Saturday, March 14, 2015

Getting Breastfeeding Off to a Great Start

Skin to skin family bonding after birth!
by Glenni Lorick, IBCLC

You know that you want to breastfeed your baby, but maybe you've heard stories about mothers who didn't make enough milk or who had a variety of problems. Many (not all) breastfeeding problems can be avoided by getting off to the right start. Today we're going to examine what that looks like!

Immediate Skin-to-Skin

The first step to a long term breastfeeding relationship is skin-to-skin contact right after birth. Let the nursing staff know that as soon as baby is born you want him placed directly on your chest. They can do all of the procedures that they need to do with baby right there on your chest. He doesn't need to be placed under a warmer because your chest is the perfect warmer for him!

Skin to skin before baby is bathed is best!
Baby will be placed on your chest naked and a warm blanket will be used to cover both of you. Some hospitals will allow you to delay eyedrops until after the first feed. It is important to note here that if there are any complications with mother or baby, this may not be possible. 

If you labor without any medication, your baby may actually latch on by himself with no help from you at all after birth. However, if you do have an epidural or even a C-section, your baby will still be ready to nurse within the first 30-45 minutes after birth.

Baby on top of mom for feed.
Research shows the following benefits for immediate skin to skin contact:

  • It helps regulate baby's body temperature
  • It helps regulate baby's breathing
  • It helps to raise baby's glucose levels
  • It facilitates breastfeeding

Positioning Baby for First Feed

If you are in a reclined position, baby may just lay right on top of you either horizontally or vertically. Baby will most likely be able to latch on with little or no help from you! 

If you feel like sitting up  instead of lying down, then you might find a reverse cradle hold or a football hold will help provide the support baby needs to stay on the breast. 

The goal of the first feed is to let baby achieve the best latch possible with as little intervention as possible. 

Baby lying horizontally with mom reclining.
Listen for swallows during the first feed.  The sound almost like tiny sighs. You should see movement all through baby's jaw, and you will see her throat move as she swallows. Even though your milk isn't in yet, your baby is getting colostrum that will form a protective seal for her intestinal tract and provide her valuable immunity. 

Let baby stay latched as long as he wants to. If he comes off and is interested in nursing on the other side, then switch sides. If not, then you will just nurse on the other side next feed.

During the First Few Days

A good latch with very little areola showing.
Every time you nurse your newborn during the first few days of life, you are creating prolactin receptors on each of your milk glands. Research indicates that early frequent feeds are a key indicator for successful long-term production of milk. You need to nurse your baby every 2-3 hours around the clock from beginning of feed to beginning of feed. The first four days or so, your newborn needs to nurse AT LEAST 10-12 times in a 24 hour period. Some babies may nurse even more!

Usually mothers who nurse frequently in the first few days have their milk come in by the fourth or fifth day. At that point baby still needs to nurse at least 8 times a day, but many will continue nursing 10 or more times in a 24 hour period. 

Upper and lower lips should be flanged.
When you nurse be sure that baby has a good latch. Latch him on with his chin low on your areola. Support your breast using a C-hold with your thumb on top and your fingers on the bottom below the areola, aiming the nipple up toward the back of baby's mouth. Wait for him to open his mouth as wide as he can, then pull him on tight. Your partner can tuck a rolled up blanket behind the hand that is supporting him for extra support. You should note that his lips are flanged , and you should see very little areola (unless you just have really big areolas!)

If It Hurts

If a baby has a good latch, your nipples will not crack or bleed. You may experience some tenderness as you get used to breastfeeding, but if your toes are curling and it's all you can do to let your baby near your breasts, then something is definitely wrong! If you are still in the hospital ask to see a lactation consultant as soon as possible. If you are home, call for the next possible appointment. It could be a problem with baby's oral anatomy or it could be that baby's latch just needs to be adjusted, or maybe your baby just needs a little bit of suck training. But get help immediately to resolve whatever issue you're having so that you and your little one can have a terrific breastfeeding experience!

Feed your baby early and often!

Special thanks to all the ANM mamas who shared these precious photos with us!!

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