Julie Peasgood: Most new parents will have been told by health professionals that breast is best. Human milk contains the right amount of nutrients in the right proportions for the growing baby. It contains many unique components and is therefore considered to be the very best for a new baby. But, some women find it painful, exhausting and sometimes embarrassing. I'd like to welcome to this studio, Heather Welford, a breastfeeding counselor of the National Childbirth Trust, to answer questions on issues around breastfeeding. Welcome to you Heather.
Heather Welford: Hello Julie!
Julie Peasgood: Thank you for joining us. Let's start with the question we all ask, how crucial is it to breastfeed? How much does it matter if we do or we don't?
Heather Welford: Well, the research is quite clear that formula-fed babies don't get the benefits of breast milk. Breastfeeding does keep a new baby healthy. It helps to avoid many of the common infections. It's maybe not a matter of life and death in the West where we've got clean water and enough money to buy a formula, but the research is quite clear, breastfed babies do tend to be healthier and that health benefit can last quite a long time.
Julie Peasgood: Good! Do you think there is a pressure there, Heather, on mums who choose not to breastfed to make -- do you think they feel very guilty?
Heather Welford: They can do and I think along with health professionals telling people that breast milk is the best start for a baby, they need to know how to support women to overcome some of the common problems, otherwise women feel disappointed and then they blame themselves, if it doesn't work out. It's not their fault. Quite often, they needed the right information and the right support and the right answer to problems and it wasn't there for them.
Julie Peasgood: Yeah. How long should you breastfeed for, ideally?
Heather Welford: Well, that's really a matter of preference. We know that the health benefits are maximized if you feed breast milk with nothing else for the first six months and then after the baby would have other food alongside it. After that time, it's up to you, there's no upper limit, nature allows us to continue to feed for as long as we and our babies want.
Julie Peasgood: Yeah. What about drying up? I know from myself, I managed to breastfeed for just under five months, and then sadly my milk dried. Is that genetic, does it mean that my daughter when she has a baby, that will happen to her, is there any connection?
Heather Welford: No. I would like to turn the clock back and maybe I could have talked to you at that time Julie and maybe helped you over that issue.
Julie Peasgood: It was a hurdle.
Heather Welford: Well, if you're not expecting that drawback, it can feel quite a challenge and very disappointing. Mothers don't normally just dry up without anything having happened to precipitate that. And sometimes mothers' supply does fluctuate a little bit with issues like going back to work or the baby going through the night, but you couldn't start to bring back the supply by feeding the baby more frequently. That's what creates the milk. The more you feed, the more milk you make. That's why mums of twins and even triplets can have enough milk to feed their babies; twice the stimulation, twice the milk.
Julie Peasgood: Excellent! I didn't realize that. What about going back to work, Heather? What do you do in that situation?
Heather Welford: The employers today have an obligation, a legal obligation, although, not all of them follow it, to make it possible for mothers to continue breastfeeding while they're at work. I'm not saying bring your baby to work and breastfeed, but they have an obligation to make sure that there's a quiet, private and clean place available for mothers to express their milk, if they want to do so. That can be important in the early months if a mother is still breastfeeding her baby quite a lot. She will feel quite uncomfortable if she goes 6-7 hours without feeding the baby. She'll need to express, as I say, in a suitable place at work.
Some mothers, particularly, if their babies are a little bit older, might decide to combine breastfeeding when they're with their babies, in the morning, evening and weekends, and they care to give formula. Breastfeeding, once it's established, is robust enough to cope without lack of stimulation. Once the baby gets a bit older, you can play around with the timetabling.
Julie Peasgood: You can play around with the timetable. What do you do there Heather, if people object or if you're just too embarrassed and you have to breastfeed in front of others? What's your advice on that?
Heather Welford: Yes, sometimes women surprise themselves. They think in pregnancy, Oh! I couldn't possibly do it in front of my dad or what about my partner's father, absolutely not, I wouldn't dare to do that. Imagining that everybody's eyes are out on stalks.
Julie Peasgood: Yes. That they've never seen it before.
Heather Welford: I know, yeah. It's up to everybody. As I say, mothers can surprise themselves. They find that they're not quite as embarrassed as they thought they would be. They get very practiced at feeding. So it just looks as if you're giving the baby a cuddle or the baby is asleep in your arms. If they ask people, if they can feed, if they think that a warning is better, but even other people may not object as much as you think and they get used to it.
Julie Peasgood: Really?
Heather Welford: It's really other people's problem. If they object to seeing somebody feeding, they don't have to look, do they?
Julie Peasgood: No, exactly and you're only doing something entirely natural.
Heather Welford: The baby is having his dinner, that's all. We wouldn't object to the -- if the baby was having a bottle, nobody would object, why should anybody object if the baby is having his dinner from mom?
Julie Peasgood: Okay. And another question I know that worries a lot of people is how painful is it? I mean, it's normal to be pretty painful at first, isn't it?
Heather Welford: Well, no, it isn't. If it's painful, then there's something not quite right. A little bit of tenderness in the first days while you're just getting used to that new sensation, that can be normal. But real pain, when the nipples are damaged with the baby sucking, is almost always a sign that the baby needs to be positioned and attached in a more comfortable way. We say to mothers, if the pain is getting worse after day one or two, then that is a real cue to get somebody who knows what they're looking for to look at how the baby is actually feeding.
Julie Peasgood: And to look at your technique, basically.
Heather Welford: Yes, it is a technical question, just getting it right.
Julie Peasgood: Yeah, great! If you're very first skinned, your breast is slightly to be more sore or it's got nothing to do with it.
Heather Welford: No, it's all down to how the baby takes the nipple in the mouth. The nipple should be going right down the back of the throat not stuck at the top of the mouth compressed between the tongue and the hard palate.
Julie Peasgood: Okay, what about dos and donts, dietary wise? Are there any things that you should make sure you're eating and also things that you should avoid?
Heather Welford: Well, again, we've got good news about breastfeeding, what you eat has hardly any effect on the quality and quantity of your milk, despite what people tell you.
Julie Peasgood: Really?
Heather Welford: People will tell mothers that they must eat a nutritious diet and they should eat so many times a day.
Julie Peasgood: Lots of spinach, green leaves.
Heather Welford: Yeah, that might make the mother herself feel a bit more energetic, if she's paying attention to her diet. But the baby will be fine, even if she is not eating well, herself. We don't need to tell mothers to avoid anything in particular. A few mothers sometimes feel that their baby does have a response if they have eaten anything, something particularly unusual.
Julie Peasgood: Or spicy, would it give your baby extra wind problems?
Heather Welford: Well, people think that, but you have to remember, mothers breastfeed allover the world on very spicy diets and their babies are just fine. But we can't say that every individual will have exactly the same response. But there's no need to avoid anything in anticipation of the baby having a reaction. Most women can eat what they like.
Julie Peasgood: Okay. What's the score on alcohol, Heather? I mean, is it okay to drink a bit when you're breastfeeding?
Heather Welford: Well, alcohol does get through to the breast milk in small amounts. But the research we have on this shows that it's not harmful to the baby. You have to be really, extremely drunk before the baby shows any signs of having your Bacardi and Cokelist(ph) breast milk.
If it worries mothers that they really feel the baby shouldn't have any breast milk at all, then they can leave one-and-a-half or two hours per unit of alcohol before they feed the baby. But really that's for their own preference. There's no need to advise mothers to do without alcohol altogether.
Julie Peasgood: To abstain completely.
Heather Welford: No, they don't need to and they don't need to what the Americans call pump and dump, to pump the milk off and chuck it. You don't need to do that. That won't speed up your body's metabolism of the alcohol in anyway, so it's a bit pointless.
Julie Peasgood: Oh! That's fascinating! What about smoking?
Heather Welford: Yes, again, smoking is one of the things that does affect the breast milk, but it's a question of balance. A smoking mother breastfeeding will still have a healthier baby than a smoking mother who's bottlefeeding or a non-smoking mother who's bottlefeeding.
Julie Peasgood: Really?
Heather Welford: Yes. Of course, it's better to give up and we know that smoking around a baby is not a good idea for his general health. But again, you can leave a little bit of time between smoking and feeding, if that's an issue for you. You would reduce the impact of the nicotine on your baby, if you perhaps have a cigarette after you've fed the baby, and then you know that you've got a little bit of time before to do it again.
Julie Peasgood: Much better, definitely, another very practical note, how do you know that you're making enough milk for your baby? How long should a feed last?
Heather Welford: Well, the length of time that a feed lasts isn't reflected in the amount of milk the baby gets, you can have a very efficiently feeding mother and baby, who can have the whole thing over and done within five minutes and another baby of the same age who'll stop and start and come off and on, and like to take a little pause in the middle of it and maybe the feed will last an hour or even longer if the baby is very small and everything in between is quite normal as well.
So we can't judge the performance of breastfeeding by the length of time it takes. A mum knows her baby is getting enough, if he is thriving, if he is happy and healthy and in the early weeks you can have a look at the nappies and they tell you quite a lot of what you need to know.
Julie Peasgood: Right.
Heather Welford: A baby should be weeing plenty. After the first three or four days, he should be having several soft yellow poos everyday. That's good indication that something good is going in the top end for it to come out of bottom end that way.
Julie Peasgood: Excellent! If feeds do last a long time, do you think that dads can feel left out or other members of the family who might want to go at feeding the baby?
Heather Welford: Yes, and other people around are great sometimes at giving the baby a cuddle, the baby can get used to another pair of arms and to help settle a baby if he is being a bit fractious. I know that dads do tell us sometimes, what can I do when my partner is feeding? What's my role? We can assure them that the research shows, dads who support the mums who are breastfeeding, who are telling them they're doing a grand job, they make a real difference to the mother's decision to continue. So that moral support is a really important role.
Julie Peasgood: Excellent!
Heather Welford: The dad's relationship with the baby can develop, because the dad can give the baby a bath, he can change the baby's nappy -- everybody pulls the face, when you say that, but you get great eye to eye contact with the baby when you're changing a nappy.
Julie Peasgood: You can wind the baby.
Heather Welford: Oh! Yeah. Dads can give skin to skin contact and babies sometimes quite likes snuggling up on dads' bare chest. That's a good way for the father to help the baby learn that love doesn't have to come with a meal attached. You can get a lot of love even from the person who's not feeding you.
Julie Peasgood: Excellent! So if your family say, oh, why are you bothering breastfeeding it, such a lot of bother or whatever, you just come to that with no -- it is the best.
Heather Welford: It is the best and it can feel strange to some families, if the mum is one of the first people in her family to breastfeed, maybe her mom and her grandmother bottlefed, everybody may look at it as if it's something really odd that she is doing and people want to help, they want to help a new mom, if you weren't breastfeeding, I could take the baby for the night. They will put that sort of helpful or would be helpful pressure on the mum.
So that can be a challenge for the mother to have all their arguments about why she is doing it and to remind people that in just a few months, they'll be able to feed the baby with solids and the feeds are less likely to be frequent and they can have all the involvement they want. If they really want to do something, I'm sure there is a pile of ironing or some washing up or a kitchen floor to be mopped and they can help that way.
Julie Peasgood: Yeah, right. Just going back for a second, I have the two some of the most frequently asked questions, one is, do your breasts change shape?
Heather Welford: They do, temporarily. The breasts do change shape for a short time, particularly, at the beginning of feeding. Then when you get well-established with feeding, they'll start to look a little bit more normal, a little bit more like they were before you were pregnant.
Then, after you've totally stopped feeding, they should go back to more or less what they were before pregnancy. It takes a little time for the body to replace the fats that gives our breasts their shape when we're not pregnant or breastfeeding. But that does come back.
Sometimes, women have been feeding a long time, look down at their breast and they go, "Well, where did it all go?", "I used to have really quite nice breast and I've lost a couple of sizes," that can be normal because the breast milk making and storing tissue replaces the fat when you're breastfeeding. When you stop breastfeeding, you need to get back to the same hormonal state you were, before you were pregnant and, then, the fat gets laid down and that's what gives our breasts the shape, the fat.
Julie Peasgood: But just to finish on a positive note, breastfeeding can help you to lose weight. Can't it?
Heather Welford: It can, that is very good news for a lot of women. If you breastfeed for at least six months, the research shows you maximize your chances of losing that extra weight. Not everybody gets into their jeans after two or three weeks after the baby. But if you carry on with the breastfeeding, it uses up a lot of the energy that you've stored as fat when you were pregnant.
Julie Peasgood: Excellent! Thank you Heather, thanks so much.
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