Getting Started Breastfeeding

Newborn / Baby Care & Feeding

Guiding new parents through baby’s first year and beyond is a top priority at Advanced Pediatrics. The following newborn and baby care articles have been written by Advanced Pediatric Associates and Pediatric Web. Should you have any questions regarding the following care recommendations, please call our Nurse Line at 303-699-6200, Option 2.

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Getting Started Breastfeeding

We encourage breastfeeding as the most natural, satisfying and beneficial way to feed babies. In addition to maintaining a close mother-baby relationship, breastfeeding offers benefits to both mother and infant. Moms experience quicker postpartum recovery, reduced health risks, and psychological benefits. Breastfeeding provides your baby with the ideal milk, enhanced immunity (protection from disease), and a far lesser incidence of allergies Studies also show psychological, developmental and cognitive benefits for breastfed babies. In addition, breastfeeding is less expensive and often more convenient. 

Before your milk comes in your breasts produce colostrum, which is yellow to orange in color and thick and sticky. Colostrum is low in fat, and high in carbohydrates, protein, and antibodies to help keep your baby healthy. Though it is low in volume (measurable in teaspoons rather than ounces), it is high in concentrated nutrition for your newborn. 

Breastfeeding is a learning process and does not always come easy. Be patient and confident that you can breastfeed your baby. It is often uncomfortable for the first few weeks until you and your baby learn to latch properly. The best rule for breastfeeding is to nurse as frequently as your baby seems interested. Babies do best on their own schedule. As you feel up to it, nursing about every 1 to 3 hours the first 2 to 3 days brings your milk in more quickly and minimizes the breast engorgement that may accompany the arrival of your milk supply. Most babies feed 10 – 20 minutes per breast, typically longer on the first breast. You will know your infant is done when he or she either “pops off” your breast and doesn’t immediately root again or falls asleep with your breast in his or her mouth. Though a baby will typically nurse from  both breasts, he or she may occasionally be satisfied after nursing on just one side. After nursing on the first breast, burp your baby, try to reawaken and offer the second breast. When feeding your infant, watch your baby not the clock. You should see intermittent swallowing and a gentle ear wiggle with nutritive suckling. Begin each new feeding on the breast that was nursed from last or not used at all in the previous feeding. 

To ensure successful breastfeeding first awaken your baby by fully unwrapping him or her, changing his or her diaper, or briskly rubbing his or her body or feet. Next, if your baby is not already rooting, stimulate the sucking reflex by letting him or her suck on your finger or by stroking the cheeks. If you need to, stimulate your nipple to get it erect. When latching your baby you need to assist your infant with head control; this is easily achieved in the football position. To achieve a good latch, baby’s mouth should be open wide and draw in an inch and a half of breast tissue into his or her  mouth.

Nipple tenderness is frequently experienced in the first week of breastfeeding with the initiation of each feeding. Pain that persists the entire feeding is not normal. The very best way to prevent nipple soreness is by making sure your baby is properly positioned on your breast. When properly positioned, your baby’s jaws go beyond the nipple to come together on the areola, about an inch and a half in, not on the nipple itself. Babies who take enough of the areola into their mouths massage the breast which causes milk to be released from the ducts. Babies who suck or chew only on the tip of the nipple do not empty the breast effectively and cause sore nipples. You can soothe soreness by expressing breast milk onto your nipples and exposing them to air dry after each nursing. You may also try lubricating sore nipples with lanolin (available at the pharmacy or grocery store) after each nursing. You need only clean your breasts once a day when bathing with warm water. 

Once you are home from the hospital it is best not to let your baby go more than 2 to 3 hours between daytime feedings. However, once your milk is in you may let him or her sleep one 5 hour stretch at night. Encouraging your baby to nurse more often during the day may result in your baby sleeping a little longer at night. 

After the first few days of nursing there are signs from both mother and baby that indicate breastfeeding is going well.

For mother these include:

  • Milk “comes in” about 2 to 5 days after delivery
  • Nipple tenderness gradually decreases
  • Breasts feel full before nursing and become softer after feeding
  • A “let-down” or tingly, pins and needles sensation including milk dripping and spraying (more typical after 2 to 3 weeks)

For baby these include:

  • Nursing 8 to 12 times in 24 hours (about every 2 to 3 hours) with at most one 5-hour stretch at night
  • Seeing / hearing swallowing during nursing
  • Baby is relaxed and falls asleep after nursing
  • Bowel movements that look like yellow, seedy cottage cheese or mustard by the 4th or 5th day of life, and come either after every feeding or every other (frequency will decrease with time)
  • Wet diapers 6 to 8 times a day with pale yellow, odorless urine

It is important that a breastfeeding mother eat regular, balanced meals. You will need 500 extra calories per day above your normal pre-pregnancy diet and should remain on your prenatal vitamins while nursing. You may eat any food that agrees with you, even spicy foods. Avoid excessive amounts of caffeine and alcohol, but an occasional glass of either is all right. Be sure you get plenty of fluids and drink when you are thirsty. 

If you need pain medication (such as acetaminophen or ibuprofen) during the first few days, you may take it. Please consult our office before taking other medications while breastfeeding. Your provider will recommend that your infant start vitamin D supplementation at two weeks of age. This is very important for all breastfed infants.

All new moms need plenty of rest and relaxation in order to recover from the birthing process. Sleep when baby sleeps, including daytime naps, especially at first. Allow family, friends and neighbors  to do things for you around the house. Remember that breastfeeding is a learning process for both baby and mother.

Supplementary formula is not usually necessary as a baby is learning to breastfeed. However, your provider may at times suggest that you give formula to supplement your breast milk until your milk comes in. Breast pumps are easily accessible and can be very helpful in getting the breastfeeding process going. 

If you are concerned about your production of milk, your baby’s intake, or if you have any questions or problems, don’t hesitate to call our Patient Care Line at 303-699-6200 and speak with one of our registered nurses. A large part of  successful breastfeeding is established in the first two weeks, and we want to be there to support you as needed.

After breastfeeding is well established (generally between 2 to 4 weeks of life), we encourage bottle feeding 2–3 times per week with either expressed breast milk or formula. This helps your baby learn how to use the bottle if the need arises, or if you will be returning to work. When returning to work, we suggest increasing bottle feedings and pumping during your work hours for 2 weeks prior to your first day at work to ease the transition. 

 

Written by Advanced Pediatric Associates

Reviewed July 2015

 

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Advanced Pediatric Associates

Disclaimer:  If you are not a patient of Advanced Pediatric Associates, we recommend that you consult with your own physician regarding health concerns. This information is provided as a guide to our patients, but in no way replaces the advice given by our staff. Occasionally, advice given by our providers or nurse line may vary slightly from that offered by Pediatric Web and its contributors. If you are unsure of any issue regarding your child's health, please call our Patient Care Line at (303) 699-6200. 

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