8 tips to help you get the best start breastfeeding

The first few days after my baby's birth went wonderfully, but then nursing problems began after my doctor advised giving her a bottle of water to "cure" her jaundice. I think she developed nipple confusion. How can I avoid this with my next baby?


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

Consider this list of 'best practices' when you're reasy to nurse again:


7 things you can do to get breastfeeding off to the best start


1. Begin preparing during pregnancy. Start early! Though breastfeeding is natural, it is not instinctive. By attending breastfeeding classes you can begin to learn more about feeding your baby. Mother-to-mother support, as provided by La Leche League or another nursing group can also prove to be invaluable (you'll share experiences with other nusing mothers).

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.

3. 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.

4. 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. 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.

5. Avoid supplements. The practice of giving water to a baby in place of breast milk 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 breas tmilk or formula does become necessary,speak with your doctor about the best method for you (a bottle, a cup, using a nursing supplementer at the breast or finger-feeding using a syringe).

6. Jaundice does not mean the end to breastfeeding. 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's generally 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 and using a pacifier early on may 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.

7. 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 five to six wet diapers and six to eight 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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