Baby Feeding
Breastfeeding is best for your baby and is recommended by health professionals and maternity services. Breast milk contains all the nutrients your baby needs and is easily digested. It is economical, safe and always the right temperature.
Breast milk protects your baby against some infections and can reduce the risk of developing allergies. Breastfeeding saves time compared with cleaning, sterilising and making bottles of formula. It can reduce the risk of you getting breast cancer and may help you get back to your pre-pregnancy weight. It can also encourage bonding between you and your baby because of the close contact it involves.
Exclusive breastfeeding is recommended for the first six months of your baby’s life. Breastfeeding can continue alongside other appropriate foods for two years or more.
Beginning breastfeeding
Breastfeeding is easy for some women but can be tricky to begin with. Start each feed on the opposite breast to the one used at the beginning of the last feed. The baby should not suck on the nipple alone, but take in part or all of the areola (the area around the nipple) as well. If the nipple alone is suckled this may damage it, and make feeding less effective. To release the baby’s latch you can gently slide your little finger (clean) into the corner of baby’s mouth.
Finishing breastfeeding
If you want to wean your baby off breastfeeding this is best done gradually. Drop one feed in one day, then after a while, drop another feed. If your breasts become engorged, expressing a little milk will make them more comfortable.
Overcoming problems with breastfeeding
Reflux
Reflux is a common problem in young babies. This is when milk and stomach acid come back up out of the stomach. Babies usually grow out of this at around four months old. See your health professional if the reflux is particularly bad; the baby is not gaining weight, or if you are otherwise concerned.
Engorged breasts
Sometimes breasts can become engorged, causing pain and difficulty in ‘latching’ the baby. Try expressing a little milk first if this is a problem.
Mastitis
Mastitis – infected, blocked milk ducts – may follow engorgement. Symptoms usually include breast pain, fever and flu-like symptoms. Your doctor or midwife may need to prescribe a course of antibiotics.
Cracked nipples
For cracked nipples apply a soothing cream, but most importantly, get help with your feeding technique – the baby is probably latching incorrectly.
Low milk supply
Sometimes mothers notice their milk supply may seem lower if their baby has been very hungry for a couple of days. If baby is gaining weight and having six or more very wet nappies per day, then the milk supply is fine. As baby gets older and bigger, he/she needs more milk and your supply naturally increases if the baby feeds more. Allow the baby to feed often and completely empty one breast before swapping to the other. Within a couple of days the milk production will increase.
Occasionally a baby may not be getting enough milk due to incorrect latching or sucking, or rarely due to an underproduction of milk by the mother. Ask your midwife or doctor for advice if you think your technique needs improving, or if your baby doesn't latch on properly. Get plenty of rest while you are breastfeeding and make sure you are eating and drinking well. Remember it's OK to ask for help if you need it, or if your baby doesn't seem like he/she is putting on any weight.
Bottle feeding
Although exclusive breastfeeding is recommended for the first six months of your baby’s life, there may be times when a bottle is needed to feed the baby expressed milk or infant formula. When using a bottle, proper hygiene measures must be followed to ensure that your baby does not get sick.
Infant formula
Never use cows' milk in infants aged less than one year because it does not contain the right amounts of nutrients and iron necessary for a growing baby. Discuss which formula is best for your baby with a Plunket nurse, your doctor or a midwife. If you think your baby may be lactose intolerant or have allergies, seek further advice before giving lactose-free or non-dairy formulas long-term.
Bottle hygiene and warming tips
Always wash your hands properly before you touch any of your baby’s feeding equipment or food
Use good quality teats and bottle, and use teats that are the right flow for your baby's age
Clean and sterilise feeding, expressing and preparation equipment for every feed, until your baby is at least three months old. A dishwasher will clean, but not sterilise
Store infant formula powder in its container, sealed, in a cool dry place. Do not allow unwashed hands or dirty spoons to dip into the powder. Keep powdered formula covered and use within four weeks of opening
Mix powdered infant formula with cooled, boiled water. Use it straight away and throw out any unused formula that is more than two hours old
Made-up formula that has not been half-drunk by a baby can be stored in the fridge for four hours. Expressed breast milk can sit at room temperature for up to four hours or in the fridge for 48 hours
Never reheat already-warmed or partly-used feeds
If you are travelling with bottles of breast milk or made-up formula, keep them cold in a chilly bag with ice packs and warm only as needed
Warm expressed milk or made-up formula by placing the bottle in a container of boiling water. Microwaves are not recommended for warming baby’s milk because they can overheat the milk or heat it unevenly. Breast milk should not be warmed in a microwave as this may destroy some of the milk’s immunological properties
Always shake the bottle once warmed and check the temperature of the milk by shaking some drops onto the inside of your wrist before giving it to your baby.
See Your Pharmacist or Medical Professional
If you have symptoms of mastitis, such as breast pain, redness, swelling, fever or flu-like symptoms
If your baby is not gaining weight
If your baby is unwell
If you are planning to take or buy any medicine, supplement or herbal remedy – these can be passed into your breast milk
If you are having trouble coping or feel like crying a lot.
Treatment Tips
Drink plenty of fluids, eat well and rest if possible
Do not smoke or expose yourself or your baby to second-hand smoke
Alcohol can pass into your breast milk – avoid alcohol or have only a small amount immediately after feeding your baby, so as much as possible can clear from your breast milk before the next feed
Plunket and the La Leche League provide help with baby feeding and breastfeeding issues (see More Information for contact details)
Treatment Options
Always discuss treatment options with your pharmacist to ensure the best outcome.
Products for reflux
[GENERAL SALE]
e.g., Gaviscon infant sachets
Settles stomach contents, preventing reflux
Do not use in infants aged less than one year without medical advice
Refer infants on a low-sodium diet to a pharmacist
Do not use with other infant milk preparations that also contain a thickening agent.
Cracked nipple treatments and breast care products
[GENERAL SALE]
e.g., creams and ointments, (e.g., Bepanthen, Lansinoh, Lucas Paw Paw ointment, Medela Purelan)
Cracked nipples are usually caused by incorrect latching or comfort sucking by the baby
Apply creams or ointments after every feed and as needed.
e.g., nipple shields (e.g., NUK Nipple Shields, Tommee Tippee Closer to Nature Nipple Shields)
Nipple shields protect the breast but baby may not get as much milk and may become confused by the different feel of the nipple shield, and struggle to change back to the breast. It is usually advisable to use them for short periods of time only
e.g., breast shields/pads (e.g., NUK Breast Gel Cushions, NUK Nursing Pads)
Keep your breasts dry with good quality breast pads, changed after each feed.
Products for thrush on the nipples
[PHARMACY ONLY]
e.g., clotrimazole (Canesten cream), miconazole (Daktarin cream)
Use an antifungal topical cream and wipe off before breastfeeding.
Sterilising products
e.g., NUK microwave sterilising equipment, NUK electric steam steriliser, Tommee Tippee Electric Steam Steriliser
If you are expressing, bottle feeding or feeding water to baby, or using a nipple shield or pacifier, clean (using detergent, hot water and brush) equipment first
All feeding equipment should be sterilized as well until a baby is at least 3 months old.
Products for expressing milk, storing milk, and bottle feeding baby
e.g., NUK manual or electric pumps, NUK breast milk containers, NUK Orthodontic Shaped Teats/Soothers, NUK Glass and BPA-free bottles,Tommee Tippee electric pump, Tommee Tippee BPA-free bottles, Avent manual pump, Medela pump (electric, battery, manual)
Expressing can be done by hand or with an electric or manual pump – the milk can be refrigerated or frozen
Specialised teats (e.g., for babies with cleft palates) are also available.
More Information
For further information about feeding your baby, talk to your Plunket nurse or midwife. The La Leche League provides help, information and support with breastfeeding, nutrition and weaning.
Phone helplines
Plunketline on 0800 933 922 – for information and advice on parenting and health issues for children under five years.
Healthline on 0800 611 116 – for advice about health concerns for people of all ages
Both numbers are staffed 24 hours a day by registered nurses or other health professionals. Calls to either line (within New Zealand) are free and confidential.
Useful websites
NZ Food Smart website at www.foodsmart.govt.nz – for detailed information about safe feeding for infants, including sterilising and cleaning bottles and feeding equipment.
Availability of medicines
GENERAL SALE available through pharmacies and possibly other retail outlets.
PHARMACY ONLY available for sale through pharmacies only.
PHARMACIST ONLY may only be sold by a pharmacist.
PRESCRIPTION ONLY available only with a prescription from your doctor or other health professional.
Consumer Medicine Information on some medicines is available at the government website www.medsafe.govt.nz
