Although breastfeeding is "natural," it does not come "naturally" for many mothers. The mechanics can be awkward, and moms may experience discomfort during initial attempts at breastfeeding. You are expected to ask many questions and may even have specific problems. Hospitals and birthing centers usually have many staff members, including lactation specialists, nurses, and pediatricians, who can offer expert assistance. Take advantage of them. If breastfeeding classes are offered, attend one after you deliver (even if you attended a class during pregnancy), particularly once you have tried to breastfeed. You also can ask for help from family members and friends who have breastfed their babies. The following information will help you get started.
Most babies are physically ready to begin breastfeeding within 30 minutes to an hour after delivery, and experts recommend that the first feeding occur during this time. Although only a small amount of liquid may be released from the breast, this early milk, called colostrum, is loaded with calories and infection-fighting proteins. This first feeding also stimulates the baby to nurse better later on. Furthermore, after an initial period of wakefulness, many babies are sleepy and not interested in feeding for 24 to 48 hours.
Successful breastfeeding depends on proper positioning of the baby and the baby's mouth. You can sit up or lie down (whichever is more comfortable for you) while you hold the baby in one of several positions. Sitting positions include the cradle, cross-cradle and football holds. The following descriptions refer to breastfeeding on the left breast.
- In the cradle (or Madonna) hold, nestle the baby's head in the crook of your left elbow while supporting the baby's body and buttocks with your left forearm and hand. Hold the baby close to you, facing your left breast, with his body turned toward yours, tummy to tummy. Use pillows to make yourself comfortable and bring the baby up to breast level. Support your left breast with your right hand, placing your thumb on top and your other fingers underneath, well away from the nipple and areola.
- The cross-cradle is a slight variation of the cradle hold, with arm positions reversed. Hold the baby with your right arm, supporting his head and neck with your hand, his body with your forearm, and his bottom with the crook of your right elbow. Support your left breast with your left hand. Many mothers find this position useful during the first weeks because it gives the mother more control.
- In the football (or clutch) hold, position your baby so he is facing your left breast with his body wrapped around your left side, under your arm. Support the baby's head and neck with your left hand and his body with your forearm and pillows. Support your left breast with your right hand. This position may be more comfortable than the cradle or cross-cradle holds for a woman who has had a Caesarean section.
- In the side-lying position, both you and your baby lie on your sides facing each other. (You will be on your left side; your baby will be on his right side.) You can cradle the baby in your left arm with his back along your forearm. Support your breast with your right hand. You also may find it helpful to place pillows behind your back or your knees, and a pillow or rolled blanket behind your baby's back. Many mothers find this position especially useful for middle of the night feedings.
You may have to try several positions before you find one that works best for both you and the baby. Always take time to make yourself comfortable. When supporting your breast, don't put your fingers on the areola (the darker area around the nipple). Once you are ready, line up your baby's nose with your nipple. Tickle your baby's upper lip or the side of his mouth with your nipple to get his mouth open. When his mouth is open wide (like he is yawning), aim your nipple slightly toward the roof of his mouth and pull his body in quickly toward you, chin first. If he has latched on properly, his mouth will cover most or all of the areola and his lips will be turned outward. The nipple will be deep in the baby's mouth, with no movement around the nipple or noise when the baby sucks. If you have pain during breastfeeding, it is most likely due to problems with positioning. Insert your finger into the corner of your baby's mouth, between the gums, and gently break the suction. Put the baby to your breast again, paying careful attention to positioning.
As a general guide, the full-term, healthy baby determines the length of the feeding. But every baby is different; some will nurse longer, some shorter. Let your baby finish at one breast before switching to the other side. Alternate which side you offer first; if you end with the left breast, start with the breast that feels fuller. Be sure to initially breastfeed your baby when given the cues, at least every two to three hours around the clock (eight to 12 times every 24 hours). For the first few days, you will continue to produce small amounts of high-calorie colostrum, which gives your newborn all the nutrition he needs and is especially easy for him to digest. Nursing your baby stimulates your body to produce transitional breast milk, which will start flowing steadily around two to five days after birth. At about 10 to 14 days, your breasts will be producing mature milk.
Remember that most new moms find it extremely helpful to have assistance when learning about breastfeeding. Even moms who have breastfed a previous child may have questions about breastfeeding a new baby. Don't be afraid to ask your health care provider for help.