Breastfeeding Course 1.

Thursday I went to breastfeeding course. Yes, you read that correctly. Barbara was not feeling well and therefore I went to breastfeeding course by myself.

We were first scheduled to have the breastfeeding course in Helmond on tuesday's. But that coincided with our zwangerschaps gym. The only possible alternative turned out to be thursday's in Gemert (about half an hour drive from our place). The breastfeeding consists of two sessions of 2 hours per session in which everything you ever wanted to know about breasfeeding is explained. I was a bit late because I never had been to that part of that village before and it turned out that the road where the course was held was closed off (so I had to run arround a bit to find it). The group consisted of 4 pregnant ladies (of which one had been pregnant before, one boyfriend, and 2 neighbourhood nurses (wijkverpleegsters). The teacher was a lactation consultant, which is a woman who can help with breast feeding in case of problems. Normally, the kraamverzorgster teaches the new mom how to breastfeed (so it is not a problem that Barbara missed the first course evening).

In Holland, 80 % of women breastfeed their new born baby. After three months, 50 % of women is breasfeeding still, and only 20 % of women breastfeed still at 6 months. There is no doubt that this decline is caused by the fact that in Holland women only get 3 months of maturnity leave. The secretary of health wants to increase the percentage of women who still breast feed at 6 months to 40 % in a couple of years, but for now maturnity leave remains 3 months.

Children are raised with the image of giving a bottle to a child, as they grow with dolls who they give the bottle. However, it is only natural to breast feed and children who have been breast feed find this the natural way. And here the teacher showed a very funny picture of a toddler in a museum who sees the naked breast of a statue and instinctively went for it :)

Breastfeeding can be very tiring, so much that one of the women told that with her first child she could fall asleep at night while the baby was having his midnight snack and would only wake up in the morning with her baby still at her breast. Also, sometimes it can be hard to find the motivation to breastfeed and then women tend to give up. However, the teacher reassured that it is OK (and normal) not to feel for it sometimes.

After the baby is born, it instinctively looks for the breast of the mother. It will start smacking its mouth, and put his little fingers in its mouth. Within one hour it will even start crawling for the breast. Therefore, it is recommend to put the child to the breast within the first hour after it is born (when you see it is longing for it). If this is not possible, because the mother is separated from the child in the hospital for some reason, then the teacher adviced for the father to go to the child, strip his shirt, and lay the child on his breast until the mother comes.

The first couple of days the milk production still has to start up and little milk is produced. But this is OK, since the stomach of the baby is not bigger then a marble and fills easily. The first days, breastfeeding can cause contractions. This is a good sign. It indicates that the hormones are working. If the milk production is not starting so well the first days, then it is adviced to milk using a pump to stimulate the milk production.
The first 6 months, breast milk is all the child needs, except that in the first 3 months it gets vitamine 'K' and 'D' extra, in the form of drops. When (fulltime) breastfeeding there is a 2 % chance of getting pregnant.

The first weeks the child has to be fead every 3-4 hours, but if the child wants to be fed more times it is also fine. It is not supposed to that we should look on the clock for feeding times, but look at the child. However, if the child is sleeping so much that he does not wake up for regular feeding times, then we should wake it up becasue there are baby's who 'suffer in silence'. Each feeding time, the baby should at least drink for 15 minutes with long hauls (see below). Some days the child will have a 'regeldag', when the child wants to be breast times more tmes then normal. A day or two later everthing is back to normal (so don't panic). These indicate that the child likes more milk and cause the mother to produce more milk. This happens arround the 10th day, 6 weeks, and 3 monhts. The growing curves used at the consultation office are based on bottle fed children, so don't panic if the child seems to grow less fast then the curve indicates. Growing curves for breastfeeding can be found at www.borstvoeding.com. Note that after birth the cild first loses weight (around 7 - 10 %) before it starts gaining weight.

The baby is put at the breast as follows: first of all, the mother should be in a comfortable position. Then the baby is placed belly to belly with the mother, with the nose against the nipple. The baby should now take a big bite ('hap') at the breast. Then the baby has to be pulled closer to the breast such that its chin is pressed in the breast and the nose is free.

When the baby has locked itself to the breast correctly then he starts making short sucking movements. After a bit it will start making long hauls and you can hear him swallowing. This is called 'toeschieten'. The mother can also feel this in her breast, even in the other breast which can also start leaking milk. If the 'toeschieten' does not happen for 15 minutes then the moter should try the other breast. The baby is taken off the breast by first putting a finger on in the side of its mouth and give a little pull (in order to break the vacuum) and then it can be taken off with ease. When the child has finished the breast it will let go, or fall asleep, or start 'headbanging'. Then it also is time to give the second breast to the child. The teacher adviced to have the baby drink one breast fully and then let it on the second breast as long as it wants to. Only the first sucking movements should be felt by the moteher, after that the breastfeeding should feel conformtable. Otherwise, there might be something wrong.

The child is drinking well if:
- it drinks at least 8 times per day, with at least 15 minutes of long hauls.
- after 4 days, it has at least 5 wet dipers per day
- after 4 weeks, it has at least 4, nr 2. (kakki) dipers
- the child is gaining weight.

Next thursday we talk about milking with the pump and about possible problems that rise while breast feeding.