How Do I Start breastfeeding?


The short answer: the best time to start breastfeeding is right in the delivery room or recovery room after giving birth.

The long answer: Glad you asked! Breastfeeding is a way to feed your baby, and it’s also a clear sign of our bodies’ intelligence.

Whether you have had a vaginal delivery or a cesarean section, a mother can prepare for her first time breastfeeding her baby by having skin to skin contact for an hour after delivery.  Skin to skin contact is when the baby is placed naked (or only in a diaper) on mom’s bare chest. There are many benefits of skin to skin contact for all moms and babies that go far beyond the benefits associated with only breastfeeding mothers and babies. Skin to skin contact is used to initiate bonding between mom and baby, initiate breastfeeding, and is also a means to naturally soothe baby, as well as regulate baby’s temperature, heart rate, breathing, and blood sugar levels.

After an hour of skin to skin contact, you will notice your baby beginning to show cues of wanting to eat, such as becoming more alert and awake, moving their head and body towards your breast, and demonstrating a newborn reflex called “rooting” which is when a baby opens their mouth, making sucking noises, and turns their head toward the breast.. To latch your baby to the breast, turn your baby’s body towards you so you are both chest to chest.  Touch the baby’s nose to your nipple (remember: “nose to nip”), which will cause your baby to open their mouth wide (because of the “rooting” reflex). Bring the baby up and over your breast so they take a large mouthful of your breast, including the nipple and areola. Once their mouth is around the breast, covering the nipple and as much areola as possible, you will see the baby’s lips fanned out like “fish lips.”  As the baby sucks, you will see that the baby’s cheek is nice and rounded.  

A mother's body is quite smart, and has begun to make milk during pregnancy. After the delivery of the placenta, the body revs up creation of hormones that tell your body to make more milk. The first milk that a mother will see, right after delivery, is called colostrum, which is thick and yellow and full of antibodies that help protect your baby from illness and provide immunity. When a baby is born, their stomach is about the size of a marble, and the small amounts of colostrum are exactly what the baby needs for their feedings during their first few days. Once your milk comes in (usually between days 3-5 after delivery), you will not only see your baby suckling, but you will be able to hear them swallowing milk.

Your labor and delivery nurses and postpartum nurses will help and support you after delivery in teaching you to breastfeed. As well as assist you with becoming more comfortable with latching your baby, different positions for feeding and troubleshooting when problems or concerns arise. However, once you go home from the hospital, it is very important to find support near you, such as a lactation consultant or breastfeeding support group, so you can continue to work on breastfeeding and get reliable support if you have any questions or encounter any issues.

Boston NAPS runs a regular breastfeeding support group for new moms in the greater Boston area; learn more at our Facebook page. If you’re looking for one-on-one support, you can schedule a lactation consultation with a Boston NAPS lactation specialist.

5 Must Have Items For Your Baby/Toddler This Summer!

1. JJ Cole Outdoor Mat: it's big, it's waterproof, it's easy to wash, you can shake the sand right off of it, and it folds up into a convenient pouch and has a shoulder strap!

2. Snapperrock Bathing Suits: These bathing suits haveUV50+ protection, and come in many adorable designs and styles. They have suits in sizes for newborns through childhood! 

3. iplay Flap Sun Protection Hat: This hat has UPF 50+ protection, an adjustable draw string and chin tie to secure the hate in place, as well as a neck flap for added protection. It also can get wet and dries very quickly!

4. Native Jefferson Shoes: These shoes are a MUST for the beach! They are rubber, easy to clean, comfortable, and can be worn on the hot sand or in the water. 

5. Babiators: These stylish shades are 100% UV protection, and are flexible and durable. The added bonus? They will replace them FOR FREE if you lose or break them within the first year! 

Choosing An OB That is Right For You

One of the first, of many, decisions you will make once finding out you are pregnant and becoming a parent, is choosing the right OB doctor for you. It is often overlooked as one of the more important decisions you can make, as we are used to not needing to see a doctor unless something is wrong. However, with pregnancy, you see your doctor quite often, every month for the first few months, then every other week, in the middle of your pregnancy and then every week towards the end of your pregnancy. So it's important to choose a doctor that you not only know and like, but trust!

Finding an obstetrician is an important first step to take to ensure the best prenatal care for you and your baby, whether you know you are going to try to conceive or you are newly pregnant. It is important to not go into this process blindly, but to instead talk to family and friends who have had babies of their own for recommendations. You can also visit the American College of Obstetricians and Gynecologists' (ACOG) website to find an OB/GYN in your area. There are many things to consider when choosing an OB. So we have compiled a list of some of the more important things to consider when making the right decision for you and your family.

  • Think about whether your prefer a male or a female physician. This is an easy question to ask yourself or your partner at the beginning of the process. It also cuts down many candidates based on the sex you prefer to provide care for you and your growing family.

  • While searching potential candidates, be sure to look at what insurance their practice accepts. Whether the OB is in or out of your "network" for insurance will determine what your co-pay/fees per visit will be.

  • If English is not your primary language, you can search OBs for those who do speak your primary language. This will be hugely beneficial to you, as it’s important that you completely understand the care that you and your baby will be receiving.

  • Consider what hospital your doctor is affiliated with in order to know where you will be delivering your baby. If you have a chronic illness or prior complications from a previous delivery, you may be cared for by a doctor who specializes in Maternal Fetal Medicine. If this is the case, it may be important to you to ensure you are delivering at a hospital with a level III NICU. This means that they have the expertise and equipment to care for a baby delivered early or to a mother with medical complications. Even if you do not have a chronic illness or history of a complicated pregnancy and/or delivery, delivering at a hospital with a level III NICU may still be important to you.

  • Find out how many OB doctors are in a provider’s practice. You’ll want to know this because you may not be able to control which doctor is on call at the time of your delivery.  While we give patients a due date, we cannot control when the baby will decide to arrive!  Make sure you choose a practice where you also feel comfortable and like other members of the team (some offices have a "Meet the Doctors Night" where you can go in and meet all members of the practice so their faces are familiar).

  • Consider where their practice is located - choosing a hospital close to home may be important, since you will see your OB monthly in the beginning of your pregnancy and, by the end, weekly. So it may be beneficial to you to choose a doctor that you easily get to and from their office, from either work or your home. It is also helpful to consider if the office provides easily accessible parking options that are free and/or affordable.

  • A good OB will take the time to sit with you on your first prenatal visit and get to know you and your partner. This is a great time to make sure their style and perspective about issues that are important to you are in line with your own beliefs. Some ways to know if an OB is a good fit for you may be if you felt comfortable during the visit, and if all of your questions were answered, and the answers provided were clear, competent and complete. If you feel rushed or do not feel like your personalities click well after a first visit, it is okay to switch doctors. You are going to spend the next 40 weeks or more with them, so it’s important you choose someone who makes your feel comfortable and well cared for.

How Do I Know My Baby Has a Good Latch?

As a lactation specialist, there are a number of elements that I look for, and tell parents about, in order to identify whether a baby has a good latch or an incorrect latch that needs to be adjusted. Here are the things I look for during every lactation consult in order to ensure mom and baby are off to a great start!

1. Does your baby have proper body alignment? Your baby's ear, shoulder and hip should all be aligned. This can be achieved by ensuring your baby is always "belly to belly", meaning your baby's belly is facing your belly.  One of the most common mistakes we make as breastfeeding mothers make is allowing our baby's torsos to turn away from us, and thus only the head is turned towards the breast. This does not allow for optimal transfer of milk from you to your baby. An analogy I often us is: think of it as an adult drink liquid out of a straw - it is much easier to drink out of a straw if it directly in front of you, as opposed to off to one side and you having to turn just your head to drink out of it. It's the same for your baby!

2. Does your baby open his mouth wide and tilt his head back prior to latching onto the nipple? It is important for your baby to have this "gape response" in order to ensure a proper latch. This wide latch allows for optimal transfer of milk and eliminates pain and damage to your nipple(s). Your baby will naturally open his mouth and tilt his head back prior to latching, so it is also important to ensure that his NOSE is aligned with your nipple when initiating a feeding at the breast. Aligning the nose with the nipple will ensure that when your baby tilts his head back to latch on to the breast, your nipple enters his mouth so that more of your nipple and areola are in the top half of your baby's mouth. This deep latch, allows him to draw your nipple along the tongue, toward the back of the mouth/throat, and up along the soft palate of his mouth to maximize transfer of milk and eliminate nipple damage caused by a shallow latch and your nipple being compressed against the hard palate of your baby's mouth. 

3. Are your baby's lips flanged out and does she maintain a wide latch throughout the feeding? It is important for your baby to have her top and bottom lips flanged out (i.e. "fish lips"), in order to create the necessarily negative pressure that will allow your nipple to be drawn into your baby's mouth and allow optimal transfer of milk. It is also important to ensure that she maintains the wide latch that was achieved by waiting for your baby to open her mouth wide prior to bringing her head to the breast. The easiest way to see if your baby is maintaining a deep latch is to simply press down on your breast near the corner of your baby's mouth to see if the angle at the corner of her mouth is a wide angle. 


4. Does your baby's jaw move in a rocker motion while sucking? If you watch your baby's jaw line while he is breastfeeding, it typically only moves in two ways; either up and done (like a piston and/or biting), or back and forth (like a rocker). The optimal motion of your baby's jaw during breastfeeding is a rocker motion, as this is an indication of a deep latch. The piston/biting motion is indicative of a shallow latch, and thus can result in pain and damage to the nipple. 

5. Can you hear your baby swallowing throughout the feeding? Hearing swallowing is the best way to know that your baby is getting breastmilk (and it also a very gratifying sound to hear as a breastfeeding mother!). When your milk is fully in, you should hear swallows often, either every suck or every other suck. When your baby swallows, it sounds like they are pushing out a small push of air from their nose/throat. It can be difficult to hear to the untrained ear, but if you sit in a quiet room during a feeding, you should be able to recognize this sound after a few good feedings. 

The last thing that I tell all breastfeeding mothers is that it's ok to break the seal if your baby has a bad latch, and in fact, I encourage this! If you are experiencing pain throughout the feeding or in the middle of a feeding that is going well start to feel pain or notice a change in your baby's latch, then break the seal by placing your finger in your baby's mouth. Then re-latch the baby and ensure she has a good latch by using the points above. And as always, whether you are off to a good start or a bumpy start, reach out to a lactation specialist near you! And for all you Massachusetts mama's feel free to reach out to us by clicking here, to schedule your in-home appointment with one of our lactation specialists. 

Boston NAPS Ultimate Baby Gift Guide

Boston NAPS Baby Gift Guide

We have talked to many moms, helped many families put together their registry list, and have seen countless happy babies rockin' the gifts from our list. 

We've put together a list of 12 items for you, or someone you love, cannot be without!

Boston NAPS baby gift guide
  1. Zutano Newborn Baby Booties –  Losing baby socks because you cannot seem to get them to stay on our active babies can be frustrating. This unique design, with two snap buttons, is the perfect solution.  They also come in many fun colors and cute patterns. 
  2. Boppy lounger – The perfect place for your baby to lounge as a newborn, and play as your baby grows! The fabric is soft and easy to wipe clean and the pillow is the perfect accessory to travel with or move from room to room, as a safe and comfortable place for your baby to relax. 
  3. Uppavista Stroller – This stroller is definitely one of the most popular on the market right now, especially for city living. Some of the best features are its lightweight design making it easy to navigate, fold up and store.  It comes with a bassinet and a front and rear facing infant seat. The rumble seat for toddlers is now made for both front and rear facing, making the 2015 model the best for more than one child.  The best part is, you can add up to 3 kids with skate board as well. It also has a large storage basket underneath, allowing for easy trips to the grocery store or a trip to the mall.  Add the drink holder and parent organizer for convenience as well. 
  4. Wubbanub – These are great pacifiers for self soothing for babies.  The wubbanub, in particular, is great because the weight of the animal makes it easy to keep the pacifier close to your newborn and then over time, as your baby grows, they are able to use the animal to control getting the pacifier in and out of the mouth.  Also, losing pacifiers can be frustrating and this unique design is easy to find in a crowded diaper bag.  Oh, and they’re cute!
  5. i Play summer hat – This brimmed hat is perfect for summer. Not only is the fabric UPF 50+ protection, but also it has an adjustable draw string to fit your baby's head perfect, as well as a chin tie, and neck flap.
  6. Oball Rattle – These rattles have lots of tiny holes in them making them easy to grab and fun to play with.  Stimulate your baby’s motor skills, sight, and sound with this cute toy! Check out all of the toys made by oball including their balls, teething toys, rattles and roll cars that can be used from birth through your child's toddler years. 
  7. Honest diapers – This is a great, all natural company, and their diapers are especially poplar.  They are eco-friendly, super absorbent and just plain adorable with all of the colors and patterns they come in.  The natural material helps prevent diaper burn/rash and the company also allows you to sign up for free samples. 
  8. Pottery Barn Chamois changing pad and crib sheets – These crib  and changing pad sheets are so soft and durable. Any baby would love to lay on this material while they sleep or while you change their diaper. They are great because stains are easily removed and the fabric never looses its softness no matter how many times you wash it!
  9. Baby Bjorn bouncer balance chair with toy bar – This chair is the perfect natural bouncer.  It has three settings that are easy to adjust from an upright bouncer to a reclined sleep position.  It also lays completely flat for easy storage and travel. Add the wooden toy bar to keep your active baby busy and entertained. 
  10. Ubbi diaper pail – This diaper pail is great because it is made of steel and really works for odor control of stinky, dirty diapers. The lid is easy to open and close and you can use any standard trash bag liner inside the can, which makes life that much easier.  They also come in 13 different colors to make your nursery more stylish.
  11. Mustella 2 in 1 Hair and Body Wash – Try not to get addicted to the smell of your baby after a bath with this hair and body wash! It is a tear-free cleanser and is safe and gentle for your newborn.  It is also quite convenient to have the 2-1 feature, especially for travel.
  12. Dohm Sound Machine - This product is great to use form birth throughout life. It's perfect to introduce as a newborn because it mimics the loud, deep toned, constant noise that babies are used to from being in the womb. This also sets the mood for sleep when turned on, and is a great indicator to babies and toddlers that it's nap or bedtime and can easily become part of your sleep routine. 

Can you add to this list? What are some other things you and your babe absolutely cannot live without? Share the knowledge!

Jaundice in Newborns

Boston NAPS blog about Jaundice

If the term jaundice is new to you, it may sound scary and have you a bit worried about your little one. You may be thinking, "Have I done something wrong?" "Can this be avoided?" "What are the potential risks?"

First, there's no need to panic. Jaundice is relatively common in infants and is easily treated if caught early. If you're a new parent, be sure to read this short post on jaundice, so you can be aware and prepared. 

What are the risks?

Most cases of jaundice are mild, caught early, and easily treated. However if left untreated, or if the bilirubin level (the chemical that causes jaundice) increases quickly, the biggest risk is that it can cause brain damage at very high levels. 

What are the signs?

The first sign of jaundice is yellowing of this skin (this is the definition of jaundice), caused by the build up of bilirubin within the baby's blood. The yellowing appears first on a baby's face, and then moves to the trunk, arms, and legs if/when the bilirubin level increases. You may also notice yellowing in the whites of the eyes. 

Should you be concerned?

In most cases, no, jaundice is not something to be concerned about. The reason being, it is recommended by American Academy of Pediatrics recommends that all infants born in the hospital be screened for jaundice and its risk factors and then have a bilirubin level drawn prior to being discharged home if indicated. It is also recommended by the AAP for newborns to have a follow up with a healthcare provider 3-5 days after birth and be screened again for jaundice and its risk factors as this is when the bilirubin levels peak in newborns. This screening process allows for early detection of jaundice and thus early treatment. Treatment is recommended and performed for bilirubin levels that are much lower than those that would cause brain damage. Reasons to be concerned would be if the yellowing of the skin gets worse (i.e the skin turns more yellow or the trunk and limbs begin to yellow) or if your baby is already jaundice and then becomes very lethargic and difficult to wake for feedings. 

Do You Have A Picky Eater?

Boston NAPS blog post

If it hasn't happened yet, chances are, it will. It can easily feel helpless and hopeless (and very frustrating) when your child is just not happy with the food you are offering.

Here are a few tips we offer our moms of children who are picky eaters...

Bring you toddler/child grocery shopping with you.

  • Make this a special even for you and your child(ren). Let them ride in the cart, of if it is a grocery store that has small carts for children, let them use one and pick out their own food items. Children are more likely to try new food if they are the ones who picked it out. 

Allow your child to help you prepare food.

  • Bring over a step stool or a chair and allow your child to participate in the cooking process. Let them mix, add ingredients, and even make suggestions. Just be careful that they aren't around when you are handling anything hot or sharp. 

Hide healthy items in foods they normally eat.

  • Don't be afraid to cut up and add extra vegetables to your grandmother's sauce or meatballs (without offending grandma!), or mix some veggies into the fruit smoothie you make for your child every morning. 

Eat dinner with your child and allow them to eat what you eat

  • Children are more likely to eat more and try new things if they are sitting at a table with their parent(s) and are eating the same foods as us. 

Don't be afraid to let your child go to bed hungry.

  • Some kids are just going to flat out refuse to eat dinner. Don't go crazy offering them a dozen different foods or making each of your children a different meal. Allow your child to eat what you eat, and on those nights they just won't eat anything no matter what you do, don't stress. They will make up for it in the coming days.