Breastfeeding: Getting started

Breastfeeding: Getting started

How to start breastfeeding
The first time you hold your newborn in the delivery room is a great time to start breastfeeding. At the beginning, your body will produce small amounts of a special milk called colostrum that will help protect your baby from infection. (Your baby’s tummy is very tiny, so she only needs these small amounts to fill up. As her tummy grows, your milk will change and you’ll produce more of it.)
Turn your baby’s whole body toward you, chest to chest. Touch her upper lip with your nipple, and, when she opens her mouth wide, pull her onto your breast, holding your breast for support. Her mouth should cover not just the nipple but as much of the areola (the darker part surrounding it) as possible.

Don’t panic if your newborn seems to have trouble finding or staying on your nipple. Breastfeeding requires patience and lots of practice. Don’t hesitate to ask a nurse to show you what to do, and request visits from a lactation consultant while you’re in the hospital (many hospitals have them on staff).

If you have a premature baby, you may not be able to nurse right away, but you should start pumping your milk. Your baby will receive this milk through a tube or a bottle until she’s strong enough to nurse.

Once you get started, remember that nursing shouldn’t be painful. Pay attention to how your breasts feel when your baby latches on. Her mouth should cover a big part of the areola below the nipple, and your nipple should be far back in your baby’s mouth.
If latch-on hurts, break the suction (by inserting your little finger between your baby’s gums and your breast) and try again. Once your baby latches on properly, she’ll do the rest.
How often you should nurse
Frequently. The more you nurse, the more milk you’ll produce. Nursing eight to 12 times every 24 hours is pretty much on target.
According to guidelines from the American Academy of Pediatrics (AAP), rather than nursing according to a rigid schedule, you should nurse your newborn whenever she shows early signs of hunger, such as increased alertness or activity, mouthing, or rooting around for your nipple. Crying is a late sign of hunger – ideally, you should start feeding your baby before she starts crying.
During the first few days, you may have to gently wake your baby to begin nursing, and she may fall asleep again mid-feeding. (To keep her awake during feedings, you may want to unswaddle her or remove a layer of clothing.) To make sure your baby’s eating often enough, wake her up if it’s been four hours since your last nursing session.
How to get comfortable
Since feedings can take up to 40 minutes, especially in the newborn months, pick a cozy spot for nursing. Hold your baby in a position that won’t leave your arms and back sore. It works well to support the back of your baby’s head with your hand, but the position you choose really depends on what’s comfortable for you.
If you’re sitting, a nursing pillow can be a big help in supporting your baby. Many moms also find a footstool helps them get comfy. Whether you’re sitting or lying down, don’t start the feeding until you and your baby are comfortable because you’ll be in that position for a while.
What you should eat
A normal healthy diet is all you need while you’re nursing. Although you can produce milk for your baby even if your nutrition isn’t up to par, eating a well-balanced diet will ensure that the quantity and quality of your milk is all it can be and will help you feel your best. Follow your hunger rather than counting calories, and drink fluids throughout the day to stay well hydrated.

Many moms feel extra hungry while breastfeeding, which makes sense – your body is working around the clock to make breast milk for your baby. Eating small meals with healthy snacks in between (the way you may have done during pregnancy) is a good way to keep your hunger in check and your energy level high. (As a general guideline, most women who are breastfeeding will need about 200 to 500 calories more than moms who aren’t.)
Don’t overdo your caffeine consumption, because you’ll pass the caffeine along to your baby in your breast milk and it can accumulate in her system. (Experts recommend limiting your intake to no more than 300 mg per day, about the amount you’d get in a 12-ounce cup of coffee).
You’ll also want to limit drinking alcohol while you’re breastfeeding, because it also enters your breast milk.
Most nursing babies don’t mind if Mom indulges in spicy foods. In fact, some experts believe that babies enjoy some variety. No foods are problematic for all babies, so there’s no need to restrict what you eat right away. But if your baby seems more gassy or irritable every time you eat a particular food (dairy products, for example), try eliminating the suspect food for a while to see if she’s better off without them in her breast milk.
Problems you may encounter
Some women adjust to breastfeeding easily, encountering no major physical or emotional hurdles. But many new moms find it hard to learn. If you’re feeling discouraged, you’re not the only one.
It’s normal to feel overwhelmed by your baby’s constant demands and exhausted from lack of sleep. And you may have questions: Is my baby getting enough milk? Should I have sore nipples? How long should my baby nurse? Should I wake her if she falls asleep nursing?
Although women have nursed their babies for centuries, breastfeeding doesn’t always come easily. Many women face difficulties early on. Some of the most common breastfeeding problems you may encounter in the first six weeks include:
Engorgement (breasts that are excessively full and uncomfortable)
sore nipples
Mastitis (a breast infection)
Don’t suffer in silence. Call your healthcare provider or a lactation consultant if you’re suffering from any of the above, if you’re in pain, or if physical discomfort is getting in the way of nursing.
Where to get help
Breastfeeding help and support is just a phone call (or a click) away.
Talk to your doctor or midwife about any health concerns that may be getting in the way of successful breastfeeding.
La Leche League International, an organization that offers encouragement and support to women who want to breastfeed their babies, can send you information or put you in touch with a La Leche League chapter near you. You can reach the group’s headquarters or get advice from its breastfeeding hotline by calling (800) 525-3243. If you attend local meetings, you can meet other new moms and get breastfeeding assistance.
For professional advice and encouragement, call an international board-certified lactation consultant (IBCLC). A lactation consultant can offer advice on how to breastfeed properly and give you hands-on help. To find one near you, call the International Lactation Consultant Association at (919) 861-5577 or use that association’s online lactation consultant finder.
You can also call the hospital or birth center where you delivered, your doctor or midwife, or your child’s doctor for a referral.
For support from other breastfeeding moms, visit the Breastfeeding support and help group in BabyCenter’s Community.
For more information, see BabyCenter’s Breastfeeding area.

The best way to store breastmilk

If you’re breast-feeding your baby and going back to work or looking for more flexibility, you’re probably considering using a breast pump. Once you start pumping, it’s important to know how to safely and properly store your expressed breast milk. Consider these do’s and don’ts for breast milk storage.

You can store your breastmilk to keep it fresh for your baby in a number of ways:

At room temperature (no more than 25 degrees C), for up to six hours.
In a cool box, with ice packs, for up to 24 hours.
In a fridge (at four degrees C or colder), for up to five days. Store it at the back of the fridge, where it’s coldest, away from meat, eggs, or uncooked foods.
In a fridge’s freezer compartment, for two weeks.
In a home freezer (at minus 18 degrees C or lower), for up to six months.

If you’re returning to work, try to get into the routine of expressing and storing your breastmilk. This will keep your milk supply up, and your baby can continue to get the benefits of your milk, even when you’re not with him.

How you store your breastmilk depends on how soon you want to use it. If you plan to use it within a few days, refrigerating is better than freezing. Freezing destroys some of the substances in your milk that fight infection. Frozen breastmilk is still a healthier choice for your baby than formula, though.

Whether you choose to refrigerate or freeze your milk, you should:

Use sterilised containers. Opt for plastic bottles or plastic breastmilk bags. Glass bottles may crack or chip.
Label and date your bottles and bags, and use up the oldest ones first.
Keep your breast pump clean. Wash the parts in hot, soapy water, and rinse them thoroughly before sterilising.
Wash your hands before expressing and handling breastmilk for storage. Keeping everything as clean as possible will make it less likely that bacteria will grow in your stored milk.

You can add freshly expressed milk to breastmilk that’s already in the fridge, provided it has been expressed on the same day. Bear in mind, though, that you can only keep it until the original milk is five days old.

If your milk has been stored for some time, you may notice that it separates. This is normal, so just give it a gentle shake to mix it up again. Some babies will happily drink cold milk straight from the fridge, while others like it warmed up. You can warm the milk by placing the sealed bottle or bag in a bowl of warm water.

If you want to freeze your milk, do it as soon after expressing as possible. Leave a gap at the top of each bottle or bag, as your milk will expand during freezing. If you’re storing milk in bags, watch out for any tears. You may not notice any until you start to thaw the milk. Remember that plastic bags tend to fall over when thawing.

You could freeze very small amounts of milk in an ice cube tray, ideally one with a lid, or you could store the tray inside a sealed freezer bag. These smaller quantities defrost quickly and are ideal if you need some breastmilk to mix with your baby’s food when you introduce solids.

You can add freshly expressed milk to frozen milk, as long as the fresh milk is chilled for at least an hour first. Make sure the amount you’re freezing is smaller than the frozen portion.

Frozen breastmilk should ideally be defrosted in the fridge, and can be stored there for 12 hours. Never re-freeze breastmilk once it has thawed.

Don’t be tempted to defrost or warm your breastmilk in a microwave. If you need the milk in a hurry, defrost it under cool, then warm, running water, or place it in a bowl of warm water. Dry the outside of the container before you open it, and use it straight away.

Using waterproof labels and ink, label each container with the date you expressed the breast milk. If you’re storing expressed milk at your baby’s child care facility, add your baby’s name to the label. Place the containers in the back of the refrigerator or freezer, where the temperature is the coolest. If you don’t have access to a refrigerator or freezer, store the milk in a cooler or insulated bag until you can transfer the milk to the refrigerator or freezer.

To minimize waste, fill individual containers with the amount of milk your baby will need for one feeding. You might start with 2 to 4 ounces (59 to 118 milliliters), and then adjust as needed. Also consider storing smaller portions — 1 to 2 ounces (30 to 59 milliliters) — for unexpected situations or delays in regular feedings. Keep in mind that breast milk expands as it freezes, so don’t fill containers to the brim.