The topic of breastfeeding is huge and inexhaustible. And we would be naive and a priori wrong if we tried to fit all aspects of this into one material complex issue. So there will be several articles on how to breastfeed correctly, and this is only the first of them. It will talk about how to establish breastfeeding for a newborn, how often to put your baby to the breast, how and why to express milk, and also how to achieve “cancellation” of night feedings...

How to breastfeed your baby correctly: starting breastfeeding

How breast milk matures. The mammary glands of a woman preparing for childbirth begin to rebuild during pregnancy. Every pregnant woman notices this - the breasts “fill up”, significantly increase in size and become denser.

In the first 2-3 days after the baby is born, the mammary gland “produces” not milk as such, but so-called colostrum - this is primary milk, which is quite different in composition and fat content from more mature milk.

Colostrum is extremely beneficial for the newborn baby and plays a key role in breastfeeding– it contains the highest concentration of proteins, microelements and fat-soluble vitamins, but is low in carbohydrates. This “cocktail” provides maximum immune protection baby, populates his intestines with primary microflora, nourishes the baby and is well absorbed.

It is very important to put the baby to the breast for the first time immediately after birth or, at a maximum, within the first 24 hours after birth.

Explains Irina Ryukhova, breastfeeding consultant for the AKEV association and author of the book “How to Give Your Baby Health. “Breastfeeding”: “The first attachment when breastfeeding is an acknowledgment of each other’s existence, the first acquaintance, it must take place at least in the first day after birth. In addition, colostrum is the natural and most beneficial nutrition for a newborn in the first days, which provides the baby with maximum protection from disease and growth. Finally, colostrum, due to its low fat content, is slightly weaker, which allows the baby’s intestines to be cleared of meconium (the first stool). In this way, the baby’s intestines get rid of the bilirubin accumulated in the meconium. This minimizes the danger of development.”

Colostrum is produced in relatively small quantities - only about 20-30 ml per feeding. But, unlike mature milk, colostrum is produced constantly, and not in sessions. Nature conceived this mechanism so that the mother would put her baby to her breast as often as possible in the first days after birth. For what? In order for the baby to constantly suck on the breast, thereby irritating the nipple. The more active the nipple irritation occurs, the faster the production of mature milk will begin. And not only faster - but also more.

Most effective way to establish breast milk production - constantly put the baby to the breast. Because it is nipple irritation that stimulates increased lactation like nothing else.

At the end of the third day, transitional milk begins to ripen in the breast, and after 2-3 weeks the mother begins to feed the newborn with full-fledged, mature milk. This is how breastfeeding develops at the initial stage.

“Dairy farm”: what determines the amount of milk during breastfeeding

If the baby suckles actively and vigorously, then, as a rule, during one feeding he almost completely empties one or both breasts. And in this case there is no need to express the remaining milk.

However, in reality, mothers often complain not about excess, but rather about a lack of milk during breastfeeding. It seems to them that the breast does not have time to fill up during the interval between feedings, it remains “empty”, and thus the baby does not finish eating. Many mothers at this moment turn to the assortment artificial mixtures and begin to actively feed the baby with food “from a jar”. This is what breastfeeding experts do not recommend doing.

And they insist: applying to empty chest Not only is it not pointless, but it is also very useful for establishing breastfeeding. Since the lactation process begins in the woman’s cerebral cortex, a stimulus is needed to “supply” milk into the breast. Active sucking is such a stimulus. The baby “smacks” the empty breast, the brain immediately receives a signal that there is a “demand” for milk, and after some time the milk begins to flow into the breast.

If you want to establish full breastfeeding, do not stop putting your baby to your breast; on the contrary, do it as often as possible, even if at first the breasts are completely empty and attempts at lactation look like a complete mockery of a newborn baby.

Attempts to establish exclusive breastfeeding may well continue without harm to the baby’s health for 2-3 days. And only if, after 3 days, there are still obvious interruptions in the milk supply, and the baby is really not eating enough, risking his health and development - in this case, it is absolutely necessary to go to the store and buy a jar of formula for supplementary feeding.

The process of implementing breastfeeding may take several days - but be patient baby crying and weight loss for the sake of the future full feeding Still standing with his chest. In 3 days, nutritional deficiency will have almost no effect on a newborn baby, but in the end, your patience and perseverance can bring you positive result: milk production will improve in full, and you will be able to fully breastfeed your baby without any “additives from the outside.”

Requirement for others: a nursing mother must be loved, protected, cared for and cherished

There are quite a few fundamental differences between humans and other mammals. One of them is that all functions of the human body are “directed” by the cerebral cortex. That is why the mother’s lactation process is greatly influenced by her emotional state.

In other words: when an elephant or a mother whale is “sad,” or when they are scared, or when they are “on the run” or in captivity, the amount of milk in their udder does not change at all.

But when a human mother is sad or very tired, her milk “leaves”, until it completely disappears. That is why it is very important to surround a nursing woman with some adequate amount of attention and care - to give her the opportunity to sleep between feedings, not to burden her with household chores and simply to please her: a woman who is breastfeeding a newborn baby is doubly pleasant and needs compliments, bouquets, kind words etc.

In addition, a nursing mother should not be limited - most ideas about this are misconceptions.

Factors that positively affect lactation in the first month of a baby’s life:

• putting the baby to the breast as often as possible (active sucking and irritation of the nipple);
• emotional support mothers, taking care of her;
• lack of stress;
• duration of the feeding “session” (than longer baby sucks - the more milk will arrive next time).

Breastfeeding styles

There are two main styles of breastfeeding:

• feeding on demand
• feeding according to the schedule

In the first case, the mother puts the baby to the breast “at the first squeak” of the child, regardless of how much time has passed since the last feeding. In the second, the baby is breastfed strictly by the hour - as a rule, every three hours.

It’s rare that a mother chooses on her own which style of feeding to practice. Reality shows that most often the main determining factor is the child’s character.

If the baby is restless, noisy and active, the mother, willy-nilly, endlessly and everywhere puts him to the breast and becomes an “adept” of the feeding style on demand. If, on the contrary, the baby is very calm from birth, sleeps constantly and rarely cries, then the mother naturally begins to adhere to the “once every three hours” feeding regimen.

It will be useful for both mothers to know that:

If the child let go on his own nipple(and therefore he is full and does not want to eat anymore), then a physiological feeling of hunger may occur no earlier than 2 hours later.

This means that if your baby, 30 minutes after feeding, screamed at the top of her lungs, then the reason for the screams is not hunger, but from something else: she’s itching, she’s tormented, she’s just “sick and in a scandalous mood.” Anything but hunger.

Taking this fact into account, modern pediatricians often suggest that mothers modify their feeding style by combining the principles of regimen and on-demand feeding into a free feeding technique. That is, the mother breastfeeds the baby on demand, but at the same time maintaining at least two-hour intervals between feedings. And while the baby is sleeping, they don’t wake him up to feed him - he’ll wake up and eat.

On the one hand, this style will protect you from overfeeding the baby (which is often the cause of prolonged colic), on the other hand, it will teach mother and baby to communicate not only through the breast (after all, it is possible in other ways besides “giving out” the treasured nipple). And finally, more or less adequate intervals between feedings will help the baby’s gastrointestinal tract system quickly establish the process of digesting food.

About expressing and storing breast milk

If you have chosen the method of breastfeeding on demand, then at the stage of lactation formation you don’t have to think about pumping. In conditions where the baby is constantly “hanging” on the chest, he simply will not allow either colostrum or the first mature milk to linger and stagnate in the chest.

It is necessary to express in three cases:

• 1 If for some reason (for example, the baby was born premature and was sent to a hospital for growing up) you are separated from the child in the first days or weeks, but you plan to establish full breastfeeding in the future.

Breastfeeding consultant for the AKEV association Evgenia Trifonova: “If you understand that resuscitation can take weeks, then to maintain lactation you need to use a breast pump no later than 6 hours after birth. And then pump every 3 hours with a 5-hour break at night. Then there is a chance to continue breastfeeding the newborn."

• 2 If you leave your baby with loved ones or a nanny, do not breastfeed, but you want your baby to eat breast milk.
• 3 If a newborn eats less milk during one feeding than what has “accumulated” in your breast.

About the last point modern specialists breastfeeding specialists and neonatologists often argue: there are supporters of pumping, and there are opponents. The main argument in favor of pumping is the risk of lactation mastitis in the mother.

Observations of Dr. Komarovsky: “Nowadays, when doctors more and more often recommend that mothers not pump at all, the number of lactation mastitis has increased significantly.”

Lactation mastitis is an inflammation of the mammary gland during breastfeeding. In 87% of cases of lactation mastitis, the cause of the disease is lactostasis - in other words, stagnation of milk in the breast. If lactostasis continues for 3-4 days (for example, the mother has plenty of milk, the baby does not suck all of it, and the mother does not pump), then inflammation of the gland is almost inevitable, since stagnant milk is an ideal breeding ground for microbes.

Expressing is also necessary in order to ensure that the baby is fed in the absence of the mother (for example, the mother goes to work, and the grandmother or nanny feeds the baby with expressed milk). Properly expressed, frozen and thawed milk is no different in composition and benefits from the milk that the baby receives directly from the mother’s breast.

We will devote separate detailed material to how to express yourself correctly, why and when to do it, as well as how to properly freeze, store and defrost breast milk. Let us just remind you that expressed breast milk can be frozen (there are special bags and containers for freezing expressed milk) in the freezer for quite a long time. However, breast milk can only be thawed when room temperature and heat only in a steam bath.

How long should you breastfeed your baby?

It is extremely important to ensure that the baby is breastfed in the first six months of his life - his health, his growth and development fundamentally depend on this.

Modern doctors around the world have agreed that if the mother has enough of her own milk, then for up to 6 months only breastfeeding can be carried out, which will fully cover the child’s needs for all necessary substances. That is, neither water nor complementary foods can be added to the baby’s diet.

The only exception is very hot climates, in which the risk heatstroke at small child increases sharply. In this case, it is necessary to replenish the pathological losses of fluids in the baby’s body by supplementing it with water, and often even mineral water(that is, water with added salts) - we wrote more about this in the material about.

And then, after you have celebrated the first six months of your baby’s life, everything regarding the duration of breastfeeding depends, first of all, on the desires and capabilities of the mother and the family as a whole.

At 6 months the child is recommended. However, it is highly advisable to continue breastfeeding. And then - frequency and duration breastfeeding gradually decreases, at the same time the frequency and volume of complementary feeding increases accordingly.

If the mother has the opportunity (she still produces milk actively) and the desire, continued breastfeeding is welcomed by all pediatricians in the world, without exception. For example, WHO ( World Organization Health) and UNICEF (United Nations Children's Fund) jointly recommend maintaining partial breastfeeding (that is, the child's diet consists primarily of other foods - vegetables, meat, cereals, fermented milk products etc., but at the same time he receives a portion of mother’s milk every day) up to 2 years or more. Explaining the importance of this strategy by the fact that breastfeeding in children of any age in to a large extent reduces the risk of various infections.

Reasoning logically, we can assume that for countries with high level medicine and low level distribution infectious diseases(Russia is one of these countries) the medical reason for long-term breastfeeding is not as relevant as for underdeveloped countries.

In modern pediatrics, there is an opinion that in developed countries with a high standard of living, breastfeeding a child after a year has not so much biological value as psychological value.

We perceived it more as an anomaly than a favorable norm. But that's a different story...

In short. To put it as simply and clearly as possible, we repeat:

• It is strictly necessary (according to all biological laws) to breastfeed the child for the first six months;
• it is very desirable to extend breastfeeding - up to 1-1.5 years;
• at the discretion of the family and if the mother herself wishes, you can continue to breastfeed once or twice a day - for as long as you like.

The benefits and reasons for night feedings: when children are for it, but mothers are not so...

Most pediatricians and breastfeeding specialists rightly argue that for up to 6 months, night feedings are necessary and justified. Even if the baby sleeps peacefully until the morning and does not wake up with a “hungry cry”, he should still be woken up 1-2 times a night and put to the breast.

However, after reaching six months of age, it is quite reasonable to reduce the number of night feedings to once. This will significantly increase your strength and good mood mother, and will not in any way infringe on the child’s need for food.

How and when can you reduce night feedings? The following activities are very helpful:

• Later nightly bathing. After 23 hours it is useful in cool water, and then feed him tightly. This scenario helps the child fall asleep quickly and deeply and, as a rule, sleep soundly for the next 3-4 hours.
• Favorable microclimate. Create a cool and humid microclimate in the room where the child sleeps, which contributes to strong and good sleep. Parameters: air temperature - no more than 20 °C, humidity - 50-70%.

Gradually, over time, night feedings can and should be “cancelled” altogether.

How to breastfeed correctly: summary

So, from the array useful information, let’s try to squeeze out a brief rational grain:

• Breast-feeding is a type of feeding for newborns, infants and children up to 2 years of age and even older, which has no analogues in terms of benefits and value. Any comparisons between breastfeeding and artificial feeding are a priori advantageous in favor of the former.
• The surest and most effective way to establish breastfeeding– in the first days and weeks of a newborn’s life, put the baby to the breast as often as possible so that he actively stimulates the nipple.
• Breastfeeding in the first six months of the baby- a necessary norm that provides the strongest possible protection for a child from diseases and fully covers all his nutritional needs.
• Give the baby more water or supplementary feeding You don’t need any products in the first six months. The exception is conditions in very hot climates, in which the baby needs to constantly replenish the water-salt balance.
• From 6 months to a year- breastfeeding (along with complete complementary foods) is highly desirable.
• Optimal feeding style for a baby up to one year old- on demand, but with intervals between breastfeeding for at least 2 hours.
• After 1-1.5 years The issue of breastfeeding is determined solely by the desire of mother and baby.
• Expressed breast milk(given that proper storage and defrosting) - is as healthy and nutritious as the milk in the breast.

Breastfeeding has been and remains a burning topic for all young mothers.

There are many myths and fears surrounding this ritual.

Some mothers, afraid of harming the baby, put themselves on strict diet, others are racking their brains over how long to feed the child and how to wean the child.

Breastfeeding: tips for a nursing mother on how to breastfeed correctly

The body's adjustment to breastfeeding begins already during pregnancy. Many women notice this even on early stages: the breasts begin to “fill up” and increase in size several times.

In the first hour after birth, the newborn is placed on the mother's breast. Many untrained women They wonder why this is needed, does the milk come so quickly? Yes, at this time there is already milk in the breast, but it is somewhat different in composition and fat content from breast milk in the usual sense. The first three days of female breast Colostrum is released. It has been scientifically proven that this is the most valuable liquid for a baby in the first days of his life.

The benefit of colostrum is that its composition is rich in proteins, microelements and fat-soluble vitamins. At the same time, it contains very few carbohydrates. This composition forms a strong immune system of the newborn, sets the correct functioning of his gastrointestinal tract, populating the intestines with beneficial microflora. Colostrum provides your baby with healthy and easily digestible nutrition.

Why is it so important to put a baby to the breast, if not in the first hours after birth, then at least in the first day? Firstly, because of the composition of colostrum, which, as mentioned above, is very useful for the child. Secondly, the reduced fat content of colostrum has a laxative effect, which helps to quickly clear the newborn’s intestines of primary stool (called meconium). Thirdly, we should not forget about the invisible connection that is established between mother and baby during breastfeeding.

The difference between colostrum and milk is that its production occurs constantly, and not in rushes. During one feeding, the child receives no more than 30 ml of formula. However, this does not mean that the child does not eat enough. You just need to apply it to your chest as often as possible. Sucking irritates the nipple, which causes milk production. It has also been proven that the more actively the baby sucks, the better lactation will be. As a rule, intermediate (between colostrum and mature) milk begins to flow 3-4 days after birth. Mature milk in the mother's breast begins to be produced after 2-3 weeks.

Breastfeeding advice for a nursing mother: what feeding styles are there?

It will be useful for every mother to know that there are two directions of feeding:

● by mode;

● upon request.

In the first case, the mother waits at least 3 hours between feedings. In the second, the breast is given to the child as soon as he begins to actively cry.

Choosing suitable style, mothers often rely not on the advice of friends/mothers/pediatricians, but on own child. Screaming babies who calm down only at the breast force the mother to stick free style. And if the child does not disturb the mother and sleeps well, then she feeds her child once at a certain time.

Now many pediatricians and breastfeeding specialists give advice to nursing mothers: try to combine both styles. The fact is that if the child is full of milk and releases the nipple on his own, it means he is full. The next time he feels hungry no earlier than 2 hours later. If the baby started screaming half an hour after he ate, the reason is definitely not hunger. It could be anything: intestinal colic, itchy allergy, Bad mood. In this case, you should not offer the breast, but you need to distract the child with something else.

At the same time, if the baby is sleeping soundly and more than 3 hours have passed since feeding, then you should not disturb your sleep to offer the breast. Believe me, a hungry child will not sleep; he will definitely make himself known with a loud cry.

Breastfeeding - advice to a nursing mother on how a mixed style helps solve several problems at once:

1. Protects the baby from overeating, because if he does not want to eat, but screams, the mother, one way or another, puts him to the breast, thinking that the child is hungry. By the way, overeating is precisely common cause colic in children under 3 months.

2. Helps mother and baby look for other ways to interact, not just through the breast. If little time has passed after the baby has had enough, but he continues to scream, the mother needs to look for other ways to calm him down.

3. Intervals between feedings of 2-3 hours are necessary so that his gastrointestinal tract begins to function normally faster.

Breastfeeding: tips for breastfeeding mothers on expressing and storing milk

Situations are different and sometimes a mother simply cannot breastfeed her child. In what cases is it necessary to express:

● if after childbirth the mother and child are separated (in this case, the mother who wants to maintain and further establish full lactation should begin pumping 6 hours after birth; this should be done every 3 hours, and at night - with an interval of 5 hours);

● if the mother is forced to leave the child with relatives or a nanny, but wants the baby to feed on her milk;

● if more milk accumulates in the breast than the baby eats (in this case, the mother needs to pump to avoid stagnation and subsequent problems due to this).

Doctors are still arguing about the last point. Some argue that to prevent lactation mastitis, the mother is simply obliged to express the milk remaining after feeding. Others are against this, arguing that mastitis can develop not only for this reason.

In fact, according to some data, moms who don't pump are more likely to suffer from this condition than those who get rid of excess milk.

Lactation mastitis is a disease that affects breastfeeding women. In 90% of cases, its development is facilitated by stagnation. They are formed due to the fact that the child does not eat all the milk that comes in, and the mother does not express the rest. If this situation persists for 5 days, then the chance of avoiding lactation mastitis is minimal. Stagnant milk leads to the development of microbes and inflammation of the mammary gland.

Expressed breast milk can be stored long time V freezer. There are even special containers sold for this. The milk is expressed and frozen. However, to feed it to your baby, you need to defrost it only at room temperature, and then warm it up to desired temperature in a water bath.

Breastfeeding: advice for a nursing mother on how long to breastfeed and how to stop night feedings

Almost every mother asks the question: how long should you feed your baby? No specialist can give an exact answer. Some say that up to a year is enough, and then the milk becomes useless. Others are of the opinion that feeding needs to take longer, since children are natural feeding They practically don’t get sick. In addition, the mother-baby connection lasts longer, which is very important for normal mental and emotional development child.

Both sides agree on one thing: in the first six months of life little man food and water can completely replace mother's milk. It is during this period that concentration useful substances in it is maximum. Breastfed children should be taught to new food should not be earlier than 6 months later.

After this time, you need to gradually begin to replace milk with complementary foods. With each week, the volume of complementary foods and its variety should increase slightly, and the frequency of breastfeeding should decrease.

To summarize, it turns out:

● up to 6 months the child needs mother's milk;

● from one to one and a half years - it is advisable to feed (not so much from a biological point of view, but from a psychological one);

● after one and a half years, feeding or ending lactation is a personal matter for each mother.

Many mothers, wanting to complete breastfeeding, begin by leaving the breast only at night. However, this approach is fundamentally wrong. Weaning should begin with the elimination of night feedings.

Up to six months, the child needs to be fed 1-2 times. Even if he doesn't wake up, you need to wake him up and offer the breast. After 6 months this is not necessary.

How to stop night feedings? Pediatricians advise following simple rules for going to bed:

1. Late daily bathing. In order for the baby to fall asleep soundly and sleep safely for at least 4 hours, you need to bathe him at 11 pm, then rinse him with cool water. After bathing, the child should feed tightly to the breast.

2. Favorable environment. Children sleep better in cool conditions, so it is important to ensure that the room temperature does not exceed 20 degrees and the air humidity is not lower than 50%.

Breastfeeding - important process for the growth and development of the baby. How long to feed is up to every mother. Many people feel sorry for ending lactation only because it is at these moments that the strongest bond occurs between mother and baby.

I would also like to add some advice on breastfeeding to a nursing mother: lactation is very important point and from the point of view women's health. Mammologists say that what longer woman breastfeeding, the lower the risk of developing breast cancer.

Most women who have recently given birth are aware of the benefits of breastfeeding and want to breastfeed their baby. However, it is important not only to tune in to this process, but also to know how to set it up correctly. It would seem that what could be simpler than putting the baby to the breast and allowing him to suck milk? But many mothers, especially first-time mothers, when left alone with their baby for the first time and attempt to breastfeed, encounter one or another difficulty.

The basic principles for establishing good lactation and successful feeding are as follows:

Early attachment of the baby to the breast.

Breastfeeding experts say that to achieve good lactation, it is important to start feeding your baby immediately after birth, within the first 30-60 minutes. It has great value, since during this period of time the neuroendocrine mechanisms for regulating lactation in a woman who has given birth are launched, i.e. putting the baby to the breast immediately after birth is a signal for female body that increased milk production is now required.

In addition, it is very important for a newborn to receive the first drops of colostrum, with which gastrointestinal tract the child is populated with beneficial microflora, and the baby develops protective antibodies.

When a baby is put to the breast early, a whole complex of psychophysiological contacts between mother and child is launched and begins to form, which become the basis for their future relationships. Thus, a close connection is established: the woman better understands the needs of the baby and is prepared for long-term breastfeeding.

1. Feeding on demand, i.e. putting the baby to the breast as often as he asks, without limiting the duration of feeding. This principle is based on the fact that the amount of milk a mother has depends on the baby’s needs - the more the baby sucks, the more milk the mammary glands produce. This phenomenon due to the fact that the hormone prolactin is responsible for the secretion of milk in a woman’s body, and it is produced in response to the baby’s sucking.

1. Mandatory night feedings, since it is at night that the hormone prolactin, which stimulates lactation, is intensively produced.

1. Avoiding extra drinking. Breastfed babies in the first months of life do not need additional liquids, since breast milk is both food and drink. However, if the house is hot and you think that the baby needs to be given water, use special ones with a nipple that follows the shape of the nipple so that the baby does not refuse the breast.

1. Avoiding supplementary feeding with formula milk. Some young inexperienced mothers They think that in the first days after birth there is no milk, which means that the baby needs to be supplemented with formula. In fact, this is a misconception. In the first few days after the birth of the baby, the mother secretes colostrum. It is actually secreted a little - only 10-50 ml per day. However, it has increased nutritional and energy value, so even 5 ml of colostrum per feeding is enough for a newborn baby.

   Colostrum plays an important role in the development of immunity in the baby, as it contains high concentrations of antibodies. That is why it is important that the newborn receives precious drops of colostrum in the first days after birth. Put your baby to your breast on demand, and your body will respond to the baby’s “request” by actively producing milk.

1. Correct application baby to breast. At the beginning of lactation, it is very important to avoid the appearance of irritation and cracks on the nipples, which complicate the feeding process.

Breastfeeding in the maternity hospital

What basics of breastfeeding should a mother learn while she and her baby are in the maternity hospital?

Proper latching of the baby to the breast

This is extremely important aspect establishing lactation. It determines how quickly the baby learns to breastfeed correctly. Proper attachment protects the nipples from injury, and high-quality emptying of the mammary gland is a good prevention of milk stagnation and mastitis. Unfortunately, the baby does not always latch onto the breast as needed, so a nurse in the children's department in the maternity hospital or a neonatologist must show and explain to the mother all the details of correct latching.

The sooner a nursing woman masters breastfeeding techniques, the better, as this will avoid unwanted problems.

Incorrect breast latch and “nipple sucking” are the main cause of cracks and inflammation of the nipples and lead to a limitation in the frequency of feedings and impaired milk flow.

The main thing that a nursing mother should remember is that breastfeeding should not be accompanied by painful sensations. If there is pain, it means the baby is taking the breast incorrectly.

With the correct latch, the baby should grasp not only the nipple, but also the areola - the dark area around the nipple. The baby’s lower and upper lips are turned out (rather than tucked in), the mouth is wide open, the nose and chin touch the chest. Only in this case will the baby's sucking movements be effective.

Positions during feeding

A woman's comfort while feeding her baby is one of important factors maintaining lactation: it is very important that at this moment both mother and baby feel comfortable. A well-chosen mother's position contributes to the baby's correct latching on the breast.

Difficulties with a comfortable body position during feeding may occur in women after surgery caesarean section or episiotomy. In these cases, the most comfortable position is considered to be “lying on your side.”

Pumping

To become successful lactation Regular and complete emptying of the mammary glands is necessary. If this does not happen, milk stagnation (lactostasis) appears and its production decreases.

In the first days after birth, colostrum is released, and around the third day milk begins to be produced. In this case, the mammary glands enlarge, harden and become painful. During this period, in order to avoid stagnation of milk, you need to put the baby to the breast as often as possible. If the baby is fed “on demand,” then, as a rule, there is no need to express the breast. The mammary glands, responding to the needs and requirements of the newborn, produce as much milk as he needs.

In what cases should you pump?

1. If you feel that you have more milk than you need and your well-fed baby he snores calmly, and your breasts become hard and filled with milk.
2. The newborn sucks sluggishly and does not latch onto the breast well (premature babies, children with intrauterine hypotrophy, children with damage to the central nervous system).
3. Mom and baby are separated and the baby can only be fed according to a schedule.
4. Painful cracks in the nipples do not allow a young mother to fully feed her child.

To avoid lactostasis, milk can be expressed using a delicate Dr.Brown's manual breast pump. It does not damage the nipples and prevents bacteria from entering the milk ducts.

Breast care

Particular attention should be paid to breast care. Following simple rules of hygiene allows you to avoid the problem of scuffs and cracks on the nipples, which make feeding the baby difficult.

It is enough to wash your breasts 1-2 times a day while taking a shower. There is no need to do this before each feeding of the baby. The fact is that when washing the breast, especially with soap, a protective layer of fat is removed from the skin of the areola and nipple, which contains factors that prevent pathogenic microbes from penetrating the skin of the breast. Frequent washing leads to dry skin and cracked nipples.

After feeding, you can apply a special cream to prevent dryness on the breasts and nipples, you can also lubricate the nipples with drops of breast milk (hind milk) and let them dry.

If cracks and inflammation of the nipples occur, they must be examined by a doctor, since they can be an “entry gate” for infection and, as a result, mastitis (inflammation of the mammary gland) can develop. Used to heal cracked nipples special means with panthenol or lanolin, rosehip oil or sea buckthorn oil.

How to eat for a nursing mother?

This is very important question, because with natural feeding children's body directly depends on the mother’s: the food that a nursing woman takes affects the quality of breast milk and, accordingly, the nutrition of the baby. A properly structured diet during lactation allows you to achieve optimal composition breast milk. In order for the baby to grow and develop well, a nursing mother must receive complete nutrition every day, balanced in proteins, fats, carbohydrates, minerals and calories.

Particular attention should be paid to foods that should not be consumed during breastfeeding, as they can harm the baby's health. For example, chocolate, honey, citrus fruits, and nuts can trigger allergies in a baby. Legumes, grapes, cabbage often cause increased gas formation in the intestines and colic, etc. in infants.

IN drinking regime There are also some peculiarities for a nursing mother. On days 2-3 after birth, when there is a sharp increase in milk in the breast, fluid intake should be limited to 800 ml per day to avoid severe engorgement of the mammary glands and stagnation of milk. After lactation is established, the volume of fluid consumed should be approximately 2 liters per day. Moreover, it is desirable that it be not only water or tea, but also compotes, kefir and other fermented milk products.

After maternity hospital

If the mother was unable or did not have time to establish proper breastfeeding in the maternity hospital or she still has unresolved issues, but the time has come for discharge, no need to worry. If you have unanswered questions, you can contact your local pediatrician, who will monitor the child at home upon returning from the hospital, or lactation consultants.

Breast-feeding

Breast milk is the best nutrition for a child, adapted by nature itself, providing him with all the nutrients necessary during the first 6 months of life. In addition to nutrients, breast milk contains essential polyunsaturated fatty acids, some proteins, easily absorbed iron. Unlike artificial mixtures mother's milk contains immunoglobulins and biologically active substances that protect the child from infections and promote adaptation of the newborn’s intestines. The composition of breast milk changes not only during the day, but also during the first year of a child’s life, following his changing needs.

The mechanism of lactation and the composition of breast milk

Lactation is regulated by prolactin, the main hormone that ensures milk secretion in lactating women. Prolactin is produced by the adenohypophysis around the clock; The hormone content in the blood reaches its highest value on the 3rd–4th day of the postpartum period. The process of secretion of breast milk is established on the 3rd day and stabilizes on the 7th day after birth. By this time, the formation of the capacitive function of the mammary gland is completed. The content of prolactin depends on the baby's sucking activity. If the concentration of prolactin is high, but milk is not removed from the breast, then lactation decreases. Prolactin has a sedative effect, so breastfeeding (especially night feeding - at this time the prolactin content is especially high) has a beneficial effect on psycho-emotional state women.

The release (milk ejection reflex) is associated with the concentration of another hormone in the blood - oxytocin. Oxytocin causes contraction of myoepithelial cells and other structures of the alveolar region and promotes the release of milk into the large ducts and cistern of the mammary gland. The degree of activation of cells that produce oxytocin depends on the intensity of sucking. Research recent years indicate the participation of oxytocin in the hypothalamic regulation of prolactin secretion. An increase in oxytocin levels in the blood precedes an increase in prolactin concentrations induced by feeding a child. If the breasts are not emptied, milk secretion stops.

The concentration of prolactin and oxytocin in the blood of postpartum women largely depends on adequate mechanical stimulation (compression, stretching, vacuum) of the mammary gland by the baby’s mouth during feeding. With such complex stimulation, a characteristic pattern of impulses appears in the afferent fibers that form the receptors of the nipple and areola of the mammary gland (mechanoreceptors), which enter the hypothalamus along the spinal cord pathways, then into the posterior lobe of the pituitary gland, where they cause the release of hormones, stimulating lactogenesis and secretion. milk.

In the first days after the birth of a child, the mammary glands of the mother produce colostrum - thick yellowish milk. Colostrum contains more protein, antibodies and other protective factors than mature milk. Colostrum has a mild laxative effect and promotes timely cleansing of meconium from the newborn’s intestines. Colostrum also promotes the development and normal formation of the baby’s intestinal functions after birth, and prevents allergies and intolerance to other foods. In its vitamin composition, colostrum differs from mature milk; it is especially rich in vitamin A. Given the unique composition of colostrum, it is very important that the child receives it from the first hours of life. Colostrum contains everything necessary components and fully meets the child’s needs for nutrients before the appearance of mature milk in the mother.

Mature milk appears a few days after the baby is born in much larger quantities than colostrum. There are “foremilk” and “hind” milk.

The baby receives “foremilk” at the beginning of feeding; it has a bluish color. Foremilk is produced in large quantities and contains a lot of sugar (lactose) and protein. Sometimes a mother thinks that her milk is defective and “skinny.”

Hind milk is released at the end of feeding and is rich white, sometimes yellowish color. Hind milk contains more fat than fore milk. Large quantity fat makes the hind milk high in energy, so you should not wean the baby from the breast prematurely, you must allow him to suck all the hind milk, otherwise he will be hungry.

Today, the benefits of breastfeeding for children under one year of age have once again been confirmed.

Proof:
a significant decrease in the number of cases of sudden death syndrome in the structure of infant mortality;
reduction in the incidence of enterocolitis, sepsis, otitis media, diarrhea, atopic dermatitis in children, food allergies, bronchial asthma, diabetes, cancer;
absence of pathological reactions during preventive vaccinations;
improving the parameters of psychomotor and emotional development of children, increasing their communication skills;
reducing the incidence of dental problems in early childhood (reducing the incidence of caries).

In addition to the benefits of breastfeeding for a child, there are certain advantages breastfeeding for mother.
Oxytocin, released by a woman when feeding her baby, promotes uterine contractions. Thus, breastfeeding is accessible and effective remedy prevention of bleeding in women postpartum period. It is very important to put your baby to the breast immediately after birth and feed him as often as possible.
Women feeding a child breast milk, spend the energy reserve accumulated during pregnancy, since milk synthesis occurs even when the energy value of food is limited.
It has been proven that women who breastfeed have a lower risk of ovarian and breast cancer.
Breastfeeding prevents ovulation and menstruation physiological method protection against pregnancy (method lactational amenorrhea). The effectiveness of the method is high if the mother feeds the child exclusively with breast milk on demand, day and night, at least 8–10 times a day and more often with an interval between feedings of no more than 5 hours. Risk of new pregnancy is about 2%.

The cost of adequate nutrition for a nursing woman is lower than the cost of formula for artificially feeding a child, and breastfeeding is much healthier for both mother and child.

Breastfeeding promotes the formation of a close, tender relationship between mother and child, an attachment that gives both deep emotional satisfaction and lasts for life. Breastfeeding promotes a mother's affectionate relationship with her child and reduces the likelihood of abandonment of the newborn. Breastfed children are calmer, cry less, and feel more secure.

The mother should be advised to sit comfortably, relax, and take a position (lying or sitting) in order to be able to hold the baby close to the chest for quite a long time. There are many ways to feed: sitting, lying, squatting. The main thing is that during feeding the mother is relaxed and the baby is comfortably positioned (Fig. 5-1).

Rice. 5-1. An example of improper latching of a child to the breast: the child is tightly swaddled, the headscarf makes it difficult to turn the head, so the child does not latch onto the nipple well. With this type of breastfeeding, there is a high probability of developing lactostasis and subsequent hypogalactia.

The child must be held in such a position that he does not have to pull his head to his chest (Fig. 5-2). If the child tries to keep the nipple in his mouth, he may damage it.

Rice. 5-2. Free swaddling promotes successful breastfeeding: it is convenient for the baby to take the desired position, touching the breast with his hands helps to reflexively increase lactation.

You should not hold the child by the head; it is enough to hold him under the back. If a child’s head is held tightly, he may instinctively try to wriggle out and “fight” at the chest.

The baby needs to be pulled to the chest, rather than the mother pulling her breast towards him.

The baby's nose should be level with the nipple during feeding (Fig. 5-3). The baby will have to raise his head a little to reach the nipple; You can help him by supporting him under the lower back.

Rice. 5-3. Correctly attaching the baby to the breast: the mother has taken a position that is comfortable for her, skin-to-skin contact with a child helps maintain lactation.

You should not use your fingers to adjust the distance between the baby's nose and the breast - this will disrupt the shape of the breast, making it difficult for the baby to latch on to the nipple. When positioned correctly, the child breathes through the edges of the nasal passages.

You should not hold or move your breasts like a bottle. These movements will disturb the child. The child should completely grasp the nipple with his mouth, up to the edge of the areola. If there is a need to support the chest, this should be done from below, preferably with the entire palm of the hand, with the edge pressed against the chest wall. Keep your fingers at a distance of 10 cm from the nipple.

If the child is sleepy or restless, you need to attract his attention to feeding by gently touching the cheek or mouth with the nipple, squeezing a drop of milk onto the surface of the nipple, this stimulates the child’s appetite. In this case, children usually open their mouths and make sucking movements with their tongue.

If the child's mouth is wide open, the tongue is deep at the bottom of the mouth, it is necessary to bring the child closer to the chest and give him a chance to “grasp.” It may take several feedings to learn how to breastfeed your baby correctly; not everyone has this skill right away.

If the baby is dissatisfied with something, is very hungry or cries at the time of attachment to the breast, he raises his tongue, making feeding impossible. If possible, you need to calm the baby down before feeding. Some babies protest before every feeding. In this case, you need to use every opportunity to feed the child. Once he calms down, you can help him latch onto the breast. If your baby suckles on one breast more readily than the other, give it to him.

Rice. 5-4. A gurney with a row of tightly swaddled children lying has long been considered a symbol successful work maternity hospital. Nowadays it is rather a symbol of an unmodernly organized separation mother and child.

WAYS TO EVALUATE THE ADEQUACY OF THE AMOUNT OF MILK A CHILD RECEIVES

Children's nutritional needs are individual. The composition of milk changes throughout the day and throughout lactation according to the child’s needs. Most babies are able to regulate the amount of breast milk they consume.

It is recommended to put your baby to the breast as soon as he shows signs of hunger or restlessness, day and night, from the first day until the end of breastfeeding. Sometimes you will have to feed 10 - 12 times a day, sometimes 6 - 8 times. Don't wait until your baby starts crying from hunger.

If a baby is given a pacifier or tightly swaddled, it is very difficult to recognize signs of hunger. Hungry children move their heads and arms, bring them to their mouths, they salivate, they smack their tongues, making sucking movements with their mouth and tongue. Children have many ways to show their hunger; screaming and crying are the last, most desperate method.

Breast milk is easier and faster to digest than artificial baby food, therefore the baby should be fed more often than with artificial feeding.

Most babies need to be fed at night. For the mother's convenience, you can place the baby's crib next to the mother's bed. Feeding is relaxing; at this time the mother also rests, even if she cannot fall asleep.

Let your child eat his fill. Ignore the clock while feeding. Sometimes children get full quickly, sometimes slowly. The child may require feeding in several doses, resting in between sucking, and sometimes prefers continuous feeding. The mother will learn to understand by sounds whether the baby continues to suckle or is simply dozing at the breast. If the baby is comfortable, he will not damage the nipple even with frequent and prolonged feeding.

If the baby spontaneously drops the breast, you should take a break, then try to offer the same breast to make sure that the baby has received hind milk. If he refuses, you should offer the second breast; if he refuses again, then he is full. At next feeding It is better to offer breasts that were “rested” during the previous feeding. If the child has a noticeable tendency towards the “favorite” breast, this is not a problem. In practice, milk from one breast is enough to satiate a child; There are women who have successfully breastfed twins and even triplets.

Milk fully satisfies a child’s needs for food and water during the first 6 months of life. Even in hot weather or hyperthermia, the child does not need to give him additional water or tea; it is enough to feed him frequently and on demand.

After 6 months, breast milk can no longer fully satisfy the child’s needs for nutrients, vitamins, and microelements, so it is necessary to introduce complementary foods, giving them with a spoon and not from a bottle.

In the first months of development, “normal” weight gain is 500–800 g per month. If the weight gain is less, you should not immediately resort to artificial feeding, you can recommend that the mother feed the baby more often. Periodically, the baby may require more frequent feedings over several days, which increases the amount of milk.

There is no need to wash your breasts and nipples before feeding; breast milk has disinfectant properties. Soap, disinfectants or alcohol remove the skin's natural oils, dry out the skin and increase the risk of cracks. One daily is enough hygiene procedure(for example, morning warm shower). However, before each feeding, the mother should wash her hands thoroughly with soap.

FACTORS AFFECTING LACTATION

It has been proven that maternal body weight does not affect the success of lactation. The dietary requirements of a nursing mother vary over a fairly wide range. A woman’s need for proteins, fats, carbohydrates, vitamins and minerals during this period is increased, but if these needs are extra energy and nutrients are not satisfied, the synthesis of breast milk will occur at the expense of the mother’s resources. A normally nourished woman accumulates the necessary reserves during pregnancy, which are used to compensate for the increased needs in the first months of lactation.

The common belief is that for normal lactation significant increase in fluid intake required, not confirmed scientific research. When the mother does not have enough fluid, the urine becomes concentrated and the woman becomes thirsty. Therefore, usually the woman herself regulates the flow of fluid.

The shape and size of the breast also do not affect the amount of milk and the possibility of breastfeeding. Often the reason for a baby's unsuccessful attachment to the breast is explained by the shape of the nipples. Small, flat or depressed nipples are often a cause of concern for the mother - will the baby be able to latch onto the breast correctly, will it be difficult for him to suckle? In most cases flat nipples do not interfere with breastfeeding; more often, the cause of unsuccessful feeding should be sought in the incorrect attachment of the child to the breast. It is necessary to help the mother properly attach the baby to the breast as early as possible, preferably on the first day after birth, before the milk “arrives” and the breasts become full. If for some reason the baby cannot breastfeed, the mother should be encouraged to express milk and feed him from a cup. You should not bottle feed your baby, as this will make it difficult for your baby to attach to the breast in the future.

CONTRAINDICATIONS TO BREASTFEEDING

For a child, a contraindication to breastfeeding may be the inability to suck the breast (severe general condition, underweight body at birth).

For the mother, a contraindication to feeding may be a serious condition, taking certain medications, or HIV infection.

Editors' note: In a situation where the mother receives medicine, incompatible with breastfeeding, you should try to find an analogue of the drug that allows breastfeeding before hastily transferring the child to formula feeding.

The anatomical features of the structure of the breast and the woman’s body, as a rule, extremely rarely lead to insufficient milk production. Psychological factors more often than others cause difficulties in feeding the child. Stress, family conflicts, lack of mutual understanding between wife and husband, significant stress experienced by a woman after childbirth (especially if there are several children in the family), lack of care and help from loved ones - real reasons, decreased milk production in the mother of a newborn.

To activate the oxytocin reflex, it is necessary to help the mother psychologically and practically - eliminate any sources of pain or anxiety, try to evoke pleasant thoughts and positive emotions towards the child.

Another common reason for a mother's lack of milk is infrequent feedings strictly according to the clock. Stopping your baby from feeding at night can also lead to a decrease in milk supply, especially if the mother stops feeding before the baby shows signs of satiety. Brief breastfeeding results in the baby not receiving enough hind milk, and insufficient breast emptying leads to decreased milk production.

Not correct application to the breast causes ineffective sucking, which further leads to insufficient milk production and the appearance of cracks, making feeding difficult.

A baby fed with a bottle or pacifier may have difficulty sucking because he or she does not latch on properly.

The introduction of supplementary feeding before 5–6 months leads to the fact that the baby suckles less and milk production decreases.

Damage to the mammary glands during breastfeeding is usually associated with improper attachment of the baby, engorgement, blockage of the milk ducts and inflammation, and the development of an abscess is possible.

Breast filling with milk occurs on the 2nd–5th day after birth. Inflammation and cracked nipples most often occur in the first days, when proper attachment to the breast and frequency of feedings have not yet been worked out. Too much frequent washing nipples (more than once a day) removes the protective film and provokes the occurrence of cracks.

Limiting breastfeeding and incorrect application a child to the breast can lead to blockage of the milk ducts, the formation of a hard, painful formation in the breast tissue, and redness of the skin over it; Fever and chills are possible. This condition is sometimes called uninfected mastitis. A woman's condition can be improved frequent application baby to the breast, complete emptying by expressing the milk remaining after feeding.

If a woman’s condition worsens, antibacterial drugs are prescribed (semi-synthetic penicillins 250 mg every 6 hours for 7-10 days or 250 mg erythromycin every 6 hours for 7-10 days, 30 minutes before meals). Treatment with these antibacterial drugs does not interfere with breastfeeding.

When HIV is transmitted from mother to fetus, it is difficult to determine the time of infection (after birth through breast milk or in utero). The risk of HIV transmission is higher when the mother is initially infected during pregnancy or breastfeeding, as well as when the disease progresses (high viral load). Many studies have proven the possibility of infection of newborns during breastfeeding if the mother is infected after childbirth (parenterally). During this period, specific antibodies are likely to appear in breast milk, but their role in protecting against HIV transmission is limited. If the mother has HIV, artificial feeding should be recommended.

An acute infectious process in the mammary gland is an indication for stopping feeding a child from this breast, but feeding the child healthy breasts acceptable. In cases of staphylococcal mastitis, feeding helps resolve the process; if feeding is interrupted, an abscess may form. It should be recommended to continue breastfeeding under cover antibacterial therapy. Mastitis often occurs as a result of lactostasis at the beginning of lactation, when the mother is just learning to feed her child.

No one will argue that better food for a baby than mother’s milk has not yet been invented, and it is unlikely that one will ever be invented. Human milk is a real storehouse of vitamins and nutrients for the baby’s body. But in order for milk to remain tasty and healthy, mother needs to take care of herself, do not forget about rest and proper nutrition.

Breastfeeding: what should mother eat?

Experts advise every nursing mother to include daily diet about 200 grams of meat or fish (poultry is also suitable), from 100 to 150 grams of cottage cheese, about a liter of milk, 1 chicken egg, 30 grams of hard cheese, about 300 grams of fruit, half a kilogram of vegetables and 50 grams butter. The menu should include various cereals, porridges (buckwheat, oatmeal), as well as berries, juices and compotes.

In principle, during feeding you can eat everything, naturally, with the exception of foods to which you are allergic. It makes sense to try something new and monitor the results. For example, try entering in the menu sauerkraut- an extremely useful product.

But there are also foods that you should avoid: spices, horseradish, garlic, mustard. These products can affect the taste of milk in a negative way.

Breastfeeding: more about mom's nutrition

A nursing mother should eat at least five to six times a day, preferably before each feeding, then milk production will occur more intensively. But don't overeat and drink more liquid than necessary. Excessive nutrition, despite popular misconception, will in no way increase the amount of milk or improve its properties. Don't forget to get enough sleep and walk in the fresh air. The young dad and relatives should understand your special position in the house and support you in everything.

Breastfeeding: how to prolong lactation

- put the baby to the breast at his first “demand”;
- breastfeed your baby even at night;
- important and psychological attitude, start imagining that you have a lot of milk and how you feed your baby, even before giving birth;
- do not forget about breast massage when you shower, do water massage using a watering can;
- try herbal and vegetable teas that increase the amount of milk, however, you need to take such teas with caution, observing the child’s reaction, this will help avoid possible allergies. A good remedy Parsley is considered green, there are also tablets for increasing milk - “Apilak”. However, it is better to consult with your supervising physician regarding any means.