Breastfeeding is one of those things that is so difficult at first but months after you know exactly what you should have done in those first few days and weeks with your newborn.
Why?
Because breastfeeding is unlike anything you have done before and the learning curve is steep. You need a lot of breastfeeding tips when you are first starting out, you have to figure out when baby is hungry, if baby is getting enough, how to latch, how to keep baby on the boob, how to establish a good supply, how to pump, and the worst, when you miss the hunger cue and have a screaming baby, how to calm baby down enough to latch and nurse. I was under the impression that baby would somehow tell me when they were hungry.
So I wasn’t ready to successfully breastfeed until someone told me exactly what I needed to know to succeed and luckily for me, I had a fantastic lactation consultant at the hospital who spent hours with me each day I was there helping me.
I am also the type of person who has to ask a lot of questions, so I felt that I left the hospital understanding so much more than I even knew existed about breastfeeding. Because this information was paramount to my success, I want to share with you all she told me.
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IMPORTANT NOTE: Some of these points might go against what you have read elsewhere and I think this happens because more often than not, people do not post ages with their advice. A baby changes so much that advice for a newborn is different than advice for a 4 month old or even a 6 month old. Here, I am telling you about how to start your breastfeeding relationship with your newborn (0-4 months) so you and your baby can succeed at breastfeeding.
Sucking produces a let-down. It takes at least a few minutes of sucking to cause a let-down. In the beginning, it can be very hard to keep baby on a breast long enough to achieve a let-down. Another way a let-down is sometimes produced is due to hearing a baby cry. Crying is a signal to your body that baby is hungry.
So this is essentially how milk works: Milk is produced and accumulates in the breast. Sucking initiates a let-down. Milk is released at first very fast. This milk is the foremilk and is mostly water to quench baby’s thirst. After a few minutes, the flowrate of milk slows down as the milk changes to hindmilk. Hindmilk is baby’s food and is very fatty. Therefore, it is important to keep baby on for the full duration so they get both the foremilk and the hindmilk. The milk slows down to a stop and that completes one let-down. If baby stays on and continues sucking after one letdown. The milk will stop flowing for about 5-10 minutes. If baby stayed on, your body will produce another let-down and the process will repeat.
The quantity of milk produced is actually quite a simple system in most cases. The more the baby sucks (even if there isn’t milk coming out), the more the body makes. More sucking signals to the mom’s body to make more. Therefore, there is absolutely no harm in letting baby continue to suck on a boob after you think they are done, and there is no harm in feeding them “too often”. Extra sucking will just mean your body will make more milk for baby. You actually can’t overfeed a baby breastmilk, but you can overfeed a baby formula. Just another great reason to nurse baby.
The term on-demand is used a lot, meaning you allow baby to feed whenever. This is awesome and you should totally do this. Why? First, you can NOT overfeed a breastfed baby so nurse, nurse, nurse, can’t overdo it. It really helps guarantee success in nursing. However, while I started out intending to do on-demand breastfeeding, I found that I didn’t know when to offer baby the boob because how did I know when baby was hungry (see more on point 3).
Some medical reasons result in a low milk supply, but a lot of times the supply is never able to reach correct quantities because there wasn’t enough nursing in the first few days and weeks following baby’s birth. Nursing often enough in those first days and weeks is also emphasized in the online breastfeeding course by Cindy and Jana, two registered nurses who are also lactation consultants.
Feeding on demand was a very confusing concept for me. I knew that this was important to not only establish my supply but also because the only person who could tell me that my baby was hungry was my baby. But my baby couldn’t say “I am hungry” so how was I supposed to feed on-demand (when she was hungry)?
One way is to recognize the early hunger cues. These include turning head side to side, eating hands, and rooting. The late cue (crying) meaning you missed the early cues. For a newborn, the time between early cues and late cues is anywhere from 5-15 minutes because their tummies are so small and empty so quickly.
A side note on eating hands: everyone will tell you that is how babies explore or they are teething. Both are true, and this is a perfect example of why advice should always have an age with it because exploration doesn’t start until at least 3-4 months and teething doesn’t start until 4 months. Before that, it is an early hunger sign. But as a new mom, a lot is going on and it is easy to miss hunger cues because you aren’t always looking for them. You and baby are getting to know each other. In a few weeks, you will be able to catch hunger cues well.
Looking back at pictures from when L was a newborn, I noticed in many of them that she was clearly rooting on me and I had no idea, like in this pic on her first day home from the hospital.
When baby is fussy and won’t latch, you might think the baby is tired. This would apply to an older baby. A newborn will sleep whenever wherever as long as they aren’t hungry. In fact you might find it hard to keep them awake long enough to finish a nursing session. It is very normal for a newborn to fall asleep nursing, as your milk contains hormones that promote sleep. Try to nurse for as long as possible to get both the foremilk and hindmilk but don’t worry if they fall asleep nursing. At this age, you will not create any bad habits.
Seriously, worry about sleep later. Everyone agrees that sleep training should always be after at least 4 months. In fact, a baby's brain starts t produce it's own melatonin at around 4 months. So, no matter what your thoughts are on sleep training methods or the subject, at this age, breastfeeding matters the most. Feed baby as often as possible to build a fantastic supply. Your milk supply grows the most and is fully established by 3 months so it is extra important to build the supply early on. After that, you can change it somewhat, but it is very hard to do so.
Always nurse (or offer a boob) at least every two hours even if you feel like you just nursed baby. The 2 hour window is small and you will feel like you are doing nothing but nursing. It’s even a smaller gap because the two hours are from the start of one feeding until the start of another. So when you start nursing, set a two hour timer on your phone. This was so important for my sleep-deprived self. I also had a colic baby, which really took a lot of my energy. If baby shows hunger signs before then, feed baby and restart your timer. I used the timer method in the daytime for the first 3-4 months because it was so easy to lose track of time. It also allowed me to avoid having any supply issues because nursing often in the early months really builds up your supply. Y
If you are more of a pen and paper type person, having a visual chart to track baby’s feedings can be a useful addition to using a 2-hour timer. Many new moms do this and find this useful. Tracking nursing can serve as a point of reference to show the pediatrician or a lactation consultant if your child is having problems with gaining. It can also be useful in noticing patterns in when your baby eats for longer periods of time, more often than every 2 hours, and to look at initial night-time patterns emerging. All of this can be helpful in forming a “routine” (I use this term loosely) when your baby is around 12 to 16 weeks. We offer breastfeeding, diaper and weight gain trackers in our breastfeeding handbook.
Now you could ignore this advice, and just wait for baby to signal they are hungry by crying but it is so much harder to get baby to latch on at that point. Their patience level is now low because they are very hungry. Once you finally calm baby and get a good latch, baby will vigorously suck and then pull off screaming, trying to tell you that there isn’t any milk. All because they haven’t stayed on long enough to produce a let-down. Parents try to then use a pacifier to calm baby, which will placate a baby but increase baby’s hunger even further as time goes by. If you get into this situation and cannot manage after trying a few times to latch baby long enough to produce a let-down, see point 19.
At night, for the first week only let baby sleep four hours and then nurse. After the first week, do not wake baby to nurse but instead always nurse baby when they wake in the night. Again, worry about sleeping through the night later. If you have a good sleeper and they are already sleeping a lot of hours at night, you might run into supply issues. To understand why nursing at night is so important to your supply see point 12.
Breastfeeding is hard at first, and you might be envious of your formula feeding friends because right now their life is easier. However, that all changes after you conquer the learning curve. To achieve this, you need to be equipped with breastfeeding knowledge such as the information here, but your partner must also be equipped with breastfeeding knowledge, so they know best how to help you. The example used in the Simply Breastfeeding Course by Cindy and Jana is if your partner tries to help by offering to give baby a bottle, it’s actually counterproductive. It will hurt your supply make nursing harder down the road. It is better to arm your partner with ways they can help you succeed.
It was also extremely important to me that my husband knew how much breastfeeding could benefit the baby. I really wanted to breastfeed in the first hour because doing so reduces infant mortality by 50%, which is A LOT. My husband could not only help to make my wishes clear during delivery but also having him educated on the benefits of breastfeeding made him want breastfeeding to succeed for our family also.
Outside of your partner, you need to have a support network. If you don't have a support network, you need to be working on that now, take our free 5 day email course to start building your support network.
How often do you switch? What side should you do? Should you do both sides each time?
I just couldn’t figure this out in the hospital. The lactation consultant told me that 15 minutes once baby is swallowing milk is a good rule of thumb to ensure baby gets both fore and hind milk. Switching too soon just gives baby a lot of fore milk which isn’t fatty. To know where baby is in the feeding cycle (fore milk vs hind milk), see point 21. If baby is still hungry, then switch and nurse from the other breast as well. I have found that while one breast can produce enough for baby, my baby was never patient enough to wait for another let-down from the same side, so I would usually do both sides every time. When the let-down occurred, she would nurse from one side and then switch to the other side, which already had milk ready. This is because when a let-down occurs, it occurs on both sides.
In the beginning it is a good idea to start each nursing session on the side that was nursed on second if you nursed both sides, or the opposite side if you only nursed on one side. This is because baby’s initial sucking will be the most vigorous so by alternating which boob is nursed first on a regular basis you will help your body to regulate a more even supply on both sides (though some variation is normal). It will also ensure that each side is adequately ‘emptied’ to help prevent clogged ducts. Accidentally skipping a feeding on one side, or nursing the same side twice in a row can lead to clogged milk ducts on the neglected side. You can read more about this in point 16. You will undoubtedly lose track of which side you nursed last and whether you did one side or two. A good trick to help is to keep a hair tie on your wrist. Simply switch the hair tie to indicate which side you should start on next time. They also sell little clips that you can wear to keep track also.
As a point of reference, L would nurse from each side for 20 mins at this age. At first you might not feel your let-downs so look to see if baby is swallowing to know. After about a month, I knew when my milk would let-down. It is a tingling sensation.
One misconception about breastfeeding is that when you nurse, your breasts empty and need time to re-fill. Your breasts are continuously filling because your body is continuously making milk. Your breasts might feel fuller at some points and emptier at other points. When they feel very full, it is usually because you haven’t fed baby in a while and your body has stored the milk in the glands in your breasts. When your glands are full, the milk production slows down but continues while your glands are emptied. When they are empty, milk production will occur at a faster rate. Once baby starts sucking, a let-down will occur and the glands will empty. After a while, no more milk will come out, which makes you think your breasts are empty. What is happening is not that your body never stopped producing milk, it just stopped releasing the milk out of your breasts. If you wait about 15 minutes, sometimes shorter, another let-down will start and the milk that your body was making is released.
Also, your boobs will feel empty in the evening, but they are not. The milk in the evening usually has more melatonin in it to help baby sleep. Baby doesn’t produce this until they reach a certain age, which is why babies usually sleep after nursing. Your boobs will also feel empty if baby is gearing up for a growth spurt and is constantly nursing. This does not mean your supply is low or baby isn't getting enough.
Having multiple let-downs all in a row or very close together is known as cluster feeding and baby does this to increase the amount of milk they are getting. This is very common when baby goes through a growth spurt and they go through a LOT. A rule of thumb for growth spurts is that they occur around 3,6,9 weeks and 3,6,9 months are the big ones. If all baby wants to do is nurse, let them. They know what they are doing. Your baby is the only thing you need to produce enough milk for them. Cluster feeding also takes place by allowing baby to feed from one breast, then switching back and forth between breasts if they still want to nurse. It is essentially marathon nursing for a few hours and when women are trying to increase their supply, they mimic this type of nursing using a pump called power pumping. However, be careful to not switch sides too soon as you want to make sure baby gets the hind milk in addition to the fore milk.
It is not uncommon for one breast to produce more milk than the other but it is still important to try to nurse as evenly as possible. If you don’t nurse from both sides, one side will quit producing milk altogether. Another reason for babies to prefer sides is how you hold them depending on if you are left or right handed. I know for me it was always easier to hold L to nurse on my left and it always felt uncomfortable or awkward on the other side. Interestingly, most babies who have a side preference have a side preference for the left side because they can hear your heart beat (isn’t that sweet).
Another reason I found the advice of setting a timer to be so helpful is because it is very easy to lose track of time with all the visitors and company that newborns attract. Baby might be hungry but because they aren’t near you, they don’t know how to signal that hunger (rooting). You smell like milk to them so when they are hungry, they know to search for the breast. However, they may not search for the breast while being held by a friend of family member. Then, when baby is handed back to you, baby will be over-hungry and start screaming the moment you hold them. Most babies when they reach that point are challenging to latch.
Baby might try rooting on other people, which can tell you that baby is hungry. If so, don’t wait, just tell your guest “oh, baby is rooting, time to breastfeed”. If you wait, baby will be very fussy and challenging to latch. As I have stated before, the earlier you are in your breastfeeding relationship, the more important it is to feed baby on cue and often.
So, spread your guests out over weeks or do a sip and see. Everyone always wants to visit the first week and that is hard on you. After the first few weeks, you and baby (and dad) have spent a lot of time together alone at home, so it is nice to have a visitor once in a while.
I consider this a breastfeeding basic because eye contact during nursing is one of the first ways baby begins to bond with you. During the first few weeks, baby sees best at the distance that is your face to your breast. This means while baby is nursing, baby can see your face. Making eye contact is so important and is one of the first things you can do to create a strong bond and attachment. This means, put down your phone so that breastfeeding is enjoyable. Enjoy the cuddles. Enjoy holding your baby in your arms and watching that adorable newborn. Take in their cute cheeks, eyes, and tiny wonderful toes because they grow so fast. Before you know it, this special bonding time will be a distant memory. Make sure to live in the moment and enjoy.
As I have mentioned a couple of times, your milk continually increases in supply until 3 months. To make sure you maximize your supply, nurse often and nurse at night. Try to not be away from baby for longer than a few hours. If/when you go back to work, have a good pumping routine in place and check out power pumping if you feel your supply isn’t where it should be. You will know this by baby not being full. A great way to get a let-down started at work is to record your baby crying for a minute on your phone. Play it and it will produce a let-down. The reason this works is because crying is how baby communicates with you that they are hungry.
If your baby is wanting to nurse every 60 minutes and you think they can’t possibly be hungry because you just fed them, well, it is very likely baby is hungry. Breastmilk is so quickly and well digested that breastfed babies need more frequent feedings than formula babies at the start. This is very important to understand if you are exclusively nursing. I don’t want you to get the wrong message here. You should breastfeed your baby and yeah, it is really hard, but it is so worth it. The benefits to both you and baby are immense. Plus, as you keep nursing, you will find that over the year it has become your bonding and snuggle time. I almost quit in the beginning because it was so exhausting, and I am so grateful I stuck it out. Nursing my child has produced some of my greatest memories and to me, it was so amazing to be able to nourish my baby (better than anything else I could have given her) and provide a place of warm comfort.
Expect marathon (cluster) sessions when baby is going through a growth spurt. The lactation consultant before I left warned me of the “velcro baby” that is 7-10 days old. This is when the first growth spurt happens and their primary job during that time is to increase your supply so it keeps up with their needs. They do this by nursing a lot more than normal, especially in the evenings. So sit down, grab a novel, or put on a show, or just enjoy the snuggles and let baby nurse. And remember, it doesn’t stay this challenging, the most intense is at the beginning and it just keeps getting better as time goes on.
Your body determines how much milk to make each day. This means every day you produce a different amount. Your body continues to increase the amount of milk you make until 3 months. At that point, your milk supply is established. After that point, it is very hard to increase your supply (but not impossible). Once a baby is 3 months old, the amount of milk they need each day doesn’t change very much anymore. This is why breastfed babies usually gain weight way faster at the beginning and then slow down. Whereas formula fed babies gain weight slower at the beginning, but gain more once they are a bit older, 4 months and beyond.
To ensure your milk supply is high enough to meet baby’s needs. Nurse as often as you can in those first 3-4 months. You can’t over breastfeed baby. Nursing baby at night is extremely beneficial to your supply. The hormone that produces breastmilk is regenerated overnight while you sleep. Meaning every time you sleep, your body produces more of the hormone. So simply, baby wants to nurse during the night because there is more milk becoming available. This is also why you will always have a lot more milk in the morning than in the evening, which is 100% okay and doesn’t mean you need to supplement. Every time you do a nighttime feeding, you increase the milk production hormone, leading to more milk. While it is tempting to let someone else feed baby pumped milk at night or do formula, you are just hurting your supply in the long run.
You will find that nursing "correctly" in that first week is not only critical but also tricky.
Newborns are super sleepy in their first few days of life. It is very common that baby will fall asleep after getting a tiny bit of milk because milk contains melatonin. You want to ensure baby gets a full feeding. Full feedings mean that your breasts emptied more and will signal to make more milk faster. To do this, you can follow this diagram below.
At the beginning, you produce colostrum. Then over the next few days after birth, your milk will slowly come in. The more you nurse, the faster your milk will come in. You NEED to be sure you are producing and that your milk is coming in. To do this, ensure that when you feed baby, baby is actually swallowing and not just sucking. If you can’t see their throat to check for swallowing, ask your partner to watch.
This is SO important, because usually your milk comes in after you leave the hospital and go home. If for some reason your milk isn’t coming in, your baby will not be getting enough. After a few hours they will be suffering from dehydration and starvation, please pay special attention here and call your pediatrician immediately if you are worried. Another way of knowing that baby isn’t getting milk or that your milk isn’t coming in, is that you never have a satisfied full baby. If you are still worried, check by pumping for 15 minutes each day and see if the amount is changing color and increasing in volume. If you do pump, don’t store it. Feed it to baby using a syringe. Baby needs everything you are producing in the beginning.
It is very tempting to start trying to work on sleep before 4 months of age but I am going to try to convince you that your time is better spent focusing on breastfeeding. It is also okay to have a messy house and to give yourself plenty of time to recover and not worry about getting back in shape. These things will all come with time, I promise. Babies need to nurse a lot in those first few months to increase your supply. If you focus on feeding on demand and not on sleep, then you will be set for breastfeeding baby for however long you want to. You can’t decide to focus on this months later, breastfeeding is very time sensitive.
Before 4 months, every professional recommends no sleep training because they haven’t gone through the milestone of knowing how to self-soothe. So, no matter what your sleep plan is, for the first 4 months, get baby to sleep any way possible. Nurse, wrap, hold, rock, swing, etc. My favorite is using a swing, which you can keep putting on a lower speed every two weeks or so until it’s not even moving. You can then place the swing next to the crib not moving. Then place baby in the crib. Transition to the open space of the crib by using a Magic Merlin Sleepsuit.
When you leave the hospital, they will say if you get a fever to call immediately. This is because of mastitis, an infection that can occur in the breast. It is horrible. Your breast will feel painful and usually hot to the touch. You will feel like you have the flu (fever and chills). When your milk comes in, it comes in fast, so it is very easy to get a clogged duct, which can lead to mastitis. To prevent this, when your milk comes in, nurse baby often and ASAP. Your milk coming in will make your breasts feel rock hard. If you have some pain and/or lumpiness in a breast, be sure to nurse from that side as much as you can. You can also run the pump to try to get a clogged duct free. Milk can still come out because there are a lot of ducts. Another awesome trick is to take a warm wash cloth or a heating pad and put it on the side of the breast that is painful (where you have a clogged duct). Then pump and/or nurse. It is important to treat a clogged duct immediately to avoid a heavy-duty amount of antibiotics. These can enter your breastmilk and therefore enter baby. It is best to keep baby free from unnecessary antibiotics, so they can establish healthy biofilms throughout their body.
Nursing should not be painful. If it is, the latch is not correct. Ensure first you are encouraging a good latch by not putting the nipple in baby’s mouth but instead put your nipple right under their nose. This will ensure a good latch. Another option you can try is to lay down on your back and place baby on your belly near your boob. Then hold and guide baby to your boob but let them latch. They will usually latch very well this way. If you are still having a lot of latch issues, I highly suggest seeing a lactation consultant to check that there isn’t an issue with a tongue or lip tie. This will result in baby getting a lot less milk because they can’t effectively nurse. An untreated tie could lead to a low supply and painful nursing.
If baby is content, then yes it means baby is not hungry. However, if baby is upset or fussy. Your baby is probably hungry. You either missed the hungry signs or baby didn’t give any besides getting upset. If you can’t get baby to latch, try to calm baby down into an almost sleep state and then try again. You can also try my trick in point 19. Again, when baby is older, they could also be tired. But for this age, it will be hungry or hungry and tired because their bellies are so small and milk digests so fast. A huge plus for breastfeeding is you can’t overfeed baby.
I remember being at the hospital and L was crying. I just kept thinking "why is she so upset, I should comfort her". It wasn't second nature to me yet that crying meant she was hungry. The lactation consultant came in then and said "wow she is MAD, she is VERY hungry, you need to nurse her." It was then that I realized if I didn't have someone to help me or a quick reference manual that could have educated me, I would have failed. I wouldn't have nursed L enough, she wouldn't have gained weight well and my supply would have been insufficient, resulting in even less weight gain for L.
Refusal of the breast can sometimes be related to pain associated with nursing. Be very careful to watch what nursing positions baby seems most happy in. The baby might find being held in certain ways uncomfortable. This is especially true for newborns because of the Moro reflex. Try holding their feet or swaddling them to make them feel secure.
But more importantly, if baby gets some milk and then pulls off and is very upset. The milk is causing pain. The baby might have a food intolerance and/or acid reflux. You don’t need to give up nursing, you just need to remove the food that you’re eating that is causing the issue. It is good to investigate this for any baby who is colic. See my post on our experience here.
I think every parent ends up in this situation. A very hungry baby who won’t latch because they are frustrated. The solution is to calm them but sometimes depending on the personality of the baby, that might be harder to do. We ended up in this situation in the hospital because my labor was so long and I was so tired and I just didn’t know how often I was supposed to be feeding L. The lactation consultant came in and after giving me a serious reprimanding for not feeding her sooner, gave me the most useful trick that I relied on in that first week when for the life of me I could not get L to latch. You will need your pump and any old syringe from a medicine or an eyedropper. I would pop on my pump and pump one side for 5 minutes. I would then remove the milk using the syringe and give it to her (no bottle to avoid nipple confusion). After getting some milk or colostrum, I would be able to get her to latch as she had calmed down because she had some milk in her tummy now.
If you absolutely can't get baby to calm down, I had success with the Boba Wrap. I would walk and bounce and shush L until she was calm enough to nurse. Once baby is older and you get better at breastfeeding. Nursing in a carrier or a wrap is an absolute must. It's so easy and is a great way to nurse in public.
With your first baby, I feel a lot of the work is guess work. I had absolutely no idea how I was supposed to know when L was full, so I asked. The term I got told is that especially for a newborn, they will look like a drunk sailor. Their eyes will usually be barely open, and they look so satisfied (and drunk). As they start to get older and more awake, it becomes harder to tell if baby is full. So, when baby finishes on one side either becomes fussy or pops off, I would hold baby up on my shoulder and first attempt to see if a burp was making her uncomfortable. After I get a burp or try for a few minutes, I face baby towards myself and put her on my chest so that her head was under my chin between my boobs. I would then just rub her back and see if she would try to root or if she wanted to sleep or if she was just content. This worked well. A lot of times, baby isn’t done but needs a burping break or baby is finished nursing on one side and wants the other.
When a let-down occurs, the foremilk is forceful and comes out in a rush. You will notice baby swallowing like crazy to keep up. When milk is still colostrum, it is not as forceful. After the initial rush, the milk will start to come out slower and slower. Baby will change from gulping down milk to a slow suck. For instance, every 4-5 seconds, baby might take 1-3 sucks. This is the fatty milk that slowly comes out. Let baby stay on for a while at this point, this is the milk that will help keep them full longer and really put on that baby chub. L would nurse from each side for 20 minutes at this age, as a point of reference, and the rule of thumb I got was 15 minutes on each side after a let-down occurs. At first you might not feel your let-downs so look to baby’s swallowing to know but after about a month, I knew when my milk would let-down. It is a tingling sensation.
Over time, you will find the nursing positions that work best for you and your baby. But one of the most useful breastfeeding tips I can provide you with now relate to nursing positions. In the beginning the cradle hold, cross cradle hold and football hold are some of the best positions because you can easily see baby and work on the latch. To start, you always want to have baby level with your boob so that they are not craning their neck to reach and compromising the latch. You also want their whole body to be facing yours for the same reason. Imagine lying on your back and turning your head while trying to latch and swallow, definitely not comfortable for baby and latching can be tricky enough as it is! You want to try and bring the baby to your boob, not the other way around. Forcing your nipple into an unwilling mouth is not going to work. Instead bring baby to your nipple when they are rooting, trying to time it so that their mouth is at its widest point. When you do this try to get their chin to make contact first and then gently “mush” their head into your boob, getting their wide mouth to cover your entire areola. Ideally, they should have their mouth around this entire area. If they have only latched onto the nipple it will create very sore nipples for you and is inefficient for baby’s sucking.
If you are having difficulty getting baby to take a deeper latch, do not wait to go see a lactation consultant. This can be a sign of lip and/or tongue ties. If that is not the problem, then it is still worthwhile to have an LC perfect the latch with you to ensure that your baby is getting enough, your supply is building, and to prevent clogged milk ducts. Once the baby is latched on and covering all or majority of areola, then you need to pay attention to the position of their lips. Their lips should be splayed out, if one lip is curled under you can use your finger to gently push it out, but if this is ineffective you need to reattempt the latch in order to avoid an abrasion caused by the friction of their curled lip on your nipple.
Get baby as close to your body as possible and avoid using your arm to bare the weight of your baby. This will lead to tired arms and less successful nursing sessions. Try propping a bunch of pillows up under your elbow and a few under baby, or use a special pillow designed for nursing like the boppy or ‘my breast-friend’ pillow. It takes trial and error to see which pillow system will work best for you. Some hospitals keep nursing pillows on hand so definitely do not hesitate to ask if you can try different ones. Additionally, if you go to a nursing support group or meet with a Lactation Consultant the facilitator may provide a variety of options to figure out what is best for your body type and baby. I also highly recommend a good nursing chair with a nursing stool. A lot of trendy nursery chairs are not ideal for nursing. I talk about this in the 9 registry items I regretted and ended up rebuying.
There are a variety of nursing positions that you can use to keep your baby fed and you comfortable while nursing. The best place to start are with the cradle hold, cross-cradle hold, the football hold, and the “biological nursing” or laid-back nursing position. All of these are great to use with a newborn while you are still trying to perfect your latch because they give ease of motion and positioning. Biological nursing is when you place baby on your stomach, skin-to-skin and allow them to naturally root onto your breast. This is excellent for developing those tiny neck muscles and core strength. It can often be easier for baby to latch this way because, as the name suggests, it is biological in nature. When I was having some anxieties around the latch at the hospital, the lactation consultant recommended this to me and it really did take some of the pressure off of me and baby and suddenly she was latching with a lot more ease. This is also a great position for nursing baby in bed before you are feeling confident enough to try the side-lying position which might be better saved for when baby is older and can latch themselves. I can be very helpful to see actual people breastfeeding to see how to nurse in various positions. Your best shot at this is a family member or close friend who is nursing. Another option is an online breastfeeding course with videos on nursing in different positions.
Source: Sakra World Hospital
I have included this point under issues because a lot of women think they must stop nursing in order to go on a diet and exercise to lose baby weight. This one my pediatrician told me. After my initial drop of 20 lbs in the first two weeks, I lost almost nothing after that. This was very worrisome to me because I had gained 65 lbs with L. I asked if I could do anything diet wise to help with weight loss but still keep a good supply and my pediatrician said until your milk establishes, it is very common to not lose weight. Your milk supply needs to keep increasing so your body is hesitant to allow its storage to go. Once its supply is set at about the end of 3 months, you will start to see the weight come off. In fact for me, the majority of the weight came off between 3-6 months and then it kept coming off as I continued to nurse L. This is a huge bonus to nursing for a year or even more.
Also remember, fueling your body with healthy foods will help you lose weight and also support breastfeeding. The only way I could realistically achieve eating healthy with a newborn was through freezer meals. I found using a freezer meal cookbook with pre-made grocery lists and no pre-cooking to be a life saver. If you have any dietary restrictions, there are also websites that cater to not only freezer meal plans but also generate all your instructions and grocery list.
I waited until after L was born to decide to find clothing to wear. It is such a weird stage where you are losing weight like crazy so your maternity clothing looks silly but you can’t yet wear your regular clothing. Additionally, I found a lot of my regular clothing didn’t work well with nursing or just wouldn’t even button because my boobs had changed so much. We tried to go shopping but I was looking for such a specific style (loose, comfortable, good for nursing) that it was taking so much effort and time. I also needed to be nursing, recovering and resting, not trying to find clothing.
This is where StitchFix came in handy. StitchFix is a service where you pay a styling fee ($25) and somebody handpicks five items for you to test based on your style and price preferences. You send back what you don't like (with pre-paid shipping) and keep what you like. Assuming you do keep something, the styling fee is waived. Now normally, I love shopping for myself but in this case. I much preferred asking a stylist to come up with items that were good for nursing and postpartum. If you try this, I would get your fix before baby so you are prepared. They also have awesome styles for postpartum that I couldn’t really find in stores. I also wanted clothing that I could nurse in, not nursing clothing. Nursing is hard and having nothing to wear doesn’t make you feel any better and actually makes it even harder. Start searching now for good options for postpartum and nursing.
I didn’t understand why I was shown how to do this when I could use a fancy pump. However, manually pumping while baby is on the breast is a great way to speed up a let-down and/or flow keeping baby engaged.
There also might be a time when you need to manually express milk. I didn’t think I would need to ever manually express but then we decided to fly cross-country when L was 3 months. This was about the time that she also went through a wonder week where everything around her was distracting. The result was an extremely long plane flight full of distractions and no ability to keep her on a breast to nurse. To say I was in pain and engorged is an understatement. My boobs were rock solid from L not nursing and I had zero access to a pump in the air, so I had to manually express milk out of each side in the bathroom to relieve the pressure and ensure I didn’t end up with a clogged duct, or worse, mastitis.
Side note: The solution to the distraction phase was a nursing cover, not because I was worried someone would be offended by seeing a nipple, but because it blocked out all visual distraction for L. I only recommend the nursing covers that still allow you to make eye contact with your baby so you can latch baby and keep baby latched. This is my favorite one!
Call your insurance company and your birthing center. I was able to get a pump at the hospital after baby was born and the birthing center billed my insurance. It was so hassle free that I recommend seeing if this is a possibility for you. I had the added bonus of the lactation consultant showing me how to use my pump correctly before I left the hospital.
One of the worst breastfeeding tips I received was that I should pump to increase my supply. Your breast pump, even the super nice ones, will help your supply at about a 5/10 whereas your baby is a 10/10. The exception to the rule is if you can’t get baby to latch and need to pump to give baby some milk to calm down in order to latch.
On Pinterest, I saw so many articles about how to create crazy high stashes of milk in the freezer that it became a priority. So, I asked the lactation consultant, how do I know how much milk to put away and how often I should pump. She told me that there is no need to create a stash right away. My top focus should be learning how to breastfeed and having my baby nurse, as they are the best pumps. Also in the beginning, baby needs everything you produce. Don’t take from their daily supply and store it. If I was planning on returning to work, then I needed to work on starting a stash only a few days before going to work. It is best to only be a few days ahead of baby because your milk changes all the time and in response to baby. For example, if baby is sick, the saliva from baby while nursing enters the breasts and tells your body to ramp up the antibodies need to fight the illness, helping baby get better faster. You would miss this communication if you are months ahead of baby. Another option is after a few weeks you could start to just pump after one morning feeding. It is important to do this in a manner where you increase the amount you produce without reducing baby’s supply for that day.
If you pump, you want to always mark the time you pumped because your milk changes over the day. The milk in the morning is higher volume, and the milk at night is going to be less volume but fattier and contain more prolactin, the hormone to make milk regenerates overnight, and melatonin, the hormone that promotes sleep. Due to this, it is recommended you pump after your morning feeding because of quantity produced during that time of the day.
If you are beyond the initial few weeks or are a few weeks out from your return to work and do want to start preparing for your first day away from baby there are some very important storage guidelines you need to know. Freshly expressed breast milk needs to be stored in very precise ways in order to ensure the safety and health of your baby. Expressed milk is shelf stable at room temperature for 3-4 hours and in a cooler with ice packs for up to 24 hours. Milk should be stored in the back of a refrigerator away from the door for between 3-8 days. As long as you are storing your milk under very clean conditions you should be able to go to the higher end of this range. This means, always washing your hands before pumping and handling milk, always using sanitized or thoroughly washed pump parts and bottles, and always using sealed and sanitized milk-storage bags like these. Milk can be frozen in a normal freezer for up to 6 months and in a “deep freezer” (0 degrees F or below) for up to 12 months. In general, you will know if the milk is spoiled and when it doubt, toss it. Just like the cow’s milk you may keep in your fridge, the smell of sour milk will be evident.
When you thaw milk to be used, it must be used within 24 hours. If it is thawed and not used within 24 hours discard immediately. Because of this rule, it can be helpful to store milk in smaller 1oz. quantities and then thawed “on demand” if you need to be away from baby so that you are not wasting your liquid gold.
Before starting to store, do a lipase test. Lipase is naturally found in breastmilk and is actually good for baby. However, it can change the taste and smell. If you have high levels in your breastmilk, which again is completely normal, and you store breastmilk, the high amounts of lipase will make the milk taste soapy and sour. Most moms learn that they have high levels of lipase because baby rejects the thawed milk meaning that mom realizes after she has already made a stash. To test, pump and freeze a small amount of breastmilk for five days and then thaw it. If you notice a smell, if it tastes sour or if baby rejects it. You might have high lipase content. To fix, you need to scald the milk first before freezing so just heat the milk in a pot until just about boiling (small bubbles) and then cool and store in bags.
The idea of bottles sounds nice. You can hand a bottle to someone and they will feed your baby. The reality of bottles compared to just nursing is that it’s actually a lot more work. You need to pump, then clean the pumping supplies, prep the bottle, give the bottle to someone, feed the baby with the bottle and then clean the bottle. With nursing, just latch baby and then you are done. You just spend some time holding and cuddling baby while they nurse. You might also think formula is easier and while it seems easier in the beginning because baby can have formula at night and it’s not you getting up. In the long run, nursing is SO much easier. For however long you nurse, you won’t have to remember anything when you leave the house besides your boobs.
The pacifier is used to calm baby but don’t use it because being fussy and/or crying is a hunger signal. The pacifier is only a temporary fix that can just cause baby to become even more upset because they are still hungry, and it also hurts your supply. Why? When baby cries and you give them a pacifier, they suck on the pacifier because sucking produces milk. They are born with this desire to suck because they need to do that a lot to build supply and to eat. They are happy sucking on their pacifier waiting for the “let-down”. Now it’s been 10 more minutes and they are really hungry and really upset. It will be very hard to latch a very hungry upset baby. The result is you either try the pacifier again and make the problem even worse or you end up giving them formula because you can’t get them to latch. If you do get them to latch, you feed them way later than what they wanted. This means you will probably get in less feedings each day, which in turns tells your body to not make as much.
Breastfeeding is hard. But I promise, it gets easier.
You are already on a great start by reading everything I learned instead of having to learn it all the hard way. Remember to prioritize nursing and nurse often to build up that supply. Get help if you are struggling. You will be surprised to see how many different ways you can find support and help within your community.
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The gift you are giving your baby by choosing to embark on this breastfeeding journey is incredible. Not only are they getting tailor-made nutrition and antibodies, but the special bond, comfort, and sense of security they will receive is also a huge benefit.
Regardless of how this journey progresses, always remember that any amount of breastmilk that your baby receives is truly liquid gold and they are so fortunate to have a mother who is putting such effort into making this work. I firmly believe that with all babies fed is best, and never want there to be any sense of shame, lack of confidence, or feeling of failure associated with the need to supplement.
Your baby is so lucky to have YOU as their mama!
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