When it comes to breastfeeding, the internet has transformed what was once a pretty simple act to something far more complicated. Breast milk-boosting supplements, nursing gadgets and information on the “right” way to feed your newborn abound.

We sat down with lactation consultant Katinka Lategan in a breastfeeding Q&A to shed some light on what’s really important for your baby – and you.

Zoie: What question do you get asked most often?

Katinka: I think the most common question is, ‘How can I increase my milk?’ or ‘My breast milk is not enough. What can I do?’

Zoie: Why are women so concerned that they’re not producing enough breast milk?

Katinka: It’s really a lack of knowledge – and I don’t mean that in a bad way. Women don’t understand their bodies and they don’t understand the process, and that brings about quite a lot of doubts. And unfortunately, our society doesn’t help. So we unknowingly engage in practices that might not help or interfere with the body’s normal instincts.

Women don’t understand their bodies and they don’t understand the process, and that brings about quite a lot of doubts.

Katinka: The big other thing is [a lack of] skilled professionals. Not all healthcare workers use breastfeeding specialists and I think we need to remember that so very often mom goes to her normal baby clinic or wherever she has her general check-ups and you know, maybe baby didn’t gain enough weight. So maybe the health professional doesn’t know how to fix it, the breastfeeding situation that’s maybe not working perfectly already. And then they start introducing top-ups for the baby. Really quickly, it can actually become a problem.

Z: So, how much breast milk should a mom be producing on average?

K: Remember, we are all different. So each and every woman will produce a different amount of breast milk per day and that will fit her baby. Milk production works on a supply and demand basis.

So there is another factor that’s also very interesting, and that is what we call the storage capacity. There are moms that can, for instance, feed the baby five or six times a day.  

They’ve got large storage capacities, so they will feed less often. And then you’ve got a mom with a smaller storage capacity, and her baby will feed more often in order to reach the needed volume.

With feeding schedules, it’s important for moms to know that in order for them to supply the baby’s needs, all they really need to do is follow the baby’s cues whenever your baby is hungry. That’s going to be the time that you feed the baby. Irrespective, you know of how many feeds or how long ago was the previous feed or things like that.

On average, a mom will produce between 600 and 900ml of breast milk per day.

Z: A lot of this seems more intuitive than anything else.

K: Absolutely. And the era we live in is not helping us because you know what? Each time a baby cries, someone will look at this woman and say, ‘But is your baby not hungry?’ And so that really undermines moms.

I think we need to just take a step back, relax a little bit and really let her [mother’s] instincts guide her.

Z: How do we manage those kinds of conversations when we go back to the clinic or to the doctor for our check-ups and somebody suggests a top-up but you’re not feeling comfortable with that?

K: Not all healthcare professionals are equally trained in lactation specifically. If anyone was in a situation like that where there’s a problem and there’s no assessment done to say, ‘But why is my baby not gaining enough weight?’ But they just jumped to top-ups immediately, let those moms contact lactation consultants, because we are trained to look at the mother, the baby and how both of them actually work together.

If a baby is, for instance, having difficulty in removing the milk from the breast for whatever reason, then this baby won’t gain weight well, and it is going to affect mom’s milk production as well.

A baby with underlying medical conditions might be unable to do certain things or maintain suction for enough time, so we need to then address all of those things.

Z: If a child has a problem with the suction, how do we fix that?

K: A baby should have the proper suck-swallow breathing rhythm. Sometimes that is distorted and that makes it difficult for this baby to actually do a proper feed because they can’t maintain the suck-swallow-breathe [pattern],for instance. Then we are most probably going to refer to a speech therapist or even an occupational therapist in order to see what is happening: Is it just a bit of prematurity or is it some neurological problem making it impossible for the baby to control this? We can even come back to more basic things like how the baby is positioned at the breast or how the baby is latched onto the breast. That will always be the very first thing that we start off with.

A baby should have the proper suck-swallow breathing rhythm. Sometimes that is distorted and that makes it difficult for this baby to actually do a proper feed.

K: Maybe it’s just a case of the baby not being supported well at the breast because mom doesn’t know how to hold the baby, for instance, then this baby might struggle because the baby’s head is turned and that makes it difficult.

Or it can be that there is some muscular tension or something that makes it difficult for the baby to remain in a certain position to feed. They actually want to get out of that position because it hurts or it’s uncomfortable for them, and then they don’t do a proper feed. Most mother and baby diets can be helped to successfully breastfeed with skilled help or support.

Have a burning question about lactation? You can have your own breastfeeding Q&A with Katinka on the Zoie app. Katinka and other lactation consultants are registered with LACSA: Lactation Consultants of Southern Africa

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