A mother whoy increases the risk of SIDS. (She also increases the risk of a premature or low birth- weight baby.)The risk is twice as great as for babies born to nonsmokers if the mother smokes after birth, and three times as great if she smoked during pregnancy and continues after giving birth. What’s more, the risk increases with the number of cigarettes smoked, as well as when both parents smoke. Parents who smoke should quit – for their own health and that for their child.

If a blocked duct is not treated, it can lead to an acute infection, known as mastitis. The breast will be inflamed and a red patch will appear on the outside, as with a blocked duct. If you can, you should continue to breastfeed because you need to empty the breast. However, you may find nursing too painful. In any case, consult your doctor, who may prescribe antibiotics.

If you can, avoid all drugs when breastfeeding. Many medications pass into the breast milk and can affect your baby. Always inform your doctor that you are breastfeeding if you are already taking medications or if you consult her for any new problems; make sure that she is prescribing appropriate drugs only. If you want to use oral contraceptives, you should take the progestogen-only “minipill,” as the estrogen in the combined pill may reduce your milk supply. However, as the effects of progestogen on the baby are not yet fully known, it is best to use some other contraceptive method until your baby has been weaned. Your doctor or family planning clinic can help you choose the method that suits you best.

If your baby doesn’t settle down to feed or appears not to be satisfied, he is probably sucking on the nipple alone and not getting enough milk. This may also lead to sore nipples. Check with your pediatrician or lactation consultant to be sure your baby is positioned correctly.

If your baby doesn’t seem very interested in food during the first few days, make sure that he takes as much as he wants from one breast. If he sleeps at the breast, it means he is contented and doing well, though premature babies should be woken and fed regularly, as they tend to sleep a lot. If your baby does fall asleep at the breast, wake him gently half an hour later and offer a feeding; if he is hungry he will perk up.

Most babies enjoy sucking on their mothers’ breasts for its own sake just as much as feeding. You will learn to tell the difference between actual feeding and comfort sucking. You may notice that your baby is sucking strongly during a feeding without actually swallowing. It’s fine for your baby for suck for a few extra minutes, provided your nipples aren’t sore. Remember: the baby takes most of his milk in the first 3-5minutes.

It is quite usual for a newborn not to suck very vigorously or for very long during his first 24 to 36 hours. If this occurs later, however, there may be a problem that needs to be addressed. Breathing difficulties are the most likely cause of a baby’s having problems taking the breast. It may be that your breast is covering his nostrils; if so, gently pull the breast back from the baby’s face, just above the areola. If he seems to have a stuffy or blocked nose, consult your baby’s doctor.

If there is no obvious cause for your baby refusing breast to eat, he may simply be fretful. A baby who has been crying with hunger, or who has been changed or fussed over when he’s hungry, can become too distressed to take the breast. You will need to soothe him by holding him securely and talking or singing; there is no point in trying to feed him until he’s calmed down.

If there has been some delay in starting to breastfeed – as with a premature baby who has had to be fed by bottle – your baby may find it more difficult to take the breast, and you will have to be patient and persevering. Your pediatrician or lactation consultant will advice you if you need to give expressed milk from a bottle or special cup until the baby can take all she needs from the breast. Avoid supplementary bottles of formula if you can; giving expressed milk is a better alternative.

It is perfectly normal for breastfeeding not to go smoothly at first, so don’t worry about minor setbacks, such as your baby refusing a feeding. Remember that he too is learning and that it will take time for you to get used to each other, so persevere and ask your pediatrician or a lactation consultant for advice.

Latching on Your baby should take the nipple and a good proportion of the areola into his mouth. The milk is drawn out by a combination of sucking and squeezing the tongue on to the hard palate.

Releasing the nipple To break the suction, slip your little finger into the corner of the baby’s mouth. Your breast will slip out easily instead of being dragged out.