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Feeding: what help exists, and what nobody tells you

Feeding difficulty is common, it usually has a practical cause, and it is not a verdict on you.

Lesson 2 of 5

11 min Text

What this lesson says

  • Difficulty in the first weeks is common and usually has a practical cause
  • Pain that does not settle is a reason to get feeding watched, not to endure it
  • Support exists through ASHA and ANM workers, hospital staff and lactation counsellors
  • How a baby is fed is a decision with medical input, not a moral test
  • A baby who is feeding poorly, very sleepy, or not passing urine needs assessment the same day

This is general education. It is not advice about your own situation, and it does not replace seeing a clinician.

Written lesson.
  1. 1. Feeding is often presented as natural and therefore easy, and the second does not follow from the first. Difficulty in the early weeks is common, it usually has a practical cause, and the useful response is to get somebody to watch a feed rather than to read more about it.
  2. 2. Positioning and attachment account for a great deal of early pain and a great deal of early difficulty, and both are much easier to correct with a person present than from a description. Persistent pain, cracked or bleeding skin, a baby who seems to feed constantly and never settle, or a feeling that nothing is being transferred are all reasons to ask for help early rather than at the point of giving up.
  3. 3. Where that help comes from: the staff on the postnatal ward before you leave, ASHA and ANM workers who visit at community level under the national programme, lactation counsellors where they are available, and your own clinician at the postnatal check. Asking early is easier than asking late, and it is a routine request rather than a favour.
  4. 4. Some things are specifically worth reporting rather than working through: a red, painful, hot area on the breast, particularly with fever and feeling unwell; a lump that does not settle after a feed; and any pain that is getting worse rather than better. These are common, they have treatments, and they get harder to treat the longer they are left.
  5. 5. How a baby is fed is a decision with medical input, not a test of anything. Exclusive breastfeeding is recommended for the first months and there is good evidence behind that recommendation — and there are also medical reasons, practical reasons and personal reasons why a particular woman feeds differently, and a clinician's job is to help you do whatever you are doing as safely as possible. Advice that comes with shame attached is bad advice regardless of who is giving it, including from family.
  6. 6. On the baby's side, get help the same day for a baby who is feeding poorly or refusing feeds, is very sleepy and hard to rouse, is not passing urine, has a fever or feels cold, or whose skin or eyes look yellow. Those are assessments, not reassurances, and no page can do them.

All lessons in this course

  1. 1 The first six weeks: what your body is doing 11 min
  2. 2 Feeding: what help exists, and what nobody tells you 11 min Reading now
  3. 3 Your mind after birth, and telling low days from something more 11 min
  4. 4 The postnatal check, and using it for yourself 9 min
  5. 5 When to get help quickly 8 min

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