Human milk and infant formula are different. Not only does human milk provide all the protein, sugar, fat, and vitamins your baby needs to be healthy, but it has special benefits that formulas cannot match. It helps protect your baby against certain diseases and infections. Because of the protective substances in human milk, breastfed children are less likely to have the following:
Research also suggests that breastfeeding may help to protect against Sudden Infant Death Syndrome (SIDS).
Other reasons why human milk is good for your child include the following:
There are also many health benefits for you because breastfeeding does the following:
Immediately after delivery, your baby should be placed on your chest or abdomen, skin to skin. Babies are very alert after they are born, and they are usually hungry, too! Your baby’s first feeding can take place within 30 minutes to an hour after delivery. The protection against infection that human milk provides is important immediately after birth. Your milk will also give the baby nutrients to prevent a low blood sugar level. This early taste of your milk also stimulates the baby to nurse better later.
If you had a vaginal delivery, you can nurse in bed or in a chair in the following ways:
If you had a Cesarean-section delivery you can nurse your baby in the following ways:
Always take time to make yourself comfortable. Do not be shy about asking for help during the first few feedings. Just as with learning anything new, it may take several feedings before you and your baby become a skilled nursing team.
How do I take care of my breasts during breastfeeding?
By the third or fourth day of breastfeeding, your milk will change from colostrum to what looks more like skim milk. Your breasts will also go from feeling soft to firm. If your nipples leak, use a nursing pad or clean folded handkerchief squares inside your bra to catch the leaking milk. Be sure to change these often. Do not use plastic-lined pads because they will prevent air from circulating around your nipples.
Between feedings, gently pat your nipples dry. This helps prevent them from getting irritated. You may also want to apply a little expressed colostrum, human milk, or medical grade modified lanolin on your nipples to prevent dryness.
How often should I nurse?
Breastfed babies tend to feed more often than formula-fed babies, usually 8 to 12 times a day. The main reason for this is that their stomachs empty much more quickly because human milk is so easy to digest.
Initially, your newborn will probably nurse every couple of hours, regardless of whether it’s day or night. By the end of the first month, your baby may start sleeping longer at night. Let your baby feed on demand—that is, whenever he is hungry. Watch for different signals from your baby, rather than the clock to decide when to nurse. When your baby is hungry, he may do any of the following:
It is best not to wait until your baby is overly hungry before you breastfeed.
Some newborns can be sleepy and hard to wake. Do not let your baby sleep through feedings until your milk supply has been developed, usually about 2 to 3 weeks. If your baby is not demanding to be fed, wake her if 3 to 4 hours have passed since the last feeding. If this persists, call your pediatrician.
How long does breastfeeding take?
While some infants nurse for only 10 minutes on one breast, it is quite common for others to stay on one side for much longer. Some feedings may be longer than others depending on your baby’s schedule and the time of day. Some babies may be nursing even though they appear to be sleeping. If your baby has fallen asleep at your breast, or if you need to stop a feeding before your baby is finished, gently break the suction with your finger. Do this by slipping a finger into your baby’s mouth while he or she is still latched-on. Never pull the baby off the breast without releasing the suction.
When you breastfeed, alternate between which breast you offer first. (You may want to keep a safety pin or short ribbon on your bra strap to help you remember on which breast your baby last nursed.) While you should try to breastfeed evenly on both sides, your baby may prefer one side over the other and nurse much longer on that side. When this happens, the breast adapts its milk production to your baby’s feedings. Remember, your baby’s feedings control how much milk your breasts produce. It is important to let your baby nurse on both sides so that each breast gets stimulation over the course of a day.
You will soon get to know your baby’s feeding patterns. Each baby has a particular style of eating, some slower, some faster. Learning your own baby’s eating patterns makes it easier to determine when she is hungry, when she has had enough, how often she needs to eat, and how much time she needs for feedings.
For some mothers and babies, breastfeeding goes smoothly from the start. For others, it takes a little time and several attempts to get the process going effectively. Like anything new, breastfeeding takes some practice. This is perfectly normal. If you need help, ask the nurses while you are still in the hospital, your child’s pediatrician, a lactation consultant, or a breastfeeding support group. Remember, the most important keys to successful breastfeeding are proper positioning and correct latch-on.
Until you and your baby develop a feeding routine, stay positive and try not to get discouraged. Remember, your milk gives your baby more than just food. It also provides important antibodies to fight off infection and has medical and psychological benefits for both of you. Breastfeeding is the most natural gift that you can give your baby.
Breastfeeding: latching-on and let-down
Correct positioning, or latch-on, is a key element of successful breastfeeding. You can encourage good latch-on by touching your breast to the center of your baby’s lips. This stimulates your baby to open his mouth widely. As this occurs, pull your baby straight forward onto the nipple and areola. Keep in mind that when a baby is correctly positioned, or "latched-on," your nipple and much of the areola are pulled well into the baby’s mouth. Your baby’s lips and gums should be around the areola and not on the nipple. This is why it is important for the baby’s mouth to be open wide.
You can help your baby latch-on by holding the breast with your free hand. Place your fingers under the breast and rest your thumb lightly on top (back behind the areola). Make sure your baby is properly lined up at your breast. Also be sure your fingers are well back from the areola so they do not get in the way.
When the baby first nurses there will be a tugging sensation. If the latch-on hurts, pinches, or produces pain, the latch-on may be incorrect. Break the latch-on by slipping your finger into the corner of your baby’s mouth, reposition, and try again. It can take several tries.
If your nipples are not sore, breastfeeding should not be painful. If it hurts while you breastfeed, then your baby may not be latched-on correctly and may need to be repositioned.
Correct latch-on is very important as it:
If your baby is latched-on correctly but you still have pain while breastfeeding, talk with your pediatrician.
Babies use their lips, gums, and tongues to get the milk to flow from the breast. This is known as suckling. Simply sucking on the nipple will not draw milk and may hurt the nipple.
Most babies will nurse actively if they are hungry and positioned correctly. For the first few weeks after birth until breastfeeding is well-established, breastfeeding newborns should not be given any supplements (water, sugar water, formula, etc.) unless there is a medical reason for it. A baby who is breastfeeding regularly and effectively will get all of the water and nutrients she needs. Some authorities believe that introducing a bottle or using a pacifier may cause nipple confusion and interfere with the establishment of breastfeeding. Others disagree and feel that nonnutritive sucking is good and does not interfere with breastfeeding. Ask your pediatrician for more information.
As you become more familiar with breastfeeding, you'll notice another aspect of the process: the let-down reflex. The let-down reflex occurs every time you breastfeed. The first few times you breastfeed this let-down reflex may take a few minutes. Afterward, let-down will occur much more quickly, usually within a few seconds.
The signs of let-down are different for each woman. Sometimes when your baby starts to nurse, you may feel a brief prickle, tingle, or even slight pain in your breast. Or, milk may start dripping from the breast that’s not being used. These feelings and milk flow are signs of the let-down reflex. This means your body is making it easier for your baby to nurse.
You may feel strong cramping in your uterus when your milk lets-down. The hormone oxytocin, which stimulates milk flow, also causes the muscles of the uterus to contract. Nursing helps your uterus go back to its original size. This cramping is totally normal and is actually a sign of successful nursing. The cramping should go away in a week or so.
To help the let-down process along, try these tips:
You can express milk manually with your hands or with a breast pump. Breast pumps are used to ease engorged breasts or to collect milk when you are away from your baby (for example, if you are ill or at work). Pumping enables you to continue to breastfeed by keeping your milk production stimulated. If milk is not emptied from the breast regularly, it sends a message back to your body to stop making milk.
To express milk manually:
Some women prefer hand expression because it can be done silently and does not require special equipment. Other women may find it easier and faster to express milk with a breast pump. Pumps are manual, battery-operated, or electric. You can find manual pumps in most pharmacies and baby stores. Do not buy those that look like a bicycle horn, because they can not be cleaned properly and milk may become contaminated.
Good hand pumps have two cylinders, one inside the other, attached to a rigid funnel-like device that fits over the breast. As you slide the outer cylinder up and down, negative pressure is created over the nipple area. This causes milk to collect in the bottom of the cylinder. This collecting cylinder can be used with a special nipple to feed your baby without transferring the milk. The entire pump can be cleaned in the dishwasher or by hand with soap and hot water.
Some hand pumps have a handle to squeeze that creates a negative pressure and draws the milk into a bottle. These may have a soft, pliable flange that fits around the nipple and areola and produces a milking action while pumping.
For most women, electric pumps stimulate the breast more effectively than manual expression or hand pumps. They are used mainly to keep breastfeeding going when a mother is not able to breastfeed for several days or more. These pumps are easier and more efficient than hand pumps, but they are much more expensive. However, you may be able to save money by renting an electric pump from your hospital or a medical supply store.
When shopping for an electric pump to buy or rent, make sure that it creates a milking action and is not simply a sucking device. Pumps that express milk from both breasts at the same time increase your amount of milk and save time. No matter which type of pump you choose, make sure that all parts of it that come into contact with your skin or milk can be removed and cleaned. Otherwise, the pump will become a breeding ground for bacteria, and the milk will not be safe for your baby.
After expressing your breastmilk, it's important that it be stored properly. Proper storage will ensure the milk does not become contaminated or spoiled and that it retains all the nutrients your baby needs. Here are some safe storage and preparation tips to keep your expressed milk healthy for your baby:
One of the most common concerns of breastfeeding mothers is: how can I be sure my baby is getting enough milk? Well, there are several ways to tell. One is by the number of wet diapers he has in a day. Make sure he has at least six wet diapers per day with pale yellow urine, beginning around the third or fourth day of life.
Your infant should also have several small bowel movements daily (there may be one after every feeding in the first few weeks). During the first week of life, your infant should have at least two stools per day. From about 1 to 4 weeks old these should increase to at least 5 per day. As your baby gets older, bowel movements may occur less often, and may even skip a number of days. Bowel movements of breastfed babies usually smell somewhat sweeter than the stools of formula fed babies.
Your baby’s feeding patterns are also an important sign that he is feeding enough. A newborn may nurse every 1½ to 3 hours around the clock. If your baby sleeps for stretches of longer than 4 hours in the first 2 weeks, wake him for a feeding. It is most important that your baby is latched-on properly during feedings. Listen for gulping sounds to know that your baby is actually swallowing the milk and not just sucking. Also look for slow, steady jaw movement.
Your baby should be steadily gaining weight after the first week of life. During the first week, some infants lose several ounces of weight, but they should be back up to their birth weight by the end of the second week. Your pediatrician’s office will weigh your baby at each visit. Keep in mind that your baby may breastfeed more often during growth spurts.
Signs that baby is getting enough milk are as follows:
Most breastfeeding babies do not need any water, vitamins, or iron in addition to breast milk for at least the first 6 months. Human milk provides all the fluids and nutrients a baby needs to be healthy. By about 6 months of age, however, you should start to introduce your infant to baby foods that contain iron.
If your baby cannot or will not nurse, or if you are having problems with breastfeeding, it is important that you call your pediatrician as soon as possible. Refusal to breastfeed may be a sign of illness that needs prompt attention.
Another frequent concern for mothers is engorgement. Engorgement is uncomfortable for the mother and can make nursing more difficult for a baby. Feeding on demand not only ensures that your baby’s hunger is satisfied, but it also helps prevent engorgement. Engorgement occurs when your breasts become too full with milk. A little engorgement is normal, but excessive engorgement can be uncomfortable or painful. If your breasts do become engorged, try the following:
Once the engorgement passes, your breasts will become soft again. This is normal and is exactly what should happen.