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Department Of
Lactation
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About Lactation

Breastfeeding plays a crucial role in the health, growth and development of babies and has benefits for the mother. Breastmilk is the best source of nourishment for infants and young children. However, it is not always easy for the new mothers to navigate this journey on their own due to several reasons. They may need some help to successfully feed their babies. They need support and reassurance as they learn this skill. The lactation consultant can work with you and your baby to increase your chances of having a long and successful breastfeeding experience.

Breastfeeding is a mother's gift to herself, her baby, and the earth.

We at Kamakshi Memorial Hospital provide lactation support through certified highly experienced lactation consultants who can provide you personalized support and care. We offer a range of services to support breastfeeding mothers, including counseling during antenatal and postnatal period, assistance with latching, emphasize on the importance of breast feeding for the baby and mother and advice on breast pumping and storage.

ANATOMY OF BREAST

During pregnancy, the mother makes all the nutrients the baby needs to grow and thrive in the womb. After the baby is born the breasts naturally begin to provide milk, making as much as is needed to feed the baby. The primary function of female breasts is to produce milk in order to nourish an infant, a process called lactation. The breasts, which are composed primarily of fatty tissue, also contain milk producing glands called lobules. Lobules are connected to the nipple by a network of tubes called milk ducts. The breasts produce milk from water and nutrients removed from the bloodstream. The milk is stored in the lobules until the hormone oxytocin signals the tiny muscles in the lobules to contract and push the milk through the ducts.

MILK PRODUCTION AND DELIVERY
Preparing to make milk

During pregnancy, the breasts may become fuller and tenderer as the milk producing glands develop. As the breasts enlarge and blood flow increases small stretch marks may appear and veins in the breast may become more visible. The nipples become sensitive to touch.

Producing and delivering milk

Once the baby is born, the breasts begin to secrete milk.

Letdown reflex
  • The let down reflex is a physiological response to the baby's sucking. When the baby suckles at the breast, sensory impulses go from the nipple to the brain. In response to this the hormones start secreting and secreting cells to produce milk.
  • The flow of milk is controlled by a hormone called oxytocin, this makes the milk which is collected in the alveoli flow along the ducts to the lactiferous sinuses and when the baby suckles, this reflex starts working and milk flows to the baby's mouth.
  • Breast milk production is dependent on frequent suckling by the baby. The more the baby suckles the more the milk is formed. If the baby stops suckling, the breast soon stops making milk.
  • The milk secreting hormone prolactin is produced at night, so breastfeeding at night is especially helpful for keeping up the milk supply. This hormone makes the mother feel relaxed, and sometimes sleepy, so when the mother breast feeds at night, she gets more relaxed.
Colostrum

The body makes several types of milk to meet the baby's needs. Colostrum, the white, clear, or yellowish "first milk" that comes when the child is born, and it is secreted in small quantities for the first 3 - 4 days. Although it is in small quantities, it is sufficient to meet the needs of the newborn baby. It is the first immunization for the baby. After a few days, the breast will gradually begin to produce more mature milk.

Foremilk & Hind Milk

Each time the baby keeps its mouth and sucks at the breast, the milk which is secreted is more watery called foremilk. This will provide more liquid along with nutrients and antibodies. As the baby continues to suck the milk gradually changes to creamy hind milk, which gives the baby additional healthy fats. Hence it is important for the baby to get both foremilk and hind milk at each feeding.

THE GREAT START...

Baby should be started on breastfeeds as soon as possible after delivery. Breast feeding takes practice just like learning an unfamiliar dance. It gets easier as the baby grows.

POSITIONS FOR BREAST FEEDING
Cross Cradle hold
  • Sit in a comfortable position. Keep the back straight.
  • Keep a pillow on your lap to support the baby.
  • Hold the baby close and facing the mother.
  • Gently support the baby's neck, back and shoulders. The palm of your other hand can support the baby's back.
  • Baby's nose should be facing towards the nipple
  • Check to make sure the baby's ear, shoulder and hip are in a straight line.
  • Tickle the baby's upper lip with the nipple. When the baby opens the mouth wide, help him/ her to attach to the breast by taking more of the areola inside the mouth.
Cradle Hold
  • Sit in a comfortable position. Keep the back straight.
  • Keep a pillow on your lap to support the baby.
  • Hold the baby close and facing the mother.
  • Gently support the baby's neck, back and shoulders with the mothers' hand and wrist
  • Support the breast with either the "U" hold or "C" hold
  • The baby's head will be in the mother's forearm and the baby's back will be along the inner arm and palm.
  • Tickle the baby's upper lip with the nipple. When the baby opens the mouth wide, help him to attach to the breast by taking more of the areola inside the mouth.
Football Hold
  • This position is more comfortable when the mother has twin babies and wants to feed them.
  • Sit in a comfortable position. Keep the back straight.
  • Keep a pillow on your lap to support the baby.
  • Hold the baby close and facing the mother.
  • Gently support the baby's neck, back and shoulders with the mother's hand and wrist
  • Let the baby lie on the mother's arm.
  • Baby's nose should be facing towards the nipple.
  • Support the breast with the other hand.
  • Tickle the baby's upper lip with the nipple. When the baby opens the mouth wide, help him to attach to the breast by taking more of the areola inside the mouth.
Lying Down / Side Lying

This is an outstanding position if the mother had a caesarean or difficult delivery, or if she is breastfeeding in the middle of the night.

  • Start by getting comfortable lying on the side. The baby lies facing the mother, so the baby's tummy is facing the mother's tummy.
  • Check to make sure that the baby's ear, shoulder, and hip are in a straight line - not twisted.
  • Put some cushions or pillows behind the mother for support. A rolled-up baby blanket can be placed behind the baby will help support them - remember to remove it after the feeding is completed.
  • Tuck the arm you are lying on under your head or pillow (ensure the baby's position is not altered by the pillow) and use the mother's free arm to support and guide the baby's head to the breast.
The Laid Back

Lay - back breast feeding, also known as biological nursing, is when the mother lies back in a comfortable semi - reclined position on a comfortable sofa or bed.

  • Lean back on a sofa or bed
  • When you are comfortable place the baby on the chest. Baby's tummy should be resting on the mother's tummy.
  • Allow the baby to self attach. In this position the baby will try to find the breast and attach by themselves. Otherwise, the mother can help and guide the baby towards the nipple.
  • Pillows or cushions can be used to support wherever needed.

APPROPRIATE POSITIONING OF MOTHER AND BABY DURING LACTATION IS MOST IMPORTANT TO MAKE
BREAST FEEDING SUCCESS.

CUES OF HUNGER IN A BABY
  • Wakes up and acts restless.
  • Put hands to mouth.
  • Make sucking noises.
  • Turns head towards breast.
  • Puckers, smacks, or licks lips
  • Has clenched hands.
Signs of Feeding Cues
Early Cues - i am hungry
stirring
Mouth Opening
Turning Head / Seeking/ Rooting
Mid Cues - i'm really hungry
Streching
Increasing Movement
hand to mouth
Late Cues - Calm me, Then feed me
Crying
Lots Of Movement
Colour Turning Red
CALMING A CRYING BABY
  • Cuddle the baby.
  • Skin to skin on chest.
  • Make sucking noises.
  • Talk or sing to the baby.
  • Puckers, smacks, or licks lips
  • Pat or rub the baby's back.
  • Change the wet diaper.
  • Feed him /her if they are hungry.
LATCHING

A latch is the way a baby attaches to the breast.

A good latch is important to
  • Prevent pain & damage to mother's nipple.
  • Prevent breast engorgement due to improper milk removal.
  • Make sure the baby gets enough milk.
  • Help the breast to make more milk
  • Prevent babies from undernourishment and weight loss.
Helping the baby to latch on
  • Sit/ lie in a comfortable position.
  • Begin by supporting the breast with your hand. Put the thumb on top and the fingers below the breast with the hand in a "C" or "U" shape.
  • Hold the baby in such a way that the nose and upper lip is in line with your nipple.
  • Tickle the baby's upper lip with the nipple
  • Wait until the baby opens its mouth very wide.
  • Quickly bring the baby onto your nipple and breast so that his chin touches your breast first and he gets a large mouthful of nipple and breast.
  • If you feel painful tugging or pinching, slide your finger into the corner of the baby's mouth to break the suction and try again.
Signs of good attachment
  • Baby's mouth is wide open.
  • More of the areola above and less of areola below.
  • Keep a pillow on your lap to support the baby.
  • Baby's lower lip is turned outwards.
  • Baby's chin is touching the breast
  • Baby will take slow deep sucks while breast feeding with some pauses.
BENEFITS OF BREAST FEEDING
For the baby
  • Breast milk meets all the nutritional needs of the baby.
  • It protects the baby from infectious diseases.
  • It is available fresh and at the right temperature whenever the baby needs it.
  • It builds a strong emotional bond between the mother and the baby.
  • The breast-fed babies are proved to be more intelligent
For the mother
  • It helps the mother to reduce body weight and get back to the pre pregnancy weight.
  • It reduces the risk of breast cancer in premenopausal women.
  • It saves you money.
  • It gives protection against breast and ovarian cancer.
  • It helps the mother in family planning as it has contraceptive effect & helps delay the next pregnancy.
  • Breast feeding mothers are more relaxed and happier.
CHALLENGES IN BREAST FEEDING
Sore or cracked nipple

If the nipples are sore and wounded, the baby may not be latching correctly. While feeding, the baby should grasp the areola with a wide-open mouth.

  • Try different and correct feeding positions.
  • Do not allow the baby to chew on the nipple.
  • When you want to remove the baby from breast while feeding, gently put your finger into the corner of the baby's mouth and slowly release the suction.
  • To soothe and heal sore nipples, after feeding express a drop or two of milk and rub it gently onto the nipple.
  • Wear loose clothes.
  • If the breasts are cracked, scabbed or bleeding contact your consultant.
Flat or inverted nipple

Most mother's can breast feed on this type of nipple without any problems because when babies are latched on correctly, they suck on the breast not on the nipple.

If needed the following tips can be tried.

  • Roll the nipple between the fingers.
  • Avoid giving baby bottles or pacifiers.
  • Can use breast pump at the start of the feed to help to draw the nipple out.
  • Use of nipple shield.
Breast engorgement

Breast engorgement is breast swelling that result in painful, tender breasts. It is caused by an increase in blood flow and milk supply in the breast.

Symptoms

Breast feels,

  • Hard or tight.
  • Tender or warm to touch.
  • Heavy or full.
  • Lumpy and swollen.

Management

  • Use warm compress or take a warm shower to encourage milk to letdown.
  • Feed more regularly in the correct position.
  • Feed as long as the baby is hungry.
  • Use a cold compress or ice pack to relieve the pain.
  • Wear a bra with extra support.
BLOCKED DUCT

Causes

  • Infrequent feeding.
  • Not breast feeding at night.
  • Tight clothing.
  • Nipple fissure.
  • Large breasts

Management

  • Correct suckling position.
  • Frequent feeding.
  • Gentle massage of the lump towards the nipple during breast feeding.
  • Wear loose clothes.
BREAST FEEDING MISCONCEPTIONS
  • Discarding the colostrums.
  • Mother should not take cereals for the first week of delivery.
  • Breast feeding will make them lose their figure and their breasts will sag.
  • Mother should be fed with more ghee after delivery.
  • Pressing the breast yields more milk
  • If the mother is ill, babies should not be breastfed.
  • If the child is sick, then he should not be breastfed.
  • Increased intake of milk by the mother will yield more milk.
  • Breast of small size cannot produce an adequate quantity of milk.
LACTATION CONSULTANT

A lactation consultant is a certified healthcare professional who specializes in breastfeeding. They provide most of their services during the first few weeks of a baby's life to help parents get comfortable and become proficient in feeding their children.

How can a lactation consultant help you?
  • Provide information on how to increase or maintain a milk supply.
  • Teach parents to recognize and respond to the cues of hunger of a baby.
  • Drafting feeding schedules.
  • Helping parents learn how to get babies to latch.
  • Treating feeding mothers for cracked and sore nipples
  • Treating mothers with breast engorgement
  • Teaching parent's positions for breast feeding
  • Informing parents on expression and storage of breast milk
  • Discuss the importance and management of breastfeeding with pregnant women and their families.
  • Managing lactation in preterm babies
Some reasons you may make an appointment with a lactation consultant are
  • Antenatal and postnatal counseling.
  • Breast engorgement.
  • Plugged ducts or breast infections like mastitis.
  • Sore, cracked, or painful nipples.
  • Milk supply concerns
  • Struggling with breast feeding positions
  • Issues with latching, tongue-tie or sucking
  • Your baby is not gaining weight.
  • Pumping either once you return to work or for bottle feeding with breast milk.
  • Baby refusing the breast.

At DR.KMH we ensure that staff have sufficient knowledge, competence, and skills to support breast feeding and enhance facility-based support to promote, protect and support breastfeeding.

Breastfeeding is fundamental to child health and survival and important for the health of women.

To book an appointment with our BPNI certified Best Lactation Consultant in Chennai, kindly call us on 044 71200200 / 044 66300300. Do not hesitate to seek help and make your breastfeeding journey a positive and fulfilling one!


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