How Does Breast Milk Production and Lactation Occur?
High levels of breast milk producing hormones result from stimulation of the breast. These include the infant suckling, squeezing milk from the breast by hand, or by using a breast pump. These particular hormones are produced more during the nighttime than during the day, therefore, feeding at night is especially effective in helping with the speed at which breastmilk is produced. If the infant feeds less often, lower amounts of milk will be produced; the more frequently an infant feeds, the larger the amount of milk will be produced (as the level of milk producing hormones are at their highest during feeding and up to around 30 minutes after feeding has ended). After that, the hormone levels drop and level off within 3 hours on average. Regular feeding will ensure that hormone levels remain high and cause the breasts to produce milk continuously.
Anything affecting the mother’s physical or emotional comfort can result in milk not flowing as well as it should, and the infant not receiving enough milk. Therefore, whenever feeding takes place, the mother should try to relax as much as possible.
Signs That an Infant is Getting Enough Milk
- Breasts should be firmer prior to feeding and softer afterwards.
- You can hear the child swallow at intervals.
- The infant breastfeeds no less than 8 times per day.
- The child is calm, happy, relaxed, and can nap after feeding.
- After 3-4 days of age, the child’s urine is a clear yellow color; the child defecates 5-6 times per day.
- The infant is active and has a healthy complexion.
Duration of Meals
The duration of feeding varies for each child. Some infants finish feeding within 10-15 minutes, while others can take nearly an hour. On average, feeding takes about 20-30 minutes, but no two infants’ feeding times will be the same.
Properly Holding an Infant While Breastfeeding
Holding the infant correctly during breastfeeding will be more effective. While breastfeeding, the mother should be in a comfortable position and as relaxed as possible.
How to properly hold an infant while feeding:
- The infant’s head and body should be straight; the neck and arms should not be twisted.
- The infant’s head should be level to their mother’s breast; the infant’s nose should be at their mother’s nipple.
- Hold the infant as close as possible.
- The infant’s entire body must be supported, including the newborn’s head, neck, back, and bottom.
Characteristics of Proper Suckling
- The infant opens their mouth wide and latches tightly on the mother’s breast.
- The infant’s mouth should be covering most of the areola, more so below the nipple than above.
- The infant’s chin and nose should be snug against their mother’s breast.
Common Problems with Breastfeeding
- Sore or Cracked Nipples – This may result from the mother holding the child incorrectly while feeding, therefore, giving the child a shallow latch around the areola, and suckling only the nipple; or the child suckling harder and longer when the mother has little milk left, leading to pain in the nipple and making feeding too painful for the mother.
Tip: Hold the child in the correct position before feeding. When the child opens their mouth wide, quickly move the child’s head towards the breast in order for the child to latch on properly. Start feeding from the side that hurts the least first. If it is too painful, refrain from breastfeeding for 1-2 days and use a breast pump instead. The mother should pump the milk every 2-3 hours until she is able to breastfeed again. Squeezing some milk, applying it to any wounds on the nipple and then letting it dry may also help to alleviate pain.
- Engorged Breasts – This is caused by producing a large amount of breast milk and not being able to release it properly. Characteristics include the breasts becoming warm, heavy, hard, and sore with redness; milk not flowing; and breasts being too tender to be squeezed or touched. It can also cause fever, though generally not lasting for more than 24 hours.
Tip: Apply a heat pack to the breast for about 5-10 minutes. If there is too much pain, pain relief medication may be taken. If the mother is able to breastfeed, the child should be held correctly while nursing, and should be fed more often to help alleviate engorgement. Engorgement may also be reduced by releasing the milk though either squeezing by hand or using a pump.
- Mastitis – This results from milk remaining in the breast for prolonged periods and becoming inflamed around the breast tissue. It can become red and painful at some parts, produce hard lumps, cause fever, and lead to fatigue. Breast milk build-up can be due to infrequent feeding, feeding for short durations, and the mother not having time to pump breast milk. Alternately, it can occur as a result of poor milk flow due to ineffective sucking, the mother pressing the breast while feeding, the mother laying on her breasts for long periods, or the mother wearing a bra which is too small.
Tip: Release milk as quickly as possible by regularly breastfeeding, starting with the problematic side first. The infant’s head should be level to the mother’s breast. Take pain relief medication if there is any pain. If symptoms do not improve within 24 hours, consult your doctor or breastfeeding clinic.