By Beverly Ann Curtis, ARNP, PNP-BC, IBCLC

As a new parent, you will find that breastfeeding is a combination of practice, patience, and proper technique. Your milk is the perfect first food for your baby and has all the nutrients your baby needs to grow healthy and strong.

Breastmilk digests easily, and is naturally gentle on your baby’s digestive tract. Breastmilk is high in antibodies protecting your baby against illness and allergies. Breastfeeding also helps the uterus return to a non-pregnant size sooner so there is less blood loss after your baby is born. Breastfeeding may even protect you against certain cancers.

Getting Started

Early and frequent breastfeeding helps make milk. It is important to understand that the more the baby nurses, and if they are nursing well, the more milk you make. If very little milk is taken from the breast or if a bottle is offered on a regular basis, instead of a breastfeeding, the breast will make less milk. To make plenty of milk, nurse your baby every 2 – 3 hours during the day with one longer stretch at night, about 4 hours, when your baby sleeps. Time the feeding from the beginning of one feeding to the beginning of the next feeding. On the average, babies need 8 – 12 feedings in 24 hours. In the early days after birth, babies are often sleepy. Please wake your baby for feedings every 2 – 3 hours until you baby regains birth weight, at about one to two weeks of age, then feed your baby when the baby tells you they are hungry.

Babies are ready for feeding when they suck on their fingers, open their mouth wide searching for the nipple, make “cooing” noises and cry. These are all signs your baby is ready to eat. You may also want to feed your baby when your breasts start to feel full or if the breasts start to leak.

Wash your hands before feeding your baby. It is not necessary to wipe off your breasts prior to feeding. Daily bathing or showering is all that is necessary. Avoid soap on your nipples during bathing.

POSITIONING

To help your baby get plenty of milk, it is important that you hold your baby so that his whole body faces the breast. He should not have to turn his head into the breast or over his shoulder to nurse. When you’re in the hospital, don’t hesitate to ask for help from a lactation consultant or a knowledgeable nurse to make sure that you have your baby positioned and latched well on your breast. This is especially important if you’re experiencing soreness that lasts beyond just the few seconds of latch pain.

Cross Cradle Hold: If nursing on the left breast, support your breast with your left hand and the baby on a pillow with your right hand on the base of the baby’s’ neck, not on the back of his head. Place your nipple in the space between your baby’s nose and upper lip. When your baby opens wide as if yawning, guide him onto the breast, lower lip first, then upper lip. For the right breast you will support your breast with your right hand and hold your baby across you supporting your baby’s body with a pillow and holding your left hand at the base of the baby’s neck.

Cradle Hold: If nursing on the left breast, support the baby with his head nestled in the crook of your left arm, the length of your arm along the baby’s back, with your left hand as close to the diaper as possible. Turn the baby all the way on his/her side. Move the baby, not the breast, to line-up his/her nose with the nipple. Hold your breast with your right hand, with four fingers underneath the breast and just your thumb on top. Keep your fingers away from areola, the dark area around your nipple. Move your breast and tickle the baby’s mouth with your nipple, stroking straight down in the direction from nose to chin. Make sure to hold your baby far enough away from the breast so that you can easily see his mouth and have room to move the breast. Keep stroking until the baby opens wide, and then move the baby onto the breast.

Football Hold: Place your baby along your side, with her belly turned toward you, not pointing up to the ceiling. Use the same arm to hold your baby as the side your baby is on; for example, if your baby is on your left side, hold your baby with your left hand. Place your hand along the base of the baby’s neck, with your palm against the baby’s shoulder blades. Do not put your hand over the baby’s head as this may cause the baby to arch back away from the breast. Support your breast with your four fingers underneath the breast and just your thumb on top. Tip the baby’s head back to place your nipple under the nose. When the baby opens wide, guide the baby onto the breast. Remember your baby may need you to continue to support the breast through-out the feeding if he has trouble maintaining his latch.

LATCHING

With correct latch-on the baby’s lips are flanged out onto the breast with the jaw moving rhythmically with every suckle. Be careful not to push the breast into the baby’s mouth. The baby will latch on much better and get more milk by being moved or guided onto the breast. When baby latches well, there should be no pain. If latch-on is painful, slip your finger in the baby’s mouth to take the baby off the breast. Try again to line the baby up nose to nipple placing your nipple under the tip of the nose. Wait until the baby’s mouth opens wide like a yawn and quickly guide the baby onto the breast. Continue to support the breast throughout the feeding, if your breast is heavy or if your hand fits under the breast easily. Some mothers, if smaller breasted may not need to support the breast.

The tip of the baby’s nose may touch the breast tissue, and he will still be able to breathe. If the baby seems too close to the breast and his nose is covered, usually this means that you may have started without the nipple under the nose. You can correct this by starting over if necessary, tip the chin in and nose out, lift the baby from the bottom or lift the breast to create an air passage. Do not press down on the breast with your fingers. Pressing down on the breast with your finger will pull the nipple enough to make the end of the nipple very sore. This is one of the primary causes of nipple soreness. Your baby will begin feeding with short rapid suckles collecting the milk just behind the nipple until your milk begins to flow. Then his/her nursing will change to deep suckling of 7 -8 suckles in a row, with swallowing, followed by a pause and than another 7-8 suckles with swallowing. This pattern will repeat again for as long as twenty minutes on the first breast. Your baby may then come off the breast on his/her own. If the baby comes off the breast after just a few minutes, re-offer the same breast, until he has nursed actively, slows down and comes off on his own. Try burping your baby and offer the other breast. He/she may only take the second side for several minutes or may not take it at all. Just offer the second breast first on the next feeding.

If you need more guidance, check out our How to Latch Your Baby post.

For more information or help don’t hesitate to contact our lactation consultants at the Breastfeeding Center of Pittsburgh at 412-246-4726.

Bev Curtis is the former Executive Director of the Breastfeeding Center of Pittsburgh.