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Breastfeeding in the real world....One breast or two?

November 23, 2008 14:56 Published by Geraldine Miskin 6 Comments

Breastfeeding in the real world....One breast or two?

I am a little frustrated this afternoon having returned from a day in the community helping mums with breastfeeding related problems. I guess the most frustrating thing of all is that so many of these problems could have been avoided if the mums had been given the correct advice or advice that is suitable to the two of them as a unique breastfeeding dyad. So I think we should have a chat about the advice mums are given and how this could apply to you or maybe not.

One breast or two? Is a popular question with mums on my Breastfeeding Workshops. The answer is not as straight forward as many other health professionals seem to think it is and here is why. Firstly, your breast shape and size is not going to be the same as the lady next door or the lady down the road, so how can we honestly expect the same feeding routine to suit all three of you? Whilst we know that breast size has little to do with the amount of milk you will produce, it does however give us an indication of how much milk you are able to store. So how does this relate to you and your breast size and shape and your baby?

If you have small breasts, you may need to feed more frequently or at least every three hours and probably from both breasts. However it is important to remember that small breasts do not always equate to frequent feeds.

If you have larger breasts you may find that your baby is able to take bigger feeds from only one breast and is satiated and content.

There are times when things will change and larger breasted mums find themselves feeding frantically off both breasts at each feed, and this may very well be normal. Remember that there is another little person involved in this equation and this little person may be very hungry or not so interested. Amazing this will vary from baby to baby and also from feed to feed.

So with all this under our buckles, when do we absolutely offer both breasts to baby? Well I am sure that many of you will have been told to do so ‘When your breast is empty’ but has anyone ever told you how you know when that is? No, thought not. You have to look at your baby. We know that milk composition changes from the beginning of the feed to the end of the feed and we call this foremilk – hindmilk transition. It is important to know that this is a gradual change and a notable difference is that the fat content increases and slows down the rate of flow of the milk. So, when you are looking at your baby feeding, pay attention to how many sucks he is doing before he swallows. If it is one or two, he has probably just gone on or you have quite a lot of milk. If he is doing closer to  twenty sucks with no swallows, we can assume that he is working to get the calorie rich hindmilk. When he is doing lots of little sucks and no swallows, do some breast compression. This should result in a manual let down. If it doesn’t and baby is still not doing any swallows, you can assume that the breast is empty. If your baby is still awake, offer him the second side. Remember, if your baby’s poos are yellow he is getting to the hindmilk. If he wasn’t getting to the hindmilk, his poos would be spinach green. If this is the case, feed him from the first breast for a longer period before offering the second breast and seek professional help.

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Comments

12.10.2008 | Name: Karen

Hi my daughter is 8wks and I have always offered her just the 1 breast at each feed. One health visitor said offer both breasts each feed another said if your baby becomes restless up to half an hour after the feed offer her the same breast as you've just fed her from. Her feeds vary from 15mins up to 35, 40mins - which one is right?? - her weight gain is good and poos are the right colour and come often!!!! I have also been told to offer the second breast after a feed to offer her a drink at the end of a feed - is this needed????? Many Thanks

07.09.2008 | Name: Cameron

I was given some bad advise when my second was born. She does the projectile vomiting so I was told by a nurse to always start my baby on the heavier let down breast, instead of alternating. Now my left breast is not used at all.. it's been weeks in fact. She turns her head and refuses it. My right breast is now twice the size and doing all the work. So far she is gaining weight and her poops are also yellow. She will be 12 weeks this coming week and I am concerned that as she gets bigger will my 1 working breast do the trick. The real problem here is that if my breast can't support her needs I can't turn to formula because she refuses to take a bottle (or a pacifier). She gags when ever she gets them in her mouth. Can you offer advise in this situation. She eats about every 2 hours. So I guess I am asking, should I stop worrying about making enough milk and can my one working breast do all the work even when she is 6 months old?

31.05.2008 | Name: Sebastians mummy

Hi...I am using breast shells to collect from the opposite breast as my little Sebastian is feeding from the other and I am finding that I produce around 5 oz per day, which I bottle feed him during the night. Shells are such a life saver!! But I am wondering if the 5oz I am collecting,using the shells between both breasts, is a reflection of how much I am producing for my little one as he feeds ?

01.09.2007 | Name: Geraldine

Hi there Lisa, You are doing a great job at reading what your little one wants and needs. There is no point in forcing your baby to take the second breast. He is putting on plenty of weight and his poos are perfect. These signs tell you that he is getting enough milk in 10 mintues from one breast. As he is an older baby, your supply is well established, the flow is even and that is great. The article above is there to help mums with babies who are not gaining weight and only feeding from one breast. You and your baby are doing beautifully.

01.09.2007 | Name: Geraldine

Hi there M Dodds, you sound really frustrated by the article. Please let me reassure you that I don't believe that there is only one solution to fit every mum. The way you fed your baby was perfect for you as I assume his weight gain was great and his poos perfect. I am not suggesting that all mums need to switch breasts during the feed, however, if your baby is not gaining weight, which was happening with the mums I referred to in this article, then feeding from both is advisable. Mums of twins, should switch the twins to the other breast, either during the feed or at the following feed, as we often find that one twin is a better feeder and will drain the breast better. This will also ensure that both breasts are evenly drained and will produce roughly the same amount of milk. You are right that your breast is never totally empty as you will always be able squeeze out a few droplets. however, if your baby is doing lots of sucks and no swallows, surely you can see that it may well indicate that your baby is not getting any milk but is still hungry - thus indicating time to offer the second. Many mums are told to feed from only one breast and offer a formula top up instead of the other breast - to ensure they get to the hindmilk! Hence me writing this article. I hope this puts your mind at ease.

16.08.2007 | Name: Lisa

I also only feed from 1 breast, I stopped offering the 2nd as he always refused it. My 10 week old is putting on plenty of weight , is healthy and has very yellow poo! He only spends about 10 minutes on my breast. His sucking pattern differs to what you have mentioned here, he almost will always do suck, suck, swallow on a constant cycle and keep it that way for the whole feed. The only time it differs is if he has fallen asleep on the breast and then he still does suck, suck, swallow but with a pause in between each swallow.

16.08.2007 | Name: M Dodds

What about Mums of twins or triplets - they can breastfeed quite adequately without switching breasts. What about Mums like me, who breastfed from one breast only (one child). You haven't mentionned the fact it is perfectly possible to do so. My breast was never 'empty' - there was always milk for my baby when he needed it. Mums need to know that milk is made on demand and that their breasts are never truly empty. Mums that think their breasts empty are more likely to grab some formula.

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