Breastfeeding, while natural, is something you and your baby will have to learn to do. It's new to both of you, and you may need lots of practice before you feel you've got it right. We've put together an all-you-need-to-know guide, as well as 12 steps to help you and your baby get off to a good start...
Your baby's first feed can take place straight after birth, if everything's fine. It can be quite tricky at first; even at this early stage, the way your baby actually feeds from your breast is so important. You both need to be comfortable and remember, getting your baby 'latched on' right means you will stay comfortable, and he will get a good feed. If it's not right, breast-feeding can make you sore and lead to an unsatisfying feed for your baby, so it can be really helpful for a midwife to guide you to begin with.
The last thing you need while you’re learning is conflicting advice – and chances are you’ll get plenty. In the first week, seek out support and practical advice from someone who knows what they’re talking about and who can spend half an hour or so at your side. Try your midwife, a local breastfeeding counsellor (in the UK call the NCT’s Breastfeeding line on 0870 444 8708) or a friend who’s been there and mastered it.
In the early days, breastfeeding can seem to dominate your life, but once you’ve got the knack you’ll be able to do it anytime, anywhere - and always have milk ready on demand.
Making milk
The first milk your body produces for your baby is colostrum, a creamy substance high in protein that provides a boost of antibodies to protect your baby and strengthens his immune system. Two to five days after the birth, your milk 'comes in' under the influence of the hormone prolactin and replaces the colostrum. Your milk supply is replenished as milk is removed from your breasts - if you don't breast-feed, your milk production gradually stops.
Feeding
When your baby feeds he takes your breast in his open mouth and draws the nipple to the very back of his mouth, using his tongue and jaw to get foremilk, the lower-calorie milk in the reservoirs behind the nipple.
The hormone oxytocin is then released into your blood and as a result the tiny muscles surrounding the milk-storage cells of the breast push the fattier hindmilk into the ducts - this is the let-down reflex or the milk-ejection reflex, and causes the milk to flow down the ducts and out into the baby's mouth.
Your baby adopts a suck-swallow rhythm, using his tongue and jaw to have an effective, satisfying feed. Feed your baby as and when he wants to ensure a good milk supply.
One or both breasts?
Follow your baby's lead. Some babies want both breasts at each feed, and you can offer the second when your baby seems to take a break. If he doesn't want it, just offer the 'unused' breast next time. To help you remember which breast to feed from next, wear a hairband around your wrist on the same side.
12 steps to make breastfeeding work wonderfully for you and your baby
- You can't spoil your new baby or get him into bad habits by feeding him too frequently. Your newborn is growing so fast that feeding on demand is the only way to keep him satisfied, and to give him the nourishment he needs.
- There’s no connection between breast or nipple size and milk supply - whatever your breast size, your milk will be perfectly matched to your baby’s nutritional needs. It can’t be too thin, or too rich and your body will produce enough of it for the hungriest baby if you feed him on demand. So don’t assume that your baby cries because he’s going hungry or ‘he’s not getting enough’. Babies also cry when they are uncomfortable, lonely, in need of a cuddle, or have a pain like colic.
- You can breastfeed sitting up, or lying down (great for nightfeeds!).
- If you’re sitting, it’s essential (for the sake of your back and to help the baby latch on properly) that you make sure you are on a comfy chair with your back supported, arms free, knees level or higher than hips - support your feet on a stool if necessary. To start with, help support your baby with a pillow or cushions. His nose should be high enough to be level with your nipple so that you never have to hunch over or draw your breast down to his mouth.
- Don't 'post' your nipple into your baby's mouth - it's 'baby to breast' not 'breast to baby', so bring him on when his mouth is wide open.
- When you’re ready to feed turn his whole body, not just his head, towards you - 'tummy to mummy' - and when he opens his mouth offer as much nipple and areola (the round area around the nipple) as possible. There should be more of the areola showing above his top lip than below. Once he’s latched on, you may need to ease his bottom lip down gently so it totally covers the areola.
- You may need to support your breast from underneath with your hand, but don’t have your fingers near your nipple or areola as you could prevent your baby getting a good mouthful of breast.
- Sore nipples are painful, but there are ways to ease the discomfort and to avoid the problem persisting. The pain certainly doesn’t mean your nipples can’t take the sucking – it’s usually caused by the baby not latching on properly and so sucking on the nipple rather than on a good mouthful of breast. Check your baby’s feeding position (see above) and soothe painful nipples by rubbing some breast milk over the sore area and letting it dry, or using a recommended nipple cream.
- You can give yourself more freedom and flexibility by introducing your baby to a bottle, allowing someone else to give a feed. You can express milk (see below), or use formula. Substituting one breastfeed every now and again with formula shouldn’t affect your milk supply once feeding is established, although it may make your breasts a little full and uncomfortable around the time the feed is due.
- Many mothers express milk with a manual or electronic breast pump to store, by refridgerating or freezing, for a later feed. Wait until breastfeeding is established before you try expressing milk. Some women find the breast their baby’s not feeding from leaks heavily. This milk can simply be collected in a milk or drip catcher (available from babycare shops), which sits on the nipple under the nursing bra, and then transferred to a bottle for storage.
- Practise expressing by hand or with a pump in the bath when you’re warm and relaxed. If you’re expressing by hand, gently massage the breast tissue down to the edge of the areola. Expressing is always easier before a feed, and when you’re feeling relaxed. Having your baby or a photo of him near you will help the milk flow naturally while you express.
- You could also try expressing from the other breast while you feed. Make sure your baby’s comfortable, well supported and latched on, then use a breast pump on your other breast.
