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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

You said earlier that you can breastfeed even if you have stopped completely. How can this be done?

Even if you stopped breastfeeding several months ago you can probably still squeeze a drop of fluid from your breast. Your milk-making system has not completely shut down. Re-starting breastfeeding after you have stopped is called relactation. Women who have never given birth have breastfed adopted babies, this is called induced lactation. The first is easier than the second.

The three principles of easy breastfeeding still apply.

· Good attachment
· Supply and demand
· Confidence

The aim is to persuade your baby to play her part. If she is now fully bottle-fed, she may have temporarily forgotten her natural skill to breastfeed and she needs reminding. Some babies just restart suckling easily, others need gentle persuasion. The delicate period is when you want your baby to suckle a lot to stimulate the milk, but she still needs to get enough to eat. She needs to be hungry enough to suckle effectively at the breast, but not so hungry that she gets frustrated when the milk supply is still low.

Every baby is different. Some babies who are bottle-fed, attach well at the breast. Others are so used to the bottle they do not work at the breast. Ask someone to give you emotional and practical support through the first days: for example perhaps a relative or friend could help with housework, queue for food or care for your other children. You will need to spend a lot of time with your baby at the beginning.

· Put your baby to the breast frequently, at least 10 times in 24 hours.

· Offer your breast whenever she wants to feed. Never force the breast; try to remind her how pleasant breastfeeding can be.

· Make sure that the position and attachment are right and comfortable for both of you.

· Whenever possible, enjoy skin-to-skin contact, even when the baby is asleep.

· It helps to sleep all night with the baby skin-to-skin.

· Do not use a dummy.

· Whether you are bottle-feeding or cup-feeding gradually reduce the amount of milk in these feeds as your milk increases.

· Use gentle hand expression to stimulate the breast.

· If you can squeeze a droplet of milk onto your baby's tongue, do this to awaken her interest.

· You can try dripping artificial milk from a spoon onto your breast so that it trickles into the baby's mouth while she suckles.

If the baby is getting frustrated before the milk comes back you can try making a breastfeeding supplementer. Only use this method if you know you can sterilize the equipment for every feed. Ask a health worker for very fine infant feeding tubes. Put donated expressed breast-milk, commercial baby milk or diluted cow's milk in a cup, jar or other available container.

Place the end of the tube along your nipple, so that the baby suckles the breast and the tube at the same time. Hold the tube in place, ideally with surgical tape (Figure 7).

Figure 7

Ask someone to hold the cup, if you find it awkward to hold. To start off the milk can be held higher than your breast and baby. As soon as the milk flows through the tube, hold it lower. The idea is to make the baby stimulate your breast-milk by effective suckling, so only a trickle must get through the tube. Reduce the milk in the cup by a teaspoonful10 at each feed as the breast-milk increases.

10 If a teaspoon is inappropriate, use an equivalent local measure for up to 5 ml, for example, a soft drink bottle cap.

Stay confident. Many women, including grandmothers, have successfully restimulated breast-milk, many years after they stopped breastfeeding.