Complete guide to breastfeeding from A to Z

How does breastfeeding work? How do you breastfeed? When do you breastfeed? Until what age? How do I know if she is getting enough milk?

The questions about breastfeeding are endless.

Trying to summarize all the advice and answers to your doubts in one article is a titanic undertaking. However, our Midwife Sara is super and has managed to create an all-to-read guide to have a reference point on breastfeeding.

Enjoy the reading!

Breastfeeding is a natural but not instinctive gesture and can put every mother to the test.

N for Natural

Breastfeeding is natural, every woman has the instinct to do so because it is stored in our cells thanks to our ancestors and time and tradition cannot erase all of this.

I as Instinct and Information

Breastfeeding is instinctive even if the daily life in which we find ourselves living is hectic and with little contact. Our ancestors breastfed for a long time, they breastfed learning this by watching their mother, aunt and other women do it because we all lived in the same room or house.
Breastfeeding is getting informed and wanting good. Today’s technology, books, people competent in breastfeeding such as midwives, ibclc and duole help and support motivated women and accompany them throughout the puerperium by promoting prolonged breastfeeding.
A breastfeeding begins even before the baby is born with his mother’s desire to make this gesture and the emotional preparation for it all.

Once the baby is born, if healthy, it must not be removed from the mother but placed on her chest, skin to skin for as long as necessary to make it seek the breast spontaneously . The mother, with the baby in her arms, produces the hormone of love and lactation, oxytocin. With the first attack, the baby takes on colostrum which is a very precious substance and with the suction it activates the production by the breast of milk which will always be adequate for its needs.

The baby must be kept in the same room as the mother throughout their stay in the hospital, both day and night, so that staff do not administer glucose (sugar water), formula milk and pacifiers without your permission. These unnecessary things can confuse the baby in the way of sucking, satiating him and not allowing for proper stimulation of the breast. If the child has a drop in weight, beyond the physiological one, you can administer your expressed milk with a teaspoon.

G how to let yourself be guided by the child

Attack the child on request, so whenever the child shows interest, even every one to two hours if necessary. Trust your child’s competence, let him guide you and support him. The more the baby sucks, the more milk will form because the breast is stimulated. The breast is not a container of milk that fills up between one feed and the next so it has to rest, but the more it is asked for, the more it produces. If you comply with the baby’s request, you won’t have problems with low milk production and the baby will adjust to his feedings and rhythms after a few weeks.

Remember to surround yourself with people and professionals who support breastfeeding.

P for nursing position

How to breastfeed comfortably?

In the back position, lean on a couple of pillows and hold the baby on your chest and let him find the breast and latch on when he wants. Support the baby by placing your hands on his bottom.
In the seated position, supporting the child with the arms, keeping the head, neck and trunk in line. The baby’s nose touches the nipple, he is tummy with you and by opening his mouth he takes the whole nipple and most of the areola.

It is the baby who goes towards the breast and not vice versa.

Remember that  breastfeeding does NOT have to hurt . If this happens it is because the baby is latched poorly, so ask a midwife for help in evaluating the feed. Stalling and using soothing creams doesn’t solve the problem.

F as frequency of feedings

When to put the baby to the breast?

Whenever he shows you signs of interest in sucking:

• Turn your head left and right in search of the breast
• Click your tongue or kick out a lizard
• He sucks his little hands or his tongue
• Cries. Remember that crying is the last sign of hunger, and the baby is already desperate.

A as Feeding in breastfeeding

A breastfeeding mother should not change her diet as there are no foods to avoid in order to avoid ‘colic’ disorders in the infant or because the baby does not like the taste of milk. It is possible that there are foods that can cause a greater gas emission for your child but this does not mean eliminating legumes, onions, garlic, spices, cabbage, broad leaf vegetables, peppers regardless. Evaluate, with a varied and healthy diet, what can really bother your child.
Alcohol and spirits are best avoided as they pass into breast milk.

R for breastfeeding rhythms: on demand or on schedule?

If breastfeeding is done by looking at what the child asks of us and responding to his needs, it must be done on request . Each baby has his own way of sucking, of regulating the amount of milk he introduces at each feed, and in each feed, the type of milk that the baby introduces into the stomach changes.

To indulge in its rhythms, every mother has the right to ask for help, to delegate household chores to family members, to sleep with the little one in the big bed so that he does self-service whenever he wants, to sleep when the little one sleeps, to surround themselves with other breastfeeding mothers and to have a midwife, consultant or doula nearby who support breastfeeding.

Offering the breast on request is not only to respond to her need for food but also for consolation, sleep accompaniment and relaxation.

A mother who breastfeeds her baby on demand can feel tired and overwhelmed with fatigue. Have patience and respect this rhythm of hers.

If you add to all this the moment in which the child arrives in the evening and bursts into desperate tears, you can also seek support from your partner:

1. Offer the breast even if it doesn’t want to eat and by squeezing the areola between your fingers, put like a cigarette, you can make sure that this is just a pacifier. In fact, the breast is also a pacifier.
2. Don’t give formula thinking that the baby will cry because your milk is “soft”.
3. Anticipate the moment of crying by relaxing the baby through massage, carrying him in a sling or taking a bath together.

A mother may have an inadequate production for the child’s requests if:

• the cradle is far from mother’s bed
• parents try to breastfeed on schedule
• herbal teas, chamomile or water are used.
• the child is always left on a bouncer or in the pram
• he is allowed to be consoled by sucking his hand or finger without offering him the breast

So if you find yourself in this situation you must:

• breastfeed on demand
• use a baby sling and keep it on
• sleep beside baby. You can absolutely keep the baby close to you as long as they are secured. The mattress shouldn’t be soft, the baby shouldn’t be covered by your blankets and it shouldn’t have a pillow. The room must have a maximum temperature of 20 degrees, the parents must not smoke in that environment and must not drink alcohol.
• Do not give artificial milk or herbal teas thinking that they will reduce the baby’s nocturnal awakenings. Every child has her own rhythms, there are children who sleep independently all of ours and others who instead have continuous awakenings. Skipping a feed provides 20% of an infant’s needs. It is also possible that a child who immediately sleeps through the night then starts waking up around 4-5 months when they realize that the mother is something separate from him and needs continuous confirmation of her presence.

P as prolonged breastfeeding: why?

• The baby is drinking milk suitable for him and not from another animal.
• It is good for the baby’s health
• It is good for the mother’s health as there is less risk of ovarian and breast cancer and adult type diabetes.
• The child receives nourishment and attachment.
• The child receives education.
• It is environmentally friendly and economical

C as the growth of the breastfeeding child

The average growth of an infant is 100 – 200 g per week and on average in the first six months of life; of 85 – 140 g per week in the second six months (WHO-Unicef ​​data). The growth of infants slows down already after the 3rd-4th month.
Do not double weigh!

Instead, check the number of pees and feces he does throughout the day.

How to understand if he eats enough?

Pee must be at least 6/7, and these must appear clear and odorless like water. The discharges will be meconium for the first 2 days, then mustard and the discharges are reduced to 1 maximum 3. A pee is considered when a diaper weighs as much as when it is wetted with 3 tablespoons of water. A newborn may decrease its monthly growth if:

• was vaccinated
• he was in poor health
• in the teething stage
• you have introduced a pacifier

D for Breastfeeding devices and accessories

The Nipple Shield

The nipple shield is an important accessory when in no way can you attach the baby to the breast after trying with a professional. But remember that you can’t use it for life so then you have to take it off patiently and gradually.

The pacifier

The pacifier is a breast substitute. The phrase “he took the breast as a pacifier” does not exist at all. The pacifier can deform the palate, you know it’s the mother’s nipple that forms the palate of her baby. It is a response to the need for sucking and relaxation that a newborn does not expect and that one day will require a lot of work to eliminate. Evaluate the pros and cons well.

B for nursing beauty

Permanent :

Yes it can! It is a treatment that does not pollute breast milk.

Hair loss

It is a temporal event and does not depend on breastfeeding but on a natural cycle of the hair. It also happens to mothers who breastfeed with formula.

Tinctures

it is possible to make both dyes and colored shampoos as the amount of ammonia has such a low concentration that it does not pass into breast milk.

Tattoo

the tattoo even if done respecting hygiene always leads to an interruption of the integrity of the skin where viruses, bacteria and molds can pass through and pass into the milk and reach the baby. Better to stall.

Nail reconstruction

There are conflicting opinions on this but the common opinion is that such a treatment does not endanger breastfeeding.

Tanning lamp 

It is allowed but pay attention to your skin, if possible avoid doing it.

P as breastfeeding problems

The fissures:

Fissures are the result of a bad latch on the breast. But they can also be due to a short frenulum, a nipple that is too big for the baby’s mouth. You need to have your breastfeeding checked by a midwife. Applying creams is only a palliative and does not solve the problem.

Traffic congestion:

it is due to incorrect breast drainage or incorrect positioning of the baby or/and mother. In these cases it is necessary to:
1. drain the breasts slowly or the breast with a breast pump or manual expression of the breast
2. breastfeed immediately after the baby
3. contact a midwife to evaluate the feed

Blocked duct:

It shows up as a bubble on the nipple, or a blister. You can make the vesicle soft by placing a small ball soaked in oil on it and then attaching the baby so that it breaks this bubble through the suction. It does not hurt.

A for Mixed feeding

As with breastfeeding, I’m also of the opinion that bottlefeeding should be done on request. Why must a pack of milk decide the quantity that a child must take and that he must suck with a distance between one feed and another of at least 3 hours? Try the baby to offer the breast at each feed and before or after the bottle with a smaller amount but more often. This is both day and night. Little by little, your milk will increase and you will decrease the formula milk.

Don’t be discouraged and have faith in your abilities as mothers and in your child’s abilities.
Happy breastfeeding

Midwife Sara Notarantonio