Early breastfeeding is a natural learning time for mothers and babies

Both may benefit from some time with a good teacher. Getting off to a good start is the key to successful breastfeeding. Our professional lactation consultants can help - in the hospital and afterward. All have advanced training in breastfeeding support, and they're certified by an international board of examiners. They'll help you learn effective positioning techniques, solve problems, and guide you over the bumps on the road to success. Call 757.312.3159 for personal counseling or appointments.

Below you'll find information geared towards helping new moms learn to breastfeed along with their newborn. Getting off to a good start is the key to successful breastfeeding. Further stages of breastfeeding will be covered in the future, so check back often.
If you have a comment or question you'd like addressed in the Lounge, please call us at 312.3159.

Why should I nurse my baby?

Breastfeeding begins a lifetime of better health and the best possible growth and development of children. Human milk, according the American Academy of Pediatrics, is "uniquely superior for infant feeding and is species-specific; all substitute feedings differ markedly from it." This is because a mother's body produces far more than just food for her baby. Her milk contains substances that protect her baby from many illnesses, from allergies to childhood cancers. Ear infections, urinary tract infections, digestive disorders, childhood cancers, SIDS, juvenile diabetes, diarrhea, and many other illnesses are much less common in breastfed babies than in those given artificial formulas. Human milk is also now known to affect the development of nerve, brain, and eye tissues. Even the formulas "most like mother's milk" are far from the real thing.

Adults, even those in old age, are healthier if they were nursed as infants. Lower rates of diabetes, heart disease, high cholesterol, stroke, obesity, colitis, Crohn's disease, liver problems, eczema, etc., affect those who were breastfed years ago.

Mothers who breastfeed are also healthier. Breastfeeding mothers have less postpartum bleeding and depression, and experience greater weight loss, than those who feed artificial formulas. In later life, lowered risks of osteoporosis and of cancers of the breast, ovaries, cervix, and uterus, are continuing benefits.

Finally, families benefit in increased closeness, and in reduced financial expense. Breastfeeding saves about $120 per month over the cost of the least expensive formulas. That's a lot of disposable diapers, or a new washer and dryer. That doesn't even include the savings in fewer doctor visits, medicines, and other health care costs. These savings average over $500 per baby in just the first year.

When should I begin breastfeeding?

According to the American Academy of Pediatrics (AAP), breastfeeding should begin as soon as possible after birth, usually within the first hour. Research has shown that healthy babies who are brought to the breast within 30 minutes of their birth, without being separated from their mothers, have the most success learning breastfeeding. Due to strong inborn reflexes, they usually nurse well, and then "remember" what they did at first. If medical conditions prohibit this first experience right after birth, simply do all you can to accomplish it as soon as conditions allow. You will still "bond" with your baby, and breastfeeding will probably still go well, as most babies' reflexes are quite strong.

How often should I nurse my newborn?

The AAP states that "newborns should be nursed whenever they show signs of hunger". Most breastfed newborns nurse 10 to 12 times per day, with some periods of cluster feeding (2, 3, or more feeds in just a couple of hours) followed by times when feeds are farther apart. Follow your baby, but generally don't let your baby go without eating well for more than 3 hours in the daytime or 4 hours at night, until your milk supply is well established and your baby has been seen to be gaining weight well.

How can I tell if my baby is hungry?

Early feeding "cues", or signs that your baby may be ready to eat, include rooting and sucking movements, but also just increased alertness and activity, tongue and mouth movements, smacking, bringing the hands to the face, etc. In very sleepy babies, rapid eye movement under the eyelids, or arm and leg movements, are quiet signs of receptiveness. Some babies will sleep through their early hunger, and are frantic and hard to feed once aroused. Offering more often in the early days will frequently make feeds much more relaxed and will help build your milk supply (built on frequency of stimulation and effectiveness of drainage). Crying is a LATE sign of hunger, and crying babies are very difficult to latch well. Don't wait that long. If in doubt, offer your breast.

How long should feedings last?

In the first few days, babies should be allowed to nurse until full or content, up to 30 minutes on first breast and until baby falls asleep or comes off second breast on their own. Some very sleepy babies may need to take one side, nap a little, then take the other side. Once mother's mature milk "comes in", usually around day 2 to day 4, typical newborns nurse for 20 to 40 minutes per feed. The "nip-n-napper" may take an hour. Babies several months old may accomplish in 5 or 10 minutes what used to take them an hour as newborns. Once your milk is in, encourage the baby to "FINISH the first side first," rather than switching after a few minutes, to obtain more of the richer milk that comes later in the feed from a breast. Always offer the second side, but follow the baby, even if it takes little.

What are some signs of a "good feed"?

The baby should appear relaxed at the breast. Once letdown occurs (which can take as much as 5 minutes at first), the baby should be seen and heard swallowing. Swallows may be a very soft "kuh, kuh", or a more obvious gulp. The cheeks should be rounded, not sucked in. A suck-pause-close pattern indicates active milk transfer as mom's milk "lets down". At least one of mom's breasts should feel softer after the feed than it did beforehand. Mom may feel drowsy or thirsty, both effects of breastfeeding hormones. The baby should be content afterwards, though many babies need to be burped or rocked.

How often should I burp my baby?

Breastfed babies tend not to need burping as much as bottlefed babies, but it's a good idea to try at least briefly, until you learn your baby's needs. If your baby gulps at the breast, you may need to burp every 3 or 4 minutes through the feed. Squirming mid-feed, especially in gulping babies, may indicate a need to burp, so try that for 2 or 3 minutes, then return to the same breast.

How do I know my baby is getting enough of my milk?

In the first week, babies should have at least as many wet diapers as they are days old, in each 24 hours. They usually have at least one stool per day up to about 4 days, when we begin seeing more stools, and by which time the stool should have changed from the dark, tarry meconium stool to the yellow, very loose breastmilk stool. By one week, most babies are having at least 6 noticeably wet diapers (disposable diapers are so absorbent that it's sometimes hard to tell they are wet; use a diaper liner or put a soft tissue in the diaper to give the baby "credit" for all its wets.) By a week, most babies are having at least two stools that are more than a stain on the diaper, per day. Some babies stool each time they feed, others do not, and some may skip a day. After a month to 6 weeks, many breastfed babies begin to space out their stools, and can go a week or longer without having a stool. This is NOT constipation, and does not require laxatives or suppositories, so long as the baby's stomach remains soft, he doesn't act ill, and the eventual stool is large and loose (be prepared for "blowouts"!).

How much weight should my breastfed baby be gaining?

Most babies lose a little weight in their first few days. As long as they wet and stool as expected, they do not need supplemental feeds. If given frequent chances to "practice" within the first few days, most breastfed babies begin to gain, and have regained their birthweight by 10 days to 2 weeks. From their low point, most breastfed babies gain 4 to 8 ounces per week if latched well and feeding according to the AAP recommendations. If the baby loses more than 10 percent of its birth weight, or is not gaining as is expected, it may not be transferring milk well due to poor latch, uncoordinated suckle, or other difficulties. Babies can suck without transferring milk! GET HELP! It may be something very simple, or for your baby's well-being, formula supplementation may be appropriate while we sort out the difficulties. Supplementation should always be a medical decision, on the basis of insufficient wets, stools, or weight gain, not because the baby is fussy. If required, supplements can be given without causing problems, by using feeding methods other than bottles. GET HELP!

What about bottles and pacifiers?

Teach your baby the motions and joys of breastfeeding, first, and establish your supply, all of which takes about a month. Then, most babies can go back and forth without trouble. Before that, some babies develop latching difficulties. And remember, time spent on bottles is stimulation and drainage for the bottle, not for mom, which may reduce her supply. You can't "spoil" your baby by nursing; remember that the word "pacifier" means "one who makes at peace." Who better than a loving mother? Besides, babies often "chomp" on pacifiers, then on mom.

What about sore nipples?

Probably because we wear clothing, and our nipples are not exposed to the air and sun very much, many new mothers do experience what is referred to as "latch" pain in the first week or two. This pain lessens within SECONDS as the baby continues beyond the first few sucks, and is caused by the baby drawing the nipple far back in the mouth to position it. Latch pain should be subsiding and becoming a tugging sensation by two weeks. Pain that continues throughout feedings, after feedings, or between feedings, IS NOT NORMAL! Pain that was getting better and then becomes worse IS NOT NORMAL! It shouldn't hurt to nurse your baby! GET HELP! If someone says the baby's latch looks good, but it still hurts, or advice you've tried hasn't helped, or things just don't seem to be going well, GET MORE HELP! Mother Nature would not make the baby's only means of survival hurt the mother.

How can I encourage my baby to "latch on" well? Four easy steps will get most babies latched well, in any nursing position:

• "Cuddle 'em close" — Hold your baby in close against your body, with the ear, shoulder, and hip in a straight line, so the baby doesn't have to turn its head. At first, use the "football" hold or "across your chest" positions, that give you control of the baby's head (with your hand behind the neck and shoulder blades, and just your fingers on the base of the skull.) Support your baby with a firm grip (you won't hurt the baby) and the baby's weight on your arm. You support the baby; pillows support you (don't lay the baby on the pillow and just hold the head.) Later, when the baby has more neck control and when you and the baby are both accomplished at getting a good latch, the familiar cradle will work fine, but mix in some other holds from time to time for better drainage, especially in the first couple of months.
• "Nose to Nipple" — Align the baby so the baby's nose (or even the eyes) is even with the nipple, NOT THE MOUTH, to begin. This will cause the baby to lift its head just a little to latch, which will keep mom's nipple off the tongue. Many babies, especially in the cradle hold, are too far past the nipple, end up "ducking" their heads to latch, and the sandpaper-like tongue rubs mom raw in just a day or two.
• "Wait for Wide" — Tickle the baby's lips with mom's nipple. WAIT for the baby to open wide like a yawn. It may take 10 or more tickles, but most new babies will eventually open wide if we WAIT. Try not to put the nipple in or let the baby "slurp" on; they learn quickly that they don't need to open wide. Teach good habits: WAIT! If the baby gets frantic, back off, calm the baby with a couple drops of expressed milk, a suck on your finger, or even some time at your shoulder, then start again. Try more frequent feeds for a few days so the baby will be more patient next time; get help, sooner rather than later, if needed.
• "Cram 'em on Quick!" — Babies don't keep their mouths open wide very long. You have to be ready, and you have to be REALLY FAST! You want to get a lot of breast tissue in the baby's mouth (remember, they "breast-feed"; they don't "nipple-feed") while the mouth is open wide. You will probably miss a few wide mouths at each feed while you're both learning, but with persistence (and insistence) in getting a wide mouth, soon you'll both now what you're doing.The resulting latch will be off-center, deeper underneath (more breast in the mouth on the chin side); the nose can touch but should not be buried; the lips should be flared out like "fish-lips". This "deep" latch puts the baby's gums well onto the milk pockets in the breast. This moves milk easily for the baby and prevents many cases of nipple soreness for moms.

Further Information

www.breastfeeding.com : Got questions? Of course you do! Find answers at this comprehensive and colorful site.
www.bflrc.com : This site contains easy to understand detail and advice on lactation issues from Dr. Jack Newman, acclaimed pediatrician, researcher, and breastfeeding advocate.

The Outpatient Lactation Center

Located in the Lifestyle Center Store - Chesapeake General. The LC Store is a one-stop place where nursing moms can get nursing bras in a wide selection of sizes, styles, and colors, books, videos, slings, and the full line of MEDELA breastpumps and accessories for sale or rental. Certified bra fittings and Lactation Consultants are available by appointment. All our professional Lactation Consultants have advanced training in breastfeeding management, and they're certified by a national board of examiners. They'll show you positioning techniques, solve problems and provide tips to help you achieve success. Call 757.312.3159 for personal counseling or appointments, or click here for a list and schedule of our available breastfeeding classes.