This seemingly natural body function of a new mom doesn’t come as easy as you may think. Some mums struggle to breastfeed after giving birth, especially with their first child. From problems with latching and low milk supply to feeling immense pressure from family to breastfeed the child, every mum goes through a unique journey when it comes to feeding. Some expert advice from lactation consultants, your OB/Gyn, a registered nurse, dai ma, your mother-in-law or mum, can really be helpful if you’re feeling overwhelmed, unsure, or underprepared.

For 2020 World Breastfeeding Awareness Week, we caught up with Dr Ananya Nema, Consultant Lactation Expert & Physiotherapist at Motherhood Hospital, and Dr Ranjana Becon, Gynaecologist at Columbia Asia Hospital. They answered the most frequently asked questions about breastfeeding, latching techniques, remedies for sore nipples, and clogged milk ducts.

Did You Know?

The golden yellow milk that the milk glands produce immediately after birth is referred to as ‘liquid gold’.

1. What are the benefits of breastfeeding for both mother and baby? 

Dr Ananya: There are many benefits of breastfeeding. 

For The Baby:

Breast milk contains all the right nutrients in the right quantity for the baby. It almost acts like a vaccine as it contains antibodies that protect your child from viruses and bacteria. 

  • For the first six months, the baby’s immune system is weak and it is vulnerable to diseases like cold and cough, ear infections and gut infections. Breastfeeding reduces the risk of such diseases and improves the health of your child. 
  • It helps in maintaining optimal body temperature for the baby. 
  • It reduces the risk of developing jaundice in the initial days of life. 
  • It promotes optimal oral and brain development. 
  • It lowers the risk of developing obesity, diabetes, heart diseases and allergies later in life. 
  • It strengthens the bond between mother and baby. 

For The Mum:

As far as moms are concerned, breastfeeding is essential as it releases important hormones like prolactin and oxytocin. 

  • Prolactin and oxytocin are responsible for the production and let down of breastmilk.
  • Breastfeeding relaxes the mum and helps her bond with the child.
  • Mothers who breastfeed have a lower risk of postpartum depression. 
  • It also helps them lose the pregnancy weight.
  • It reduces the risk of breast and ovarian cancer.

Dr Ranjana explains, “Human milk oligosaccharides (HMOs), structurally complicated sugar molecules unique to human breast milk, are the third most abundant solid component in human milk after lactose and fat and act as a prebiotic that promotes the development of the gut microbiota, a key influencer of allergic disease.

Breast milk is also full of antibodies that help the newborn fight infections caused by viruses and bacteria. Colostrum, the first milk, is thick, particularly rich in protein that provides high amounts of immunoglobulin A (IgA) as well as several other antibodies. That is why breastfeeding should start within an hour of birth. Babies who are breastfed as infants have lower rates of ear infections, pneumonia, stomach viruses and diarrhoea, cancers such as lymphoma and leukaemia, bowel diseases such as Crohn’s, asthma, allergies, eczema, diabetes, sudden infant death syndrome (SIDS).

Breastfeeding has benefits for the mother as it also reduces the risk of cancer, heart disease and osteoporosis. Breastfeeding quickens the uterus return to pre-pregnancy size, thereby hastening the postpartum healing rate.”

2. Until what age should a child be breastfed? 

Dr Ananya states, “According to the World Health Organisation (WHO), all babies should be exclusively breastfed for the first six months. You should start homemade foods for the baby after 6 months of age, and continue to breastfeed until the child is two years or as the mother and baby desire.”

Dr Ranjana’s adds, “Exclusive breastfeeding up to six months for infants allows them access to an easily digestible and suitable form of protein, sugar and fat for the unique needs of a newborn.”

3. What are the reliable signs a baby is not getting enough milk?

  • “Baby is passing a small amount of urine (less than 6 times a day) after 6 days of life.
  • Baby is gaining less weight (less than 500gm a month) or is less than birth weight after 2 weeks of life.

Keep a lookout for these signs,” says Dr Ananya.

4. What does latch mean in breastfeeding? How do I know if the baby has latched on properly?

Dr Ananya explains latching as nothing but how your baby attaches to your breast to breastfeed. A good latch is essential to have a successful breastfeeding session. She says that a latch is considered proper if there are these signs:

  • Baby’s mouth is wide open
  • Baby’s lower lip is turned out like a fish against the breast
  • Baby’s chin touches the breast
  • You can see more of the areola above the baby’s mouth and less below
  • The baby’s tongue is down the lower area of the breast below your nipple
  • You are comfortable and do not experience any pain while feeding (a little tenderness or soreness after multiple feeding sessions is normal)

5. How do I know if my milk duct is clogged? What are some remedies to unclog it?

Dr Ananya’s list  symptoms that indicate that your milk duct may be clogged include:

  • A lump in your breast and engorgement around the lump
  • Pain or discomfort during feeding or pumping that subsides afterwards
  • Pain during let down
  • Blister at the opening of your nipple

She says, “If a clog is ignored and not treated, it may lead to an infection called mastitis. If you have a fever along with other symptoms, please visit a doctor. Remedies to treat a clogged duct are: Massage the breast while feeding or pumping and continue to breastfeed. Ensure you drain out the milk completely. Use an appropriate position while breastfeeding. 

If you do develop mastitis, antibiotics prescribed by your doctor can be taken to stop the infection.”

6. How do I deal with and minimise breast engorgement?

Here are Dr Ananya’s expert tips:

  1. Regular feeding with a correct latch.
  2. Using warm compresses to encourage let-down just before feeding or expressing the milk.
  3. Massaging the breasts.
  4. Using a breast pump or expressing the milk by hand.
  5. You can use a cold compress or ice pack after feeding or expressing the milk.

7. How do I deal with leaking breasts postpartum?

“Again, frequent breastfeeding is a solution. If your baby skips a feeding session, you can pump the milk and store it so your breasts do not leak. If you are going out you can use breast pads to absorb the milk. Keeping a jacket at hand is also helpful”, states Dr Ananya.

8. Why are my nipples so sore from breastfeeding? How can I alleviate the pain?

Dr Ananya says, “Sore nipples can develop due to many reasons like improper latch or incorrect use of a breast pump. If there is an anatomical problem with the baby like a tongue-tie, that may also lead to sore nipples. Some more serious causes can be mastitis or thrush infection.

To relieve the pain, make sure your baby is latching on properly and after your baby is fed, carefully break the suction by putting your clean finger into the baby’s mouth. Try not to pull your baby away. After feeding, apply breast milk on the nipples or use baby safe gel to soothe the pain. Keep away from soaps. If you develop cracks in your nipples, it is advisable to consult a lactation specialist or doctor.”

9. What are some foods that enable healthy milk production?

“Foods like oats and barley are known to increase the hormone prolactin, which helps in milk production. Whole wheat or brown rice can also be consumed. Other foods that encourage milk supply are asparagus (shatavari), fenugreek (methi), red beets, poppy seeds (khus khus), coriander seeds (dhaniya) and garlic. Increase everyday consumption of liquids”, advises Dr Ananya.

Dr Ranjana says, “Lactating mothers should be careful about their diet as it will have an impact on the breastfed baby. They should take high-protein foods such as whole grains, dried and fruits, vegetables, cereals, pulses, eggs and chicken, and also drink a lot of water, fresh fruit juices, tender coconut, lassi and lime juice to maintain the right level of hydration. However, lactating mothers should avoid alcohol at all costs.”

10. Is pumped breast milk safe for the baby? How should I store it?

Dr Ananya says, “Yes, pumped milk is completely safe for the baby. Pumping is extremely helpful in case the baby is premature or cannot latch properly. Moms can use a breast pump to express milk if they plan to resume working.

Here are some tips: 

  1. Store the expressed breastmilk in a clean airtight glass container or a special breastmilk storage bag. 
  2. The duration of storage depends on the temperature at which you are storing it.
  • At room temperature (19 – 26 degree Celsius): Less than six hours, it is better to use it within four hours
  • In the fridge (< 4 degree Celsius): 3 to 4 days. Keep it at the back of the fridge where the temperature is the coolest
  • In the freezer (-15 degree Celsius): Up to two weeks 
  • In a deep freezer (-20 degree Celsius): Up to 6 months or a year”