by Karen D. Crowdis

To learn to breastfeed effectively, start by educating yourself. Read and talk to other moms. Your midwife or doula is an excellent source of breastfeeding information. Surround yourself with family, friends and caregivers who support breastfeeding. Include people who are knowledgeable about it. Consider scheduling a visit with a lactation consultant in the first few weeks.

Early days
Breastfeed as soon as possible after birth; within an hour is ideal. Then feed frequently until your milk has come in and a good supply has been established. “Frequently” can mean feeding as many as twelve times in a 24 hour period. The benefit is that feeding frequently will reduce engorgement, increase milk supply, and ensure the right fat content. On average, babies will spend 20 to 30 minutes nursing, but remember that every baby is different. Watch for early hunger cues and feed as soon as you see them. This will keep your baby calm and prevent him from getting frantic because he is so hungry. Keeping baby with you in the hospital or your room at home will help you bond and learn your baby’s early cues. Skin to skin contact is great for bonding, and it just feels really nice. Limit visitors while you establish the feeding relationship. Avoid using pacifiers, because they may inhibit your nursing relationship.

Positions
The best position is always the one that is comfortable and effective for you and baby. Following are the most common positions.

CRADLE/CUDDLE: Baby lies on your lap, tummy to tummy with you. His face and knees should be close in and facing you. Baby’s head fits in the bend of your elbow with his mouth directly in front of your nipple. The lower arm can tuck around you to keep it out of the way. There should be a straight line from the ear to shoulder to hip.

FOOTBALL/CLUTCH: Baby lies along your side. Her head will be in the palm of your hand on the same side, and her back will rest on your forearm. Baby’s feet can tuck behind you.

TRANSVERSE: Same as cradle, but hold him in the arm opposite the side you are feeding from. Ensure he is at the level of the breast, body turned toward you.

LYING DOWN: Most convenient for sleeping. You lie on your side with pillows supporting your head and back. Line baby’s body up with yours, tummy to tummy with your nipple opposite her mouth. She will nurse from the lower breast.

TAILOR: Good for older babies and similar to cradle, but baby lies in your cross-legged lap.

Latching on
The latch is very important for a successful breastfeeding relationship. Find a comfortable position, then place four fingers under the breast and thumb on top not touching the nipple or areola. Lightly touch baby’s lower lip with the nipple. Wait for baby to have an open mouth, wide like a yawn, and quickly move baby to the nipple. Ensure you get as much of the areola in the mouth as possible. Avoid latching just to the nipple as this can cause pain and trauma for mom.

When baby is positioned correctly, the mouth is open wide and the lips are turned back. Baby’s chin will be tight to the breast and her nose will be on top. It may press slightly on the breast, but she will be able to breathe as the nostrils will flare to the side. Listen for swallowing and look for the suck-swallow sequence. Remember to break the suction before taking baby off to burp or switch sides.

The first milk to come out of the breast is watery and thirst quenching. The milk that follows, called hind-milk, is rich and fatty. Allow your baby to finish feeding on one side before switching to the other to ensure he gets the hind-milk. Burping breastfed babies can be less critical at times because they do not ingest as much air as from a bottle. Also keep in mind that your baby will eat more often if you breastfeed because breast milk digests easier and more completely than formula.

Let down and engorgement
Let down is the process of your breast releasing milk to the ducts. It is initiated when your baby suckles at the breast. Most women have some sensation in the breast when let down occurs. For some it is a tingling or a feeling of release. Other women find it uncomfortable or painful. Working with a lactation consultant can help you get comfortable with the process during the early days.

Engorgement occurs when the breasts are too full. It can happen when feedings are not frequent enough. Try to ensure feedings are no more than three to four hours apart early on. Expressing a little milk before feeding can reduce the swelling that makes it difficult for baby to latch properly. Additionally, engorgement can lead to blocked ducts and infection. Using warm or cold compresses is often helpful.

Don’t give up
You might experience some discomfort during the early days, but having a support network will help you succeed. Drink lots of water and stay calm. If you are having trouble or just need encouragement talk to your health care practitioner or contact La Leche League. Don’t give up. The benefits for you and baby are worth it. Stick with it because before you know it, it will be as easy and natural as it seemed like it should be.

Published in Birthing Magazine, Autumn 2008.

The information provided in this article is for informational purposes only. It is not a substitute for professional advice from your primary healthcare provider. Always consult your healthcare professional.

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