Breastfeeding: Encyclopedia II - Breastfeeding - Breastfeeding method

Breastfeeding - Breastfeeding method

There are many texts available to new mothers to assist in the establishment of breastfeeding. The baby will usually indicate hunger by crying or moaning and fussing. When the baby's cheek is stroked, the baby will move his or her face towards the stroking and open his or her mouth, demonstrating the rooting instinct. Breastfeeding can make the mother thirsty and can last for up to an hour (usually in the early days, when both mother and baby are inexperienced) – it is therefore common for the mother to replace lost water by drinking during the process.

Breastfeeding - Feeding and positioning

While for some people the process of breastfeeding seems natural there is a level of skill required for successful feeding and a correct technique to use. Incorrect positioning is one of the main reasons for unsuccessful feeding and can easily cause pain in the nipple or breast. By tickling the baby's cheek with the nipple the baby will open its mouth and turn toward the nipple, which should then be pushed in so that the baby has a mouthful of nipple and areola; the nipple should be at the back of the baby's throat. Achievement of this position is referred to as latching on. Inverted or flat nipples can be massaged to give extra area for the baby to latch onto. Many women choose to wear a nursing bra to allow easier access to the breast than normal bras.

The baby may pull away from the nipple after a few minutes or after a much longer period of time. Sometimes the baby will relatch on the same breast or mother may offer the other side. The fat content of the milk increases as the breast empties.

The length of feeding is quite variable. Regardless of the duration, it is important for the breastfeeding woman to be comfortable.

• Upright: The sitting position with the back straight.
• Mobile: The mother carries her nursling in a sling or other baby carrier while breastfeeding. Doing so permits the mother to incorporate breastfeeding into the varied work of daily life.
• Lying down: Good for night feeds or for those who have had a caesarean section.
  • On her back: Mother is usually sitting slightly upright; particularly useful for tandem breastfeeding.
  • On her side: The mother and baby lie on their sides.
• Hands and knees: The mother is on all fours with the baby underneath her (not usually recommended).

There are many positions and ways in which the feeding infant can be held. This depends upon the comfort of the mother and child and the feeding preference of the baby – some babies tend to prefer one breast to another. Most women breastfeed their child in the cradling position.

• Cradling positions:
  • Cradle hold: The baby is held with its head in the woman's elbow horizontally across the abdomen, "tummy to tummy", with the woman in an upright and supported position.[36]
  • Cross-cradle hold: As above but the baby is held with its head in the woman's hand
• Football hold: The woman is upright and the baby is held securely under the mother's arm with the head cradled in her hands.[37]
• Feeding up hill: The baby lies stomach to stomach with the mother who is lying on her back; this is helpful for babies finding it difficult to feed.
• Lying down:
  • On its side: The mother and baby lie on their sides.
  • On its back: The baby is lying on its back (cushioned by something soft) with the mother on her hands and knees above the child (not usually recommended).

When tandem breastfeeding the mother is unable to move the baby from one breast to another and comfort can be more of an issue. This brings extra strain to the arms, especially as the babies grow, and many mothers of twins recommend the use of more supporting pillows. Favoured positions include:

• Double cradle hold[38]
• Double clutch hold[39]
• One clutched baby and one cradled baby[40]
• Lying down[41]

Breastfeeding - Breast and nipple pain

Breastfeeding may hurt some women. Sometimes this is related to an incorrect technique, but it usually eases over time. Milk ducts can block up on occasion, leading to breast engorgement or mastitis, and should be addressed with massage and by encouraging the baby to suck from that side to keep it as empty as possible until the problem goes away. The presence of thrush in the nipples can also be painful. Limiting feeding time does not prevent soreness.

Although it is said that fair skinned mothers are most likely to experience cracked nipples, cracked nipples can happen to anyone whose baby is not positioned correctly. The baby's rough tongue can also cause grazes and the suction can cause bruising if the mother and baby have not learned to latch and unlatch. To break the suction, mothers should wait for the baby to come off the breast, insert a finger just inside the baby's mouth, or press down gently on the breast. The use of nursing pads or tight bras can lead to breast and nipple pain, as can hair dryers, sun lamps, soap, alcohol, perfume, deodorant, hair spray, body powder and incorrect use of breast pumps. Bottles and nipple shields may change the way the baby sucks, as well.

Some mothers apply medical grade lanolin to sooth nipples; La Leche League International has endorsed Lansinoh, an ultrapure medical grade lanolin cream designed for breastfeeding mothers. Mothers can also express milk and rub it on the nipples.[42] After six weeks of breastfeeding, the process usually becomes easier, as both mother and baby learn the best technique. Mothers can also buy or rent breast pumps to extract the milk, if nipple pain becomes unbearable. It should be noted, however, that pumping breast milk can also be associated with nipple pain, and is best used only as a temporary solution while the most common culprit, a poor latch, is improved.

Nipple damage due to breastfeeding can increase the liklihood of a Candidiasis infection. If a baby develops symptoms of oral thrush, both the mother and the child must be treated at the same time.[43] Proper antibiotic treatment will help neutralise the infection and aid in the nipple healing process.

Breastfeeding - Weaning

Weaning is the process of gradually introducing the infant to what will be its adult diet and withdrawing the supply of milk. The infant is considered to be fully weaned once it no longer receives any breast milk and begins to rely on baby food or other solid foods for all its nutrition. Most mammals cease the production of the enzyme lactase at the end of weaning, becoming lactose intolerant. Many humans have a mutation that allows the production of lactase throughout life and can drink milk well beyond the age of weaning [44]. Typically, this milk comes from domesticated animals.

Adapted from the Wikipedia article "Breastfeeding method", under the G.N U Free Docmentation License. Please also see http://en.wikipedia.org/wiki