For newborn babies, breastfeeding provides perfect nutrition and many benefits for immunity which can reduce the occurrence of infections such as gastroenteritis, ear infection and even future obesity and is also especially important for babies with a family history of serious allergies.
Breastfeeding is also shown to reduce the risk in mothers of ovarian and breast cancer, rheumatoid arthritis, late onset diabetes, postnatal depression and it improves bone density. Due to these benefits of breastfeeding and the added bonding it can provide, it is highly recommended that babies are breastfed for the first 6 months if possible, introducing solid food alongside continued breastfeeding from this point onwards.
However, breastfeeding can be challenging so it is advisable to seek help from your local breastfeeding drop in clinic, breastfeeding peer supporter, health visitor, midwife or GP if you feel it is not working as it should. You can also call one of the breastfeeding helplines.
When should I start to breastfeed?
If birth has been straightforward, it is best for you and your baby to share skin to skin contact and attempt a few short feeds within the first hour after birth. This aids bonding and triggers the hormones that will stimulate milk production whilst allowing you both to gain confidence with the technique.
Newborn babies need feeding very frequently as their stomachs are only very small and fill and empty very quickly. Some parents worry that this frequent (sometimes almost constant) need to feed means that the milk is not good enough or something else is wrong, however, as the first breast milk (known as colostrum which lasts for the first 3-4 days) is very rich and concentrated, it delivers high nutrition in small regular doses, the perfect way for newborns to feed. This frequency is also good for mother’s breasts as it will keep sending the message to make more milk. As your baby grows they will start to have longer intervals between feeds and as you both gain skill you can learn to recognise feeding cues such as sucking fingers, licking lips, nuzzling and burrowing.
It might seem like it’s trickier to know for sure if breastfed newborns are eating enough, but one way is to monitor what ends up in their nappy. In the first 24 hours after birth, your baby will pass a black sticky poo called meconium. The more meconium your baby passes the better as this shows that your baby is taking in lots of colostrum to clear out his gut. Gradually your baby’s poo will change to a dark brown colour and by day 3 should be a green grainy colour. The number of wet nappies will also increase daily and by day 6 you should expect around 6 heavy wet nappies and at least 2 but preferably lots more yellow poo about the size of a £2 coin. In reality breastfed babies who are taking in lots of milk tend to have a ‘suck and squit’ approach to pooing! Any less than this and it is worth checking with your midwife or health visitor to make sure everything is going.
After the colostrum, the mature breast milk will come in between 3-5 days after birth. This is less concentrated and varies across the course of a feed, the watery milk comes through first and the richer, creamier milk tends to come towards the latter part of the feed. Because of this, it is important to let babies drink their fill from one breast before offering them the other if they still seem to want to feed.
If you restrict your baby’s feed time or change breasts too early, she may miss out on the fat-rich milk which may inhibit her weight gain. As you become familiar with the way your baby feeds, you may notice a change in the way she suckles towards the end of a feed. This slower, more fluttery way of suckling with less frequent swallowing can easily be mistaken for a full baby but is actually associated with the richer higher fat content milk coming through. These little fluttery suckles can be a good sign that your baby is getting the milk she needs during feeds. As long as she is feeding effectively for as long as she wants to, and weight and nappies are good, then you can be confident that she is getting what she needs.
As we live in a culture where bottle feeding seems normal, breastfeeding can seem less familiar. With bottle feeding, the teat sits just inside baby’s mouth and they can easily withdraw milk. Breastfeeding is a bit different.
To feed effectively, the baby actually needs a large mouthful of breast so that the nipple sits towards the back of the mouth near the junction of the hard and soft palate.
To achieve this position, the baby instinctively opens their mouth very wide with their head tilted right back. We need to put them in the right position so they can get it right and their chin is pressing against the breast and their lower lip is rolled back. Often parents worry that this may obstruct their breathing but in the right position, a baby’s nostrils will be free to breathe. If your baby’s breathing is obstructed she will simply unlatch so this should not be a cause for concern. In some positions, usually when mum is more reclined, the baby has more control about how they latch on and mum supports baby to help them follow their instincts. This involves Mum reclining on a chair or bed and placing baby lying horizontally on her chest. In this position, baby may begin head bobbing and rooting and will usually decide for himself which breast to feed. Ask your midwife, health visitor or breastfeeding counsellor to talk you through laid back breastfeeding.
There isn’t one breastfeeding position that is better than all the others. You may need help to find the one that’s right for you.
In the correct feeding position, there should be little or no pain involved for you, as your nipple isn’t pressing or rubbing against anything. If after 10 seconds pain does not subside this suggests that your breastfeeding position may need a small adjustment. You might need to try a few times until it feels more comfortable and remember it’s a mistake to suffer through a painful feed as you will only increase damage to your nipple and it also means baby may be getting less milk.
Cracked or sore nipples indicate that your baby has not been attaching properly. Perhaps your nipple has been pressed against her hard palate or rubbing against the back of the tongue or has been pulled in the wrong direction. Check your nipple at the end of a feed – it should be in much the same shape as before the feed. If there are any signs of compression (it may resemble the shape of a new lipstick) this is another clue to suggest your nipple is not far enough back in your baby’s mouth. You should address the underlying problem as it may also mean that your baby is expending a lot of energy for not a lot of milk. Similarly, nipple shields can actually make it harder for your baby to latch on and effect milk production as the message to your breasts from the baby’s sucking is not as strong.
If your baby is struggling to latch on properly, you may experience long feeding sessions that seem to leave your baby hungry and frustrated. If in doubt do ask your breastfeeding counsellor, health visitor or midwife for help and to discuss the best way to get your baby to latch on properly.