First Time mother breastfeeding dilemma - useful tips

siti gina

New Member
Hello there

I have decided to transfer my tip # 5 from my previous thread to this new thread
Tip #5 Breastfeeding dilemma - most common for first time mothers. Based on my experience, many clients really have such unrealistic expectation with regards to their milk production capability. Partly, lack of knowledge about the working of their own bodies. Usually, the more information they got from various sources, the more stress they become. I usually tell them, those are just general guidelines. Other factors play a part in this special relationship between mother and baby.

I usually give these simple guidelines to address their concern.

1) For smaller babies (less than 3 kg upon birth), their feeding pattern definitely differ from babies who are bigger. Average baby weight betweeen 3.3 - 3.5 upon birth differ from slightly bigger babies (ie 3.8 - 4.5 kg).. (yup, I did have client with baby weigh 4.5 kg upon birth - thru normal delivery .. well done to the mother).

2) For the first 2 week, for smaller babies, their feeding interval should not exceed more than 2 hourly. Babies usually do not have the stamina to continue sucking longer than 15 minutes, hence, they tend to get hungry easily. A schedule of between 1.5- 2hr is good for them. For average size babies, an interval of between 2.5 - 3hr is okay. For bigger babies, usually their capacity to suck and store are better, they can stretch up to 4 hourly cos they can consume more at any one feeding.

3) For the same period, baby with jaundice, reading above 160, usually tend to be lethargic, sleepy, less alert. Most of the body system mobilize to overcome the jaundice, hence, not much resources for other activities including staying awake. Mothers need to be extra alert and observe feeding time properly, if needed, wake the baby up for feeding and not let baby continue to sleep past their feeding time. As babies need to preserve as much strength as possible, baby tend to be rather weak to even suck the breast. It is advisable to express the breastmilk and use bottle instead, so as not to exert more stress on the baby.

4) As for first time mothers, the first 5 days after delivery, the milk supply can range from 10ml to 50 ml. This is average for most mothers. Depending on the baby weight and frequency of feeding, may not be sufficient to cater to baby needs. Hence, supplementing with formula may be needed. At the same time, mothers should continue to work on the breast ie direct feed and pump. This routine is important to be observed for the first 2 week, as the body "program" the extra activity ie milk production- allocating resources, scheduling, ect. The body usually requires between 10 days to 14 days to respond to new changes (eg when taking new supplements ie vitamins, minerals,) before result can been seen. Consistency is important as this give the required signal to the brain to take into account. Mothers need to continue latching, pumping, even when there is very little milk, clearing every drop, if possible. And its good to use warm towel to compress and do gentle massage each time.
(for my clients, I usually teach them to do some breast massage 2 week before EDD. Mainly to get them acquianted with the different parts of the breast eg the lymp nodes, the technique. Usually this help ease the tension, and improve readiness for the breast to start supply ealier.)

5) The milk production would slowly increase in supply in the 2nd week, can even reach up to 90 ml. This is sufficient for most babies. By 3rd week, the milk supply can reach more than 100 ml and continue to full production by 4th week. I am referring to the interval of 2.5 to 3 hourly. By end of the month, most babies feeding interval can be stretched to 4 hourly.

6) Factors that can affect milk supply - not drinking enough fluid. As I explained in the previous post, ph for water is 6.6 neutral. This is what the body recognize and utilize directly for the various metabolism and maintaining the body critical balance. Any other fluids, eg soup, red-dates, have different Ph reading and thus need to go thru "filtering process" would require time before ready to be used by the body. Mothers need to stay hydrated as much as possible so as not to affect the milk supply. Mothers need to drink plenty of plain water (neutral ph) .

As milk is produce from the nutrition in the body (eg fats ), mothers need to have sufficient food to spare for the milk production. The body would not surrender any nutrition needed for maintaining critical processes, hence, would only utilize "excess" for non-critical funtion like milk production

Another factor, enough sleep (esp the first two week). Each night, the body go thru "maintenance process" while we sleep. This process is important for repairs, topping-up, cleansing, detoxing, ect involving the various organs. It lasts between 4-5 hour. Its important for the body to have totally control in order to carry out the various processes. A deep sleep of 4 hours is sufficient for the body to complete the process. I usually advise my clients to try to get at least 3-4 hrs sleep after baby last feeding, eg 11pm or 12midnight, possibly asking someone else to help with baby. Most mothers say its tough even to do that.

7) Some mothers do have blocked breast ducts. Breast stimulation massage to clear ducts need to be done first 5 days to ease flow. The ducts distribution and apertures vary between women. At times, I would joke with my clients their "pattern" - eg shower head (with many distributed openings) or running tap water (with centralise, large opening).

8) Also, most first time mother tend to make the mistake of assuming their breasts as "engorged" just the first few days. Actually, this is not the case as the milk production is not in full swing as yet to cause engorgement. What really happen is the muscles in the breast are being stretched to create the space for milk storage. I usually use the analogy of someone who has never run before, not doing any warm-up exercise and start running a sprint, resulting in every inch of the muscles aching. A warm compress and drinking lots of hot drink can help to ease.

9) Other "strange" sightings - not everyone would experience this. During the early phase, the lymph nodes (esp the upper part of the breast), becomes bigger. Some clients mistaken this as engorgement. Due to the wrong technique of massage employed, there are some cases where the lymph node get "displaced" more towards the side of the breast, causing discomfort. If this happen, i would help to massage and re-allocate back to the original place. At times, breast massage alone can take up 45 mins to an hour, depending on the problem and tolerance level.. it can be super-painful.

A few cases, the lymph nodes under the armpit become protruding, to the size of a golf ball. For those not acquainted with the lymphatic system, this is one of the most importance "drainage" system in the body. Just like our sink can get choke, the flow can be affected when the fluid concentration is affected, causing changes like the enlarged nodes, ect. I usually tell clients not to touch nor massage cos using the wrong technique can make it bigger. The best way to clear is to drink plenty of water ie every hour (what I term as "flushing") and this usually ease the problem after a day.

Another change, the different in supply between the left and right breast. Theres a simple explaination for this.. and it happen for most mothers..Next time I share. And also why wearing maternity bra is important during nursing...

Ok, I hope these help. Feel free to ask any question if you have any. I be happy to help, if I can. can email me too ( [email protected])

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Tip #6 Why the different supply between the left and right breast..

This is another question that constantly asked by my clients..honestly, many seem so overly worried..:)

without giving my clients too technical details, I usually give a more "common sense" answer.

If you have some knowledge about the human body, you would notice that heart organ is on the left side of the body. The stomach is also located on the left side, and of also one side of the lung. just imagine if the breast is full of milk, it be pressing on the heart, as though the heart is receiving constant CPR (Cardiopulmonary resuscitation) whoa...Nature intended it as such that the milk supply would be more abudance in the right breast as compare to the left so as to protect the vital organs.

Initially, while the brain still working out the best combination, the left breast may seem to have more supply then the right. The milk production channel starts from the right breast, flowing to fill up the left breast. At the side of the left breast, nearer to the armpit, there is what I call "overflow drainage point" (imagine how our toilet cistern pump work). Once it reaches maximum, the milk supply would stop, hence, preventing leakage and wastage. Marvel, how smart our body system is !

One of the important thing to note, esp during the first 5 days, is to ensure that the "overflow drainage point" is not block. If is its, the milk supply would definitely be affected for both breast. Many times, during breast massage, this point become very tender to the touch. And in many cases too, blockage causes engorgement and even "mastitis" with fever higher than 39, swelling. Each time my client complain her breast is engorge, this is the first point I would check, to ensure that it is not block. Mastitis is super-super-super paintful. I have helped many clients cleared this point, causing tears to flow, scream as I though I am torturing..(at times I do joke with clients that I am a sadist who enjoy hurting others)

I have helped many clients and offer a very simple "remedy" without needing to consult doctor nor take any medication (next time I share ok)
Tip # 7 why wear nursing bra - how to choose

Hello there

A woman got to do what a woman got to do. Best to enjoy it. Pregnancy, delivery, breastfeeding - the beautiful experience

Often, on the first day I meet a new client, the first thing she complains is "my belly still look like I am pregnant 6 month!"..I get to hear the account how miserable it makes her feel at the gynae clinic someone remark "so, when is your delivery date?"...hahahah..thats what I did.. I laugh seeing the crumpled look, the stress..:)

"My dear, giving birth is not like going to toilet. Its not like once you unload, your bowel or rectum clear totally. Our body treat waste products differently. The fats lining the womb are not waste. Accumulated for 9 months, the body cant just shed every thing at one go. Fat is one of the 3 nutrients (along with protein and carbohydrates). Need to go thru a different process to get rid."...

I usually assure client one of the reasons why we use the long, non-stretchable traditional wrap/binder. I know some masseuer use elastic binders which is not effective. The binder serves other more important purpose and why wearing one and the discipline to adhere is required. Next time I cover this.

Back to the topic of nursing bra. For those who do not know, there is not a single bone in the breast. The breast is makes up of tissues - special tissues that form the lobe, the ducts -network of ligaments, fibrous connective tissue, nerves, lymph vessels, lymph nodes, and blood vessels. The breast is supported by a suspensory ligaments ( I prefer to use the term supportary ligament) that link to the main ligament of the rib, at the side of each breast.

The contant "exercise" of the suspensory ligaments during milk production tend to make the breast extend further down, esp bigger breast ie cup size 'c' and above. As the breast loses more fat, the cup size decreases, Ligment is different from muscle, more elastic, strech easily. just like rubber-band, once it passes the elastic tensile, it can no longer regain its original elasticity. Continuous strain make it elongate more. Sagging ligaments can no longer provide the support.

Few things that happen during breastfeeding.. The cup size reduces. The breast appears to sag, losing its firmness.
So, to minimize, for the more beauty conscious (which means most of us :)), include enough fat in your diet. The body metabolise using the algorithm "last in first out" ie it would use the more "loose" fats than the stablised, stored fats. This would help you reduce the fats from your breast. Btw, fats storage in the body, slightly differ from woman to woman - that account for the body shape ie pear, apple, bossom, ect.

Wearing a good nursing bra help to support the ligaments from the extension. The ligaments that need most support is the ones located at the side of the breast, strething under the armpits. So, you dont need to wear a "wired" nursing bra. In fact, I always discourage my clients from wearing a wired-nursing bra cos it would impede the blood flow, especially the vessels maintaining the mammary gland lobules near the base of the breast. I usually pointed to my client the "entry point" which connect to the so-called "milk factory". This is also the point I check to advise my client of the "breast activity" ie milk production process is "slow" or "running".

The wired nursing bra only invented not long ago, I did not see it the first few years I started providing postnatal services. A month ago, I wrote to one manufaturer giving a free tip for nursing bra to incorporate motif that can stimulate "early development" learning for infant while nursing ( I am also trained in early development). The idea came up when I saw my clients' bra with design instead of the usual plain material. Told the manufacturer it would be a good marketing strategy.. Lets see what happen next couple of months.

[Dear reader, pls note that as most of my clients - in fact 99%, clueless about the anatomy and working of the breast, I created my own terms to simplify the explanation, and avoid too technical.]

As usual, thanks for reading. Feel free to comment
Have a nice day !