What you need to know about breastfeeding

Breastfeeding may seem daunting, but remember, both you and your baby will need to learn how to breastfeed successfully. Give yourselves some time to figure it out.

The Ministry of Health recommends exclusive breastfeeding for the first six months of your baby’s life. Exclusive breastfeeding means that, since birth, your baby has only had breast milk (from the breast or expressed) and prescribed medicines. Try to breastfeed your baby exclusively until they are around six months old. If your baby is exclusively breastfed, they don’t need water or any other drinks or food until they’re around six months old. After six months, exclusive breast milk is not enough on its own for your baby to grow and develop. You should start your baby on solid food and also continue breastfeeding until they’re at least one year old. When you’re away from your baby, try to ensure that they’re fed with expressed breast milk rather than infant formula.

Preparing for the first feeds

Newborn babies are placed straight onto their mothers as soon as they are born. This skin-to-skin contact with you after birth is good for your baby’s physical health and helps you to bond with each other. Skin-to-skin contact is the best way to keep baby at the right temperature and it encourages the baby to start breastfeeding.

You and baby will spend some time recovering from the birth. Within an hour, your baby will start to show interest in breastfeeding. Baby will:

  • Feel the warmth of your body.
  • Feel your body rhythms.
  • Recognise your voice.
  • Smell the breast.
  • Start to push upwards towards the breast.
  • Open their mouth.
  • Suck their tongue.

Your midwife will help you to position your baby for breastfeeding and make sure that baby has a good latch on your breast.

The first milk: Colostrum

It’s important in the first few days that your baby feeds whenever they need to, so that they get the first milk, or colostrum.

Colostrum is the first milk that your baby gets. This special milk is yellow in colour and is thick and sticky. Colostrum protects your baby from infections and gives your baby their first food. Your baby feeds on colostrum for the first few days until your milk “comes in”. This is when your breasts start making more milk and the milk changes from thick and sticky colostrum to the normal breast milk, which is thinner and whiter.

Baby’s hunger signs

Babies will show hunger signs when they are ready for a breastfeed. These may happen with eyes closed or open. The hunger signs are:

  • Rooting around with the mouth – opening the mouth and moving the head as if looking for the breast.
  • Sucking movements and sucking sounds – often quite soft sounds.
  • The tongue coming out of the mouth and almost licking the lips.
  • Hand-to-mouth movements.
  • Sucking the fingers or hand.
  • Opening the mouth and possibly turning the head in response to a touch around the mouth area.

These signs are often called early hunger signs. If you miss these early hunger signs your baby will cry. Crying is a late hunger sign. Try to not let this happen, or your baby may be too upset to feed well.

How long on each breast?

Different women find different ways to breastfeed, but as a general guide:

  • Feed your baby from one breast for 20–30 minutes.
  • Change your baby’s nappy then feed your baby from the other breast.
  • Remember to start the next feed on the breast that you last fed from.
  • New babies need to feed about 8–12

times every 24 hours. This means that you will be feeding your baby during the night. Some days your baby will need more feeds. You will not run out of milk – if you feed your baby more, your breasts will make more milk.

Does baby have a good latch? 

Your baby’s chin will be touching the breast but their nose should be reasonably clear. Baby’s bottom lip will be turned outwards and not turned inwards. They’ll be sucking quite quickly, but once the milk starts to flow they’ll change to rhythmic, longer sucks with some short pauses. You’ll also start to hear baby swallowing – this will happen more as your milk comes in and flows more. Your baby’s cheeks should stay rounded when sucking.

Feeling comfortable

If it doesn’t feel comfortable – start again. Slip your finger into the corner of your baby’s mouth between their gums, with the soft side (not the nail) next to the lip so that you gently break the suction. If you let your baby suck the wrong way it can cause problems. If you feel pain in your nipples or breasts, ask your midwife for help.

Positioning your baby

There are different ways that you can hold your baby to breastfeed – find the ones that are comfortable for you.

How to breastfeed

A good latch is the key to successful breastfeeding. Babies should be breastfed “tummy to tummy”. If you can see your baby’s tummy button, they’re not turned close enough to latch well. Make sure that: 

You bring baby in close. 

Baby’s head is tilted back. 

Baby’s mouth is wide open. 

Baby’s tongue is forward and right down. 

Baby’s chin touches your breast and baby’s nose lines up with your nipple. 

Gently tickle the top part of baby’s lip with your areola (the darker area around the nipple). Bring your baby to your breast quickly so the bottom lip is pushed back to form a suction cup. Let your baby take in a large mouthful of breast, not just the nipple.

Cross-cradle position: It’s often easier to start breastfeeding by holding the baby in the cross-cradle position. This means that the baby’s head is supported with your hand at the base of their neck. The position of your hand is important as the baby needs to be able to tilt their head back slightly. Make sure that your arm or hand is not behind the baby’s head, or they might not be able to tilt it back. Your other hand is supporting your breast.

Cradle hold: Once baby is latched well, you can change to a cradle hold, which might be more comfortable. Release your hold on your breast (unless it is very heavy and full, in which case you may need to support it during the feed – see the underarm/ rugby hold below) and move your arm gently around the baby.

Underarm or rugby hold: The underarm or rugby hold can also be useful if your breasts are heavy, as the weight is partially supported by the baby. Also, using a lying-down position or the underarm or rugby hold can be useful if you’ve had a Caesarean.

Breasts feel hard and sore (engorgement) 

Many women’s breasts start to feel full, sore and hard as their milk supply increases (the milk “comes in”). This feeling is most common three to five days after baby’s birth. If your breasts are really sore and hard, and feel too full, it helps to put something cool on them after a feed. This can reduce the hot, swollen feeling.

If your baby is finding it tricky to get a good latch, you can hand express a little milk first. This will soften the areola (the darker area around the nipple) so that it’s easier for baby to latch – and less painful for you.

Blocked milk ducts or mastitis 

Talk to your midwife or doctor straightaway if you feel unwell and part of your breast is red or feels sore, hot, or lumpy. You may have a local inflammation caused by a blocked milk duct or a more general breast infection (mastitis). It is better for you and baby if you continue breastfeeding.

It is important to empty the sore breast; if this is too hard to begin with, feed from the other side until the sore side “lets down”. Be sure to empty the sore side by feeding or pumping. Massaging the sore area gently at the same time can help, as does warming the breast before feeding. Emptying the breast will help to reduce the blockage and keep your milk flowing. It is important that you have bed rest for at least 24 hours and that you drink plenty of fluids.

Keep the sore area warm with a wheat pack or wrapped hot water bottle, or cold pack if preferred – whatever will help you to feel more comfortable. Your midwife or doctor may, if necessary, prescribe an antibiotic to reduce the inflammation, but if caught early, this is not usually necessary. Wear a supportive bra that does not cause painful pressure.

Some babies will be able to empty both breasts every time they feed. Others will be full after one. Although babies often prefer one breast, make sure that baby feeds from both breasts throughout the day to avoid blocked milk ducts.

Breastfeeding in public

Breastfeeding is the perfect way to feed your baby when you’re out. Breast milk is free, fresh, and requires no preparation. It’s your right to feed your baby anywhere, any time and any place.

Some mums might be shy, but breastfeeding is part of everyday life – it’s not something that should be hidden away. Here are some tips if you feel a little uncomfortable.

  • Be relaxed.
  • Get the support of friends and whãnau. Ask them to sit with you in a café or on a bench in a shopping mall while you feed your baby.
  • Be comfortable. Before you start, make sure that you have somewhere to sit that is comfortable and has back support.
  • Practise before you go out. Try breastfeeding your baby in front of a friend or the mirror to practise your technique and see what works best for you.
  • Wear the right clothing. Wear a breastfeeding or nursing bra that can be undone with one hand. Tops that are easy to pull down or push up can also help. If you want more privacy while you’re breastfeeding, you can cover up using a large wrap, muslin, shawl, or blanket draped around your shoulders
  • You could also try a baby sling or baby carrier. Make sure that your clothes are easily adjustable so that you can feed your baby without having to take the sling off.

Drinking alcohol

Alcohol passes through your breast milk to your baby, so you should avoid it while you are breastfeeding. Drinking alcohol can also lower your milk supply and it might make your baby irritable, unsettled or sleepy, and not able to feed well. If you do have a few drinks, make sure that you avoid breastfeeding for at least a couple of hours afterwards. You could use expressed milk instead. If you choose to drink, make sure that your baby has someone looking after them who is alert to their needs and free from alcohol or drugs.

For more help or info

Reprinted with permission of The Ministryof Health (www.health.govt.nz)

If you’re worried your baby isn’t getting enough milk

Sometimes you may feel as if you don’t have enough milk. This is hardly ever the case. Babies normally have some breastfeeds close together (this is called cluster feeding). They also breastfeed more often when they’re going through a growth spurt. Sometimes they are fussy and unsettled, but that’s just because they are new babies and going through normal newborn unsettled periods.

Remember that the more often breast milk is removed from the breast by a baby, the more milk will be produced.

BREAST MILK = good for baby, good for you

Breast milk is the perfect food for your baby because:

  • It’s all that your baby needs to eat and drink for about the first six months. 
  • It helps to protect your baby against colds, tummy bugs, infections and allergies. It also helps to protect your baby from dying suddenly in their sleep. 
  • Breastfeeding helps your baby to feel safe and secure. 

Breastfeeding is perfect for you too because:

  • It gives you a chance to rest while you are feeding your baby. 
  • It helps you to feel close to your baby. 
  • It saves you time. 
  • It’s free. 
  • It may reduce your risk of some cancers and bone disease. 

Problems with breastfeeding

Sore nipples

You may have sore nipples until your breasts become used to breastfeeding. Nipples are usually most sore in the first week after baby’s birth. They should feel better seven to 10 days after baby’s birth. 

During that first week, the initial soreness should wear off 15–30 seconds after the baby has latched. If it doesn’t, ask your midwife for help. You may need help with positioning and latching your baby. 

If nipple soreness continues into the second week, or gets worse rather than better, get help. If there is a problem with baby’s latch this can be corrected, or the soreness may be due to another issue.

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