Breastfeeding

To get breastfeeding off to a good start, offer the breast within the hour after birth, skin to skin, then on demand: 8 to 12 feeds per 24 hours. Colostrum is enough. From day 5, at least 6 heavy nappies a day, yellow stools and weight going back up show that your baby is getting enough.

There is no ideal breastfeeding position, but there are common rules: baby facing you, ear, shoulder and hip in line, nose level with the nipple. The cradle hold is for everyday use, the cross-cradle guides a baby who latches poorly, the football hold and side-lying spare a caesarean scar, and the laid-back position lets baby lead the feed.

Cracked nipples, small splits in the skin, almost always come from a shallow latch: get it checked, with a professional if needed. Meanwhile, start on the less sore side, dab a little milk on the nipple after the feed and keep it dry. See someone if the wound does not heal, bleeds or comes with a fever.

Engorgement affects both breasts, often between day 3 and day 5. A blocked duct forms a tender lump without fever. Mastitis combines a red, hot, painful area with fever or aches. In all three cases, you keep breastfeeding on demand, with cold and gentle touch. If nothing improves within 24 hours, see a doctor.

Your milk usually comes in between day 2 and day 5 after birth: the breasts become fuller, warmer and heavier, and colostrum gives way to more abundant milk. The discomfort often lasts 24 to 48 hours. Frequent feeds, cold and a few expressed drops bring relief. If you are not breastfeeding, avoid stimulating the breasts.

A breast pump helps when baby cannot feed, to relieve a very full breast or to prepare for a separation. To build a stash, express after a feed, once breastfeeding is well established. If baby drinks only expressed milk, plan about 8 sessions per 24 hours. The flange must fit you, and suction should never hurt.

Expressed breast milk keeps a few hours at room temperature, a few days in the fridge at 4 °C and several months in the freezer at -18 °C, but times vary between countries. In great heat, chill it straight away. Thaw it in the fridge or under lukewarm water, never in the microwave, and never refreeze it.

In Morocco, a private-sector employee who breastfeeds is entitled to a paid nursing hour per day for 12 months after she returns, which can be split into two 30-minute breaks. To combine breastfeeding and work, start expressing three to four weeks before, talk to your employer early and pump at the office at the rhythm of the feeds.

The timing of weaning is yours to decide. The WHO recommends exclusive breastfeeding for 6 months, then continued breastfeeding up to 2 years or beyond, but every decision to stop is legitimate. To wean gently, drop one feed at a time, wait 2 to 4 days for your breasts to soften before the next, and replace the breast with cuddles. Allow about four weeks.

Eating while breastfeeding does not call for a special diet: a varied diet is enough, with about 330 to 400 extra calories a day according to the CDC. Drink regularly, limit caffeine and fish high in mercury, and avoid alcohol. To make milk, frequent feeds matter far more than helba or sellou.

Combination feeding means feeds at the breast alongside meals given another way. To protect your milk supply, wait 4 to 6 weeks before the first bottle if you can, keep the morning, evening and night feeds, express when a feed is skipped, and use paced bottle feeding: baby upright, bottle almost horizontal, never forced to finish.

A true low milk supply shows up in nappies and weight, not in soft breasts or a baby who feeds often. At least 6 well-soaked nappies a day after the first week and steady weight gain are reassuring. To increase your milk: more frequent feeds, a good latch and qualified help.

When a baby suddenly refuses the breast after months of breastfeeding, it is most often a nursing strike, not weaning. It usually lasts a few days. Look for the cause (blocked nose, teeth, ear infection, distraction, flow too fast), express your milk to keep your supply, and watch the nappies.

A short tongue frenulum is only a problem if it interferes with feeding: persistent pain for the mother, a baby who slips off, clicks or gains weight poorly. Diagnosis is functional, not just visual. A frenotomy is only discussed after breastfeeding support has failed, with the paediatrician or family doctor.