Key Tips to Keep Breastfeeding Simple

Nursing is natural, but it helps to learn as much possible before you start.

Nursing is a natural and simple way to provide nutrients to your newborn. Nature intended your baby to drink breast milk, and your body is perfectly designed to produce it. During pregnancy your body has been preparing for breastfeeding, and colostrum (early breast milk) will be ready and waiting. Right from birth your baby is able to let you know when he is hungry, to attach to the breast, and to suck, swallow and digest milk that meets his specific nutritional needs.

So how does it work? Your baby's sucking at the breast stimulates milk production, so the more he nurses, the more milk will be available to him. Pacifiers and formula supplements will interfere with this process, especially in the early weeks. Your baby should nurse at least eight to 12 times in 24 hours during the first weeks. (The exception to this is the first 24 hours after birth, when many babies sleep more.) He may nurse in clusters, rather than every 2 hours, and he should nurse until he's satisfied. This ensures that he receives your hind milk, which is rich in fat and calories. Limiting nursing to 5 or 10 minutes on each side deprives your baby of this important and nutritious food. Let baby finish the first breast before offering the second. Watch your baby, not the clock.

Contrary to what you may have heard, you do not need to drink large amounts of fluid or avoid certain foods* when you're breastfeeding. Eat and drink to satisfy your thirst and your appetite, but aim to take in about 500 additional calories per day, for a total of about 2,700 calories daily (discuss your personal nutritional needs with your doctor). Most women find nursing helps shed some pregnancy pounds since it burns between 600 and 800 calories a day.

Your baby will let you know when he is ready to nurse, lastly by crying but first with a number of early feeding cues: rapid eye movements under the eyelids, an imitation of sucking, hand-to-mouth gestures and small sounds. If you wait until your baby cries, it may be difficult to help him settle down enough to latch on properly. Keep your baby close, and you'll learn to spot his hunger cues.

Latching On
It's instinctual for a newborn to attach to the breast. Studies have shown that a baby placed skin-to-skin on his mother's chest right after birth can crawl to the breast and latch on. If you hold your baby in the traditional cradle position, he'll be able to latch on properly when his head is level with your breast, aligned with his body, and he is facing you. You should not have to lean toward him, and he should not have to reach toward you to attach. Wait for your baby to open his mouth wide so that he attaches to the areola, not just the nipple.

Another option is the football hold, where your baby is tucked by your side. Hold him on his side, his nose to your nipple. Place your arm along his back, supporting his shoulders and neck with your fingers and thumb behind his ears. Don't hold the back of his head; he will instinctively throw it back as he latches on. Be patient and let your baby lead you; don't rush him or pressure yourself. Remember, he knows how to do this.

As he sucks, watch and listen for his swallowing. This is the ultimate assurance that he is getting milk. Your baby will let you know when he is finished by unlatching or falling asleep; he may not want to nurse on the other breast. If he doesn't, it will feel full when he is ready to nurse again, so start with that side.

If you pay attention to your baby's feeding cues, nurse him often and allow him to nurse until he is finished, you can be sure he is getting enough milk. Look for these signs:

• You will notice the change in his sucking: bursts of sucking will be followed by a pause as he swallows. You can also see the neck muscles move as he swallows milk.
• The color of his stool will change from the dark meconium to mustard yellow by day four if he's getting enough milk. By day six, your baby should have at least six wet diapers and three or more bowel movements in a 24-hour period.
• Your baby should be gaining weight, although it may take 2 to 3 weeks for him to regain his birth weight.

Some babies take a few days or even weeks to breastfeed effortlessly. If yours is not nursing frequently, you are unable to identify swallowing or he is not producing enough wet diapers and bowel movements, contact your health care provider or lactation consultant immediately. Also, keep in mind that it's common to experience some discomfort during the first few minutes of breastfeeding. However, your nipples shouldn't hurt throughout the entire feeding. If they do, it's likely that your baby isn't latching on properly. If your baby is latched correctly and you're still experiencing pain after a few minutes, you should seek help. Most breastfeeding problems have simple solutions, but it's important to get help sooner rather than later. Many pediatricians and hospitals have lactation consultants on staff and may conduct regular breastfeeding classes. Your local department of health may also have a referral service.

You and your baby were made to breastfeed. Have confidence in yourself and your baby's ability, and treasure this natural bonding time.

*Alcohol and many prescription and non-prescription drugs pass through your breastmilk to your baby. Consult your health care provider or lactation consultant for information on what is safe. Some women have reported that certain foods they consume cause their babies to have increased gas. If you suspect that is the case, discuss it with your pediatrician or a lactation consultant.