Whether you're a new mom or a seasoned parenting pro,
breastfeeding
often comes with its fair share of questions. Here are some answers
to common inquiries that mothers - new and veteran - may have.
When will my milk come in?
During the first few days after the birth of your baby, your
body will produce
colostrum
, a sort of pre-milk. For some women, colostrum is thick and
yellowish. For others it is thin and watery. Colostrum contains
many protective properties, including antibacterial and
immune-system-boosting substances that are so important to your
baby and aren't found in infant formula. The flow of colostrum
is very slow, which allows your baby to learn how to nurse and also
how to coordinate sucking, breathing, and swallowing.
After about 3 to 4 days of nursing, your breasts will start to
feel less soft and more firm as your milk changes from colostrum to
milk that looks kind of like skim milk. Your milk will be
transitional for the first 10 to 14 days, after which it's
considered to be mature milk.
During this time, the amount of milk your body produces will
increase, responding to your baby's nursing. Your milk supply
is determined by the stimulation your body receives. In other
words, the more you breastfeed, the more milk your body
produces.
Mothers who deliver by Caeserean section (C-section) may find it
takes longer for their milk supply to increase. Sometimes, for no
apparent reason, a mother's milk may take longer than a few
days to come in. This is perfectly normal and is usually no cause
for concern, but make sure to let your doctor know. While babies
don't need much more than some colostrum for the first couple days,
the doctor may need to make sure the baby is getting enough to eat.
It can help to breastfeed more frequently, putting the baby to the
breast every 2 to 3 hours.
If your milk still hasn't come in within 72 hours after the
birth of your baby, you may want to talk to your doctor about
temporarily supplementing with formula (just until your milk supply
is up) so that your baby gets enough nutrients and doesn't lose
weight unnecessarily.
Don't be alarmed if your baby drops a little weight at
first. Most babies typically lose up to 7% of their body weight in
the first few days.
When should I begin breastfeeding?
If possible, try to start nursing within an hour after the
birth. This timing takes advantage of the wakefulness of your
newborn after birth. Many babies will instinctively take to the
breast, even if it's their first time. After the initial period
of being alert, a newborn will spend much of the next 24 hours
sleeping. So, it may be more difficult to get your baby to latch on
after the first few hours.
Even if your baby doesn't officially latch on (or correctly
attach to your breast), starting early helps you and your little
one to practice and get used to the idea of breastfeeding.
It may take a few times before getting it right, but it's
important that your baby nurses with a wide-open mouth and takes as
much as possible of your areola (the dark-colored area of the
breast) in his or her mouth (not just the tip of the nipple). If
your baby is sleeping at the breast, try to wake him or her up by
tickling the feet or undressing the baby. Frequent attempts to burp
and changing the diaper between breasts can also be helpful.
To help both you and your baby get used to breastfeeding, try to
feed about every 3 hours, even overnight. In many hospitals, you
can ask for your baby to "room in" (or stay in the
hospital room with you). For moms who want - and need - the extra
shut-eye during those first couple of days after the birth, you can
have your baby stay in the nursery at night and ask the staff to
bring your newborn to you to feed.
Are bottles or pacifiers okay?
If you're committed to trying to exclusively breastfeed, you
don't want your baby to suck on a pacifier or a bottle. In the
beginning, it's important to allow your baby to practice
breastfeeding without being confused by a bottle or a pacifier.
Some experts feel that if you start giving bottles too early -
before your baby is used to breastfeeding - your little one might
have "nipple confusion" and may decide that the bottle is
the quicker, better option than the breast. While some babies
experience this confusion, others have no problem transitioning
between a bottle and the breast.
If a pacifier is
occasionally
needed in the nursery (such as during a
circumcision
, when baby boys are often given pacifiers with sugar water), it
won't disrupt your nursing. If the doctor tells you the baby
needs a little supplementation with formula, it can be given with a
bottle or through a nursing system in which the formula goes
through a small tube that attaches to your nipple.
What are the signs that my baby is hungry?
Despite what some new moms might think, crying is a
late
sign of hunger. You should try to nurse
before
your baby is so hungry that he or she gets really upset and becomes
difficult to calm down.
Signs that babies are hungry include:
- moving their heads from side to side
- opening their mouths
- placing their hands and fists to their mouths
- puckering their lips as if to suck
- nuzzling again their mothers' breasts
- stretching
- showing the rooting reflex (when a baby moves its mouth in
the direction of something that's stroking or touching its
cheek)
How can I tell when I'm ready to breastfeed?
Many women can feel the
milk ejection reflex
(or
let-down
) - when the milk starts coming into their breasts for a feeding.
When and how it happens is different for everyone, though.
During the first few days to weeks after delivery, you may feel
strong cramps in your uterus when your milk lets down. Let-down may
also begin before you start nursing (some women experience let-down
from simply seeing their baby or hearing a baby cry). Or, it may
happen after your baby is latched on and has sucked a few times
(you may notice your baby starting to gulp).
You may also feel a sense of engorgement, like your breasts are
filling up and becoming firm, or a sort of tingling sensation in
your breasts. You also may feel or see some milk leaking from your
nipples. Some women, however, never have a feeling of let-down,
which is OK, too. Even if you don't feel it, you should still
see milk coming from your nipple and hear your baby swallowing.
How can I tell if my baby is latched on correctly?
This is often the No. 1 reason that new mothers have a hard time
with breastfeeding - their babies aren't latched on to their
breasts properly, which can be frustrating for the babies and
downright painful for their mothers.
Here's how you can make sure your little one is latched on
correctly every time:
- Make sure your baby's mouth is opened wide and his or her
tongue is down when latching on.
- Support your breast with your hand, positioning your thumb on
top and your fingers at the bottom, keeping your thumb and
fingers back far enough so that your baby has enough of the
nipple and areola (the circle of skin around the nipple) to latch
onto.
- Gently glide your nipple from the middle of your baby's
bottom lip down to his or her chin to help prompt your baby to
open his or her mouth.
- When your baby opens his or her mouth wide and the tongue
comes down, quickly bring your baby to your breast (
not
your breast
to
your baby). Your baby should take as much of your areola into his
or her mouth as possible.
- Make sure your baby's nose is almost touching your breast
(
not
pressed against it), his or her lips are turned out (or
flanged
), and you see and hear your baby swallowing. (You should be able
to tell by seeing movement along your baby's lower jaw and
even in your baby's ear and temple.)
When properly latched on, you may have 30 to 60 seconds of
latch-on pain (this is caused by the nipple and areola being pulled
into your baby's mouth) then the pain should subside. It will
then feel like a tug when your baby is sucking. If you continue to
feel pain, stop feeding momentarily and reposition your baby on
your breast. If you still feel pain during feeds even after
repositioning, talk to your doctor to make sure something else
isn't going on, such as an infection.
Your baby will often give four to five sucks, followed by a 5-
to 10-second pause. Your baby's sucks will increase in number
as the quantity of your milk increases. As the milk flow slows,
your baby's pattern will probably change to three or four sucks
and pauses that last longer than 10 seconds.
Most babies will release the breast on their own. If your baby
doesn't release your breast but the sucks now seem limited to
the front of his or her mouth, you can slip your finger in the side
of your baby's mouth (between the gums) and then turn your
finger a quarter turn to break the suction. Then, try to
burp
your baby and switch him or her to the other breast.
How can I tell if my baby is latched on wrong?
If your baby tends to suck on the tip of your nipple, without
getting much of your areola, he or she is latched on incorrectly.
Babies who tend to latch on wrong will also frequently sleep at the
breast and may not seem satisfied because they may not be getting
enough. If either of these occurs, break the suction and reposition
your baby onto your breast to include the nipple
and
areola.
Call your doctor or a lactation consultant if:
- you're unable to nurse your baby without pain (you may
just need help getting your baby to latch on correctly, or it
could be a sign of a breast infection)
- your baby consistently sleeps at the breast
- your baby is nursing but doesn't seem satisfied when
feedings are over
I'm having a hard time. What can I do?
This is completely normal. Whereas nursing may come easily for
some women, it can take some adjustment and practice time for many
others. Breastfeeding your baby may be one of the most challenging
but rewarding things you'll do as a mother.
While you're in the hospital, don't hesitate to use the
expertise of the nursing staff and your OB-GYN. They can be very
helpful in answering any questions you might have, as well as
walking you through the dos and don'ts of breastfeeding. The
nurses can even watch and coach you as you try to breastfeed your
baby. The hospital also may have a lactation consultant on staff
who may be able to offer some guidance and reassurance.
Doctors usually want to weigh infants and evaluate breastfeeding
within 48 to 72 hours after a mother and newborn leave the
hospital. But if you have any concerns or difficulties before then,
make sure to talk to your doctor.
Whatever you do, try not to become too discouraged. With a
little patience and some practice, it will likely become easier for
both you and your baby in the coming weeks. Like the old saying
goes, practice makes perfect!
Is there more than one way to hold my baby?
Yes. You can experiment with several different
nursing positions
(or holds) to figure out which one is the most comfortable for both
you and your baby. They include the:
-
Cradle Hold:
This is the traditional hold many mothers will try from the
get-go, holding the baby across the chest and using the arm on
the same side as the nursing breast to support the baby.
-
Clutch (or Football) Hold:
This position holds the baby at the side, and is good for the mom
who's had a C-section (because the baby doesn't put
pressure on the mother's belly), as well as for mothers with
large breasts or twins.
-
Cross-Cradle (or Crossover) Hold:
Similar to the cradle hold, this position involves using the arm
on the opposite side as the nursing breast to support the baby.
Some mothers find that this hold makes it easier to control how
their babies latch on.
-
Side-Lying Position:
This position, in which mom lies on her side facing the baby,
allows moms to get some rest during feedings and is also a common
choice for mothers who've had C-sections.
How can I make breastfeeding more comfortable?
Again, it's mostly about finding a comfortable nursing
position and proper latch-on - once you've gotten those down,
it can make for a truly rewarding bonding experience. Here are some
other things you can do that might also help you to relax and enjoy
the experience:
- Keep a breastfeeding goodie bag or basket near all of your
regular nursing areas at home (next to the bed, on the couch,
etc.). Fill it with bottled water, some healthy snacks, a few
magazines, your portable home phone or cell phone (so you
don't have to get up to answer or make calls), plenty of burp
cloths or cotton diapers for dribbles and spit-up, and the remote
controls if you want to use a TV, DVD player, VCR, or stereo
nearby.
- Find the most comfortable seating arrangement and stick to it
so that your baby gets comfortable with - and looks forward to -
the routine. Many mothers like to sit in a glider or in a cozy
chair with armrests.
- Give your feet and back a break. Footstools and pillows can
provide extra support. Pillows that some women find helpful are
the donut-type nursing pillows or the "husband" back
pillows with arms on each side for nursing in bed.
How long should I plan to breastfeed my baby?
The American Academy of Pediatrics (AAP) now recommends that
babies should be breastfed exclusively (without offering formula,
water, juice, non-breast-milk, or food) for the first 6 months and
that breastfeeding should continue until 12 months (and beyond) if
it's working for both the mother
and
baby.
Studies on infants show that breastfeeding can lower the
occurrence or severity of diarrhea, ear infections, and bacterial
meningitis. Breastfeeding may also protect children against
sudden infant death syndrome (SIDS)
, diabetes, obesity, and asthma.
Reviewed by:
Larissa Hirsch, MD
Date reviewed: May 2008
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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