Breastfeeding, understand its phases and physiology up to weaning.

Breastfeeding, like everything else, has its stages, and it is important to know where you are in order to understand what is happening in your body. For this reason, the midwives of Happymami have created this post especially for you. Breastfeeding, understand its phases and physiology until weaning.

Stages for breastfeeding initiation

Phases of lactogenesis

It seems surprising, but from the 5th-6th month of pregnancy, you will already be able to have a small amount of breast milk. This stage is called lactogenesis I. And after delivery, lactogenesis II will arrive, with an abundant production of breast milk and is popularly known as “milk surge“. And finally galactopoiesis or lactogenesis III will arrive. Which is the process that maintains milk production once breastfeeding is established.

Unlike other mammals, lactogenesis II or milk replenishment begins a few days after parturition. These days represent a critical period for breastfeeding, since this is when most of the difficulties in breastfeeding originate.

Regulation of milk synthesis, secretion and ejection.

Although it is the maternal hormonal changes that occur postpartum that trigger the surge of breast milk, it is the frequent sucking and emptying of the breast. If we talk about the production and ejection processes, several regulatory systems are involved. All of these are strongly influenced by the baby’s sucking and other stimuli on the nipple.

Prolactin

During pregnancy, in response to increased estrogen and progesterone levels, the pituitary gland produces prolactin. It stimulates the dairy production. However, during pregnancy, it remains inactive due to progesterone and placental lactogen that prevent the binding of prolactin to its receptors (competitive binding). After delivery, the levels of these two hormones decrease rapidly and the action of prolactin is no longer blocked, initiating the secretion of breast milk.

After delivery, prolactin release occurs in pulses following various stimuli, the most effective being nipple suckling. The maximum peak plasma prolactin concentration occurs approximately 20-30 minutes after suckling, so its most important effect is to produce breast milk for the next feeding. Hence the saying, “the more suction, the more production“. This effect is of particular importance when breastfeeding is being established, since after a few weeks there is no relationship between the amount of prolactin and the amount of breast milk produced.

How to interrupt the baby’s sucking?

Stop suckling before removing the baby from your breast. Do this by placing a clean finger on the side of your baby’s mouth, between his jaws. Do not remove it until you notice that it is finished. Or insert the little finger pressing the palate to avoid damaging the nipple.

Do I have to perform any special breast care during breastfeeding?

Your breast does not need any special care during pregnancy and breastfeeding. Perform daily hygiene, and it will be enough. In addition, wear practical and supportive underwear that will make you feel more comfortable.

How do I know if my baby is eating enough?

To find out if your baby is doing well with feedings, you can take into account:

• Feeding frequency: Your baby should feed between 8 and 12 times a day.
• Stool: Count diapers whose contents are the size of the circle you form when you touch the tips of your thumb and forefinger.
  • 1-2 days of life, 1-2 wet diapers, meconium variable
  • 2-6 days old, 5-8 wet diapers, at least 3 greenish bowel movements
  • 6 days to 6 weeks, 5-6 wet diapers, at least 3 mustard yellow stools
  • Over 6 weeks, 5-6 wet diapers, some babies have fewer but larger and softer stools.
• Appearance and general condition: Normal color, firm skin, active and alert.
• Weight gain and growth: This section will be assessed by your pediatrician or pediatric nurse.

Find out more information on how to know if your baby is getting enough milk by clicking here

What should I eat while breastfeeding?

Breastfeeding women do not require special diets. The best nutrition comes from a healthy and varied diet, avoiding additives and contaminants. Only in some cases, due to illness or nutritional problems, the physician may advise some supplements.

Although it has been proven that the aroma of foods passes into the milk and can change its smell and taste, there are no foods that are forbidden during breastfeeding. These flavor changes in breast milk help the baby to become familiar with different tastes, which will make it easier for him to accept complementary feeding. Only in the case of repeatedly observing that after the mother has eaten a certain food, the baby shows some kind of discomfort (vomiting, diarrhea, rashes, discomfort or refusal of milk), it may be necessary to avoid that particular food.

Can I take medication while breastfeeding?

If you need to take medication during pregnancy or after childbirth, you can consult a doctor. Remind you that most medications can be used during breastfeeding. Not all drugs pass into milk and in general, in virtually all circumstances, alternatives can be offered if the drug of choice carries some risk. You can check the compatibility of medication and breastfeeding on the page www.e-lactancia-org.

Conclusion breastfeeding guide for the first days.

Each case is unique, and you should approach these recommendations to yours. Without a doubt, the bottom line is that if it is your free and informed decision to offer your baby breastfeeding, you can. The beginnings can be a little difficult because of the doubts that this new stage generates, but little by little with this breastfeeding guide you will learn and consolidate breastfeeding. In addition, do not hesitate to rely on your midwife and breastfeeding groups who will be happy to help you in your case.

Lactogenesis II. The rise in milk prices

As we have mentioned, the onset of lactogenesis II or “milk rising” is the occurs after the abrupt postpartum drop in progesterone and placental lactogen. During this phase, the synthesis of breast milk components increases and this causes the breasts to increase in size and become hot and painful. There is no relationship between symptom intensity and subsequent breast milk production.

Clinically, the “breast milk let-down” occurs around the third day of thethird day postpartum, but up to 25% of mothers perceive the increase after 72 hours. At that time, your baby expresses about 20 cc of breast milk at each feeding.

Factors favoring lactogenesis and lactation:

• The early contact of the mother’s skin with the child’s skin.
• Initiation of breastfeeding in the first hour after delivery.
• Frequent breastfeeding.
• Good mouth-chest coupling.
• Adequate emptying of the breast.
• Early and frequent sucking in the first days.

Factors that hinder or delay lactogenesis:

• The obesity and poorly controlled diabetes and poorly controlled insulin-dependent diabetes play a role in the delayed “rise” observed in diabetic and obese mothers.
• The retention of placental debrisdue to the presence of progesterone and placental lactogen, may inhibit lactogenesis II.
• The difficult childbirth and stress are another cause and the one that has been most associated with the early abandonment of breastfeeding. In the mother, stress acts by blocking the oxytocic reflex; in the infant it may alter adaptation to the breast or cause weak sucking.

Galactopoiesis. o milk stabilization

Once abundant breast milk production has begun, the quantity depends on the efficiency and frequency of breast emptying. In addition to volume, suction may regulate, in part, the composition of the milk. Breast milk is continuously produced and stored until the next feeding inside the alveoli and in the duct system. Breastfeeding Guide.

Weaning, how to do it?

Like everything else in life, there will eventually be a time when breastfeeding comes to an end, and understanding how to do this is important. It is well known that the recommendation of the WHO and clinical guidelines is 6 months exclusively and complementary with food up to two years of age, and it is even described up to 7 years of age. There is no reason for cessation at a certain age, but obviously this decision will be all yours, and at Happymami, we will accompany you and give you the best solution for the decision you make.

Circumstances that may condition the end of breastfeeding or “weaning”.

And what are the reasons for weaning? Each case is unique and all are respectable, I feel the most important ones, by maternal decision, by the baby’s will, by illness of the mother or infant or by labor necessity. Remind you that you have at your disposal our post about the maternity leave. y parental leave.

Types of weaning

In theory, there are 4 types of weaning, depending on the cause of weaning.

• Inevitable weaning due to medical or other causes. The reality is that there are few diseases and medications that contraindicate breastfeeding. You can always consult the website e-lactancia.org for any medication to get out of doubt. Guide to breastfeeding problems
• Voluntary weaning by the child: You will see how your baby gradually decides not to breastfeed. There are occasions that may be conditioned by a new pregnancy, which can sometimes alter the taste and quantity of breast milk.
• Weaning by maternal decision: Your own decision to continue breastfeeding or not is legitimate, and you should not accept value judgments for making the decision you consider. Always inform yourself about the pros and cons and you will make the best decision for your case. On a personal note, you can’t change what people think, but you can change how it affects you, and you’re doing great.
• Forced weaning due to external causes. Social or family. Other than the mother and the child. Remind you that the decision whether or not to continue to offer breastfeeding is yours alone.
• Inadvertent weaning. Progressively space feedings apart until your baby is weaned.

Feelings may arise during weaning:

Many feelings, such as guilt and sadness, can arise during this weaning stage, and this is completely normal. Lean on your midwife, she will support you in your decision, helping you in your case so you will be able to manage it better and understand the process. You should know that on the one hand, your baby, if weaning has been your decision, may show tantrums or inconsolable crying. This is because as a nursing baby, if she is hungry she thinks of her breast, which she loves and is satisfied with, and obviously does not understand if she cannot use it. And conversely, if breastfeeding was stressing you and straining your mother-baby bond, it will be perceived as a relief for both of you.

Weaning guidelines

There are several options for weaning, and if you talk to other moms, each one used a different method and some did well and others did poorly, each case is different and you should always adapt these recommendations to your particular case. On the one hand, you should know that if you are weaning overnight, your doctor may recommend specific medication to cut off the milk. If, on the other hand, you wean progressively, the feedings will gradually be spaced out and breast milk production will decrease.

How to do progressive weaning:

There are several strategies that you can choose for weaning that are recommended by the AEPED:

• Do not offer, do not refuse. If he/she does not ask to breastfeed, do not offer breastfeeding. If you ask for it, do not refuse it.
• Spacing of shots. Distract him in other ways (in the park, playing with him, reading a story, lulling him to sleep in your arms…).
• Offer another type of food food at the times when they usually ask for breastfeeding. Anticipate your needs.
• Manage feedings with the child. Telling her “only at home”, “only 3 minutes”, “only one breast”, “only to sleep”, etc.
• We must talk to him and agree with him about weaning, explaining that “mommy does not want to continue giving teat”.
• If there is pain, periodic extractions should be performed to avoid complications such as mastitis. If weaning is well tolerated, it will not be necessary.

False weanings:

Remember, there are lactation crises and they do not mean weaning. These breastfeeding strikes are totally normal, in which your baby may lose interest in breastfeeding, for example if they are sick, because of a scare during the previous feeding or because they have been forced to breastfeed. Why is my baby crying?.

Conclusion breastfeeding, understanding its phases and physiology up to weaning

As we have seen, there are several factors that influence the formation and ejection of milk, all of which are fundamental for the correct establishment of breastfeeding.breastfeeding. Prolactin and oxytocin will be the fundamental hormones in this process, but necessary for the overall functioning of the system. From Happymamiwe remind you that it can be a difficult process at the beginning, but later it will be very easy. Trust in yourself, your baby and the health care team around you, such as your midwife, who will help you achieve your breastfeeding.

Benefits of breastfeeding

Breast milk is unique. It is a living liquid that is specially designed for the human baby and that changes, shot by shot, day by day and month by month, to meet your baby’s needs. It also provides active defenses against infection. If you are interested, you can discover more information aboutthe importance of breast milk.

Benefits for your baby

• Protects against respiratory infections, otitis, gastrointestinal and even urinary infections.
• Protects against Sudden Infant Death Syndrome.
• Breastfeeding provides physical contact for babies which helps them feel more secure, warm and comforted.
• Breastfed children have better dental development with fewer orthodontic and caries problems.
• It boosts intellectual development because breast milk has specific components that are essential for brain development.
• Breast milk is better digested and has long-term positive effects on the child’s health, reducing the risk of allergies, diabetes, celiac disease, inflammatory bowel disease, obesity, hypertension or high cholesterol.
• It appears to have some protection against lymphomas and some other cancers.
• Human milk is the food of choice for all infants, including premature infants, twins and sick infants.

Benefits for the mother

• It prevents post-partum hemorrhages, since the baby’s suction helps the uterus to recover its initial size and reduces the possibility of anemia.
• It favors the recovery of pre-pregnancy weight.
• It produces emotional well-being and provides a unique mother-child bonding opportunity.
• Reduces the risk of breast and ovarian cancer.
• Improves the calcium content of the bones at menopause.

Benefits to society and the environment

• It is free of charge. Savings on artificial formulas
• By reducing infections and their severity, it reduces medical expenses and the work and family problems that such illnesses pose for parents and society. It reduces the use of human and material healthcare resources and if children get sick, they recover sooner.
• Breast milk is a natural resource that does not pollute and protects the environment since it does not produce waste, nor does it need packaging or special treatments that require energy expenditure in its production or CO2 emissions.

Are there any contraindications to breastfeeding?

There are very few situations in which breastfeeding will becontraindicated, but they are minimal. This means that almost all women will be able to feed their babies with their breast milk, if they choose to do so. Contraindications are:

• Mother with HIV infection: in our setting this is considered a true contraindication.
• Galactosemia: it is a disease that very few babies are born with that does not allow them to digest the lactose in milk, so it contraindicates breastfeeding.

How do I prepare my breasts for breastfeeding during pregnancy?

Nothing needs to be done to prepare the breast for breastfeeding during pregnancy. What is advisable, however, is to be well informed on the subject. You can attend maternity preparation classes taught by midwives. Seek help, support, advice and information from professionals who are experts in breastfeeding (nurses, midwives, gynecologists, pediatricians, family doctors…). Ask anything you need or are concerned about. Talk to your partner, share information, so you can decide together. Talk to other family members to organize a small support network at home so that you can spend time enjoying breastfeeding and getting to know you and your baby.

Initiation of breastfeeding after childbirth or cesarean section

It is very important to initiate breastfeeding after birth as soon as possible, regardless of how the baby was born. It is recommended, as long as the condition of the child and the mother allows it, that the mother and newborn remain in skin-to-skin contact after delivery, at least for the first two hours, or until the baby’s first breastfeeding.

Your baby has innate abilities that, if we let him or her, will come into play after birth. Lying face down on your abdomen, thanks to its senses (especially touch and smell) and its reflexes, it is able to reach your chest on its own. By crawling up to it, he will smell it, touch it with his hands and then with his mouth and finally, he will be able to latch on to the breast spontaneously, with his mouth wide open, covering the nipple and a large part of the areola. Find out more about the stages of breastfeeding .

Colostrum, a superfood

In this first feeding, you will discover colostrum. It is the first milk that the mammary gland produces during the last months of pregnancy and the first days after birth and provides your baby with all the nourishment he or she needs during those first days. It is very dense and yellow in color and the mother does not feel her breasts full. This liquid is rich in calories, proteins, antibodies and beta-carotene, while it is lower in fat and lactose.

Gradually the milk will become whiter and lighter and the quantity (mature milk) will increase according to your baby’s needs. Clinically, the “breast milk surge“occurs around the third day postpartum, but up to 25% of mothers notice the surge after 72 hours. At that time, your baby expresses about 20 cc of breast milk at each feeding. Keep in mind that if your baby is sucking on his hands, it is not a consequence of hunger, it is a reflex of a normal and healthy child.

Factors favoring the initiation of breastfeeding and milk let-down.

• The early contact of the mother’s skin with the child’s skin.
• Initiation of breastfeeding in the first hour after delivery.
• Frequent breastfeeding.
• Good mouth-chest coupling.
• Adequate emptying of the breast.
• Early and frequent sucking in the first days.

How does your baby react in the first days of breastfeeding?

Newborns generally have a phase of about two hours after birth in which they are very awake and active. During this period of time, most of them manage to spontaneously perform their first breast feeding during early skin-to-skin contact. They then go into a sleep phase (physiological lethargy, “recovery” from labor) that can last between 8 and 12 hours. During this phase, if kept in skin-to-skin contact, the baby will return to the breast when needed.

From the first day of life it is usual for your baby to suckle frequently, about 8-12 times a day or more, and for feedings to be irregular and more frequent at night. However, some infants remain very sleepy, ask for little and suckle less than they need. In these cases it is advisable to place them in skin-to-skin contact, which helps them respond to the mother’s scent and suckle spontaneously. Sometimes it may be necessary to help them wake up by undressing and re-dressing them, giving them a rotary massage on the soles of the feet or a gentle caress on the back from bottom to top. We leave you a link in case you need more information about waking or not waking your baby.

Do I give her both breasts?

In this first stage, both breasts must be given to the child at each feedingIt is necessary to empty one breast completely before offering the second breast to obtain the milk at the end of the feeding, which has a higher fat content, causing the baby to grow and put on weight. It is much more important to let the child finish taking the first side before offering the second side, even if this means that the child refuses the second side during that feeding. You should not limit the time in the shots. It is best to allow the child to suckle until he shows signs of satisfaction, such as letting go on his own or having his arms and hands relaxed. If it takes too long, the little finger should be pressed against the palate to avoid damaging the nipple. It is not necessary to wash the breast before or after each feeding, nor should soap be used on the nipples as it dries them out.

Number of outlets

It is important to offer breastfeeding on demand, whenever the baby requires it and for as long as he/she wants it. That way we will be sure that he will receive everything he needs, sometimes it will be food, sometimes it will be warmth, affection or protection.Each child is different and needs his or her time to feed, and so do we (not all of us eat at the same speed).

The first few days they need to suckle between 8 and 14 times a day, for two main reasons: the early establishment of breastfeeding and the reduced risk of hypoglycemia in the infant. Strict feeding patterns should not be used, as they inhibit natural mother-infant interactions, interfere with natural hunger cycles and produce anxiety in the mother.

The earliest signs of hunger are sucking, nodding, sticking out the tongue, putting the hands to the mouth… This is the ideal moment to put him to suckle. It is not good to wait until he cries to put him to the breast as crying is a late sign of hunger and it will not be easy for him to latch on to the breast until he has calmed down. Here is a post about crying and its and its meaning according to the type.

Breastfeeding techniques

Most breastfeeding problems are due to problems in breastfeeding technique, either due to improper positioning, improper latching or a combination of both.

For a good latch-on it is important that the baby’s whole body is facing the mother, and that when she opens her mouth she inserts a large part of the areola, especially at the bottom (where her chin is) so that when she actively moves her tongue she does not injure your nipple.

The signs that will indicate a good grip are:

• Your baby’s chin touches your breast
• Your baby’s mouth is wide open
• The lower lip is outward (everted).
• Cheeks are round or flattened (not sunken) when sucking.
• More areola is seen above the mouth than below.

Positions that will help you in breastfeeding

Regardless of the position you adopt with your baby for feedings. There are some basic tips to keep in mind that will make it easier to hold your baby. Because there is no single suitable position for breastfeeding, what is important is that the mother is comfortable, that the latch is adequate, and that the baby is facing and close to the mother’s body.

• As a mom, you should feel comfortable with the posture. For this purpose, the use of pillows or cushions may be useful.
• Your baby’s body should be in close contact with yours. When you are lying down, your baby’s weight will rest on your body. This will make it easier to maintain the close contact that facilitates the development of your baby’s reflexes.
• Your baby’s head should be in front of the chest, well aligned with the body. (Your neck should not be bent and your head should not be turned.) It is preferable to move the baby than to move the mother’s breast.
• Your baby’s chin should be resting on the breast with the nipple above the upper lip, at the level of the nose. Thus, when your baby starts the search reflex and latches on to your breast, the neck will be slightly hyperextended, facilitating coordination, sucking, swallowing and breathing.
• Remind you that it is preferable to favor the spontaneous anchoring. When your baby’s mouth is wide open, bring your baby close to your breast and let your baby latch on. If your baby does not succeed, directed grasping may be helpful.

Positions favoring the initiation of breastfeeding

Here are some postures that can help you to initiate a happy and long-lasting breastfeeding. Find out more about the breastfeeding positions

• Cradle position:
  • As a mother, hold your baby’s neck and head with the same arm and hand as the breast you offer
• Reclining position:
  • Lie on your side so that your chest rests on the mattress.
  • This posture is especially useful to promote maternal rest when there is pain in the perineum (instrumental delivery, hemorrhoids…).
• Rugby position:
  • Support your baby’s body and head with the forearm and hand of the same breast you are going to give. This leaves you with one hand free to make a targeted grip if needed.
  • This position is especially useful in cesarean sections, mothers with very large or morbidly obese breasts or simultaneous breastfeeding in twins.
• Biological breeding position:
  • Position yourself semi-recumbent (between 15º-65º) and comfortable.
  • This posture is especially useful when there are difficulties with grasping, as it helps the newborn to activate its instinctive reflexes. You will see how your baby nods and moves around looking for the mother’s breast.

How to interrupt the baby’s sucking?

Stop suckling before removing the baby from your breast. Do this by placing a clean finger on the side of your baby’s mouth, between his jaws. Do not remove it until you notice that it is finished. Or insert the little finger pressing the palate to avoid damaging the nipple.

Do I have to perform any special breast care during breastfeeding?

Your breast does not need any special care during pregnancy and breastfeeding. Perform daily hygiene, and it will be enough. In addition, wear practical and supportive underwear that will make you feel more comfortable.

How do I know if my baby is eating enough?

To find out if your baby is doing well with feedings, you can take into account:

• Feeding frequency: Your baby should feed between 8 and 12 times a day.
• Stool: Count diapers whose contents are the size of the circle you form when you touch the tips of your thumb and forefinger.
  • 1-2 days of life, 1-2 wet diapers, meconium variable
  • 2-6 days old, 5-8 wet diapers, at least 3 greenish bowel movements
  • 6 days to 6 weeks, 5-6 wet diapers, at least 3 mustard yellow stools
  • Over 6 weeks, 5-6 wet diapers, some babies have fewer but larger and softer stools.
• Appearance and general condition: Normal color, firm skin, active and alert.
• Weight gain and growth: This section will be assessed by your pediatrician or pediatric nurse.

Find out more information on how to know if your baby is getting enough milk by clicking here

What should I eat while breastfeeding?

Breastfeeding women do not require special diets. The best nutrition comes from a healthy and varied diet, avoiding additives and contaminants. Only in some cases, due to illness or nutritional problems, the physician may advise some supplements.

Although it has been proven that the aroma of foods passes into the milk and can change its smell and taste, there are no foods that are forbidden during breastfeeding. These flavor changes in breast milk help the baby to become familiar with different tastes, which will make it easier for him to accept complementary feeding. Only in the case of repeatedly observing that after the mother has eaten a certain food, the baby shows some kind of discomfort (vomiting, diarrhea, rashes, discomfort or refusal of milk), it may be necessary to avoid that particular food.

Can I take medication while breastfeeding?

If you need to take medication during pregnancy or after childbirth, you can consult a doctor. Remind you that most medications can be used during breastfeeding. Not all drugs pass into milk and in general, in virtually all circumstances, alternatives can be offered if the drug of choice carries some risk. You can check the compatibility of medication and breastfeeding on the page www.e-lactancia-org.

Conclusion breastfeeding guide for the first days.

Each case is unique, and you should approach these recommendations to yours. Without a doubt, the bottom line is that if it is your free and informed decision to offer your baby breastfeeding, you can. The beginnings can be a little difficult because of the doubts that this new stage generates, but little by little with this breastfeeding guide you will learn and consolidate breastfeeding. In addition, do not hesitate to rely on your midwife and breastfeeding groups who will be happy to help you in your case.

Oxytocin

Oxytocin is released in response to nipple stimulation, by suction or manipulation, and in response to pleasant physical, visual, sound or emotional stimuli, generally related to the baby.

This hormone is responsible for the contraction of the cells that envelop the alveoli producing the ejectionón dairy. Facilitating the movement of breast milk through the ducts to the nipple.

This process occurs continuously during suction and refills the ducts as they become empty. It is important to note that stress, anxiety and other sudden unpleasant physical stimuli can block the oxytocin ejection reflex.

Other regulatory factors

The retention of breast milk within the alveoli increases intra-alveolar pressure, affecting the function of the alveolar cells, and can also compromise vascularization and hinder hormonal influx, slowing milk production when the maternal breast is full or there is no effective drainage of the gland.

Your baby overrides these inhibitory effects by properly emptying your breast. In this way, breast milk production is adapted to your baby‘s needs, from one feeding to the next and independently for each breast.

Lactogenesis II. The rise in milk prices

As we have mentioned, the onset of lactogenesis II or “milk rising” is the occurs after the abrupt postpartum drop in progesterone and placental lactogen. During this phase, the synthesis of breast milk components increases and this causes the breasts to increase in size and become hot and painful. There is no relationship between symptom intensity and subsequent breast milk production.

Clinically, the “breast milk let-down” occurs around the third day of thethird day postpartum, but up to 25% of mothers perceive the increase after 72 hours. At that time, your baby expresses about 20 cc of breast milk at each feeding.

Factors favoring lactogenesis and lactation:

• The early contact of the mother’s skin with the child’s skin.
• Initiation of breastfeeding in the first hour after delivery.
• Frequent breastfeeding.
• Good mouth-chest coupling.
• Adequate emptying of the breast.
• Early and frequent sucking in the first days.

Factors that hinder or delay lactogenesis:

• The obesity and poorly controlled diabetes and poorly controlled insulin-dependent diabetes play a role in the delayed “rise” observed in diabetic and obese mothers.
• The retention of placental debrisdue to the presence of progesterone and placental lactogen, may inhibit lactogenesis II.
• The difficult childbirth and stress are another cause and the one that has been most associated with the early abandonment of breastfeeding. In the mother, stress acts by blocking the oxytocic reflex; in the infant it may alter adaptation to the breast or cause weak sucking.

Galactopoiesis. o milk stabilization

Once abundant breast milk production has begun, the quantity depends on the efficiency and frequency of breast emptying. In addition to volume, suction may regulate, in part, the composition of the milk. Breast milk is continuously produced and stored until the next feeding inside the alveoli and in the duct system. Breastfeeding Guide.

Weaning, how to do it?

Like everything else in life, there will eventually be a time when breastfeeding comes to an end, and understanding how to do this is important. It is well known that the recommendation of the WHO and clinical guidelines is 6 months exclusively and complementary with food up to two years of age, and it is even described up to 7 years of age. There is no reason for cessation at a certain age, but obviously this decision will be all yours, and at Happymami, we will accompany you and give you the best solution for the decision you make.

Circumstances that may condition the end of breastfeeding or “weaning”.

And what are the reasons for weaning? Each case is unique and all are respectable, I feel the most important ones, by maternal decision, by the baby’s will, by illness of the mother or infant or by labor necessity. Remind you that you have at your disposal our post about the maternity leave. y parental leave.

Types of weaning

In theory, there are 4 types of weaning, depending on the cause of weaning.

• Inevitable weaning due to medical or other causes. The reality is that there are few diseases and medications that contraindicate breastfeeding. You can always consult the website e-lactancia.org for any medication to get out of doubt. Guide to breastfeeding problems
• Voluntary weaning by the child: You will see how your baby gradually decides not to breastfeed. There are occasions that may be conditioned by a new pregnancy, which can sometimes alter the taste and quantity of breast milk.
• Weaning by maternal decision: Your own decision to continue breastfeeding or not is legitimate, and you should not accept value judgments for making the decision you consider. Always inform yourself about the pros and cons and you will make the best decision for your case. On a personal note, you can’t change what people think, but you can change how it affects you, and you’re doing great.
• Forced weaning due to external causes. Social or family. Other than the mother and the child. Remind you that the decision whether or not to continue to offer breastfeeding is yours alone.
• Inadvertent weaning. Progressively space feedings apart until your baby is weaned.

Feelings may arise during weaning:

Many feelings, such as guilt and sadness, can arise during this weaning stage, and this is completely normal. Lean on your midwife, she will support you in your decision, helping you in your case so you will be able to manage it better and understand the process. You should know that on the one hand, your baby, if weaning has been your decision, may show tantrums or inconsolable crying. This is because as a nursing baby, if she is hungry she thinks of her breast, which she loves and is satisfied with, and obviously does not understand if she cannot use it. And conversely, if breastfeeding was stressing you and straining your mother-baby bond, it will be perceived as a relief for both of you.

Weaning guidelines

There are several options for weaning, and if you talk to other moms, each one used a different method and some did well and others did poorly, each case is different and you should always adapt these recommendations to your particular case. On the one hand, you should know that if you are weaning overnight, your doctor may recommend specific medication to cut off the milk. If, on the other hand, you wean progressively, the feedings will gradually be spaced out and breast milk production will decrease.

How to do progressive weaning:

There are several strategies that you can choose for weaning that are recommended by the AEPED:

• Do not offer, do not refuse. If he/she does not ask to breastfeed, do not offer breastfeeding. If you ask for it, do not refuse it.
• Spacing of shots. Distract him in other ways (in the park, playing with him, reading a story, lulling him to sleep in your arms…).
• Offer another type of food food at the times when they usually ask for breastfeeding. Anticipate your needs.
• Manage feedings with the child. Telling her “only at home”, “only 3 minutes”, “only one breast”, “only to sleep”, etc.
• We must talk to him and agree with him about weaning, explaining that “mommy does not want to continue giving teat”.
• If there is pain, periodic extractions should be performed to avoid complications such as mastitis. If weaning is well tolerated, it will not be necessary.

False weanings:

Remember, there are lactation crises and they do not mean weaning. These breastfeeding strikes are totally normal, in which your baby may lose interest in breastfeeding, for example if they are sick, because of a scare during the previous feeding or because they have been forced to breastfeed. Why is my baby crying?.

Conclusion breastfeeding, understanding its phases and physiology up to weaning

As we have seen, there are several factors that influence the formation and ejection of milk, all of which are fundamental for the correct establishment of breastfeeding.breastfeeding. Prolactin and oxytocin will be the fundamental hormones in this process, but necessary for the overall functioning of the system. From Happymamiwe remind you that it can be a difficult process at the beginning, but later it will be very easy. Trust in yourself, your baby and the health care team around you, such as your midwife, who will help you achieve your breastfeeding.

Benefits of breastfeeding

Breast milk is unique. It is a living liquid that is specially designed for the human baby and that changes, shot by shot, day by day and month by month, to meet your baby’s needs. It also provides active defenses against infection. If you are interested, you can discover more information aboutthe importance of breast milk.

Benefits for your baby

• Protects against respiratory infections, otitis, gastrointestinal and even urinary infections.
• Protects against Sudden Infant Death Syndrome.
• Breastfeeding provides physical contact for babies which helps them feel more secure, warm and comforted.
• Breastfed children have better dental development with fewer orthodontic and caries problems.
• It boosts intellectual development because breast milk has specific components that are essential for brain development.
• Breast milk is better digested and has long-term positive effects on the child’s health, reducing the risk of allergies, diabetes, celiac disease, inflammatory bowel disease, obesity, hypertension or high cholesterol.
• It appears to have some protection against lymphomas and some other cancers.
• Human milk is the food of choice for all infants, including premature infants, twins and sick infants.

Benefits for the mother

• It prevents post-partum hemorrhages, since the baby’s suction helps the uterus to recover its initial size and reduces the possibility of anemia.
• It favors the recovery of pre-pregnancy weight.
• It produces emotional well-being and provides a unique mother-child bonding opportunity.
• Reduces the risk of breast and ovarian cancer.
• Improves the calcium content of the bones at menopause.

Benefits to society and the environment

• It is free of charge. Savings on artificial formulas
• By reducing infections and their severity, it reduces medical expenses and the work and family problems that such illnesses pose for parents and society. It reduces the use of human and material healthcare resources and if children get sick, they recover sooner.
• Breast milk is a natural resource that does not pollute and protects the environment since it does not produce waste, nor does it need packaging or special treatments that require energy expenditure in its production or CO2 emissions.

Are there any contraindications to breastfeeding?

There are very few situations in which breastfeeding will becontraindicated, but they are minimal. This means that almost all women will be able to feed their babies with their breast milk, if they choose to do so. Contraindications are:

• Mother with HIV infection: in our setting this is considered a true contraindication.
• Galactosemia: it is a disease that very few babies are born with that does not allow them to digest the lactose in milk, so it contraindicates breastfeeding.

How do I prepare my breasts for breastfeeding during pregnancy?

Nothing needs to be done to prepare the breast for breastfeeding during pregnancy. What is advisable, however, is to be well informed on the subject. You can attend maternity preparation classes taught by midwives. Seek help, support, advice and information from professionals who are experts in breastfeeding (nurses, midwives, gynecologists, pediatricians, family doctors…). Ask anything you need or are concerned about. Talk to your partner, share information, so you can decide together. Talk to other family members to organize a small support network at home so that you can spend time enjoying breastfeeding and getting to know you and your baby.

Initiation of breastfeeding after childbirth or cesarean section

It is very important to initiate breastfeeding after birth as soon as possible, regardless of how the baby was born. It is recommended, as long as the condition of the child and the mother allows it, that the mother and newborn remain in skin-to-skin contact after delivery, at least for the first two hours, or until the baby’s first breastfeeding.

Your baby has innate abilities that, if we let him or her, will come into play after birth. Lying face down on your abdomen, thanks to its senses (especially touch and smell) and its reflexes, it is able to reach your chest on its own. By crawling up to it, he will smell it, touch it with his hands and then with his mouth and finally, he will be able to latch on to the breast spontaneously, with his mouth wide open, covering the nipple and a large part of the areola. Find out more about the stages of breastfeeding .

Colostrum, a superfood

In this first feeding, you will discover colostrum. It is the first milk that the mammary gland produces during the last months of pregnancy and the first days after birth and provides your baby with all the nourishment he or she needs during those first days. It is very dense and yellow in color and the mother does not feel her breasts full. This liquid is rich in calories, proteins, antibodies and beta-carotene, while it is lower in fat and lactose.

Gradually the milk will become whiter and lighter and the quantity (mature milk) will increase according to your baby’s needs. Clinically, the “breast milk surge“occurs around the third day postpartum, but up to 25% of mothers notice the surge after 72 hours. At that time, your baby expresses about 20 cc of breast milk at each feeding. Keep in mind that if your baby is sucking on his hands, it is not a consequence of hunger, it is a reflex of a normal and healthy child.

Factors favoring the initiation of breastfeeding and milk let-down.

• The early contact of the mother’s skin with the child’s skin.
• Initiation of breastfeeding in the first hour after delivery.
• Frequent breastfeeding.
• Good mouth-chest coupling.
• Adequate emptying of the breast.
• Early and frequent sucking in the first days.

How does your baby react in the first days of breastfeeding?

Newborns generally have a phase of about two hours after birth in which they are very awake and active. During this period of time, most of them manage to spontaneously perform their first breast feeding during early skin-to-skin contact. They then go into a sleep phase (physiological lethargy, “recovery” from labor) that can last between 8 and 12 hours. During this phase, if kept in skin-to-skin contact, the baby will return to the breast when needed.

From the first day of life it is usual for your baby to suckle frequently, about 8-12 times a day or more, and for feedings to be irregular and more frequent at night. However, some infants remain very sleepy, ask for little and suckle less than they need. In these cases it is advisable to place them in skin-to-skin contact, which helps them respond to the mother’s scent and suckle spontaneously. Sometimes it may be necessary to help them wake up by undressing and re-dressing them, giving them a rotary massage on the soles of the feet or a gentle caress on the back from bottom to top. We leave you a link in case you need more information about waking or not waking your baby.

Do I give her both breasts?

In this first stage, both breasts must be given to the child at each feedingIt is necessary to empty one breast completely before offering the second breast to obtain the milk at the end of the feeding, which has a higher fat content, causing the baby to grow and put on weight. It is much more important to let the child finish taking the first side before offering the second side, even if this means that the child refuses the second side during that feeding. You should not limit the time in the shots. It is best to allow the child to suckle until he shows signs of satisfaction, such as letting go on his own or having his arms and hands relaxed. If it takes too long, the little finger should be pressed against the palate to avoid damaging the nipple. It is not necessary to wash the breast before or after each feeding, nor should soap be used on the nipples as it dries them out.

Number of outlets

It is important to offer breastfeeding on demand, whenever the baby requires it and for as long as he/she wants it. That way we will be sure that he will receive everything he needs, sometimes it will be food, sometimes it will be warmth, affection or protection.Each child is different and needs his or her time to feed, and so do we (not all of us eat at the same speed).

The first few days they need to suckle between 8 and 14 times a day, for two main reasons: the early establishment of breastfeeding and the reduced risk of hypoglycemia in the infant. Strict feeding patterns should not be used, as they inhibit natural mother-infant interactions, interfere with natural hunger cycles and produce anxiety in the mother.

The earliest signs of hunger are sucking, nodding, sticking out the tongue, putting the hands to the mouth… This is the ideal moment to put him to suckle. It is not good to wait until he cries to put him to the breast as crying is a late sign of hunger and it will not be easy for him to latch on to the breast until he has calmed down. Here is a post about crying and its and its meaning according to the type.

Breastfeeding techniques

Most breastfeeding problems are due to problems in breastfeeding technique, either due to improper positioning, improper latching or a combination of both.

For a good latch-on it is important that the baby’s whole body is facing the mother, and that when she opens her mouth she inserts a large part of the areola, especially at the bottom (where her chin is) so that when she actively moves her tongue she does not injure your nipple.

The signs that will indicate a good grip are:

• Your baby’s chin touches your breast
• Your baby’s mouth is wide open
• The lower lip is outward (everted).
• Cheeks are round or flattened (not sunken) when sucking.
• More areola is seen above the mouth than below.

Positions that will help you in breastfeeding

Regardless of the position you adopt with your baby for feedings. There are some basic tips to keep in mind that will make it easier to hold your baby. Because there is no single suitable position for breastfeeding, what is important is that the mother is comfortable, that the latch is adequate, and that the baby is facing and close to the mother’s body.

• As a mom, you should feel comfortable with the posture. For this purpose, the use of pillows or cushions may be useful.
• Your baby’s body should be in close contact with yours. When you are lying down, your baby’s weight will rest on your body. This will make it easier to maintain the close contact that facilitates the development of your baby’s reflexes.
• Your baby’s head should be in front of the chest, well aligned with the body. (Your neck should not be bent and your head should not be turned.) It is preferable to move the baby than to move the mother’s breast.
• Your baby’s chin should be resting on the breast with the nipple above the upper lip, at the level of the nose. Thus, when your baby starts the search reflex and latches on to your breast, the neck will be slightly hyperextended, facilitating coordination, sucking, swallowing and breathing.
• Remind you that it is preferable to favor the spontaneous anchoring. When your baby’s mouth is wide open, bring your baby close to your breast and let your baby latch on. If your baby does not succeed, directed grasping may be helpful.

Positions favoring the initiation of breastfeeding

Here are some postures that can help you to initiate a happy and long-lasting breastfeeding. Find out more about the breastfeeding positions

• Cradle position:
  • As a mother, hold your baby’s neck and head with the same arm and hand as the breast you offer
• Reclining position:
  • Lie on your side so that your chest rests on the mattress.
  • This posture is especially useful to promote maternal rest when there is pain in the perineum (instrumental delivery, hemorrhoids…).
• Rugby position:
  • Support your baby’s body and head with the forearm and hand of the same breast you are going to give. This leaves you with one hand free to make a targeted grip if needed.
  • This position is especially useful in cesarean sections, mothers with very large or morbidly obese breasts or simultaneous breastfeeding in twins.
• Biological breeding position:
  • Position yourself semi-recumbent (between 15º-65º) and comfortable.
  • This posture is especially useful when there are difficulties with grasping, as it helps the newborn to activate its instinctive reflexes. You will see how your baby nods and moves around looking for the mother’s breast.

How to interrupt the baby’s sucking?

Stop suckling before removing the baby from your breast. Do this by placing a clean finger on the side of your baby’s mouth, between his jaws. Do not remove it until you notice that it is finished. Or insert the little finger pressing the palate to avoid damaging the nipple.

Do I have to perform any special breast care during breastfeeding?

Your breast does not need any special care during pregnancy and breastfeeding. Perform daily hygiene, and it will be enough. In addition, wear practical and supportive underwear that will make you feel more comfortable.

How do I know if my baby is eating enough?

To find out if your baby is doing well with feedings, you can take into account:

• Feeding frequency: Your baby should feed between 8 and 12 times a day.
• Stool: Count diapers whose contents are the size of the circle you form when you touch the tips of your thumb and forefinger.
  • 1-2 days of life, 1-2 wet diapers, meconium variable
  • 2-6 days old, 5-8 wet diapers, at least 3 greenish bowel movements
  • 6 days to 6 weeks, 5-6 wet diapers, at least 3 mustard yellow stools
  • Over 6 weeks, 5-6 wet diapers, some babies have fewer but larger and softer stools.
• Appearance and general condition: Normal color, firm skin, active and alert.
• Weight gain and growth: This section will be assessed by your pediatrician or pediatric nurse.

Find out more information on how to know if your baby is getting enough milk by clicking here

What should I eat while breastfeeding?

Breastfeeding women do not require special diets. The best nutrition comes from a healthy and varied diet, avoiding additives and contaminants. Only in some cases, due to illness or nutritional problems, the physician may advise some supplements.

Although it has been proven that the aroma of foods passes into the milk and can change its smell and taste, there are no foods that are forbidden during breastfeeding. These flavor changes in breast milk help the baby to become familiar with different tastes, which will make it easier for him to accept complementary feeding. Only in the case of repeatedly observing that after the mother has eaten a certain food, the baby shows some kind of discomfort (vomiting, diarrhea, rashes, discomfort or refusal of milk), it may be necessary to avoid that particular food.

Can I take medication while breastfeeding?

If you need to take medication during pregnancy or after childbirth, you can consult a doctor. Remind you that most medications can be used during breastfeeding. Not all drugs pass into milk and in general, in virtually all circumstances, alternatives can be offered if the drug of choice carries some risk. You can check the compatibility of medication and breastfeeding on the page www.e-lactancia-org.

Conclusion breastfeeding guide for the first days.

Each case is unique, and you should approach these recommendations to yours. Without a doubt, the bottom line is that if it is your free and informed decision to offer your baby breastfeeding, you can. The beginnings can be a little difficult because of the doubts that this new stage generates, but little by little with this breastfeeding guide you will learn and consolidate breastfeeding. In addition, do not hesitate to rely on your midwife and breastfeeding groups who will be happy to help you in your case.