Breastfeeding

v Preparing for motherhood + the first moments of motherhood and

skin to skin care
A mother’s milk is the perfect nutrition a child could have. It is designed to
provide the infant with the nutrients he/she needs for a healthy development.
Breast milk adjusts to the child’s changing needs as he/she grows and
protects him/her from infections and diseases. It is also easy to get and is
available whenever the child needs it.
Breastfeeding also helps create a strong bond between mother and her baby
and helps the baby feel love and warmth.

v Breastfeeding during the first hours + signs of hunger:

It is very important to breastfeed a newborn at least 8 to 12 times within a 24
hour-period during the first week of the baby’s life. The infant should be fed
whenever he/she shows signs of hunger. These signs may include:
- Making noises or yelling
- Crying
- Sucking on his/her fist or finger
- Placing hands in mouth
- Moving the arms or legs
- Closing the fists tight
- Moving the head when his/her cheek or mouth is touched

v The correct positions and various positions for breastfeeding:

Correct positions for breastfeeding:
- Sit-up straight to support the back and the legs.
- Wrap your arms around the baby’s back and move him/her closer to
you.
- Place your hand under the baby’s neck and shoulders instead of the
head to allow the child to adjust his/her position when breastfeeding.
You can also use various methods to support the baby’s position.
- Move the baby closer to your breasts and don’t bend your back.
- Check that the nipple touches the baby’s upper lip.
 - Caress the child’s lips with the nipple and you will notice that the child
will respond by opening his/her mouth and turning the tongue
downwards.
- Make sure the baby’s lips are firmly closed around the nipple and part
of the breast.
- It is best to alternate between breasts when feeding. If a mother
breastfeeds using one breast the first time, she can use the other the
next time, and so on. Make sure to clean the nipple with a wet cloth
before breastfeeding.

v Low milk supply:

Almost all women are physically capable of breastfeeding. Start breastfeeding
early on after childbirth and continue doing so. The more milk the baby feeds
on, the more milk the breast produces. You may experience a low milk supply
for several reasons:
- If the baby is placed in an incorrect position and is not latching to the
breast or is not feeding correctly.
- If the baby is not regularly feeding in enough quantities or is not being
breastfed enough during the night.
- If the baby is not feeding for long enough each time.
- Adding formula to the baby’s diet.
- Using a bottle to feed the baby or a pacifier to keep him/she quiet,
especially during the first weeks.
- Feeling psychological pressure, pain or fatigue.
- Losing a large amount of blood during childbirth.
- Having had surgery to the breast, including some breast reduction
operations.
- Some medical cases such as: Thyroid issues, infections, polycystic ovary
syndrome.
- Some medicines: Combination birth control pills, antihistamines, and
some types of herbal tee.
- Breast engorgement.
 - Pregnancy.
- Using alcohol or tobacco (smoking) products.
v Breast engorgement the third day after childbirth.
When the breast is completely filled with milk, it becomes engorged. In this
case, the breast feels painful and lumpy. You can overcome this problem by
watching out for signs of hunger and feeding the baby eight times or more
during the day, morning and night.
The following table offers some useful steps you can take to handle this
situation:
After breastfeeding During breastfeeding Before breastfeeding
- Pump the excessive - Massage your breast to - Place a warm damp
milk or squeeze it help increase the flow of towel on the breast for
out with your hands milk. several minutes before
between feedings to - If the baby is finding it breastfeeding or shower
get relief. Be careful hard to latch to the breast, in warm water.
not to pump all the it is recommended to
milk because this pump or squeeze out some - Place ice cubes inside a
may lead to the milk to soften the breast piece of cloth and tie it
production of large and help the baby latch on around the breast. Leave
quantities. correctly and start feeding. it there for 10 minutes
- Place cold - Apply counter pressure to each time and repeat as
compresses (you can soften the areola around much as needed to
put ice in a plastic the nipple. Using your reduce the swelling in
bag) on the breast fingers, press gently on the the milk ducts and help
for 5 to 10 minutes. base of the nipple then the milk flow.
push inwards towards the
breast. Repeat until you
feel that the tissues have
softened.
- Change the baby’s
breastfeeding position to
help the milk flow to all
parts of the breast.
v Pain in the nipple while breastfeeding:
Breastfeeding is a natural way to feed a baby and shouldn’t hurt.
If a mother is experiencing pain in the breasts or the nipples, this is usually
due to the baby’s incorrect feeding position. Ask for help from your doctor to
identify the problem.

v Changes in the breast’s skin color or temperature (breast

inflammation):
- Constant fatigue
- Fever and shivers
- Red and warm lumps in the breast
This is often caused by an inflammation in the breast that won’t harm the
baby when breastfeeding from the affected breast and shouldn’t stop the
feedings. If you feel uncomfortable during breastfeeding, you should consult
with a doctor as you may need to take antibiotics to stop the infection.

v Swelling in the breast area (blocked milk ducts):

If you notice some lumpy areas in the breast, accompanied by redness and
swelling, you may be experiencing blocked milk ducts. This is a common
event and has several causes:
- The blockage may be due to irregular breastfeeding with large amounts of
milk in the breast.
- This may be due to pressure from a bra, tight clothes, or the baby carrier
strap.
To remedy the situation, you can place warm compresses on your breast 15 to
20 minutes before breastfeeding. Massage the breast gently moving inward
toward the nipple. If the ducts remain blocked and breastfeeding remains
uncomfortable while the baby refuses to latch, ask your doctor for help so the
blockage doesn’t turn into an infection.
v Sore and cracked nipples:
If the breast is engorged:
- Empty milk from the breast by breastfeeding several times or pumping milk
(using a pump).
- Place warm compresses on the engorged breast.
To prevent cracks in the nipple:
Use moisturizing creams after consulting with the doctor.

v Adding food at the end of the sixth month

Breastfeeding a child past six months has many benefits as it boosts the
baby’s immunity and provides the necessary nutrients for development.
Some evidence points to it helping infants digest solid food. Breastfeeding
also provides the balanced nutrients a baby needs. The World Health
Organization recommends breastfeeding for up to two years or more.

At the beginning
- Give the child small quantities of food: one to two spoons maximum (5-10
ml). An infant’s stomach is small and only requires small quantities of
food at first.
- Start with one type of food and wait two days to see if the baby exhibits
any allergic reactions to it.
The infant’s development is the true sign of whether or not he/she is getting
enough food.

v Weaning:
Weaning a child is when a mother stops breastfeeding her child and starts
introducing foods to his/her diet. This is a natural process that all children
have to go through and may be a difficult stage for both mother and baby.
v Effects of coffee and tea:
Caffeine passes from the mother to her child in small quantities through breast
milk. It doesn’t usually affect the child when the mother is only consuming
small to moderate quantities (2 to 3 cups of coffee). However, when the mother
is consuming more than that, around 10 cups of coffee or more a day, signs of
sleeplessness, irritability and disinterest can be seen in the baby.

v Effects of fasting:
Islam allows breastfeeding mothers to break their fast during Ramadan to
preserve their health and that of their children. Fasting during Ramadan
depends on several factors, including the child’s are and his/her need for milk.
You should consult with your doctor or breastfeeding nurse to check whether
or not you can fast. Studies have found that fasting does not affect a baby’s
health.
No significant difference was found between the health of a fasting mother and
that of a mother who breastfeeds outside fasting times. A mother’s body
naturally adjusts to the fast and the produced milk quantities are not affected.
However, some mothers may experience dryness while they fast. Symptoms
include:
- Constant thirst
- Changes in the color of urine
- Dizziness
- Fatigue
- Dry mouth and eyes
- Severe headache
If you experience some of these symptoms, break your fast immediately.
General guidelines for breastfeeding mothers during Ramadan:
- Get enough rest during the day.
- Make sure to eat varied and healthy foods over multiple periods.
- Make sure you consume enough liquids and drink enough water all the
time.
- Do not skip the Suhur meal as it provides you with the energy you need
during the day.
- Consult with your doctor to see if you need vitamins or food
supplements.

Contact your doctor in case:

- The number of wet diapers the baby produces is reduced
- If the baby is not satisfied with the produced milk and asks for more
- If the baby looses weight or maintains the same weight

v Affects of medication:
In case you are taking certain medicines, check with your doctor if you can
continue to take them while you breastfeed. Many types of drugs can be
safely used during breastfeeding and do not affect the child, but others do.

v Breastfeeding while working or studying:

- If you are going to be away at work for a short period, feed your baby
directly before you leave the house and as soon as you get home.
- If the working hours are flexible, you can be an hour late for work or leave
early.
- If you are going to be away from the house for a long time, try to take the
baby with you or to leave the baby at a daycare center close to work so
you can feed him/her at any time.
- If you are not able to take your baby with you, pump (using a breast pump)
or squeeze (using your hands) milk from your breasts. Different types of
pumps are available to suit different needs. The pumped milk can be given
to the child by the carer when the mother is way. Pumped milk can be kept
in a clean covered cup or in a disinfected container.
 v Effective breastfeeding:
It is very important to make sure the baby latches on correctly to the breast
otherwise breastfeeding will be ineffective and may cause pain in the nipples.
Make sure to:
- Bring the nipple close to the baby’s nose and upper lip.
- Wait until the baby opens his/her mouth wide.
- Bring the baby closer to the breast so that the lower lip touches the breast
and the baby grabs the nipple and part of the breast with his/her mouth.

v Signs of correct latching:

- A wide open mouth
- The chin touches the breast
- The lower lip is turned back

v Common breastfeeding problems:

- Inflammation and soreness in the nipples:
Both mother and baby should be comfortable during feedings. The baby’s
lips should cover the entire areola (the dark part of the breast) and the nipple
should be erect and round after the baby is done feeding. If you experience
pain during or after breastfeeding, this may be a sign that something is
wrong: a wrong breastfeeding position or a shallow latch. These are the most
common causes of soreness in the nipple and can be avoided by:
ü Placing some drops of milk on the nipple before and after
breastfeeding.
ü Always changing the breast dressing, if any, especially if the dressing is
wet.
ü Avoid using soap to wash the nipple.
ü Use a product specific for healing cracks in the breasts.
ü Let your nipples air dry by leaving your bra off for a few minutes after
breastfeeding.
If the above doesn’t work, consult with your doctor.
- Blocked milk ducts:
To prevent the blockage of milk ducts:
ü Place the baby in a comfortable position and make sure the baby
latches on to the breast correctly.
ü Continuously breastfeed the baby in different positions. Start with the
breast where the blocked ducts are as the strong sucking motion may
help alleviate the blockage.
ü If you feel some lumps in your breast, massage the area gently with the
tips of your fingers before and after breastfeeding.
ü Do not suddenly reduce the number of feedings.
ü Wear a cotton bra or a special breastfeeding bra. You can remove the
bra and massage the breast to empty the milk ducts.
ü Do not wear an underwire bra.
ü Do not carry heavy bags with shoulder straps because they may
increase pressure on the breasts.
ü Do not offer the baby a pacifier or formula since this may lead to
skipping or delaying feedings.
ü Check that the milk can flow easily during breastfeeding or pumping.
ü Make sure to rest, eat healthy and regularly wash your hands.
- Breasts full of milk:
Before After
During breastfeeding
breastfeeding breastfeeding
Place a warm damp - Massage your breast to help - Place ice
towel on the breast increase the flow of milk. compresses on the
for several minutes breast for 5 to 10
before - Pump or squeeze some milk to minutes.
breastfeeding or soften the breast.
shower in warm - Get some rest
water. - Change breastfeeding positions while the baby
to help the milk flow to all sleeps.
parts of the breast.

- Breast inflammation:
If you see signs of breast inflammation:
ü Keep the breastfeeding schedule regular by feeding the baby every two
or three hours to maintain the flow of milk.
ü Place warm compresses on the breast for 5 to 10 minutes before
breastfeeding.
ü Use the tips of your fingers to gently massage the breast, starting
behind the lumpy areas and moving along the breast to the nipple. Do
this before and during breastfeeding.
ü Feed the baby from the lumpy breast first and then the other breast.
ü During breastfeeding, place the baby in a way that the chin touches the
lumpy part as this will help empty the milk from that part.
ü You can use painkillers that are safe for the baby after consulting with
your doctor.
ü Eat healthy food and drink lots of water.
Clinical Health Education Department
For more information, please contact us by email on:
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