More and more women are becoming aware of the important advantages of breastfeeding to their babies and to themselves. Breastfeeding develops a special closeness between a mother and her baby that is beneficial to both. Your breast milk is the perfect food for your baby, ideally suited to his nutritional needs and bodily development. Breastfeeding benefits your baby by providing added protection against disease, infection, tooth decay and allergy.
The vast majority of women are physically capable of nursing their babies. Nature has seen to it that the production of mother’s milk is closely related to the needs of the newborn infant. For the first few days of life a newborn baby sleeps much of the time and is content with the colostrum present in his mother’s breasts. Colostrum is a yellowish fluid which is rich in protein and benefits the baby by giving him immediate protection against disease and infection. Colostrum also has a slight laxative effect and, in general, readies your baby’s digestive tract for the milk he will be getting in a few days. During this period, it is normal for babies to lose weight. Usually it takes at least 10 days for a baby to regain his birth weight.
Your milk may come in gradually or suddenly. This may be accompanied by an uncomfortable fullness which will subside by itself. Whenever possible, this fullness can be relieved by letting the baby nurse between feedings for a minute or two or by expressing milk by hand.
Don’t be discouraged from nursing your baby. Be patient, people sometimes try to talk you out of doing something they couldn’t or wouldn’t do. If they did not do well at breastfeeding, they probably did not follow advice.
The practical suggestions on the following pages will help you to succeed in the womanly art of breastfeeding and to make your nursing experience happy and rewarding.
NURSING IN THE HOSPITAL
Wash Your Hands Before You Breast-Feed Your Baby. This helps to protect your baby from infection. If your doctor advises, you will be provided with water and sterile cotton with which to rinse off your nipples before nursing.
Make Yourself Comfortable So You Will Be Relaxed. Hold your baby so his head is a little higher than his tummy, whether you nurse lying on your side or sitting up. If you sit up to nurse, it helps to put a pillow on your lap under your baby. If you want privacy, tell the nurse.
Many Newborn Babies Do Not Nurse Vigorously the First Few Days. Help your baby to start nursing by holding him close so that his cheek touches your breast. This will cause him to turn his head and search for and find the nipple. Give him time to find it; he’s learning too. If your breast is very full and firm, press your breast away from your baby’s nose so he can breathe easily.
Be Sure Your Baby Takes as Much of the Areola (Darker Area of the Breast) as Possible into His Mouth, Not Just the Nipple. This helps your baby to obtain the maximum amount of milk from the milk ducts behind the areola. Flatten the areola slightly to help him get started, then release the areola to allow the milk to flow unrestricted.
Try to use Both Breasts at Each Feeding (but don’t worry if your baby doesn’t want the second breast.) Nurse five minutes on one side, five on the other. If there is no tenderness, gradually increase nursing time to ten minutes on each side. Alternate the side you begin with at each nursing. A safety pin fastened to the strap of your bra will help to remind you.
Welcome the 2 A.M. Feeding. It aids greatly in bringing in your milk since frequent feedings will help to build up your milk supply. The sooner you nurse the less swelling you will have.
Never Pull the Nipple from Your Baby’s Mouth. This can hurt the nipple. To break the baby’s suction press the breast away from the corner of his mouth or lift baby’s lip by putting your clean finger into the corner of his mouth.
Burp Baby after Feeding (and it is sometimes necessary during the feeding). Either hold him upright over your shoulder and gently pat or rub his back or sit the baby on your lap and support him with one hand in front while gently patting or rubbing his back with your other hand. Some babies need no burping at all.
Wearing a Nursing Bra will Provide Comforting Support while Preventing Your Breast Tissue from Stretching. If your bra flap sticks to your nipple, moisten the flap before lowering to avoid breaking the skin. Allow the flap to dry before replacing it.
Air Heals and Toughens the Nipple. Leave the nursing flaps of your bra down whenever possible. Always air dry the nipple after nursing, before applying lanolin or other ointment. The removal of any plastic bra liners will provide better circulation of air.
Uterine Cramps frequently occur during breastfeeding. This is nature’s way of returning your uterus to its normal size.
NURSING AT HOME
First Night Home. Your baby may be fretful and sensitive to the change. Give him loving care and he will soon adjust to his new home.
Continue to Use Both Breasts at Each Feeding. Nurse 10-15 minutes on the first breast to be sure it is “emptied”. (although the production of breast milk is a continuous process, the bulk of the milk is emptied in the first several minutes of nursing.) If there is no tenderness, nurse as long as your baby wants on the second breast. Alternate the breast you begin with at each feeding to give each breast equal stimulation.
Frequent Nursing. It is not uncommon for a breast-fed baby to nurse every two or three hours during the day and once or twice at night in the beginning. The fourth through eighth days of life are often days of particularly noticeable increased demand. This is nature’s way of building up your milk supply and gives your baby comfort. He will gradually go longer between feedings. The four-hour schedule followed in some hospitals should not influence your nursing pattern at home.
The More Often You Nurse the More Milk You Will Have. It is how often you nurse more than how long that builds up your milk supply. In the beginning, prolonged sucking is more likely to cause nipple tenderness than short, more frequent nursings.
When Your Breasts Become Softer and More Normal in Size your milk has not gone, only the swelling. It should be remembered that breast milk, once established, looks thin and bluish, like skim milk.
Bottles of Any Kind Weaken the Sucking Reflex of the Breastfeeding Baby. Breastfeeding is usually more successful if water is not given except on excessively hot days. Nursing more often the first days home will eliminate the need for water bottles as well as a supplemental formula. Be patient, the first few weeks are a period of mutual adjustment.
An Occasional Bottle. After your milk is established you will be able to give your baby an occasional bottle if you must be away for a feeding. But remember, you will want to nurse as soon as you get home to relieve the fullness of your breasts. Leave just enough breast milk or formula to satisfy your baby until you get home. If you will be gone 6-8 hours, express your milk by hand or use a breast pump while you are away to prevent your breasts from becoming overly full and difficult to empty.
Tender Nipples. Leave your bra flaps down inside your blouse after nursing to allow air to circulate around the nipples as much as possible. Pure hydrous lanolin can be applied lightly after nipples have sufficiently dried. Any tenderness is usually temporary and will soon subside.
You Need Not Use Soap, Alcohol, Tincture of Benzoin or Antiseptic Pads on your nipples. Soap and antiseptics tend to cause excessive drying. Continue to wash your hands before nursing.
Very Loose Bowel Movements are normal for a breast-fed baby. Sometimes the movement is little more than a stain. It is normal for some babies to have a movement at each feeding and for others to go five days or more without a movement. Even though they may strain heartily their movements will be of normal consistency and therefore, not constipated. Completely breast-fed babies do not become constipated. Early bowel movements quite often contain traces of meconium, which is dark green or blackish in color.
Drink Water for Two. Make a habit of having a drink of water, juice or milk shortly before each feeding or while you are nursing. Such a habit helps the let-down reflex and acts as a reminder that you are literally drinking for two. Don’t overdo on “no calorie” drinks, coke or coffee. There is no particular beverage (or food) that is known to increase the quantity of breast milk.
Six or More Wet Diapers a Day or pale urine is your assurance that your baby is getting enough milk. (This is not a good way to judge it you are giving your baby water too.)
Sleepy Baby. Although feeding on demand works best for most babies, occasionally a placid baby who nurses every four or five hours fails to gain weight. This baby needs to be encouraged to nurse more often during the day for a while. Changing his diaper or rubbing your nipple against baby’s cheek will help waken him. Monthly examinations by the doctor will assure you he is gaining, even if slowly.
Company and Excitement sometime hold back the free flow of your milk supply. Everything will get back to normal if you nurse a little more often for the next few feedings. Limiting your housekeeping and visitors for the first few weeks will help you get off to a smoother start. If you have help, let her take care of the housework while you care for your baby. Take a nap or rest whenever possible, especially in the early weeks after birth.
You Can Nurse Without Being Noticed if you wear an overblouse or knitted top that can be lifted from the waist.
To Prevent Leaking. Press the heel of your hand against your nipple until the “tingling” stops. Uncontrolled leaking is usually temporary.
Stop the Feeding if your baby clamps down on your nipple with his gums, even though this usually doesn’t hurt. This will train him not to bite when he does get teeth.
Laxatives, Diuretics and other Medications for mothers may sometimes upset breastfeeding babies. Some antihistamines and hormones may decrease your milk supply – check with your baby’s doctor before using any drug.
There Is Usually No Need to Avoid Any Nutritional Food. There is no medical evidence of a baby ever being allergic to breast milk itself, but occasionally a baby may react to something a mother eats. Rather than restrict your diet in advance, give up only that food that consistently bothers your baby.
A Healthy Diet Is Important to Breastfeeding. A poor diet can cause you to feel tired. Vegetables, fruits, eggs, milk, meat and fish are good for you, especially while you are breastfeeding. Limit cake, candy, soft drinks, etc. which will make you put on weight.
Appetite Spurts or Growth Spurts frequently occur during the early months, commonly at 5-6 weeks and again around 3 months. If your baby begins to act hungry or fussy and chew his fist around these times this does not mean that you have lost your milk. Your baby probably just needs more milk to satisfy an increasing appetite. By nursing every 2 or 3 hours during the day for a few days the extra sucking will cause your milk supply to increase to the amount your baby needs and he will again go longer between feedings. Supplemental bottles at this time would gradually decrease your milk supply.
Don’t be Anxious to Rush Solids. Most babies, whether breast-fed or bottle-fed, have some fussy periods during the day or evening which are not necessarily due to hunger. If, in the very early months, a baby’s hunger is partially satisfied with solids he will have less desire to nurse vigorously, and vigorous nursing is important to the production of breast milk. When solids are given, nurse your baby first to keep your milk supply from decreasing.
Even in the Later Months You can Build up Your Milk Supply if you nurse more often for a few days. If you give your baby less solid food for a few days, he will want to nurse more often. The increased stimulation will cause your breasts to produce more milk.
A Rash of Little Pimples on Your Baby’s Face or Body may be caused by poorly rinsed laundry, especially if you have “hard” water. Try using a mild detergent. Measure the amount and rinse well. This will prevent soap film from building up in baby’s clothes and sheets. If the rash or blemishes do not go away, check with your doctor.
Continue to Breast-Feed if You have Your Period. Your baby may act fussy for the first day or two if you menstruate. Menstruation will not change the quality of your breast milk.
Weaning can be Comfortable if You Wean Gradually. When you and your baby decide it is time to wean, offer your baby milk in a bottle or cup in place of the breastfeeding in which your baby seems to be losing interest. About every 7 days offer another bottle or cup feeding for another breastfeeding until your milk is gone. (Go slower if you or your baby are uncomfortable.) Your doctor will tell if you should offer bottle or cup feedings. This will depend on the age of the baby.
Some Leaking after Weaning is Normal. Any milk remaining in the breast will gradually be absorbed by the body.
Special Note: Getting started at breastfeeding is often more comfortable if a simple nipple exercise is started about two months before the baby is due. Exercise: Twice a day support the breast with one hand; with the other hand grasp the nipple at its base and pull gently but firmly forward and roll between the fingers (do not hurt yourself). Gradually turn the hand to apply pull all around the nipple. Repeat on the other nipple.
The information contained in this folder has been approved by the
Committee on Fetus and Newborn of the American Academy of Pediatrics.
However, your physician may wish to vary these Instructions for your individual needs.
Prepared by Doris Haire ©2000