I've been receiving a lot of questions lately about breastfeeding so I wanted to share some thoughts.
First, here are three excellent resources:
Second, breastfeeding books I own - these are available to borrow, the birth centers also have lending libraries as does La Leche League, and the local library:
The Nursing Mother's Companion
The Breastfeeding Book: Everything You Need to Know About Nursing Your Child from Birth Through Weaning
The Womanly Art of Breastfeeding: Seventh Revised Edition (La Leche League International Book)
Third, random tips from me!
* In the beginning it's often easiest to nurse sitting up (with lots of pillows for positioning) so you can best see how the baby is latching on and correct as needed. Try the cross cradle hold with baby's head on your dominant side, that way your dominant hand can hold your breast (make a "c" shape, thumb above and fingers below.) You can also try the cradle hold or football hold.
* However, especially immediately after birth when you are tired it can be great to nurse the baby side lying. The day your baby can latch on well while you're both laying down you will sing with joy - nursing while napping is the best!!
* Drink something every time you nurse to make sure you're getting enough fluids throughout the day. Keep a cup of water by your bed for nighttime nursing. You may find that your appetite while nursing is even stronger than at the end of your pregnancy, and you'll want to pack snacks as blood sugar crashes can hit you fast! Take care of yourself, as you're burning around 500 calories a day while nourishing your baby.
* What you consume goes to your baby - check with your care provider about what medications are safe and if there are any foods/beverages you need to avoid. Some babies can develop allergies while still nursing, having never consumed solids themselves. If your baby is crying, having explosive diapers, congested, vomiting a lot, has eczema, shows blood in their stool, or any other concerning symptoms then talk to your care provider. Babies will sometimes react to foods in your diet such as dairy, and an elimination diet can help you discover the culprit. Yes, it can be scary to think of having to remove foods from your diet but when you discover your baby's hysterical sobbing was from that ice cream you ate then you'll drop dairy in a heartbeat. 🙂 Talk with your care provider about any dietary changes to ensure you're still getting the nutrients you need. Dairy is a frequent cause of problems for moms I speak with, but within three days of eliminating it from your diet they report a radical change in baby's behavior.
* You don't need to put any ointments or cream on your nipples, but make sure you keep them dry between nursing sessions. Because of the sugar in your milk if your nipples stay wet it can turn into a yeast overgrowth (thrush) which can cause painful, burning nipples and cracked skin. If this happens call your midwife/OB and you'll need to check with your child's pediatrician - thrush can be passed from your nipples to your baby's mouth and through their system, which can cause a painful, bright red and blistering diaper rash. Change your breast pads frequently to help your nipples stay dry.
* You may want to avoid any strong smelling soaps or lotions postpartum. Your baby knows your scent and you don't want to mask that. Plus you probably wouldn't want to eat if someone poured perfume on your food. 🙂
* Your baby should have wet diaper the first day, two the second, three the third, etc. The first few days postpartum when you have colostrum are a lovely learning period so you and baby can figure out your nursing relationship before your breast milk comes in. Babies are beautifully designed to come with extra padding for those first few days and losing weight is normal. Check with your pediatrician or midwife if you have any concerns about your baby not getting enough.
* Babies will be alert usually right after the birth, then they'll crash and have a long day of sleep (waking every few hours to nurse.) This is your chance to REST! Babies sleep a lot in the first couple week, waking up more after that. Rest, recover, take care of yourself. If your baby goes more than 4 hours asleep then you'll want to wake them up to nurse, but check with your care provider about their guidelines - some say every three hours to nurse, some say wake them if they go five hours so ask your doctor.
* Newborns often need a lot of help figuring out how wide they need to open and where to put their tongue to get a good latch. Improper latch is the most common reason I hear for painful nursing - if it hurts after the first few seconds then put your finger into the side of your baby's mouth to break the seal and pop them off, and try again. You need your baby's mouth wide open so your nipple and about an inch of aerola are in their mouth. It sounds like a lot but your baby needs to be massaging your aerola to get the proper milk flow. Sucking on just the nipple will cause you PAIN and it will be give inefficient milk to your baby. This is why you want to hold off on introducing a pacifier or bottle in the first three weeks - babies suck on only the nipple of a pacifier/bottle, but they need to open wider to properly latch onto you. Yes, they can figure it out but in the meantime you may have some painful latches from the baby treating you like a pacifier so you may want to wait until they are a bit older to try. There's also concern that if the baby is on the fake nipple then your breasts aren't being stimulated to produce milk - those first few weeks are crucial to establishing your milk supply so if the baby wants to suck, your breast is the best place for them to get that early comfort.
* Some babies need to suck a lot for comfort, some not so much. In the first weeks if your baby shows interest (rooting, sucking on fingers, turning head, mouthing) then offer the breast first. Eventually you'll figure out what your baby means and if the baby's tummy is full and they are rejecting the breast but still rooting then it's time to see if a pacifier will help soothe them. Some babies just need to suck more than others!
* In the beginning a baby (especially if born a bit early/small) may have a weak suck. Nursing can take a long time as they get tired and will suck a few times, then pause. Don't be surprised if your baby takes over half an hour to seem satisfied at the breast. But don't watch the clock - watch your baby. Even tiny newborns have enough control that when they are full and content they will pull off the breast and sigh and let you know they are full. (Or just very sleepy and done for now!) If your baby is still actively sucking then be sure you let your baby drain the breast - don't feel like you need to pop them off after a certain time and switch sides. You want to make sure your baby gets the high fat hindmilk, not just the low fat foremilk.
* In the past it was suggested that moms nurse on both breasts with every feed, but this can cause problems if the baby's getting mostly foremilk. This milk is higher in lactose and can cause gassiness, fussiness, explosive diapers, etc. It's now advised that you offer the baby one breast per feed, and nurse baby until they are full/pull off or the breast seems drained. Some moms can feel their breast soften and feel a tingling with letdown - some can't feel a difference, but around 20 minutes on the breast should drain it. Burp your baby and if they seem still hungry then offer the other breast. For your next feeding session start with the second breast to ensure it's drained. Your breasts are beautifully designed to adjust to your baby's needs, so your milk will adjust and you won't walk around perpetually lopsided. 🙂
* As babies grow their suck becomes stronger and they become more efficient nursers. You may find your six week old nurses for 30 minutes and your six month old only nurses for 10 minutes. Your breasts have adjusted to produce a different type of milk as your baby grew, and your breasts will alter let down and your baby will get more milk faster. It's normal for babies to nurse less time as they get older, but during growth spurts you'll find your baby may nurse a lot more often - going back to nursing every two hours vs. four hours. This is also normal and only lasts a few days - it's your baby's way of stimulating your breasts to produce more milk for their growing needs. Expect this around 2 weeks, 6 weeks, 12 weeks, and again when your baby starts solids.
* How to tell if your baby is getting enough.
* How dads can help with breastfeeding support.
Fourth, a video with some basic breastfeeding tips. Sometimes seeing it is easier than reading about it.