Breastfeeding

How Do I Start breastfeeding?

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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.

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. 

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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.