Breastfeeding - the fascination of breast milk

During pregnancy, not only does new life miraculously grow inside you, your body also develops a spectacular nutritional system for your unborn baby in a fascinating way. The breast milk that will later be available serves far more than just to ensure your baby's nutrition. It contains unique active ingredients that influence a wide range of functions in your body and in your child's body. It even has medicinal properties that play an essential role in your baby's health.

Breast milk: a magic potion for strong babies

Breast milk is a very special drink. Not only does it contain all the important nutrients such as proteins, minerals, vitamins and fats that your baby needs to grow, it is also perfectly adapted to the newborn and later to the toddler, as its composition changes depending on what the child needs at the respective stage of development! It also contains extremely important antibodies, many types of living cells and stem cells with the ability to develop into different types of cells. Breast milk also contains active ingredients for certain growth factors as well as cells that promote the baby's brain development and strengthen the immune system. It is easy for your baby to digest and supports the development of its digestive system in a unique way. The World Health Organization (WHO) repeatedly points out that breastfeeding is the ideal form of nutrition for babies, especially in the first six months of life. If children are fully breastfed during this period, they normally no longer need any additional food or fluids. It is therefore recommended that children continue to breastfeed on demand until the second year of life.

What are the benefits of breastfeeding for you and your baby?

Breastfeeding is incomparably practical. As a mother, you always have the absolute best and perfectly tempered food with you. No annoying lugging around bottles, milk powder, hot and cold water. No purchase costs such as bottle warmers, no constant shopping for the right formula, preparing the bottle or cleaning or sterilizing the utensils. Your breast milk is completely free and immediately available to your child. Breastfeeding also promotes a close bond between you and your child. Skin-to-skin contact in particular gives your baby the necessary security and closeness. Sucking on your breast and skin-to-skin contact with your baby also releases hormones such as oxytocin. This in turn creates feelings of happiness that make it easier to get through the exhausting strains and sleepless nights of the first few months as a mother.

So that you can feed your child right from the start, milk production starts immediately after the birth. In the first few days, you produce colostrum, also known as colostrum. This is a thick, yellow liquid that is very rich in nutrients and particularly easy for your baby to digest. It consists of white blood cells that fight off infections and activate and strengthen the immune system. Your body instinctively knows that the newborn needs extensive protection against viruses and bacteria outside your body. Colostrum contains all the important protective substances that line your baby's intestines and provide effective protection against serious illnesses. This milk also has a laxative effect and helps your baby to pass its first bowel movement, known as meconium or baby food. This is black and sticky and contains amniotic fluid and dead cells that the baby ingested while still in the womb. Colostrum contains minerals such as magnesium, which strengthens the bones and stabilizes the heart rhythm, as well as zinc, which contributes enormously to your baby's brain development and builds up its immune system.

The start of breastfeeding

• The foremilk in the first few days after the birth of your child is called colostrum. During these days, you should breastfeed your baby as often as possible so that it gets enough colostrum.
• Between the second and fourth day after birth, a transitional milk forms . It is very creamy and has a yellowish color. You can feed your baby with this until the end of the second week of life.
• After that, mature breast milk forms, which is white-bluish in color.

Immediately after the birth of your child (spontaneous delivery or caesarean section), you should seek undisturbed skin contact with your baby. As soon as your baby and you have recovered from the strenuous birth, you will notice that he or she is awake and intensively absorbing the new impressions around him or her. After a while, your baby will get hungry for the very first time. Then, for example, it will suck intensively on its hand, search for the nipple with its mouth or cry and be much more restless. Now is the time to put your baby to the breast for the first time. Make sure you get enough rest. Give yourself and your baby the time you need and avoid any uncertainty. Even if it doesn't work straight away or even hurts a little,you shouldn't be put off by any initial problems. If it still doesn't work properly after several attempts, don't be afraid to ask one of the local midwives for help. They will show you different breastfeeding positions and will be happy to help you to latch your baby on correctly. These midwives are specially trained in overcoming initial difficulties and avoiding many breastfeeding problems from the outset.

Tips for breastfeeding:

The environment plays an important role. Make sure there is enough peace and quiet and a pleasant atmosphere. The more relaxed you are, the easier breastfeeding will be.

• Before you put your baby on, get into a comfortable sitting or lying position, as breastfeeding can sometimes take longer.
• Don't wait too long in the early stages before you put your baby back on. If your baby is too hungry, it may be too excited to be fed in peace.
• Stroke your baby's mouth with a finger or your nipple to encourage them to suck.
• Wait until your baby opens his mouth wide.
• Take your breast in a C-grip by placing your thumb on the breast and the rest of your fingers under the breast. Squeeze the breast slightly at the front of the areola and place the nipple and areola in your baby's mouth.
• Always bring your baby to the breast and not the breast to your baby.
• If sucking hurts too much, reapply your baby to avoid sore and painful nipples. Breastfeeding should not hurt.

Breastfeeding positions

There are various positions in which you can breastfeed your baby. It is always particularly important that you are well supported and feel comfortable. Pillows, blankets or even a nursing pillow can help you here. This way, you too can enjoy the togetherness that comes with breastfeeding and relax perfectly. Many mothers worry that their baby won't get enough air to breathe in certain breastfeeding positions. Don't worry: all babies have a convex nose. This gives them a real little snub nose. This not only looks cute, but also offers your baby enormous advantages. Your child can lie directly against your breast without getting into difficulty breathing. However, it would still be advisable to change breastfeeding positions from time to time so that your breasts are fully emptied and stimulated to produce milk. Even if you have milk engorgement or sore nipples, you can choose a different position that relieves the breast in question. If the breastfeeding position is unfavorable, your baby may not be able to suckle properly at the breast, which can be painful for you. This can also cause severe and uncomfortable tension.

The most common breastfeeding problems::/H3

The most common reason for early weaning is pain during or after breastfeeding. Pain is nothing unusual, especially in the early days. In the period immediately after the birth of your baby, breastfeeding can even lead to abdominal pain. This is because breastfeeding promotes the involution of the uterus. The resulting contractions of the uterus can lead to unpleasant abdominal pain. Some mothers experience pain in their breasts or nipples in the early days despite correct latching on. In most cases, your nipples are particularly sensitive in the early days and only get used to the newborn's vigorous sucking over time. This type of pain is most uncomfortable when you are latching on, but becomes less and less during breastfeeding. If breastfeeding is very painful for the entire duration of breastfeeding, your baby may not be latched on properly and does not have the entire nipple with the areola in its mouth. Stop breastfeeding immediately and latch your baby on again. A very strong milk let-down can lead to swelling of the mammary glands, and the resulting strong pressure can also be a cause of pain. The breasts are often so swollen that the nipples are very flat and your baby can no longer grasp them properly. The milk let-down reflex can also be painful at first. However, this usually subsides on its own after a few weeks.

Possible causes of painful breastfeeding

• Unfavorable latch-on of your baby:
  Ifyour baby hasnot grasped the nipple and areola deeply enough, a pressure mark can form. In extreme cases, this can also burst open. A very painful experience.

Tip: If breastfeeding is too painful, put your baby back on. Important: Do not simply pull your nipple out of your baby's mouth. This can lead to sore nipples and is also extremely painful in the long term. Place a finger in the corner of your baby's mouth and release the vacuum before pulling your breast away.

• Injuries caused by expressing with a breast pump:
  Expressing breast milk with a breast pump can quickly cause injuries to your breast or nipples. If the pump funnel is not selected to fit your nipple or is not positioned correctly on the breast, this can also lead to injuries. In addition, the vacuum created by the breast pump should always be below the pain threshold. It is important not to pump for too long as this causes irritation. Once the milk flow has decreased, continue pumping for a maximum of two to five minutes to increase the amount of milk.

Tip: Get proper advice if you are considering renting or buying a breast pump.

• Special feature of your baby's mouth or incorrect sucking behavior:
  Your baby's ability to latch on to your breast and suck correctly depends on numerous factors: Severe reflux in the baby, premature birth and low muscle tone increase the likelihood of your baby not latching onto your nipple correctly or developing incorrect sucking behavior at your breast.

Tip: This is where the support of a midwife or lactation consultant is needed. You may need to maintain milk production by pumping or hand expressing until you get the help you need and can continue breastfeeding.

• Frenulum of tongue too short:
  If the frenulum of the tongue is too short, this leads to a severe restriction of tongue mobility. As a result, the baby cannot suck effectively at your breast and receives less milk. Affected babies often try to hold the breast with their lips, which can lead to cold sores. Breastfeeding can be very painful and very sore nipples often develop.

Tip: In some cases, it helps to adopt a different breastfeeding position, e.g. reclined breastfeeding. Asymmetrical latching on could also be a good option to make breastfeeding easier. Sometimes, however, this does not help either, and cutting the lingual frenulum is unavoidable.

• Special features of the nipple (too large or too small):
  Sometimes the shape of the nipples or the size of the breast can make breastfeeding difficult.

Tip: You can try out different breastfeeding positions. Breastfeeding shields may also be helpful.

• Sucking confusion (if bottle-feeding or a pacifier is used in addition to breastfeeding):
  Sucking on a bottle is very different from sucking at the breast. Your baby has to perform a completely different movement pattern at your breast than at the bottle. Especially in the first few weeks, when the baby is still practising breastfeeding, feeding or giving a pacifier can lead to so-called sucking confusion.

Tip: Sucking confusion can be remedied with a lot of time and patience.

• Baby bites the breast:
  Your baby may bite the breast or clench its jaw if it is lying in an unfavorable breastfeeding position and cannot grasp the nipple properly. In some cases, an excessive milk let-down reflex can also cause your baby to have a biting reflex because it is overwhelmed by the strong flow of milk. Birth trauma , KISS syndrome, a cold with a blocked nose and sucking confusion can also trigger the bite reflex. Some babies even start biting their breasts when they are teething. This is usually due to the pain that occurs when the teeth break through.

Tip: Changing the breastfeeding position can help. With a teething baby, it is also a good idea to put a finger between the teeth as soon as you notice that your baby wants to bite. This can prevent biting.

• Too much milk:
  It can also happen that you have too much milk reflex and your baby cannot process the massive amount of milk properly. Frequent vomiting after meals or gushy spitting and colic can also be signs of too much milk, as can a permanently restless child who cries a lot, always seems to be hungry and wants to breastfeed very often.

Tip: It is advisable to breastfeed against gravity. The best breastfeeding position is leaning back. Before breastfeeding, you should empty the breast a little by hand.

• Milk engorgement:
  Milk engorgement is characterized by painful and hard spots on your breasts. Even breastfeeding will not soften these areas. Sometimes the skin in the affected area is reddened. In some cases, milk engorgement can even lead to flu-like symptoms and fever. The reason for a milk blockage is often a mechanical obstruction, such as a blockage of a milk duct due to a fatty plug, insufficient emptying of the breast, premature removal of the breast or a stress- or fatigue-related impairment of the milk let-down reflex.

Tip: The affected breast should be emptied completely. The best way to do this is to adopt a breastfeeding position such as the four-footed position. Your baby's chin should point directly at the painful and swollen area. You can empty the breast by pumping or by hand. After breastfeeding, a curd compress helps to relieve the milk stasis and alleviate the pain. Leave it on the affected area for 20 to 30 minutes.

• Mastitis:
  With this breast inflammation, bacteria enter the breast via the milk pores and multiply there. Mastitis is usually accompanied by the same symptoms as milk stasis. Flu-like symptoms and fever accompany this inflammation. In the case of mastitis, it is advisable to empty the breast carefully and completely. If the symptoms do not subside, be sure to consult a doctor to start antibiotic treatment if necessary. There is a risk of an abscess forming in the case of breast inflammation.

Tip: Unless the doctor treating you recommends otherwise, your baby can and should continue to breastfeed even if they have a breast infection.

• Milk blisters:
  Milk blisters are a typical sign that your baby is creating a very high vacuum at your breast. They often appear in the early days of breastfeeding and heal on their own. Sometimes a thin membrane even grows over the milk duct.

Tip: If these blisters occur more frequently, it could be that your baby is not latching on to the breast properly and therefore needs to create a larger vacuum. You may also find it harder to trigger the milk let-down reflex, which could be due to stress, fatigue, smoking or alcohol. Place a warm, moist compress on the nipple before breastfeeding. This softens the area before breastfeeding and makes it less painful.

• Fungal infection:
  A thrush infection on the breast is not always easy to diagnose because there are often no visible symptoms. Affected mothers notice burning or stinging pain during or after breastfeeding. Most doctors proceed according to the exclusion principle and first make sure that it is not due to an incorrect latch-on or breastfeeding technique and that other causes can also be ruled out. If your baby is infected with thrush, symptoms may also occur. A white, non-wipeable coating on the baby's tongue could be an indication of an infection.

Tip: If you suspect a fungal infection, you should definitely consult a doctor. The mother's breast and the baby's breast must be treated at the same time, as otherwise they may infect each other again.

• Tense chest muscles:
  Tension in the shoulders or chest can lead to pain in the chest muscles. The tense muscles put pressure on the blood vessels that supply the breast and nipples. This results in poorer blood circulation, which often causes pain when breastfeeding.

Tip: Make sure your posture is relaxed and don't tense up. Avoiding a posture because you fear pain when breastfeeding can cause further tension. Relaxation exercises and massages of the affected areas bring enormous relief.

• Vasospasm of the nipple (white nipples):
  This causes burning and stinging pain in the breast. The nipples literally fade because the blood vessels in the nipple become very constricted. Reduced blood flow often occurs if the baby has not been latched on properly. Women who often have cold hands and feet or drink caffeinated beverages are particularly affected.

Tip: Check that your baby is positioned correctly and correct the position if necessary. Taking magnesium can also help.

• Sore nipples:
  There are many reasons for sore nipples. Particularly in the early days, the unaccustomed strain and increased sensitivity after the birth can cause sore and painful nipples. In most cases, however, the reason is incorrect latching on, because some babies suck too hard on the breast and thus create a strong vacuum

Tip: The most important measure here is to correct the breastfeeding position and latch-on. The baby often does not get enough breast in its mouth. You should therefore keep correcting the feeding position to avoid sore nipples. After correction, the pain will subside very quickly and the nipples will heal, even if you continue to breastfeed. Changing your breastfeeding position will also provide relief. You should still rinse the sore nipples regularly, e.g. with a saline solution from the pharmacy.

Is my baby not getting enough milk?

At the beginning of the breastfeeding relationship, mothers often find it difficult to correctly assess whether the baby has had enough to drink and is full. Many babies fall asleep again and again at the breast due to the exertion and some want to be breastfed for several hours. This can be very exhausting, especially if babies cry again immediately after breastfeeding. However, this behavior is completely normal for babies. Especially shortly after birth and during growth phases, the baby wants to be breastfed several times or over a longer period of time. This is called "cluster feeding" or "campfire breastfeeding". Frequent latching and undocking promotes milk production and ensures a plentiful supply, as your milk supply continuously adapts to the baby's increasing needs. This complex process should never be disturbed by additional feeds. If there is too little milk for a short time, this can of course upset your baby, but frequent suckling will quickly boost milk production. Many mothers pump breast milk in advance or supplement with formula because they are afraid that their baby will not be properly fed. This also has to do with the fact that the baby's crying is often misinterpreted as hunger.

If you notice the following symptoms in your baby, be sure to talk to your midwife or pediatrician. They could be signs that your baby is not getting enough food:

• your baby is gaining little or no weight
• the eyes or fontanel are sunken in
• the mucous membranes are dry
• your baby is constantly unhappy (fussy)
• the urine is very yellow or orange in color and smells strong
• skin folds remain

TIP: Your baby's diapers should be wet 4-6 times throughout the day.

What does "wet" mean here?

When full, the diaper should contain around 300 ml of urine. If you don't know exactly how much that is, you could use a measuring cup to determine the amount and slowly fill a fresh diaper with it. This will give you a good comparison.

Increasing the amount of milk

The milk production rate, i.e. how quickly breast milk is produced in the breast, depends primarily on the degree of emptying of the breast. In most cases, the baby does not empty the breast completely, but on average only drinks about three quarters of the milk present in a breast. But even here there are large fluctuations. If the baby is not very hungry, it will drink very little milk. When demand is low, milk is also produced only slowly. Babies who are very hungry, on the other hand, empty their breasts heavily. The milk production rate then switches to full speed. However, this happens independently in both breasts.

In order to produce as much milk as possible, your breast must be emptied as completely as possible as often as possible.

This mechanism also ensures that milk production increases massively in the first few days or weeks after the baby is born. Production is directly linked to demand. However, if the breast is not emptied sufficiently during this crucial phase, the milk-forming mammary gland tissue gradually recedes. However, the amount of this tissue determines how much milk can be produced in a given period of time. Without sufficient mammary gland tissue, increasing the amount of milk by frequent and thorough expressing is only possible in the short term at best. However, this will not be able to meet your baby's needs without additional feeds. However, frequent and thorough emptying of the breast still stimulates the formation of new mammary gland tissue. However, this can be very lengthy and can take several days to a few weeks or even months. So if you want to increase your productivity after the first three to six weeks, your body will need more time and more intensive work.

In the case of over-the-counter medication or lactation teas, no milk-increasing effect beyond a placebo effect has been proven to date.

The effect described above can also be used to increase milk production in the long term. To do this, mothers should empty their breasts completely as often as possible (eight to twelve times within 24 hours). Below we have listed some further tips to help you achieve the greatest effect on milk production:

• You will generally achieve the most effective emptying of your breasts by latching on correctly and adopting a correct breastfeeding position.
• Your baby should be breastfed frequently, e.g. every 1.5 to 2 hours. You should avoid longer breastfeeding breaks of more than 3 hours, but a break of 4-5 hours once a day is acceptable, e.g. at night. You are welcome to wake your baby if there is too long a gap, for example because he or she is sleeping for too long at a time.
• You and your baby should have as much and frequent direct skin-to-skin contact as possible. This promotes the production of prolactin and oxytocin.
• It is advisable to always offer both breasts. Let your baby empty the first breast first and then place it on the other breast. With this tip, you can further stimulate milk production immediately after the birth. Later on, it is usually enough for your baby to empty only one breast during a feed.
• Alternate breastfeeding: Keep switching breasts if your baby is no longer actively feeding, but only sucking or even dozing off while breastfeeding. On average, each breast should be used two to three times per feed. This ensures effective emptying.
• To increase the flow of milk during breastfeeding and thus support the emptying of the breast, you can apply breast compression by hand: As soon as your baby takes a break from breastfeeding, squeeze your breast further up.
• Do not let your baby feed from just one breast for too long in one breastfeeding session. Shorter breastfeeding sessions per breast (10-15 minutes each) are more effective at stimulating milk production.
• If you are feeding formula, it is best to do this with a breastfeeding kit. This has several advantages: Milk production is still stimulated even during supplementary feeding, and your baby practises sucking properly at the breast.
• If your baby does not empty the breast enough, you will have to do the rest by pumping or by hand. Continue pumping for 2-5 minutes after the last drop of milk has flowed (but no longer, as "dry pumping" for too long has a negative effect on milk production).
• If it is not possible to breastfeed your baby at one breast, you should empty the affected breast eight to twelve times within 24 hours. It is true that the first yield is greater if the previous break was longer, which is why many consider this to be the more productive strategy. However, the total volume over the day is actually higher if the intervals are shorter.
• By warming the breast during pumping and gently massaging it before and during pumping, the fat content of the breast milk obtainedincreases and the breast can be emptied more thoroughly
• Another way to increase milk production is power pumping. Not only do you empty your breast eight to twelve times a day by breastfeeding or pumping, but you also have additional sessions where you pump or empty your breast by hand. This imitates a "cluster feeding" of your baby and gently increases milk production. Use this technique mainly in the evening or before bedtime. After your baby has emptied your breasts, wait for about an hour and a half and then pump your breast every 10 minutes for about 5 minutes with a 10-minute break in between (or until no more milk comes in and then for another 2-5 minutes). You may only gain a few drops per session, but you are sending a clear signal to your body to produce more. Between pumping sessions, you should massage your breasts to properly release the milk fat and continue to stimulate the milk let-down reflex.

Nutrition during breastfeeding

Many breastfeeding mothers are concerned with the question of proper nutrition while breastfeeding. In fact, they do not necessarily have to eat differently than others. It is only important that nutrients such as vitamins and fatty acids are supplied in sufficient quantities. Just like pregnant women, breastfeeding mothers should make sure they eat a healthy and varied diet. However, there are differences: While raw meat (e.g. tartare and undercooked steak) and raw milk cheese were taboo during pregnancy, such food is generally allowed again when breastfeeding. Bacterial transmission of toxoplasmosis to the child via breast milk is not possible. If the mother is fully breastfeeding, she consumes approx. 500-600 kcal more per day than a non-breastfeeding woman. However, this additional calorie requirement should not be covered by sweets or cakes, but by a balanced diet. Lots of vegetables, potatoes, wholegrain products, fruit, meat and fish once a week. Eggs, dairy products, healthy fats and oils are also particularly important now. If you eat a balanced diet and are sparing with sweets and fatty foods, you can even lose weight even though you eat according to your appetite. Your body's additional needs make it possible. However, dieting is not recommended during breastfeeding. Firstly, the fat-soluble harmful substances that are released from the fatty tissue during a diet pass into the breast milk, and secondly, a reduced calorie intake of less than 1500 kcal per day has a negative effect on milk production and reduces the amount of milk. Breastfeeding also increases your daily fluid requirement. So you should drink plenty.

Some mothers worry that flatulent vegetables and spicy and acidic foods can cause stomach ache and a sore bottom in their baby after breastfeeding. We can give the all-clear. There is no scientific evidence that tomatoes, strawberries, cabbage, onions or citrus fruits cause such symptoms in babies while breastfeeding.

However, if you suspect that some foods are causing your baby discomfort such as a sore bottom or even colic, you should avoid these foods for a few days and check whether there is any improvement. To make sure that the food in question is actually responsible for your baby's discomfort, observe whether the symptoms return the next time you eat it. If your baby has an intolerance to certain foods, this may disappear on its own as your child gets older. Colic in particular has many causes, and it is not always due to certain foods. If your baby is not latched on properly, it can also happen that he or she swallows a lot of air when sucking. A very careful latch-on or a reclined breastfeeding position can help here. Even the pacifier can lead to colic under certain circumstances. And even if you have a lot of breast milk and your baby gets too much watery front milk and too little fat-rich back milk, this can lead to digestive problems. If you suspect this, only let your baby drink from one breast during a breastfeeding session. If he wants to nurse again shortly afterwards, give him the same breast again.

The swing2sleep team wishes you and your baby a wonderful breastfeeding relationship.

Sources:

• www.baby-und-familie.de "The best nutrition for your baby"
• www.medela.de
• www.lansinoh.de "First steps in breastfeeding: tips & information"
• www.kindergesundheit-info.de "Breastfeeding - the best for babies"
• www.stil-lexikon.de
• www.eltern.de