The key to breastfeeding success is to know why you are doing it. If you understand in your heart and mind why breastfeeding is best for your body and breast milk is best for your baby, then you will be motivated to persevere through challenges.

Breast milk is a living fluid containing organisms and proteins that offer protection against bacteria and viruses: breastfeeding reduces the risks of your baby suffering from acute diarrhoea; respiratory, urinary tract and ear infections; asthma and allergies; coeliac disease, ulcerative colitis, insulin dependent diabetes and childhood lymphomas. Breastfeeding also aids your baby's speech, eyesight and intelligence and promotes a special bond between you and your baby.

As your baby's cries escalate, you can be sure to hear well meant enquiries of, "are you sure you have enough milk?" or "maybe your milk isn't strong enough?" (By the way this second proposition is NEVER true, even though it was a common belief in your mother's day).

It is much more likely that your baby is simply hungry: it is perfectly normal for a breastfed baby to need feeding every two hours - and that means to hours from the beginning of one feed, to the beginning of the next - not two hours between feeds. In the early weeks, babies' tiny tummies are only the size of their tiny fists, so simply don't hold enough food to go long between feeds, day or night.

Feeling 'fluey' any time when you are breastfeeding is a warning sign that you could be coming down with mastitis, an inflammation of the breast that may or may not also be infected. Symptoms of mastitis can hit suddenly and hard: one minute you feel just fine and the next you feel shattered and aching all over with chills and a fever. Sometimes flu-like symptoms come on even before you get a fever or notice breast tenderness. Mastitis can affect you emotionally too - it is common to feel 'just awful' and teary.

Another sign that mastitis may be rearing its ugly head is an intensely painful breast. Your whole breast may feel tender and 'tight' and be swollen, red and hot or you may present with a red, sore, lumpy patch on one area of your breast only. A sore, lumpy breast may also be caused by a blocked duct or, in the early days of breastfeeding can be due to engorgement (full breasts). A blocked duct or mastitis without infection will start to feel better with simple measures such as rest and emptying the breast but if you feel increasingly unwell, you will need to seek medical treatment – the sooner the better!

I have a newborn and as this is the first Christmas season since I have had my baby, I am wondering, what is a safe alcohol level while breastfeeding?

The National Health and Medical Research Council are currently revising safe drinking guidelines and it looks as though pregnant and breastfeeding women will be advised not to drink alcohol at all. This is because, in light of worldwide research, a safe limit of alcohol consumption can't be determined during pregnancy and breastfeeding – there are potential risks to babies whose immature livers aren't able to process the alcohol transmitted through the placenta or their mother's milk.

Daily consumption of alcohol by breastfeeding mothers has been shown to affect baby's sleep patterns (with babies falling asleep more quickly but waking more often), increases the risk of slow weight gain and slows gross motor development.

Breastfeeding has been going well: your baby is thriving and happy. But now you are returning to work and feel sad at the prospect of weaning. Take heart - returning to paid work doesn't mean you have to stop breastfeeding. Your baby can enjoy the health and nutritional benefits and you will still have that unique connection through the one thing that only you can do for your little one - snuggling him close as he drinks your milk.

To make breastfeeding and working possible from a practical perspective, it is important to choose a carer who is breastfeeding friendly: your carer will need to be motivated to implicitly follow your instructions to store and thaw (if necessary) and feed your milk to your baby. Also, there is nothing worse than arriving with full breasts to pick up your baby, only to find she has just been fed, so do request that your carer considers this. She can either help your baby wait (as long as he isn't upset) or offer a small amount of milk to 'tide him over' (rather than a full feed) if you are on your way home. This will also require close communication on your part – perhaps a call as you leave work with an estimated arrival time.

By Pinky McKay

Its ok, you can keep your shirt on! You don’t have to bare your man boobs to help with breastfeeding. But did you know that your impact is the single most crucial factor in your partner’s breastfeeding success? That’s what the research says, so even though you may be feeling that you can’t really be involved because she has the breasts, there are some important ways you can support your lady. The bonus to your efforts is that there is nothing more of a turn on than a partner who nurtures the new mum so she can focus on the intense needs of your newborn. This doesn’t necessarily mean you will get a romp in the sack any time soon and that shouldn’t be your prime motivation (you are a grown up now and you do want the very best for your baby, don’t you?), you will be accumulating loving feelings and ‘goodwill’ rather than resentment that can brew if she feels isolated and unsupported as she adjusts to this new life – the tiny one attached to her breasts for hours on end. So, how can you help with breastfeeding?

Man up!

I’ve seen too many new dads who seem like little boys who don’t want to share their partner’s attention – or breasts. There was even a recent US advertisement for baby bottles with the headline ‘Reclaim your wife’s breasts’.  As I used to tell my own kids when they were small and had a treat, “it tastes better when you share.” This goes for your partner’s breasts – right now they are for providing optimum nutrition to your baby. This will save you an absolute fortune, not only in the cost of formula which is expensive, but in medical and dental bills because of the immune factors and physiology of breastfeeding. The health benefits to your baby will last a lifetime so ‘man up’ and be patient, your partner already has a baby so she doesn’t need you to behave like one.

You don’t need to give bottles to bond with your baby.

Actually, there is more eye contact in changing a nappy! If your partner has to express milk just to make you feel connected to your baby (it’s different if she is popping up the street and wants to make sure you have some milk ready in case baby needs a feed before she gets back), that’s one more job she has to do: its far easier and more efficient to pop your baby straight on the boob. Pumping is hard work, time consuming and besides, who is cleaning the breast pump?  Of course, it’s your prerogative as parents to make your own choices about whether you give your baby an occasional bottle, but do remember that it’s best to wait until after the first 6 weeks to introduce bottles because sucking from a bottle is very different from breastfeeding. Giving bottles in the early days could make it more difficult to establish breastfeeding: your baby may take longer to become an efficient feeder and it could take longer for your partner to establish a good milk supply. Also, breastfeeding works on a supply and demand rule: the more milk your baby drinks, the more milk mummy’s breasts will make. To maintain her milk supply, your partner will need to express when you give a bottle because if she ‘skips’ a feed, her body won’t get the signal to produce milk for the next feed or she could get blocked ducts from being ‘over full’ and then she runs the risk of getting mastitis which will make her feel extremely ill and require medical help.

Share the love, your way

There are lots of ways to share precious time with your baby - by burping or settling him after feeds or when he has a belly ache, bath or shower  with your little one, make him laugh, ‘wear’ him in a baby carrier or learn baby massage  (see Pinky’s Baby Massage DVD  http://www.pinkymckay.com.au/massage/pinky-mckays-baby-massage-dvd). If you make one activity specially yours, this will not only help your partner, but it will create a beautiful shared ritual that  will boost your confidence as you see the looks of recognition and joy on your baby’s face.

Love up your lady

It might look as though your partner is just sitting around all day but it takes a lot of energy to make mummy milk and nurture a baby - even the easiest baby will take nine hours of basic care each day!  If you love up your lady by helping her relax and focus on feeding right now, she will remember you were there for her when the going was tough and that’s a big investment in your relationship: bring her a drink, feed her healthy food (breastfeeding burns calories and low blood sugar can make a cranky, irrational mummy), notice things that need doing, without being asked – throw on a load of washing, do the dishes, tidy up, and call on your way home from work to see if she needs you to pick up a few things. If you help her, she will have more energy and time to share with you.

Bring out your caveman!

Your partner’s confidence is a big factor in her ability to breastfeed but there can be a lot of advice that causes stress and self-doubt.  Whenever a baby cries somebody (hopefully not you), is sure to ask, ‘is he hungry?’ or ‘do you have enough milk?’ or even ‘perhaps your milk isn’t strong enough.’ By the way this last one is never true but it was a popular belief when you were a baby so it’s often said by grandmothers. Although most advice is well meant, there can be no worse feeling for a mother than worrying whether she might be starving her child. So, although you won’t really need to behave like a Neanderthal man, your role here is to have your partner’s back and protect her from negative comments – learn the basics of breastfeeding (see Pinky’s ebook and recording pack ‘Breastfeeding Simply’) so you can be a buffer against unhelpful advice.  Your protector role also extends to limiting visitors and making sure they don’t stay too long, especially in the early days when she needs to rest and recover from birth and establish breastfeeding.

Get qualified help

If your partner and baby are having breastfeeding difficulties, consider it an investment to hire a lactation consultant to come to your home. By having a professional come to you, there isn’t the stress of getting to an appointment, your lady will get the time and individual attention she deserves to sort out problems and enjoy breastfeeding.

Pinky McKay, International Board certified Lactation Consultant (IBCLC), and best-selling author is also the creator of Boobie Bikkies, natural and organic cookies to nourish breastfeeding mothers and encourage a healthy milk supply. You can grab a pack of Pinky’s Boobie Bikkies and her free Ebook ’Making More Mummy Milk, Naturally’ at www.boobiebikkies.com.au

By Pinky McKay

Here you are, dripping milk, all ready for your baby to feed – but he won’t!

If you have a newborn, there is every chance you will be ‘woman handled’ as somebody tries to get your baby to latch by grabbing baby and boob and shoving them together  (if this happens, put your hand up in a stop sign and ask, ‘please can you guide me, I would like to try myself’). Or, if your baby is older and has been happily breastfeeding until now, you are probably wondering, ‘is he weaning?’

Whatever the reasons for your baby’s breast refusal, your baby isn’t ‘refusing’ to breastfeed because he is being stubborn and forcing him won’t help. For newborns, generally if your baby won’t breastfeed it is because he can’t right now,  but it doesn’t mean you won’t be able to breastfeed at all – although you will need to be patient, with the right help, most babies will ‘catch on’ and latch on. Reasons for your newborn not being able to breastfeed in the early days may include being affected by drugs that you have taken during labour – being able to latch on and coordinate sucking, swallowing and breathing isn’t easy when your central nervous system is ‘hung over’ by drugs such as pethidine which pass through the placenta to your baby, staying in their body for several days or longer. Some drugs given by epidural have been found to affect breastfeeding for up to four weeks.

Early feeding attempts can also be affected by a difficult birth. For instance, babies who have had a forceps delivery may have some pain when they feed, others could be in pain in particular positions if, for instance, they have a sore shoulder or clavicle after birth. These babies often benefit from some gentle adjustments by a paediatric osteopath or chiropractor (it is important that any practitioner is trained to treat infants).

Other babies may have difficulty latching on due to problems with their oral anatomy such as a high palate (which can be helped by careful breastfeeding positioning) or a tongue tie (this can be easily remedied by seeing a Dr who will ‘snip’ the tongue tie). And some babies seem to develop an ‘aversion’ to breastfeeding after being ‘forced’ to breastfeed (your baby has a natural reflex to resist if his head is pushed forwards – don’t ever push your baby’s head against the breast).

Another possible reason for ‘breast refusal’ could be nipple confusion: bottles and dummies require a completely different sucking action to the breast and babies can become ineffective at breastfeeding if they are given bottles in the early days.  If your newborn is having difficulty feeding at the breast, it is better to offer supplements by spoon or a syringe, or you could use a ‘nursing supplementer’, a device with fine tubing that slides into baby’s mouth, so he gets milk while he is at the breast. If you do have to temporarily offer some feeds from bottles, please don’t feel ‘this is the end’. With patience and persistence, even though it may take a few weeks, it is possible to gradually encourage your baby to breastfeed.

Is baby unwell or ‘on strike’?

After the early days, even babies who have been feeding beautifully can refuse to breastfeed or seem to struggle at the breast.  A baby who has oral thrush may find it uncomfortable to breastfeed and a baby who has gastro oesophageal reflux can squirm and pull off the breast if feeding is causing discomfort. A baby with reflux may find it more comfortable to feed ‘sitting up’ perhaps straddled across your leg to feed.  Babies with allergies can also seem restless during feeds or may reject the breast.

Although your baby is NEVER allergic to your milk, if he is sensitive to something in your own diet, a bit of detective work and eliminating the culprit food can make all the difference.

Older babies can seem to be rejecting the breast as they become more efficient feeders so feed more quickly and are also easily distracted; painful teething can see babies ‘go on strike’; babies who have been given bottles can almost suddenly seem to ‘prefer’ drinking from a bottle and other babies can refuse the breast for reasons that aren’t at all obvious.

What can you do?

Whatever the reasons for your baby refusing to breastfeed, the most important considerations are to feed your baby (please don’t EVER try to ‘starve’ him into taking the breast), and to maintain your milk supply, by expressing so that when your baby does attempt to feed, his efforts will be rewarded by good milk flow.

Offer lots of skin to skin contact – wear clothes with quick access to the breast and cuddle your baby with your top off, allowing him to fall asleep on you. Wear, cuddle and carry baby lots and sleep with or close to him, so you can offer the breast at his very first hunger cues.

Try feeding in different positions and at different times – lying down, standing or walking, in the bath. Try offering the breast as baby is just waking, as he is falling asleep or when he is asleep but stirring slightly.

Don’t try to pressure your baby to feed. Stay calm (not always easy!) and avoid making your baby frustrated. If he is becoming stressed, feed him however you have been and try again later.  If baby is having bottles, he may try the breast after he has had a little drink, rather than when he is very hungry.

Be patient. It can take time for babies to learn to feed effectively but this can happen more quickly with expert help from a breastfeeding counsellor or lactation consultant.

Pinky McKay, International Board certified Lactation Consultant (IBCLC), runs a private practice in Melbourne specializing in gentle parenting techniques. A sought after keynote speaker and best-selling author with 4 titles published by Penguin, including her recent book Parenting By Heart, Pinky is also the creator of Boobie Bikkies, natural and organic cookies to nourish breastfeeding mothers and encourage a healthy milk supply.

Pinky’s books, parenting resources and her free newsletter ‘Gentle Beginnings’ can be found on her website www.pinkymckay.com.au

You can grab a free sample of  Pinky’s Boobie Bikkies and her free Ebook ’Making More Mummy Milk, Naturally’ at www.boobiebikkies.com.au