Kraambed 2 Verloskundigen Amersfoort Balk

Breastfeeding

You have probably already thought about whether or not you want to breastfeed after giving birth. Below we provide additional information so that you can make an informed choice.

Feeding your newborn is one of the first things you will have to deal with as a new mother. Important questions arise: Why do I choose to breastfeed? Why is breastfeeding good for my child and for myself? How often and when do I breastfeed? What should I pay attention to when feeding?

It goes without saying that the partner also plays a very important role in the success of breastfeeding. Breastfeeding is a responsibility that you share.

Breastfeeding versus bottle feeding

The choice of breastfeeding or bottle feeding is up to you as parents. As midwives, we would like to support you as good as possible.
There are many benefits of breastfeeding that we would like to draw your attention to. You can use this information to make a choice. More can be read about this below.

It is also possible that you consciously choose bottle feeding. Then it is wise to look into that carefully as well in order to know what to expect and what choices can be made in this regard. For this information we refer you to the website of the ‘Voedingscentrum‘ (Nutrition Center) in Dutch.

Benefits of breastfeeding for the child:

Breastfeeding contains many antibodies against germs, making your child less prone to all kinds of infections, at present and in the long term. You can think of a runny nose, ear infection, meningitis, infections of the respiratory tract and intestinal diseases. This is less common in all breastfed children.
Breastfeeding has a laxative effect (especially in the first few days), which makes stools come up faster. In addition, it is easily digestible, which benefits your baby’s fragile digestive system.
Breastfed children are less likely to develop allergies and diabetes. It has also been shown that there is a reduced risk of cardiovascular disease and certain types of cancer later in life.
By sucking the breast certain muscles in the mouth are exercised, allowing the baby’s jaw to develop properly. This has a positive effect on the ability to speak.
Research has shown that breastfed infants develop faster than formula-fed infants.
Breastfeeding adapts precisely to the needs of your child in terms of composition and quantity. It has the right temperature and can be offered as often as necessary.
Sucking on a nipple is very satisfying for a baby and it also provides comfort.
Breastfeeding is cheap, always at hand and environmentally friendly!

Benefits of breastfeeding for the mother:

Because breastfeeding is a very intimate event, it makes an important contribution to mother and child bonding.
Breastfeeding will cause the uterus to shrink more quickly, which also has a beneficial effect on the amount of blood loss.
The risk of breast cancer decreases the longer you breastfeed.
The risk of developing osteoporosis is reduced.
By breastfeeding you will return to your old weight much faster.
You have to take time to breastfeed, so that you build in a moment of rest for yourself several times a day.

Often, many questions arise when breastfeeding. A lot is changing in your body and there are many things to take into account. We will discuss these questions with you during the postnatal week. Below we have made an overview of the most important and relevant topics during breastfeeding.

Latching on

A good and frequent latch is important to prevent sore and cracked nipples and to promote high milk flow. This also allows for your baby to receive enough nutrition and grow quickly.
The first hour after birth, your baby is awake and alert and usually has a very strong sucking reflex. It is important to make use of this. If your baby sticks out his tongue and makes smacking noises, you can latch him/her on to your breast and s/he will start sucking immediately.

This first feeding has an imprinting effect on the baby: how to drink at the breast is then stored in the brain. As a result, your baby will know exactly how to drink next time he is breastfed.
Your baby will immediately consume colostrum. This is the very first food your baby will get. Colostrum contains many antibodies and has a laxative effect, which stimulates the intestines to quickly release the meconium (the first tough stool after birth). This is important to prevent your baby’s skin looking yellow (jaundice).
Your baby’s sucking at the breast causes the uterus to contract properly, limiting blood loss.
While your baby lies comfortably against you and is breastfed, you can get to know him in a very comfortable setting. Skin-to-skin contact promotes the bond between mother and child and stimulates your milk production.

Even after a caesarean section, it is preferred to start breastfeeding within one hour. This can save a lot of time and energy later in the maternity period. Sometimes a baby does not want to suck the breast immediately after birth. That’s okay. In the days after the delivery, there is still plenty of time to practice.

A good latch works like this:

Bring your baby to your breast so that he is with his nose and mouth directly opposite the nipple.
Make sure his head, shoulders and hips are in a straight line so that he doesn’t have to turn his head to reach your chest.
Caress your baby’s upper lip with the nipple.
When your baby opens his mouth wide, place him on the breast, pointing your nipple towards his palate.

You can tell there is a good latch when:

The mouth opens wide over the nipple and closes the areola.
The lips are curled outward.
The nose touches the chest.
The chin presses slightly against the chest.
The cheeks are convex.

Breast infection

There are several causes for breast infection:

Clogged milk duct (this is most common)
Reduced resistance
Fungal infection (thrush or candidiasis)
Too much time between feedings, e.g. due to your baby sleeping better and longer
Combination of the above

Symptoms of a breast infection are:

Warmth and red patches on your chest
Breastfeeding is painful
Fever, shivering and sore muscles
Headache

If you have a breast infection (right and/or left side) it is important to properly empty that breast and keep it that way:

Heat your breast with nursing compresses
Massage your breast very gently before and during feeding towards the nipple
Always let your baby empty the affected breast first (the milk is good and safe to drink)
After 2 hours repeat as described above
Take 2 paracetamol and go to bed, having enough rest is important

There are different types of antibiotics that can be given for a breast infection. Usually after 2-3 hours the fever will have gone down and you feel a lot better. If the fever has not subsided after 24 hours, contact the midwife or GP.

Breast milk composition

The composition of breast milk for a premature baby is completely adapted to his needs at the time. So extra proteins (the baby must grow well), specific substances for the maturation of the organs and antibodies that reduce the risk of infections (including intestinal and respiratory infections). Especially for a premature baby it is very important that he / she is breastfed. Start pumping as soon as possible after delivery so that your baby can benefit from your breast milk as soon as possible.

Feeding on demand

Feeding on demand means that you let your baby drink as often and for as long as he wants. The first days you must maintain a minimum number of 8-12 feedings per 24 hours. Especially during those first few days, your baby will want to drink often, even at night. When your baby is sleeping, also go to sleep to get enough rest. After a few days, breastfeeding is well underway and your baby will find his own rhythm more and more. A clear sign of breastfed babies is that they drink less often in the morning and prefer to drink more often at the end of the afternoon and during the evening.

Getting used to

For the mother, breastfeeding can also bring discomforts that can be troublesome. For example, the first days are often practice days that require the necessary patience, because both mother and child have yet to master the technique of feeding and latching on. In addition, many parents are uncertain at first because they wonder whether their child is getting enough nutrition. Cracked nipples and breast infections are also issues that you can encounter when you are breastfeeding.

Losing and gaining weight

Breast milk contains all the nutrients your baby needs for growth and development. A healthy, full-term baby has fat and moisture reserves so that the first few days the first milk suffices. Whilst your breast milk production is still increasing, most newborn babies lose some weight in the first few days. This is normal. By weighing your baby at a fixed time every day (for example before the bath), you can keep a close eye on when your baby will start growing again. It is certainly not the intention to weigh your baby before and after each feed. This is not accurate and causes a lot of concern.

The number of pee and poop diapers is a good indication of how much a baby is breastfeeding. From the third or fourth day, a baby has four to six full pee diapers and two to five poop diapers per day.
If your baby tends to lose too much weight (more than 7% of the birth weight), it is necessary to evaluate breastfeeding. It is important to check whether your baby is feeding well and actively at the breast, whether your baby is drinking often enough and whether the milk production is getting started properly. Latch on properly and latch on more often ensures that milk production increases and your baby gets more nutrition, so that he will soon be back at his birth weight.

If your baby is losing too much weight, is not (yet) feeding properly at the breast and milk production has not yet started properly, then you should start pumping and supplementing your baby with expressed breast milk. In addition, it may be a good idea to seek guidance from a lactation consultant in properly latching on and teaching your baby to drink properly.

If supplemental nutrition is required on medical grounds, breast milk is preferred. If pumping is not successful, extra supplemental nutrition can be given in consultation with the midwife. A hypo-allergenic diet is then preferred. Medical reasons for feeding are:

A baby with a high or too low birth weight
A skinny baby
A baby who has lost 10% of its birth weight
Temporary use of medication by the mother; this applies to a limited number of medicines. You can breastfeed normally with most medications

Milk production

With each feeding you offer both breasts to stimulate milk production. In principle, your baby can drink until he falls asleep or lets go of the breast. Always check whether your baby is actively breastfeeding. A baby usually starts feeding with a few quick suckings to start the flow of milk. Then a baby swallows clearly audibly after one or two sucking movements. Over time, your baby will make more sucking movements before swallowing. If your baby is drinking well, you can see his ears move.

After the first latch on, latch on your baby about every two to three hours, this is 8 to 12 times every 24 hours. If your baby doesn’t wake up on its own during the day, wake him up every 3 hours. Milk production starts from the second or third day after delivery. Your breasts can therefore become very full and tense. This breast engorgement is temporary and will disappear sooner if your baby is breastfeeding well and often.

Nipple shields

Sometimes, during the maternity week, it may be necessary to use the bottle or nipple shield as a temporary aid and under proper supervision. This will always be done in consultation with your midwife.

Disadvantages of nipple shields:

The baby teaches itself a wrong sucking technique
The nipple does not end up in an ideal position, i.e. it is not at the back of the baby’s throat, because the top of the nipple shield will be occupying that space
The nerve endings in the areola are less stimulated (there is a plastic layer between them). As a result, less clear signals will be sent to the brain and less prolactin will be secreted and therefore less milk will be made
Because the breast is not properly emptied via a nipple shield, your baby will receive less nutrition and therefore grow less well

Pacifier

In principle, we do not recommend the use of a pacifier for your baby. Sucking on a pacifier disrupts the supply and demand mechanism during breastfeeding. In addition, some babies do not learn to breastfeed properly if they are also offered a pacifier. This is probably due to a difference in drinking technique between breast and teat.

Pumping

If your baby is not breastfeeding properly or doesn’t want to latch on the breast at all within 12 to 24 hours after delivery, then start pumping. This is done best with a double-sided electric pump. You can rent these at the ‘thuiszorgwinkel’.

The first few days, when there is still little milk, the expressed milk can be given with a teaspoon. Feeding with a cup is also very good (cup feeding). We prefer the latter. In the meantime, it is important to keep practicing to get a good latch. As soon as your baby starts to breastfeed better, you can start to reduce the pumping.

When circumstances dictate or allow you and your baby to be separated, it is important that you start pumping as soon as the situation allows. Pumping is best done at times when you would normally breastfeed your baby. It is important to note that frequent and short pumping stimulates milk production better than pumping a few times for an extended period of time.

Regulation days

At around two weeks, three months and six months postpartum, many babies want to drink more often for a number of days. We call them “regulation days”. These days are days on which the demand of your baby and the supply from your breast are recalibrated. These times are not strict and some women do not know what regular days are. If they are there, never doubt your breastfeeding, because there is nothing to worry about. Your baby indicates more often that he wants to drink, sometimes even every hour. If you respond to this and your baby latches on more often, your production will adjust again to the increased needs of your baby. The more often you feed your baby, the more milk you have. After a few days you will notice that your baby is getting back into a rhythm and the regulation days are over. It’s just part of the natural process. Take extra rest during the regular days. After 1 to 5 days, supply and demand will be aligned again and your baby will sleep longer between feedings.

Rooming-in

Rooming-in means that you and your baby stay together in a room day and night. Because you are close together, you will quickly get to know your baby and his needs well. This is especially important in the first week because the breastfeeding is still in a start-up phase. As soon as your baby indicates that he wants to drink, you can latch on. You can already latch on your baby when he is in light sleep. You can recognize a baby in light sleep by moving arms and legs and you often see the eyes moving back and forth under the eyelids. Sometimes they bring their fist or fingers to their mouth, make smacking noises or search by turning their heads back and forth. When you pick up your baby and latch him on, he will start feeding immediately. In this way you sometimes give 2 to 3 feedings extra per 24 hours, which promotes the production of breast milk.

Sensitive nipples

During the first few days it is normal for your nipples to be sensitive or sometimes painful for the first 30-60 seconds because muscles in the nipple are stretched. When the milk starts flowing, this feeling subsides. After a few days, the nipples are used to this and the first suction no longer hurts. Feeding then feels pleasant. Some people take longer to get used to than others. If the sensitivity does not decrease after 60-90 seconds and the feeding still hurts, take your baby off the breast by inserting your little finger into the corner of your baby’s mouth. The vacuum will be broken and your baby will let go of the breast. Then try latching on again.

Work

During the first nine months after childbirth, an employee may interrupt work for a maximum of a quarter of the working time to breastfeed or pump. During this time you will continue to be paid. This is only allowed if you have notified the employer of the same. You can read more about this on the website of the Ministry of Health, Welfare and Sport.

If you go back to work after your maternity leave, you can practice pumping 2 to 3 times a week after about 6 weeks. A good time to do this is after the morning feed because this is when you have the most milk, or at any other time that you think is suitable.

In the early stages, the amount of milk you express is less relevant, e.g. 20-30 cc is sufficient. You can increase the amount of milk expressed over the following weeks. In the meantime, you can practice feeding your baby from a bottle. Don’t be surprised if you don’t express much milk the first few times. Of course the feeling of breastfeeding is very different from pumping. Sometimes it takes some getting used to.

Expressing is also something very personal. Some like to use an electric breast pump and the other a manual one. Gather enough information and choose the pump that suits you best.

More information

Books (in Dutch)

Borstvoeding – Stefan Kleintjes – ISBN13: 9789000323265
Handboek borstvoeding – La Leche League – ISBN13: 9789051218732
Borstvoeding geven, een antwoord op al je vragen – A. de Reede – ISBN13: 9789032510466

Internet (all in Dutch)

Lactation experts

During the maternity period, we will help and support your breastfeeding together with maternity care. Sometimes it is necessary for a lactation consultant to watch, we will arrange this for you at that time. The maternity agency often also employs a lactation consultant whom they can consult.

Borstvoeding Midden Nederland
Christa Beumer, lactatiekundige IBCLC, Koningin Wilhelminastraat 24, 3931 CJ Woudenberg ( ook verhuur van kolven)
Borstvoeding Madelief
Zwarteweg 12, Leusden
Het Melkmeisje
Ellen Kamman Lactatiekundige IBCLC, Tuinslak 20 Amersfoort
Inge Stoof Lactatiekundige IBCLC
Peerlenburg 49
Prima lacta
Petra Jongeneel, Lactatiekundige IBCLC, Amersfoort

Fees

On zorgwijzer.nl you will find an overview of lactation assistance reimbursements that several health insurance companies offer..

Your choice

It is up to you and your partner to decide which form of feeding most appeals to you; the point is that you feel good about your own choice. We will always respect your decision in this regard. You can always count on our guidance and support, whatever form of feeding you choose. Naturally, this topic can always be discussed during consultation hours.