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Breastfeeding for Beginners
There are many good reasons to breastfeed, starting with the nutritional value of breast milk, which is really the only food a baby needs for six months. Human milk is full of living cells, antibodies, growth hormones and anti-infective properties. By putting only human milk into your baby's immature digestive system you greatly reduce its chances of getting sick (diarrhea and ear infections), allergies and certain diseases, including asthma and diabetes. Mother's own milk is designed not just for nutrition, but as an infant support system as it provides the antibodies, the growth hormones, the fatty acids needed for growth and development. It also helps a baby with its single most important goal: learning to breathe. Because a new baby's tummy is tiny (on Day One, an infant's stomach is the size of a small marble; on Day Ten, it's the size of a ping-pong ball), it needs to fill up frequently. Mother's first milk, colostrum, is produced in small amounts and is very concentrated and sticky, which is important as it keeps a baby from overfeeding and spitting up or aspirating.
Babies usually start to feed within the first 60 minutes of life, so the moment immediately after birth is actually a good time to start nursing. If your baby is a healthy full-term infant, ask the nurse, midwife or doctor to leave you and your baby undisturbed until it has its first breastfeed. This means delaying weighing and medications, including eye drops.
Keep your baby on your belly, skin-to-skin (a baby's natural habitat.) It will start making movements towards your breast all by itself. Let your baby latch or attach itself to the breast. It will literally seek your breast out and move toward it through sense of smell.
If you have received medications during labor, your baby may be sleepy and not ready to feed. You may need to help position the baby at the breast, but be patient and let it latch by itself. Babies approach the breast like we approach an ice cream cone, with lips and mouth, and nobody wants to be pushed into their ice cream. Still not latching? Keep your baby skin to skin and hand-express your milk onto your finger. Put it into your baby's mouth. It will eventually figure out what to do.
Babies nurse 8-12 times every 24 hours during the first months of life, making and your breastfeeding baby a unique dyad. Your baby nurses and empties your breast, which signals the breast to fill back up with milk for the next round of feeding. As an added bonus, every time baby nurses your body releases oxytocin, the "love hormone," which causes you and baby to relax and get sleepy - a good reason to get comfortable nursing lying down.
There are numerous ways to hold your baby, but the principles are the same
- Have the baby's body rolled up snuggly against you. There should be no gaps between you and the baby and it shouldn't need to turn its head to face your breast.
- Align your nipple with it nose.
- Let its chin and lower lip sink into the puffy underside of the breast
- Keep the head tilted back, while avoiding putting your fingers or hand on directly on it.
Other positions to try include:
- Tucking your baby under your arm (The Football Hold)
- Having your baby face down on your breast (The Australian Hold )
- Letting your baby's head and neck fall back onto your wrist and forearm (The Cradle Hold)
- Holding your baby's body across your tummy (The Cross Cradle Hold)
Common Problems and Solutions:
Low Milk Production and Mastitis
The most important way to keep your body producing plenty of milk is to frequently empty the breast. If the baby is having trouble doing this, then hand express or pump. It is critical that your start this process early within the first few hours after birth. This will also keep your breasts from becoming engorged which can lead to mastitis (inflammation of the breast tissue). If engorgement occurs, apply cold packs such as bags of frozen peas - twenty minutes on, twenty minutes off - and keep working to get the milk out. A low milk supply can occur if the milk stays in your breasts. During the first two weeks your breasts are in the market research phase. This is when they are determining how much milk to make for your baby or babies (most women can exclusively nurse twins and triplets if they establish a good supply early on).
Once it's well established, breastfeeding should be comfortable and pain-free, however nipple pain is sometimes a problem. A shallow latch is the most common cause of pain. Allowing the baby to latch herself soon after birth significantly decreases nipple soreness or pain. Make sure that your baby's head is tilted back and it attaches to the breast asymmetrically. The nipple is not the bull's eye, in fact babies do not have to have a nipple to latch on (do not worry if you have ‘flat' nipples), they just need a breast - the nipple is the ‘straw' that the milk comes through. And if she pinches it with a shallow latch it hurts and it makes it harder for her to get the milk.
Sometimes mothers are told that babies are allergic to their milk. This condition, while valid, is also extremely rare. Other breastfeeding issues, including oversupply of milk or tongue-tie sometimes mimic allergy symptoms. You probably will not need to eliminate certain foods from your diet, however women that drink a lot of cow's milk (a quart or more a day) sometimes have gassy, uncomfortable babies. If you are concerned about any problems with breastfeeding, contact a board certified lactation consultant, IBCLC.