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Friday, May 18, 2012

How to Breastfeed with Confidence

This is a great article about Breastfeeding by Judith A. Lothian (RN, PHD, LCCE, FACCE).  I just wanted to share this great information from her!



The simplicity of breastfeeding should inspire confidence in all of us. Nature intended your baby to be breastfed, and your body is perfectly designed to produce milk for your baby. During pregnancy your body prepared your breasts for breastfeeding. Colostrum was ready and waiting for your baby right after birth, and your body will continue producing high-quality milk for your baby, as long as he continues to nurse. Your baby is able, right from birth, to let you know when he is hungry, to attach to breast, and to suck, swallow and digest milk that is perfectly designed to meet his specific needs, for as long as he nurses.

Breastfeeding is a simple process. The baby’s sucking at the breast stimulates milk production. The more your baby nurses, the more milk you will produce. Because of this, pacifiers and supplementing with bottles of infant formula will set the stage for decreasing, rather than increasing, milk production. Your baby should nurse at least 8 to 12 times in 24 hours in the first weeks. He may nurse in clusters, rather than every two hours. Let your baby nurse at the breast “until he’s finished.” This insures that he receives the “hind” milk, rich in fat and calories. Limiting nursing to five or ten minutes on each side deprives your baby of this important and nutritious milk.

Regardless of your diet, your body produces high-quality milk. Contrary to what you may have heard, you do not need to drink large amounts of fluid or avoid certain foods. Eat and drink to satisfy your appetite. Some of the weight you gained while pregnant will be used for calories while you are breastfeeding.

Your baby will let you know when he is ready to nurse, not by crying, but with a number of early feeding cues: rapid eye movements under the eyelids (he may seem to be stirring from sleep), moth and tongue movements, hand to mouth movements, body movements and small sounds. If you wait until your baby cries, it will be difficult to help him settle down enough to latch properly and he and you will have missed important nursing time.

Keeping your baby close to you will insure that you do not miss his feeding cues. Consider using a sling-type carrier to hold him close during the day, and co-sleeping, in the same bed or at least the same room, at night.

Babies do not have to learn to attach to the breast. Right after birth, skin-to-skin with their mothers, babies crawl to the breast and self-attach. If you hold your baby in the traditional cradle position, he is best able to latch properly to your breast when he is flexed, relaxed, his head both level with your breast and aligned with his body, and facing you. You should not have to lean toward him, and he should not have to reach toward you to attach. Wait for the baby to open his mouth wide so that he attaches to the areola, not the nipple. Be patient and let your baby lead you. Don’t rush him or pressure yourself. Remember, your baby knows how to do this.

If your baby is positioned and latched properly, when he sucks he will get milk. Watch and listen for his swallowing. This is the ultimate assurance that he is actually getting milk. Your baby will let you know when he is “finished” nursing by coming off the breast himself or falling asleep. He may or may not want to nurse on the other breast. The other breast will feel full when he is ready to nurse again, so you will start with that side.
How do you know your baby is getting enough milk? You can feel confident that he is getting enough if you pay attention to his feeding cues, you nurse him often, you allow him to nurse until he is “finished” and he is producing wet diapers and having bowel movements. At one day of age your baby will have two wet diapers and one bowel movement and over the course of the first week will increase that number gradually; by day seven, you’ll see six to eight wet diapers and three or more bowel movements.

Some babies take a few days or even weeks to breastfeed effortlessly. If your baby is not nursing frequently, you are unable to identify swallowing or he is not producing wet diapers and bowel movements, contact your healthcare professional or lactation consultant immediately. Most breastfeeding problems have simple solutions, but addressing them quickly is important.

You and your baby were made to breastfeed. Have confidence in yourself and in your baby’s ability to breastfeed. And treasure the joy of nursing your baby.

Breastfeeding Basics
Proper positioning can make all the difference to your breastfeeding success. If your baby is positioned correctly at the breast, you’ll feel better and your baby will be more satisfied. Start by making yourself comfortable: Sit up in bed or in a rocking chair or armchair, and use a bed pillow or nursing pillow if that makes things easier. Keep a glass of water and a healthy snack within reach so you can get nutrition while your baby does.

Cradle Hold
The cradle hold is a good position for newborns. The baby should be facing you stomach to stomach, his head and neck should be straight and he should not have to strain to reach your nipple.

You can also use the cradle hold for older babies. To avoid shoulder and neck pain, bring your baby up and toward you rather than leaning toward him. Be sure the baby’s head is nestled in the bend of your elbow.

Football Hold

The football hold works especially well for premature infants and for women who have had cesareans. Support your baby’s head and neck with your hand, and position his face directly in front of your breast. (The side-lying position, not shown here, is also comfortable, especially for cesarean moms. Place your baby on his side facing you in bed and guide him onto your nipple.)

To encourage your baby to latch on properly, tease him gently with your nipple. As soon as he opens his mouth wide (very wide, like a yawn), bring him onto the breast, leading with the chin.

When your baby is latched on correctly, his mouth should cover the nipple and at least one inch of the areola. His chin and the tip of his nose should touch your breast.

If your baby is not latched on properly, break the suction by putting your finger gently between his gums. Then start again. Don’t worry if proper latch-on takes several tries at first. Take a deep breath, and remain patient.

Burping Your Baby
After your baby has nursed from one breast, burp him. Then burp him again after the feeding is over. If he doesn’t burp after a minute or two but seems content, no burp is needed. If he seems uncomfortable, keep trying until you hear the burp. Here are three positions that you can use.

  1. Sit your baby on your lap, apply pressure on his tummy and firmly pat his back.
  2. Drape your baby over your shoulder and firmly pat his back.
  3. Lay your baby down and firmly pat his back.

Judith A. Lothiam, RN, PHD, LLCE, FACCE teaches childbirth education in Brooklyn, NY, is the former president of the Board of Directors of Lamaze International and is the chair of its certification council. She has five children.

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