Cover Image
close this bookInfant Feeding in Emergencies: A Guide for Mothers (WHO, 1997, 48 p.)
View the document(introduction...)
View the documentForeword
View the documentIntroduction
View the documentWhy is breastfeeding so important?
View the documentAre commercially-made baby milks as good as breastfeeding?
View the documentWhy are commercially-made baby milks not so good?
View the documentBut can every woman breastfeed?
View the documentBut why don't the experts tell us this if breastfeeding is so important?
View the documentDo babies also need tea and water?
View the documentWhen do babies need more than just breast-milk?
View the documentSo a sick baby should go on breastfeeding?
View the documentDo breastfed babies get fewer diseases?
View the documentBut my friend's baby got ill and he was breastfed
View the documentSo breastfeeding is like a medicine?
View the documentPeople say that stress stops the milk, so during stressful times how can we breastfeed?
View the documentWhat about women who have lost a lot of weight? Can they produce milk?
View the documentDo we need special nutrition for breastfeeding?
View the documentBut what about anaemic women? Does breastfeeding drain their strength?
View the documentSomeone told me breastfeeding stopped you getting pregnant, but isn't that just a story?
View the documentHow does breastfeeding work?
View the documentWhat about women with small breasts or flat nipples?
View the documentYou said the baby has a part too. What can he do?
View the documentWhy is the baby's suckling-action important?
View the documentHow does a baby stimulate the milk?
View the documentThe first principle of breastfeeding: good attachment
View the documentWhy does good attachment not always come naturally to the baby?
View the documentWhy does the baby not always get this right?
View the documentSometimes it is hard to get a baby close because he is swaddled and his clothing gets in the way
View the documentEven if my baby attaches well, how can I be sure there will be enough milk?
View the documentYou said earlier that milk changes during a feed. Can you explain that?
View the documentBut I thought you must feed from both breasts?
View the documentYou said earlier that confidence was important but not everyone has that. What can we do?
View the documentI know women with breastfeeding problems. Can they be helped?
View the documentMy mother told me that you always get sore nipples and you just have to put up with them
View the documentWhat about special creams for sore nipples? How can we get them during an emergency?
View the documentWith this baby-led feeding how can I be hygienic and wash my nipples?
View the documentSo if I get my baby well-attached, I will never get sore nipples?
View the documentYou say breastfeeding should not hurt, but what about the engorgement that every woman gets a few days after the birth?
View the documentYou mentioned blocked ducts, mastitis and abscess. Are they common and how can we treat them?
View the documentAll these problems make breastfeeding look too difficult
View the documentYou said earlier that you can breastfeed even if you have stopped completely. How can this be done?
View the documentFood supplies can be precarious. How can we feed the babies over 6 months who need more than breast-milk alone?
View the documentWhat about premature or very small babies?
View the documentI can see the reason for expressing milk for sick or premature babies, but must all women learn to express?
View the documentHow do I express milk?
View the documentI can see that breastfeeding is possible in most cases, but we still have to face the times when it is not possible: emergencies create orphans, abandoned babies and severely ill or wounded mothers
View the documentIs it possible to feed a baby artificially without a bottle?
View the documentHow do you cup-feed a baby?
View the documentA final word

How does a baby stimulate the milk?

Signs of hunger start long before crying: a baby turns her head, opens her mouth wide, sticks her tongue out and salivates. When you stay close together, you learn to recognize these signs. You can then offer your breast before your baby cries. A baby learns to breastfeed better if she is not distressed before a feed.

Every baby is born with reflexes to enable him to breastfeed. You may have noticed a baby doing the following:

1. A baby instinctively turns his head from side to side to look for his mother's breast.

2. A mother offers her breast and holds her baby close. The touch of her nipple stimulates him to open his mouth wide and take in a 'good mouthful' of breast (Figure 2). He takes in much of the underpart of the areola (the darker area surrounding the nipple). He holds his tongue down so that it goes under the breast. His lower lip is turned outwards and his chin indents the breast. The tip of the nipple touches the roof of his mouth far back. This stimulates him to make the milking action or 'suckling'.7

7 The term 'suckling' in English is different from sucking, although in English and many other languages the word sucking is often used for feeding at the breast. It is important to differentiate as sucking is a different action from suckling. Suckling is the milking action at the breast (as described) whereas sucking is how we drink through a straw. A baby usually sucks on a bottle or dummy, but suckles at the breast. If the translator can use different words or phrases for the two actions this will help get the information across.

Figure 2

3. The suckling action is like a wave. The baby's tongue and lower jaw compress the darker area behind the nipple (the areola). The movements of the baby's tongue press the mouthful of breast against the roof of his mouth. This action presses out the milk. The baby's suckling stimulates nerves in the areola to send messages to the mother's brain which then releases two breastfeeding hormones which go through the bloodstream to the breast. The first hormone (called prolactin) stimulates the breast to make milk. The second hormone (called oxytocin) makes the milk flow (Figure 3).

Figure 3

The baby does not suckle continuously. At first he suckles quickly a few times to start the milk flowing. Then he changes to deep rhythmic suckling, sometimes pausing. Sometimes a mother mistakenly thinks her baby wants to stop feeding when he pauses and she takes the baby off. In fact the pauses mean the milk is flowing and feeding is going well. Always let the baby end the breastfeed in his own time. Of course in a special situation, a feed must be interrupted. Put your little finger in your baby's mouth and take him off gently so that he does not pull on your breast and hurt your nipple.

4. When the milk flows out of the breast, we call it the oxytocin or milk ejection reflex. Some women feel this as a tingling sensation in their breasts.

5. You can see now why nipple shape does not matter. What is important is that the baby gets 'a good mouthful' of breast and not just the nipple. This enables the baby to stimulate the nerves which trigger the hormones and also to press out the milk which collects in little 'sinuses' under the areola. A baby should breastfeed, not just suck the nipple. If she is 'well-attached' she can make a good milking action (suckling).

Three principles for happy breastfeeding

Make sure breastfeeding does not hurt you - the good attachment principle.
Let your baby suckle as often and as long as she wants - the supply and demand principle.
Know that you can make enough milk for your baby - the confidence principle.