Lorna C. Aliperti, APRN, IBCLC

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Getting Started

Breastfeeding Tips for Beginners

The First Days

Suggestions for what to do, what to buy and how to solve the most common problems faced by nursing moms.

  1. Before you have your baby, get a reliable book on breastfeeding. One of the best is Breastfeeding Made Simple by Nancy Mohrbacher, IBCLC. The book is non-technical and full of practical information. Go to a La Leche League meeting. Many women have never seen a mother breastfeed.
  2. Don’t automatically decide to have an epidural. Some studies have shown that epidurals are related to increased breastfeeding problems in the early days. The best breastfeeding rates have been shown to be associated with natural childbirth and the presence of a doula. Nonetheless, even if you have a Cesarean birth, epidural and every possible medical intervention, you can still breastfeed.
  3. Make sure that you get help with latching the baby on as soon as possible after delivery—even if you have a cesarean. The sooner the better, but preferably within the first two hours. Many studies have shown that women breastfeed for a longer time (because it is going well) the earlier breastfeeding is started. In fact, the first several weeks may establish a setpoint for breastmilk production (by determining the number of prolactin receptors in the breast) which may not be easy to change later. Milk removal–by baby or pump–at this time is important.
  4. Room in with your baby if you can. Many reasons given for keeping the baby in the nursery are for hospital convenience only. It is easiest if you have the baby’s father or another support person to help you, so you aren’t the only available caregiver.
  5. Nipple confusion does seem to occur in some babies, especially those who are having trouble latching on. It is not so much confusion as preference—if one method works better, a baby will tend to prefer it. If the baby is given a supplement, there is no proven advantage to cup feeding, finger feeding, using a medicine dropper, etc feeding. Babies can come to prefer any of them. If you are going to supplement, bottles and nipples with a wide base such as Avent or Evenflo Ultra Wide do seem to help the baby get used to opening their mouth more when they feed.
  6. If your baby has not latched on, or is latched but causing you extreme pain before pumping and feeding with anything, consider trying a nipple-shield (a silicone cover for your nipple which looks a bit like a Mexican hat). Not only does a nipple shield makes it easier for the baby to latch on, it also reduces the excessive suction which can not only cause nipple pain, but also usually reduces milk transfer. Modern nipple shields do not lower milk supply, for which they once got a bad name. After the baby is feeding, there is less stress and latch can be addressed in a more relaxed manner. Keep track of the baby’s intake (see #11) as with any breastfed baby.
  7. It is best to feed the baby often—at least every three to four hours in the hospital, and to wake the baby if necessary to feed. Sleepy babies who don’t breastfeed tend to get more sleepy, making it harder and harder to get started. The baby tends to feed more often just before your milk “comes in”. Some call it the second day feeding frenzy. It is always darkest before the dawn.
  8. Don’t arbitrarily switch sides when you breastfeed your baby. No one wants to be stopped mid-meal and moved to another table. Let the baby finish feeding on one side. The emptier your breast is, the more fat there is in your milk, so you don’t want your baby to miss dessert. However, if your baby is unhappy feeding on just one side, follow his or her lead. The customer is always right..
  9. Sore nipples are a common problem which plague many new moms. If you feel more than a mild “ouch” at the beginning of the feeding, it is best to get help, make sure the baby is transferring milk. This not only hurts, but results in less milk for the baby , who will usually either fall asleep or want to nurse all the time. For the first few days, nipple soreness caused by trauma (sunburn- like feeling, hurts most at the beginning of feeding, scabs or blisters) can be helped by lanolin or gel discs such as Soothies. Medicated ointments such as Bactroban are especially helpful. Soreness of any kind that persists for a week or returns after a period of pain free nursing indicates the need for help.
  10. Engorgement often causes babies to have trouble latching on. Moms find that the baby who nursed well in the hospital is having difficulty and may start crying when mom tries to put him or her to breast. The breasts are often too full for the baby to get a good mouthful. The answer is cold compresses to reduce the swelling, and warmth and pumping just prior to nursing to help soften the breasts. Many moms find that cold cabbage leaves applied to the breast and left to wilt before being replaced seem to help. Research on this has been mixed, but it can’t hurt. You can wear them inside your bra.
  11. It is a good idea to keep track of the baby’s output and feedings for the first few days. See the Breastfeeding Log. That way you can be sure that the baby is getting enough, or have an indication that there may be a problem. Many moms find it difficult not knowing how much the baby is getting. Learn to watch your baby. It is usually safe to assume that a fussy or crying baby is hungry and wants to nurse. Being hot or cold, wet or soiled, etc. is less likely to be the problem.
  12. Once home, make sure you have help and reliable sources of advice. Dad could make no better use of his vacation time. Don’t let anyone in your home who will make you uncomfortable. Now that you are a mother, your baby is dependent on you. It is not selfish to see that your needs are met. As they say, “If momma ain’t happy, ain’t nobody happy.” A tense or unhappy woman can’t be an optimal mother.

Final thought: In general, the more you feed, hold, talk to and comfort your baby in the early days and weeks, the happier and easier to live with he or she will be. Babies are people. When you are making parenting decisions, try putting yourself in the baby’s place. Remember the golden rule, and you can’t go wrong.