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Breastfeeding

Breastfeeding is learnt over the first weeks and months of your child’s life. It is always a unique and special experience for families as no two mothers or babies are the same.

 

The amount of information available on how to breastfeed successfully can seem overwhelming at times. We recommend finding a trusted source that provides evidence-based information and techniques for you to trial, and using what works for you.

If you are experiencing difficulty then it’s a good idea to get a second opinion. For support contact the Karitane Careline, your child and family health nurse, the Australian Breastfeeding Association or a private lactation consultant.

Karitane Tip: Any amount of breast milk you can offer your baby is good. The World Health Organisation endorses exclusive breastfeeding beginning one hour after birth until six months of age. From there, add nutritious, complementary foods while continuing to breastfeed, until your child turns two.

Frequently Asked Questions

 

How do I help my baby attach to the breast?

The latch your baby develops with your breast is key to successful breastfeeding. Your baby is hardwired to breastfeed and will instinctively find your breast within the first hour after birth.

Getting a good attachment to your breast may be challenging. Finding a method that works for both of you makes all the difference to your success. Generally, the way your baby latches and your position don’t really matter, as long as you are not experiencing pain and your baby is comfortable and receiving enough milk.

Watch this 'How to Breastfeed: getting a good attachment' video sourced from Raising Children (www.raisingchildren.net.au).

Here are a few tips on getting a good latch:

  • Your baby should be held close, unwrapped and well supported
  • Make sure your baby faces you and is tucked in close to your body

Skin to skin contact is helpful

  • Position your baby’s nose and top lip in line with your nipple
  • Move your baby toward your breast
  • Encourage your baby’s mouth to open by teasing with your outer nipple and bring your baby to your breast
  • Ensure your baby gets a good mouthful of your nipple

Once attached, your baby will have a short, initial burst of sucking, then slow to an even rhythm, with deep jaw movements. As your child continues, pauses may occur. Don’t worry. This is a normal aspect of feeding. Pause frequency may increase as the feed continues. Eventually, your baby will stop feeding by coming off the breast themself.

If you experience pain during the feed, and/or the pain doesn’t settle after a few sucks, you’ll need to help your baby learn how to latch more successfully. Gently break the seal of their mouth on your nipple by using a clean finger at the corner of your child’s mouth to detach. Once your baby’s mouth  is off the breast, help them reattach.

Karitane Tip: If you experience any pain while feeding, it is vital to detach your baby from the breast.

 

 

Baby-led attachment is another latching method. It involves allowing your baby to follow their natural instincts to find your breast and attach at will. This method works best soon after birth – however, it can also be introduced a few weeks later. This video demonstrates successful baby-led attachment (sourced from Raising Children).

Some tips to apply to baby-led attachment:

  • Trust your baby to find your breast
  • Look for cues that your baby is hungry

These often come after your baby wakes

  • Skin to skin contact is helpful
  • Pick a warm place where you feel comfortable
  • Use pillows for support

You may find laying back is easier for your baby

  • Keep calm

Soothe your baby if they cry

  • Place your baby on your chest, between breasts
  • Support your baby’s shoulders and bottom

They may wriggle and bob from side to side when looking for a preferred breast

  • Only support your baby’s head as necessary

It is better for babies to have freedom to find the breast through licking, smelling and nuzzling

  • Support your baby’s thighs and back while they position themselves to latch

As above, if you experience pain during the feed, and/or your baby seems uncomfortable and restless after a few sucks, you’ll need to help your baby detach and reattach.

For more information on breast attachment, visit the Australian Breastfeeding Association.

Karitane Tip: Feeding within the first hour of life helps get your breastfeeding experience off to a good start. While pregnant, it is helpful to have a chat to your midwife or doctor to implement this into your birthing plan.

Which breastfeeding position is best?

There are many different breastfeeding positions you can try. As long as you and your baby are comfortable, and there is no pain, go with whatever works for you both.

 

Watch this video for breastfeeding positions from Raising Children (raisingchildren.net.au) or for visual references, see the following breastfeeding positions below.

Football

Cradle

With Pillow

With Pillow

How do I know if my baby is hungry?

In the early weeks your baby will try to communicate their needs. As you get to know each other better, you’ll begin to understand these cues.

Babies are ‘wired’ to look for food when hungry, and feeding times can vary greatly. On average, newborns feed every 2-3 hours – so if your baby starts to fuss and hasn’t been fed in the last few hours, checking their appetite is a good start. It’s normal to feed a newborn baby 6-12 times per day.

Karitane Tip: Your baby’s hunger cues are the best indicator for when to feed. Going by a set time period doesn’t take your baby’s individual needs into consideration.

Hunger cues include:

  • Sucking noises
  • Opening mouth
  • Turning towards breast or bottle
  • Sucking fingers and/or fist
  • Crying
  • Being unsettled

Sometimes your baby just wants to feed for comfort. This reassurance is fine when your baby is very distressed as it can be calming in these situations.

The following videos demonstrate some baby hunger signs.

Sourced from Raising Children.

www.raisingchildren.net.au

As your baby grows, you’ll notice they are able to latch more independently with increased sucking efficiency – which means that they can feed for a shorter time, but with the same satisfaction. At around three to four months, you may also notice your baby becomes easily distracted, and detaches and attaches several times during the feed. This is more prone to happen in new and/or stimulating environments, like a shopping centre.

Around this time babies also generally reduce breastfeeds over 24 hours. At this point, it is common for babies to feed every 3-4 hours – including overnight feeds. Remember to keep looking for hunger cues as an appropriate indicator of when to offer the breast.

Karitane Tip: We recommend giving your baby only breast milk or formula for the first six months, as these contain all the nutrients your child needs. To cater to your baby’s growing development, you can begin to introduce solids around this six-month period. For more information on solids, read more here.

When assessing whether your baby is actually hungry or not, it’s important to consider other things your baby might be trying to express. Look at your baby’s growth, development, sleep routine, activity, health and environment, to determine whether your baby is really hungry, tired or needs changing.

Is my baby growing properly?

Every baby is unique and will therefore grow a little differently.

 

However, you may find it helpful to have your baby’s head length and weight checked and recorded at regular intervals. Your child and family health nurse can do this for you, during regular child health checks. You’ll find a copy of their growth percentile chart in the Blue Book.

 

Your baby’s weight will vary significantly as your breastfeeding routine is established over time. All babies experience greater periods of hunger at certain times, so your baby may increase feeds to change your milk supply at these times of growth. Look for these additional hunger cues and feed to your baby’s demand.

 

Babies tend to grow according to their percentile. This expected weight gain table offers a general guide to growth rates.

 

Age

Weight Gain

0 - 3 months

150 - 200g / week

3 - 6 months

100 - 150g / week

6 - 12 months

70 - 90g / week

Birth - 1 year

2 - 3 x birth weight

1 - 2 years

2 - 3kg / year (40 - 50g / week)

2 - 5 years

2kg / year

Sourced from the NHMRC Infant Feeding Guidelines, 2012.

 

Your baby’s development influences when and how often a feed is offered. As your child grows, you’ll find they begin to attach and breastfeed with more ease. Breast milk should remain the primary source of nutrition before solid foods are introduced at six months. At this stage water may be introduced in small amounts, for thirst only.

Does the feeding routine affect sleep?

At Karitane, we’ve found promoting a feed, then play, and then sleep helps you determine your baby’s hunger and sleep cues more easily. Not feeding when they’re due to be sleeping also helps your child learn to sleep more independently over time.

Additionally, you’ll find daily activity helps reduce snack feeding – promoting better, healthier feed and sleep patterns. Activity for infants up to one year is typically floor play, including tummy time and time smiling and talking with mum and dad.

Feeding and sleeping work closely together. Too little sleep can make it hard to feed well, just as too little food affects sleeping patterns. Over the first few weeks, you’ll experience some trial and error when it comes to these. Don’t be discouraged. It takes time to get know your baby.

For more information on establishing age appropriate routines, we have a number of brochures available.

FLEXIBLE DAILY ROUTINE BROCHURE

 FEEDING MY BABY BROCHURE

FEEDING MY TODDLER BROCHURE

Do health conditions impact feeding?

Health conditions can impact feeding. Medical conditions like gastro-oesophageal reflux disease (GORD), cardiac conditions, and metabolic disorders may influence the feed volumes and frequency your baby requires. Short-term medical issues, including viruses and infections, also impact the feeds your baby can manage. If your baby has a medical condition be sure to get support early.

How do I establish a good feeding environment?

Babies find it difficult to regulate their own body temperature, so your baby can easily overheat with overdressing, multiple blankets, room heating and/or hot weather. This increases their need for extra fluids. If your baby is under six months, this may mean additional feeding.

If your baby is too hot, they may wake for more feeds or fluid overnight. If your baby is too cold, they may expend more energy to stay warm, and demand more feeds to sustain this energy.

As a general rule for hot weather, dress your child in one item less than you’re wearing. In the cold, add one layer extra.

Karitane Tip: There is also no evidence to support maintaining a specific room temperature, or any specific bedding configuration (number of blankets required) as this depends on a number of factors, such as what your baby is wearing, whether it is summer or winter, and whether there is heating or cooling within the room where your baby is sleeping.

Sourced from Red Nose: Room Temperature.

How do I know my baby's getting enough food?

When deciding whether your baby is getting enough out of their feed, it’s useful to remember every child is different. No two babies have the same appetite. Instead of focusing on each individual feed, try to consider the feeds over the whole day. There will be times of the day where you will feel your baby has had a good feed and other times of the day where your baby might have had a short feed or been fussy.

Contentment:

If your child seems generally content after a feed, this is a cue of satisfaction. You may notice your baby also appears more alert and active when awake. Remember, in the early months it’s normal for your baby to experience one or two unsettled periods a day, and they may want to feed more often – so don’t be worried if this occurs.

Output:

Urine: Your baby will have six or more wet nappies over the course of 24 hours. Healthy urine is a clear, pale yellow. Should the urine darken, seek medical advice.

Stools: Your baby’s bowel movements are soft, and occur many times in the first 6-8 weeks. If your baby is also taking formula, stool (poo) frequency and consistency can be firmer and less regular (every 1-2 days on average). Once solid foods are introduced, colour, texture and frequency often change as your baby adjusts to the new diet.

Karitane Tip: If you notice firm, pebble-like stools, difficulty passing stools, crying when passing stools, or bleeding when passing stools, seek medical advice.

For more information on breastfeeding, download a copy of Breastfeeding your Baby by the NSW Ministry of Health. 

What are some common breastfeeding challenges?

Common challenges include engorgement, blocked ducts, mastitis, damaged nipples, and low milk supply. Here are our tips to help overcome these challenges.

Engorgement:

Your milk will come in approximately 2-3 days after birth. If you have engorgement, you’ll feel very full and uncomfortable for another few days. This ‘full’ feeling may continue to last weeks, until your milk becomes established.

When feeding your baby, we suggest emptying at least one breast at each session. Ensure your first breast is soft and comfortable before offering the second breast. This reduces the risk of blocked milk ducts. During the next breastfeeding session, ensure your baby starts feeding on the same breast they finished on. Depending on your baby’s appetite, they may drink a little or a lot of milk from the second breast.

Karitane Tip: If a full breast is making attaching difficult, you can hand express enough milk for comfort and softness, so your baby can latch.

Engorgement tends to decrease with time. You may find using a supportive maternity bra and applying a cold press to the breasts between feeds helpful during these early days.

Blocked ducts and mastitis:

As mentioned above, we suggest emptying at least one breast during each feed. Tight tops and bras can cause blockages, so avoid them where possible.

A blocked duct may present as a lump. Encourage your baby to feed on the affected breast first, while applying gentle massage behind the affected area for relief. You can also place a warm, moist face cloth on the breast prior to feeding to help with your milk flow, if your child is over ten days old.

If left untreated, a blockage can lead to mastitis – an infection of the breast tissue. This may begin as a red area on the breast, which progresses to swelling, pain and heat. It may also involve flu-like joint aches, chills, rigors, and/or a temperature.

Karitane Tip: If you display any of these symptoms, it is important to visit your doctor as you may need some antibiotics.

In the case of mastitis, here are some things to try:

  • Feed your baby frequently

Start with the affected breast. It is important you continue to breastfeed to drain your breasts well.

  • Apply a warm cloth to the sore breast before feeding

A warm shower will also help your milk flow more easily.

  • Massage the area gently

Massage towards the nipple while feeding.

  • Apply cold packs after feeding

These will offer additional comfort.

Damaged or painful nipples:

It is common for some mothers to experience mild nipple pain when their baby attaches to the nipple in the early weeks. If your nipples become grazed or cracked, you may experience pain, bleeding or infection. Damaged nipples are often due to your attachment method. Click here for tips on getting good attachment: How do I help my baby attach to the breast?

General nipple care includes avoiding use of shampoo and soap on the nipples, allowing them to air-dry after feeding, and avoiding ointments, sprays and powders. If you use breastfeeding pads, be sure to replace them frequently.

To avoid further damage it is also important to gently detach your baby from the breast. If pain persists, see your child and family health nurse, lactation consultant, or general practitioner.

Low milk supply:

If your baby appears to want more breastfeeds, or becomes fussy at times, offer more comfort and feeding to see if the fussiness passes. If you find your supply seems low, apply these useful tips:

  • Breastfeed more often

This is the quickest, most successful way to boost supply. Try offering both breasts more than once during each feed.

  • Offer a top up if your baby doesn’t settle after a feed
  • Express after feeds and offer the expressed milk to your baby
  • Make skin to skin contact

This will help you both relax.

  • Rest
  • Eat well
  • Keep fluids up
  • Accept help from friends and family

You may feel that your milk supply is low especially if your baby is unsettled after a feed, but there can be other reasons for this (see Your Crying Baby ). This is one of the common challenges of breastfeeding, as you can’t measure how much your baby is drinking. There are other signs to let you know your baby is getting enough. Visit How do I know if my baby is getting enough food? to assess the situation.

Still concerned? Speak to a healthcare professional. This could be a child and family health nurse, a lactation consultant, an Australian Breastfeeding Association counsellor or our Karitane Careline.

Where do I go if I need help with breastfeeding?

If you experience challenges with feeding, don’t be afraid to reach out. There are many avenues available to you.

 

  • Karitane Careline

Karitane provides feeding support through our free careline. Should you reach us out of hours, an experienced child and family health nurse will phone back within 24 hours, between 12.30pm – 9pm / 11pm – 6am Monday to Thursday, or 9am – 3.30pm Friday to Saturday.

1300 CARING | 1300 227 464

  • Karitane emails

We’re also open to online enquiries. Don’t hesitate to email if you have any feeding questions.

KRTNE-OnlineEnquiries@health.nsw.gov.au

  • Friends and family

If you’re lucky to have generous friends and family offering to help, request assistance in practical ways. They can help by making meals, doing laundry, hosting play dates, preparing snack boxes, and offering emotional support.

  • Child and family health nurses

Registered child and family health nurses are qualified in child and family health, and are trained to support parents with feeding issues.

  • Your local community health centre

Local family health centres are a great place to seek help with feeding. Many centres offer drop-in feeding clinics and/or appointments for difficulties.

www.healthdirect.gov.au

1800 022 222

The ABA is a non-profit organisation run by other breastfeeding mums. Their breastfeeding helpline is staffed by trained volunteers, and is available seven days a week.

1800 MUM 2 MUM | 1800 686 268

  • Lactation consultant

A trained breastfeeding specialist can provide support and advice, often in a clinical or home setting. Free lactation consultations are available from a child and family health centre. Private consultations will incur a fee. To find a consultant, ask your family doctor or search online.

  • Your local feeding clinic

Many large hospitals house specialist feeding clinics. These are often required after oral surgery, feeding tubes, oral trauma, medical conditions or interfering feeding behaviours. Ask your family doctor for a referral.

Need to talk to someone?

Call Karitane Careline on 1300 227 464 or 9794 2350

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