Author: Robyn

Most new mums worry they won’t produce enough breast milk for their baby. However, a less feared but still quite alarming problem is when you have an overabundance of milk, also known as hyperlactation. Yes, some people will give you the “Please, some of us have real problems!” reaction, but it’s unsettling to watch your baby choke, gasp and even spew milk from her nose.  Plus there’s the embarrassment of constant leaking and spraying, and the fact that your baby might refuse to feed.

Eventually (usually this month or next) your milk supply will start to stabilise and the gushing river of milk will trickle down to a more appropriate level.

To help control the flow:

Try feeding from only one breast per feeding, adequately draining one side of breast milk while making your body think it should slow milk production in the other. But be careful to switch to the other side at the next feeding. If one breast per feeding isn’t diminishing your supply, try feeding from only one breast in a two-hour period while slightly pumping the other to prevent engorgement. Then switch to the other breast for the next two hours.

Before a feeding, hand express or – for some women – just let the milk flow on its own before putting your baby to your breast. Often the let-down produces the most forceful flow, causing your baby to choke and sputter. But remember not to pump too much out, as the more breast milk you take out, the more you’ll produce to meet the demand.

Gently applying pressure to the areola while feeding can also help slow the flow.

Reposition your baby so he or she is sitting up more, or even try feeding on your back to let gravity slow things down. Be careful not to always feed this way though, as it could cause a clogged duct or breast infection.

If the problem persists call a lactation consultant for more tips.
Written by Linda Drummond for Kidspot, New Zealand’s leading pregnancy and parenting resource.

Sometimes, due to complications or unforeseen circumstances, breastfeeding alone isn’t enough and you need to supplement with formula.  And sometimes mums just want a break from the around-the-clock feedings and are looking for a little relief.

First of all, don’t feel discouraged.  The less you feed, the less you’ll produce, but it’s still possible to maintain enough for a few daily feeds. It’s also possible that undue stress might be more damaging to your milk supply than taking breaks from feeding anyway. As with every aspect of motherhood, do what is right for you and your baby.

Your baby will receive some necessary nutrients through formula, and because you’re still feeding a few times a day, your baby will benefit from breast milk’s unique antibody properties.  A little breast milk is better than none.

How do you know if you need to supplement?

Look for signs that your baby isn’t eating enough  and talk to your doctor as soon as possible.

While it might be necessary to start supplementing, most lactation consultants recommend waiting until your baby is a month old to prevent any production disruptions. If your milk supply is compromised, know that your baby’s health is more important than where the nutrition is coming from. If supplementing is a choice, perhaps weigh your options on waiting it out, as it is best to stay on the breast as long as you can.

Moving onto a bottle

To make the transition smoother, have someone else give your baby bottles in the beginning. Babies are more likely to refuse bottles if they can smell breast milk. If your baby is frustrated or frantic, she is less likely to take the bottle.

There might be changes in your baby’s bowel movements and eating habits when you start supplementing, since the consistency of formula keeps babies fuller longer.

The World Health Organisation recommends exclusive breastfeeding for the first 6 months of your baby’s life, followed by the timely introduction of safe and adequate foods. WHO recommends continued breastfeeding for the first two years and beyond. Breastfeeding provides babies with the best nutrition and is preferred when possible. Always follow professional advice before using an infant formula. Introducing formula can have a negative effect on your milk supply and be very difficult to reverse. Proper use of an infant formula is important to the health of the infant, only use as directed.

Written by Linda Drummond for Kidspot, New Zealand’s leading pregnancy and parenting resource.

Breastfeeding provides babies with the best nutrition and is preferred whenever possible. However, if you are unable to breastfeed, or are using formula for any other reasons, it is vital that you have all the information you need to keep your baby safe and healthy.

The water:

• Boil water and allow to cool. Boil town water for formula until your baby is at least three months old. If you are using bore or tank water, boil it until your baby is 18 months old
• You should always boil water regardless of the age of your baby, if you are pre-preparing formula.
• As filtered water doesn’t remove bacteria from the water, you should follow the rules above depending on the source of the filtered water.

The formula:

• First up – wash your hands
• Before you begin to make up formula, ensure that you have everything you need – sterilised bottles, clean equipment, and somewhere safe to store the bottle if you’re not going to be using it straight away. Wash and sterilise all equipment until your baby is at least three months old.
• Always be careful to follow the manufacturer’s instructions.
• Make sure that you level off each scoop so that you use the correct amount of powder.
• Measure the correct amount of water before you add it to the bottle. Always add the powder to the water, rather than the water to the powder.
• Don’t pack the powder into the measuring scoop.
• Thoroughly mix the water and powder by shaking the bottle.
• Test the temperature of the of the milk with a few drops on the inside of your wrist – it should be nicely warm (cooler is better than too hot though). Run the bottle under cold water if necessary.
• If storing bottles in the fridge, make sure you put them at the back, where the temperature is the most consistently cool.
• Discard any formula left in the bottle at the end of the feed.
• Throw out any premixed formula that hasn’t been used within 24 hours. Reheat bottles by putting the bottle in a bowl or jug of hot water. Shake. Microwave reheating is not recommended.

Travelling with formula:

It is best to pack cool boiled water and powder separately and then mix them just as you need – this negates the need to carry an insulated bag of pre-prepared formula.

The World Health Organisation recommends exclusive breastfeeding for the first 6 months of your baby’s life, followed by the timely introduction of safe and adequate foods. WHO recommends continued breastfeeding for the first two years and beyond. Breastfeeding provides babies with the best nutrition and is preferred when possible. Always follow professional advice before using an infant formula. Proper use of an infant formula is important to the health of the infant, only use as directed.

Understand the difference between choking and gagging

Many babies gag as they learn to regulate the amount of milk or solid food they are swallowing – but there is a big difference between gagging and choking. Learning to recognise the difference will make mealtimes more relaxed.

The gag reflex automatically closes off the throat and pushed the tongue to the front of the mouth. It’s a reflex we have for our whole lives and is similar to the swallow, sneeze and cough reflexes. Your baby may gag a lot when you first introduce solid food – and later finger food – to her diet as she learns to regulate the amount of food she can manage to chew and swallow at one time. And much like adults, she is also likely to gag when she tastes food she doesn’t like.

If your baby gags, it will be a temporary situation and will resolve itself naturally and quickly. Some very young babies seem to gag a lot on their own spit – this is because babies tend to have excess mucous in their throat and the gagging reflex removes it so that their airway remains clear.

Choking occurs when the airway becomes blocked and prevents breathing. Generally, if your baby chokes, she will start to cough in an effort to dislodge the blockage. Soft foods are usually easily brought back up to the mouth with coughing but hard foods or other objects like small toys may require some additional help to dislodge.

IMPORTANT!

The key to effectively dealing with a choking incident is to stay calm. It is likely that your child will be able to dislodge the obstruction herself but this will be an upsetting incident for her – and you – and if you panic, you will only upset her further.

Choking first-aid

• Check to see if your baby coughing, crying or breathing.
• Monitor your baby if she is coughing as she may dislodge the obstruction on her own this way
• DO NOT hit your baby on her back in an effort to dislodge the obstruction
• DO NOT try to dislodge the obstruction by putting your fingers down her throat – this may just push the object further down the throat
• If breathing becomes laboured at any stage, seek medical assistance immediately.

Babies under 12 months:

• To assist a choking baby less than 12 months old, lie her face down over your lap, ensuring her head is lower than her chest, and then give her five firm blows between the shoulder blades using the heel of your hand. Check her mouth after each blow for the dislodged object.
• If she is still choking, lie her on her back on a firm surface and, using two fingers, give her five chest thrusts in the centre of her chest, checking after each for the dislodged object.
• If the object is still lodged, alternate between back blows and chest thrusts until emergency help arrives.

Children older than 12 months:

• Bending your child over so that her head drops towards her chest, give a sharp back blow between the shoulder blades using the heel of your hand. Repeat up to five times, checking between back blows for the dislodged object.
• If after five back blows, the object is still obstructing the airway put one hand on your child’s back and the other in the centre of her chest. Using the heel of your hand, give her five chest thrusts, checking each time for the dislodged object. Chest thrusts are similar to CPR compressions but are sharper and slower.
• If she is still choking, alternative back blows and chest compressions until emergency help arrives.

IMPORTANT!

If your baby or child becomes unconscious, start CPR immediately.

Avoiding choking hazards

• Never leave your baby unsupervised when she is eating or drinking from a bottle.
• Never let your baby or child eat while lying down
• Keep small toys and other objects out of reach of your crawling baby – babies can choke on anything that’s smaller than a D-size battery.
• Always cut food up into small pieces.
• The most common foods children under five years choke on are round-shaped and are sweets, grapes and nuts.
• Avoid sticky foods such as peanut butter while your child is small and learning to regulate the swallowing of solid food.
• Ensure that your child eats slowly, takes small mouthfuls of food and that she chews it thoroughly before swallowing.
• Never force your child to eat.

TIP!

Consider introducing finger foods such as fruit via a feeding mesh bag. These mesh bags hold the food safely inside while allowing your baby to access the food by chewing on the mesh which keeps pieces very small and manageable.

This article was written by Ella Walsh for Kidspot. Sources include St John Ambulance Australia and Vic Governement’s Better Health Channel.