Source: Pregnancy-The Complete Childbirth Book by Nutan Lakhanpal Pandit

Source: Pregnancy-The Complete Childbirth Book by Nutan Lakhanpal Pandit

Some more Questions & Answers
 

Q 1. What if the mother is not able to breastfeed?

A 1. To be able to breastfeed successfully:
 

Q 2. What about the babies who constantly demand breastfeeding?

A 2. Often there are babies who fake constant hunger. When put to the breast, they are playful or disinterested feeders. Such babies are actually demanding comfort sucking, not nutritive feeding. They probably have mothers who do not cuddle them between feeds and hold them only for the purpose of feeding. If the mother cuddles them between feeds they will stop pretending to be hungry just to feel warm and secure. Sometimes if the mother is stressed, tense or depressed the baby senses her anguish and wants to be constantly near her for reassurance. Such babies cry a lot and seem to be hungry. Further babies may be actually hungry when they have a growth spurt, that is, when they grow taller, fatter or longer. Their growth requires more milk so they go through a temporary phase of about 2 days approximately when they want frequent feeding. This steps up the milk supply in the breast. Once milk supply is increased, they go back to bigger gaps between feeds. At such times it is best for the mother to take 2 days off and go to bed with the baby and concentrate only on feeding for those 2 days. 

Q 3. Can I express and store my milk in the refrigerator in case I have to go out?

A 3. Yes, milk can be expressed and stored in a refrigerator in a glass which has been sterilized for the purpose. The milk will settle in fat and water layers, but that does not mean it has gone bad. It can be fed to the baby while you are away from the glass or with a spoon. Avoid the bottle totally in order to prevent nipple confusion, that is, the' mechanism of sucking' at the breast is different form sucking at the bottle. The bottle drips milk regardless of the baby's jaw effort. The baby therefore tends to prefer it and rejects the breast.

Further one can never reach the bottom of the bottle to clean the milky slime off it. It therefore encourages a prolific growth of bacteria which is why it needs to be thoroughly sterilized by boiling.
The entire feed should not be expressed at one time. One can collect milk over several hours (say 4 to 6 hours). Breast milk stays in refrigerator for 24 hrs. Breast milk should not be boiled before feeding. It can be given cool from the refrigerator. If it is very cold, it can be warmed by standing in a mug of warm water before feeding. 

Q 4. Why does one get sore nipples?

A 4. When you want to stop feeding, if you pull and drag the baby off the breast, it might give you sore nipples. So instead, you must break off baby's suction by putting the tip of your finger in the corner of the mouth, and then take him off the breast. Or, pull the chin of the baby downwards, before removing from the breast.

Further, if you press your breast down with the finger, by forming a big dent on the breast, in order to prevent the baby's nose from getting blocked, the act of pressing down the breast will cause the nipple to project upwards and hit the roof of the baby's mouth when it feeds. This hitting of the nipple on the hard palate will cause it to get sore. Instead of denting the breast in this fashion, place your fingers under the breast and raise it slightly, so that the nipple projects straight towards the baby's throat, and any bulge of the breast that is there goes backwards and meets with the chest.

Soreness may also happen if the baby munches on the nipple instead of on the areola, the dark area behind. Make sure the baby is latched on properly, by placing both the nipple and areola well into baby's mouth.

Soreness sometimes occurs of the nipples are frequently washed with soap. Water is sufficient to wash them.

Pressure applied at the same point constantly can also need to soreness. It therefore helps to change positions during a feed and to adopt different positions for different feeds, so that pressure is applied to different points on the breast.

Soreness may be caused by a baby sucking too long after the breast has been emptied. The baby takes approximately twenty minutes to empty a breast; after that he only indulges in comfort sucking. Restrict comfort sucking. 

Q 5. How do you help heal sore nipples?

A 5. Soggy nipples, that is, nipples that remain wet for long periods, are more prone to soreness. It therefore, helps to expose your nipples to air and sunlight as much as possible, until the soreness heals. You can wear a loose garment without a bra.

Avoid using creams on cracked nipples. Dry corn flour can be dusted on them instead. It is also very helpful to express some milk after a feed and rub on the sore nipple where it should be left to dry. This quickens healing considerably. Avoid the use of water-proof-backed bra pads. Do not remove any crust appearing on the nipple. It is a part of healing process.

Always offer the less sore side first. That will establish the flow on the sore side before the baby takes it, thus making it less painful. You can use breathing for labour to be able to handles the pain.

An Aspirin or a mild alcoholic drink like wine or beer, taken shortly before a feed will help reduce the pain. It ca be taken if the pain begins to interfere with the let down or release of milk.

You can try using a cold compress on your nipples before feeding. Apply ice-cube wrapped in a towel or hanky. You can wear a blotting paper on a ever-dry nappy liner inside the bra to keep the nipples dry.
Sometimes, a sore nipple may bleed. There is no harm if the baby swallows tiny amounts of blood with the milk. This can be quite frightening; especially when a baby burps after a feed, and along with the curdled milk brings up a little blood. However, this is harmless to the baby. Continue to treat your sore nipples and carry on feeding.

There maybe a risk of infection of sore nipples, if the baby has thrush, that is, white spots on the tongue that do not wipe away. Thrush must be treated medically. You can take the baby off the breast for a few feeds until the skin has healed. The milk can be expressed and fed to the baby from a spoon.
A nipple shield can be used. It is a rubber shield that fits over the nipple and aeola and prevents direct suction on the nipple.