It's true that getting off to a good start with breastfeeding can be more difficult than what many may expect. While the American Academy of Pediatrics recommends exclusive breastfeeding for the first six months, with continued breastfeeding along with complimentary foods until 1 year or longer (the World Health Organization recommends at up to 2 years and beyond), just 44% of American moms are exclusively breastfeeding at 3 months. This is due to many factors, but preparing yourself ahead of time and having good support can go a long way in helping you to reach your breastfeeding goals. Consider taking a breastfeeding class, visiting a local La Leche League meeting, and taking the time to research breastfeeding basics before your baby arrives. Here are my 5 Top Tips for getting off to a good start:
1) Breastfeeding shouldn't hurt!
Many people will tell you that breastfeeding is just going to hurt for a couple of weeks, and that you'll get through it. While many moms may experience discomfort in early breastfeeding, it shouldn't, and doesn't have to be painful. If you are dreading feeding your baby or you have noticeable damage to your nipples you should get help right away. With proper support and guidance, you can learn how to achieve a deep latch which will not only protect your nipple from injury, but is also the most efficient way of transferring milk to your baby. There is no "wrong" way to breastfeed if your latch is comfortable and your baby is getting what they need, but if you are experiencing pain, it is an indicator that the latch needs to be assessed. A non optimal latch does not transfer milk well, so the sooner you get help the better for you AND your baby!
2) Skin to skin is not just for the hour post birth!
Many people are now aware of how important skin to skin time is after delivery, but aren't as aware that skin to skin time continues to be important for the first few weeks and even months of life for several reasons. In particular, skin to skin time before and during feedings can help rectify latch problems. It is thought that skin to skin time calms the baby, and restores the pre-programmed biological behavior to attach to the breast and begin suckling. Keeping baby nice and close will also give you plenty of opportunities to nurse and ensure you don't miss any feeding cues.
3) Feed on cue- not on schedule (AKA watch your baby, not the clock)
To establish and maintain a good milk supply you should be watching for hunger cues from your baby, and feeding on demand. The rule here is to feed "early and often". As soon as your baby begins showing interest in eating by exhibiting feeding cues like rooting, bringing hands to the mouth, and mouthing/suckling/ lip smacking motions, you'll definitely want to bring them to the breast. Crying is a late sign of hunger, and a crying baby can be difficult to latch. Some suggest bringing baby to the breast even before the well known cues present. REM (Rapid Eye Movement) sleep, into which a baby cycles every 30 minutes or so while resting, when their little eyelids begin fluttering, is now known as a feeding cue according to the Healthy Children Project Center for Breastfeeding. The Center for Breastfeeding says that the REM and "quiet alert" states are ideal for starting to breastfeed. You don't need to wait for any other specific motions, and you may be better off if you begin the feeding before the more well known cues present.
4) Proper body position- "Tummy to Mummy, nose to nip"
Say it with me,"tummy to Mummy, nose to nip". This mantra is well known to all lactation professionals, because it is an easy way to remember proper body position for beginning a feeding. The baby's belly needs to be completely in contact with its mom's belly in order to achieve an ideal latch. In addition, you should be aiming your nipple at the baby's nose, not its mouth when offering the breast. The excretions from your nipple's Montgomery glands not only help the baby locate the breast, but also elicit a gape response, causing the baby to open its mouth widely- which is needed to establish a deep (comfortable and effective) latch.
5) Latch basics- watch for gape, bottom Lip leading, asymmetric latch
Once you've gotten tummy to tummy and presented your nipple near your baby's nose, you'll watch for your baby's gape. As you bring your baby to the breast he'll begin to tilt his head back, his bottom lip will reach the breast first, and his mouth will seal around a mouthful of breast-- not just the nipple. Check the corner of baby's mouth- the lips should be opened widely, more than 90 degrees if baby is latched deeply. The lips should also be flanged out like a fish. The baby will have more of the bottom of the areola in his mouth than the top, forming an "asymmetric latch". This is important, because it will allow the nipple to be placed comfortably in the top rear portion of the baby's mouth, contacting the soft palate, not the hard palate where the nipple can be easily injured.