by Theresa Hardy
At my monthly breastfeeding class, I always open with a discussion of concerns that expectant moms might have about breastfeeding. The top two concerns are avoiding nipple pain and establishing a good milk supply. I always reassure the moms that they have made an excellent first step towards breastfeeding success, and that’s coming to a breastfeeding class. Knowledge is power! By the end of our two hour class, we have gone over what to expect in the early days and weeks, how to improve baby’s latch, how to tell baby is getting enough milk, using good physical supports to reduce your fatigue, waking a sleeping baby, managing return to work and breastfeeding, as well as pumping and milk storage.
Your journey to successful breastfeeding begins with lovely, uninterrupted skin to skin contact with your newborn, which is simultaneously soothing and stimulating to baby. Skin to skin contact reduces crying, regulates their temperature, and brings them “right up to the dinner table” for a nursing. Newborns are often wide-eyed and alert immediately following their birth. Cuddled against your breast, baby may just latch on her own, or she can be assisted to latch. Take advantage of this alert time, because after an hour or two, baby gets really tired, and often needs to be coaxed to feed for the next several feedings.
There will come a time when your little one will need almost no assistance or supports to latch effectively, but newborns can’t reach or hold. They (and you) definitely benefit from physical support such as nursing pillows, rolled blankets to lift baby’s head and shoulders, and a nursing stool. You will be spending many hours a day nursing your little one, and those physical supports will reduce your fatigue as well as promote the best latch possible.
Since breastfeeding is new to you and your baby, you will be wondering how to know if baby has a good latch, and if he is drinking enough. Though your nipples will be tender in the early weeks, if baby has a good latch, you should feel a gentle tugging, and not pain. When baby is latched well, your nipple floats freely in baby’s soft palate. A shallow latch feels “pinchy” or painful. Baby makes a characteristic “kuh” sound when he is drinking. We like to see 10-15 minutes of active drinking each breast each feeding. You will hear more drinking as the early days go by. When your full volume of milk is coming in, you will hear gulping! Baby should be very content after a nursing sessions. We also expect to see more wet diapers and stools each day until about day five, then at least 4-5 stools a day.
Babies learn to breastfeed by breastfeeding. When your friends tell you how much easier breastfeeding is than bottle feeding, they’re not talking about the first few weeks. Over time, baby gets more and more efficient, and feedings get spaced out a bit. Feedings are shorter and more effective, and you will get lots of milky smiles. Perhaps the most important thing you can do is to get good help if breastfeeding isn’t going well. Most hospitals have lactation consultants on staff. I am a lactation consultant/pediatric nurse practitioner in private practice, and can do both home and hospital visits. At a consult, latch will be fine-tuned and adjusted, drinking will be assessed, and you will be shown how to position the baby so both of you are comfortable. Together, we will come up with a plan for breastfeeding success!