Getting Started with Breastfeeding
You will be given the opportunity to breastfeed within the first few hours after birth as long as there are no major health issues with you or your baby. This will help you to begin bonding with your baby and establish breastfeeding as early as possible. When you arrive at the hospital to deliver your baby, make sure to make your nurse or doctor aware that you plan to breastfeed.
However, know that your milk will not come in immediately! Before your milk comes in, you will express small amounts of a yellowish or golden-colored fluid, called colostrum, from your breasts. Colostrum is full of antibodies to help your baby begin building their immune system.
Your breastmilk will take 2-5 days to come in. When this happens, your breasts will feel heavier. This is often a time that babies will "cluster feed" or feed very frequently now that these rich nutrients are finally available to them.
Your baby will feed at least every 2-3 hours during the first several weeks of life, and sometimes more often when breastfed. If your baby does not wake up to feed within 3 hours, you should wake him/her up to feed. This is very important for his/her growth.
It is normal for your baby to lose up to 10% of his/her body weight in the 1st week of life, especially when exclusively breastfed. Your baby is only getting colostrum during the first few days of life, which while rich in nutrients and antibodies, is not very rich in calories. Once your calorie-rich milk comes in, your baby should start to regain weight. Your baby should regain weight steadily and be back to his/her birth weight by 2 weeks of age. Your baby's doctor will check to make sure this is the case.
Once you go home from the hospital, you will need to follow up with your baby's doctor within 1-2 days so your baby's doctor can see how breastfeeding is going and ensure your baby is growing as expected.
If you plan to pump and do not already have your breast pump, ask your doctor for a prescription for one during one of your doctor's visits or before you leave the hospital. Many private insurance companies will cover the cost of a standard electric breast pump with your doctor's prescription. However, sometimes it takes a few weeks for your pump to be shipped to you so ask for this during one of your doctor's visit in your last trimester if possible to be sure it arrives in time.
Tips for Success
Breastfeeding should not be painful, but it can be if your baby is not latching correctly. Here are a few tips to make breastfeeding as comfortable and successful as possible for both you and your baby:
Make sure you are sitting in an upright position with good back support. You can achieve this by sitting up in bed or on a chair/couch; you can put a pillow behind your back for extra support if needed.
It may also be helpful to use a breastfeeding pillow or a regular pillow in front of you and/or on your side(s). This will help to support your baby and your arm as you hold your baby while breastfeeding and prevent fatigue. This can also provide some cushion for your abdomen while you are breastfeeding, especially if you had a cesarean section.
Once you are in good positioning, hold your baby in the desired position. The "cross cradle" position, where your baby is lying in front of you, is most often used. However, you may find the "football" hold, where your baby is positioned on your side, more comfortable, especially if your abdomen is still tender from a cesarean section. You may want to try both positions to see which seems more comfortable for you and your baby.
When your baby is hungry, he/she will usually be "rooting". Rooting is when your baby opens his/her mouth and moves his/her head from side to side quickly, looking for your breast or nipple to suckle.
Wait until your baby's mouth is open wide, then place him/her onto your breast. This will help to ensure that you get more than just your nipple in your baby's mouth. If only your nipple is in your baby's mouth, you will experience a sharp pain when he/she latches. Make sure that some of your areola (the darker part of your breast just behind your nipple) goes into your baby's mouth as well when latching on. This allows for a more effective suck and will prevent pain and sore nipples.
If your baby has difficulty latching on or staying on due to the shape of your nipple (may be flat or short), a nipple shield or nipple guard can be helpful in the beginning while you and your baby are still establishing breastfeeding. A nipple shield or guard is shaped like a nipple and fits onto your own nipple to make it easier for you baby to latch.
Breastfeeding is a skill and it takes work! It does not always come easy to you or your baby. Try not to get discouraged if breastfeeding does not come easily in the beginning. It will get better as your baby gets bigger and as both you and your baby learn how to breastfeed well.
Ask your nurse or doctor early on if your hospital has a lactation consultant. If so, you can request that they visit you in the hospital to help with breastfeeding. Your baby's doctor may be able to provide additional breastfeeding help at your baby's first few doctor's visits. Also, check with your insurance company for information on lactation resources and services that are covered.
At times during breastfeeding, you may experience some issues.
Your breasts will feel heavy at times, especially when you milk has just come in or when it is time for your baby to feed. However, if this heaviness feels painful or uncomfortable, you may be engorged. Engorgement is when your breasts are overfull with milk. If you are feeling engorged, feeding your baby will usually relieve the pain or discomfort that can be associated with this. If feeding your baby does not relieve this, you can express some milk by hand or by using a pump to further relieve the fullness in your breasts.
You may sometimes experience sore nipples, and even some cracking or bleeding. This can be normal, especially in the beginning, and is not a reason to stop breastfeeding. Using a nipple cream can help to relieve some of the soreness and cracking. Applying a cool compress or even ice after feeds can provide relief to the sore area(s) as well.
If you experience a rash, itching, or severe pain to your breasts, you should notify your doctor and/or your baby's doctor. You may need to be evaluated and treated for a yeast/fungal infection of your skin, for an infection within your breast tissue (mastitis), or for other common conditions related to breastfeeding.
Also, your baby's doctor will check his/her mouth for thrush, which is a yeast/fungal infection your baby can get due to an immature immune system. This infection is easily treated once identified. However, if both you and your baby have a yeast/fungal infection at the same time, you may both need to be treated to prevent passing the infection back and forth to each other as you continue to breastfeed. However, you should not stop breastfeeding if you are concerned for this. You should talk to your doctor and/or your baby's doctor so you both can be treated as you continue breastfeeding.
If you are using a breast pump (electric or hand), this can sometimes lead to breast pain. Make sure that your flange(s) (the funnels that go over your breasts and connect to your pump) are the right size for your nipples. Your pump will usually come with standard size flanges. Make sure that your nipples do not rub against the inside of your flange when pumping; if they do, this will lead to pain and you likely need a larger size flange. Also make sure that you are feeling suction and see your nipple expanding while pumping; if you do not experience this, you likely need a smaller size flange.
Increasing Milk Production
First, know that most newborn babies will take about 1-2 ounces of milk per feed. Therefore, as long as you are producing about this much in the beginning and/or if your baby is growing well, you are producing enough!
However, there may be times during breastfeeding when you may feel you need to increase your milk supply or you may just desire to do so. There is no one proven way to increase milk supply but there are several things you can do to give your body the best chance at having a plentiful supply:
Continue taking your prenatal vitamin (or a women's multivitamin).
Drink plenty of water (with a goal of 64 ounces, which is equivalent to 8 small cups, 4 tall glasses, or 4 regular-sized water bottles) daily.
Continue to eat. Breastfeeding burns between 200 and 500 calories per day, in addition to your usual recommended daily caloric intake. This means it is important to continue eating at least three meals daily. These meals should be nutrient-rich and contain a balanced amount of healthy fats, protein, and carbohydrates.
There are many lactation supplements out there, everything from teas to cookies to shakes that you can try. Be sure to read labels and make sure that the products you are consuming are safe for breastfeeding moms. If in doubt, ask your doctor or your baby's doctor if certain supplements are safe and/or for any specific recommendations they may have.
Remember that breastfeeding takes work and dedication, for both you and your baby. But you can achieve it and hopefully these tips will help.
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