Dr. Neetu Talwar, Senior Consultant Fortis Memorial Research Institute in Gurgaon, joins us and answers worried mommies about their breastfeeding concerns. Thank you, Dr. Talwar, for your support to the New Moms Club.
1. Diksha – How do we get to know if our bf is sufficient? Because at times when I press nipples, milk does not come out but still she sucks it…so is she getting sufficient bf, although she is on formula twice a day?
Diksha, you don’t have to test, check and press the nipples to see if the milk is coming out or not. Once your baby is sucking well at the breast- it means that the milk is there and she is sucking it. Most of the times especially in the initial weeks, milk may not come out, but when the baby is put to the breast and sucking on it, she will get enough of it and that should be sufficient.
2. Neha – My little one is not taking bf. She will turn 3 on 20th of this month. I’m so worried about her health. I tried a lot but all is of no use. She is completely on ff. What should I do to provide her complete nutrients?
First of all, the most important question is that – why is the baby not on breast feeding because even if you are working, we have options like expressing milk- you can express you breast milk manually and keep it outside or inside the refrigerator and give her the benefit of breast milk so you need to see your neonatologist or pediatrician to see why breast feeding is not going on. And the other thing is that – in case for some reason you are unable to breastfeed your child, then you can give her any of the formulas that are well available in the market. All of them, more or less have equal amount of nutritive value and they are all equally good.- I wouldn’t recommend anything in particular.
Another thing, if the baby is rejecting for genuine causes like for someone with moderate amount of inverted nipples etc., we have techniques to fix it. For example, we tell the mother to massage the nipples or use the syringe technique by which a little bit of nipple is formed just before she is due to start her breast feeding. The reason we advise women to go for breast feeding is for many reasons, which includes a higher IQ in babies and lesser chances of breast cancer in women. So unless the mother has a genuine health problem or if, for some reason, she is unable to stay with the child- we don’t advise women to formula feed over breast feeding.
In case you are working then your expressed milk in the open remains good for consumption for 6 hours and if stored in the refrigerator, then it is good for 24 hours. The only thing to remember is that – breast milk cannot be directly heated. Go for a check up. Most of the time it is a lack of communication and a lack of confidence, especially in first time mothers that my baby is not getting enough milk. And then the top milk comes in after which the baby develops nipple confusion and then the baby gives up one of the two- usually it is the breast because clearly, sucking from a bottle is less work. 🙂
So if you are seriously worried, please go see a doctor, show them your technique of breast feeding and they will help you with some corrective measures- the way you position your baby, the way you hold your breast; all of this matters a lot. All these little things combined will make you a successful breastfeeding mother.
3. Karuna & Sabitra Though I have been consistent to feed from both breasts alternately, my left side gets more full and heavy quickly and at times I end up feeding only from left to get rid of the lumps and pain first. This might affect the production in right side which is already less?
So this is again a very common complaint that even though you are feeding the baby from both the sides, one side, which is usually the left side, with most of us being right-sided so we hold the baby from the left side and maneuver things with the right side: the milk is more on the left side. So what needs to be done in such cases is that you have to continue to feed your baby from both the sides. In case one of the sides is still fuller, after the feed has been completed, you can throw out the extra milk on that side and believe me when I tell you this, it will not compromise on the amount of milk that your baby is going to get. So at the end of the day, YOU should not have any problems or breast lumps and you should not end up with secondary infections and breast abscesses. So feed the baby from alternate sides. For example, if in the morning you fed from the left breast, the next time you go in for feeding, make sure it is from the right breast. And like I always say that for the first 3-4 weeks, feeding from one side is sufficient. After around 40 days, one side will not be sufficient. So you have to finish off with one, shift over to the other and the next time, start with that half side, empty it completely and then shift over to the other side.
4. Sandhya – I take Dolo 650 sos for headache as I have migraine. I am breast feeding my 4 months old – will it affect her?
Don’t worry at all Sandhya, this medicine is completely safe and the dosage you’ve mentioned will not all affect either your milk production or your baby in any way.
5. Richa- My lo s 7 months old, inspite of trying lactare granules, I’m not having enough milk supply…and milk only comes from left side…right side produces lit bit…it may affect breast size later? Please help
Back to the basics- the technique of breast feeding, right from Day-1, should be correct. You need to ensure for the sake of your baby that you know the right technique, the right position- we always advocate a very comfortable environment and very comfortable positions in a comfortable room, where you are talking to the baby, you connect to the baby, because they are listening to you. This will all help them to achieve their milestones faster. Don’t be distracted, don’t do it while you are watching the Tv or when you are chatting over the phone- where you are feeding the baby with a distracted mind- All that is going to effect the milk production and affect the baby, who will feel that the mother is not interested.
Believe me, the children are very receptive. So keep talking to the baby, keep stroking his/her body with your hands.
Again, the most important point is alternate breasts- one breast at a time, and like I said previously, if one side is not enough, switch over to the other side because we are talking about the hind milk which is more important. It give satiety or satisfaction to the baby and so the baby is going to remain satisfied for a long time- at least 2.5-3 hours after the feed.
Lactare granules or such products are very good. They do have their effect- they have excellent results upon milk production, but the bottom line is that you have to physically feed the baby. Don’t think that I will take the granules and then the milk production will increase and then you will start feeding the baby. As long as you are feeding the baby, that stimulus is good enough to cause a let down reflex and it will be sufficient for the baby, at least for the first 4-6 months. In case you are taking the medicine and not being patient, no medicine will help. Again you will definitely feel more comfortable holding the baby from one side, which will lead to more production on that side, but you have to make sure that no matter how uncomfortable it is you have to continue feeding from both the sides.
6. Bharti & Divya My lo is 1 year old and I’m still breastfeeding her. How can I wean? She doesn’t take any other milk not by bottle and neither by sipper. Any solution please?
Largely till one year, breastfeeding is good enough but after that we aren’t benefiting the baby much by continuing to breastfeed. So I know it is going to be difficult for you but believe me, it is only going to be difficult for one or two days or one or two nights. You shouldn’t be lying down besides the baby in the night because it is usually the night feed the baby wants the most and you being around will not help her. So what you can do is sleep in the other room so as to relieve yourself or her from any stress. She shouldn’t think that the mother is there and still refusing to feed.
No amount of applications are going to help either- applying bitter stuff etc. so just sleep in the other room for two nights to wean her off your breastfeeding- which she in any case she is not benefiting from. Another thing to remember is after the age of one, they don’t require to be fed at night. The meal that you give them, khichdi, dal etc. is enough for her. It’s just us as mothers who think that we need to feed the baby and we feel the need to stuff the baby with extra feed.
7. Shraddha – My dd is 6 month old, getting less milk. How to increase milk supply at this stage?
Keep being patient and keep the baby at the breast. Don’t check for the amount of milk supply. As long as the baby is feeding, rest assured, the baby has got enough intelligence, they will never suckle at a breast that is empty. They will get irritated, they will move their face side to side, they will cry, they will not take feed from an empty breast. As long as the baby is sucking, continue and then shift to the other side. Another good suggestion is to burp the baby for good 10 minutes by the clock at the end of the feed. This is because most of the babies are mouth breathers. So they take their feed, breathe, and so back and so forth. So what happens is that they end up taking too much air with the milk. This air will fill up their stomach and they will not be able to fill up their stomachs with ample milk and will only be falsely satisfied.
So burp them and give more feed. So again if you feel like the baby has taken feed for good 40-45 minutes, burp and offer the breast again. If they are full they will refuse it.
8. Kitty – My lo is suffering from mouth thrush or yeast on her tongue due to which her appetite is going low she is 5 month old we are giving her nystatin n diflucan but its isn’t is helping much.
The medicines that you are mentioning Kitty, are really high-end, which aren’t required. Mouth thrush is usually due to bottle feeding etc. So we, for this reason, don’t recommend bottle feed but in case you are using it, change the nipples. The other thing is oral candid ointment (the candid lotion is a watery solution which is easily available in the market) you should apply that every one or two hours and for 24 hours, long after the baby becomes normal so doesn’t come back quickly. Otherwise even if a little bit of fungus is there in your body, it leads to repeated infection quickly. Also remember to treat both your nipples simultaneously as well- or else the infection will keep traveling back and forth from you to him and vice-verse.
9. Kala – Is taking avomine medicine harmful when we are on bf. My baby is 9 month old.
Kala, the medicine you are taking is safe. Only the medicines that are given along with chemotherapy and HIV are considered unsafe, so this is fine.
10. Suløchana – My milk supply is very very low and that also only from right side. From left only 1% maybe. I tried many things to increase d supply but in vain – my lo latch only from right side so d size of breast is not same anymore. What to do? I’m depressed n guilty for not able to feed my lo fully. He is on top feed..Please answer…
Sulochana, I am really touched by your question. It shows how sincerely you are trying to breast feed and how willing you are to improvise. So what you need to do is take a balanced healthy nutritious diet, more than what you were consuming pre- pregnancy. Along with that, good books, good thoughts – these also have a huge impact on the milk supply. Stress should be avoided and you have to feed from both the sides, and most importantly you shouldn’t be feeling guilty. In fact this is the most enjoyable period for any mother. This is the time when you get an opportunity to cultivate a bonding and emotional rapport with your child. So I would recommend you to stay in a quite comfortable room with your baby, put dim lights and soft music- no tv, no phones. Talk to the baby, touch the baby and your milk supply will definitely go up.