Breastfeeding for new mothers can be a learning process, but with guidance can be a rewarding experience. In this article, Dr. Jindal answers questions surrounding breastfeeding for new mothers. She talks about  breastmilk supply, quality, storage and insufficiency, concepts of a good latch, C- sections and breastfeeding and cluster feeding

Understanding breastfeeding concerns with Dr. Taru Jindal

Dr. Taru Jindal is an obstetrician and gynaecologist, who has redefined the scope of community medicine through commitment and work in rural areas, saving thousands of pregnant women and children in rural Bihar. She is a published author, and has received the “Most inspiring woman of the year award for valuable contribution in the field of healthcare”.

As a new mother, breastfeeding can appear as a challenge. However, a combination of patience, excellent technique and perseverance will help you easily achieve the goals.

How can one check the quality of breast milk?

A lot of mothers may think I am so thin. I did not put on so much weight during pregnancy. Maybe my milk is not that good. There is nothing like good or bad milk. It has been proven that the diet of the mother doesn’t influence the quality or quantity of milk supplied to a large extent. The fat that you put on during pregnancy is your reserve. That fat is going to melt and be produced in the form of milk.

When the milk from mothers in Africa or undernourished mothers with low BMI was compared to mothers in developed countries, it was found that the quality and quantity of milk made by the mothers was comparable or had a similar composition. The only thing you need to remember is that a breastfeeding mother needs 550 extra calories in the day. The quality of milk will be maintained to match your growing baby’s needs. Ensure plenty of water intake and healthy nutrition.

How can one know if the baby isn’t cluster feeding and hasn’t taken the hind milk?

Usually, cluster feeding happens in the evening and usually during growth spurts when the baby is on marathon feeding.  The baby will spontaneously delatch and relax when it is full. If you wish to check if your breast is fully emptied, just extract a few drops from your breast. If a transparent watery discharge is coming out, it means it is foremilk and your baby is yet to take in the hind milk. If more white, thicker milk is coming out, it means the baby has only partially received the hind milk, and if few to no drops come out, it means your baby has fully emptied the breast and if it shows signs of hunger, offer the second breast.

How to get a good latch during breastfeeding?

The core of breastfeeding is how the mother positions herself. Second, is how she holds the baby and third is how the baby attaches herself/himself. This is the core of the entire lactation experience. If this is perfected, everything is perfected. These are skills that must be brought during the pregnancy period. But unfortunately, very little priority or focus is given on this. Maternity visits should go beyond the abdominal examination of the baby such as what’s the heart rate of the baby or the ultrasound. 

After childbirth, the more the baby touches the mother there is more oxytocin release and a good flow of milk. Your clothing is of paramount importance when establishing breastfeeding. Make sure to have loose cotton clothing wherein during breastfeeding with the baby having access to both breasts and the baby’s skin coming in contact with the mother’s skin. One great way to hold the baby is the football hold so that the mother’s hand does not impede skin to skin contact. The mother should make herself comfortable during breastfeeding. She should avoid bending and support her back well. Breast milk is let-down or released because of the sucking efforts of your baby. Baby’s chin should touch the breast and the mouth is wide open. The baby shouldn’t latch head-on because it’s the jaw of the baby that moves. A sandwich grip of holding the breast also helps in latching.



What should one do when breastmilk is insufficient?

When the baby is born, it has been in the uterus for almost 9 months in a bag of water. So, the birth weight is not the correct weight of the baby. There is some extra weight because of the water that has been absorbed. In the first two weeks of life, the baby will pass that out through urine. You’ll see a fall in the birth weight in the first few days because of the loss of extra water in the urine. We consider it that up to 10 percent of weight loss is normal and beyond that is not normal. Usually, the baby will drop the weight by 7 percent and if you’re breastfeeding, then the baby will start to regain weight and  by day 14, the baby should come back to the birth weight.

If there is an excess loss of weight of the baby, remember to never starve the baby. If for any reason you’re not able to provide enough milk, the first option is the milk bank. It’s important to check if your hospital has a milk bank. In rural areas, there is the usual practice of wet-nursing by another breastfeeding woman in the family. Another option is formula. Giving your baby formula in addition to breastfeeding is called supplementing. It’s ok and perfectly safe to do, and many families choose this type of combination feeding method, whether out of necessity (e.g., low breast milk supply), convenience, or simply as a choice. 

How to increase milk supply? 

Focus on the latching position. It’s helpful to get in touch with a lactation consultant or a paediatrician or gynecologist who knows this well. Keep putting the baby to the breast. More demand generates more supply. Make sure you are adequately hydrated and improve water intake.The secretion of breast milk is highest between 1-4 am so make sure to not skip nightly feeds. Try to latch the baby every 2 hours. Pumping using a manual or electric pump also helps increase production.

How does a C-section affect breastfeeding?

Cesarean delivery is defined as the delivery of a fetus through surgical incisions made through the abdominal wall (laparotomy) and the uterine wall (hysterotomy). In cesarean delivery there is separation and the mother is in pain. Third is probably the mother has been sedated during the Cesarean.Separation, pain and the mother not getting a good position to breastfeed, the chemicals required to breastfeed the baby such as Prolactin and Oxytoxin are chemically affected during Ceasarian. The Mother-Baby contact should happen in the chest and after the baby is shifted to the room. Maximum skin-to-skin contact should continue in the room after Ceasarian. In the first two days, the mother gets colostrum which is the thick yellowish milk which is full of antibodies.It’s like a vaccine to the baby.Lot of efforts have to be taken by the entire maternity system to ensure that we counter the effects of Cesarean. It’s definitely not a normal method of delivery.

A lot of efforts have to be taken by the entire maternity system to ensure that we counter the effects of Cesarean. The doctors and supporting staff should try to ensure immediate skin to skin contact once the baby is delivered by a c-section. Placing the baby on the mother’s chest, away from the operating area is a great way to do it. Even when the mother has been shifted to the room, efforts should be made to keep the mother and baby together.

This article will help new mothers and their caregivers to understand breastfeeding and take care of their infants’ growth and development. 

Disclaimer: This article is for informational purposes only and should not be construed as a substitute for medical advice or treatment.

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