Breast-feeding

Parenting in the Early Years

Breast-feeding

Breast-feeding is the natural and best method for feeding your baby and is strongly recommended by your baby's doctor. It provides unique and superior nutrients, as well as some protection against common childhood illnesses. Studies indicate that breast-feeding also promotes brain development and may provide protection against obesity and some adult disorders.

Although breast-feeding may seem somewhat awkward at first, you will soon master the skills to make this one of the most enjoyable experiences of childrearing.

Remember, there is no one correct way to breast-feed an infant. Styles of breast-feeding vary with the individual situation and personality and age of the baby.

If you feel that you are having problems or if you have questions about breast-feeding, contact your child's physician or call Meriter Hospital's Breast-feeding Helpline at (608) 417-6547 or 1-800-261-4449.

Most breast-feeding problems can be easily solved if dealt with early.

Cradle hold for breastfeedingHow Often to Feed

Feeding schedules vary from infant to infant. One baby may breast-feed every hour while another may require feeding every two to three hours. Let your baby be the guide.

A healthy baby with a good suck will eventually fall into a nursing pattern that is best suited for her. The average infant will feed 8 to 12 times per day. During the fussy period, additional feedings may be needed.

Wake your baby to feed at least every three hours for the first week. This helps to establish a good milk supply and to ensure that the baby is getting enough milk.

Volume of Feedings

The amount of milk you produce will depend on the amount of sucking the baby does at the breast. The more the baby sucks, the more milk you will make.

A good way to tell if the baby is getting enough milk is to count the number of wet and stool-soiled diapers. During the first day or two, she may wet only two or three diapers per day and the stools are tarry black (meconium stools). After the fourth day she should have 6 to 8 wet diapers per day. The stools increase in frequency (at least four per day) and gradually change to a loose yellow-green to yellow-tan color.

Most babies lose weight after birth (8 to 10 percent of their birth weight is expected). This is normal. After several days they begin to regain weight and are usually back up to birth weight by 2 to 3 weeks of age.

Engorgement

Engorgement is a painful over-fullness in the breast. It does not always occur, but is normal when it does. This occurs within the first few days of nursing, and goes away in a few days. If the breasts get too full, the nipples look flat and it is harder for the baby to latch on. You can hand express a small amount of milk right before a feeding to help soften the nipple area. Some women like to hand express while standing in a warm shower, or apply hot packs on the breasts before feeding. Frequent feedings will help to relieve your breasts of accumulated milk. Cold packs after the feeding can also help decrease discomfort.

Most mothers leak some milk from their breasts. Most leaking occurs when the breasts are very full, when you hear a baby cry or in response to sexual orgasm. You can temporarily stop the leaking by putting gentle pressure on the nipple. You can also wear nursing pads made of cloth. Do not use plastic lined pads, which prevent air circulation. Avoid wearing hard plastic shells between feedings as they put constant pressure on the area around the nipples and encourage leaking.

Avoiding Sore Nipples

Most women experience nipple tenderness in the first few weeks of nursing, especially when the baby first latches on. Pay careful attention to the following suggestions that will reduce nipple soreness.

Latching on during breastfeedingNurse in a place where your back is well supported and comfortable. Hold your baby close to your breast and relax.

Once comfortable, bring the baby up to nipple level-do not lean over. This will prevent neck and back strain.

Arrange the baby so that she faces the breast and does not need to turn her head to nurse. Alternate nursing positions.

Breastfeeding

  • Use one hand to cup your breast behind the areola (darker skin around the nipple). Place the thumb on top and four fingers underneath. Your hand should make the shape of the letter "C."
  • Gently tickle your baby's lower lip with the nipple and wait for her to open her mouth wide. Then pull her in toward the breast allowing the mouth to engulf the entire areola and nipple. Her chin and tip of the nose should touch your breast. Her body should be closely tucked into yours.
  • Break the suction to end the feeding by inserting your little finger into the corner of her mouth
  • Feed the baby frequently. If she becomes too hungry, she will suck more vigorously and this can contribute to nipple soreness.
  • After each feeding, allow the breast milk to dry on your nipples. This is Mother Nature's breast cream. Leave your bra flaps down to allow complete drying of the nipples. Avoid using soap, ointment or creams unless advised to do so. Use plain water when bathing the breasts.
  • Alternate the starting side at each feeding. If one nipple is more tender than the other, start with the less tender side and then switch after the milk is flowing.
  • Ideally, the baby will feed around 15 minutes/side. Exercise caution in allowing extended nursing times when the baby is not actively nursing. The wet mouth on the wet nipple area can cause nipple soreness.
  • Call for help early if soreness persists and gets worse.

Flat Nipples

Some women have flat or inverted nipples. To raise the nipple, permitting easy attachment, roll the nipple between your fingers and thumb until it stands up. Applying ice is another method to help it stand up. Plastic breast shells can be worn between feedings. These are worn inside your bra.

Plugged Ducts and Breast Infections

A plugged duct is an accumulation of milk or dead cells in a milk duct. This causes a small, pea-sized lump that is felt in the breast. It may be tender and may feel somewhat warm to the touch. It usually goes away in a day or two using hot packs to the breast, massage during nursing and frequent position changes during nursing. Changing positions frequently reduces the pressure of nursing to different areas of the breast. Wear non-constrictive clothing. If you are weaning, do so gradually.

If the lump is still present after 2 or 3 days, contact your physician for further assessment.

Breast infections are associated with a localized lump that is hot, painful and red. There may also be fever and chills. Breast infections need to be treated with antibiotics. Contact your physician. You do not have to stop breast-feeding.

Your Diet

If you have healthy eating habits, there is no reason to change them. Most mothers find they can eat anything they like - in moderation.

Some babies may react to certain foods in their mother's diet, including caffeine, chocolate and spicy foods.

Foods that upset the mother's stomach have the potential to upset the baby's stomach too, causing cramping.

The Supplemental Bottle

Many mothers find it convenient or even necessary to supplement breast-feeding with bottles of stored breast milk or infant formula.

Some babies find it easier to suck on a bottle than the breast, and may refuse the breast if a bottle is introduced too early. For this reason, it is best to wait until breast-feeding is going very well before introducing the bottle.

On the other hand, some babies will prefer the breast and refuse the bottle. If supplemental bottle feeding is required, perseverance typically results in success. If you plan to use a supplemental bottle, introduce it after breast-feeding is well established.

If you are having problems with the transition of breast to bottle, call your physician.

Supplemental Vitamins and Flouride

Vitamin D supplement, needed for calcium absorption to develop good bone strength is recommended for breast fed babies. This is administered via an infant multi-vitamin liquid. Unfortunately, these often have a strong smell and infants may spit them out. Mixing with 1-2 ounces of breast milk may make administering easier.

Your doctor will address the need for a fluoride supplement if you do not have fluoridated water. 

Medications

Consult your physician before taking any medications, although most over-the-counter medicines are safe in moderate doses. Take minimal doses when possible.

Please remember that all the reasons you avoided alcohol, smoking and "street drugs" during your pregnancy are now equally important for healthy breast milk.

Fertility

Breast-feeding is not a satisfactory method of birth control. Some oral birth control pills can reduce breast milk production. Talk with your physician about this issue.