naturally boost your milk supply

Using a supply line

Breastfeeding after breast surgery

Breastfeeding after breast removal (breastfeeding from one breast)

Oversupply

What causes an oversupply?

Mastitis

Nipple shields

Other tricky business

Breast refusal

Tongue-tie

Lip-tie

Thrush

Nipple vasospasm

Babies with special needs and poor sucking ability

Alcohol and breastfeeding

Smoking and breastfeeding

Caffeine and breastfeeding

Medications and breastfeeding

When breastfeeding is not recommended

Food for Mum

Top 10 foods to include in your diet

Chapter 5 The magical six-week milestone

Breastfeeding is established

Natalie’s breastfeeding adventure – her first week

Socialising

The first outing

Growth spurts and weight gain

Average weight gain for a breastfed baby

Exercise and breastfeeding

Food for Mum

What to avoid

Does what you eat affect the nutrient content of your breastmilk?

Chapter 6 The next six months

Why breastfeeding is important

Breast or bottle?

Breastmilk

Infant formula

Growth spurts and demand feeding

When it’s time to start solids

Breastfeeding and infant biting

Returning to work or study

Breastfeeding and contraception

Getting back into shape

Tips to help you lose weight

Food for Mum

Food for work

Food for home

Chapter 7 When and who to ask for help

When to ask for help

Who to ask for help

Helpful contacts

Dealing with criticism – who knows best?

Final word

Index

Acknowledgements

Glossary

Foreword

While there are many areas of controversy in the world of nutrition, there is unequivocal evidence that breastmilk is best to feed our babies. In Australia the National Health and Medical Research Council (NHMRC) recently updated its advice after reviewing the scientific research. The Council now recommends exclusive breastfeeding to around six months of age and continuing to breastfeed alongside complementary foods until the baby is 12 months of age and longer if both Mum and baby wish. Unfortunately we are not achieving anywhere near these recommendations.

Although we have excellent rates of mums initiating breastfeeding after birth with 96 per cent choosing to do so, this falls away dramatically in the first few months. By three months of age only 39 per cent of babies are still being exclusively breastfed, and by five months only 15 per cent.

There are a number of reasons why this may occur. Mothers returning to work, lack of support in dealing with breastfeeding problems, concerns over whether the baby has enough milk, wanting others to be able to feed the baby, and a lack of confidence to breastfeed, especially in public, have all been cited as reasons to cease breastfeeding. In some cases there is also a lack of understanding about the benefits of breastfeeding for both mum and baby and so the motivation to continue doing so may dwindle.

Having breastfed two babies myself and listened to other mothers around me describe their various problems, anxieties and attitudes to breastfeeding, I well understand these concerns. But the fact is the vast majority of these obstacles can be overcome and with more information and understanding we can promote a shift in attitudes of both mothers and those around them to better support longer breastfeeding practices.

That is where this fantastic book from Rowena Gray and Anne Hillis comes in. Not only does it expertly explain the science and physiology of breastfeeding, clearly outlining the many benefits, it packs in all of the practical information a new mum needs to know.

Every conceivable problem or worry is covered with potential solutions and direction given as to where to seek further help when necessary. I have no doubt that this will fast become the feeding bible for all new mums and I sincerely hope the end result is far more babies reaping the benefits of nature’s truly amazing first food.

Dr Joanna McMillan (drjoanna.com.au)

PhD qualified dietitian and nutritionist, author and health presenter

Prologue

During my first pregnancy, the seemingly benign, So, do you plan to breastfeed? question was everywhere and I quickly got into the habit of providing the politically neutral response, If I can, I will. I did the reading, searched the sites, collected the pamphlets, and talked to the experienced and the passionate. The information was there.

Then I met my daughter, and thanks to a couple of post-birth complications, the harsh plastic wall of a humidicrib separated us within minutes of her arrival and for the next five days. As I watched and waited for her tiny systems to kick into gear, I found myself saying, I will breastfeed my child if it’s the last thing I do. The will was there.

Bolstering my arsenal, I had a supportive mother who had breastfed each of her children for about 12 months, excellent access to council maternal and child health services, and a very good friend who was also a caring and extremely competent lactation expert. The way was there.

Surely, that was all that was needed.

And yet, the disruption of those first five days proved to be a monumental hurdle. The special care nursery treatment program of constant lights and a miniscule protective blindfold, combined with around-the-clock formula feeds (supplemented at every opportunity with expressed colostrum), meant that my daughter’s sense of rhythm, routine and feeding technique were skewed from the outset.

With the breakdown of sleeping patterns that eventuated, the breakdown of feeding patterns followed. Through the fog of fatigue, I was struggling to pull together the breastfeeding safety net I thought I had so carefully constructed as feeding became painful, seemingly ineffective and altogether unpleasant.

Thankfully, those around me refused to let us fall, and after several months – through the gracious assistance of many – my daughter and I finally started to hit our straps. I went on to breastfeed her to 14 months, at which point she decided that she was ready for bigger (if not better) things.

Fast forward two-and-a-half years, and I was bracing myself for the arrival of my second baby and all that he would bring. I felt that this time around, I would be going in ‘eyes wide open’ and would be ready to make some pragmatic (if not ideal) decisions sooner rather than later if breastfeeding did not unfold well. After all, I told myself, I’m managing both a baby and a toddler now, and some sacrifices may need to be made.

Thankfully, I could not have been more wrong in my presumptions. My son was successfully breastfeeding within minutes of his arrival and seemed to take to the whole thing like the proverbial ‘duck to water’. As the next 13 months of breastfeeding flew (mostly happily) by, I claimed some of the credit, but knew all the while that this time it was possibly he, not me, who had created such a wonderful outcome.

So, I learned that even with all the support and encouragement in the world, circumstance is everything. When the pressure was on, the ability to find empathy – even for my own hungry child – was difficult. The desire to care for this new life, and to try to understand her little world and what she needed to thrive, was, devastatingly, not enough. Wrenching myself from the cloud of my own challenges to see the world from her perspective was the massive leap I needed to make – and on two hours’ sleep that’s a big ask.

But now, along comes a book that reaches into a bubba’s very consciousness and translates it for semi-informed, hopeful but tottering breastfeeding mothers. Born to Breastfeed provides an insight into exactly what babies want, when and why, so that mums can be not just well versed but truly attuned to our infants’ needs from the moment of their arrival.

Had this valuable guide existed during my early months of motherhood, I would have been less mystified and more aware of the small things that could be averted – or embraced – henceforth. Indeed, I would have had a better understanding and appreciation of the magic of what was happening between my baby and I.

Finally parents everywhere have a resource that will see them safely through so many common breastfeeding misconceptions, challenges and milestones.

Naomi Pollock

Mother of two breastfed children, IT professional

Introduction

Dear new mum

Congratulations on wanting to breastfeed. This is just the right book for you. I know how important breastfeeding is for you and your baby, so I will give you all the help that I can.

Sometimes it is easy and sometimes the going gets pretty tough, but I have worked hard to provide you with as many answers as I can, based on the latest research and my extensive experience working with babies and mothers. I have included some of my personal experiences as a mum as well as those of others who have been kind enough to share their stories.

While there are some very good breastfeeding support services available, there are simply not enough to go round to help all new mothers at their critical time. In view of this gap, Born to Breastfeed aims to provide information to help and guide you through your breastfeeding journey.

I have enlisted the help of my own mother – nutritionist, dietitian and author Anne Hillis – to write the information on ‘Food for Mum’ in each chapter