Breastfeeding strategies from a CHOC lactation consultant
By Michelle L. Hart, certified lactation consultant at CHOC
During your pregnancy, you may have planned that when your baby was born, you would breastfeed. It is the best and most natural way to feed your baby, so it should come naturally, right? Not necessarily.
Breastfeeding your newborn baby involves some learning for both you and your baby. This includes learning what your breasts are doing to make milk, how often and for how long your baby should be feeding at the breast, how to latch your baby to your breast so they will effectively remove milk from your breast and how to tell if your baby is getting enough nutrition from breastfeeding.
This article will answer some of these questions. With a little time and patience, you and your baby will become well acquainted and confident in knowing what to do to breastfeed successfully.
Feeding frequency in newborn babies
A newborn baby will eat very frequently. They will want to eat eight to 12 times in a 24-hour period, including throughout the night. In the first few days, babies get very small volumes of breast milk, or colostrum, from the breast. But the frequent stimulation of your baby latching and suckling at the breast encourages your body to make more milk.
The amount of breastmilk you make usually increases around day two to five after your baby delivers. This is the same time your baby will need to start getting more breastmilk to grow.
Newborn hunger signs
When a baby is starting to get hungry, they will show you by doing the following:
- waking up and moving around,
- becoming more active and alert
- opening and closing their mouth,
- bringing their hand to their mouth,
- and possibly sucking on their fist.
When you spot your newborn doing these signs, bring them baby to breast to eat.
Breastfeeding positions for parents
If your baby is calm and quiet, bring them to your breast unswaddled. This will help them stay alert and allow you to get them nice and close to your breast. Get yourself comfortable with support from pillows or a breastfeeding pillow. A footstool can be surprisingly helpful. Position your baby so their head and body are in a straight line, with their nose at your nipple.
Two positions that often help babies latch successfully when you and your baby are both learning this new skill are called the cross-cradle hold and the football hold. With both, one of your arms fully supports your baby so you can bring them closer to your body, and your other hand supports and shapes your breast to help your baby achieve a deep and comfortable latch. To know which way to shape or “ridge” your breast, think of the direction in which your baby’s mouth is opening and try to shape your breast in the same direction. Think of when you bite a big sandwich or hamburger and squish it to fit it in your mouth. It is the same idea as helping your baby get a large mouthful of your breast.
Your baby’s latch
A deep latch is very important for two main reasons. One is that if the latch is not deep enough or is shallow, you will have nipple pain. This may include cracked and bleeding nipples. With a shallow latch, your baby does not have enough breast tissue in their mouth. This means they are not able to remove milk from your breast when they suckle. If the latch is not deep, you will end up with painful nipples and a baby who is hungry and not growing well.
When your baby has a deep latch, it will look like their mouth is wide open, and you will see their bottom lip flanged out, which will help them make a good seal around your breast and remove the breastmilk better. If the lips are tucked in, you can gently pull the lip slightly away from the breast while holding the baby securely at the breast so as not to break the latch, and this will improve the seal against the breast. If the baby has a good, deep latch, you may feel a strong pulling or tugging sensation, but it should not be painful.
How to tell if your baby is getting enough milk while breastfeeding
Watching your baby closely in a quiet environment will help you notice the signs that tell you your baby is drinking milk from your breast. You will be able to hear and see swallows. Watching your baby’s jaw drop down low with each suck, their chin will pause momentarily when they swallow.
When your baby is getting milk, their suck will be slow and strong; pauses are normal while your baby rests and takes a deep breath, then they will begin to suck again, usually within a few seconds. Over the first couple of weeks, your breasts will gradually make more milk. You may notice your breast(s) feel softer after they have fed. A baby may let go of the breast when they are full, and they will be relaxed and not show any more signs of hunger. Your baby will also have frequent pees and poops and be gaining weight at pediatrician check-ups.
How to pump and bottle feed your baby
If you are returning to work, you may want to start pumping and offering your baby a bottle after you have learned how to breastfeed well, usually when your baby is about three to four weeks old. You can pump one to two times a day after breastfeeding to build up your milk supply and store some extra milk in the freezer. There are also ways to bottle feed your baby that are more like breastfeeding, which will keep your breastfeeding relationship going well. You can look up “Bottle feeding a breastfeeding baby” on YouTube for tips on this. Also, if you give your baby bottles instead of breastfeeding them at certain feeds, you may need to pump to keep a good milk supply.
If you have questions or concerns about breastfeeding or making breastmilk for your baby, a lactation consultant or specialist can be extremely helpful. Most delivery hospitals will have lactation consultants to meet with after you take your baby home. Organizations like WIC and La Leche League are also very helpful for free or low-cost lactation help. Lactation Network is another organization that does in-home lactation visits that are covered by some insurance companies.
Remember that when you and your baby first meet, you are both learning a new skill in how to breastfeed. With time and practice, you will know what to do and enjoy a special experience only a mother and baby can share.
Learn more about CHOC’s Clinical Nutrition Program
At CHOC, we specialize in providing a full continuum of pediatric nutrition services, including inpatient and outpatient services, depending on our patients’ needs.
