Barriers to Breastfeeding

However, when a woman feels that she can’t breast feed, or her breasts seems to be “dry”, a medical issue is rarely the cause. According to Paediatrician, Dr David Bratt, once a woman can get pregnant, she can produce milk, and when a woman feels she can’t breastfeed or has no milk, the reasons are not medical – they are psychological.

Dr Bratt has good news for women who believe there is no hope of them breastfeeding their infants: “It is almost impossible for a woman who has carried a baby to term to not be able to produce milk. There are no medical reasons, neither are there biological reasons why women won’t produce milk. Women need to understand that once they can carry a child for nine months, the same hormones that keep the baby healthy in the womb are the same hormones that produce the milk.”

He said many mothers believe as soon as their baby is born the breasts must begin to “pour milk”. This does not happen in most cases. He also pointed out that a newborn’s stomach is very small, so, contrary to what many mothers believe, a baby doesn’t need a lot of milk in the first few days - all a newborn needs is two to three teaspoons of breast milk every two to three hours.

“A lot of women get disappointed and think they do not have milk because they don’t see it pouring out. When they see only a trickle, immediately they start thinking about supplementing the baby with formula. Once you start with the formula it cuts down on the production of the milk.

“Mothers believe that as soon as the baby is born the breast must begin to pour milk, which does not happen for most women. Some women have more milk than others. There is a bad habit women practise, which is squeezing the breast to see if they have milk. This is not an appropriate method, because milk almost never comes when you do this. For some women it comes, but squeezing your breasts is not a good way to see if you have milk,” Dr Bratt said.

He explained that a mother can express the milk using a massage technique to stimulate the mammary glands. The Informative Breastfeeding Service (TIBS) is available to counsel and educate women on this technique, Dr Bratt said. He explained: “In the first hours after giving birth, a yellowish liquid called colostrum is the first fluid available to the baby. It is usually very thick and looks nothing like breast milk.

Some women view this as not producing the healthy white milk they know, and instead turn to formula. Women need to know that in most cases mature milk takes three to four days to produce after having the baby. “Colostrum is a special milk that newborns need. It contains a lot of protein and is produced in very small amounts, which is normal. Colostrum also contains high concentrations of antibodies and helps build the newborn’s immune system which protects them from various infectious diseases. Babies have very small digestive systems and colostrum delivers its nutrients in a very concentrated low volume form.”

Dr Bratt said breastfeeding is purely psychological, in that a mother must feel good about herself and be free from worry, since worry causes the milk reflex to be inhibited.

“There are a lot of psychological issues that can cause problems with breastfeeding. In order for the mother to have a good experience breastfeeding she must feel good about herself, she must feel happy and contented.

“If she is in pain, or if she is worried over something, if the father of the baby is absent, or anything that makes her anxious, it will inhibit the production of the two hormones that cause milk to be produced by the breast.”

According to Dr Bratt, some mothers may suffer painful conditions of the breast such as engorgement, cracked nipples, plugged ducts, mastitis and inverted nipples. He said most of these conditions can be overcome with time, patience and guidance.

Medical conditions such as tuberculosis, HIV or AIDS, or conditions that require chemotherapy or treatment with certain medications may make breastfeeding unsafe.

Whatever your reasons for not breastfeeding — intense discomfort or unrelenting frustration, The Informative Breastfeeding Service (TIBS) can help you.

Anyone wishing additional information about breastfeeding counselling may call TIBS at 628-8234, or email at

Tips on making breastfeeding work

Learn your baby’s hunger signs – When babies are hungry, they become more alert and active. They may put their hands or fists to their mouths, make sucking motions with their mouth, or turn their heads looking for the breast. If anything touches the baby’s cheek — such as a hand — the baby may turn towards this hand, ready to eat. This sign of hunger is called rooting. Offer your breast when your baby shows rooting signs. Crying can be a late sign of hunger and it may be harder to latch once the baby is upset. Over time, you will be able to learn your baby’s cues for when to start feeding.

Follow your baby’s lead – Make sure you are both comfortable and follow your baby’s lead after he or she is latched on well. Some babies take both breasts at each feeding. Other babies only take one breast at a feeding. Help your baby finish the first breast, as long as he or she is still sucking and swallowing. This will ensure the baby gets the “hind” milk — the fattier milk at the end of a feeding. Your baby will let go of the breast when he or she is finished, and often falls asleep. Offer the other breast if he or she seems to want more.
Keep your baby close to you – Remember that your baby is not used to this new world and needs to be held very close to his or her mother. Being skin-to-skin helps babies cry less and stabilises the baby’s heart and breathing rates.

Avoid nipple confusion – Avoid using pacifiers, bottles, and supplements of infant formula in the first few weeks unless there is a medical reason to do so. If supplementation is needed, try to give expressed breast milk first. But it’s best just to feed at the breast. This will help you make milk and keep your baby from getting confused while learning to breastfeed.

Sleep safely and close by – Have your baby sleep in a crib or bassinet in your room, so that you can breastfeed more easily at night. Sharing a room with parents is linked to a lower risk of SIDS (sudden infant death syndrome).

Know when to wake the baby – In the early weeks after birth, you should wake your baby to feed if four hours have passed since the beginning of the last feeding.
Your breasts will easily make and supply milk directly in response to your baby’s needs. The more often and effectively a baby breastfeeds, the more milk will be made. Babies are trying to double their weight in a few short months, and their tummies are small, so they need many feedings to grow and to be healthy

Most mothers can make plenty of milk for their baby. If you think you have a low milk supply, contact The Informative Breastfeeding Service (TIBS)..


"Barriers to Breastfeeding"

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