Happy Baby, Happy Family: Learning to trust yourself and enjoy your baby

The size of your breasts increases as the milk comes in, and many women go up several cup sizes. Having an ill-fitting bra can cause backache. A loose-fitting bra to begin with for your hospital bag and wearing around the house is fine until you feel like a trip out to get properly fitted.

Cracked nipples

If your nipples are very sore and using expressed breast milk or gel is not sufficient, then you may need to get a prescription for cream to heal the nipples. Any cream you use will need to be washed off before feeding the baby so they are fiddly and more time-consuming than using gel or hind milk. But sometimes if you use a cream for just 24 hours and let plenty of air get to the breasts, the nipple will heal a lot faster.

If you are suffering, using a cream to heal faster is well worth the bother, and much better in the long run than feeding on a very sore breast. Apply the cream in a thick layer, then wipe off with damp cotton wool before you feed your baby. I know this can be a real pain during night feeds, but do make sure it’s all gone, as the baby should not ingest any of the cream.

While the nipple is healing you may want to breastfeed on only one side and express milk from the sore breast, just until it is comfortable to feed again.

If you are diagnosed with thrush, then not only will you need to finish any course of treatment to clear the infection but the baby will need to take oral medication as well (see also the A–Z section for more about thrush (#litres_trial_promo)).

Blocked ducts

You may notice a small tender lump in your breast that could indicate a blocked duct. Try massaging the breast or using the warmth from a covered hot water bottle or warmed pad to help to disperse it. You may find this works best if you gently massage the breast to unblock the duct while you are in the bath or shower. This is best done after a feed; a good feed will help to empty the affected breast and clear the blockage. If a blocked duct does not clear it may lead to mastitis, so ask your health visitor or doctor for further advice at the earliest opportunity.

Mastitis

Mastitis can be a mild or severe inflammation of the breast and sometimes can cause fever and vomiting. If the breasts are painful and swollen and/or hot and red, you may have mastitis. Seek medical advice as soon as you notice the symptoms, especially if you have flu-like symptoms and are feeling hot and cold with achy joints and feeling generally unwell. Your doctor may prescribe some antibiotics if the mastitis has become infected. Only take medication as instructed by your health practitioner.

Drink lots of fluids and try using warm packs, or sometimes an ice pack can help, or even a small quantity of frozen peas in a plastic bag wrapped in a clean towel (remember not to eat the peas later on, though you could label them and refreeze for medicinal use again).

Do keep feeding the baby if you can, and check the position for breastfeeding and how the baby latches on to ensure you’re going to be as comfortable as possible. (Revisit the Latching Techniques and positioning advice earlier in this chapter to double-check.)

Expressing breast milk (EBM)

You can express breast milk either by hand or by using a hand or electric pump so that your baby can get their milk from a sterilised bottle, cup or spoon rather than at the breast for a feed.

It is usually preferable to feed your baby at the breast and not to express milk in the early days but it may be something you want to do for a short time if you are experiencing sore nipples or you are separated from your baby. You may not be able to meet all your baby’s milk needs through EBM alone but it can be a useful supplement alongside breastfeeding or for babies who are in a special care baby unit.

Breastfeeding Shopping List

Breast pads

Nipple gel or cream

Freezer bags

Steriliser

Breast pump

Bottles

Bottle brush

Nipple shields

Breastfeeding tops, dresses, cardigans

A shawl

Feeding pillow

Muslin

Breastfed babies need to get milk from both breasts as often as possible to establish and increase the supply of breast milk with frequent sucking. It is very unlikely that a mother can express the same amount of milk for her baby that feeding at the breast delivers, so unless there are special circumstances, like the baby being in a special care unit, I would advise that you feed from the breasts for the first two weeks or so to get the milk supply established.

If a baby is premature or poorly and is in a special care unit, a mum has no other choice than to use EBM if they are not allowed to put the baby to the breast. Whatever your circumstances are, expressing breast milk is hard work. It often gives you flexibility, but some women find it draining, and you will need even more sustenance to both express and also breastfeed.

EBM can be really handy to have in the fridge when your baby is demanding huge amounts of milk in the night; giving your breasts a rest, and if your partner takes over it’ll give you a rest, too. Expressing milk does mean extra washing and sterilising of bottles and equipment (this is often a good job for your partner to take on; have a look at Chapter 2 to find out how to sterilise bottles and equipment). Many mums find that expressing after a feed works best. This milk can either be chilled in the fridge for up to 48 hours or frozen for up to three months for later use.

Pumps can be bought at the pharmacy, and some breastfeeding organisations lend out pumps, usually for a small charge, as electric pumps are expensive.

There are many pumps on the market but the important thing to remember is that they must be sterilised before each use and you will need to follow the instructions for correct assembly and usage. This is a job your partner could take responsibility for, as the pump needs to be ‘built’ before each use, and it is much better to be handed the pump sterilised, assembled and ready to go. Even if you prefer to express whilst your partner is at work, they could always get it ready for you before they go in the morning.

Leaking milk

Leaking varies enormously for many women: some mums find a crying baby (not always their own) causes leaking and can’t leave the house without breast pads; other women have only a little leak now and then. Most women do need to use breast pads inserted in their bra to cope with leaking between feeds in the first months of breastfeeding, as this is when milk production is highest.

When there have been some hours between feeds, leaking is often copious and the first feed of the morning may soak your clothes whilst you are feeding from the first side, so it can be helpful to insert a muslin (soft cotton) cloth into your nightdress or top to mop up the milk if you haven’t had the chance to put on your bra and a breast pad yet.

A little consolation for all this dampness is that you are producing lots of milk for your baby. You’ll find that when weaning starts and you start to reduce the number of times you feed a day you’ll leak less and may not need to wear breast pads any more.

Colic

You will be able to see if it is colic that is making your baby cry when they draw up their knees, arch their back or try to push themselves off your lap or out of your arms with their feet. Keeping a firm hold will keep them safe and secure. To calm them you may want to try the Up-Down Technique (see Chapter 3 (#litres_trial_promo)) to get them to stop crying – dads are usually great at this.

Try soothing your Little One: babies love sympathy. If you calmly tell them Mummy or Daddy is here and you know how hard it is, it will help focus your mind and give them comfort to get over the colic spasm quickly. It is hard for your baby when they have colic, as they don’t understand what this pain is, and they don’t know it will pass soon enough.

Colic, which literally means ‘pain’, is horrid for your baby and for you. Your Little One is experiencing the discomfort of digestion for the first time. Just picture all the rumblings in their tummy and the windy feeling as a brand-new gut has to digest all the nutrients from their milk. Their bodies are learning how to do this, and your baby’s problem is gas, not you. I know it’s horrible when they get beside themselves with colic, but your baby has no idea what is causing this pain and does not know when it will end. It comes as a bit of a shock for them after all those months of a carefree existence in the womb.

You can give your Little One some relief by staying calm and giving them lots of comfort; it may be you want to try some skin-to-skin contact so they can feel your warmth and hear your heartbeat.

There are products on the market to help relieve colic, and your doctor or health visitor can write you a prescription or you can get over-the-counter remedies from the pharmacist.

There are remedies you give to your baby before the feed which work by bringing all the little bubbles of wind together to help your baby to burp them up, and they may posset and vomit up a little milk as well which is to be expected with these products.

You can also use gripe water from the ages of six to eight weeks by giving a 2.5 ml spoon in 1 fl oz of cooled boiled water in a sterilised bottle. I usually say gripe water works best when your Little One is experiencing colic as it will help to bring up any wind if you give it to them 10–15 minutes before their feed, and make it more likely they’ll have an easier job finishing their milk.

What works for your baby may not be the same as for your friends’ babies, so keep an open mind and use only one product at a time. I have known mums who have been having such a hard time and are so desperate to find a remedy they’ve given all the products together, but not only would this mean you wouldn’t know which product worked for your baby, it would be unsafe as well. (See the A–Z section (#litres_trial_promo) for further information.)

Posseting

Posseting is common in most babies and is an old-fashioned word that we use for babies who bring up little bits of vomit after feeding or sometimes even during a feed. It is normal for babies to posset because, as they burp, often some partly digested feed comes up. Many babies will be experiencing symptoms of colic as well as posseting from birth to six months, so it is no wonder it makes many parents feel anxious. Posseting is nothing to worry about unless you think it is affecting your baby’s weight gain and well-being.

You cannot stop your baby being sick but you can help them by feeding frequently (usually every two to three hours); raising the head end of their crib by placing a folded blanket or muslin underneath their mattress so your baby can rest in a more upright position; and giving your baby the opportunity to be on their tummy during regular supervised ‘Tummy Time’. Once they can sit up with support, being upright may help lessen their vomiting reflex. Once babies start to wean and are having solid food and spend more of their day in an upright position, most parents notice they posset less or not at all.

Reflux