Experts agree that breastfeeding is the optimal source of nutrition through the first year of life. It is recommended to exclusively breastfeed for a minimum of four months, but preferably for six months, and then gradually adding solid foods while continuing to breastfeed until at least your baby’s first birthday. Thereafter, breastfeeding can be continued for as long as both mother and baby / child feel like it. This article, The How To Of Baby Breastfeeding will cover everything you need to know about breastfeeding your baby if that is what you choose to do.
Breastfeeding should begin as soon as possible. Ideally right after birth, usually within the first hour. Newborns should be nursed whenever they show signs of hunger, but to be approximate, it should be eight to twelve times every twenty-four hours. The amount of time for each feeding depends on each mother-baby pair. It might be anywhere from ten to forty-five minutes in the first few weeks.
Your body starts preparing to breastfeed as soon as you get pregnant. The area surrounding the nipples – like the areola – become darker. The breasts themselves swell up and enlarge as the cells that will manufacture the milk multiply, and the ducts that will carry the milk to the nipple develop. This increase in breast size is normal and is simply a sign from your breasts are getting prepared to produce milk for your baby. Meanwhile, the rest of your body starts storing excess far in other areas to provide the extra energy that is needed for pregnancy and lactation. So this is why is a good idea not to deprave yourself and to eat! eat! eat!
As early as the sixteenth week of pregnancy is when the breasts are ready to product milk as soon as the baby is born. Early milk, called colostrum, is a rich, thick-appearing, yellow-orange substance that is produced for several days after your baby is born. Colostrum is considered “liquid gold” – the uber most healthiest part of breastmilk. Be mindful that this contains more protein, antibodies and other protective properties than later breastmilk, but less fat and calories. Your body will produce colostrum for several days after you give birth, but it will gradually change into mature, regular, breastmilk. Colostrum is a form of milk, even though people usually say that the “milk comes in” two to five days after delivery. At this time, colostrum increases rapidly in its volume, and becomes milklike in color and it is thinner in consistency, and remarkably continues to adjust to the baby’s needs for the rest of the time that you breastfeed.
You can also read, “The How To Of Baby Feeding” for more information about feeding your baby in general, including both breastfeeding and bottle feeding.
As your body prepares naturally for breastfeeding, there is really nothing that you need to do. Your nipples won’t need to be “toughened up” to withstand your baby’s sucking. Tactics like stretching, pulling, or rolling the nipples might interfere with normal lactation by harming the tiny glands in the areola that secrete a milky fluid that lubricates the nipples in preparation for breastfeeding. Pretty much it can make your nipples more likely to develop soreness and irritation.
Normal showering & bathing and drying gently are the best ways to care for your breasts. Although a lot of women use lotions and ointments on their breasts to soften them, the truth is its not necessary and may clog the skin pores. Salves, particularly the ones that contain vitamins or hormones, are very unnecessary and can cause problems for your baby if its used while you are breastfeeding.
Some women will start wearing their nursing bras during pregnancy. These are more adjustable and roomier than regular bras, and are more comfortable as the size of the breast increases. Nursing bras also have flaps that can be opened for either breastfeeding or pumping.
By the time your baby is born, your breasts will already be producing colostrum. As he nurses, your baby’s actions will let your body know when to start and stop the flow of milk. This process of the baby going to the breast starts in those first moments after birth in the delivery room. The placement of the baby on your upper abdomen in the first few moments after birth will allow your new baby to move up your chest and latch on during the first 30 minutes after birth. The process starts with baby getting a good grip on the areola, not just on the nipple, and starting to suck. He will do this “latching on” instinctively as soon as he feels his mothers breast against his mouth.
Once you are both out of the delivery room, and the first real breast feed takes place, you can help him get started by holding him so that he directly faces the breast and then stroking his lower lip or cheek with your nipple, or touching his chin to your breast. Doing this stimulates that reflex that causes him to search for nipple with his mouth ( also known as the “rooting reflex”.) It will result in the baby opening the mouth widely; at that moment, your infant should be moved toward the breast.
You want to make sure that as your baby takes the breast into his mouth, his jaws are closing around the areola, not the nipple. His lips will separate and the gums will encircle the areola while his tongue forms a trough around the nipple and, in a wavelike motion, compress the milk ducts and empty the milk reservoirs. Putting your baby to the breast in the first hour after giving birth will establish good breastfeeding patterns at a time when infants are usually alert and vigorous. Later in the first day he will get very sleepy, but if he began nursing in the first hour, he is more likely to become a successful breastfeeder.
In some cases a baby will have trouble latching on. This happens most often in newborns who have been given bottles or pacifiers. Sucking from the breast is different from sucking the nipple of a pacifier, or a bottle, and some babies are very sensitive to the difference. These infants may simply lick, nibble, or chew with their jaws instead of using their tongue. Others might show their frustration by pulling away or crying. This sensitivity has also been called “Nipple Confusion” or a nipple preference. Although nipple confusion has been considered controversial, now there is good evidence to support that starting artificial nipples early on is associated with decreased exclusive breastfeeding and decreased breastfeeding duration. Researchers are still unsure if the artificial nipples are the cause of breastfeeding problems or are just a response to a breastfeeding problem that was already existing? Experts ( like KellyMom ) recommend that you avoid bottles and pacifiers for the first several weeks until you feel like breastfeeding is going well. During this time, if the baby seems to need more sucking, offer the breast again, or help him first his own hand & fingers to soothe himself.
When your infant suckles effectively at the breast, his movements will stimulate the nerve fibers in the nipple. Breast stimulation also has milk flowing through the milk ducts in what is known as the “let-down reflex” which is associated with the release of oxytocin, a hormone that comes from your pituitary gland whenever you see your baby / smell your baby / think of or are nearby your baby. In addition, the release of the hormone prolactin from the pituitary gland as well as the removal of milk from the breast causes the breasts to make more milk.
Oxytocin causes many nice and wonderful things to happen for you. It gives a feeling of euphoria and eliminates the sense of pain immediately after birth. Some say that it enhances the feeling of love between you and your baby. It causes the muscles of the uterus to contract. So in the first days or weeks after you give birth, you might feel “after pains,” or cramping of the uterus, each time you nurse. Although this might be really annoying and painful on occasion, it helps your uterus return quickly to its normal size and condition and reduces postpartum blood loss. So if your baby is feeding effectively then that is a good sign. Use some deep-breathing techniques or take some pain medication to ease the pain.
Once lactation has started, it usually takes just a brief period of sucking before the milk lets down ( begins to flow. ) Simply just by hearing your baby cry actually can trigger milk flow! The sign that let-down is occurring vary from mother to mother and change with the volume of milk the baby demands. Some moms feel a subtle tingling sensation, while others experience a buildup of pressure that feels as if their breasts are swelling and overfull – these are sensations that are quickly relieved as the milk starts to flow. Some women have never felt these sensations, even though they are nursing successfully and the baby is getting plenty of milk. The way the milk flows also varies widely; it may spray, trickle, gush or flow. Some women have leakage of milk with a let-down or between feedings and others do not; either case is normal. Flow or leakage may also be very different in each breast – maybe gushing on one side and tricking on the other. This is because of slight differences in the ducts on either side and is no cause for concern, as long as your baby is getting adequate milk and growing well.
If you had a normal delivery, and you and your baby are alert and awake, he can be placed on your stomach or chest to allow him access to your breast, so you can nurse him right away. If there was complications with the delivery, or if your newborn needs medical attention immediately after delivery you might have to wait a few hours. If the first feeding happens within the first day or two, you shouldn’t have no physical difficulty nursing. If nursing has to be delayed beyond the first few hours of life, the nursing staff will help you with pumping and hand expression.
If you do happen to nurse right after delivery, you may find it most comfortable to lie on your side, with the baby lying facing you, opposite the breast. If you would rather sit up, use the pillow to help support your arms ad cradle the baby slightly below breast level, making sure baby’s entire body, not just his head, is facing your body. Following a Cesarean delivery, the most comfortable position might be a side hold, or what is also called a football hold, in which you sit up and the baby lies at your side facing you. Curl your arm underneath him while supporting and hold his head at your breast. This position keeps baby’s weight off your abdomen, but the baby must squarely face the breast for proper grasp.
If you stroke your newborns’s lower lip with your nipple, he will instinctively open his mouth wide, latch on, and begin to suck. He has been practicing this for while by sucking his hand, fingers, and possibly even his toes in utero. It might take a little encouragement to get him to nurse, but you may need to help him properly grasp the areola. You can hold your breast with your thumb above the areola and your fingers and palm underneath it. Some gentle compression might be helpful to form a surface for latch on. Then, when your baby open his mouth very wide, pull him onto the breast. It is important to keep your fingers behind the areola and be sure the nipple is level or pointed slightly up. No matter which technique you try, you need to make sure you keep your fingers clear of your areola so the baby can grasp it. Be sure that your finger are no closer than two inches from the base of your nipple. Then relax. Let your baby nurse at the first side as long as he wants to, then put him on the other side if he is still interested in feeding. It is really important that he completes a feeding on one breast than to have brief feedings from both breasts. The longer that your baby feeds, the more fat and calories he will consume. When you have let-down, uterine cramping, hear swallowing sounds and return to sound sleep by the baby are all signs that breastfeeding is going successfully. In the beginning it might take one or two minutes for your let-down to happen. Within a week or so, your let-down will happen much more rapidly and your milk supply will increase dramatically
If you are not sure if you are experiencing a let-down sensation, just watch your baby. Following a let-down, at the start of a feeding he should be swallowing after every few sucks. After five or ten minutes, he might switch to what’s called “non nutritive sucking” which is a more relaxed sucking that provides emotional comfort along with small amounts of creamier, fat-rich hindmilk. Other signs of let-down vary from mother to mother and already have been discussed: uterine cramps the first few days after you give birth; sensations of let-down; leakage of milk from the opposite breast during breastfeeding; the breast feeling full before and soft after a feeding. The more relaxed and confident you are, the quicker your milk will let down.
The first feedings in the hospital might be difficult because of excitement or perhaps your uncertainty about what to do. Breastfeeding should not’t cause sustained pain in the nipple; areola, or breast. If there is pain for more than a few moments at the beginning, you should ask the doctor, nurse or lactation specialist to evaluate the breastfeeding and suggest what changes need to be made. Ask the hospital staff to help you, as they are very experienced at assisting nursing mothers and babies.
Once you are back home, try the following suggestions to help your let-down reflex
If you still are not letting down after trying all the suggestions, contact your pediatrician for more help. If you continue to have difficulties, ask to be referred to a lactation expert.
For the first few days after you give birth, your breasts will be soft to the touch; but as the blood supply increases and milk-producing cells begin to function more efficiently, the breasts will the become firmer. By the second to fifth day after giving birth, your breasts should be producing transitional milk ( the milk that follows colostrum ) and might feel very full. At the end of your baby’s first week you will see creamy white breastmilk; after ten to fourteen days, your milk might initially look like skimmed milk, but as the feeding continues, the amount of fat in the milk will increase and the milk will look creamier. This is normal and doesn’t mean there is anything wrong with your milk. Nursing your baby frequently and massaging your breasts before and during a feeding might help minimize the fullness
Engorgement happens when the breasts become overfilled with milk and will start leaking. This can be very uncomfortable and at times very painful. The best solution to this problem is to breastfeed your baby whenever he is hungry, feeding at both breasts every three hours. Sometimes the breasts can be so engorged that the baby has trouble latching on. If that happens, you can apply a warm compress to soften the breasts, and if necessary, use a breast pump to relieve some pressure. Doing this might help your baby get a better grasp and nurse more efficiently.
You can also try several methods to ease the pain of engorgement such as the following:
Fortunately, engorgement only lasts a few days while lactation is getting established. However, it can happen anytime when feedings are skipped and the breasts are not emptied frequently.
The volume of milk which is produced by the breasts increases dramatically over the first week. Your baby might take a little as 1 teaspoon (5ml) at each feeding in the first couple of days. By the fourth or fifth day, the volume might be up to 1 ounce (30ml) and by the end of the week – depending on the size and appetite of the baby and the length of the feedings – you might be producing 2 to 6 ounces ( 60 – 180 ml ) at each feeding. At the end of your baby’s first month, he should be receiving an average of 24 ounces (720 ml) of milk a day.
Breastfed babies all differ greatly in their feeding behaviors. They generally eat more frequently than formula-fed babies. Breastfed newborns typically feed around eight to twelve times per 24 hours. As they get older, some might be able to go longer in between feedings, because their stomach capacity enlarges and their mothers milk production increases. Some continue to prefer smaller, frequent feeds.
What is the best feeding schedule for a breastfed infant? It’s one that he designs himself. Your baby lets you know when he’s hungry by waking and looking alert, putting hands toward his mouth, making sucking motions, whimpering and flexing arms and hands, moving fists to his mouth, becoming more active, and nuzzling against your breast. ( He can smell its location even though your clothing.) It’s best to start nursing your baby before crying starts. Crying is a late sign that your baby is hungry. Whenever possible, use these signals rather than the clock to decide when to nurse him. This way you will ensure that he is actually hungry when he eats. In the process, he will stimulate your breast more efficiently to produce milk.
As I said earlier, breastfeeding for the healthy mother and baby is generally most successful when you start nursing immediately after delivery ( in the first hour.) Keep your baby with you as much as possible ( rooming in with him in the hospital ), and respond promptly to cues of hunger ( which is a practice called demand feeding.) Sleepy babies should be woken up to feed after every three to four hours during the first few weeks of life so that they have a minimum of eight feedings in twenty-four hours.
Allow your baby to continue breastfeeding on the first breast as long as desired. When he spontaneously stops for a prolonged period or withdraws from the breast, burp him. If your baby seems sleepy after the first breast, you might want to wake him up a bit by changing his diaper or playing with him a little before switching him to the seconds side. Since your baby sucks more efficiently on the first breast he uses, you should alternate from feeding the one he uses first. You can place a safety pin or an extra nursing pad on the side where your baby last nursed as a reminder to start first on the other side at the next feeding. Or you can start on the breast that feels the most full.
Initially your newborn will probably nurse every couple hours, regardless of whether it is day or night. By six to eight weeks of age, many newborns have one sleep period of about five hours. Establish nighttime sleep patterns by keeping the room dark, warm and have some white noise handy nearby. Whatever you do, do not turn on a bright light for the nighttime feeding. If soiled or wet, change his diaper quickly and without fanfare before this feeding and put her right back to sleep afterward. By four months, some babies are sleeping six hours or more at a stretch without waking. A lot of babies, especially breastfed babies may continue to wake up frequently for feedings at night. You will also discover that your infant might require long feedings at certain times of the day and be satisfied quickly at others. He will let you know when he is finished by letting go or drifting off to sleep between spurts of non nutritive sucking.
Your baby’s diapers will provide clues on whether he is getting enough to eat. During the first month, after your milk supply increases and if your baby’s diet is adequate, he should have a wet diaper six or more times a day and generally have three or four bowel movements a day ( often a little one after the feeding ) Later he might have less frequent bowel movements, and there may even be a day or more between them. If the bowel movement if soft, and your baby is otherwise thriving, this is quite normal and nothing to worry about. Another clue about intake is whether you can hear your baby swallow, usually after several sucks in a row.
Appearing satisfied for a few hours right after a feeding is also a sign that he is getting enough. On the other hand, a baby who is not getting enough to eat over several days might become very sleepy and seem “easy” to care for. In the early weeks, a newborn who regularly sleeps more than four hours at a time should be seen by the pediatrician to make sure he is gaining weight as expected.
One of the most accurate ways to determine if your baby’s intake over the course of time is by checking on his weight gain. It is recommended that newborns be examined by a health care provider at the fourth to sixth day of life, which provides an opportunity to check his weight, feeding, and head circumference. During the first week of life, the average weight loss is less than 10 % percent of birth weight, but after that he should gain fairly steadily. By the end of his second week, he ought to be back to his birth weight. If you’ve breastfed other children, then lactation will become established more quickly this time around, so the new baby might lose a little weight and return to his birth weight within days.
Once your milk supply is established, your baby should be gaining between 1/2 and 1 ounce (14-28 grams) a day during the first three months. Between three and six months, the weight that your baby gains each day will be even less. Your pediatrician typically will weigh and measure your baby at every visit. If you have concerns between visits, call to schedule an appointment to have the baby weighed; don’t depend on a home scale, which is not reliable for babies.