BREAST CARE FOR LACTATING MOTHERS

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The main function of the female breast is to provide milk to the newborn baby. They are the mammary glands which have been developed by nature for this express purpose. It is very necessary that the mother know the correct way of suckling the baby and also maintaining proper breast hygiene once the feeding is done. This will keep the breasts clean for the next feeding of the baby and also regain the breasts to their original shape and size once the baby is weaned.

The Correct Way to Breastfeed a Newborn Child

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It takes a little while for first time mothers to learn the right way to breastfeed their newborn. Only with patience and a little practice can both mother and child learn how to share correctly in this fantastic natural process. The correct way to breastfeed a baby is described below:-

The first important thing is to hold the baby in the right position. Support the baby's weight by keeping it in your lap (slightly upraised) or by holding it steadfast at its lower back. The baby's mouth must conveniently reach the nipple without having to exert. Remember that babies become more enthusiastic at the sight of a nipple, and if they are not able to reach it conveniently, they may hurt themselves.

Next, place the nipple into the mouth of the baby. Allow the baby to take the nipple as much as possible inside its mouth. You will know that the nipple has reached its right position when it touches the roof of the baby's mouth (palate).

The baby's lips should be locked around the areola. Hence, the baby's mouth should be over the breast tissue while the nipple should be on the palate of the mouth. Babies suckle by pressing the nipple with their tongue against the palate, thus squeezing the milk out of it.

Though it is a cumbersome process in the beginning, you will quickly get used to it and, keep in mind, the milk of your own breast is the best food that the baby can have at this age, which will immunize it against several diseases.

Breast Care Before Childbirth

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During pregnancy, the proper care for the breast must begin even before the baby is actually born. This is to ensure that there is a proper milk flow when the childbirth occurs. It is essential to carry out the following procedures regarding breast care before its birth:-

Keep the breast always clean. Wash them with water (either hot or cold as per convenience), but do not use soaps and lotions.

Start breast massages during pregnancy so as to ensure proper stimulation of the mammary glands. One very effective exercise is to hold the breast and then to pull it out towards the nipple. Carry this on for a couple of times. This exercise will not only stimulate the mammary glands, but they will also keep the nipples loose and flexible for the baby to suckle on. It will also prevent the nipples from getting inverted or from becoming sore and cracked.

A positive outlook is also very important when the mammary glands begin lactating, i.e., in the ninth month. Always keep thinking of the baby to come and how you would hold it to suckle. Keeping a baby picture or two in the room would help. Though this seems far-fetched, such an act would actually help in stimulating the milk-producing hormones.

Breast Care During Lactation

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Post-partum breast care is only slightly different than during pregnancy. Once the birth has occurred, the initial milk called colostrum begins to flow. It is from this moment on that proper breast care during lactation must begin.

Contrary to whatever the old wives' tales say, the colostrum is not to be wasted. This is the initial extremely nutritive food for the baby which will immunize it from a host of diseases. After each feeding wash the breasts with water.

Avoid the use of soap, shampoo or any kind of lotion on the breasts. This may cause the nipples to become sore and cracked. The best medium to wash the nipples and areolas after the feeding is water. Washing it important as it will clean the nipple area and keep it hygienic for the baby's next feeding.

Feed the baby every time it makes a demand. This is the best way to allow the milk to flow out of the breasts. If you miss feedings, then there is a possibility of the milk getting accumulated in the breast leading to what is called as engorgement. If engorgement occurs, then you must remove the excess milk by either squeezing the breast with your hands, or by using a breast pump.

Perform regular exercises on the breasts during lactation. This will keep the milk in a good state of circulation (from the lobules to the nipple) and will also flush out any toxins that may be produced due to accumulated milk.

Avoid wearing restricting clothes such as bras and corsets when you are lactating. This will help in maintaining a proper flow of milk and will not cramp the breasts.

It is a rare gift that nature has given all mammals. It is the primary bond that the mother establishes with the baby. Thus it is very necessary to carry this out with the correct procedure and take proper care after the feeding is done. This could make breastfeeding a joy for both mother and child

Breast and Nipple Care

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Australian Breastfeeding Association (ABA) counsellors are trained to provide breastfeeding support. They are mothers who want to help other women enjoy breastfeeding their babies. Many mothers have problems with their breasts. If you deal with these problems straight away you may stop them getting worse.

Here are some simple suggestions which can help. If you want more information or want to ask a question, ABA is nearby. All states have a counselling service and email counselling is also available. Counselling is free to anyone who needs help with breastfeeding. The telephone interpreter service could help you to talk to a breastfeeding counsellor. Our booklet Breast and nipple care also contains lots of valuable information. It is available from Mothers Direct.

Ante-Natal Preparation

• ask your medical adviser to examine your breasts and nipples.

• check that your bra fits correctly as your breasts enlarge during pregnancy.

•  do NOT use soap or anything drying (e.g. methylated spirits) on your nipples.

• avoid scrubbing with rough towels or brushes - gently pat breasts and nipples dry after showering or bathing.

• if you wish you may pull out your nipples and roll them gently between thumb and forefinger - should be done firmly but should not hurt.

• expose the breast area to air for short periods. 

To Help Relieve Sore Nipples

Feed your baby often - don't put off feeds

Before Feeds:

• Make yourself comfortable and relax, remembering your ante-natal exercises.

•  Massage your breasts gently.

• Apply warmth to your breasts - warm shower, warm face washer.

• Express some milk to soften the areola, to get the milk flowing and to lubricate the nipple. For pain relief, try applying a covered block of ice to the nipple, or ask your medical adviser about other alternatives.

During Feeds:

• Offer the less sore side first.

• Make sure baby is properly positioned at and attached to the breast. (See diagrams below, description of positioning in Increasing Your Supply Feature and refer to an ABA counsellor).

• Try different feeding positions.

• If you wish, restrict comfort sucking while nipples are tender. Gently break suction with clean finger before removing baby from the breast.

After Feeds:

• Check your nipples for signs of stress.

• Express a few drops of hindmilk and smear on the nipple. Leave your bra open for a few minutes until nipples are dry.

• Keep nipples dry. Change nursing pads frequently. Consider washable nursing pads if disposable ones are chaffing.

• Use breast shells or nipple protectors over tender nipples to stop clothes rubbing and allow air to circulate.

Avoid:

• Using anything on your nipples which is drying or which may damage nipple skin (e.g. tinct benz co., methylated spirits, soap, shampoo, harsh towels, toothbrushes, etc).

• Wearing poorly-fitted bras and plastic-backed nursing pads.

• Using suction breast pumps.

• Using nipple shields.

• See your medical adviser if soreness persists.

To Help a Cracked Nipple

Follow the suggestions for sore nipples while continuing to feed your baby particularly with regard to correct positioning and allowing air to circulate around your nipples.

• If it is too painful to feed, take the baby off the breast temporarily to rest the nipple and allow healing to begin.

• Express by hand (not pump) to keep the milk flowing and to keep up your supply.

• Feed the expressed milk to your baby.

• Start feeding again gradually, with short feeds spaced out during the day.

• See your medical adviser if healing is slow or you need pain relief.

• If all else fails try a nipple shield. (Use with supervision)

• Contact a lactation consultant, child health nurse or an ABA breastfeeding counsellor for further help.

To Relieve Engorgement

• Feed your baby frequently from birth, without limiting sucking time.

• Take your bra off completely before beginning to breastfeed.

• Avoid giving other fluids.

• Wake your baby for a feed if your breasts become full and uncomfortable.

• Use warmth before feeds.

• Express a little before feeds if baby has trouble latching and staying on.

• Massage the breast gently while you are feeding.

• If necessary, express after feeds.

• Careful use of cool washed cabbage leaf compresses.

• Ask your medical adviser or hospital staff about pain relief if required. 

To Help Relieve Blocked Ducts

• Start treatment immediately.

• Rest as much as possible.

• Keep the affected breast as empty as possible by feeding frequently.

• Apply warmth to the affected breast area before a feed.

• Feed from the affected breast first, when baby is sucking vigorously.

• Gently but firmly massage the lump toward the nipple during (and after) feeds.

•  Massage the breast gently while baby feeds.

• Change feeding positions to help empty the breast.

• Hand express if necessary.

• Cold packs after a feed may help relieve pain.

• See your medical adviser if you cannot clear the lump in 12 hours, or sooner if you develop a fever or feel unwell.

To Relieve Mastitis

• Start treatment immediately.

• Follow all the suggestions for a blocked duct.

• Consult your medical adviser as soon as possible.

• Go to bed, if you can, and take your baby with you.

• Breastfeed frequently.