#AskTheExpert – Dr. Shweta Bajaj – Session 1 – Transcript

We are always working towards making parenting a joyful and stress-free journey. So we have our #AskTheExpert sessions, where we take all your queries and get them answered by our expert. For this session, we had with us Dr. Sweta Bajaj, who is a certified lactation consultant.

She is a gold medalist with an experience of over 7 years. She has also worked with Mother Bee as a lactation consultant. She is also a member of La Leche Asia an organization that aims to provide help to moms who want to breastfeed. Dr. Bajaj is also a blogger on the topic and conducts sessions on lactation for new moms. She conducts classes for new dads to help them understand their partners when it comes to breastfeeding.

Questions:

Q. Whenever I am feeding my baby, I feel a needle pricking pain in my breast and nipples appear white what should I do? -Priya

Needle pricking pain is a sign of fungal infection. Make sure you check your baby’s mouth if there are white lines in the baby’s lips and mouth; then it is also a sign of oral thrush infection. So you need to consult a doctor and you can apply candid oral paint over your nipples and over the baby’s mouth.

Q. My baby had a hand, foot and mouth disease – she is not taking my breastfeeding. What should I do? -Sneha

After the disease, the baby has stopped accepting your breast. To cure this, don’t bring the breast to the baby only when you want to feed her; let the baby play with the breast, observe the breast etc. The more time you spend with your baby the more easy and friendly the baby will become with the breast. Have a bath with your baby – make the baby more comfortable with your breast; let her pull and pinch, kiss over you and slowly the baby will come back to the breast.

Q. My son is 5 months old and I am breastfeeding him for the last 5 months but suddenly my right breast has been appearing red along with pain and burning sensation. What should I do? -Roshini

The sudden pain in breast is a classical sign of mastitis or breast engorgement; it may be that the baby is not able to empty the breast completely so what you need to do is take a warm bath and do warm compresses during the bath. You can hand express some milk or through a pump and after some time the breast will become less heavy and the redness will decrease slowly but still if you feel that the redness is increasing then you should consult your gynecologist and take medication.

Q. My baby boy is 5 months old and recently he started biting me very hard even though milk flow seems to be sufficient. I want to know the reason behind this and also I want to know whether my milk is sufficient for him or not, please help me clarify? -Jeevana

Around 5 months age the babies start teething so biting is the initial symptom of teething. What you can do is hand express some of your milk and make it into small ice cubes and make small ice popsicles and before feeding the baby give the ice popsicles. As they are hard and cold so the gums of the baby will be soothed so he’ll bite you less and have more frequent feeds.

Q. My baby is six weeks old my busts are on the heavier side. How do I lay down and feed? -Priyanka

For a heavier breast mother, it is easier to breastfeed when you are lying down or in a kneel down position so that the breasts are against the gravity and the flow of milk is under control. When you lay down comfortably make sure your neck and back are well supported.

Q. My baby is about 3 months old. Please suggest when should I feed him, should I maintain any gap and any food suggestions which will help me produce more feed for my baby? -Ashni

For a 3-month-old baby, you need to feed on demand and this depends upon the growth of the baby and the demand can vary from 30 minutes to 3 hours. You can use sabudana, jeera, jaggery, khichdi, and other Indian food substances which act as galactogogues and they help to enhance the milk supply.

Q. How do I know that my baby’s stomach is full and if she is latching correctly?

To know whether the baby is getting feed sufficiently or not you need to count the number of diapers a baby is wetting in a day. A baby on a mother’s feed should wet at least 5 to 6 diapers in a day. This shows the urine outlet of the baby and the urine should be diluted and not have a strong smell. Secondly, your pediatrician is the best guide to tell you whether the baby is getting enough of feed or not through weight monitoring which is the pure guide to know that the baby is gaining weight. A breastfeed baby should gain at least 700 to 1000 gms per month.

To know whether your baby is latching properly or not there are 4 signs you must see:

• The baby should be at an equal level of your level
• Ear, shoulder, and buttocks of the baby must be in one line so when you are holding the baby make sure the face of the baby is towards you, the tummy of the baby should touch the tummy of the mother and when you are latching the baby should come from below towards your breast.
• Make sure the baby opens a large mouth and you put the larger part of your breast inside the baby’s mouth and not just the nipple.
• When the baby suckles you must make sure that the chin of the baby touches your breast and the areola is visible more on the upper side and less on the lower side.

Q. Does oiling my hair increase milk production or is it just an old wives tale? -Reshmi

In a way it’s an old wives tale but we can say it helps in milk production because after oiling the hair, mothers feel relaxed which leads to oxytocin release and more oxytocin will help produce more milk.

Q. How do I burp and ease me baby? -Rakesh

It is not necessary that all babies make a sound to burp. What is important is that after every feed you carry your baby in an upright position and hold him gently for at least 10-15 mins and gently tap the back of the baby.

Q. My baby gets restless whenever I change my breast too soon. Is it okay? How do I know when to offer which breast? -Shalini

It is not okay to change your breast frequently; make sure that you completely breastfeed your baby from one side and only then you change the side because when you frequently change your breast the baby only gets the foremilk which is the watery milk and which is the first form in the breast so baby will never get the required amount of milk which helps in increasing weight. So the milk which is coming later is thicker and has good consistency. So offer one breast at one time and if the baby is feeding for more than 25 mins then you can switch to the other breast.

Q. My baby is losing her latch; in first two months she latched properly however in the third month she is latching and making sounds and losing her grip and also swallowing air and choking which is making her uncomfortable and that’s why she is unable to feed and starts crying. What should I do ?- Priya

Since your baby was latching properly for two months and now unlatching it may be because around three months of age some babies enter a growth spurt age. So if that is the condition don’t lose hope. Within a few days baby will come back to the normal stage. In this growing spurt stage, the baby has become more cranky and so they want their mother to be near them.

Q. How do I know that I am producing enough breast milk ?-Upasna

There is no hard and fast rule by which a mother can identify whether she is producing enough milk or not but there are two things by which you can come to know – make sure you count the wet diapers of the baby. If a breastfeeding baby is wetting more than 6 diapers a day that’s a good sign that the baby is getting enough milk and secondly when you go for regular checkups to a pediatrician, the weight monitoring of the baby will help you make sure that the baby is getting enough breast milk.

Q. My baby drinks only 70% formula and 30% breast milk. Because of a C-section I was unable to produce milk initially. I have flat nipples too so my baby has latching issues now. I feel that while I may be producing a moderate amount of milk the baby has grown to prefer bottle feed and even refuses to breastfeed. What should I do ? –

Flat nipples are not at all a barrier for feeding. Any breast anatomy of any mother can easily make and feed the baby normally. So what you can do first to treat your flat nipples is you can take a 20 ml syringe cut the upper portion and put the barrel against it in the opposite Direction. First make sure to place it in your hand and check which pressure is pulling your skin out. Use the same pressure and apply it on your nipples and just gently do it one or two times – pull it outwards the pressed nipple will come out so the baby will easily be able to latch it. The second problem is that the baby has gone on an easier process of drinking through a bottle so gradually instead of formula for one day one meal, you remove the formula and give him your breast milk and slowly your baby will come back to your breast.

Q. My 2 months old baby has decreased the breastfeed timing from 25mins to 5mins per session. I am worried that my breast feels fuller than before and he’s showing no interest in feeding. Please tell me a solution ?-Tanya

If the baby is gaining proper weight and he is active then that means there is no problem as the breastfeeding duration anywhere between 5mins to 20mins is considered as a normal breastfeeding duration. Some babies become more active and their latching and suckling power is more so if your baby has got strong suckling power then he can suckle the same amount of milk in 5mins to fulfill his tummy so you don’t have to worry, secondly if you are feeling that your breast is heavier than before you must hand express the milk and don’t throw it. You can use it for bathing your baby.

Q. My baby is 4 months old and I had a tough time with my breast milk supply for the initial two month but I kept feeding him – that meant frequent feeding time and exhausted body but now when I feed him for about 30 mins session he is relaxed and in a good mood. What does it mean – is my supply enough for him? -Shatabdi

Yes, it definitely means that a happy baby who’s not troubling you means that the baby is happy and content and your breast milk is doing a wonderful job.

Q. How can I avoid colic while breastfeeding?-Mandira

Colic usually happens when babies gulp air; it can be during breastfeeding or during crying so what you can do is while breastfeeding if the baby is getting colicky you must make sure that the latch of the baby is proper, secondly if it due to crying so you must make sure that you give a good baby massage and give some tummy time to the baby. Make the baby sit and hold him – this also eases the colic of the baby and you can burp the baby so that the colic gets eased.

Q. How can I tell that my baby is getting enough milk?-Anu

There are two things which you need to keep in mind make sure you count the number of wet diapers in a day – a baby who’s completely on mother’s milk should wet at least 6 to 7 diapers a day and the next is weight monitoring. Whenever you go to your pediatrician the weight monitoring will be done and the doctor will advise you whether the baby is gaining a good amount of weight or not.

Q. What causes leaking and how do I stop it?-Radhika

Leakage from the breast is very common during the initial days when the demand and supply rule is not yet established by the mother’s body so the body still has not got the correct signal of how much amount of milk has to be made. So if the leakage is at that time you can use a breast pad but if you are facing the leakage problem when you are feeding from one breast and the other breast is leaking then that will also get controlled in a few days. The second type of leakage happens when you are away from the baby – it is best to use breast pad at that time and if you are at home you can use cold cabbage leaves; you can cut cabbage leaves place them in the freezer and then you can apply it. Even that will soothe and stop the leakage.

Q. Is there a special diet that should be followed while breastfeeding ?-Tina

Yes, a breastfeeding mother should take at least 1,500 to 2,000 kilocalories per day and you must use dairy products, take a good amount of protein, make sure you take 3 bowls of vegetables, curd or cereals and you must include nuts also and dry fruit in your diet.

Q. How frequently should I feed my baby?-Sonali

In the initial few days around 10 to 20 days after delivery, you must feed after every 2 to 3 hours and then once the baby demands. The initial frequent feeding is advised so that the mother’s body makes an established feed for the baby. Once the speed is established then you can feed on demand.

Q.How does position affect breast feeding?-Neelu

Position of the mother and the baby – both are important for breastfeeding because it is not a one day thing; it is something you have to continue for two years, so if you are not comfortable you won’t be able to feed your baby for a longer duration. So first of all make sure that you are at a comfortable position; always make sure that your neck and back is well supported and in a straight direction. Then you must make sure that the baby is close to you and don’t lean over the baby so make sure you bring the baby to your level by using pillows and you can feed in many positions like cradle position, cross cradle position, football hole. So it is very important to make sure that the position of the baby and mother is comfortable.

Q. Till what age should I breastfeed my baby ?-Sukhmani

According to WHO you must exclusively breastfeed your baby till 6 months and with complementary feeding till the age of two years but nowadays we advise till the mother and the baby are comfortable in breastfeeding, they can continue to breastfeed.

Q. Should I not feed the baby when I am sick? – Selena

No, until and unless there is some special reason for your sickness for which your doctor has recommended to stop breastfeeding. Otherwise there is no reason that you must stop breastfeeding. Rather you must continue breastfeeding because of the day when you got the infection and the day when the symptoms appeared in your body till then also you breast fed your baby – you have already passed the infection to the baby and when it is the time to get the antibodies from your milk to fight against the infection, it is going to help your child and you. If you stop breastfeeding the child, symptoms will increase and get worse so it is very good to breastfeed even if you are sick.

Q. Is pumping the milk a good idea?-Komal

Pumping is a good idea but only if you are not at home or the baby is refusing to latch or you are joining back and you have someone to take care of your baby. Always store your milk and always make sure that the caretaker knows how to boil or warm the milk and give it to the baby. It is not safe to boil the milk so it is good to bring it to room temperature.

Q. Is it safe to be on birth control during breastfeeding?-Preeti

Breastfeeding amenorrhea is a different kind of a thing – it helps you by not getting pregnant. But only if you are exclusively breastfeeding and you are not back on your periods but is not a 100% guaranteed method. It is successful only 98 to 99% and it is always advisable to be on a different kind of contraception.

Q. Can baby’s stool help me understand that the baby is getting proper feed?-Shreya

Stool cannot be considered as a confirmed method of determining the feed because sometimes the baby can have diarrhea and sometimes the baby can have constipation so it is better you focus on the urine output of the baby to determine the amount of feed the baby is getting.