Читать книгу Truly Happy Baby ... It Worked for Me: A practical parenting guide from a mum you can trust - Holly Willoughby, Holly Willoughby - Страница 11

Lay your baby on her tummy vertically along your body. Make sure she’s properly latched on so she doesn’t drag on the nipple.

Expressing breast milk …

Expressing milk means extracting breast milk by hand or using a pump. The milk can be kept for a feed, so anyone can give it, not just you! Regular expressing is a great way to help establish your milk supply. Other good reasons to express:

• It frees you up to have a well-earned snooze.

• You might be struggling with feeding your baby directly from the breast, but still want to give her breast milk (and keep your supply up).

• Your baby might not be emptying the breast fully, so you need to express off the rest.

• You are suffering from a breast infection or engorged breasts and it’s too painful to feed directly.

I expressed in different ways, for different reasons and with varying regularity, for each of my babies. In all honesty I think you need to focus on getting your milk really established for the first three months, which means looking to feed or express every three to four hours, ideally. This might sound like an arduous task at a time when you’ve never been so tired, but after you’ve put the work in your milk will be there, and more often than not it won’t go away even if you want it to!

There’s a lot of talk about expressing between feeds to increase your milk supply and I think it certainly helps, particularly if you’re struggling with breastfeeding. If your baby is taking some milk from the breast but not emptying it, offer her a bottle of expressed milk if you have some stored – or formula – to top her up. And then express the rest of the breast to empty it fully. This way your milk will replenish and there will be plenty there for the next feed. If you are part bottle- and part breastfeeding, you might hear the term ‘nipple confusion’. Personally I think this is rubbish! If you get your baby used to anything early on and keep swapping from one thing to another, she will see it as normal, but you should consider all the facts for yourself and make your own decision about this.

Due to Chester’s reflux, I battled with breastfeeding for two and a half months until, eventually, I had to face the fact that breastfeeding was just not for him. He couldn’t get on with it and it wasn’t making him happy, which was stressing me out, which in turn was having an effect on my milk supply. I ended up expressing every feed for the next few months until I decided that expressing, on top of sterilising and feeding with two other children in tow, was just too much and it was time to hit the formula.

If, like me with Harry, you are successfully breastfeeding all your feeds, I don’t think you need to express in between, unless you want to express a bottle for your partner to give the baby so you can head to bed early and get a decent sleep! With all three of my children I expressed one of the night feeds for Dan to give so I could get to bed after the 7pm feed. But I would still wake up at around 11pm to express off that feed and save it for the following night, or else my breasts would have engorged or I’d have risked my milk not replenishing enough for the last night feed.

Breast pumps Breast pumps simulate a baby’s sucking action to get your milk flowing but there are so many to choose from! I think it’s better to see what your situation is before you buy a pump. When I was pregnant with Harry I googled one of those ‘What to buy for your baby’ lists and went shopping, and one of the things on the list was an electric breast pump. It wasn’t until I actually used it that I discovered it was really noisy, which isn’t ideal in the middle of the night when you’ve finally got the baby off to sleep. I didn’t really need to express much at all with Harry, so I tried a manual hand pump instead, which was a fraction of the price, much quieter and completely portable (although it did of course take longer to express the milk).

So work out the best and cheapest expressing option for you. Mummy websites review most of the main brands and there are plenty of discussion threads. Pumps vary quite a bit in price, from the basic manual hand pump I had with Harry to hospital-grade double electric pumps. When I realised what sort of feeding regime I was in for with Chester, I rented one of these; because it was a double pump it was much quicker – and quieter – than my old shop-bought electric one.

Does expressing hurt? There’s no two ways about it – when you’re expressing milk you’ll feel like a cow with its udders hooked up to a milking machine! But it shouldn’t hurt. If you’re using an electric pump there will be several power settings, and if you’ve got it cranked up to the highest one, hoping to produce more milk, you’ll be in agony and probably produce less milk than you would if it was on a lower, more comfortable setting. Experiment to find the comfiest setting for you. If you’re in pain, you won’t produce the oxytocin that triggers your milk letdown (see here).

Another reason for expressing being painful might be the size of the part of the pump that covers the nipple. If your nipple is too big and is being squashed on all sides once you start the machine up, you might need a bigger part. There should be space around the nipple or it’s naturally going to chafe, so find out if your pump has different sizes.

Once you get it right, expressing should be really easy and you’ll soon find ways of clamping the cones into your breastfeeding bra so you can be hands-free to blow-dry your hair whilst pumping! Every second of you-time counts!

Storing breast milk Freshly expressed breast milk should be placed in the fridge immediately and kept for no longer than 72 hours. If you put it in freezer bags or those special milk bags and date it, you can freeze it for up to six months. Remember that breast milk changes as your baby grows and her needs evolve. If you’re giving her a feed you expressed two months ago, there may not be all the nutrients she needs at that point. So if you are freezing milk, use the earliest dates first.

Milky goodness A good reason for freezing a little breast milk is that it contains natural antibodies that are good for eye infections, little cuts, etc. Even if you’re not feeding any more and your milk production has stopped, you might have something in the freezer to treat your nine-month-old’s conjunctivitis! (Although check with your GP first!)

THE LOW-DOWN: BOTTLE-FEEDING

If you’re exclusively using formula, I’d recommend buying a formula dispenser. These are cheap to buy and usually have about three compartments so that you can measure out the right amount for each feed in advance. These dispensers are great if you are using a narrow-neck bottle, as they act like a funnel and are particularly handy when you’re out and about – or if you need to make up a bottle in the middle of the night and have lost the mental ability to count scoops accurately (it happens!).

Choosing a formula …

All the formulas contain similar stuff, but I picked one with added prebiotics. These are naturally found in breast milk and help to promote the production of friendly bacteria in your baby’s gut to boost her immune system. If you find that your baby is struggling to keep her feeds down every time, it’s worth trying another brand to see if it makes any difference.

Formulas suitable from birth have whey as their main ingredient as it’s easy to digest and nutritionally closest to breast milk. If you find you have a very hungry baby, and one that is putting on a lot of weight due to the amount of milk she’s consuming, you can get hungrier formulas, which use casein as their main ingredient. Casein is harder to digest and means that your baby won’t need to feed so often, but only use this if your baby fits the profile, otherwise it can wreak havoc on your baby’s digestion, which will leave you all in a pickle!

At about six months you can consider moving your baby to follow-on milk. I did because it contains extra vitamins for older babies, but there’s another school of thought that says they get those vitamins from solid foods once you’re weaning. Whether you choose to keep your baby on breast, infant or follow-on, don’t start her on cow’s milk until she’s twelve months old.

Formula comes as powder that you have to make up or ready-made in cartons. Of course, the little ready-made cartons are easier and more convenient to use, but they’re also a very expensive option. I always bought the big drums of powder, which I used at home, alongside a portable formula dispenser for when I was out and about. That said, there are occasions when a ready-made carton of formula is like the Holy Grail to a mum out and about! Perhaps you didn’t put the lid on properly and your bottle of boiled water has leaked all over your bag; or you brought the bottles out with you, but forgot the formula dispenser. There will be at least one occasion when you find yourself running into the nearest chemist for a pricey carton of ready-made formula. And, believe me, you’ll never feel more grateful for modern convenience!

How much formula to give …

There will be feeding guidelines on the back of every formula container to help you work out the recommended amounts according to your baby’s age and approximate weight. These guidelines are definitely worth considering, but crucially, don’t forget that no two children are the same. They’re all born at different birth weights, so, for example, the guidelines at two weeks for a baby born weighing 7lb (3kg) might not be enough food for one born weighing 10lb (4½kg). As with everything, adapt the rules to suit your baby.

Which bottle? …

There are so many different bottles – breast-shaped bottles, anti-colic bottles, coloured bottles, glass bottles! So how do you choose the right one? Again, it’s down to personal preference.

I used BPA (bisphenol A)-free bottles, which are made from food-grade plastic as opposed to one that might leak the chemical into your baby’s milk. In fact, with Chester, I opted for traditional glass bottles. I know they’re not to everyone’s taste, but I absolutely loved them. Because I had to bottle-feed him from so young, I liked the fact he wasn’t having a plastic bottle. It just felt purer to me. Apart from the risk of them getting broken, they’re also quite heavy, so if your baby is intent on holding her bottle maybe opt for plastic!

I used basic bottles with Harry but tried the anti-colic bottles with Belle, and I think they’re worth a whirl if you have any colic/reflux concerns (see here). The only downside is that they have even more parts to them, so there’s even more to sterilise and assemble!

Which teat? …

Teats come in lots of different shapes, sizes and materials. It’s a matter of preference but be aware you can get slow, medium or fast flow. If the hole in the teat is too big for your baby, she’ll drink too quickly, leaving you in a world of winding pain! If the teat is too small, she’ll have to suck really hard, which will leave her frustrated and possibly too tired to finish the bottle. There’s a risk you’ll mistake an exhausted baby for a satisfied sleepy one because she’s had to work so hard to feed. When changing teats, give her a few feeds to get used to it, but if the milk is flooding out, you’ve moved up a size too early.

Bear in mind that your baby has to work harder to suck the milk from your breast than from a bottle, so it’s not the change in vessel that frustrates her, it’s the speed she’s getting the milk. If you are combining breast and bottle, perhaps keep a slower-flow teat for longer. This will keep your baby having to work harder at the teat, so there isn’t such a big difference between bottle and breast. That said, be sure she is getting enough milk and isn’t frustrated.

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Cold or warm milk …

The pros of cold milk It’s totally up to you whether you want to warm your baby’s milk before you give it to her! Some people say babies drink and digest warm milk better (and do be aware of the official guidelines - see here), but if yours is happy with a cold bottle then why make a rod for your own back? It’s a pain in the neck if you’re out and about and you suddenly have to heat a bottle for a screaming baby who’s decided she’s hungry half an hour earlier than you expected, especially as many cafés and restaurants won’t heat milk for you for health and safety reasons. It’s equally frustrating having to warm a bottle in the middle of the night. It’s far easier to have ready-cooled bottles of water on your bedside table, tip in the formula from the dispenser, give it to your baby and then all go back to sleep. The less paraphernalia you need for your baby, the better!

How to warm milk If you decide to warm your baby’s milk, there are numerous electric bottle warmers on the market, but in my opinion these tend to take longer to warm a bottle than standing it in a jug of boiling water. Not to mention, it’s just another thing you have to find a plug socket for on the kitchen work surface!

When I asked about using a microwave to save time, I was told you can use them but it’s safer not to. Microwaving doesn’t evenly distribute heat through the milk, so there’s a chance your baby will scald her mouth on patches of boiling liquid.

Test the temperature by tipping a few drops onto the back of your hand. If should feel just warm, not hot.

Shortcuts for warming milk I didn’t warm milk for my first two children, but because Chester needed the carobel thickener (see here) in his milk for his reflux, I had to warm it for it to dissolve properly. Determined to make bottle-warming as hassle-free as possible, I devised a quick and easy plan once he’d moved on to formula. When I went up to bed, I would take a thermos flask of boiling water and, say he was having a 7oz bottle, I would fill a sterilised bottle with 6oz of cooled boiled water. Then when Chester needed a night feed, I would top the cooled bottle up with 1oz of boiling water from the flask, which made it the perfect temperature for the formula and carobel to dissolve and Chester to drink right away (although with carobel you do need to leave the milk to thicken for a few minutes). Likewise, during the day, say I was going out at midday for the afternoon, I’d put 7oz of freshly boiled water in a bottle, then zip it up in a bottle cosy so it would cool down slowly. By 3pm it would have cooled just enough to add the formula and be the perfect temperature for a hungry baby. But if Chester hadn’t had reflux, he would have been getting room-temperature milk all day long!

Is my baby thirsty? Should I give her water? …

I was told that, as a rule, babies get all the fluid they need from milk and shouldn’t need any extra water. If it’s a boiling hot day, you should feed your baby more often to stop her from becoming dehydrated.

HOW TO: BOTTLE-FEED

Whatever position works best for you, make sure you are positioned comfortably and have everything you need to hand. When you begin, your baby should make a seal around the teat with her lips to stop her swallowing too much air as she feeds. If there’s milk pouring down her chin during a feed, try adjusting the position of the teat in her mouth. It should be straight, not at too much of an angle. If her lips are dragged in when you put the teat in at first, give the bottle a gentle twist to release her lips.

Your baby’s head should be slightly tilted back, so there’s plenty of room in her throat for the milk to flow down. If you’re not holding her upright enough, it will be difficult for her to swallow freely. It’s also very important that the teat is completely full with milk. Otherwise, any air in the teat will get swallowed along with the milk and you’ll end up with a very windy baby on your hands.

Bottle-feeding positions to try …