We need support to feed our babies not "breastfeeding promotion"
Maybe the most common question you will have been asked in your antenatal appointments is how are you planning to feed your baby? The most common advice is likely to have been you “should” breast/chest feed.
So many parents find the flip side of this is once the baby is born if they have any experience other than a perfectly latching and growing baby with no effort the advice changes to perhaps you “should” just give them a bottle.
This situation leads to so many parents feeling they have failed and feeling guilty.
This is the difference between breastfeeding promotion and baby feeding support.
So let's be really honest. Establishing breast/chest feeding is probably more often than not an intense experience where challenges have to be faced and worked through. It is completely normal to need support with feeding your baby.
Am I making enough milk? Should my nipples be this painful?
The most common concerns that new parents have are making sure their baby is getting enough milk and having comfortable nipples.
Having realistic expectations can really help you with feeling confident that your baby is getting enough milk. Knowing your baby will need to feed AT LEAST 8-10 times in 24 hours can help but experiencing that may still feel overwhelming. Most babies don’t feed at exactly regular intervals. Eight times in 24 hours would be once every three hours but more likely there will be times when your baby sleeps for 4 hours and times when they want to feed again 10 minutes after the last time they fed. It’s very common for there to be a time of day, often early evening, when your baby feeds constantly on and off for a couple of hours or so, this is called cluster feeding.
It’s also important to remember that feeding can be for lots of reasons not just for hunger, sometimes it’s for comfort or pain relief or connection. Newborn babies' tummies are very small this visual representation might help you imagine how they can feel hungry again quite so soon after they are fed.
It’s also good to remember that what goes in must come out so if your baby is having plenty of wet and dirty nappies then you can feel confident they are also getting lots of milk in their tummy.
Being familiar with baby feeding cues will also help you make sure you’re feeding baby as soon as they are starting to feel hungry which will help make sure they get plenty of milk. Usually, the rule of thumb is that you can’t overfeed a breast/chest fed baby so if in any doubt just pop them back on to feed some more, they will soon let you know if that’s not helping. Learning about hunger cues and feeding your baby at the first sign they might be feeling peckish rather than waiting until they are hungry enough to cry for a feed can also really help if you're finding it a struggle to get baby latched on well calm babies are much less stressful to position and attach.
This infographic from the NCT is a really helpful reminder of feeding cues you might miss if you don't know what to look for.
How it feels for you matters too
If your baby is getting lots of milk and putting on lots of weight but your nipples are sore and damaged you’re still going to feel miserable about breast/chest feeding. There’s a subtle pressure in our society that as long as our babies are okay we should just put up with our own pain as parents. This is not okay and it’s doing harm to postnatal mental and physical health. If it doesn’t feel right feeding your baby then there’s very likely to be an (often very small or subtle) change or tweak that can help you go from toe-curling to comfortable. If the person who is supporting you with breastfeeding says "pain is normal just suck it up" please get a better breastfeeding supporter -second opinions are available.
If you’re worried about whether or not your baby is getting enough milk or if you are in pain please do phone a breastfeeding helpline (such as the NBH) and ask someone who knows how to support you both confidently. You might also want to visit a local breastfeeding support group the sympathy and experience of other parents in the same stage of life can be a real boost that might just get you through the intense bit and on to the enjoying it stage.
Things you might not be expecting but are completely normal.
It may take your baby longer than the first hour of skin to skin to latch on for their first feed especially if they have been born with the help of a vacuum cup, forceps or cesarean section or if you have had pethidine or morphine during your labour. If it’s taking a bit longer for your baby to latch on than you or your care providers had hoped you can express some colostrum onto a spoon or into a syringe and feed your baby that way to help them get going. Some people like to express a few syringes’ worth of milk during pregnancy but if that’s not your choice it can be done after your baby is born. Your midwife is trained to help you with this. If you struggle to get your baby latched on you can ask to see the infant feeding specialist midwife, you don’t have to keep struggling on unsupported.
It’s common for babies to be quite sleepy for the first 24 hours or so you may have to wake them up to feed them every three hours. It’s also very common for them to feed constantly for the second night. This doesn’t mean they are not getting enough milk it means they are doing everything they should be to get your milk supply going.
What to expect if you choose to bottle feed your baby
If breast/chest feeding is not for you for any reason you might well still have questions about what’s normal and what to expect. Bottle fed babies will often feed on a more regular schedule and the instructions on the box of formula will usually let you know how much to expect them to have over 24 hours. Your baby will still be an individual however and you will still spend time working out what works best for them, are there times of day they are more or less hungry? Other times they might want to use a dummy/pacifier if they need to suck for comfort but aren’t really hungry. Make sure you’re really comfortable with how to make up bottles safely. First Steps is a really great resource. https://www.firststepsnutrition.org/parents-carers You might want to also read up about paced or baby let bottle feeding. Here's a good place to start https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2019/04/Infant-formula-and-responsive-bottle-feeding.pdf