8 tips to help you get the best start breastfeeding
The first few days after my baby's birth went wonderfully. The problems with nursing started after my doctor advised giving her a bottle of water to "cure" her jaundice. I think she developed nipple confusion. I want to nurse my next baby. Any words of wisdom would be greatly appreciated.
Question:Debbi Donovan
Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more
I'm sorry that your first experience with breastfeeding was not what you had hoped for it to be. It does sound like there were quite a few issues following your baby's birth that made it really difficult to get breastfeeding off to a good start.
8 things you can do to get breastfeeding off to the best start
1. Begin preparing during pregnancy. The single most important thing that you can do to assure your success in breastfeeding is to begin preparing during your pregnancy. Though breastfeeding is natural, it is not instinctive. By attending breastfeeding classes you can begin to learn more about the loving act of feeding your baby at your breast. Mother-to-mother support, as provided by La Leche League, can also prove to be invaluable. At these meetings you will share experiences with other nursing mothers and can begin to learn more about the art of breastfeeding.
2. Get referrals for a Lactation Consultant. Find a Board Certified Lactation Consultant that seems like a good fit for you during your next pregnancy. Call and interview her ahead of time. If you have any difficulties, seek help early on, and get breastfeeding off to a great start. It's a great gift to give yourself and your baby.
3. Reconsider the use of labor medication. Medications used during labor -- including the epidural -- can have an affect on your baby's behavior at the breast. This may last for the first two weeks because these medications may take quite a while to clear from your baby's system. A baby whose mom has had a medicated labor/birth has more chance of being a baby who is sleepy or exhibits sucking difficulties right after birth. Using a labor assistant for your birth may help you to avoid or reduce the amount of medication you use. If you do use medication, the less medication you receive, and the later in labor, the less you will pass on to your baby.
4. Nurse early and often. Breastfeeding should be initiated as soon as possible following your baby's birth. Research has shown that in the two hours following the birth, infants are in a state of alertness, which is accompanied by a strong sucking reflex. It is at this time that your baby, eager for the comfort of your arms, will lick or nuzzle your nipple and may even decide to latch on and take her first taste of your milk (colostrum). These early feeds have an imprinting effect and help to get breastfeeding off to a good start.
Next page: More tips to help you get the best start
5. Give your baby lots of practice time at your breast. This is very important during those first few weeks of your baby's life. In the beginning, she may just nuzzle or lick your nipple. That's okay. Allow her a lot of skin-to-skin contact. She will quickly become accustomed to, and prefer, your smell and your taste to any artificial nipple. Your baby should be fed on cue at least every two to three hours. Nursing your baby early and often helps to keep your breasts soft and graspable, and helps to lessen or even prevent engorgement. Watch your little one for signs of hunger, such as sucking sounds and/or lip movements, rapid eye movement during the light sleep cycle and changes in facial expression. Try to anticipate your baby's hunger by watching for these signs.
6. Avoid supplements. The practice of giving water to a baby in place of breastmilk could be dangerous. It definitely does not "cure" jaundice, or reduce your baby's bilirubin levels. In fact, this practice could complicate the situation in several ways. Supplementation of water reduces the time your baby spends at the breast, in the days your milk supply is developing, decreases your baby's caloric intake, and increases jaundice levels. When a baby is put to the breast for frequent feeds she is less likely to be jaundiced. If supplementation with breastmilk or formula does become necessary, a cup can be used, your baby can be fed at the breast using a nursing supplementer, or can be finger-fed using a syringe.
7. Jaundice does not mean the end to breastfeeding. Remember, physiologic jaundice is a normal event and occurs in almost every baby. It is not a disease. Many babies -- at least 50 percent -- develop this type of jaundice. It is not dangerous to your baby. Frequent feeds in the early days really help your baby to clear the bilirubin from her body. The more bilirubin cleared, the less jaundiced your baby will become. And the less jaundiced, the more awake your baby will be, and eager to nurse. As an aside, water supplementation, using artificial nipples, can also affect your baby's suck. If your baby does become jaundiced, it is not always necessary to supplement, and it is not always necessary to remove your baby from the breast for a 24-hour period (as a test) to see if her levels fall. The American Academy of Pediatrics, in its 1994 practice guidelines, states, "The AAP discourages the interruption of breastfeeding in healthy term newborns and encourages continued and frequent breastfeeding (at least eight to ten times every 24 hours)."
8. Feel confident that your baby is getting enough milk. Many moms worry whether or not their baby is getting enough milk. In the early weeks, as breastfeeding is getting established, it's a good idea to monitor your baby's output. Your baby should be having at least six to eight wet cloth diapers (five to six disposables) and two bowel movements a day, beginning around day three -- about the time your milk supply increases. This should continue until your baby is about six weeks old, when her wetting and stooling pattern may begin to change. Your baby should have regained her birth weight by the second or third week of life. Average weight gain during the first six months is four to eight ounces per week.
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