Mums’ top questions on breastfeeding answered by a midwife

Breastfeeding may not always be easy but it is one of the best ways to nourish a growing infant and protect their future health. Every year, the World Breastfeeding Week (1-7 August 2022) is a reminder that we all have a part to play in supporting and encouraging women to breastfeed. 

This year on World Breastfeeding Week, TMBTV hosted a Facebook live chat with registered midwife Tylah McConnell to answer some common questions and concerns about breastfeeding and life with a newborn. This episode of TMBTV was brought to you by Tommee Tippee’s new and improved ‘Made for Me’ breastfeeding range. 

Watch the full Q&A with Tylah on Facebook or read on for her advice on some of the questions asked during the chat.

Does having a caesarean birth impact milk supply?

Tylah: There are some studies that suggest having a caesarean may impact things whether it’s from the anaesthetic to delayed skin-to-skin contact but if you know ahead of time, there are so many things you can do to help counteract that. 

One of the biggest things would be talking to your care providers about skin-to-skin in the operating theatre. My favourite type of caesarean to do is with direct skin-to-skin so often what will happen is the obstetrician will pass the baby to the midwife and then I put it straight onto mum, wet and all, messy and all. I really love doing this direct skin-to-skin because you really get to experience that moment of your baby just being born rather than being taken away and dressed. You can see if your hospital offers that first and then you can try and have baby skin-to-skin all the way through recovery and then all the way onto the maternity ward. 

The next best thing would be expressing your breast milk from 36 weeks and we might touch on this a bit more.

Tell us more about expressing prior to the baby arriving; when do you do it and how?

Tylah: Antenatally, expressing is generally done from 36 weeks though some people may have restrictions where it’s not suggested so definitely make sure you’re talking to a midwife or healthcare provider before you start. You can get syringes or I even love urine pots because they’re sterile. Now you’re not necessarily going to get this massive flow of breast milk like you might see on some YouTube videos straight away, but you will start to get little beads of colostrum and then you can collect them because even 0.1 of a ml can go a long way and you can start to label it and freeze it as well.

Talk to your hospital about what they have for storage. If they only have a fridge, defrost milk only lasts 24 hours so you can bring a little bit at first and then get someone to grab more for you when you need it.

It may even be that you don’t need to give any of that colostrum to baby. During expressing and harnessing colostrum, you’re stimulating your breasts, you’re increasing your supply, you’re learning how to breastfeed. So you find that expressing antenatally, you do have the confidence in your breastfeeding journey. But should you need to give that colostrum to baby, there’s many ways like finger feeding. Put some on your finger and have baby suck that, supply lines or even cup feeding. Have a chat to your midwife if you’re interested in giving it to baby or if baby needs it, they can take you through the options.

Read more on expressing and storing colostrum antenatally.

What’s the best way to increase milk supply?

Tylah: The biggest thing in terms of supply is that the more you feed, the more you make. The first thing we are encouraging to increase supply would be to offer baby more frequent feeds, making sure that  attachment is correct; when baby is feeding they’re taking in as much as they can, keeping baby awake on the breast, tickling the baby, changing their nappy in between – all these things are great. Other things are just knowing that breastfeeding takes an extra 500 calories a day so increasing your hydration (breastfeeding mothers should have 3 – 4 litres), increasing your nutrition is really important.

There’s a medical route as well if you’re interested, there’s a drug called domperidone. These days this will require ECG monitoring of your heart before it’s prescribed. 

Does breastfeeding and expressing at the same time impact supply? If I start expressing, does it mean I have to keep doing it in the long term?

Tylah: It really depends, it’s so hard to know personal circumstances like age of baby etc. The general consideration would be really when you’re expressing you’re telling the brain to make that much, because baby needs that much. If you’re storing the milk and happy to store the milk then you could keep doing that. You can go through an adjustment period where you taper off the expressing if that’s what you’re wishing to do in the long run. This is really good to do with a healthcare professional where you can weigh baby frequently to make sure they’re getting the adequate amount. It’s really this beautiful dance of demand and supply and you’ll find that you adapt to create this demand and supply model.

How does a mum know if her breasts are drained?

Tylah: Studies have shown that women really have different perceptions of what a drained breast is and I think sometimes saying you must know if it’s drained can really stress a lot of breastfeeding people out. So I think it’s really good to just tune into your body and what you’re feeling. Most women won’t necessarily have a full breast and then this completely empty breast, but they will feel if there’s tightness that goes down, they might feel their breast is a little bit more soft. But having full and empty breasts is not necessarily a sign of supply so I wouldn’t worry about that but a lot of women will tell you on their breast betting journeys which breast that they last fed from because one definitely feels fuller and one feels more drained. 

What is your advice on preparing the body and mind for labour?

Tylah: I think the biggest thing when it comes to labour, especially if you’re interested in having a normal birth without pain relief, it’s the self-belief you can do it. Getting up your confidence is so important to realise how strong you are. To build that confidence, it’s important to educate yourself about strategies you can use when things get intense like antenatal classes, hypnobirthing, reading books, really filling yourself with positive birthing experiences. On the other end of that I would say, it’s important to be guarded about what you let into your mind. In pregnancy, it’s really important to expose yourself to as many positive things as you can.

For more breastfeeding advice, visit the Australian Breastfeeding Association website.