Breastfeeding can have its challenges early on. There's learning the appropriate feeding positions and techniques, knowing when and how often to feed the baby, and so many other intangibles.
Getting off to a good start is key to successful long-term breastfeeding. Here are five things moms should do right from the time the baby is delivered:
Have your baby placed skin-to-skin on your chest immediately following birth.
Remember, the first feeding sets the tone for the next several feedings. Keeping your baby skin-to-skin until after the first feeding is important. Ask that your baby be placed on your tummy after delivery. Skin-to-skin contact, beyond feeding purposes, has other advantages. For one, it's a way for both mom and dad to bond with the new baby. It also helps the baby stay warm and comfortable, latch on better and feed longer, and cry less, among other things.
"Skin-to-skin has a lot of benefits, including stabilizing all of the baby's vital signs, including their heart rate, their respiratory rate, their blood sugar, their blood pressure, their temperature, all of those things," says Melissa L. Droddy, a Carroll Hospital lactation specialist. "Laying babies skin-to-skin after delivery is really just kind of letting them acclimate to this real world. And then once they get themselves together, usually they start kind of wiggling around and looking for the breast and trying to eat, usually after an hour or so. Sometimes, it's quicker than that, sometimes it takes longer."
If you give birth by cesarean section, you can hold your baby on your chest or cheek-to-cheek, or your partner can hold the baby skin-to-skin until you are able to breastfeed.
If possible, start the first feeding right after birth, as this is when newborns are alert and very eager to be fed. Ask the nurses if it's possible to delay routine newborn treatment until after the initial feeding. "The baby is usually really alert for the first two to three hours," Droddy says. "After that, the baby gets really sleepy."
After that first feeding, you can breastfeed your baby when he or she seems hungry or on demand. Just keep in mind that newborns need 8 to 12 feedings each day. Why so often? "Breast milk is a natural laxative, so basically what's going in comes right out," Droddy says.
Room-in with your baby and keep your baby with you all night.
If possible, keep the baby with you during your hospital stay so you can begin to learn his or her feeding cues (such as rooting and hand-to-mouth activity) and readily start feeding. This way, your baby won't miss any important on-demand feedings.
Also, research has shown that moms don't sleep much better with the baby away in the nursery than they would with the baby in the room. At times during your hospital stay, the baby may have to be taken for required tests or procedures. But under normal circumstances, your baby should not be away from you more than two hours a day, if at all.
Avoid supplementary feedings.
Offer your breast often. Avoid formula unless medically indicated and prescribed by the doctor. If you have to use formula, nurses can show you alternative ways to feed your baby so you can avoid bottle nipples during the first few weeks (the fast flow and different feel of a bottle nipple can potentially confuse babies and make subsequent feedings difficult). In addition, if supplementation is indicated, mothers should start pumping to protect and increase their milk supply.
Avoid the use of pacifiers and limit swaddling.
Remember, any time your baby seems hungry, offer the breast and continue skin-to-skin holding. It's ok to allow the baby to suck on his or her hands (any self-inflicted scratches on the baby's face as a result should heal fast).
Your doctor may recommend the use of a pacifier at some point, but likely not until breastfeeding is well established. As for swaddling, research has shown that babies who are regularly swaddled do not wake up as often for feedings. Babies should be swaddled loosely to allow them to get their hands to their mouth to show feeding cues.
Frequent feedings over the first few weeks helps assure an abundant milk supply.
Ask for help.
Reach out to a lactation consultant if you feel the breastfeeding sessions aren't going well or if you're concerned about breast soreness. Droddy says you should also call your doctor if the baby:
- Is not eating at least 8 times within a 24-hour period
- Is jaundiced (yellowing of the eyes or skin)
- Often needs to be awakened for breastfeeding (newborns should have no more than one 4- to 5-hour break per day, including at night)
- Has not returned to birth weight in 10 to 14 days
- Has sudden stool pattern changes
Visit LifeBridge Health's community page for more information about upcoming breastfeeding support group meetings. You can also check Sinai Hospital's breastfeeding and lactation page as well as Carroll Hospital's website for additional information on breastfeeding resources.