Our Q&A with the Lactation Consultants at Kareena Private
Talk to mums of a certain generation about the “good old days” and they will tell you stories of week-long hospital stays, post birth.
However, this is no longer the case, with a growing number of mums choosing to discharge themselves sometimes mere hours after delivery. Understandably, some mums just want to get back to the comfort of their own home, and often have other children to worry about. But those first few days after delivery are critical to the wellbeing of both mum and bub, especially if breastfeeding is part of the plan.
Current recommendations from the World Health Organisation state that new mums should stay in hospital for at least 24 hours post birth if they can, however our friends at Kareena Private encourage new mums to stay for four days.
We sat down with lactation consultants Stacy Hahn and Di McKay and trainee lactation consultant Kellie Campbell at Kareena Private, to understand why four is the magic number.
MOTS: How do I know if my milk has come in?
Kareena Private: Your milk will usually start to come in around 48-72 hours post birth. Some signs you may experience include a firmer, heavier feeling in the breast or breast engorgement. Your colostrum will start to change to a thinner consistency and become whiter in colour. You will also hear your baby start to gulp and swallow. Your baby’s stools will become a yellow mustard colour. Because of this timeframe, we advise new mums to stay until their milk has come in and we’ve had a chance to help them once it has.
MOTS: How can I help bring my milk in?
Kareena Private: You can help bring your milk in by regularly breastfeeding your baby, ensuring your baby has a correct latch, eating a healthy balanced diet, keeping up with hydration and resting when possible.
MOTS: How do I help my baby to latch properly and how do I know I’ve done it correctly?
Kareena Private: Bring baby’s chest and stomach to rest against your body – their chin will be touching your breast with their nose exposed. Their mouth will be open wide taking in as much of the areola as possible (not just nipple), their lips are turned out (special K shape) and you will notice their jaw moving with no sucking in or dimpling of the cheeks. Their ears should wriggle with each suck and your nipple should come out round or elongated once baby has finished.
MOTS: Should breastfeeding ever be painful?
Kareena Private: Some women do find breastfeeding uncomfortable especially if they have sensitive nipples – generally, this initial discomfort should subside after 20-30 seconds. It is therefore best to check each attachment with the lactation consultant or midwife at each feed, especially in the first few days.
You should also bring the baby to you for each feed, rather than leaning down to the baby when attaching, and making sure the baby is not wrapped or overdressed. It is also important to offer your baby skin to skin in between feeds to allow your baby access to the breast as often as possible.
A correct latch is pain-free.
MOTS: How would I know if my baby has a medical condition such as tongue tie or a poor latch that is making breastfeeding difficult?
Kareena Private: If breastfeeding is persistently painful or the nipples are damaged, positioning and attachment would be reviewed and an oral examination by the lactation consultant and paediatrician would be performed to assess for a tongue tie or any other anatomical causes.
MOTS: What should I do if I think I might be getting mastitis?
Kareena Private: Mastitis is an inflammation of the breast tissue usually caused by blocked ducts. If you are worried that you think you have mastitis, consult your lactation consultant and or midwife in hospital or if at home, call the hospital or your GP.
You can ice the area, gently massage any lumps towards the nipple when feeding or expressing, or when in the shower. Avoid pressure on breasts from fingers or clothing when feeding and avoid wearing an overly tight bra or top.
See a lactation specialist or child health nurse to ensure the baby has a correct latch and is draining the breast efficiently. Drink plenty of water and try to rest as much as possible. See your GP if symptoms persist and you become unwell (i.e. fever) as antibiotics may be needed.
MOTS: What’s the best way to treat sore nipples?
Kareena Private: Sore nipples are very common in breastfeeding new mums. Applying freshly squeezed colostrum or breast milk onto cracked nipples and letting them air dry may help them heal by providing antibacterial protection. A warm compress and a hospital grade lanolin ointment or hydrogel dressing can help soothe cracked nipples and help them retain moisture.
MOTS: Can I breastfeed if my nipples are bleeding?
Kareena Private: Yes, it is safe to breastfeed if nipples are bleeding, as long as the pain isn’t too severe for the mother. If it is too painful, they can rest and express for 24 hours and give the nipples a chance to start healing. Do as above with the cracked nipples.
MOTS: Should I be feeding my baby on demand or spacing out the feeds?
Kareena Private: Once your milk has come in, the baby should be having at least six feeds in 24 hours, but a breastfed baby will usually have between 8-12 breastfeeds in a 24 hour period. Demand feeding is the best way to ensure your baby gets what they need and your milk supply is adequate for them.
MOTS: What should I do if I have too much or too little milk?
Kareena Private: Too much or too little milk can have an impact on both the mother and the baby. Both issues can generally be improved with a lactation plan of management. A lactation consultant and or child and family health nurse are able to implement these plans.
MOTS: When should I pump?
Kareena Private: Pumping may be necessary if your baby is unable to breastfeed i.e. prematurity or separation due to illness or returning to work. Pumping can also be initiated during the first few days after your baby is born to increase your milk supply, or if the baby is not latching and feeding effectively from the breast (which will delay your ‘milk coming in’).
MOTS: What’s the difference between a handheld breast pump and an electric breast pump?
Kareena Private: An electric pump is usually more efficient than a hand pump. It depends on the reason for pumping – if it is just an occasional need, a hand pump could be all that’s required. If it’s a regular/frequent need, an electric breast pump would probably be a better option.
MOTS: What should I do to give myself the best chance at breastfeeding?
Kareena Private: Breastfeeding can be difficult so it’s important to arm yourself with information and support. Before you deliver, you might want to attend an antenatal class that talks about breastfeeding. Expectant mums can also hand express after 37 weeks.
After you deliver, two hours of skin to skin contact is recommended, as is a breastfeed within two hours of birth. Ask the midwife for assistance with latching once baby is born, remain calm and ensure hydration and diet is adequate. Make sure you have a good support network at home, too.
MOTS: What are some good resources to help me on my breastfeeding journey?
Kareena Private: Seek support from those close to you, child family health nurses, the Australian Breastfeeding association, and private lactation consultants, consult your midwives and lactation consultant while an inpatient. Reach out if you need help and utilise the outpatient services of the hospital you delivered in.
MOTS: What kind of support does Kareena Private provide expecting and new mums on their breastfeeding journey?
Kareena Private: Before the birth of your baby, we provide antenatal classes and support with experienced nurses and/or lactation consultants. While you are an inpatient at Kareena, all equipment required for successful breastfeeding and/or expressing is provided, as well as lactation consultant support.
We also provide postnatal education given by experienced midwives and lactation consultants, and the opportunity to utilise our lactation services for four weeks post discharge.
