My booby juice (aka breastfeeding) hopes & fears with Medela!

Breastfeeding with my first was completely new to me (obviously) and in no way was I prepared for the journey. In May 2014, I wrote all about my experience with breastfeeding the first-time round so I won't repeat myself here except the points that are necessary. It was hard. Harder than I ever thought it would be and I wish I had been more prepared. Archie latched well and was never the problem; it was me that struggled to handle the expectation vs. reality of breastfeeding, so here are my hopes for the second time round, now I have the benefits of hindsight on my side.

hopes_
"Baby will latch."
_
Obviously, this is kind of a biggie as some Mummy's find they can't breastfeed at all; whether their babies are born too early and struggle, or they just can't get the latch quite right, or due to other issues such as tongue ties and a lack of help to get started. I was very lucky with A in that he latched well immediately and that wasn't something we really had a problem with, but I can only hope we have the same luck this time round - it seems like sods law that now I finally feel positive and ready to make the most of breastfeeding, exclusively and for as long as possible, we'll probably struggle!
_
Now I know a little about what's to come, I hope I can find it in me to be more relaxed about breastfeeding; to not worry about the dirty washing left in the corner or the dishes that need washing, but to realise that baby's having a growth spurt and that they need me, maybe for 30 minutes, maybe for a few hours, maybe I won't be able to tackle much else all day - I hope I can let everything else go and enjoy being wanted and needed this time round.
hopes_
"I'll be more relaxed."

I was lucky enough to be able to ask Medela's lactation consultant a few questions about my concerns around breastfeeding the second time round, and I hope they can help others who've experienced similar too. Here's how the fab Sioned addressed my concerns:
Q: Me_
One thing I was always concerned about as first-time Mum was whether baby was getting enough milk just from me. Is there anything we can do to ease these worries or any tips on how we can be sure we’re doing it right?
A: Sioned_
In the first few weeks you should expect several dirty nappies a day –lots of poo –lots of milk. After 4-6 weeks, you will have established your milk supply and you will be making what your baby needs. There is very little waste as it is tailor made for your baby, so it's normal for an exclusively breastfed baby not to have a dirty nappy for up to 10 days. What you should expect is good wet nappies and urine that is weak and straw like in colour.
Weight gain is usually steady for the first 4 months but around 4-6 month mark, the growth slows down a little on the curve. Your baby will have growth spurts at around 3 weeks & 3 months and you may feel that your baby nurses all the time but this is normal; it's not because they are not getting enough to satisfy them, it's just that they are having a surge in brain development & growth and you will see if you weigh, plot head circumference and length, that baby has grown.
Sometimes weight is used too much as signs of growth and development – a happy contented baby that is petite and lean is well within the range of normal, as well as the baby who is heavier and exclusively breastfed.
Q: Me_
Do you have any top tips for pumping? Does it all depend on the pump you’re using? Is there any need for Mum’s to worry that if they aren’t pumping alot, their baby may not be getting everything they need from breast feeding?
A: Sioned_
If you are looking at pumping for having a little flexibility, it is advised to wait until breastfeeding is well established and you both have had lots of practice, feeding and latching on is great and you can see and hear that baby is sucking and taking in and swallowing the milk.
If however you are needing to express after birth – whether baby isn't feeding well or they're in special care, you can express with the advice and support of a breastfeeding specialist or midwife.
The pump that you use does influence the flow; milk ejection reflex and the energy value in your milk. If you are pump-dependent from birth, using a Symphony Double Electric Breast Pump with unique initiation, maintains pattern support and effective activation of the milk making cells in the first week – this is a cycle program combining several stimulation cycles, pauses and expression. Once your milk comes to volume you would then benefit from a 2-phase stimulation and expression cycle that mimics the natural sucking rhythm of a breastfeeding infant.
Volume isn’t a huge factor to worry about. Baby is often better at stimulating a milk ejection reflex and a pump is mechanical. Our research shows that a baby removed 67% of the available milk and a pump 72% so very similar with a 2-phase breast pump.
Top tips
- Wait 45-60 minutes after the end of a breastfeed and you will get refill.
- Leaving bigger gaps between feeds or pumping sessions doesn't give you more milk – it will actually trigger a hormone to start switching off as you will be more engorged and this will impede flow and increase risk of mastitis.
- For more milk, pump and feed more frequently – small and often will drain the breast more effectively and give you more milk per day.
- Buy a pump that will do the job you want it to do – if you are looking at expressing a lot, 3 or more times a day, a Freestyle Double Electric Breast Pump or hiring a Symphony Double Electric Breast Pump would best suit your needs.
- If it's only for occasional use (2-3 times a day) to compliment breastfeeding, a Swing Electric Breast Pump and Harmony Manual Breast Pump are all 2-phase and would be the ideal choices.

Q: Me_
Is discomfort and cracked nipples a normal occurrence and something we just have to battle through (with the help of cream) or does it mean we're doing something wrong?
A: Sioned_
There are many myths around the preparation of the nipples for breastfeeding in pregnancy – all that is required is a good supporting bra and if you do experience a little milk leakage, some nursing pads.
Tender nipples are very common in the first week and it is best to be prepared for this. The nipple is very similar in tissue to your lips and when they chap, we tend to lick them more and this can make them sore and crack. This is the same for nipples and early breastfeeding – during the early days, the nipples are suckled every 1-2 hours which results in their natural moisturiser from the montgomery glands not being able to manage.
Top tips
- Massage a little expressed milk onto the skin and nipple after every feed.
- A small blob of nipple cream such as Purelan (perfume-free and safe for infants to ingest) applied to the nipple and areola will keep the breast in tip-top condition to replenish the moisture loss when baby is licking and sucking.
- Changing your nursing pads at every feed will keep the breast dry and minimise potential infection from bacteria.
- Try and have times without a bra so that air can circulate, just wear a loose t-shirt instead.
- However painful, cracked nipples are most often caused by having latch difficulties. If the latch isn’t great you are more likely to get engorgement, bleeding and scabs as the baby is nipple-feeding and the suck is compromised as the nipple may not be deep enough in baby's mouth.
- Check that baby can open his mouth wide – nipple to nose, chin to breast and a little tilt of his head back.
- If it still isn’t right – talk to your midwife early on and get specialist advice to help with positioning and attachment.
- Some babies do have a tongue-tie that does restrict the movement of the tongue and lead to mums experiencing extremely sore and painful feeding with often associated engorgement and mastitis. This does need a full feeding assessment and may need to be reviewed for a release to help comfortable feeding.
Disclosure; We are working with Medela and have been sent a number of their wonderful products to aid with breastfeeding and pumping, but all words and photography are my own and aren't influenced by anyone else.
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