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Breast is Best

The benefits of breastfeeding are clear — if you are able to breastfeed, doing so has myriad advantages for you and your baby. As Ms Cynthia Pang, Assistant Director of Nursing and Senior Lactation Consultant of KK Women’s and Children’s Hospital, says: “Breastfeeding is universally accepted as being ideal for your baby because of its numerous advantages for both the mother’s and baby’s emotional and physical health; and because of the remarkable qualities of natural breast milk compared to commercially prepared formula milk.”
According to Ms Pang, here are the advantages of breastfeeding: 
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For the mother
It can help a mother bond physically and emotionally with her baby.
It helps the womb to contract faster and reduces blood loss after childbirth.
It reduces the mother’s risk of breast and ovarian cancer later in life.
It can help the mother lose some of the weight gained during pregnancy faster as calories are burnt during breastfeeding.
Breast milk is readily available and is always at the right temperature.
For the baby
Breast milk has the right balance of nutrients a baby needs, including protein, carbohydrates, fat, calcium, vitamins and minerals.
Breast milk is easy to digest.
Breast milk has antibodies that can boost a baby’s immunity and protect from common childhood illnesses such as diarrhoea and respiratory tract infections.
Breast milk reduces the risk of allergies in the baby.
Breast milk has been linked to a baby’s brain development; there is evidence that breastfed children perform better in intelligence tests.
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​Breastfeeding starts when the baby is born, but until after birth, there’s plenty you can do to prepare during pregnancy. Arming yourself with information on breastfeeding techniques and troubleshooting will help you through those tough early days with your newborn.
1. See a lactation consultant
Start in early pregnancy, says Ms Pang. Check with a lactation consultant to see if you have inverted or flat nipples as these can affect how your breastfeeding. Pre-delivery, under supervision from a lactation consultant, you can try to correct the inverted or flat nipple with the use of a device called the “niplette”. The device helps to draw the flat or inverted nipple out, making it easier for baby to latch on. You start start using the niplette as early as 12 weeks into your pregnancy, but do be patient as it may take between four and 12 weeks before it has an effect.
2. Do your research
Find out more about breastfeeding by reading books, attending breastfeeding talks and talking to friends who have breastfed their babies. With increased knowledge, you will be better able to cope with breastfeeding.
3. Take care of your breasts (and nipples)
Wash your breasts daily – but don’t use harsh soaps – to remove dead skin and to avoid clogged pores and ducts. As your pregnancy progresses, you’ll find your breasts growing – some women gain more than two cup sizes! Use a good support bra without underwire, or switch to a nursing bra as your breasts get bigger. As you get near to your delivery date, you might find that your breasts begin to leak – simply use a breast pad if it bothers you, and change the pad whenever it gets wet through.
Your baby’s first feed should take place as early as possible after delivery, ideally within the first hour of birth, says Ms Pang. During the first hour, your baby is alert and his sucking reflex is at its most intense. Subsequently, feed baby on demand and allow him to feed for as long as she wants. A healthy baby usually has eight to 10 feeds a day, or once every two to three hours.
Ensure that the baby is held correctly and latches onto your areola. This enables him to suckle effectively. If you experience difficulties in latching, try using the modified cradle or football hold. With these two types of hold, you will be able to exercise better support and control to ensure that your baby opens his mouth wide before you swiftly bring him to latch onto the areola.
1. Support your baby at your breast  
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2. Hold your baby with his body turned on the side and his mouth facing your nipple. Support your breast with four fingers below and the thumb by the side, away from the areola.
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3. Tease your baby’s lower lip with your nipple to get him to open his mouth. 
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4. Bring your baby to the breast when he opens his mouth wide. 
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5. Make sure that your baby grasps as much of the areola (the dark ring surrounding the nipple) as possible.
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You are holding your baby correctly if:
• Your baby’s head and body are supported at the breast level.
• Your baby’s chin is touching the breast.
• Your baby’s mouth is wide open, covering the areola.
• Your baby’s gum is covered by his tongue.
• Your baby’s lips form a seal on your breast with the lower lip turned out.
Signs of correct sucking:
• There is no pain or discomfort in your nipple.
• Your baby’s jaw is moving rhythmically.
• You are able to see or hear him swallowing the milk.
• Your baby’s ears are wiggling.
• There is no clicking sound from your baby.
• Your baby’s cheeks are not drawn in.
Allow your baby to finish feeding from the first breast and let him detach on his own — don’t end the feed early by actively removing your baby from your breast. Finishing a feed from each breast is satisfying for the baby because hind milk (milk from the later part of a breastfeed) has a high caloric content. Offer your baby the other breast even though it is not necessary for your baby to feed on both breasts for a feed (and not all babies will). For the next feed, offer the second breast first. 

A baby who has had enough is content and wets about six to eight nappies in 24 hours. During the first two days after birth however, your baby may only wet two to three nappies in 24 hours and pass three to four dark greenish stools. The number of wet nappies will increase by the fourth and fifth day with the increase in milk supply. By day seven onwards there will be about three to eight loose or soft yellowish stools per day.
Ms Pang shares that maximising the milk production during the first two months after delivery is essential for prolonged breastfeeding. To ensure successful breastfeeding and a sufficient milk supply, you need technique and support. Latching your baby on as early as possible, and making sure that he latches on correctly, can stimulate your milk supply. Doing so can also help minimise problems such as sore nipples and engorgement.
Milk production operates on a demand-and-supply basis. Milk is effectively removed from the breast when your baby is correctly latched on, and suckles well. This helps to build and maintain your milk supply, enabling you to breastfeed for a longer time. If your baby is unable to latch on to breastfeed, you will have to express your breast milk regularly in order to stimulate and maintain your milk supply.
Some mothers need to supplement their baby’s intake with expressed breast milk or formula milk. Initially, avoid using the bottle as this may make it more challenging for your baby to latch on to breastfeed. Consider using alternative feeding methods such as a spoon, a cup or tube-feeding at the breast. Seek professional help early and you should be able to gradually reduce the amount of formula supplementation and works towards full breast milk feeding. This may take several weeks to achieve, so be patient and persevere!
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