Breast-feeding – Nipple preparation and milk supply
Written by Jill Dunn - MHSc Complementary Medicine, Registered Naturopath, Registered Medical Herbalist, Registered Nurse (Non-practising)
During pregnancy, the glandular structure within your breasts develops in preparation for breastfeeding your baby. Within each breast there are 15 to 25 lobes that radiate around the breast and produce milk that passes through ducts to the nipple. Surrounding the nipple, is deeply pigmented tissue called the areola that contains sebaceous glands, which give a slightly bumpy appearance. These sebaceous glands produce sebum that moisturises the nipple, nature's way of helping to reduce chapping and cracking of this delicate tissue.
When your baby suckles at the breast your pituitary gland is stimulated in two ways. It produces the hormone prolactin that starts off your milk production, as well as oxytocin which produces the let-down reflex that causes contraction of individual alveoli within the lobes, sending milk down the ducts to the nipples.
In the initial 2 to 3 days before milk production begins, a yellowish fluid called colostrum is secreted. Colostrum is rich in protein, vitamin A and K, minerals and immunoglobulin A (IgA) antibodies that provide your baby with immunity against a wide array of micro-organisms. You only produce 10-20 ml of colostrum each day but this provides baby with all the essential nutrients to satisfy their needs until your milk comes in. It is advisable to put your baby to the breast as soon as you can after birth, as this stimulates your pituitary gland and the production of milk. It also stimulates the emptied uterus to contract down to its pre-pregnant size.
Breast milk has advantages for the infant:
- Fats and iron are better absorbed and it's amino acids (units of protein) are metabolised more efficiently than cows milk.
- Apart from the IgA antibodies it has a host of other beneficial substances that protect infants from infection.
- Mother's milk contains substances which support the baby's immune system and prevent excessive inflammatory responses.
- Breast milk has a natural laxative effect that helps cleanse the baby's bowels of meconium, the tarry green-black material that contains old cells from the digestive tract, bile and other substances. Excessive bilirubin is cleared from the baby's body through its bowel movements.
- Breastfeeding also encourages the growth of beneficial bowel bacteria that provide a source of vitamin K and B complex vitamins to the baby.
Breast-feeding for the first time requires patience, help and support. It can take several weeks to properly establish your milk supply and for the new mum to gain her confidence. Seeking the advice of a lactation specialist can help overcome any problems early on. While your milk supply is establishing itself and adjusting to the needs of your baby, you will have times of breast engorgement, which needs to be quickly remedied in order to prevent breast infection. Cracked nipples as well as being painful, can also be a source of breast infection if not treated promptly. There are a number of natural remedies that can be very helpful at this time, for the prevention and correction of common ailments. [See article “Mastitis – How to prevent and overcome”]
Caring for your nipples
If you are planning to breast feed, it is important to get your nipples into the best shape for feeding and even more so if you are fair skinned, as these people may be more prone to nipple tenderness and cracking. To prepare your nipples for breastfeeding, each day for several minutes six weeks prior to the expected birth, massage infused calendula oil or cream (in a base of almond, sesame and jojoba oils) into the darkened areola tissue, drawing the nipple out. Such preparations moisten and nourish nipple tissue and can also be used after each breast feed to prevent dry, tender nipples. Calendula heals grazed and cracked skin surfaces and has natural antimicrobial properties that provide some protection against infection.
When breast feeding, in order to prevent sore nipples, make sure your baby is properly latched on to the breast. The baby should be latched on to the entire areola in order to stimulate milk production and to prevent painful, sore nipples. To get baby to open their mouth properly stroke their cheek closest to you and squeeze your breast so that the nipple area is slightly upwards and then place the whole areola in the baby's mouth. Once latched on properly, you will be able to feel a suction effect over the nipple area, baby's top lip will be turned upwards and his ears and jaw will be moving rhythmically.
Preparations containing chamomile or lavender essential oils can be particularly effective at soothing stinging, sore, nipples and can be applied after feeding. Before the next feed remove residue by washing your nipples in warm water without soap, as this is drying.
Establishing your milk supply
Milk is produced on a supply-and-demand basis, so the more you feed, the more milk you will produce. Avoid introducing a bottle with either expressed milk or formula until breastfeeding is properly established. Sucking from the breast requires a different sucking technique to that from a teat, and could make your baby slower at learning how to breastfeed. If you have insufficient milk, galactogogue herbs are used to increase milk supply and include herbs such as fennel seed, fenugreek seed, dried goats rue leaves and milk thistle seeds. Many of these herbs are available commercially, either singularly or in combination as teas or capsules. Teas are weaker and can be taken four times daily. They are best left to stand for 10-15 minutes covered with a saucer and taken four times daily. Capsules can be taken as prescribed on their label, generally three times daily. Also make sure you are drinking plenty of water, getting enough rest and are eating a nutritious diet that is high in protein.
Homeopathic remedies can also be useful if milk production stops or dwindles, and they are prescribed according to the individual's range of symptoms. Combination homeopathic remedies can be used to assist normal production of breast milk, and because they address a wide range of symptoms, may better suit those who are not trained in homeopathy. When taking a combination or single remedy, take three or four drops twice daily until improvement occurs, then stop. Repeat the treatment as and when necessary. The following remedies are commonly used to increase milk production, and can be taken as a single remedy or in a combination:
- Asafoetida 30c – is used when there is not enough milk produced and the mother is excessively oversensitive.
- Calcarea carbonica 30c – is used when either the mother has an abundant amount of milk that is disagreeable to the baby, or there is insufficient milk supply. Also used where the nipples are cracked, ulcerated or very tender or when there is severe, stitching pains in the breasts when feeding.
- Lac defloratum 30c can be used when the breastfeeding mothers milk production stops and is accompanied by depression, chilliness and thirst.
- Pulsatilla 30c can be prescribed when there is very little milk and it is thin and watery. The breast-feeding mother cries when trying to feed the baby and her breasts feel sore and stretched. Useful when poor supply is due to stress and anxiety.
- Ricinus comm. 30c can be used when there is little or no milk and the mother feels weak in mind and body.
- Urtica urens 30c can be used when the breasts are swollen and tender and in conjunction with an absence of milk.
Once properly established breastfeeding is easy, but at first requires patience and support. Breast feeding offers your baby, nutrition that is perfectly designed to meet all its needs and comes without an additional financial cost. The international organisation ‘La Leche League’, which has been operating for 40 years in New Zealand, offers an excellent support service to breast feeding mothers and an opportunity to make new friends. For La Leche League check out www.lalecheleague.org/LLLNZ/
Other articles in this section:
