12 min read
BY LAUREN BRENTON | ENDORSED MIDWIFE & CHILDBIRTH EDUCATOR
Feeding your baby is one of the biggest decisions that you will face when you become new parents. Is breastfeeding the best? What happens if you are unable to or don't want to breastfeed? Midwife Lauren Brenton shares with us her insights on how best to feed your baby.
Does it really make a difference how you feed your baby? Some people have a set idea of whether they will breastfeed, formula feed or do both, however most people don’t have any set plans before they have their baby and that is okay too.
What matters is that you have weighed up the pros and cons of all feeding methods and you have made the choice that works best for you and your family. Let’s consider all available options.
BREASTFEEDING
Breastfeeding is a natural and beneficial way to feed your baby, breastmilk contains all of the necessary vitamins and minerals, antibodies and hormones that your baby needs for their growth and development. So much so that it is recommended by the World Health Organisation that all babies be exclusively breastfed for the first 6 months and then continue to be breastfed in addition to solid food for a minimum of two years.
1. How often, How much and when should I breastfeed? Should I be following a routine?
It is recommended to feed your baby on demand and not try to fit them to any type of routine. This is because their tummy’s are so small, meaning they get full quickly but they also get hungry quickly.
In the first few weeks babies can feed anywhere from 1-2 hourly to 4-6 hourly and the intervals between feeds will be different times. This is because some meals they will take entrée, main and dessert while other feeds they may just take the main meal and that is perfectly normal. As they grow older they may get themselves into their own little routine but it is important to always follow their hunger cues, their lead and feed them anytime that they want.
Babies will also have periods of cluster feeding where they will feed frequently in a period of time, this may be because they are growing through a growth spurt, are trying to increase your breastmilk supply (especially overnight when the prolactin levels are highest) or are in need of extra comfort or support to wind down for bed.
2. What are the best feeding positions/techniques?
There are many different breastfeeding positions, most women will adopt the cross-cradle hold. This is where the baby is chest to chest across your body and is able to get nice and close to the breast to feed. However, some other women will find feeding in an underarm or football hold position is easier or more comfortable for them. There is no right or wrong when it comes to feeding position, whatever feels most comfortable to you is the one you should stick with.
The most important thing to consider when thinking about which feeding position to use, is ensuring that you are able to get a deep latch for your baby. This will reduce any nipple pain or trauma and ensure baby is sucking effectively at the breast.
3. What happens if my baby is not latching?
If your baby is not latching, it is important to see a lactation consultant as soon as you can. They are able to effectively assess the whole situation and give you specific guidance to help with your baby. They may also put a feeding plan into place to help you if you are struggling.
4. How do I prevent sore nipples?
The best way to prevent sore nipples is to make sure that your baby is latched perfectly every single feed, starting from the very first feed. If a baby is not latched properly, they may be sucking just on the nipple up against the hard palate in their mouth, instead of having the nipple at the back of their throat on the soft palate. This will cause nipple pain and damage. Another great way to prevent sore nipples is to use the Silverette Nipple Cups in between every feed to help soothe the nipple as well as heal any potential damage.
5. What do I need to know about expressing?
You may be expressing milk for a variety of reasons, whether it is to try and increase your milk supply after feeds, because you prefer to express and bottle for your baby or because you are separated from your baby. It is not recommended to express in the first 6 weeks after birth, unless there is a medical reason for expressing, this is because it is recommended to exclusively breastfeed to try and regulate your breastmilk supply.
After the first 6 weeks, expressing can allow your partner to help out with a feed or allow you a little more freedom when it comes to being away from your baby. Regardless of the reason for expressing it can be physically and emotionally exhausting as well as hard to find the time to pump. Sometimes, pumping may make it difficult to maintain your milk supply, as usually babies are much better at getting the milk out than we are.
6. How can I increase my supply of milk?
If you are concerned that you aren’t producing enough milk for your baby it is important to see a lactation consultant.
When you are breastfeeding, in order to produce a good supply of milk it is important that you stay hydrated and eat a healthy, well-balanced diet. Furthermore, breastmilk supply works on supply and demand, meaning that the more that you feed or express for your baby, the more that the body sends messages to the brain to make more breastmilk.
Some women swear by lactation cookies and some herbs such as fenugreek or blessed thistle to help increase your supply but it is always essential to consult a lactation consultant before trying any supplements.
7. Is it safe to drink alcohol when breastfeeding?
Alcohol does go into the breastmilk, however the amount of alcohol that is in the breastmilk is significantly less than the amount of breastmilk in your blood stream. Time is the only way that you can achieve zero alcohol in your breastmilk when you feed your baby. After you consume one standard drink, the alcohol is present in your breastmilk after 30-60 minutes. It then usually takes 2 hours for that one standard drink to be out of your breastmilk. So, it is important to wait at least 2 hours after your baby has fed to ensure your baby is not receiving any alcohol through the breastmilk.
8. Is it safe to take medication or vaccines eg (covid or flu shots)?
Before taking any medications or having any vaccines it is important to consult with your healthcare professional. Most vaccines are safe to have during breastfeeding, however it is always important to check. When it comes to taking medications during breastfeeding, call MotherSafe – this is a free resource set up by the Australian government and they will tell you which medications that you are taking are safe during breastfeeding.
9. What is mastitis and how can it be managed?
Mastitis occurs when one of the ducts in the breast becomes blocked and potentially infected. It often presents with breast pain, redness, lumps, swelling and flu-like symptoms. To manage mastitis it is important to continue breastfeeding or expressing as normal to try and keep the milk flowing. You can gently try to massage the lump whilst in the shower or while feeding your baby to get the blocked milk flowing again as well as taking Panadol and anti inflammatory medications. If symptoms persist or become worse, see your GP for assessment and potentially antibiotics.
FORMULA
1. Are there different types of formula? Which is best?
All formula in Australia is very heavily regulated and is safe for your baby. The Australian Infant Feeding Guidelines state that it is important to start on a formula with a cow’s milk base, instead of soy or goat milk bases. This is because the proteins are more similar to that of breastmilk and therefore, are more easily broken down by baby’s tummy. However, all babies tolerate formula differently and it may be a bit of trial and error to find the formula that suits your baby the best.
2. What should be mindful if I am preparing formula?
When preparing formula, it is essential that you follow the instructions on the back of the tin exactly and only prepare the number of scoops to water that is recommended. Babies’ organs are very immature and it can be life threatening if formula isn’t prepared correctly. Furthermore, it is essential that the water used to make the bottles is boiled and then cooled before use, this ensures that any bacteria in the water is killed before being fed to baby.
Another thing to be mindful of is that once the bottle has been made, it needs to be used within an hour or it needs to be disposed of. When out and about, most families will take the premeasured water in a bottle and the premeasured scoops of formula in a separate container and only mix them when it’s time to feed the baby.
3. What is the best bottle for feeding my baby? How do I sterilize my baby bottle?
Unfortunately, there is no one size fits all when it comes to bottles for babies. We personally found the Haakaa bottles were great for Wilder, however you might end up trying a few different bottles until you find one that is right for your baby.
There are many different ways you can sterilise your bottles and teats including electric sterilisers, microwave sterilisers and UV sterilisers. These are all great options to make sure that your bottles are sterilised properly after use. Sterilising is important to kill of any bacteria that may grow and may cause your baby to become sick. It is important to sterilise your bottles before you first use them and after each use.
4. Do you have any tips if my baby is refusing to take the bottle?
If your baby is refusing to take a bottle here are some tips to help:
- Get your partner or a family member to try and give the baby the bottle when you aren’t around.
- Try a different shaped teat
- Try giving your baby the bottle when they’re sitting upright instead of lying down
- Try walking around outside while giving your baby the bottle
- Try introducing the bottle at your baby’s calmest time of the day
- Experiment with different temperatures from room temperature, to slightly warmed and see which one your baby likes best.
When giving your baby a bottle, it is important that they are not lying down flat as this may allow the milk and bacteria to pool at the back of their mouth and can potentially cause ear infections.
It is important to adopt an upright or semi-upright feeding position when giving your baby a bottle to avoid this.
INTRODUCING SOLIDS
The World Health Organisation recommends exclusively breastfeeding for the first 6 months and then to accompany solid food for a minimum of 2 years.
According to the Australian Infant Feeding Guidelines it is recommended to introduce solids when your baby is around 6 months. This is because our babies’ nutritional requirements around 6 months of age are no longer satisfied by breastmilk or formula alone.
It is important when introducing solid food, to try and focus on foods that have high nutritional value, specifically iron and zinc. The introduction of solid foods doesn’t mean that you have to wean your baby off breastmilk or formula. You can continue feeding solid foods and breastmilk or formula for up to two years. It is important to note that cow’s milk should not be given as a drink to babies under 12 months of age.
2. What are the challenges of introducing solids?There are some challenges when introducing solids including:
- If solid food is introduced when the baby is too young, the baby may reject the spoon due to their tongue-extrusion reflex and the parents may think that the baby is rejecting the food when in fact they’re rejecting the spoon in their mouth.
- Another challenge with introducing solid foods too early is that it may mean less time spent on the breast for the baby, which may cause a reduction in the mother’s milk supply and potentially under-nutrition may be a risk for that baby.
- If solid foods are introduced too late, the development of skills such as chewing may be delayed. Thus, the baby may be unwilling to try new tastes and textures.
- The next biggest challenge of introducing solids is time and preparation. Introducing solids means that you will spend a lot of time trying to prepare and offer food to your baby. Planning your mealtimes can help you manage your time and better enjoy your solids journey.
Food can be introduced in any order and at any rate that suits that baby. This means that there are no recommendations on the number of new foods that can be introduced at a time and that foods can be mixed together for the baby. Slow introduction of solid foods is not necessary.
It is important that all food introduced to the baby is of nutritional value, starting with iron rich foods such as pureed meat, poultry and fish, as these are all sources of haem iron. Other great sources of iron include cooked tofu and legumes. Other foods that are great for your baby include vegetables, fruit and dairy products (cheese, full-fat yoghurt and custard).
The main thing to focus on is foods high in iron and zinc, protein, vitamins, fat and other essential minerals from each of the five food groups.
4. What foods should I avoid when introducing solids to baby?
Avoid foods that have high levels of fat, sugar and/or salt. Foods such as cakes, biscuits, lollies, chocolate and chips should be avoided or limited as much as possible. These foods have no nutritional value for your baby.
Honey should not be given to babies under 12 months old. This is because it contains the spores of Clostridium botulinum meaning that it has a high risk of the baby developing a condition called infant botulism where the spores go into the baby’s intestines and make a toxin.
It is also important to avoid foods that are high choking risks such as whole nuts, popcorn, seeds, raw carrot and chunks of apple. These foods should be avoided for the first 3 years to reduce the risk of choking.