|Infant Feeding in Emergencies: A Guide for Mothers (WHO, 1997, 48 p.)|
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.
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).
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