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Pregnancy is a period of change which affects you physically and can affect you emotionally too, so you might be both excited and anxious at the same time. You may be wondering what your baby will be like or be worrying about how you will cope; you may swing from feeling totally exhausted or have bags of energy.
Pregnancy is the ideal time to start building a relationship with your baby. The positive impact you can have on his/her development starts now and begins with talking to or singing to your baby, being aware of movements and different stages of development and starting to recognise baby’s sleep patterns so that you are more aware that baby will have wakeful periods at times of the day and night once it is born.
During pregnancy you will begin to think about how you are going to feed your baby; this is a really important decision. To help you with this, your Health Visitor should spend time talking to you about your thoughts and feelings on feeding your baby and may share with you some information about the difference between breast and bottle feeding. She will also give you information about some simple steps you can take to make breastfeeding your baby easier such as the importance of skin to skin after delivery and of looking out for your baby’s early feeding cues (wriggling, licking their fingers or fists, rooting, rapid eye movements) which are important regardless of how you feed.
In some areas there are classes you can attend before your baby is born to talk about feeding. Your health visitor will give you details of these.
Your breasts during pregnancy
As soon as you become pregnant your milk-producing cells and milk-collecting ducts get ready to produce milk. There is an increase in the blood supply to your breasts as well. These changes inside sometimes make the breasts feel tense, extra sensitive and possibly large in size and you may need a larger bra.
From about the sixth or seventh week of pregnancy you may notice small raised ‘spots’ on each areola (the dark area surrounding the nipple). These are called Montgomery’s tubercules, and they secrete an oily substance that keeps your nipples and areola supple and soft.
From the middle of your pregnancy onwards, your breasts make concentrated milk (colostrum), which is a highly valuable, antibody-rich fluid. It is designed to meet your baby’s nutritional needs for the first few days after the birth until the mature milk is produced. Every woman makes breast milk at first, whether or not her baby ever comes to the breast.
The delivery of the placenta (afterbirth) sets up a hormonal response in your body, and prolactin, the hormone which stimulates milk production, starts acting on the breasts, ‘telling’ them to make milk.
At some time between day two and day five after the birth, your baby is ready for more milk and your breasts start producing more breastmilk in response. You may feel your breasts heavier than usual. It’s not just the milk that makes them feel like this; there is a large increase in the amount of blood and fluid going to your breasts at this time.
How you continue to make milk- the more you feed the more you make
You continue producing milk only if it taken from the breast. Normally this happens as a result of the baby feeding at the breast, so when your baby is feeding effectively you make milk in response; in the amount your baby needs in order to thrive.
You can also encourage milk production by expressing your milk. You may need to do this if your baby is very sleepy and reluctant to feed in the early days, or if he is unable to breast feed directly from you, perhaps he is born to early, termed –‘pre-term’ or ill. If you don’t breastfeed, or express, your milk production gradually stops. However, it’s possible to start producing milk again if you express, or put your baby to the breast often enough, your health care professional can support you with this.
I would prefer to bottle feed
However you choose to feed your baby, staff at your local hospital and those visiting you once home should make sure you are supported and confident. Many mothers don’t actually decide how they are going to feed until their baby is born and in their arms. It is amazing how differently you may feel once you see your baby and hold him/her in skin to skin contact.
Feeding your baby responsively
We recommend you feed your baby responsively, whether you are breast or bottle feeding. This means looking for baby’s feeding cues (rooting, putting fingers in mouth and waking/eye movements). Holding your baby close, comforting and cuddling increases loving hormones and lowers the stress hormones which is good for your baby’s brain development.
Breastfeeding is the best form of nutrition for your baby. Exclusive breastfeeding is recommended by the Department of Health for the first 6 months of life as it provides the best start for babies and is compatible with baby’s needs. Breastfeeding gives your baby all the nutrients he or she needs to protect them from infection and other diseases, It reduces your chances of getting some illnesses later in life and it can help you and your baby get closer both physically and emotionally.
Once your baby is born the midwives and then your Health Visitor will help you with breastfeeding positioning and attachment. Breastfeeding is a skill to be learnt by you and your baby and can sometimes take a little time to get the hang of - make sure you ask for as much help and support as possible in the early days – from your midwife, Health Visitor, peer supporters, partner, friends, family etc.
Skin to skin
Being born can be a tiring and stressful time for your baby, and we now know that the best way to help your baby adapt to his new environment is to hold them in skin-to-skin contact. This is one very simple step that every mother can take to welcome her baby into the world and help make sure that her baby gets everything they need in those first few hours. No matter how you choose to feed your baby, spending some time in skin-to-skin contact is very beneficial.
After delivery your baby will be gently dried and then placed on your chest, (it’s fine to have a nappy on your baby, just in case!) and a warm blanket may be placed over you. You can then spend some time getting to know him or her.
Because this is such a special time the staff will not hurry you, it is exactly what your baby needs to calm them after their journey through labour and delivery. This means their heartbeat and breathing will be better controlled and getting used to life in the new world will be so much easier. If you or your baby is unwell and unable to have contact immediately after birth, skin-to-skin contact can start as soon as you are both well enough.
You can have skin-to-skin contact as often as you want with your baby, it’s a great way to calm your baby and let you both get to know each other, and the more time you spend in skin-to-skin contact the quicker this will happen.
Why would my baby choose skin to skin contact?
There is lots of evidence about the many benefits of skin-to skin contact. We know that babies who have spent an hour in skin contact are significantly less stressed after the birth experience, this means that their breathing and heart rate are more stable, they cry less, and when they start to feed, they digest their food better.
A mother’s chest area is significantly warmer than other parts of her body - ready to welcome her new baby and prevent them from cooling down - which is a significant risk. Your baby has been lovely and warm in your uterus (at around 37 degrees) whereas the labour room will be significantly cooler, and they are wet - it’s like getting out of the swimming baths, you need to get dry and warm quickly.
Being close to mum will help pick up some of the friendly bacteria from your skin and help protect from catching infections.
How will skin-to-skin contact help me with breastfeeding?
When in skin-to-skin contact your baby is close to their food. They can see and smell the nipple/areola and this acts as a draw to encourage them to start to breastfeed. In addition, holding your baby in this way will help trigger the release of the hormones that help your breastmilk to start to flow and also help you to bond with your baby and feel confident to look after them.
When else should I think about using skin-to-skin contact?
Skin contact will help in any situation where your baby needs help to calm down, so a hungry or fractious baby will benefit. It will also help to trigger feeding if your baby is slow to feed or sleepy and also help with any breastfeeding difficulties you may have such as if your baby is not gaining weight well.
You can enjoy skin-to-skin contact at any time with your baby and it is also a lovely way for dad to feel close to baby. Many dads speak of the special bond that forms when they hold their baby next to their skin in this way.