Frequently Asked Questions: Starting Out

Breastfeeding is best for your baby. There is detailed information about the benefits of breastfeeding on www.breastfeeding.org.nz. Below are a few facts about breastfeeding:

Good for now, good for later – breastfeeding gives your baby vital antibodies (especially in colostrum – produced in the first few days) that helps protect them against illnesses like colds and chest infections. It can also reduce their chance of developing allergies, eczema and childhood diabetes.

Easy on the tummy – there’s a low risk of contamination. Breastfed babies are less likely to suffer from stomach upsets and constipation. Breast milk is easy for baby to digest because it is the perfectly designed food.

Just for mums – research has shown that women who breastfeed are less likely to develop breast and ovarian cancer.

The easier the better – no bottles to prepare, no kits to take with you, it’s always the right temperature, and best of all – it’s free!

Back to normal - it can help your uterus return to the normal size after birth sooner. It can also use up calories and make it easier to lose pregnancy weight. Breastfeeding may also delay the start of menstruation.

If you can’t breastfeed, or if you decide not to for whatever reason, you’ll need a suitable alternative to breast milk. Infant formula is the only suitable alternative to breast milk, and your baby will need to stay on formula until at least 12 months old.

Remember, cow's milk isn’t appropriate as a main milk drink until your baby is around a year old because it is not nutritionally suitable - it is too low in iron and too high in protein and other nutrients.

Yes, babies can become constipated. It’s more likely to happen if your baby is on formula, it’s less common for breast-fed babies.

If you see them straining, that’s not necessarily a sign of constipation as a lot of babies do that during a bowel movement. You’ll know if they’re constipated because their stools are hard and pellet-like, appearing as either separate, hard lumps or as a lumpy sausage shape – they’ll be difficult or painful to pass. The best thing to do here is see your GP for advice.

Every baby is different. Some will fill their nappies just about every feed, while some others (especially breastfed babies) can go for several days without a bowel movement; both are fine. If your baby hasn’t gone in a very long time or they appear to be in pain when they pass a motion you should contact your GP. You needn’t worry if they seem to strain a little when they go, or there doesn’t seem to be any real pattern timing-wise, that’s all pretty normal.

<p>Be prepared for anything!&nbsp; The contents of your baby's nappy can vary from day to day, so it’s hard to say exactly what you’ll get.</p>

<p>As a rough guide your newborn's first nappy will be filled with a sticky and dark greenish-black substance. That’s normal, so don’t panic – it’s called meconium and consists of the waste products that built up while your baby was in the womb.</p>

<p>Next it’ll change to a mustard yellow colour and, if you’re breastfeeding, it’ll be pretty runny. If you’re formula feeding your baby you can expect their poos to be firmer and more paste-like as well as darker in colour.&nbsp; When baby starts solids in a few months expect their bowel motions to change again.</p>
 

Unfortunately there isn’t a cure for colic, but the good news is that it’s not permanent and usually passes within a couple of months. Your baby isn’t in danger, but it can be pretty distressing for both of you. Here are a few things that can help:

Soothing motion – a car ride, or a trip in the buggy can make a difference

Burping –  burp baby after feeds

Check your diet – some common gas-causing foods like cabbage, or alcohol and caffeine can affect your breast milk and make your baby windy

Over the counter - infant colic drops can sometimes help

Change their bottle - a fast-flow teat reduces the amount of air swallowed with the milk

If you’re really concerned about your baby's crying, or if you’re finding it hard to cope, talk to your health professional, family or friends.

If your baby is crying a lot this could be the reason. As it’s pretty normal for your baby to shed a few tears, it can be tricky to figure out just how much is too much. Try the rule of three as a guide: if your baby is crying intensely for three hours a day, three days a week, or for more than three weeks in a row – that’s more than average and colic might be to blame. Babies with colic will often pull their knees up to their chest, have a rigid back, and clench their fists – that’s something to look out for too.

Around one in five babies will suffer from colic so it’s fairly common. No one is quite sure what causes it, but trapped wind is sometimes blamed. While it’s not nice for either of you, Colic isn’t dangerous, so you don’t need to panic.

It’s not uncommon - the milk your baby brings up during or just after a feed is called spilling. Some babies spill more than others, but if your little one is feeding well and is gaining weight you probably don’t have anything to worry about.

If your baby starts vomiting frequently or violently, if they seem like they’re in pain or they’re not putting on any weight then you should definitely talk to your health professional.

Some babies will stop during a feed and burp on their own, if your little one doesn’t just wait till the end of the feed to burp them.  Hold your baby upright against your shoulder or sit them on your lap, or you can place them face down on your lap. All you need to do is rub their back gently – if they don’t burp after a couple of minutes they probably don’t need to.

While you’re breastfeeding you’ll be passing on a lot of nutrients to your baby, so your diet can really make a difference. Getting plenty of good foods in your diet during this time will make sure you’re both getting the nourishment you need.

Some babies may react to certain foods and drinks passed through their mother’s breast milk (in very small amounts) and become windy, colicky or unsettled. Possible culprits are caffeine, or fruit and veges like onions, beans, broccoli, cabbage and grapes – the things that may cause wind in adults.

If you’re worried your baby is reacting to something you’ve been eating, the best thing to do is avoid that food for a few days to see if they improve. Be careful not to cut out whole food groups (like dairy or wheat) without chatting to your health professional first.

On the other hand your diet can also expose your baby to a variety of interesting tastes. You never know what they could be developing a love for in those very early stages.

Yes - what you eat when your breastfeeding can affect your breast milk. Just aim for a nutritious balanced diet. Here are a few things to watch out for:

• Alcohol – this can pass into your breast milk, so it’s best to avoid it.
• Caffeine – this can affect your baby's feeding, sleeping and digestion. Decaffeinated versions of your favourite drinks might be the best option for a while. If you do drink coffee and tea, try not to go overboard. 
• Fish – this is a great food because it’s so nutritious. And for most types of fish you don’t need to worry about high levels of Mercury. If you want more information on fish to avoid visit www.foodsmart.govt.nz .

Eating really well while you’re breastfeeding is good for two major reasons. Firstly it means you’re passing on plenty of good nutrition to your baby. Secondly, it’s fuel for you– giving you plenty of energy to make it through sleepless nights, and bounce back after giving birth.
Try not to go for too long without food. You might want to switch your three meals a day for smaller meals, more often. Here are some foods that are great when you’re breastfeeding:

• Fruit and veges – whether they’re fresh, frozen or canned – try to have at least six servings (a serving is around a handful) each day.
• Starchy carbohydrates - bread, pasta, rice, kumara and potatoes. Not only do they taste good, but they’ll give you plenty of energy too. Aim for around seven servings each day.
• Fibre – you can find this in wholegrain bread and breakfast cereals, pasta, rice, fruit and vegetables. Constipation can be a common problem after giving birth and fibre can help to get things moving.
• Protein - lean meat, poultry, eggs, seafood, legumes, seeds and nuts are all good sources of protein, and provide your body with iron and zinc. Have at least two servings every day.
• Fish – aim for two servings a week as part of your protein rich foods. Fish, particularly oily fish, is a source of vitamins, minerals, protein and omega 3 fatty acids.
• Milk and milk products – foods like milk, cheese and yoghurt are a great source of calcium and protein. Have at least three servings each day.
• Water – try and drink plenty of fluids, nine glasses of water or other fluids each day if you're pregnant or ten glasses of water or other fluids each day if you're breastfeeding.  Having a big bottle of water beside you on the couch, or in the bedroom can be a good reminder to drink more.  Drinking plenty also helps with the bowels.
• A vitamin and mineral supplement - while a folic acid supplement is important during pregnancy, during breastfeeding the best source of vitamins and minerals is a good balanced diet. If you are concerned you’re not eating well and may need a supplement, talk to your GP before taking one.

The good news is there’s really is no right or wrong way to hold your baby when breastfeeding. What matters most is that you’re comfortable and your baby is feeding well. Here are a few positions you might want to try.

Cradle – cradle your baby’s head in the bend of your arm. They should be lying sideways against you, turned towards your body with their mouth right in front of your nipple.

Cross Cradle - similar position to the cradle, but you can hold your baby with the opposite arm to the breast they’re feeding from.

Underarm – sit down and lie your baby beside you, you can use a pillow to support them and rest your arm on. Gently cup the back of their head with your palm and support their body with your forearm so they can feed. Your baby’s legs can tuck in behind you.

Lying down - lie on one side and get comfortable with a pillow. Lie your baby facing you with their tummy against yours - your nipple should be opposite their mouth. You can use a hand to support your breast if you need to.

Breastfeeding can take a fair bit of practice - getting your baby to latch is a bit of an art form, so don’t worry it if takes a while. Once he or she gets it, it’ll help stop your nipples from becoming sore, cracked or uncomfortable.

To help your baby latch on you can try gently stroking their cheek with your finger until their mouth opens wide. Then move your baby towards your breast, aiming your nipple at the roof of the mouth. You want them to take your nipple and a good mouthful of breast to form a tight seal.

When your baby has finished feeding or you want to transfer to the other breast, simply slip your little finger gently into the corner of your baby's mouth to break the suction.

Once you start breastfeeding it’s normal to wonder whether you’re feeding your baby enough each time, or if you should be feeding more often. Happily, your baby will dictate a lot of this. They tend to let you know when they’re hungry, and when they’ve had enough.

Each baby will feed at a different pace, some will want to drain both breasts at each feed, and others will want less. It’s just about you being flexible and getting to understand their patterns.

It is common for newborn babies to feed frequently. Some parents are happy feeding their baby on demand and others like to establish more of a routine.  As they grow their feeds become quicker and less frequent. Watch out for growth spurts though (often around two, four, six and 12 weeks) and they’ll feed more during these times.

As you breastfeed, hormonal changes and the more your baby feeds will encourage milk production, so trust that your body knows what to do.

You know your baby is well fed if they seem satisfied after their feeds and produce lots of wet nappies (6-8 wet nappies in a 24 hour period). They should also gain weight steadily after the first two weeks, have times when they’re awake and alert, and your breasts and nipples shouldn’t be sore.

Remember if you have any questions you can chat to your midwife (LMC), well child, or Tamariki Ora nurse or Plunket nurse or lactation consultant or any breast-feeding support groups eg La Leche.

Here are some general helpful hints, please see the Ministry of Health website for more information on breastmilk storage. Before you start expressing breastmilk, have a chat to your LMC or Well Child Provider who can give you some helpful advice.

Breastmilk is best stored in the fridge. Just remember that your baby isn’t as resilient as you, so be extra careful to keep your pump and all storage containers clean and sterile. This will help avoid any tummy upsets due to contamination. Here are some helpful hints for storage once you’ve expressed:

Chilled– put expressed milk in the fridge straight away. You can store it for up to 48 hours as long as the container is in the coldest part of the fridge, which is nearest the back. If it’s in the freezer compartment of your fridge, it can be stored for up to 2 weeks, and if it’s in the freezer it can be stored for up to 3 to 6 months. See the Ministry of Health website for more information on breastmilk storage.

Thawing – if you’ve frozen your breast milk try to thaw it out gently. You can do it by leaving it in the fridge to slowly thaw, or putting the container in a bath of warm water. Use it as quickly as possible after thawing.

 Label it – it’s a good idea to label your containers with the time and date so you know how long you have to use each one.

Before you start expressing breastmilk, have a chat to your LMC or Well Child Provider who can give you some helpful advice. Expressing can take a bit of practice, so be patient. While you can express milk by hand, most women will use a pump. There are manual types, which need you to squeeze a handle, and automatic types that run off batteries or mains power. You can also get single (one breast) and double (both breasts) options, so you’ll be able to find one that suits. All breast pumps will come with an instruction manual explaining how to use, clean and store your breast pump. You can buy breast pumps from retail stores, pharmacies and the internet. Your midwife, well child or Plunket nurse or GP will also know where you can buy them from.

If you’re having trouble getting more than a trickle, try expressing at different times of the day. Many women find the morning is the best time. You can also try warm baths, expressing with your baby nearby, or looking at a picture of them to help your breastfeeding or ‘let down’ reflex.

Before you start expressing breastmilk, have a chat to your LMC or Well Child Provider who can give you some helpful advice. Expressing your breast milk can be really handy. It gives you time to take a break and let someone else feed your baby, it can relieve sore breasts and it can boost your milk supply. It’s also good if your breasts are so full your baby is having trouble latching on.  Another benefit is if you’re returning to work and you want to carry on feeding your baby breast milk. Here you'll find more information from the Department of Labour about breastfeeding at work.

Before you start expressing breastmilk, have a chat to your LMC or Well Child Provider who can give you some handy advice.If you’re thinking of expressing breast milk, you’re probably wondering when the right time is to start. It’s often a good idea to wait until breastfeeding is established and you and baby have a good routine set up.  Once you’re ready, expressing your breast milk can be really handy. It gives you time to take a break and let someone else feed your baby. It can relieve sore breasts and boost your milk supply. It’s also good if your breasts are so full your baby is having trouble latching on. Like anything, it can take you a bit to get the hang of expressing milk, so be patient and allow yourself plenty of time