While breastfeeding
is the most natural thing in the world, babies are not born knowing how to nurse
(although some do get the hang of it sooner than others). The art of breastfeeding
in something that you learn by doing, and it gets easier with practice. In the
old days, young women grew up seeing their family members and friends nurse.
In today’s society, many women have never seen anyone nurse a baby. The
idea of taking classes or reading books to learn about breastfeeding would have
made our great-grandmothers laugh, but in today’s world, it makes sense to learn
as much as you can about breastfeeding before your baby is born. If possible,
attend a prenatal breastfeeding class and attend La Leche League meetings during
your pregnancy.
One thing
is for sure: childbirth and breastfeeding are two experiences that no amount
of reading, attending classes, or watching videos can really prepare you for. What
they mostly do is tell you about what the “average” birth experience or the
“average" breastfeeding experience will be like. You need to remember
that your baby hasn’t read those books or taken those classes," and he
doesn’t have a clue that he is supposed to behave like the “average” baby.
In fact, there is no such thing as an “average” baby. Each baby is unique,
and so each nursing experience will be different. Often the mothers who
have done the most intensive prenatal preparation are the ones who have problems
adapting when things don’t go ‘right by the book’.
There
are some basic things you can do from the beginning to help get breastfeeding
off to a good start.
Breastfeed early. Put your
baby to the breast as soon as possible after birth, while his sucking instincts
are strongest. Babies are most alert during the first hour after birth,
and soon settle into a sleepy stage than can last for hours or even days.
Try to take advantage of this early alert period. Early nursings, before
your milk comes in, let him practice while your nipple is soft and easy to grasp. His
sucking helps contract your uterus, reduces bleeding, and helps speed up delivery
of the placenta.
Nurse often. Room in with your
baby, and learn to recognize his feeding cues (such as wriggling around, rapid
eye movements, putting his hands in his mouth). Try not to wait until
he is crying before you offer the breast. When he is crying and upset,
he is less likely to be willing to settle down and nurse, and may respond by
shutting down and falling asleep. Crying is a late feeding cue – learn
to recognize the early ones. Newborns usually need to nurse 10-12 times
or more in 24 hours. The more he nurses, the sooner your milk will come
in, and the more milk your body will produce. Make sure that you offer
the breast at least every 2-3 hours during the day, with no more than one 4
hour stretch during the night. Since newborns tend to be sleepy, you may
have to wake him up for feedings (see article on “Waking
the Sleepy Baby"). If you are separated from your baby after
birth, or if he doesn’t nurse well, use a hospital or professional grade pump
(015 Classic, 016 Lactina Select, or Pump In Style) to stimulate and maintain
your milk supply.
Nurse for comfort as well as nourishment. Plan
to spend most of your time nursing in the early weeks. Babies nurse for
lots of reasons, and they are all valid. You really can’t overfeed him,
so put him on the breast whenever he fusses. One of the greatest things
about nursing is that you always have a built in pacifier – it works if he’s
hungry, tired, lonely, sick, or scared. Don’t be afraid to use the breast
as a pacifier – it works, makes your baby happier, builds your milk supply,
and forces you to stop and rest. If friends and family members want to
help, let them take care of you while you take care of the baby. While
everyone wants to hold the baby and give you a break, the most helpful thing
they can do at this stage while you're are resting and building your milk supply
is to cook, clean, run errands, entertain older children, etc. There will
be plenty of opportunities later on for them to play with the baby.
Set up a ‘nursing station’ in the
living room and the bedroom. Get all the supplies you will need together
so you don’t have to move once you get settled: pillows, diapers, change of
clothes, towel or cloth diaper for leaks or spit up, nursing pads, wipes, change
of crib linens, bottle of water, remote control, book to read, etc.
Don’t limit the time he spends at
the breast. Let him nurse as long as he seems interested. He needs
to nurse long enough to get the high calorie hindmilk that comes later in the
feeding, after the milk lets down. Especially in the early days of nursing,
it may take several minutes for the let down reflex to ‘kick in’.
Offer both breasts at a feeding. Nurse
him at least 10-15 minutes on the first side, then burp and change
him and offer the other breast. Next feeding, begin with the breast he
nursed on last. Many babies will only take one breast at a feeding once
your supply is well established, especially if you have a plentiful supply,
but in the beginning, you need to stimulate both breasts.
Don’t be surprised if your baby ‘cluster
feeds’. This means that he may nurse constantly for several hours, then
conk out and sleep so soundly you can’t wake him up for four or five hours. It
really doesn’t matter, as long as he is getting enough to eat. For most
babies, this means nursing at least 8 times in 24 hours. However,
if your baby has regained his birth weight by day 3, there is no reason to set
your alarm and wake him up every 2 hours to nurse. As long as you keep
track of his urine and stool output and his weight gain (see article on “How
to Tell if Your Baby is Getting Enough Milk”), it really doesn’t matter whether
he nurses every one and a half hours or every four hours, whether he took both
breasts or one, or whether he nursed for five minutes or thirty. Remember that
the mythical “average” baby doesn’t really exist.
Avoid artificial nipples and supplemental
feeding during the early weeks of nursing. (See article on “Introducing
Bottles and Pacifiers to the Breastfed Baby” for more details). While some
babies switch back and forth from breast to bottle easily from the first day,
many babies will become nipple confused if you introduce artificial nipples
before they have mastered the art of breastfeeding.
Colostrum, the yellow fluid that
your breasts start producing during pregnancy, is the perfect first food for
your baby and will meet all his nutritional needs for the first couple of days
until your milk comes in. (Interesting piece of trivia: in lower mammals,
newborns die if they don’t receive the immunities from their mother’s colostrum. Ask
someone who raises horses or puppies. The mother horse who refuses or is
unable to nurse her newborn is dooming him, unless another newly lactating horse
can be found ASAP. Thank goodness this isn’t true for humans!)
While colostrum isn’t quite as important
to human babies, it does provide immune factors that newborn infants can’t receive
anywhere else. It is easy to digest, and is full of antibodies and immune factors. Colostrum
is often called “baby’s first vaccine”.
During the first couple of days after
your baby is born, he will take in only teaspoons (not ounces) of this precious
fluid. His immature kidneys are not meant to handle large volumes of fluid
at this time, and the colostrum has a laxative effect that clears the meconium
(the black tarry first stool) out of his system. Excreting the meconium
will help him avoid becoming jaundiced (see article on “Jaundice”). Your
baby is born with extra fluid in his tissues, and will excrete it during the
early days. Most babies will lose some weight in the first couple of days
after birth – the average seven and a half pound baby will lose about 7% of
his birth weight, or around 8 ounces. This is normal, and he will quickly regain
his weight in a few days once your milk comes in. Babies don’t need water,
even when it is hot outside. Human milk contains plenty of water.
Giving formula supplements at this
early stage can cause all kinds of problems, including a decrease in your milk
supply. Formula takes longer to digest than breastmilk, so your baby stays full
longer and is less likely to nurse as often as he needs to stimulate your supply. While
many babies tolerate formula well, the younger your infant is when he is exposed
to artificial milk, the greater the chance of allergies or digestive problems. The
longer you wait to introduce formula (if you introduce it at all) the better.
If
supplements are medically indicated, it is best to use alternate feeding methods
rather than bottles. See the article on “Introducing Bottles and Pacifiers
to the Breastfed Baby” for detailed information on alternate feeding methods
such as cup, syringe, tube, or finger feeding.
Make
sure that your baby is latched on correctly and is nursing effectively. The
article on “Sore Nipples” contains detailed information on how to make sure
your baby is positioned and latched on correctly. His mouth should be open
wide, his lips flanged out, his tongue extended over his gum and under your
nipple, and he should have not just the nipple but some or all of the areola
(the dark area around the nipple) in his mouth as well. He should be pulled
in close with his chin and nose touching the breast. His whole body should
be facing yours, tummy to tummy, so that he doesn’t have to turn his head to
nurse.
Learn signs
of effective, nutritive nursing. Look for a long, drawing, rhythmic
motion along his jaw-line, and a wiggling at his temple. You should be
able to hear him swallowing after your milk comes in. Some babies will
stay on the breast for long periods of time, but will ‘flutter suck’ ineffectively
in their sleep, and won’t get the milk they need or supply you with the stimulation
to produce more.
For the first
couple of days, your breasts will produce sticky yellow or gold colostrum. Once
your milk comes in, you will produce transitional milk – a mixture of colostrum
and mature milk, which may be yellowish and creamy looking. During the
next week or so, less and less colostrum is produced, and by the time your baby
is two weeks old, mature milk has replaced the transitional milk and no more
colostrum is produced. Even if you only nurse your baby for a few days
or a couple of weeks, you are still providing him with important immune factors.
(See Article on "Breastfeeding
Benefits; How they Add Up"). Of course, very few mothers
who make it through the first two weeks of nursing will give up at that point. That’s
just when you are over the hump and things are starting to get easier.
Most breastfeeding problems (sore nipples, engorgement, latch on problems, etc.)
will be resolved after the first two weeks.
Days three and
four are usually the roughest, and the time when most mothers are likely to
give up and switch to formula. There are many reasons for this: the physical
stress your body has been through (you often just don’t feed good – even with
a natural childbirth with no complications, you are still physically drained,
and you may be dealing with additional stresses like constipation, hemorrhoids,
episiotomy stitches, or recovering from a c-section), the hormonal upheavals,
sleep deprivation, and the overwhelming pressure of being the one person totally
responsible for the nourishment of this new little person in your life.
It’s normal
for babies to become agitated and fussy on the third or fourth day, because
they are feeling hunger pangs for the first time. Their little tummies
rumble and growl, and they don’t like this new feeling one bit. They have
no way of knowing that if they go on the breast, they will get milk and feel
good again. They will soon figure it out, but it is a learning process.
Be patient and hang in there.
Do whatever you
have to do to survive the first two weeks. If you have to use slings, swings,
bottles, pacifiers, formula, or pain medicine, use them and don’t feel guilty
about it. The most important thing is that you make sure your baby gets enough
to eat while lowering your stress level, enjoying your baby, getting your strength
back, and continuing nursing. It really won’t matter down the road, and sometimes
using these things can make the difference between continuing to nurse or giving
up in the early days.
Be prepared for
growth spurts. These are periods of time when your baby wants to nurse
constantly and never seems satisfied, and usually occur around 7-10 days, 3
weeks, 6 weeks, 3 months, and 6 months. If you have been feeding every
1-2 hours around the clock, and your baby doesn’t go any longer stretches than
that in 24 hours, consult a Lactation Consultant if this pattern continues
longer than a few days. The baby who nurses ‘constantly’ for several hours,
then sleeps for a 4 or 5 hour stretch, is probably still getting in his minimum
of 8 feedings in 24 hours, and is likely to be getting enough to eat. However,
if he nurses ‘constantly’ around the clock with no long stretches between feedings
and never seems satisfied, he may not be getting enough milk for a variety of
reasons, and a consultation to discover the cause is indicated.
Remember
that nearly all breastfeeding problems can be solved if you are strongly committed
to nursing your baby, and you receive advice and encourage from a knowledgeable
breastfeeding professional. Don’t ever be afraid to ask for help.
About the Author
Anne Smith, anne@breastfeeding-basics.com http://www.breastfeeding-basics.com
Anne Smith is an IBCLC – International Board Certified Lactation Consultant
and La Leche Leader since 1978. More importantly, she is a mother to 6 breast
fed kids with twenty plus years experience of counseling nursing mothers. Her
site, www.BreastfeedingBasics.com
, provides expert advice and solutions to breast-feeding problems and gives
basic information on how to breast feed. Anne also features her recommended
breast feeding products and breast pumps.
if you have any questions or comments!