Breastfeeding is the final part of a wonderful, exhausting, and life-changing triathlon launching us into motherhood, but while we tend to plan and research for stages one and two – pregnancy and labour – it’s easy to put off thinking about this last bit. It’s understandable, there are wonderful little apps that help you navigate and understand your pregnancy, and there are an array of courses and books to help you plan your birth, but we tend to think of nursing as something that will just come to us.
Yes, breastfeeding is the biological norm, and yes it can be magical and rewarding, but it can also be unexpectedly painful, tiring, and time-consuming.
It is a learned skill for both mama and baby. And yes, for the most part, we instinctively know what to do, but how to do it takes time, perseverance, confidence, and above all HELP, to master. As with any challenge, we have the best chance of success by being prepared before we undertake it.
1) Pregnancy preparation
In the same way, we have a birth plan, it’s good to have a breastfeeding plan. This shouldn’t be rigid or become a stick to beat ourselves with if things don’t turn out the way we hope, but simply a guide to help us, and the people around us, cope with the steeping learning curve.
Breastfeeding has been hidden away in many modern societies, so the realities can come as a shock – not just for mothers but for their partners, who may never have seen a nursing woman. It’s helpful to set out and talk about hopes and expectations because as with many parenting discussions, it is best not to wait till baby arrives to make sure everyone is on the same page.
A good time to start research is the second trimester, once the fatigue and nausea have passed, but before the discomfort of the last few months hits.
There are some excellent books to read, but these three come highly recommended:
Dr William Sears, TheBreastfeedingBook: Everything You Need to Know About Nursing Your Child from Birth Through Weaning;
Dr Jack Newman’s Guide to Breastfeeding,
La Leche League International, The Womanly Art of Breastfeeding.
It might seem bizarre to read about nursing before delivery, but it’s helpful to become familiar with this brave new world in order to better cope with common issues such as tongue-tie, mastitis, and jaundice.
Most ante-natal classes cover breastfeeding in their range of topics, but La Leche League often offers dedicated Prenatal Breastfeeding Classes that tackles core issues including good positioning, latch, and how to know if the baby is getting enough.
2) Hospitals and Paediatricians
Those giving birth in the public system will be allocated a hospital according to residential area, but it still pays to do some research in advance on the breastfeeding policy. All government hospitals purport to support nursing, but the extent they do so varies, plus attitudes vary depending on the duty team during your stay.
Such variables are not in our control, but if we set out what we want, and make sure it’s on the birth plan, it is far easier to advocate when the time comes.
Mothers can make clear no artificial nipples or pacifiers, or formula is to be given to baby unless medically required and agreed to by a parent. If formula is needed or it’s necessary to express milk instead of direct nursing, insist the staff cup or syringe feed the babies to help prevent nipple confusion.
If medically possible ensure the baby has skin to skin and nurses in the first ‘golden hour’ and also request a visit from the hospital’s lactation consultant within the first 24 hours. Make sure the baby stays close to aid frequent breastfeeding and to ensure staff follow the care requests set out.
Assessing weight gain the days following discharge can be stressful, so it helps to see a doctor who understands the breastfed baby.
3) Boob Squad
Assemble your boob squad to help navigate the chaotic early days:
Supportive partners: This could be hubby, could be grandma, could it be a trusted mummy friend or a wonderful helper but this core group should provide emotional, physical, and nutritional support. This means getting water to drink and snacks to eat, holding the fort so mama can shower, swaddling, changing and rocking baby, or simply answering texts about ‘what’s normal’ in the wee hours.
Lactation consultants: It is worth saving for a private lactation consultant to do a home visit. Some health insurance also covers this but if not it is worth remembering that help from a qualified professional may mean you can avoid spending money on formula, which costs thousands of dollars per month. Home visits are particularly good if you had a difficult birth and mobility is restricted, but also just as a sanity saver. The first days home from the hospital can be terrifying as the reality of being totally responsible for the tiny person hits you and it can be helpful to have a calm influence advise on latch, creative positioning for mother and baby (options such as rugby hold, side-lying, or laid-back can be feeding game changers), check weight gain, and assess your well-being. If you book a package these occasional appearances can be a welcome breath of fresh air as you navigate the fourth trimester and beyond.
La Leche League: Often reachable by email and text, the women here can be a lifeline, plus the regular meetings are a great way to meet other new mothers.
4) Self Care and Self Belief
In the early days, women often feel that all they do is nurse, that they’ve managed to do nothing all day. But it’s worth reframing that thought from ‘endless breastfeeding’ to ‘growing a human with a specially created super fuel’ and appreciating the wonder of that achievement. It’s an old adage but it’s true: The days are long but the years are short. Let the housework and life admin wait and just enjoy the newborn bubble. Why worry about getting back the pre-pregnancy body when the post-pregnancy body is doing incredible things. It is an intense period and it’s vital to accept help, where we can, and take time to rest when we can. It’s vital to remember that using formula is not failing, and many people do so and then go on to breastfeed successfully and extensively. Don’t be held hostage to a constructed idea of perfection as the nursing journey will have ups and downs, so it is important to be flexible. Choose what is right for both you and your baby.
It’s normal for self-doubt to creep in and to worry about everything from whether baby is getting enough milk, gaining enough weight to why they feed so often, but it’s worth remembering that the human race would not have survived if breastfeeding failed us as regularly as has been claimed. It’s also worth remembering newborn stomachs are tiny and untested. Colostrum, that first milk often dubbed liquid gold for its intense colour and remarkable nutritional and immunological properties, and the breast milk that follows is easily digestible to account for that. This means breastfed babies nurse more frequently. They also nurse when they are thirsty, tired, need comfort coping with the wild world, or just want reassurance from mama, and they cluster feed to boost milk supply. To the uninitiated, this seemingly constant feeding is taken to mean a problem with their milk production when actually the problem is with society’s expectations of what newborns should do. We have been taught to expect the three-hourly formula feeding schedule as normal, but it simply doesn’t work for breastfed babies, and if adopting it can be catastrophic for your nursing plans.
It’s good to talk to a lactation consultant about any concerns and to keep an eye on wet and soiled nappies, but it’s also good to have confidence in our bodies. Speak with medical professionals about the best way to proceed if your baby is premature, as their requirements can be different from babies born at term.
5) Survival Tools
Seasoned breastfeeders will say all you really need are boobs and baby to breastfeed. Arguably it’s true, but there are a few things that will help make it easier for you sail from nursing novice to veteran in a matter of months.
Stock up: Around a month before due date, order a bumper iHerb delivery including your favourite snacks, stack the freezer with easy meals, and stash some sweet treats. The aim is simply to give you easy access to nourishment once bub arrives and commands all attention.
Water bottle: Nursing is thirsty work so it’s a good idea to have a couple of refillable 1l water bottles dotted around your key nursing spots so that you can swig as you go. Keeping hydrated also helps with your milk supply. Some mothers say coconut water provides an energy and supply boost.
Muslins: There will be spit-ups, there will be poonamis, so a collection of these versatile cloths is a must.
Breast pads: When your milk comes in, for some there’s no stopping it. Re-usable breast pads are ideal to soak up the overflow without it seeping into your outfit. Some women opt for shells, which can be placed over the nipple and collect any milk that has leaked.
Lanolin or Coconut Oil: It’s rarely mentioned but the truth is for many women, breastfeeding can be painful at first. Put simply our nipples, previously delicately encased in pretty bras, need time to toughen up. In the first few weeks, as mama and baby work on the art of latching, there can be a few seconds of stinging pain. It’s normal and it will fade, but dabbing coconut oil, or lanolin cream on nipples between feeds can soothe in the interim. It’s ideal to have a lactation consultant check for issues such as tongue tie or baby’s latching skills to catch problems early on. If the pain is unbearable, seek medical advice to rule out underlying issues.
Breastmilk and Silverettes: Breastmilk has anti-bacterial properties so can be a useful tool for minor scrapes and ailments for mama and baby. Silverettes are a really helpful product for anyone dealing with cracked, bitten, or chafed nipples. Simply drop some breast milk into the tiny cups, made of 925 silver, which is anti-inflammatory and anti-microbial, and place on the nipples between feedings to help speed the healing process.
Gel Pads: Gel-filled pads that can be gently heated are really helpful if you have persistent lumps or clogs, or are just in need of some soothing. The bonus is that you can use them for sporting injuries once your nursing needs for them have finished.
Lecithin: Some mothers find lecithin help with issues such as persistently blocked ducts but discuss with a healthcare professional before taking supplements.
Supply boosters: Mother’s Milk Tea and Fenugreek are fairly good starting points to improve supply, while lactation cookies have the benefit of being both yummy and helpful. Opt for a recipe with brewer’s yeast, such as this one.
Netflix: Whether its Gilmore Girls, Friends, and Friday Night Lights, a feel-good series (or ten) is helpful to get through the times when the days and nights seem to stretch on endlessly.
6) Online resources
A great benefit of being a 21st-century mother is the ease with which we can access resources. This doesn’t replace the importance of talking to doctors or midwives, but it does mean we have a chance to do some research and make a judgement about seeking further help.
When it comes to breastfeeding, there are a few that are trusted and reliable. KellyMom uses evidence-based research and articles to tackle and answer all the key issues you may come up against when nursing.
Dr William Sears, a passionate advocate of breastfeeding, has an excellent website that looks at all the big questions you may have – from the importance of breast milk for brain development to nursing while pregnant and tandem-feeding.
Low Milk Supply, despite its fairly basic look, is a helpful site for those looking for explanations about their own milk production.
Breastfeeding and Medication, a website run by UK-based advocate and trained pharmacist Wendy Jones, which helps evaluate what medicines can be taken if you are nursing.
7) Create Your Village
Breastfeeding evolved in a social setting, we were never meant to be doing it alone. But the modern world can be a lonely place for nursing mothers. Somehow we’ve ended up trying to handle the considerable task of nourishing a human – solo. The matriarchal village has been lost, but there are ways to recreate a version that works for you. The online resources above help with all the questions new mothers have, but it is also nice to feel there is a sisterhood to support you.
8) Stepping out
Going out for the first time solo can be daunting but one of the great benefits of breastfeeding is that we are already carrying what we need in terms of equipment and nourishment: breasts are the original zero waste packaging and the milk is ‘on tap’.
A structured baby carrier can make it easier to nurse discreetly but it’s best to have a few practice runs before heading out as it can take a little time to master nursing on the go in this way.
It’s normal to feel self-conscious nursing in public for the first few times, breastfeeding may be the biological norm but society has forgotten that, and those initial trips can feel stressful. Take a deep breath, focus on meeting the baby’s needs, and remember the world is full of smartphone zombies that rarely look up. Don’t worry about what anyone else is doing or thinking.
Breastfeeding advocates worldwide are campaigning for a situation where women feel free to nurse unfettered, but that remains a push for freedom so that no one is penalised for their personal choices. There are an array of firms selling beautiful nursing covers, but it is worth keeping in mind, not all babies comply.
9) Pumps and Bottles
Lactation consultants generally advise waiting until breastfeeding is well established – usually around four weeks – before introducing a bottle feed (it is still possible to syringe or cup feed express milk before this) to avoid nipple confusion.
A less talked about issue is that some babies refuse the bottle, particularly if it is introduced after eight weeks, so women on limited maternity leave should keep in mind that some little ones need to be coaxed to take milk from anything other than the breast.
It’s not unusual to need to try an array of bottles before baby settles on a favourite, with Pigeon, Dr Brown’s, Avent, Nuk, and Mam all regularly featuring on most bought lists. Newer brands, purporting to better mimic a mother’s breast and nipple, include Nanobebe, Comotomo, and Olababy. One baby has settled on an acceptable option, invest in a few, as it will be easier to match parts after sterilisation.
It’s important to spend a little time researching pumps, as there’s a vast array on the market, for varying needs.
Medela, Spectra, and Youha are the ‘big names’, offering everything from hospital grade to ‘travel’ options. Mothers that will be intensively pumping and away from baby for much of the day or night with work, should invest in the more powerful machines – the Medela Symphony and Spectra S1 and S2 – are sometimes provided in Hong Kong public hospitals, even if they are more cumbersome to transport to the office. A dual pump and hands-free pumping bras are also valuable time savers. It’s a big initial financial outlay but worth it to make best use of time, and to protect milk supply.
There are plenty of options for milk storage bags, but Wean Green and Life Factory offer environmentally friendly options. Industrial pumpers may need to invest in a small ‘milk’ fridge which can later be converted into a wine fridge.
For those that pump less frequently, there are lighter, portable styles such as the Spectra S9 that can fit neatly into a handbag but have less power.
Women who prefer a manual option should opt for the Haakaa silicon pump, which enables simultaneous nursing and pumping. But it is worth assessing it’s long term value as some have found the suction fades over time.
10) Returning to work
Paid maternity leave in Hong Kong is woefully short, currently set at 10 weeks (though expected to rise to 14 weeks this year), and many women return to work before they are really emotionally, or physically ready.
Financial realities can mean there’s no way of avoiding that, but being prepared can help. Companies are rarely set up to consider nursing needs so the first step is to have a frank discussion of what those are. Be firm and unapologetic with senior managers or HR, and if necessary highlight government recommendations for pumping mothers.
Do not accept any suggestions to pump in the bathroom, or anywhere that could be unsanitary.
The wider world is not pumping savvy, so colleagues can be a challenge. Some will be disgusted by the idea, others irritated by the ‘extra breaks, others will worry about breast milk contaminating their lunch. Keep in mind that these are the idiotic responses of the ill-informed and try to practice the art of being polite but not giving a damn.
Seek out support from others in the same situation as it can be an invaluable boost on days when pump parts are forgotten and there is crying over spilt milk.
Take heart from the fact there are many working women in the same position, and each step taken to normalise pumping now makes the path so much easier for the next generation.
11) Breastfeeding older babies
There seems to be an arbitrary time period – around three months – where breastfeeding is commended and accepted. But around 12 weeks, just ahead of the 4-month sleep regression where a new mother’s sanity is pushed to the limit, is the precise point that the insidious undermining begins with gusto. This is the time where questions about sleep, size, and schedules, always seem to be answered with the word ‘formula’. Despite the World Health Organisation recommending exclusively breastfeeding for at least six months and thereafter with food to aged two and beyond, this is regarded as strange behaviour. Six months is usually the point people talk about the need to encourage ‘independence’, and once bub passes their first birthday, then mother’s who continue to nurse are often accused of ‘only doing it for themselves’. Those that breastfeed beyond two years are regarded as freaks.
Isn’t it more bizarre to be disgusted when women opt to give their children breastmilk, which is uniquely tailored for each human baby, rather than cow breast milk?
It’s time to rethink our attitudes: It is wonderful that support at the newborn stage is slowly becoming the new normal, but we should be celebrating every milestone and every hurdle that nursing mothers clear.
It is wrong to say breastmilk loses nutritional value once babies celebrate their first babies. It still retains all the nutritional value it always had. But even if it didn’t, breastfeeding and breast milk still offer immunological, emotional, and developmental benefits.
The age range for natural term weaning in humans is actually anywhere between aged two and aged seven. Most women who continue nursing their smalls in toddlerhood will tell you it is a parenting superpower that helps children in times of illness, anxiety, rage, fear, sadness, as well as boosting confidence for exploration and independence.
Nonetheless, it can be lonely nursing an older baby, toddler, or child as it is less accepted and understood. For those that want to continue, it is vital to find like-minded souls to help navigate the challenges at home, and in wider society. Breastfeeding Older Babies and Beyond is an excellent and well-moderated group where you will find mothers dedicated to natural term weaning and many nursing kids aged two, three and four.