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Hey, new mum! Is there a right way to do this?

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Hey, new mum! Is there a right way to do this?

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Why is my baby crying so much? Are they supposed to sleep at this time? Am I doing this right? Is it supposed to be this hard?

New mums, these are a few of the questions you may have asked yourself, your mother, mother-in-law or your paediatrician. It is extremely common for new mothers to feel confused and question everything because becoming a first-time parent is a new and complex experience. So, we at oDoc have answered six of the most commonly asked questions to help you out.

 

 1. How often should I feed my baby?

Every child is different and there is no ‘golden rule’ for how often you should feed your baby. If you are breastfeeding, you may have to feed them more often as breast milk gets digested faster than formula. It is recommended you nurse every 1.5-3 hours if you are breastfeeding and every 2-3 hours if you are giving formula. As they grow older the time between feeds will increase. 

Newborns are most likely to nurse eight to 12 times a day for the first month; when your child gets to be 4 to 8 weeks old, they’ll probably start nursing seven to nine times a day.

2. How do I know when my baby is hungry?

It’s difficult to distinguish between the sleepy-cries, carry-me-now – cries and hunger-cries. But watch out for the following cues your baby might give if they are hungry

  • Leaning toward your breast or a bottle
  • Sucking on their hands or fingers
  • Opening their mouth, sticking out their tongue, or puckering their lips
  • Fussiness and crying 

These may indicate that it is time for their next (which would feel like their 100th) meal for the day. 

3. How can I increase my milk supply?

It is common to worry about not producing enough milk. In fact, it is very common amongst new breastfeeding mothers. So you aren’t alone. Data from the Centers for Disease Control and Prevention shows that approximately 75% of new mothers start off breastfeeding their babies, but many stop either partially or completely within the first few months. One of the most common reasons for this is the worry about insufficient milk production. Most women usually have sufficient milk production but if you are worried you could try the following: 

  • Try feeding more often – as your baby feeds, your pituitary gland releases hormones that are involved in lactation. 
  • Eat foods that are proven to increase milk production such as ginger, garlic and fenugreek.
  • Try feeding your baby from both breasts – stimulation of both breasts will increase milk production.
Mother holding her baby

 

4. Will I spoil my infant if I hold onto them too much?

No, absolutely not. Contrary to popular belief this is not true. You can’t spoil a baby by holding on to them or by giving them too much attention. In fact, giving them constant attention is crucial as it is the foundation for them to grow emotionally, physically and intellectually. So, next time someone says you are giving your baby too much attention, tell them you are just ensuring their needs are met, just like the good mom you are. 

5. Is this colour of poop normal?

This is probably a question you’ve asked yourself many times. Do you open the pamper and always examine the poop to make sure the colour is ‘normal’? But not sure what exactly the ‘normal’ baby poop colour is?  Below are what each coloured poop may actually mean (source: Healthline).  

Table comparing different colours of poop

6. How often should my baby poop?

Meconium, the newborns first poop, will pass in the first 24-48hours. After that, the bowel movement settles in, and the poop may be light brown, yellow, or yellow-green in colour. A baby should poop about 3 times a day when breastfed in the first 6 weeks. Some may even poop 4-12 times a day. After starting solids they can poop more than that. For formula-fed babies, 1-4 bowel movements per day, is expected. 

So next time these questions arise in your mind, we hope these answers will also pop up and calm you down a bit. We just wanted to say that we are sure you are doing an amazing job and there are many moms out there who are questioning the same things as you. If you have any questions regarding your baby’s health or would like some medical advice you can consult a paediatrician from the comfort of your home via the oDoc app. Click here to download oDoc now. 

Stay indoors and be proud of all you have achieved with your little one. 

 

Sources

Santos-Longhurst, A. (2018, May 7). 5 Ways to Increase Breast Milk Production. Healthline. https://www.healthline.com/health/parenting/how-to-increase-breast-milk

Brody, B. (2015, July 23). Baby Feeding Schedule. WebMD. https://www.webmd.com/parenting/baby/baby-feeding-schedule#1

UNICEF. (n.d.). Busted: 14 myths about breastfeeding. Retrieved October 12, 2021, from https://www.unicef.org/parenting/food-nutrition/14-myths-about-breastfeeding

Prime, D. K., Garbin, C. P., Hartmann, P. E., & Kent, J. C. (2012). Simultaneous Breast Expression in Breastfeeding Women Is More Efficacious Than Sequential Breast Expression. Breastfeeding Medicine, 7(6), 442–447. https://doi.org/10.1089/bfm.2011.0139

Canadian Breastfeeding Foundation. (n.d.). Herbs for Increasing Milk Supply. Canadian Breastfeeding Foundation. Fondation canadienne de l’allaitement. Retrieved October 12, 2021, from https://www.canadianbreastfeedingfoundation.org/induced/herbs.shtml



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Understanding the dynamics – breastfeeding, pregnancy and COVID vaccines

Understanding the dynamics - breastfeeding, pregnancy and COVID vaccines

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As Sri Lanka rolls out its vaccination program, the questions have shifted from “Which vaccine should I get?” to “Should pregnant and breastfeeding women get vaccinated?” 

The answer in short: Yes, everyone should get vaccinated when offered the chance.

For a more detailed answer on how the vaccine affects pregnant and lactating women, read more below.

Breastfeeding and vaccinations 🤱🏾

Women who have recently given birth or are still breastfeeding should get the vaccine. 

Initially, the clinical trials for the COVID-19 vaccines currently in use did not include women who were breastfeeding. So, there was no clinical data on the safety of vaccines in lactating women, effects of the vaccine in breastmilk production and the consequences on the baby. However, now according to the WHO and new research, lactating women can receive a COVID-19 vaccine.

Recent reports have shown that breastfeeding women who have received COVID-19 vaccines have antibodies that pass on to the baby via breast milk, helping in protecting the baby. 

 A study conducted in Israel with thePfizer-BioNTech vaccine, with 84 breastfeeding women, showed that IgA antibody (the first line of defence when exposed to an infection) secretion was present as early as 2 weeks after vaccination in the breast milk. This was followed by a spike in IgG antibody (important for remembering the virus to prevent future infections) 1 week after the second dose in the breast milk. This suggests a potential protective effect against infection in the infant as these antibodies are passed on to them via the milk. No mother or infant experienced any serious adverse event during the study period.

More data is needed to understand what protection these antibodies provide to the baby. Even though the studies on breastfeeding and vaccinations are not advanced, the present data shows no indication of harm to the mother or child.

Pregnancy and vaccinations 🤰🏾

As with many other vaccines, the effects of the COVID-19 vaccines on pregnant women have not been studied extensively yet. However, health professionals assess the risks of COVID19 vs. the COVID vaccine when deciding whether pregnant women should receive the vaccine. 

Pregnant women with any of the following conditions are at a higher risk of contracting severe COVID than women who are not pregnant: 

  • have underlying health conditions (for example diabetes, high blood pressure or asthma)
  • are overweight
  • are aged 35 years or over

Preliminary findings in a study conducted in the US on the effects of mRNA vaccine in pregnant women did not show obvious safety signals among pregnant women who received mRNA Covid-19 vaccines compared to the control group.

It must be noted that injection-site pain was reported more frequently among pregnant women than among non-pregnant women, whereas other side effects such as headache, chills, and fever were reported less frequently. However, a more detailed and longitudinal study is needed to understand the full impact of vaccination on pregnant women. 

We already know pregnant women are at a higher risk of getting severe COVID and also at a higher risk of delivering a baby prematurely. So in a country like Sri Lanka, where the transmission rate is high, the benefits of getting the vaccine far outweigh the risks. 

Fertility and vaccinations 🌸

Women who are planning to get pregnant in the near future can absolutely take the vaccine. There is no evidence of COVID vaccines affecting fertility or the chances of getting pregnant. So get your vaccine when it becomes available to you. 

If you want more detailed information on getting vaccinated you can speak to one of our on-demand GPs at any time via the oDoc app. If you or your loved ones are showing any COVID symptoms please consult a doctor via oDoc immediately or use the oDoc COVID symptom checker to understand what you should do next.

Sources

  1. Perl, S. H., Uzan-Yulzari, A., Klainer, H., Asiskovich, L., Youngster, M., Rinott, E., & Youngster, I. (2021). SARS-CoV-2–Specific Antibodies in Breast Milk After COVID-19 Vaccination of Breastfeeding Women.
  2. Vaccination Considerations for People Pregnant or Breastfeeding. (2021, June 16). Centers for Disease Control and Prevention. 
  3. Public Health Scotland. (2021, June 18). Pregnancy, breastfeeding and the coronavirus vaccine. The Coronavirus (COVID-19) Vaccine. 
  4. WHO. (2021, June 4). Episode #41 – Vaccines, pregnancy, menstruation, lactation and fertility. World Health Organisation.
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Is My Baby Drinking Enough Milk?

Is my baby drinking enough milk?

Milk supply myths debunked!

Nicole Parakrama | BSc Hons Molecular Cell Biology, UCL (UK) | 17th April 2021 | <5 minute read

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“Aney why is he crying so much?”…

…“Hungry-da?”…..

Mothers of infants might find this line of questioning familiar!

In our culture, we tend to cajole and bribe our children into eating more, with the goal of making them as chubby as possible. However, when we don’t allow our children to regulate their hunger for themselves, this can lead to unhealthy eating patterns (see this study here) with repercussions all the way into adulthood (some other great longitudinal studies here and here). We do our children a great disservice when we don’t take into account their varying body structures, feeding patterns, and metabolisms when considering when and how often we feed them.

“Aney why is he crying so much?”…

…“Hungry-da?”…..

Mothers of infants might find this line of questioning familiar!

In our culture, we tend to cajole and bribe our children into eating more, with the goal of making them as chubby as possible. 

 This same culture can extend to breastfeeding as well, with negative repercussions as a result! A study conducted by Rodrigo et al among 249 mothers at the Colombo North Teaching Hospital, found that “a family member telling mothers that their milk supply was low had

However, when we don’t allow our children to regulate their hunger for themselves, this can lead to unhealthy eating patterns (see this study here) with repercussions all the way into adulthood (some other great longitudinal studies here and here). We do our children a great disservice when we don’t take into account their varying body structures, feeding patterns, and metabolisms when considering when and how often we feed them. This same culture can extend to breastfeeding as well, with negative repercussions as a result! A study conducted by Rodrigo et al among 249 mothers at the Colombo North Teaching Hospital, found that “a family member telling mothers that their milk supply was low had the most

the most significant impact on Perceived Inadequacy of Milk (PIM)”.  In other words, we can give undue weight to the opinion, however well-intentioned, of someone who is (to put it simply) not the mother of our baby. 

It is not surprising, then, that one of the most Googled questions on breastfeeding is – “How can I tell if my baby is drinking enough milk?”  This is an understandable concern, as we simply cannot see how much milk our baby is taking in at the breast, so we have to guess!  Rest-assured, our babies are very clever at making their needs known – and they will usually drink as much milk as they need.  In turn, our breast tissue will respond over time and produce a supply of milk to match their demands. There ARE instances where concerns are warranted, and supply is low for medical reasons, but this is very often not the case.

This same culture can extend to breastfeeding as well, with negative repercussions as a result! A study conducted by Rodrigo et al among 249 mothers at the Colombo North Teaching Hospital, found that “a family member telling mothers that their milk supply was low had the most significant impact on Perceived Inadequacy of Milk (PIM)”.  In other words, we can give undue weight to the opinion, however well-intentioned, of someone who is (to put it simply) not the mother of our baby. 

It is not surprising, then, that one of the most Googled questions on breastfeeding is – “How can I tell if my baby is drinking enough milk?”  This is an understandable concern, as we simply cannot see how much milk our baby is taking in at the breast, so we have to guess!  Rest-assured, our babies are very clever at making their needs known – and they will usually drink as much milk as they need.  In turn, our breast tissue will respond over time and produce a supply of milk to match their demands. There ARE instances where concerns are warranted, and supply is low for medical reasons, but this is very often not the case.

significant impact on Perceived Inadequacy of Milk (PIM)”. In other words, we can give undue weight to the opinion, however well-intentioned, of someone who is (to put it simply) not the mother of our baby. 

It is not surprising, then, that one of the most Googled questions on breastfeeding is – “How can I tell if my baby is drinking enough milk?” 

This is an understandable concern, as we simply cannot see how much milk our baby is taking in at the breast, so we have to guess!  Rest-assured, our babies are very clever at making their needs known – and they will usually drink as much milk as they need.  In turn, our breast tissue will respond over time and produce a supply of milk to match their demands. There ARE instances where concerns are warranted, and supply is low for medical reasons, but this is very often not the case. 

A longitudinal study by Nielsen et al studied the milk intake of 50 healthy, exclusively breastfed babies over 6 months, and found the milk intake and fulfilment of energy values to be in excess of literature values.

Unfortunately, it is this fear of having a low supply which can become a roadblock in our breastfeeding journeys, far more often than it being an actual medical issue.

At a very high level, the rule of thumb is – if your baby comes off the breast looking relaxed, and if the number of heavy, wet diapers in 24 hours is more than or equal to the number of days old (for newborns up to one week), and 5-6 thereafter, your baby is very likely getting adequate milk (check out this comprehensive presentation by the Sri Lanka College of Pediatricians, particularly slides 41-46).

There are 9 common occurrences that may worry mothers, but which are not necessarily an indication of inadequate milk supply:

1. My baby wants to nurse very frequently

Breast milk is actually digested very efficiently (usually within 1.5-2 hours) and frequent feeding is common as a result.  Some babies are also more ‘sucky’ than others or require more skin contact.

2. My baby suddenly nurses more frequently, or for longer durations

This may be a growth spurt, which usually lasts a few days to a week. Since milk production is supply & demand-based, allowing your baby to feed extra will result in your breasts producing more milk to catch up.

3. My baby suddenly nurses less frequently, or for shorter durations

With age, as your baby gets more efficient at extracting milk, and the size of their little tummy increases, this will happen and is not an indicator of low supply.

4. My baby guzzles down a bottle of milk after nursing

Many babies will take a bottle of milk even after a full breastfeed, due to their suckling reflex, and then fall asleep due to exhaustion rather than satiation.

5. My breasts don’t leak milk, or only leak a little, or have stopped leaking

Leaky breasts have nothing to do with your milk supply adequacy. Leaking often stops once your milk supply has adjusted to your baby’s needs, and/or as the feeds become more predictable.

6. My breasts seem softer, or don’t get engorged anymore

Again this often happens once your milk supply has adjusted to your baby’s needs, and/or as the feeds become more predictable.

7. I don’t feel a let down sensation

Some women may never experience a let down sensation (tingling, pins & needles or a feeling of warmth), or find that it reduces over time. This is not connected to a reduction in supply.

8. I get very little milk when i pump

There are many reasons why this could be… pumping technique, pump type, flange size etc. At the best of times, your baby’s suck will always be more efficient at draining your breasts than the pump can mimic.  Pump output should not be used as a reliable indicator of production.

Hopefully you will find some reassurance if you are in this boat of questioning your supply.  However, if you have already found it in yours or your baby’s best interest to give formula, there is no guilt or shame in that. Breastmilk, while optimal, is not the only way to feed your baby. There are many circumstances where combination feeding (formula + breast milk) or only formula is necessary, and your child will be none the worse for it.  A well-fed baby combined with a happy mother really is the best end result.

How I became ‘The Milk Coach’

When my first child was born, I was quite unprepared for what lay ahead.  Particularly when it came to breastfeeding – I was naïvely expectant that I could just place him onto my chest, and let nature take its course.  What a surprise I was in for!  Cracked nipples from sub-optimal positioning, and my milk taking its own time to come in, led to terrible pain.  This pain became excruciating when my son developed oral thrush which travelled through to my milk ducts.  Fortunately, thanks to a lot of research and some wise mum friends, I was able to power through those awful first few months.  Most crucially, I was able to advocate for myself with health professionals (and I’m thankful for the ones who listened to me when I did!).

This birthed a passion to peer-to-peer counsel, share with and advocate for my fellow Sri Lankan mums, to support them to achieve their breastfeeding goals. To this end I am working to add to a science background (in Molecular Cell Biology) with an accreditation by La Leche League International (LLLI). 

Join the conversation, follow @themilkcoach on Instagram or Facebook.

Download oDoc today on the App store or Play store.
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