Breastfeeding 101

So you’ve just become a mother!! Congratulations. You have heard about breastfeeding and want to give it a shot, but what do you do? What do you need? How do you start? Don’t worry...here is a crash course for you.

I remember when I started to nurse my daughter, I was in the hospital after a wonderful homebirth, for observation, and felt very uncomfortable. It was hard to establish a breastfeeding relationship when I felt like I was being judged for how well I produced milk, what shape my nipples were and how the baby latched on.

I had nurses poking at my breasts and hurting them, and trying to shove my daughter’s face into my nipple to latch on. It was frustrating and not at all what I pictured for my first nursing session for us. Learning to breastfeed can be a lesson in patience as well, so go slow and give yourself the time to establish a good routine before you get ready to throw in the towel. It can take a few weeks ( or even months) to really be comfortable with it, but the benefits of breastfeeding and the bonding make it so worth the time you will spend establishing your nursing relationship.

I thought breastfeeding was a natural thing. I figured that my motherly instinct would kick in and my baby’s instinct to eat would have us off and running from the starting gate. Turns out it was more of a jaunt then a run, but we built up the pace and soon we were breastfeeding everywhere and did so for a year.

What do I need?

The first thing you need is comfort and privacy. Place a sign on the door that says “Knock first please, breastfeeding session on going”, or something of that nature, if you are trying to start your breastfeeding relationship from a hospital room. You may want to give it a try by yourself first before you ask for help, so don’t be afraid to tell your nurse that and ask for some quiet time, assure them that if you need help you’ll ask.

Rest assured once you get home in your own bed, and your own surroundings you will be able to relax much better, though in most hospitals you will need to show a good effort before they allow you to leave with a breastfeeding baby. If you have birthed at home in the first place, hopefully you are comfortable and well rested and ready to start breastfeeding.

To start your nursing relationship find a comfortable place to sit, grab a pillow or two for your lap, a foot stool for comfort if your sitting straight up in a chair, or lots of back support with extra pillows behind you if your in a bed. The lap pillows are to get your baby lifted up to your breast easily and so you won’t slouch. This is also more comfortable and helpful if you have had a c section, and your abdomen is tender. You don’t want to slouch or lean to get the baby to your breast as this will make your back and neck very sore and stiff over time.

Posture is important for a good breastfeeding relationship. Poor posture can cause sore backs and neck muscles which stress out the mom and can cause poor lactation. This can lead to more stress for mother, if you’re already having trouble getting started and possibly cause a failed attempt at breastfeeding. Of course you need to prepare by making your breasts available and free from clothes. Early on in your nursing sessions a free flowing nightgown with buttons, or nursing garments are very helpful, so you’re not struggling through layers of clothes to try and breastfeed.

It makes no difference what side you start on, but be sure to switch and alternate breasts during the feedings so they both are emptied well of fore and hind milk, and are ready for the next session. Some babies may only need one breast at a time during feedings, and that is ok too, a helpful way to remember which breast you need to start with next is to place a safety pin on your bra on the full breast side after the last nursing, so you won’t forget which one to start with.

In a warm room at home, allowing your baby to be skin to skin with you while breastfeeding increases the bonding for the baby, and makes them feel very relaxed and comfortable, which will aid in latching on. Draping a blanket over you both and allowing skin to skin contact will feel wonderful for you and baby.

The Cradle Position

Get your baby in your arms in the traditional cradle position, with your baby’s face facing your breast and kind of laying on their side a bit, on top of the pillows. Their shoulder and hip should be aligned in a straight line, and the baby’s knees should be a bit bent to allow for a comfortable position for the baby. With the baby’s head resting in the crook of your elbow, their back is supported by your forearm. Your other hand is free to help latch on. Their lower arm can be tucked underneath your arm for ease and comfort.

During the early weeks good positioning is especially important. When you and your baby are both well positioned, your nipples stay healthy. Most cases of sore nipples are due to poor latch due to positioning of the baby and mother. Proper positioning helps eliminate many cases of sore nipples.

Latching on

The next step is to latch your baby onto your breast so that he may compress the sinuses in your breast and receive milk. You want your baby to get a deep latch. If your baby only latches onto just your nipple, you will experience very sore nipples, and your baby may not obtain enough milk to gain weight sufficiently, as they will likely stop before the hind milk is released. You want the baby to take in as much of your areola as possible as well.

A good latch takes practice and you may need to repeat the latch several times at each feeding until the baby is correctly on your breast. Don't hesitate to take the baby off your breast if he is on incorrectly and try again. To remove your baby from your breast, insert your baby finger into the corner of your baby's mouth between the gums to break the suction. Never just pull the baby away from the breast as they could hurt your nipple by trying to stay latched as they are.

To help your baby latch on, support your breast with your thumb above your areola and your other fingers below your areola in a "C hold". It is important that you keep your fingers back away from your areola so your baby can latch on deeply to as much of the areola as possible. Support your breast throughout the feedings for at least the first few weeks.

The key to a good latch-on is being patient and waiting until your baby opens his mouth wide like a yawn before bringing him onto your breast. The wider his mouth, the more breast tissue he is able to take into his mouth. You can encourage your baby to open his mouth wide by gently stroking your baby's lower lip with your nipple to stimulate the rooting reflex.

Once your baby opens his mouth widely, quickly bring him onto your breast so that his lips are flanged out and his chin is touching your breast.



How will I know if my baby is well-latched?

If you can hear slow and rhythmic swallows and the feeding is comfortable for you, your baby is well latched. You can also notice a well-latched baby's ears moving during a feeding due to the strong action of his jaws working effectively to draw the milk from the breast.

If your baby has incorrectly latched onto your nipple, you will probably be uncomfortable and your baby will be sucking quickly and not making any swallowing sounds. He will also most likely be fussy since he will be unable to obtain the milk he wants and needs. Carefully remove him from your breast and try latching-on again.

So How do I know my milk has come in?

The first milk you produce when you begin breastfeeding is called colostrum. It is a yellowy sticky liquid that is so important to your baby’s life. It is low in fat, and high in carbohydrates, protein, and antibodies which help nourish your baby. Extremely easy to digest, it is the perfect first food for your baby since. It ‘s low volume but high in concentrated nutrition has a laxative effect on your baby and this is helpful and designed to allow your baby to pass his first stools easily. It aids in the excretion of excess bilirubins and helps prevent jaundice in your baby.

After the colostrum, anywhere from 2 to 5 days after birth you will start to lactate Fore Milk and Hind milk. This is whiter then the colostrum, and smells sweet. Many expect mother’s milk to be white like cows milk, but it has a little tint to it so don’t be upset if your milk does not appear to be pure white. Foremilk is the milk which comes out first during a feeding. It is generally thin and lower in fat content, and it satisfies the baby's thirst and liquid needs. During the last part of the nursing the hind milk will follow. It is richer in fat content and is high in calories. The high fat and calorie content of this milk is important for your baby's health and growth. You will want to make sure at each nursing session to let your baby drain one breast before moving on to the other, to ensure that they receive all the benefits of both foremilk and hindmilk.

You can tell that your breasts are producing milk because they will be tender filling up and produce extra heat. Lactation occurs by the baby sucking stimulation that triggers nerves in the brain to release prolactin into the blood stream, once the prolactin is in the blood stream it stimulated the breast to let down the milk for the baby to drink. The key to successful breastfeeding is keeping this supply and demand working together. The more you have a demand for the more you will produce. That is why it is recommended to pump and stimulate your breasts and empty each breast fully if your baby has latching problems at the start. You can feed your baby the milk by spoon or cup (or needless sring) so they get their milk, and you keep your breasts producing milk.

How do I know when to breastfeed?

A crying baby is the late sign of a hungry baby. Babies have many signs to show you they are hungry, by watching your baby between feedings you will notice them, and be able to meet your baby’s need before it become an urgent need. When a baby’s need for breast milk is met early they are calmer and are better able to latch then when they are crying strongly from hunger. It is recommended to try and feed about 8 times every 24 hours, or about every 3 hours or so.

Signs to watch for are increased alertness or activity, mouthing or rooting. Rooting is a reflex when a hungry baby turns their head to the side looking for the breast. They move their tongue and mouth in a suckling type movement, and nuzzle your chest.

Sucking on their fist, and stiring from sleep and becoming alert can be a sign as well. Really hungry babies will cry very hard, move their legs in a bicycle like motion and clench their fists, these are signs to really watch for, it will tell you if you need to feed your baby more often in the day or longer during each session.

You will learn over time when your baby is hungry by their signs and as well by how your breasts feel, they get fuller and probably sore to the touch with engorgement if you wait too long. Many doctors and Lactation consultants don’t recommend going any longer then 3 hours between feedings for newborns, and to feel it out as you go, and follow the babies lead, by being in tune with the early signs I just mentioned.

There are several common positions for breastfeeding your baby. Correctly positioning your baby can help ensure that your baby is obtaining lots of milk at the feeding and can also minimize sore nipples. The most common breastfeeding position is the cradle hold, but the cross-cradle hold and football positions are excellent alternatives that you may find to be easier and more comfortable. Experiment and alternate your positions throughout the day until you discover what works best for you and your baby.

How long should I feed at each breast?

As you watch your baby breastfeed, you will notice he may slow down his sucking and possibly even fall asleep on the first breast after about 20 minutes. When you feel that he has finished the first breast, gently remove him from the breast, burp him, and position and latch him onto your other breast. Allow your baby to breastfeed for as long as he wishes on the second breast, then burp at the end of the feeding.

If you limit the amount of time your baby breastfeeds, you may not allow him enough time to obtain the high-fat, hindmilk which is essential for good weight gain. It is more important to watch your baby than to watch the clock!

How often should I feed my baby?

Newborns should breastfeed 8 to 12 times in 24 hours. Since breastmilk is easy for babies to digest, they need to eat every 2-3 hours around the clock with possibly one 4-5 hour stretch (hopefully at night!).

Most health care providers recommend that you wake up a baby who is less than 2 weeks old if they are sleeping longer than 3 hours. Since a newborn's stomach is only the size of a walnut, small, frequent feedings are essential for a good weight gain.

How do I know my baby is getting enough to eat?

Hearing your baby swallow during every feeding, noting that he seems content after feedings and that your breasts feel softer after the feedings are all good signs that your baby is getting enough milk. Another excellent way of determining how much your baby is taking in is to keep track of your baby's diapers. Frequent feedings lead to frequent wet and stooled diapers. By the time your baby is 5 days old, your baby should be wetting at least 6- 8 diapers and his stools should change from dark green/black color to bright yellow/mustard color. If you are not seeing these diaper changes, contact your health care provider immediately.

Most pediatric health care providers schedule office visits to see you and your baby within a few days of your release from the hospital to weigh your baby, see how things are going, and answer any questions you may have. It is normal for babies to lose up to 7-10% of their birth weight in the first week but most babies will return to their birth weight by two weeks of age. After two weeks, a weight gain of about one ounce a day assures you that your baby is getting lots of wonderful breast milk and is thriving.

Copyright June 2003


-Ril Giles.