Mar 09

Breastfeeding – Getting Started

Watch these three great videos to learn the basics of breastfeeding from women around the world.

Breastfeeding In The First Hours

Within the first few hours after birth, most healthy newborns will instinctively move to their mother’s breast and attach on their own.

This video shows early breastfeeding initiation.

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Attaching Your Baby At The Breast

Good attachment will help a baby get more milk and make breastfeeding more comfortable.

This video shows why good attachment is so important to breastfeeding success.

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Positions For Breastfeeding

The way a mother holds her baby affects how easy it is for her baby to feed effectively.

This video shows basic points important for any position.

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Breastfeeding Techniques

Basic Positioning:

Sit up straight and keep your back supported.

Bring your baby to your breast instead of hunching forward and straining your back. Placing pillows on your lap or next to you can often help with this.

Cradle your baby in your arm. Place your palm behind your baby’s neck, fan your fingers around your baby’s head and behind the ears and use your forearm to hold/support the back.

Some common positions are the “cradle hold,” the “cross-cradle hold,” the “football hold,” and the “side lying position.

Unswaddle and hold your baby against your bare chest. Skin-to-skin contact helps encourage breastfeeding.

Bring Baby To Breast:

Bring your baby towards the breast instead of moving your breast to the baby. This helps your baby latch better and prevents your from straining your back while breastfeeding.

Use your free hand to support your breast while feeding. Create a “C shape” around the breast a few centimeters behind the areola and compress the breast so your baby can grasp more of the breast tissue.

Aim the nipple towards the roof of your baby’s mouth to help promote a good latch.

The nipple and most of the areola (the dark ring of skin around the nipple) should be in the infant’s mouth while breastfeeding. If the infant has only latched around the nipple, breastfeeding will not be successful.

More Feeding Pointers:

Keep your baby’s head tilted slightly backwards. This helps keep the tongue naturally down so the breast slides over it easier.

It is also easier for your baby to suck and swallow during feeding in this position.

Your baby’s chin should be touching the breast and the nose will either be lightly touching or off the breast.

Tickle your baby’s lips. This helps them open their mouth wide so they are more successful at latching and feeding.

How do you know if you have a good latch? Look for some of these signs:

  • You are comfortable and there is little/no pain with feeding.
  • Your infant has latched over most of the areola.
  • Your baby’s tongue is cupped under the breast.
  • You can hear and see your baby swallowing.
  • Your baby’s chin is touching your breast.
  • A strong, coordinated suck pattern that is emptying milk from your breast.

If your infant has not latched well or if the latch is causing you discomfort, you are allowed to break the latch!

Insert your finger between your breast and your baby’s gums and wait until you hear a soft pop or feel a change in pressure. After this occurs, you have successfully broken the seal and you can reattempt feeding.

After your child feeds on one breast, offer the other breast. If your child is full and is not showing interest in feeding, start the next feed with the breast that was not emptied to prevent engorgement.

Milk Basics

Your milk will start as colostrum. This milk is thick and yellow and is extremely rich in antibodies, proteins and growth factors.

The nutrients in colostrum are important in the development of your child’s immune and digestive systems.

Your body will produce small volumes of colostrum after birth – this is completely normal.

Do not worry that your child is not receiving enough milk. The amount your body produces matches what your baby needs and can digest.

Approximately 3-5 days after birth the colostrum transitions to mature breastmilk. This milk is thinner and produced in higher volumes and you will begin to feel more breast fullness as your milk comes in.

Mature breastmilk has a different composition of fat, protein, sugar and nutrients compared to colostrum but still has all the essentials to help your baby grow.

How do you know if your milk has come in?

Here are some signs to look for:

  • Your breasts feel full but this improves after breastfeeding.
  • Milk sometimes dribbles from the nipples.
  • You can hear your baby swallowing and gulping while breastfeeding.
  • You can see milk in your baby’s mouth while they feed.

Breast Changes

If you are experiencing discomfort from engorgement, try some of these techniques to help relieve the pressure:

  • Pump between feeds to drain your breasts of excess milk.
  • Massage the breasts gently to help soften them.
  • Apply warm or cold compresses to the breasts.

Sometimes milk ducts can become clogged. This is very common with breastfeeding.

You may notice a sore, tender lump in the breast. If this happens, keep breastfeeding and massaging the area to help open up the clog.

If the milk ducts remain clogged for too long, you may develop an infection of the breast tissue called mastitis.

The breast generally becomes red, swollen, tender and warm.

It is safe to continue breastfeeding if you have mastitis. (It actually helps with recovery!) However, please visit your doctor if this occurs, as you may need antibiotics.

If your nipples are sore or tender from breastfeeding:

  • Make sure your infant has a good latch and is not sucking only on the nipple while feeding.
  • Change breastfeeding positions. Sometimes different positions may provide more comfort.

  • Hand express breastmilk and rub it on the nipple. Breastmilk has natural healing properties and may help soothe any soreness.
  • Avoid trapping moisture in the area. Allow breast to dry after feeding, avoid tight fitting clothes, change nursing pads if they become moist or wet.
  • Talk to a lactation consultant.

All women are different and have different bodies which can affect breastfeeding. Sometimes nipples can be inverted, flat or large which can make nursing troublesome.

But remember, your baby needs to latch over the nipple AND the breast to make feeding successful, so there are ways around this:

With inverted or flat nipples, make sure infant has latched well over the breast. Over time, the nipple will start to protrude more and more.

With large nipples, it may be difficult for the baby to latch on to enough of the breast. This generally improves as your child grows.

Preventing sore nipples and heading off breast pain will help you be successful at breastfeeding. Watch these great videos for more information on both of these subjects.

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Breastfeeding After A C-Section

About 1/3 of all women in the US deliver by Caesarean delivery, often referred to as a C-section, instead of a vaginal birth.

If the C-section is done without prior planning, you may have endured a long and difficult delivery.

If that’s the case, your doctor may be more worried about your rest and recovery and less likely to encourage you to breastfeed right after delivery.

You may feel disappointed by this unexpected turn of events, which can inhibit the let- down and flow of your breast milk.

Women who have planned C-sections, on the other hand, often know what to expect and are fully prepared to breastfeed their newborn.

The good news is that the method of delivery has little effect on your ability to nurse your baby.

Your breast milk will come in almost as readily as it would have if you had delivered vaginally.

It is especially important to begin breastfeeding as soon as you are able and to continue breastfeeding your baby on a frequent basis to ensure a good milk supply.

Even if you need a few hours to recover from your surgery, you will be able to breastfeed as soon as you feel up to it.

Use of Pain Medicines

Most drugs administered to mothers who give birth by cesarean delivery do not seriously affect the infant.

You will probably receive a regional anesthetic, such as an epidural, rather than the general anesthesia that once made women unconscious during the delivery.

Since less regional anesthesia gets into your bloodstream than with general anesthesia, it causes less sedation in the newborn.

Some newborns tend to be a bit sleepy following an epidural and may suckle with less enthusiasm at first, but no long- term negative effects on full-term babies’ development or ability to breastfeed have been demonstrated.

Even if you are given general anesthesia, you should be able to breastfeed as soon as you’re awake enough.

When you are counseled about a cesarean delivery, it is a good idea to remind the obstetrician and anesthesiologist that you intend to breastfeed.

Following a cesarean delivery, your doctor will give you pain medications, initially through your IV and later in pill form, to help make you comfortable. In most cases, little of this medication passes through your breast milk to your baby.

Some pain medications may temporarily make your newborn a little sleepy, but the benefits of breastfeeding far outweigh this potential drowsiness.

Pain interferes with the release of oxytocin, a hormone which helps your milk to flow readily for your baby, so adequate control of your pain is important.

If you have any concerns about the pain medication you are being offered, speak with your doctor or lactation specialist.

Getting Comfortable

Your abdominal incision may make finding a comfortable breastfeeding position a little more difficult at first.

You might adjust some of the basic positions by sitting up in bed, using one or two extra pillows to support your baby on your lap and protect your incision, by lying down on your side with your baby facing you, or by using a football hold with enough pillows to raise your baby’s head to the level of the breast.

Make sure to get into a comfortable position before beginning to breastfeed, and don’t be shy about asking for help.

As your incision heals and you are able to move about more readily, nursing will become much easier—but expect to need some extra rest and assistance until you are fully back on your feet again.

Be grateful for the help of family and friends with household chores, so you can concentrate on recovery from surgery and breastfeeding your baby.

The American College of Obstetricians and Gynecologists. (2016). Labor, Delivery, and Postpartum Care: Breastfeeding Your Baby [Pamphlet]. Washington, DC.
U.S. Department of Health and Human Services, Office on Women’s Health. (2011). Your Guide to Breastfeeding. [Brochure]. Washington, DC.
UC San Diego Health. Breastfeeding Guide and Logbook. [Brochure]. San Diego, CA.
UC San Diego Pediatrics – adapted from Marianne Neifert, MD, and the clinical staff of The Lactation Program, Rose Medical Center. (2011) Breast Feeding: Sore Nipples [Pamphlet] Denver, CO.
New Mother’s Guide to Breastfeeding, 2nd Edition (Copyright © 2011 American Academy of Pediatrics).
Special Thanks To Global Health Media Project For Sharing Their Important Work Around The Globe.