Expressing Colostrum, the ‘newborn milk’, is not necessary, but with correct guidance and proper technique under the supervision of a lactation consultant, you may be able to try and harvest Colostrum before birth and freeze it, as long as your pregnancy is stable and there are no complications or concerns with regards to premature birth.
It would be just a few mls that you would be able to hand express, in the last few weeks of pregnancy, as the volume is low. You also do not want to stimulate or induce a premature labour.
These small amounts, frozen in a few small syringes, can be given to your baby after birth in the first day or so, especially if the baby is fussing, not latching for any reason, and if there is a specific reason that the baby would not be able to breastfeed immediately after birth (as in a premature birth or other complications).
Labour stimulates the colostrum to drain through the breasts in preparation for the baby after birth. If you have a Caesarean Section birth, there can be a delay in the milk filling your breast in the first few days.
Colostrum can be safely expressed after baby is born. The hormone responsible for contractions or surges during labour and birth, the ‘Love Hormone’, Oxytocin, flows and stimulates the ‘let-down’ reflex, the expression of Colostrum and milk, as well as contracting the womb, to control bleeding.
Breast care and gentle intentional massage regularly, helps drainage of Colostrum through the breasts.
Positioning and latching effectively with large breasts take practice. Finding a comfortable and suitable way to feed the baby as he grows and develops requires regular adjustment.
The laid-back position is a good one to use once your supply is established, but not practical to use other than at home on your bed or comfy couch.
The rugby/football hold is by the far the easier position to use. You would however, need to wear a scarf/shawl or breastfeeding drape, to hang over your arm if you do not want to be completely exposed. Some breastfeeding tops or shirts allow for movement to the side for ease of feeding.
The upright or Koala hold may also be convenient as you can then support your breast as you sit and hold baby facing you. This position however will need space.
Feed your baby regularly through the day and on demand at night once the baby is back to birth weight. Follow your baby’s needs and watch his cues to feed. A full-term baby thriving on breastfeeding will manage the supply he needs. Expressing only really needs to be if the baby misses a breastfeed for some reason. You need to give him milk and protect your supply when the baby breastmilk feeds.
At 9 months of age a baby will choose to feed or not if offered and request a feed through communicating skills and behaviour. He will also divert from feeding for specific reasons. In this particular case, because he still drinks willingly at the other breast, it may be because he has worked out that there is a lower volume in the other breast and he needs to work harder to remove the milk, whereas the other breast flows well.
Babies make a choice based on ease and comfort as well. Try a different position. The ‘dangle’ position may work well here as gravity helps with the flow and you can massage your breast at the same time. Place your baby on a safe surface and lean over your baby with your breast above his face. He may out of curiosity and distraction take your breast well.
The longer you wait to seek professional help, the less chance of success. Breastfeeding is established in the first couple of weeks. Struggling beyond that, makes it difficult to get all the aspects of your journey back in place and optimal.
Ideally it’s good to make sure that your breastfeeding is in place from the start. Feeling confident in what you are doing and understanding and knowing what to expect makes it much more manageable.
Support, encouragement, and professional guidance is key.
Usually, the upright or cradle and cross-cradle holds will help feed the baby comfortably, as the warmth of your tummy against the baby is soothing and helps baby relax and allows movement in their gut.
There are many different positions to burp the baby, but moms normally cope by lifting baba up onto their chest or over one shoulder. Usually just this movement and change in position helps loosen trapped wind.
This lift is also part of offering the other breast for feeding, but with a burp ‘break and wake’ before continuing feeding.
Absolute fiction! 20 weeks is way too early for any kind of real preparation.
Babies breastfeed, not nipple feed, and therefore there is no preparation needed for breastfeeding. Personal self-care is important. The nipple is made of the same tissue as the penis as it’s sensitive, erectile tissue that lengthens and expands in the baby’s mouth on the palate. Any harsh physical methods of preparation or application of any type of product is not advised. There is no evidence-based research to validate this subject of question.
- Milk Supply is related to your baby’s demand.
Early frequent breastfeeding ensures a good full supply. Your ‘filling’ happens in the first week and then establishes as baby breastfeeds regularly. Milk drained from the breast makes more milk and will match baby’s need to grow well and thrive.
- There can be a delay in milk ‘filling’ your breast after a booked C/section birth.
Gentle breast care or ‘Intentional massage’ before birth, once a day in the shower, can stimulate drainage and help prepare and improve the flow of milk after birth.
Continue to massage regularly after birth, before a feed. This will help drainage and manage your ‘filling’ of milk in your breasts in the first week.
Early, frequent breastfeeds in a skin-to -skin contact, will help stimulate and establish your milk flow and supply.
Watch this: Breastfeeding – getting off to a good start: https://youtu.be/REAfZ9jNX0U
This is a medical question unrelated to our topics and is best handled by your gynaecologist as a clinical assessment needs to determine the course of action.
Most meds do not interfere with your ability to breastfeed, but it’s best to verify this with your physician or gynaecologist.
Firstly, if you are “allergic” to dairy and gluten, I highly recommend you see a qualified allergist so this can be properly confirmed. More often than not my patients are not truly allergic, and are avoiding certain foods unnecessarily. If it is an intolerance then using any supplement of your choice is fine.
There are many reactions the baby may present with and they will usually occur within minutes of exposure. Some (not all) symptoms include skin hives, swelling on lips, eyes, mouth, loss of activity or consciousness, fast or difficulty breathing, vomiting, choking or a change in colour.
Yes. Allergies in general are more likely if a parents or first degree relative has allergies so looking out for allergies as a whole is important.
When breastfeeding doesn’t go as planned and how to avoid common breastfeeding mistakes? – Sr Letennwe Morudu
Breastfeeding should not stop mothers being able to continue their medications. But, it depends what the medications are for and when you were placed on the medication. If it is chronic medications the child was exposed to it during pregnancy so there is no need to worry. But, do always inform the health team while attending the ante-natal clinic or ask the doctor if you are seeing a private practitioner.
If it is new medication, inform the prescriber that you are breastfeeding and ask the impact of the medication will be on the production of milk and the health of the baby. Always consult with a health professional or lactation expert and avoid over- the -counter medications.
It depends on the condition of the mother and baby. If all is well then expressing milk via a breast pump can start within the first hour of life. If the condition of the mother is not good, it is wise to wait till she is stable. If the condition of the baby is not good, the mother is encouraged to express using a pump and the milk can be stored in the freezer until such time the baby is ready to feed. Colostrum is vital for the baby’s immune system.
It differs from person to person. It also depends on the genetics of the family and the lifestyle of the mother- her diet and exercise. Some mothers never lose weight, while others don’t gain much weight. Some women only start losing weight after child bearing age, which can be from about 40 years of age.
Is she aware of the environment around her? What is environment like during the day? Is there anything that might distract her? Are you using any nipple shields? What do you use during the day to give her the expressed breast milk? Are you giving food supplements during the day that fill her up so she doesn’t go hungry enough to want to suck? If so, stop giving additional feeds and exclusively give her breast milk from the breast
What frequency of feeds are you following? Have a feeding schedule and adhere to it. If she is hungry enough then she will suck. You can also feed her on demand. But don’t let her go without feeding for over four hours. Learn her feeding pattern / behaviour and follow that– this is team effort. Always seek advice from a lactation expert; it helps when all fails.
If the child was to react to any food type they would have done so while being breastfed only as they get the nutrients from the type of food you eat via breast milk.
There is no need to introduce one food type at a time but you may consider the quantity, frequency and texture. Often slow introduction of the normal balanced soft / puree diet after the age of six months works. The dietician will be very helpful in this regard.
Myths about breastfeeding
Most mothers believe that they should change their diet while breastfeeding. There is no need to change your diet simply because you breastfeeding but a balanced diet is vital. The infant has been exposed to the type of food you eat while in utero. If you suspect that the child reacts to the food you eating, focus and check which food type is it. Most importantly consult a health expert like a paediatrician.
Babies are born with the reflex to look for their mother’s breasts but most mothers need practical support and assistance with positioning of their babies for easy latching / nursing of their babies. Breastfeeding requires time and practice for both the mother and baby.
It is time intensive so mothers need support and enough space; both at home and at work.
This might be due to some challenges related to breastfeeding such as sore/ inverted / cracked nipples; engorged breasts or plugged milk ducts. These are common conditions associated with breastfeeding especially during the first week of lactation. They tend to happen when the mother and baby are learning how to feed.
With right support, positioning and latching / nursing this can be controlled and managed with ease. The support can either be through lactation practitioner or experienced family member.
This is not necessary as from birth the child is used to the smell and sound of his /her mother. Nipples produces a substance that the baby smells and this substance has a good bacteria that helps to build the baby’s immune system.
Avoid use of perfumes or fragrances directly to the breast.
Midwives and paediatricians encourage skin to skin contact between mother, father and infant. This is also known as Kangaroo care. They are to establish a routine of resting when the baby is resting and be awake and alert as the baby is alert and awake to manage exhaustion or what is commonly referred to as ‘breastfeeding blues’.
Kangaroo mother care helps to establish and initiate breastfeeding as well. In the beginning help might be required from the health expert / lactation practitioner or family member.
It is ideal to initiate breastfeeding immediately after birth or within the first hour of life; that is if both mother and child condition permits. It can be started later, but may be more difficult.
If you need or want to, it is important to consult an expert health practitioner who will give advice on how to do it. Expressing is also an alternative if the mother has milk but is unable to breastfeed directly from the breast.
This is sometimes referred to is insufficient milk production by the mother. Most mothers produce enough milk for their babies. This is determined by how well the baby is latched, the frequency and how well is the breast emptied by the infant as well as the number of nappies changed per day and the type of stools passed by the baby.
he baby should feed at least 8 -12 times per day. Breastfeeding is not just the mother’s responsibility, it requires team effort particularly for the first weeks of the baby’s life. Support and guidance from family (particularly bogogos), lactation practitioner and / or health expert is vital, coupled with healthy eating habits, sufficient fluids intake and rest.
Exercising is healthy and will not affect the taste nor mother’s production of milk. It should be done according to mother’s tolerance and guidance from fitness experts as well as health experts.
It depends on what the mother is suffering from and what medications she is on. The mother can continue breastfeeding even when sick with the correct medications and advice from the physician / health expert, balanced diet and rest.
Vitamins and supplements are recommended and any other medication should be taken under direction and supervision of health experts / physicians. Avoid over-the- counter medications.
Babies are all different. Some babies are easy to wean off and others are not. Because breastfed babies are held most of the time to enhance bonding with their mothers, it might take a while to adjust to separation with them.
It differs from baby to baby but what is evident is that babies that there is benefits for both mothers and babies where breastfeeding was for longer than a year.
It is a legal expectation that all employers are to support and encourage breastfeeding. Companies and employers are have expressing areas where mothers can express milk and where possible storage facilities for the milk. Some employers have crèches with employees that look after babies while mothers can continue with their work,
It is the right of the mother to breastfeed after returning to work. Mothers have to be educated on safe ways of expressing milk to avoid challenges and complications related to expressing milk, especially where breast pumps are used.
The baby may refuse to nurse / latch on. This is experienced when a baby who was nursing / latching well refuses to suck. This does not mean the mother should stop breastfeeding. The baby may just be fussy.
Causes of this may include: Pain from teething, fungal infection like oral thrush or a cold sore; an ear infection which might cause pain while sucking or pressure when lying on a side; being upset from prolonged separation with the mother or change in routine; introduction of new position for feeding; distractions such as being in interested in something within the area where they are fed.
It is normal to be frustrated when the baby refuses to latch / nurse but this does not mean the mother is inadequate or incompetent. It requires patience and understanding. Keep trying or give the baby space and time. When he / she is hungry enough they will feed. Pump / express the breast to prevent engorgement / swelling.
Not true, although the mother may release milk during sex. Milk spurts out because there is release of oxytocin with orgasm. If it bothers you and partner, breastfeed first before the act or wear breast pads to manage the overflow.
Breastfeeding is the only feed that offers exclusive health benefits for the mother, family and child. It is convenient and both time and cost saving.
Strategies for returning to work while continuing to breastfeed – Sr. Theresa Mokone
You still have time! So try to relax about it. Here are my tips:
- Wait for the baby to be hungry.
- Make sure that the milk is warm by squeezing a little onto the back of your hand.
- Squeeze milk into her mouth from the bottle and advance it slowly into her mouth.
- Check the type of teat that you are using. Use a teat that is soft and that resembles shape and size of your nipple.
- Persist on bottle feeding during the day e.g. from 8am to 18hrs.
- Involve a nanny or father to bottle feed during the day. Take a back stance– take time out.
- Feed directly from the breast at night.
- Breast milk is produced according to demand of the baby. You supply what your baby needs.
- The age of the baby also determines the demand. From birth to 2 weeks they suck very little, more frequently, get satisfied and fall asleep on the breast.
- From 2 months old and onwards they suck for longer from both breasts and sleep longer after a feed.
- From 2 months and older during feeding you will notice that the other breast swells and milk flows out automatically. If this happens it means that your milk production is sufficient.
- The baby only sleeps when she’s full. But to make sure, hold her upright and rub her back to stimulate a burb/breaking of the wind. Then put her on the other breast to suckle.
- Be patient don’t stress.
- For added peace of mind, consult your paediatrician.
- Reflect on whether there are any emotional or physiological reasons for low libido.
- Are you thinking or feeling that three is a crowd?
- You could also be exhausted, which is not conducive for an active sex life. Make sure you rest as much as you can so that you have energy for other things besides just the baby.
- It’s normal to have periods of low libido as hormones fluctuate following the birth of a child.
- Added stress can also lower the libido.
- Keep the lines of communication open between you and your partner.
- Maintain eye contact when talking to each other when the baby is asleep.
- Allow him to touch you and respond. This will arouse your feelings and stimulate your hormones.
- Schedule time to spend time with your partner.
- Do your best to give your partner some of you attention and your affection and he will respond positively.
- Recall the times of excitement and sparkle that you had in your relationship before the baby arrived.
- It takes 2 weeks to a month to establish routine.
- This helps you to rundown your daytime milk production before returning to work by expressing milk from your breasts.
- It takes a baby 3 to 6 weeks or longer to settle into a pattern of feeding and sleeping. So, learn to accept offers of help graciously.
- It gives you time to gradually let go so as to assess your separation anxiety as you entrust your baby to another person e.g. caregiver/nanny.
- You become more organised and at peace looking forward with contentment and pride to going back to work.
- Hand over in preparation to go back to work. Let go and let others in.
- Remember that our maternity leave period differs.
- Supply is dependent on direct breastfeeding. It is also stimulated by your love, attachment and emotional state.
- Breasts pumps can be used any time after the birth of the baby.
- If you commit to breastfeeding, you may start immediately after birth (unless you have a premature baby)
- Yes, you collect it, let it cool down and put it in the refrigerator in different bottles before mixing it. Then freeze it.
- For freezing only use plastic bottles never glass.
The benefits & miracle of breastfeeding – Annéke da Silva 
This varies from person to person. From personal experience, I used 3 different pumps during my pumping journey and found the Spectra S1 double pump to be most effective. But pumps hat are classified as “hospital grade” work very well. Be mindful of the difference in pumps when you need to pump exclusively as you will need one with a stronger motor.
If you’re having a straight forward, low risk pregnancy you should not be collecting colostrum beforehand. There are certain medical reasons where a midwife/doctor might recommend you collect colostrum beforehand, but please discuss this with them as everyone’s pregnancies are different. There is a risk of premature labour with hand expressing colostrum before birth. Doing this before 37 weeks can induce early labour. This is why you need to discuss your individual case with your doctor/midwife.
Never use a breast pump before your baby is born.
If you’re having success with breastfeeding after the baby is born and you’re not experiencing any issues and your baby is gaining weight sufficiently, please try to wait 6 weeks before starting to express with a pump. It usually takes 6 weeks for your milk supply to stabilise and establishing a breastfeeding routine.
If there are medical reasons why the baby needs milk and you are struggling with breastfeeding in the early days, you can try to hand express milk for your baby. If you’re going to be separated from baby for whatever reason, a lactation consultant can help you with pumping milk in the early days if you’re also struggling with hand expression.
Again, this might be personal preference but the Spectra S1 – hospital grade double pump worked amazingly for me and is available online at a relatively affordable price (more affordable than Medela for example).
If you are going for Medela, I would recommend the Medela Freestyle – also hospital grade. But there are so many options on the market these days, it’s good to do your research before baby is born. You don’t have to buy one before your baby is born because you want to establish latching and feeding straight off the breast first before introducing a pump (this is for a baby who is gaining weight accordingly and with no other health issues). If you need to have extra milk on standby or your baby was born prematurely etc, you can rent breast pumps from hospitals until you can purchase one yourself.
Nipple shields are not necessary unless you struggle with flat/inverted nipples. The first option would be to have a lactation consultant assist you with latching techniques and try to help you get the baby to latch skin – to – skin. Nipple shields causes a barrier between mother and baby and it might also affect the milk supply because the baby can’t pull milk as effectively through the nipple as they can when they are latching directly to you.
Does moms diet affect the quality of milk? – Dr. Kath Megaw 
Breastmilk is still beneficial from a nutritional point of view up to 2 years old and thereafter doesn’t hold as much benefit.
Weaning off the breast slowly or going cold turkey is a preference. The older the child is the harder it may be to wean so statistically so cold turkey works easier for children over a year and slow weaning up to 9-12 months.
Breastmilk can cause constipation if a newborn is allergic to cow’s milk protein and the mom eats dairy. This can be solved by eliminating all dairy from the diet. However, it’s important to be sure that your baby is actually constipated, as newborns can appear constipated as they haven’t learnt to push from their tummy and tend to push from their whole body. An exclusively breastfed baby can have 1 stool in 7 days or 7 stools in one day.
To increase milk supply: drink 2-3 L of water per day, eat three meals and three snacks per day and include healthy fats, proteins and whole grains at each meal and snack time. Consider including a nutritional supplement to increase calories if needed.
Breastfeeding moms can eat all foods and the baby will get used to them. Don’t avoid any healthy foods unless advised by a medical person. A very small percentage of baby’s may be allergic to cow’s milk and soya protein in the moms diet, but only remove them from your diet under guidance.
There is no nutritional benefit in pumping or direct breastfeeding and nutrition of milk, but supply is often better with direct breastfeeding.
If you eat raw fish or any protein that is contaminated with salmonella bacteria, your baby can get exposed through your breastmilk. So, make sure your source of all protein foods is reputable.
There is no specific food you need to eat to induce lactation just a good healthy balanced diet and your prenatal supply.
Milk stout can increase milk supply but the alcohol is not safe for baby so you would need to pump and dump, so it defeats the purpose.
You don’t need to use any supplement other than healthy foods and lots of water. A good balanced nutritional supplement like Ensure (it’s easy to find, reasonably priced and there is also a plant-based version) can be helpful on days when you eat all snacks and meals.
Yes, you can increase your milk supply at any time.
The green smoothie mix is safe and fine—but avoid any drinks with stimulants like guarana or caffeine.
The best way to avoid extra weight gain is to focus on healthy fats, lean proteins and wholegrains that are low GI. Avoid refined starches and sugar.
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Deciding whether to breastfeed or not is one of the most significant choices new moms face.
