How to avoid breastfeeding pitfalls

Author: Li Rui, deputy chief nurse at Peking Union Medical College Hospital

Reviewer: Ma Liangkun, Chief Physician, Peking Union Medical College Hospital

After ten months of pregnancy, the baby is born. For every family, welcoming the arrival of a new life is a happy and joyful thing. Every family member wants to give the baby the best nutrition and let the baby grow up healthily, but choosing what kind of feeding method is often a problem faced by every family with a new baby. Breastfeeding is currently recognized as the most economical, nutritious, natural and most suitable feeding method for babies. However, during the feeding process, some mothers often fall into various misunderstandings due to their incomplete understanding of breastfeeding and lack of guidance from professionals. The following examples will teach you how to avoid those "pitfalls" of breastfeeding.

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Case 1: No breast milk in the first 3 days after the baby is born?

Xiaoli just gave birth to a baby boy, and the whole family is very happy. Xiaoli has attended a breastfeeding course at a maternity school and knows that breast milk is the most nutritious and suitable for babies. She decided to breastfeed her baby from birth, but her family strongly opposed it, believing that the mother has no milk in the first three days and can only "produce milk" after three days. Is it true that breastfeeding during these days will make the baby hungry?

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1. Understand the principles of lactation

In fact, after pregnancy, the mother's body will undergo complex endocrine changes, and the mammary glands will develop again to prepare for milk production. From the second trimester, the breasts have the function of lactation, and colostrum is already in the breasts, preparing for breastfeeding immediately after the baby is born. Colostrum contains a large number of immune active substances and cells, and the immune protection significance of early postpartum breastfeeding is greater than the nutritional needs of the baby. This is very important for all babies, especially for premature babies. The amount of milk secretion is small 1 to 2 days after delivery, and the breasts are not full. This is the best starting stage for establishing a mother-child relationship, which is conducive to the sucking and swallowing of the newborn, and for the mother to find a comfortable way to breastfeed. As the baby's stomach capacity increases, through frequent sucking, milk will be secreted in large quantities 3 to 8 days after delivery, and the breasts will enter the full capacity lactation period. The mother will feel the breasts warm and full, which is commonly known as "milk production". In addition, the time when the breasts begin to secrete a large amount of milk after delivery is closely related to whether the baby sucks frequently and effectively removes the milk.

2. Understand your baby’s sucking needs after birth

The first thing a baby should do after birth is to have skin-to-skin contact with the mother in her arms, and the mother should follow the baby's sucking needs to breastfeed. Sucking helps relieve the stress felt by the newborn during birth and can also help the newborn adapt to the new environment. Even if the mother suspects that she has no breast milk, the baby can still suck colostrum, which is thicker and yellower in color. It is a "super milk" that can meet the baby's nutrition in the first few days and can also help the baby remove meconium from the body.

Case 2: What is the truth behind nipple cracking?

Xiaoli is now 10 days postpartum and has achieved exclusive breastfeeding. She is very happy that her baby can get enough breast milk. However, every time the baby sucks milk, it takes a long time and the nipples are unbearable. Every feeding is like "torture". My family said that breastfeeding is like this, just bear with it, and you will naturally get used to it over time. Is this really the case?

1. What causes nipple cracks?

Incorrect breastfeeding posture or baby sucking posture, short tongue tie, Candida infection, excessive cleaning, improper use of breast pumps and nipple shields, etc. can all lead to nipple cracks. Among them, incorrect breastfeeding posture or baby sucking posture is a common cause of nipple cracks.

2.What are the main symptoms of nipple fissures?

When the baby's feeding and sucking posture is incorrect, the mother will feel nipple pain, and after the baby stops sucking, a horizontal red mark will appear on the nipple. In severe cases, nipple fissures may occur, and the mother will feel a needle-like pain in the nipple, which is obvious during breastfeeding and gradually relieved after breastfeeding, with small and shallow cracks on the surface of the nipple.

3. What should I do if nipple cracking occurs?

(1) Identify the cause and make timely adjustments.

(2) Feed the side without wounds or with less severe injuries first. If the wound is severe, use a breast pump or other lactation aid to remove the milk before feeding.

(3) Squeeze a small amount of breast milk and apply it on the surface of the nipple to facilitate wound healing. Expose the nipple to the air as much as possible, keep the area naturally dry, and avoid friction.

(4) Apply pure natural, additive-free lanolin cream to the nipples and areolas to help the skin retain internal moisture and accelerate wound healing.

(5) Use a nipple shield to protect the wound and prevent clothing from rubbing against the wound and causing pain.

(6) If infection occurs, apply antibiotics topically as directed by your doctor.

4. How to prevent nipple cracks?

(1) Mothers should be proficient in the correct breastfeeding and baby’s latching posture.

(2) After each feeding, you can apply breast milk to the nipples and expose the nipples to the air for 1 to 2 minutes.

(3) When breastfeeding, the mother should be relaxed and the baby should be comfortable.

(4) Use the breast pump correctly.

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Case 3: Can I take medicine during breastfeeding?

The weather has been hot recently. Xiaoli caught a cold after using the air conditioner and had a slight cough. She heard that taking medicine during breastfeeding will affect the baby through breast milk. Her family also advised her to drink more water, rest more, and endure for a few days, but her condition became more and more serious. Can I take medicine during breastfeeding?

You cannot take medications at will during breastfeeding, but that does not mean you cannot take medications. You can use safe medications during breastfeeding as a substitute. You need to consult professional medical personnel when taking medications during breastfeeding, and you cannot take medications at will. Currently, medications during breastfeeding are graded according to the "L" classification, that is, the drugs are divided into L1 to L5 according to the breastfeeding risk index. Only by understanding the safety of medications during breastfeeding can you stay away from medication minefields.

1. Safety level of drugs during lactation

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2. Principles of medication during lactation

(1) Breastfeeding mothers should take medication under the guidance of a doctor and there should be strict medication indications.

(2) L1 and L2 level drugs should be used. L3 level drugs should be used after weighing the pros and cons.

(3) The medication should be taken right after breastfeeding and the interval between the medication and the next breastfeeding should be at least 4 hours, or the interval between breastfeeding should be adjusted according to the half-life of the drug.

(4) Long-term use of medication or high dosage may cause adverse effects, and the blood drug concentration of infants needs to be monitored.

(5) When a breastfeeding mother must take medication but there is a lack of relevant safety evidence, it is recommended to suspend breastfeeding.

We hope that the above three cases can help pregnant mothers easily escape from the "pitfalls" of breastfeeding. Advocate breastfeeding and enjoy happy time with your baby!

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