What should I know about getting started with breastfeeding?
The first weeks of breastfeeding are a learning time for you and your baby. You are learning how to care for and feed your baby, and your baby is discovering how to breastfeed and ask for comfort. Be patient. Over the next days and weeks, both of you will learn how to breastfeed. Help with breastfeeding is available. A nurse or lactation consultant will observe you and your baby breastfeeding before you leave the hospital.
During the first weeks, your milk will change from colostrum (a thick, rich fluid) to mature milk (a thinner, whitish fluid). This happens gradually. Your milk provides all the food and fluid your baby needs.
A good start with breastfeeding
- We encourage you to put your baby to breast after birth.
- Keep your baby with you so you can breastfeed often (24 Hour Rooming-In).
- Breastfeeding provides comfort as well as nutrition to your baby. Offer your breast whenever your baby shows feeding cues such as mouthing, lip smacking, turning toward the breast, sucking on fists. Feeding on cue or on demand will assure good milk supply because baby’s nursing drives the milk supply.
- Newborns breastfeed often. The average is eight to 12 feedings per day.
- Breastfeeding should not hurt.
- The more you breastfeed, the more milk you will make for your baby.
- Once you and your baby learn how to breastfeed, breastfeeding will be a good time to relax and enjoy each other.
Where should I breastfeed my baby?
Select a quiet, comfortable place to breastfeed. If you'd like, pour yourself a glass of water or juice to drink while you are breastfeeding your baby. Choose a chair with arm support and put your feet on a stool to bring your baby closer to you. Or try lying down on your side. Use pillows on your lap or under your arms to support your baby and avoid straining your back.
If you are in pain, take medicine before breastfeeding to help make you more comfortable.
How should I hold my baby?
Hold your baby close to you, "tummy to tummy." Your baby's whole body should face your body. Remove your baby's clothing, except for the diaper. Hold him or her as close to you as possible. Skin-to-skin contact is best. Keep your baby's head higher than his or her stomach.
Here are two examples of positions to hold your baby while learning to breastfeed. Choose a position that is comfortable for both you and your baby.
During the early weeks, many mothers find a variation of the cradle position, called the cross-cradle position to be useful. For this position, your baby is supported on a pillow across your lap to help raise him to your nipple level.
Pillows should also support both elbows so your arms don't hold the weight of the baby; they will tire before the feeding is finished.
If you are preparing to breastfeed on the left breast, your left hand supports that breast in a "U" hold. You support your baby with the fingers of your right hand. Do this by gently placing your hand behind your baby's ears and neck with your thumb and index finger behind each ear. Your baby's neck rests in the web between the thumb, index finger and palm of your hand, forming a "second neck" for baby. The palm of your hand is placed between your baby’s shoulder blades. As you prepare to latch on your baby, be sure your baby’s mouth is very close to your nipple from the start. When baby opens his/her mouth wide, you push with the palm of your hand from between the shoulder blades. Your baby’s mouth will be covering at least a half inch from the base of your nipple.
Clutch or Football Position
This is a good position for a mother who has had a cesarean birth, as it keeps the baby away from the incision. Most newborns are very comfortable in this position. It also helps when a mother has a forceful milk ejection reflex (let down) because the baby can handle the flow more easily.
In the clutch position, you support your baby's head in your hand and his back along your arm beside you. You support your breast with a "C" hold. Your baby is facing you, with his/her mouth at nipple height. Your baby's legs and feet are tucked under your arm with his/her hips flexed and his/her legs resting alongside your back rest so the soles of his/her feet are pointed toward the ceiling. (This keeps your baby from being able to push against your chair.) Pillows again help bring the baby to the correct height.
How should I position my baby on my breast?
Hold your breast with one hand. Place your thumb on top of your breast and four fingers underneath, away from the dark area around the nipple (areola).
When your baby's mouth is open wide (like a yawn), quickly bring your baby onto your breast, leading with the lower lip and baby’s head tilted slightly back.
Check your baby's mouth position to make sure the bottom lip is rolled out. Your baby's chin should be touching your breast. Your baby's mouth will be about one inch behind the nipple and on the areola, not on the nipple.
In this position, place your baby’s lower arm around your waist. Your baby’s head will rest in the bend of your arm, with your forearm supporting your baby’s back, and your hand holding your baby’s buttocks. Support your breast with the other hand. Place your hand behind your baby’s neck, and rest your baby’s back on your forearm. Support your breast with your other hand. You will feel a tugging at your breast. This should not be painful. If it hurts, break suction (gently slip your finger into the corner of your baby's mouth) and try to latch your baby on your breast again.
How do I know when my baby is getting milk?
Changes in your baby's sucking pattern will help you know when your milk lets down or is released. Your baby will begin with rapid, short sucking motions. Soon after you will notice a slower, steady sucking pattern and will hear your baby swallow.
How often should I breastfeed?
Feed your baby on demand every one to three hours during the day and night. Most newborns need to breastfeed about eight to 12 times per day. Your baby might want to nurse every hour or so for several feedings (this is called cluster feedings).
Let your baby breastfeed for as long as your baby is nursing vigorously longer on the first breast until he or she seems satisfied. There is no need to limit the length of the feedings unless your nipples are sore. Burp your baby and then offer your other breast.
It is OK if your baby does not feed at both breasts during each feeding. Start on the other breast at the next feeding.
How do I know if my baby is getting enough milk?
By one week of age, be sure your baby has had at least six to eight wet diapers and three to four large, yellow, seedy stools every 24 hours. The urine should be pale in color after the first week. If your baby is not getting enough milk, the urine will become deep yellow in color and the amount will decrease.
If it's hard to tell if your baby is wet, place a square of toilet paper on top of the diaper. When your baby urinates, the toilet paper will be wet
Breastfed babies have yellow, seedy, loose stools, often with each feeding. Later on, some breastfed babies might only have one stool per week.
To see if your baby is gaining enough weight, weight checks are available at your local breastfeeding support groups or you can call your healthcare provider’s office.
Wash your hands before breastfeeding. A bath or shower once a day is all you need to keep your nipples clean. Do not use soap or other products when washing your nipples. Use warm water only. Allow your nipples to dry after a feeding.
How can I avoid sore nipples?
Sore nipples are common in the first weeks and are often caused by poor positioning. To avoid sore nipples, follow these guidelines:
- Make sure your baby's mouth is opened wide (like a yawn) before he or she latches onto your breast.
- Change your position for breast feeding.
- Be sure the baby's mouth is latched deeply to prevent soreness.
- Rub colostrum or breast milk into your nipple and areola after each feeding, let air dry.
- If your nipples are sore and dry or cracking, start breastfeeding with the less sore breast first.
- Use acetaminophen (such as Tylenol®), an anti-inflammatory (such as ibuprofen), or other pain medicine, as prescribed by your healthcare provider, for short- term relief.
If your nipples remain sore or are painful, call a lactation consultant.
When can I introduce bottles?
Do not introduce bottles until you and your baby are comfortable with breastfeeding. In fact, some mothers never use bottles at all. After the first three to four weeks, once you and your baby have become comfortable with breastfeeding, bottles can be introduced. It might help if someone other than you feeds your baby the first bottle.
You might choose to pump your breasts and use this breast milk for an occasional or regular bottle feeding.
The American Academy of Pediatrics (AAP) recommends exclusive breast milk feeding for the first six months of life, continuing with complementary food through the first year of life and beyond.
If you will be returning to work, call a lactation consultant two to four weeks before you return to work to discuss your options. You may also find information at www.womenshealth.gov.
Are supplements necessary?
There is no need for supplements in the first weeks for healthy, full- term babies, unless recommended by your provider. In fact, avoid supplements, as they will decrease your milk supply. Frequent emptying of the breast is important to establish your milk supply.
Avoid artificial nipples, pacifiers, and bottles for the first four weeks, as they might decrease your milk supply.
Your baby controls your milk supply by feeding often. As your baby grows, there will be times when he or she breastfeeds more than usual, and this will increase your milk supply.
How can I take care of myself the first weeks after delivery?
Get enough rest. Whenever the baby is sleeping, you should rest, too. Let your family and friends help with older children and house chores. Your job during the first weeks is to get to know your new baby.
Good nutrition remains important. Follow the same guidelines for healthy eating as you did during pregnancy. Remember, eating well keeps you healthy. Your healthcare provider might recommend that you continue to take a prenatal vitamin while you are breastfeeding.
If you are uncomfortable from delivery, take the pain medicines as directed by your healthcare provider. Pain can make breastfeeding more difficult, since it can interfere with your milk letting down. Pain medicines prescribed by your healthcare provider will not harm the baby.
Ask your healthcare provider or lactation consultant about the safety of any medicine you might need to take while breastfeeding. Most prescription drugs or over-the- counter medicines are safe to take while breastfeeding.
Common concerns about breastfeeding:
Are my breasts too small to breastfeed?
Breast size does not affect your ability to breastfeed. The amount of milk your breasts make will depend on how much your baby eats, not how big your breasts are.
Will breastfeeding hurt?
Breastfeeding should not hurt if your baby is latched onto your breast well. Your healthcare provider can help you learn how to hold your baby when you breastfeed for the first time. Your breasts might be tender the first few days, but this soreness should go away as you continue to breastfeed.
Is breastfeeding hard to do?
Breastfeeding is a learned skill and takes practice, but the health benefits you are gaining for you and your baby are worth it. Help with breastfeeding is available. There are many ways for you to learn about breastfeeding. Many hospitals offer breastfeeding classes that you can attend during pregnancy. In most cases, nurses and lactation consultants are also available to give you information and support. Talking to other breastfeeding moms might be helpful and make you feel more comfortable.
I am shy and think breastfeeding might embarrass me.
You can choose to feed your baby in private. Or, you can breastfeed in front of others without them seeing anything. You can wear shirts that pull up from the bottom, just enough for your baby to reach your breast. You can put a blanket over your shoulder or around your baby so no one can see your breast.
Do I have to drink milk if I choose to breastfeed?
No, you do not have to drink milk to make breast milk. Other sources of calcium-rich foods include yogurt, cheese, tofu, salmon, almonds, calcium-enriched fruit juice, corn tortillas, leafy green vegetables, broccoli, and dried beans and peas. Eat four servings of calcium-rich foods every day to provide proper nutrition for you and your baby.
What if I need to go out?
If you can take your baby with you, your baby can eat when he or she is hungry. If you need to be away from your baby, you can learn to pump or "express" your milk and store it so that someone else can feed your baby.
How can I breastfeed when I go back to work?
When you return to work, you can learn to pump or "express" your milk and store it so that someone else can feed your milk to your baby while you're at work. For more information on breastfeeding for working mothers, go to: www.womenshealth.gov
Will breastfeeding take too much time?
Feeding your baby takes time, no matter which method you choose. Your choice to breastfeed is a personal one. We hope this handout explained some of the benefits of breastfeeding for you and your baby. Please feel free to discuss your concerns with your healthcare provider or a lactation consultant.
How can Dad or partner bond with the baby if I am breastfeeding?
Dad or partner can provide skin-to-skin contact, which is a loving way to bond and to give the new mother some time for herself. Dad or partner can also take the baby for a walk in a front carrier or a sling and help with basic baby care.
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