The 1st 2 weeks of breastfeeding, pumping, or a combo of the 2 are the most challenging. Here are some tips from Bex @Physio Therapy Singapore, who has just gone through this for the 2nd time, to make your experience much easier.

1) Learn the Different Stages of Lactation

1st Stage

In the 1st couple of days, you will produce a minimal amount of Colostrum, which is usually thick, yellow, and sticky (but can be thin, white, or orange in colour). This colostrum is very nutrient-dense and usually provides all that the baby requires in the first few days of life. You can also try squeezing your breast (hand expression) to remove colostrum, which makes it easier for your baby to take it from the nipple with a syringe. It is nicknamed ‘Liquid Gold’ because of the protein, antibodies, and growth factors it contains, and it also helps prevent jaundice.

2nd Stage

The milk is called the ‘Transitional Breast Milk’ and is a combination of colostrum and mature milk. This milk starts about 3-5 days after delivery, and as a result, your breasts will swell quite dramatically, and you may feel hardish lumps form within the breast, particularly near the armpit. There can be general tenderness of the breasts due to all the swelling. The milk will become less yellow, whiter, and thinner, and the quantity should increase. The normal amount of milk produced at this stage is about 2-4oz.

3rd Stage

Mature Breast Milk becomes available when the baby is about 2 weeks old, with lower protein and higher fat and carbs.

2) Learn the Different Positions to Try

3) Work on Getting the Baby Latched Correctly

Signs you have the perfect latch:

• Baby's chin touches the breast & lips are curled outwards like a fish
• Baby's mouth around as much of your areola as possible
• Your nipples are not uncomfortable
• You can hear swallowing

Tips on how to achieve the perfect latch:

• Bring your baby close to you, tummy to tummy
• If the baby does not open her mouth wide, naturally brush your nipple over their lips
• Baby needs to put her chin and lower jaw on the breast first, and then you can help her latch if you tilt the head back
• Can help her then put her upper jaw onto your breast by tilting the head

4) Keep Up the Frequency of Breastfeeding or Pumping?

By removing milk from the breasts, you will stimulate your body to make more milk. It is recommended to pump for about 15 minutes every 2-3 hours during the first few weeks to maintain a healthy milk supply. Stimulating the baby to feed at the breast has a positive effect on milk production, so if you are combining breastfeeding and pumping and having issues with your milk supply, try increasing the breastfeeding-to-pumping ratio.

5) For Nipple Relief

When starting with breastfeeding or pumping, the most important thing to remember is ‘If You Feel Pain, Seek Help’. There should not be pain during feeding or pumping. This can be addressed by seeing a Lactation Consultant. If you leave it, it will only get worse if the latch is not correct and may lead you to give up. The Lactation Consultant can try different latches with you or correct issues with your pumping technique and tools to help relieve the pain. There may also be issues, such as inverted nipples or the baby experiencing a tongue tie or a tight top lip, that make latch very difficult. These will need to be addressed ASAP, and your Lactation Consultant can recommend the right people to help.

If you just have some soreness in the nipples when starting, this is very common, and here are 3 things that you can try to help.

• Lanolin Cream
• Silverette Nursing Cups
• Cooling Gel Pads

6) Learn Self-Massage

Massage can help improve milk flow and clear blocked milk ducts, which commonly occur during breastfeeding or pumping. Click here to watch a video that will help you learn a good technique for the early stages – try to do it for 5 mins before each feed or pump.

7) Improving Milk Supply

As mentioned earlier, the best way to stimulate milk supply is to feed or pump frequently, but you can also take herbs to help, such as Fenugreek.

If milk supply is really an issue, ask your doctor whether Motilium tablets will help; they need to be prescribed.

8) Learn How to Know You Are Giving Your Baby Enough Milk

Wet nappies are a good guide – below is a guide to how many wet nappies to expect a day:

• Day 1 – 1 nappy
• Day 2 – 2 nappies
• Day 3 – 3 nappies
• Day 4 – 4 nappies
• Day 5 to end of 2nd week – 6 nappies

9) Learn Effective Burping

Your baby will always need to be burped during and after a feed to relieve any gas and tummy pain that may result from swallowing a little air when feeding.

10) Seek the Right Help ASAP When Needed

Please seek help as soon as possible if you are experiencing any of the following issues. If left, the problems are only likely to become worse:

• Pain in the Nipple – see a Lactation Consultant
• Issues with the Baby Latching – see a Lactation Consultant
• Pain in the Breast That Occurs When Breastfeeding or Pumping – see a Lactation Consultant
• Areas in the boob that are painful, hardened, or look red that do not resolve with feeding, pumping, or self-massage – see a Physio experienced in Lactation Relief who can help with ultrasound therapy and massage.
• Lasting engorgement – see a Physio to help with ultrasound therapy and massage

Physio Therapy Singapore offers Lactation Relief by physios for mums, including home visits.

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