How to Get Breastfeeding off to a Good Start

Welcome, Carnival of Breastfeeding readers! I’m glad you’re here. Be sure to check out the other contributors, whose links are at the end of this post.

I have two children, and I had two very different breastfeeding experiences. My daughter Hannah was born 6 weeks early. Between her prematurity, the enforced separation, and my own health complications, it was a rough start. I often felt discouraged and unsure if I could successfully breastfeed her. Jacob, on the other hand, was born at full term with no complications. From the beginning things have been much smoother.

There’s not really anything I could have done to prevent Hannah’s prematurity and our early separation, the two biggest causes of my breastfeeding problems. The good news is like many moms I was able to overcome my difficulties, and went on to have a long and successful breastfeeding relationship. But the things that I learned about breastfeeding in the 3 1/2 years between my babies also helped me get Jacob off to a smoother start. Here are some pointers I have to offer based on hard-won experience:

1. Avoid unnecessary interventions during childbirth.
Research shows that pain medication during labour, including epidural anesthesia, can interfere with breastfeeding. So can medical procedures performed on newborn babies. I would never suggest that you pass up necessary medical treatment. However, there are a some things that you can do to stack the odds in your favour if you want to reduce interventions. The first is to seek out a professional doula. Women who use doulas report lower rates of nearly every type of intervention, as well as greater overall satisfaction with their birth experience. The second is to seek out a care provider who shares a similar philosophy, and to make your wishes clear before you’re in the delivery room. And if things do go sideways, go easy on yourself and remember that the most important thing is that you and your baby are healthy and safe.

2. Spend the first hour (or longer) skin-to-skin with your baby.
Skin-to-skin contact between moms and babies is also called ‘kangaroo care‘. It involves holding a baby wearing nothing but a diaper upright against mom’s bare chest. Babies held this way receive many benefits – their breathing and heart rate are regulated, and their body temperature is, too. Any adult can do kangaroo care, but there is a special advantage for moms. When held skin-to-skin many babies gravitate towards the breast and begin to nurse spontaneously. By spending your baby’s first hour skin-to-skin you can help your newborn to transition to life in the outside world and facilitate breastfeeding.

3. Try baby-led latching.
Back in 2005 when Hannah was born the conventional wisdom dictated a mother-led approach to breastfeeding. You lined the baby up, waited for the mouth to open wide, and then used ‘rapid arm movement’ to get the baby latched. And while it sounds simple, it’s pretty hard to co-ordinate when you’re holding a wiggly newborn. A new approach, called baby-led latching, is becoming the preferred method of bringing baby to the breast for the first feeds. Championed by Dr. Christina Smillie, it follows naturally out of skin-to-skin contact between mother and baby. You can find detailed instructions online, as well as a review of her fabulous DVD. I used baby-led latching with Jacob, and he really did know how to nurse effectively right from his first moments.

4. Keep your baby with you as much as possible.
Breastfeeding is a two-way street, it requires mom and baby to be together. By keeping your baby near you, you can ensure that you pick up on all your baby’s feeding cues. Babies often have a harder time latching successfully when they’re very hungry and upset, so being present and proactive is a real help. While separation is sometimes unavoidable, the more time you can spend with your baby the better in establishing a good breastfeeding relationship.

5. Nurse frequently in the early days.
Breastfeeding is a supply and demand system. In general, the more that your baby nurses, the more milk you will make. This is particularly critical in the beginning when your milk supply is being established. By bringing your baby to the breast at least 8-12 times in a 24 hour period, you are ensuring that your body receives the proper signals to set up a healthy milk supply. In the days before your milk comes in frequent nursing also ensures that your baby gets lots of colostrum. Colostrum is the yellowish liquid produced by the breasts during pregnancy and immediately postpartum, and it’s packed with immune factors. It also has a laxative effect, which can help prevent jaundice. Colostrum is the perfect first food for your baby’s immature digestive tract. Nursing frequently in the early days really pays off in the long run.

6. Breastfeeding shouldn’t hurt.
Some moms report that nursing really hurts. When your baby is nursing well it shouldn’t hurt and it definitely should not result in nipple damage. If you find breastfeeding agonizing, it’s a sign that something is wrong, and no one else can evaluate that as well as you. It’s especially important to remedy the situation because nursing pain can be a sign of a poor latch, and when a baby isn’t latched well he or she can’t nurse as effectively. If you find a lactation professional dismissive of your pain, please seek out other information and opinions until you find a solution that works for you.

7. Avoid introducing a bottle or pacifier in the first month.
The skills needed to drink milk from a bottle and to breastfeed are different. While many babies are able to switch back and forth without problems, not all babies are. And you can’t tell if your baby will have a problem until you try it. Most lactation professionals recommend avoiding artificial nipples in the first 3-4 weeks of a baby’s life. Meeting your baby’s sucking needs with a pacifier may decrease breast milk intake as well, since it may reduce the time spent at the breast.

Those are my tips for getting breastfeeding off to a good start. I’d love to hear any great pointers you have, too.

Don’t miss these other breastfeeding ‘how-to’ posts.

  • Motherwear: How to help your baby kick the nipple shield habit
  • Mama Saga: How to breastfeed (Or just look like you know what you are doing)
  • The Marketing Mama: How to pump successfully at work
  • Baby Carriers Downunder: How to breastfeed hands free
  • Breastfeeding Moms Unite: How to become a breastfeeding support professional
  • Milk Act: How to care for a sick nursling
  • Maher Family: How to increase breastmilk supply using supplements
  • Blacktating: How to treat a cold while breastfeeding
  • The Bee in Your Bonnet: How to be comfortable around a breastfeeding mom
  • Breastfeeding Mums: How to wean a breastfed toddler
  • Mama Knows Breast: How to get a spouse to help with breastfeeding
  • MoBoleez: How to (naturally) increase your milk supply – try seaweed!
  • Happy Bambino: How to deal with family members who aren’t supportive of breastfeeding
  • Breastfeeding 1-2-3: How to teach your baby nursing manners
  • Natural Birth and Baby Care: How to improve milk supply through nutrition
  • zen_mommy: How to use YouTube to STOP nosey questions!
  • Tiny Grass: How to tandem nurse without driving yourself and your nurslings crazy!
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      Comments

      1. Fabulous post, Amber. I will save this as a link to send on to my friends who need assistance. I am soooooo lucky to have three wonderful breastfeeding experiences. I’m not sure why but I did follow most of your points . . . my midwives were fantastic, so helpful and supportive. I loved that skin-to-skin contact in the first few hours, just laying in my bed nursing a new baby. Moments I will cherish for the rest of my life. :)

        p.s. I’m so sorry your first experience was less than perfect. It makes me so sad when I hear stories like that . . . thank goodness you’re getting an easier go of it this time around!!!

      2. The baby-led latching sounds interesting – wish I’d heard of it before. Q-ster was born the same year as Hannah, and I was also taught what you describe as mother-led latching. Thanks for the tip – I’ll mention it to any future first-timers who ask for input.

        I got lucky that my boys were very flexible with breast and bottle from day one. For Q-ster, I had developed pre-eclampsia and had to take meds for a week that prevented me from nursing, but he transitioned over to the breast really well during the second week. Things went much more smoothly for Buster, thank heavens.

      3. It is a great post, although to be entirely truthful I’m not sure how I feel about telling people to avoid epidurals and pacifiers. Having information is helpful, but until you’ve been there it can be really hard to understand that you just get the labour and delivery and baby you get, and telling people they should plan to avoid all this stuff can lead to anxiety and guilt. I was determined both times to be medication free, but my body was just determined not to dilate beyond seven centimetres without oxytocin — the second time it was my midwife advising me to take the epidural, after sixty hours of labour and no further progression. When Angus was born, the nurse on duty asked very carefully if I wanted to consider a pacifier after I’d sat up after a c-section nursing him continuously from eleven at night until four in the morning. The pacifier was a life-saver and there was no nipple confusion.

        I know I sound defensive. I feel defensive. It’s almost impossible not to with all the information we have, and the fact that it seems that as smart, capable women we should have more control over birthing babies. I agree equipping expectant mothers with all the information possible is valuable. I just think the first and foremost piece of advice should be something like: expect the unexpected and don’t beat yourself up over things you can’t control. (I know you did kind of say that.) I didn’t have a doula, but my sister did, and if I ever did it again I would definitely have one.

        Whew. Is 8:42 a.m. too early for vodka?

      4. Great post Amber, and chock full of useful info (def worth bookmarking).
        re: epidural and breastfeeding – hmmm. compared with using some of the opiates and injectable pain relief i would consider an epidural as far superior if you have to take this route (gas and air was a waste of time). the epidural drug doesn’t reach the foetal circulation or suppress infant reflexes since it circulates in the spinal cord space of the mother. i know i chose this type of pain relief specifically for this reason. also if labour does indeed progress to a c-section it’s easier to remain ‘alert’ (ho ho) for that crucial one-hour window of bonding and initial breast feeding post op. we (wee guy and i) had a blissful first feed together only half an hour after delivery by c-section. he was responsive and i was capable. it worked, and compared with some of the nightmare that followed, it was the best decision.

        and yes, — doula, most definitely!

      5. My eldest child didn’t latch for four days, no matter what we did. We did everything “right” and it still didn’t happen. In our case, what we needed was patience and a nipple shield.

        Our second was born and I expected a fight. She had her own ideas. As soon as she got within a couple of centimeters of the breast, she latched happily and perfectly. For us, the experience of baby-led latching was the clincher, I think.

        You’re right that we can’t control our birth experiences or the ease with which our breastfeeding relationships form, but we can do our best to stack the odds in our own favour.

      6. The baby-led latch is interesting. I will have to think about that. No one was with me with my second for the first feeding, so we were kindof on our own. And, I have to say, it was MUCH more painful that first few days than with my first. Odd.

        Definitely getting stressed about it doesn’t help much.

        Thanks for the good advice!

      7. I think most women are not really giving informed consent when they agree to or ask for the epidural. It causes so many problems, including nursing problems. I am glad that more moms are birthing naturally again and rooming in with their babies and initiating breastfeeding at the hospital.

      8. Relaxing is so important- and I think a lot of new moms (and repeat moms- the newborn stage is easy to forget) get very worried about whether or not what the baby is doing is “normal.”

      9. Thank you so much for helping moms-to-be and new moms to understand how to become great at breastfeeding. I breastfed my 2 boys until they were each 14 months old. I got pregnant with my second when my first was 10 months old and I continued breastfeeding for 4 months. 98% of all moms out there are physically and mentally able to breastfeed, and start their newborn’s life by doing it. There is no good reason to explain why so many stop, except the fact that they experience lack of support and societal pressure. It’s time to enpower women to make breastfeeding a first step in their baby’s life. Breastfeeding moms rule!
        Read What I felt compelled to put together on the 10 things people don’t tell you about breastfeeding on my post at:
        http://perfectingmotherhood.wordpress.com/2010/05/28/10-things-people-dont-tell-you-about-breastfeeding/

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