The Breast Start

by Carol Berkowitz, M.D., president of the American Academy of Pediatrics

The Breast Start

You’ve heard that breast is best: Nursing provides the ideal nutrition for your baby, can help the two of you bond, and has health benefits for you to boot. The following tips from the American Academy of Pediatrics (AAP) can help you and your baby get off to a successful start:

? Tell your doctors. Let your obstetrician and pediatrician know ahead of time that you plan to breastfeed. If you can, breastfeed within an hour of birth to take advantage of your baby’s sucking instinct, which is strong right after delivery when he is awake and alert. This also starts the process of establishing your future milk supply and helps your uterus contract and return to its prepregnancy state.

? Try different positions. Before leaving the hospital, experiment with several breastfeeding positions and ask your nurse or lactation consultant to check your technique. Using more than one position can help prevent nipple soreness and clogged milk ducts, since each position drains the breast differently.

? Straighten up. When sitting, keep your back straight but relaxed as you offer your baby the breast. Your newborn may find it more difficult to latch on properly if you’re leaning forward or back, since this changes the angle at which he receives the breast. Laying your baby on a nursing pillow on your lap can help, as well as placing pillows behind your back for support. Plus, sitting up straight can prevent back strain for you.

? Ensure proper latch-on. Use your free hand to support your breast, placing four fingers underneath and your thumb on top to present the nipple to your baby. Make sure your fingers are well behind the areola (the darker area around the nipple) so they don’t get in your baby’s way. Tickle your baby’s lower lip with your nipple to cause him to open his mouth. When he opens wide, quickly but gently draw him to you. The key to a good latch-on is having your infant take enough of the breast (including the areola) into his mouth.

? Breastfeed on demand. Keep your newborn close to you so you can feed him as soon as he shows hunger cues, such as increased alertness, smacking his lips, making suckling motions, or moving his head around in search of your breast. Try not to wait until he begins crying, since that’s actually a late sign of hunger. Offer both breasts at each feeding, alternating the one you give first, and let him feed at each until he seems full and detaches all by himself.

? Keep track of feedings. While you won’t be able to measure exactly how much breast milk your baby gets, there are other ways to tell whether he’s getting enough to eat. He should nurse at least eight to 12 times a day and seem satisfied and happy for a few (one to three) hours between feedings. Dirty diapers offer helpful clues as well: By the end of the first week, your baby should have three to six bowel movements and four to six wet diapers each day. Your pediatrician will want to see your baby at 3 to 5 days of age and again at 2 to 3 weeks to monitor his weight gain and evaluate how the breastfeeding is working for you. Talk to your baby’s pediatrician about any concerns you may have; she can also refer you to a lactation consultant if necessary. To learn more, check out the AAP book, New Mother’s Guide to Breastfeeding.