Breastfeeding Basics
Making Breast Milk
Colostrum is a special milk for the baby's early feedings. It is made by the milk glands starting early in pregnancy. It is thicker than other milk and just what your baby needs for the first few days. Colostrum is the perfect first food for your baby.
During the first 3-4 days your breasts will begin to feel fuller before feedings. The milk glands are changing from making colostrum to making milk. People say the milk is "coming in." The breasts are making MORE milk, because your baby is ready for more.
As the milk comes in, your breasts may become engorged (swollen). Most mothers feel heavier or fuller before feedings but do not get engorged. Breastfeeding at least every 2 - 3 hours during the day and at least once at night will help keep your breasts comfortable as your milk comes in.
When your baby is about two weeks old (or before), your breasts will get a little softer and smaller. This does NOT mean you have less milk. Your breasts are getting used to holding milk and are less swollen.
Let-Down
As your baby starts to nurse, your milk starts to flow. Several times during a feeding your milk glands release more milk. This is called let-down (or milk ejection reflex). The same hormone that causes the let-down makes your uterus contract (tighten). As your milk lets down, you may also feel your uterus cramp and have heavier vaginal bleeding. After the first few days, the uterus is smaller and you do not feel that cramping anymore. Some mothers feel a tingling or tightening in their breasts with the let-down at the start of each feeding. Some mothers do not feel the let-down but see their babies start to gulp as the milk comes faster.
Making Enough Milk
When you nurse as long and as often as your baby wants, you are telling your breasts how much milk to make. This is often called supply meets demand. Supply meets demand as long as you breastfeed, even when your baby is bigger. Your body makes as much milk as your baby is taking.
Holding Your Baby for Feedings
There are different ways you can hold your baby when breastfeeding. Choose the position that is most comfortable for you. If you have a c-section, you will probably want to use the football hold or lie down to nurse at first. That will keep the baby off your stomach.
Football
Place a pillow or two at your side to raise the baby to the level of your breast. Put the baby on the pillow with her bottom and legs touching the back of the chair (like an "L").
Hold the baby's shoulders in the palm of your hand supporting the base of the baby's head. Use your other hand under the breast to keep it in the baby's mouth.
Across the Lap
Hold the baby's shoulders in the palm of your hand with your arm supporting the baby's bottom. Bring the baby across your lap. Use your other hand under the breast from the side to keep the nipple in the baby's mouth.
Cradle
Cradle the baby in your arm, his tummy against yours. The baby's head will be resting in the bend of your elbow. The baby's whole body is facing you, tummy-to-tummy. Use your other hand to support the breast.
Lying Down
Lie down on your side and pull the baby close to you so that you are facing each other. Some mothers place a pillow or rolled-up towel against the baby's back to keep the baby in position. A pillow behind your back may make you more comfortable. Help the baby latch on to the breast closest to the bed.
Getting Your Baby Latched On
Have pillows or folded blankets under the baby. The baby's hips need to be almost as high as the baby's head. This will help keep the baby's jaw relaxed to nurse without pinching your nipple. As your baby gets older you may not need this support, but it is very helpful at first.
Hold your baby close to you. The baby's ear, shoulder and hip should be in a straight line. Do not push the baby's head forward. Pushing the head makes it hard for the baby to swallow.
Hold your breast in one hand with your fingers underneath and thumb on top. Have your hand back from the areola (the dark skin around the nipple). Your hand should not get in the way as the baby latches on. The baby needs to get the nipple far back in the mouth to nurse so milk can flow easily.
Line up the baby's lips with your nipple. Touch the lips with your nipple until the baby's mouth opens wide. The baby is looking for something to suck. This is called rooting. Pull the baby quickly onto the breast. Once the baby starts sucking, you will feel a tug on your nipple. It should not hurt after the first few sucks.
If it hurts, start over. Put your finger in the baby's mouth between the gums and take your nipple out. Make sure the baby's mouth is wide open and the tongue is down before the baby latches on again. It is okay to start over several times.
Signs That Breastfeeding is Going Well Breastfeeding is going well for you and your baby when:
- You feel a tug, but it does not hurt when the baby sucks.
- Your baby swallows hard after a few strong sucks.
- Your baby is content at the end of the feeding.
- By 4 days old, your baby has at least 6 wet diapers, and 2-5 yellow bowel movements every 24 hours.
- Your baby is gaining weight at each check-up.
These are other signs that you may see:
- Your uterus may tighten during or after feedings the first few days after delivery.
- You may feel sleepy or relaxed when your baby nurses.
- You may notice that your breast softens as your baby nurses.
- Your baby's arms and shoulders will relax during feeding.
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