If it is your first time trying to breastfeed and your baby does not latch on as quickly and effectively as you thought they would, or perceive to have not enough milk production, breastfeeding can be quite frustrating and your confidence quickly plummet. Here are some helpful tips to consider, to make your breastfeeding experience more successful:
1. Is your baby showing signs of hunger, or is it time to feed again?
· Some hunger cues to look out for are mouthing (hands to mouth), rooting (turning head side-to-side), fidgeting (moving arms and legs), suckling and smacking (licking lips). Crying is often a late sign of hunger.
· You want to feed the baby 8-12x/day, or every 2-3hrs. A feeding can last a few sucks to 40+ minutes long. Yet, allow your baby to feed more often and longer if they desire.
· If possible, it is best to start breastfeeding within the “golden hour”, or first hour after birth since newborns are most alert and most likely to feed during this time. Also, your breasts are softer, thus making it easier to learn how to latch on.
· If your baby is sleepy, and does not want to feed despite 3+ hours passing, undress the baby, place skin-to-skin and offer breast. Placing the baby skin-to-skin will also help increase your milk production.
2. Get yourself and the baby into a comfortable position to feed.
· Wearing a wireless nursing bra/clothes will help offer support and easy access for baby to breastfeed.
· Consider what style, or “holds” you want to breastfeed (i.e. cradle, cross-cradle, clutch/football hold, or side lying). You may need to try multiple positions to find what is most comfortable for you.
· Use pillows (i.e. nursing pillow) to help support the baby and you in a comfortable position.
· Avoid needing to lean over. Bring the baby to the level of your breast instead, with the baby’s nose at level with your nipple.
· Hold the baby close to your body, and support the baby’s head at the base with your hand in a “c” shape. Ensure the baby’s ear, shoulder and hip are in a straight line.
· Support your breast with your other hand in a “c” shape (like you are holding a cup) 1-2 inches from the areola, with your fingers parallel to the baby’s lips and making the breast more oval shaped.
· Ensure the baby’s head is tipped up, with chin touching the bottom part of your breast. This will help ensure your nipple is pointed to the roof of the baby’s mouth, and that the baby latches on to more of the lower part of your areola.
· Rub the upper lip in a downward motion with your nipple to entice/tease the baby to open their mouth wide open. Once wide open bring your baby quickly and gently onto the breast, chin first, with their lower jaw far below the nipple.
· The baby’s lips should be “flanged,” or turned out. Your baby should have long stretches of sucking and swallowing that you should be able to hear. Wait for the baby to suck before relaxing your hold on the breast.
· Watch this 15 minute video to help you visualize good breastfeeding technique.
4. Troubleshooting
· If your baby is having difficulty latching, hand express some milk before feeding to help soften your breasts, thus making it easier for the baby to latch on. Also, you can rub some expressed milk on your nipple/areola, as well as under the baby’s nose to entice the baby to latch on.
· The latch should not hurt you and have any biting/pinching pain. If it does, you need to break the suction by sliding your finger into the corner of the baby’s mouth, and try again.
· If you have sore/cracked nipples, consider rubbing some breastmilk that has anti-pathogenic and healing properties onto your nipples before/after breastfeeding. Also, applying gel pads may help soothe and reduce friction on your nipples.
· If your baby is crying, they might be too upset to breastfeed. Calm your baby down first by rocking them before trying to breastfeed. Also, consider if your baby needs their diaper changed, or if it might be too hot/cold for them.
· If your baby is too fidgety/active, it might help to wrap them up in a swaddle.
· If your baby is too sleepy to suck at the breast, implementing breast compression massage will help increase milk flow/production, thus stimulating the baby to suck. Also, you can gently rub behind baby’s ear, back, legs, and feet to help stimulate them to suck at the breast.
5. Things to consider
· Learning how to hand express colostrum (baby’s first food, aka “liquid gold”) every 2-3hrs after breastfeeding for ~5 minutes, until your milk “comes in”, is a good way to stimulate milk production.
i. To hand express, lean slightly forward to help gravity pull milk down. Gently massage your breast to help milk get ready to flow. Then, support your breast with your hand in a “c” shape about 1-1.5 in away from the nipple, and push your breast back. Next, compress your breast gently by bringing the pads of your thumb and fingers together. Lastly, relax your hand.
ii. The earlier and more frequent milk is expressed, the sooner milk comes in, and more milk is produced. Your partner can also help hand express if you get too fatigued.
iii. If the baby is having a hard time latching on, you can hand express/pump your milk, and then provide it to the baby via a spoon, syringe, or SNS (Supplemental nursing system).
iv. In general, breastmilk is good for 4-8 hours at room temperature, and 4-8 days if refrigerated.
· Watch this 7 minute video to help you visualize good hand expressing technique.
https://med.stanford.edu/newborns/professional-education/breastfeeding/hand-expressing-milk.html
· Remember to offer both breasts at a feeding. If the baby only takes 1 breast make sure you start with the other breast at the next feeding to ensure proper milk removal, increased milk production, and reduced breast engorgement.
· Also, consider using different “holds” positions when breastfeeding which will help your baby drain the different areas of your breasts more effectively, thus helping prevent clogged ducts.
· The more milk you pump, or baby takes from the breast, the more milk will be produced. Therefore, be cautious when supplementing with other milk sources for it may lead to the baby not breastfeeding as often, breast engorgement, and a lower milk supply.
· Wait when your breastfeeding is going well for at least 1 month before introducing an artificial nipple/pacifier to your baby.
· Make sure you are sufficiently eating and drinking.
· Consider meeting with a lactation specialist, joining a breastfeeding class, and/or talking to your pediatrician.
6. Manage your expectations
· Your mature milk will increase in quantity, or “come in” in 2-5 days after birth. Until then, you have colostrum to provide to the baby.
· Remember, a newborn’s stomach is very small at birth (~5-7ml, or the size of a grape), thus will not need a lot to become full.
· On days 1-4 of a newborns life, a teaspoon (5 ml) per how many days old they are, per feeding is usually considered a normal good feed. By day 10, most newborns eat 12-15 tsp (60-75 ml) per feeding.
· On days 1-4 of a newborns life, a wet/stooled diaper per how many days old they are is usually considered sufficient.
· Babies are born with extra fluid, and so it is often expected for them to lose 7-10% of their birth weight during the first couple of days after birth, and should regain their weight by day 10.
· Remember to be patient with yourself and baby for a good latch is a learned response that requires practice for the both of you to get used to.
7. Track your progress and look for signs of a well breastfed baby
· Here is an example of how you can keep track of your progress
Date; Time | Pee | Poo (Color) | Breastfed (min, side) | Expressed (mls, how) | Supplemented (mls, how) | Burp |
1/1/22; 04:00 | Yes , Black | 10 min, Right side | 2mls, Hand | 5mls, Donor milk | Yes |
· Some good signs that your baby is getting enough milk are: your baby’s mouth and lips are wet and pink, they are active/alert with a strong cry, and have enough wet diapers/stools for their age.
· Your breasts soften after the baby feeds, as well as seeing/hearing your baby swallow is a good sign your baby is getting enough milk.
· Another good indicator of a well fed breastfed baby is if the baby is having bright yellow stools, and 5-7 wet diapers per day by day 5. As well as, if the baby has regained their birth weight back by day 10.
What tips have you found helpful when breastfeeding?
Photo source: bbcgoodfood.com
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