How to Breastfeed

You and your baby will benefit from lots of skin contact with each other after the birth, and also by being kept together. This way you will both be happier and you will be able to get to know your baby better.

We used to think babies would let us know when they were hungry by crying, we now know that this causes the baby distress and also uses much needed energy, you may find that if left to cry for any length of time, when you try to feed your baby he falls asleep before finishing a feed. If you allow him time close to you and gently calm him you will know when he is ready to feed again by showing his feeding cues.

Some cues for feeding readiness from birth

Just lay awake or rousing from his sleep.
Wriggling and stretching.
Sucking his hand/fist.
Pushing his tongue in and out of his mouth (this is the way he will milk the breast).
When picked up- breast searching & head bobbing.

How to hold your baby to feed him

There is no single, right way to hold a baby to breastfeed. You need to find a position which feels good for both of you. The size and height of your breasts will determine certain holds, So what works well for your friend may or may not work well for you. You may also find that a hold that works well at first does not work as your baby gets bigger. It's good to practice a few ways of holding your baby to feed.

Lying down to feed can be a really useful position, especially for night feeds and also in the day so that you can catch up on some rest!

Find feeding positions that allow you to relax your shoulders and if you sit up to breastfeed, make sure you have good back support. Some women like pillows to help support them. Others don't. Be sure that your pillows don't stop your baby from being able to tilt his head back to attach to the breast correctly see attachment section below.

Whichever position you choose this basic guide should be followed

Your baby's head, shoulders, and hips are in line, not twisted or turned. (A twisted baby will find swallowing really difficult- you try the position you are holding him in and try swallowing if you are in any doubt)
Your baby is directly facing the breast, he should not have to turn his head to attach or reach out for the breast.
His body is pressed against yours, bottom, and shoulders pulled in close.
His head should be free to tilt back a bit. The chin should touch the breast first.

Attachment

Comfortable breastfeeding depends on where your nipple is in your baby's mouth. This depends on how your baby attaches at the breast.

To understand this better, put your thumb in your mouth. Feel the hard ridges of the roof of your mouth against it (hard palette).When your nipple is pressed against this hard area in your baby's mouth, it can be very uncomfortable especially when rubbed back & forth for the length of each feed.

If you go back a little further in your mouth, you'll feel where the roof of your mouth turns from hard to soft (soft palette). Once your nipple reaches the soft palette breastfeeding feels comfy. There is no undue friction or pressure on your nipple.

Wait for your baby to be ready to feed, and hold him as described above

Hold his body so it is facing yours, with no gaps.
Hold your baby so that his nose is in line with your nipple. You can encourage him to open wide by teasing him with your nipple - rub it along his top lip!
Let his head tilt back a bit. (Avoid pushing on the back of his head.)
As his mouth opens wide, quickly bring him onto your breast- chin first.
Give him a gentle push from behind his shoulders to hold him firmly in place.
He will take a large mouthful of breast

Signs he is well attached

His chin is tightly against your breast
You feel a gentle pulling at the breast but no pain. (In the first week or so, you may feel some discomfort for the first few sucks)
You can see more of the dark area around the nipple above your baby's upper lip than below, which means the latch is off-centre as it should be.
Your baby breastfeeds with a wide open mouth, not a narrow mouth.
You hear your baby swallowing. He starts with short bursts of sucking followed by long rhythmical sucking and swallowing. It is normal for him to take a breather and pause for a while.
His mouth looks full of breast
He finishes the feed and comes off on his own
Offer the other breast. Babies take one breast at some feeds and both breasts at other feeds- let him decide

Breastfeeding at birth

What to expect in the early days

A newborn's tummy is as small as a marble.
At birth, you have just the right amount of milk to fill it.
For the first 3-4 days you will make 'colostrum' which is thick, immunity boosting clear or yellowish fluid. This comes in perfect sized amounts roughly 1 and a half teaspoons for each feed on the first day, quickly increasing to 7 and a half teaspoons by the time the milk 'comes in' on the 3rd-4th day
Your baby may want to breastfeed often. He will need to get 8 to 12 feeds in 24 hours
If your baby is reluctant to feed you may need to rouse him- this could be due to pain killers given to you in labour or that your baby is jaundiced if you are at all concerned please speak to your health professional or visit your GP
Your breasts will never empty- the more you feed the more milk you will make- A mother can make enough milk for twins, triplets, and more.
Your baby will need no other food or drink, lots of breastfeeding brings in more milk faster.If you give other fluids- this will reduce your milk supply and it may increase your baby's risk to infection by stopping the flow of immunity through the milk.
Lots of breastfeeding also prevents engorged breasts see problems page
Keep your baby skin to skin as much as possible. His feeding instinct and your milk supply will be better for this

Your nipples may feel tender for the first few sucks, then pain free
If your baby does not seem full you can offer each breast more than once.
1-2 wet nappies each day and black stools until your milk 'comes in' (day 3-4).
Up to 10% weight loss by Day 4 is okay.

The black stool of a baby feeding on colostrum in the first 3-4 days

From 4 Days to 6 weeks

His tummy grows from marble to large walnut size by Day 10.
Most babies feed 8-12 times a day but not at set times. Clustering feeds together at certain times of the day is common.
Babies may take one breast at a feed, or they may need to feed from both breasts, you may even wish to swap sides again if he appears to still be looking for food.
More breastfeeding makes more milk.
Most mothers make lots more milk from Day 3 or 4 onward.
Drained breasts make milk faster. Full breasts make milk slower.
Just breastfeed. Try to avoid dummies, this may confuse the way your baby learns to breastfeed.
Try to avoid water and other liquids this will confuse your milk making hormones and reduce your supply
Your milk supply grows from (30 ml) to about (900 ml)per day between Day 1 and 6 months

If your breasts feel very full, breastfeed more or express milk. This will make you feel better, not worse.
By Day 3-5, the black stools turn first green and then yellow.
After that, expect 3-4 or more yellow stools every day.
By Day 5 you will expect to see 5-6 or more wet nappies per day
Your baby should be back to birth weight by 3 weeks,and will then gain at least 6 ounces (170 g) a week (This will be logged in your child health record book)
Most babies sleep for one 4-5 hour stretch in a day. But this may not be at night.

The yellow stool of the baby receiving plenty of breastmilk from day 4-5 onward

How often to feed him

Be aware of your baby's cues to feed

Let him feed when he asks for it (Baby led feeding). This way you can be sure he is having all that he needs. Just like we as adults eat when we're hungry and drink when we're dry, your baby has the ability to tell you that he has those needs too. Your breastmilk is his glass of water right through to his 3 course dinner and he knows exactly what he needs to thrive.

8 - 12 feeds in 24 hours would be normal

From 6 weeks to 6 months

As your baby gets bigger and older his stomach grows larger and holds more milk, so he may feed less often.

Your breasts may no longer feel full, even thou you have adequate milk supply. Your body is capable of providing milk when it's needed without storing it up in your breasts

Babies need about the same amount of milk per day at six weeks as six months.

Older babies often feed faster.
Some babies this age have fewer stools per day but gain weight perfectly well.
Older babies may pull off the breast when they hear or see things going on around them, they are becoming more social & nosey!
Until 4 months, a weight gain of at least 6 ounces (170 g) a week
From 4-6 months, a weight gain of at least 4-5 ounces (113-142 g) a week

More than one baby to feed?

If you have had twins or triplets, the art of achieving comfortable breastfeeding is to treat each baby as a single one & give them each the opportunity to learn to breastfeed before trying to feed 2 together. This way you will minimise your chances of becoming sore.

Most mums can provide enough milk for multiple births

Tandem feeding

This is when a mum is feeding a toddler or older child alongside a new baby. This can be a really rewarding experience for all of you, but you need to remember that the newborn should have priority when feeding. He needs to receive a good supply of immunity- boosting colostrum and of course essential nutrients to thrive!