BREASTFEEDING

Diet During Breast Feeding

Breastfeeding mothers usually have doubts about what should be eaten and how much during this period. You should continue eating a balanced diet like the one during your pregnancy. An extra 300 Calories above the pregnant requirement should be taken (600 Calories above the pre-pregnant state). One must continue taking Iron and Calcium supplementation during breastfeeding for 4-6 months
Alcohol interferes with milk let down reflex  .   A study shows babies consume less breast milk after the mother has consumed alcohol.
Smoking should be avoided as nicotine interferes with let down reflex     resulting in low milk supply.

Breast Care

During pregnancy you don’t have to take special care of your breasts / or nipples. But one must examine them during pregnancy itself

• Be sure to wear the bras, which provide enough support. Nursing bras are available, which give room for extra growth of your breasts.
  
• Wash your nipples with warm water before and after each feeding.
  
• Soaps, lotions may not be necessary and can cause irritation.
  
• To prevent dryness apply little expressed colostrum, human milk, medical grade modified lanolin.

Breast Care In Special Situations

During pregnancy if you have inverted nipples consult your doctor for correction. This is done by manipulation or by shields in later month of pregnancy.

Once you start breastfeeding you may experience slight tenderness of the nipples. This is quite normal in the first 2-3 days after delivery.
Soreness of nipples in early lactation period is due to wrong positioning of the baby. 

Sore nipples can be extremely painful. Nipple shield should not be used. Breast-feeding should be continued. . Nipple should be exposed to air and sunlight. Don’t use ointment/creams; instead use a drop of hind milk expressed from the breast.

If the soreness persists or suddenly appears after a week or two of delivery, then it is mostly due to fungal infection. This soreness is associated with pain and itching over the area around the nipple. The baby may also have thrush inside the mouth. Consult a doctor for treatment of the fungal infection of your breast and your baby’s oral thrush.

(iii) Breast engorgement:

Breast engorgement may occur when your breasts become too full with milk. A little engorgement is normal, but excessive enorgement becomes painful or uncomfortable. This makes the hard and your baby may find it difficult to feed. Thus a vicious cycle begins as the breasts are not properly emptied and get engorged. 

If your breast becomes engorged then:

• Express some milk before you breast-feed your
  baby.
  
• Gently massage your breast from under the arm down towards the nipples. 

Engorgement can be prevented by “feeding on demand /by expressing out excess milk if your breasts feel uncomfortable.

(iv) Mastitis:

Mastitis is infection of a blocked milk duct leading to swelling, redness, pain and fever. Consult your doctor for the treatment. Treatment includes rest, warm compresses, antibiotics, adequate breast support and continued breastfeeding.
If breastfeeding is painful, then:

• Allow the breast milk to ooze out as your baby suckles at the other breast.
  
• Breast milk can be manually expressed  .  
• Pumping     the breast may be required.

Medications During Breast Feeding

Usually medications are safe to take during breast-feeding, but there are a few that can be dangerous for the baby. To be sure, let your doctor and your baby’s doctor Pediatrician know that you are breastfeeding. Get approval for all medications, including non-prescription drugs. Also, take  the medication just after you nurse rather than just before.  Some birth control pills also might affect your milk production, but effects vary from woman to woman and with the type of pill  .   Discuss this with your doctor.

Breast Feeding In A Working Women

Most offices give a maternity leave of 3 months. Central government offices may give 4 1/2  months leave. It is recommended to continue breastfeeding for additional 3 months. When you resume your work after these 3 months, DON’T stop breast-feeding. You can do both. Working women can continue breast-feeding, by adopting different methods after
their maternity leave is over.

 For this you may require:

• Special permission from your superior to allow you to express breast milk during office hours.

• A separate room, if your company does not have a lactation room.

• Co-operation from your colleagues.

• A refrigerator / small cooler and ice packs when you can store the milk.

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