Breastfeeding your new baby

There's no disputing the evidence: breast milk is the best possible food for your new baby. It contains substances that help regulate appetite, promote brain development and guard against diseases both in the short and the long term. It adapts to suit your baby's stage, and varies from mother to mother and from one day to the next. Once established, breastfeeding is cheap, easy and convenient, with no formula to buy and prepare and no specialist equipment needed, save a few good feeding bras and breast pads for you.
Sounds great? Well, when it works well, it is. However, despite being perfectly normal and natural, not all new mothers find it easy, whether it's down to sore nipples, engorged breasts, mastitis, not producing enough milk or not latching the baby onto the breast correctly. Whatever the problem, it's worth persevering as it can be one of the most rewarding experiences of motherhood. The World Health Organization recommends exclusive breastfeeding for at least six months, but you can carry on longer if you wish (extended breastfeeding is more common in non-western cultures) and if you only do it for a few weeks or months, you can be reassured that you have given your baby a great deal of goodness.

Getting started
  • As soon after the birth as possible, put your baby to your breast; the baby is born with rooting and sucking reflexes, which will help the baby to find your nipple and extract milk from it. You will have to make sure to put the baby in the right position, so make sure there's a midwife around who can help you out.
  • Your position is vital: you should be able to sit up straight rather than hunching over your baby, as this is bad for your posture. If necessary prop your baby up on cushions or pillows so s/he's at the correct height.
  • Your baby's position is also vital: s/he should be lying on his side with his mouth level with your nipple, so that when it goes into the baby's mouth, all of the nipple and most of the areola are in the mouth. S/he will be so close that the baby's nose is touching your breast and the lips are curled back - this means s/he is sucking your breast, not chewing your nipple.
  • Relax and let your baby feed for as long as s/he needs to, which could be anything from ten minutes to an hour, If s/he stops sucking and falls asleep, chances are s/he's probably had enough.

Eat well
  • Just as it's vital to eat well during pregnancy, so it's important to have a healthy diet while breastfeeding - remember, your milk is what's sustaining your baby so make sure it's top quality. Now you really are eating for two, so you will be eating more than normal, perhaps up to 500 calories a day extra.
  • Eat lots of carbohydrate-rich foods such as pasta, rice, wholewheat bread, pulses and cereals.
  • Make sure you get at least five portions of fruit and veg a day, as these will provide lots essential vitamins and minerals. Otherwise, follow the healthy eating advice in the pregnancy section.
  • The following nutrients will help your growing baby: fatty acids (find them in oily fish, pulses and nuts); vitamin D (exposure to sunlight, fortified margarine, oily fish, eggs and milk); calcium (milk, cheese, fortified soya milk, canned pink salmon, sardines, baked beans, nuts and green leafy vegetables); zinc (meat, nuts, seeds, cheese and tofu); iron (meat, fish, green leafy vegetables, eggs).
  • Keep up your fluid intake - you may find you feel thirstier anyway - if your milk supply feels low and your urine is dark, you need to drink more. Water is best, but any liquid will help, such as fruit juice or herbal tea. Fizzy drinks, however, may give your baby indigestion.

What to avoid
  • It's probably best to avoid peanuts if there's a history of allergy in your or your partner's families.
  • Certain foods may affect the flavour of your milk, such as garlic, hot and spicy foods, citrus fruit, grapes, although as no-one knows exactly how long it takes a food to reach your milk, it's hard to pinpoint a particular culprit. The most common reaction from your baby is for him to be unsettled and windy and perhaps suffer from mild diarrhoea; if it's just the taste, you may find he fusses at the breast more than usual.
  • If you think your baby has reacted to a food, consult a doctor before cutting out an entire food group from your diet, as this could be detrimental to your baby's health.

Common problems
Sore, cracked nipples: this usually occurs as a result of your baby not being latched on properly; if this is the case, seek advice and try different positions at each feed. A little nipple cream may help, but make sure it's safe for your baby or clean it off before feeding again. Do make sure your nipples are clean and dry between feeds.
Breast engorgement: this is where your breasts feel heavy, lumpy and tender. It is common when your milk first comes in and can happen if you stop breastfeeding suddenly. The best remedy is to carry on feeding, alternatively apply a warm compress (a muslin cloth soaked in warm water with a couple of drops of camomile, geranium or lavender added) to soften and reduce the swelling. A cold white cabbage leaf placed in your bra will also feel cool and soothing. If you're too engorged for your baby to latch on to your nipple at the next feed, express a little milk off first, then feed as normal.
Mastitis: a common infection of the breast, symptoms include swollen, engorged breasts, sometimes with red patches, and occasionally a fever. It is often a result of the breast not being emptied properly, perhaps as a result of not being latched on properly. Do keep feeding, as stopping could make it worse, but make sure you get plenty of rest and fluids. If symptoms do not clear within 24 ours, see your doctor as you may need a course of antibiotics.