Postpartum confinement following childbirth is a traditional practice to allow the mother to rest and recover following childbirth. The length of this period varies depending on the different cultural background which can range from 30 days to 100 days. This first 3 months postpartum is also affectionately known as the ‘fourth trimester’ where both the mother and infant(s) begin to bond and learn the skills of breastfeeding.  

Many mothers (especially mothers with their first child) often worry about producing enough milk supply or able to breastfeed safely and correctly.  Their lack of knowledge or experience may cause a great deal of anxiety.  The increased effort and commitment required often results in supplementing initially with formula milk and eventually early cessation of breastfeeding.  It is therefore important to educate mothers on the correct way to sucking, proper latch, feeding frequency and support to during the early stages. 

Breastfeeding has been shown to have the following benefits;

• It is a complete meal with all the essential nutrients and vitamins
• It is easier to digest and results in less diarrhoea
• It has antibodies which can protect the infant from infections
• It encourages mother-child bonding
• It helps the mother lose excess weight gained during pregnancy
• It lowers the risk of the mother developing breast cancer and ovarian cancer

The ABC tips to successful and enjoyable breastfeeding

• Awareness.  Be aware when your child is hungry (see below) and be ready to feed on demand
• Be patient. Try not to rush your child.  The session may take between 10-20 minutes with some rest periods in between
• Comfort.  Make yourself comfortable with head, neck and back support

Frequency of Feeds

How often you need to breastfeed depends on the age of your child.  Some infants prefer small frequent meals while others prefer larger meals.  In between feeds, you may also need to pump your breast to prevent complications such as engorgement and prevent blocked ducts.

The golden rule is to breastfeed on demand whenever the baby shows ‘hungry cues’ such as;

• Head turning to look for the breast
• Becoming for alert and active
• Rooting (mouth or jaw movement when looking at your breast)
• Opening and closing of the mouth
• Lip smacking or sticking out the tongue
• Putting the hand or fingers in the mouth
• Being fussy or calling for attention

The Ministry of Health recommends feeding on demand and does not put a limit to the frequency or duration of each feed.  Your baby’s instinct knows that more frequent feeding will trigger more milk supply.  During a growth spurt, your baby may require cluster feeding.  This may occur between week 3 to week 6 and can be exhausting for the mother but fortunately, this rarely goes on for more than 2 days at a time.

The table below is a rough guide for the frequency of feeds for your baby;

Age	Frequency
Newborn	Every 2-3 hours
2-5 months	Every 3-4 hours
6 months onwards	Every 4-5 hours

Blocked milk ducts are common because you may be producing breast milk faster than it is used or when there is incomplete emptying.  It is important to get into the routine habit to pump each breast for several reasons; 

• Ensures CONTINUOUS production and flow of breast milk
• REDUCE RISK of blocked ducts, mastitis or infections
• Allows mothers to FREEZE & STORE the breast milk and used when they are at work

Reasons to Pump Breast Milk

There are many reasons to pump breast milk to store and be fed to the baby at a later time.

• You have a premature baby in ICU who cannot be breastfed
• You have to return to work or unable to breastfeed during certain periods
• Your baby does not want to feed but your breast is engorged with milk
• Your nipples are too sore to breastfeed
• You have twins or triplets (which require breastfeeding at different times)

How often should you Express or Pump Breastmilk?

Scenario	Duration & Frequency	Suggested mode
New-born unable to suck colostrum	5-10 minutes every 1-2 hours	Express by hand using Marmet technique
To increase milk production	20 minutes every 2 hours (at least 6 times a day)	By hand or using pump
To soften the areola	3-4 times a day	Apply reverse pressure softening with your fingers
To clear blocked duct	Apply compress (cold if painful, warm if no pain)	By hand
Working mother away from your baby	15-30 minutes every 2-3 hours	Using pump (ideally double electric pump)

Discuss with your Doctor. Mid-Wife or Lactation Therapist if you have difficulty breastfeeding your baby

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Disclaimer. TELEME blog posts contains general information about health conditions and treatments. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. The information is not advice and should not be treated as such. 

If you think you may be suffering from any medical condition, you should seek immediate medical attention from your doctor or other professional healthcare providers. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.