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Establishing Breastfeeding

The first few days after the delivery of your baby can be a blissful blur. There is elation at the birth of your new baby, coupled with exhaustion and recovery afterwards. During this time, you are also bonding with your new child, and for many, establishing breastfeeding. Straight after the birth of your child it is desirable to have skin-to-skin contact, and to attempt to nurse your baby within the first hour. This is the beginning of the bonding process, where your baby will discover the warmth, smell and feel of your skin. Attempting to nurse within the first hour will comfort most babies after delivery. Babies suckling instincts are also strong right after birth, and most will be alert within the first hour. After this, babies will usually be sleepy for hours. During your first few days with your new baby, your lead maternity carer may offer to assist you with starting breastfeeding. It is your decision as to how much input you need them to have. Some women appreciate extra help and guidance, while others feel more comfortable alone with their baby for the first latch-on attempts.

Latching

Latching baby successfully is one of those things new mothers worry about most. The important thing to remember here is – your baby is learning how to breastfeed. Some will take to the breast right away, and others need a little practice to get started. If you are breastfeeding for the first time, expect it to take a few attempts for you too. Although you can read literature on how to breastfeed, or go to breastfeeding classes beforehand, it really is a unique experience once you are establishing feeding in practice.

The key points for latching are:

• take your breast in your hand and gently nudge at baby’s lip with your nipple, this will encourage baby to open their mouth. Gently nudging their chin down with the back of your finger can also help.
• once the mouth is open, place your nipple inside aiming towards the roof of baby’s mouth. This will help get a good nursing position for baby to suckle, and should get a little breast or areola (the dark area around the nipple) in the lower part of baby’s mouth too, which is necessary for good breastfeeding.
• hold baby so they are facing towards the breast, with baby’s nose just touching your breast tissue. Your baby’s mouth should be wide open on the breast, like a butterfly-wing or hour-glass shape.
• you should not feel any pain when breastfeeding. If you do it is usually due to the positioning of the nipple in baby’s mouth. Take baby off the breast by using your finger to separate baby’s lips and gums, breaking the seal, and try latching again.

The First Few Days

During the first days of breastfeeding, your nipples will excrete a gold-yellow coloured substance called colostrum. This will be your baby’s first food. Colostrum has high levels of antibodies and Vitamin A among other essential nutrients, and is a real boost to your baby’s immune system and health after birth. In fact, it has been referred to by some midwives as ‘liquid gold.’ Colostrum will last for the first few days, and is usually followed by your first milk let-down 2-4 days after birth.

Once you have established how to latch baby on, feed on demand as much as you can. This will help establish your milk supply as your breasts begin production. Feeding your baby formula in the first few days, unless for health reasons, can interfere with the onset of your milk production. Though it may be tempting to bottle feed if your milk is taking a few days to begin, and your baby seems hungry, it is natural for them to feed up to 12 times a day in the first few days of life. Demand feeding (this means feeding baby whenever they want to) is therefore advised to give your baby as much colostrum as they can have, and to encourage your milk production to start.

Most mothers will notice their milk supply has started 2-4 days after delivery of their baby. Gulping, swallowing, can be signs your baby is getting milk now, sometimes you may notice wet lips. Many mothers will be able to feel the let-down sensation in the breast once baby is feeding, but a lot of first time mothers will not necessarily experience that sensation.

Feeding Positions

The positions of both baby and mother are important during breastfeeding. Briefly, as a breastfeeding mother you need to make sure you have a good posture while feeding your baby, especially if you are feeding upright. Avoid slouching or hanging your head, which is tempting especially when baby starts getting heavier. This can lead to back and neck ache. Propping cushions or pillows under your arm while you cradle your baby will help correct your posture while feeding, and take any strain off your muscles.

For upright feeding sitting up, there are two common positions to hold baby in. One is to hold baby across your stomach, so you are tummy to tummy, with baby cradled in your arm. Another is to hold baby tucked under one arm, so their feet are towards your back and they are lying along your side, their back along your arm, with their head tilting slightly upwards at the breast while supported by your hand. You will need to experiment to see what position is most comfortable for you and your baby.

Feeding while lying down is also a common practice. For this, lie towards one side and have baby lying lengthways like you, tummy-to-tummy. Your arm should again be cradling baby to support their position at the breast while feeding.

Whichever feeding positions you will use, ensure baby is able to comfortably achieve latch-on. This means baby is facing towards the breast, with their nose just touching your breast tissue. Your baby’s mouth should be wide open on the breast. It should feel comfortable for both of you.

How Often

When milk supply is underway, it is recommended that you continue to feed baby on demand. Your baby will grow rapidly during the first year, and during growth cycles needs to get all the nutrition their body and immune system require. You cannot really ‘over feed’ a baby as they will stop when full, but you can underfeed and have a fretful baby if you try to space feeds out. Feeding on demand does not mean you need to stop what you are doing immediately and tend to your baby. It is alright for baby to have a short wait while you finish what you are doing if you need to.

Offer baby one breast, and let baby feed from the first breast until you think the milk has been exhausted. Then offer baby the second breast if they are still hungry. If not, offer baby the second breast first for the next feed. You do not need to offer both breasts at every feed. Ensuring the breast you offer is fed from until it is ‘empty’ makes certain baby is getting fat-rich content in the hind milk.

Newborns that are fed on demand can feed every 3-4 hours, sometimes more frequently during the day. Feeds can last anywhere from 10-20 minutes or more, depending on how strong a suckler your baby is, how hungry they are, and how fast your let-down is. Do not worry about establishing a feeding routine. As baby grows at varying rates, they may be hungrier at certain times than others, according to the needs of their body. You may notice a natural routine emerges for a while, but be prepared for this to change according to your baby’s varying growth and nutritional demands.

In Summary

To establish breastfeeding