Post partum

Breastfeeding - getting started

1. Get an early start

Nursing should begin within an hour after delivery if possible, when an infant is awake and the sucking instinct is strong. Even though you may not be producing milk yet, your breasts contain colostrum, a thin fluid that contains antibodies to disease. It is not uncommon to feel uterine cramping when you start to breast feed. This cramping lessens with time.

2. Proper positioning

The baby's mouth should be wide open with the nipple as far back into his or her mouth as possible. The newborn’s mouth needs to surround as much of the dark area around your nipple as he/she can. This minimizes breast soreness. There are many resources such as nurses, lactation consultants and clinical specialists, to help you find a comfortable nursing position.

3. Nurse on demand

Newborns need to nurse frequently, at least every two hours, and not on any strict schedule. This will stimulate the your breasts to produce plenty of milk. Later, the baby will settle into a more predictable routine. Because breast milk is more easily digested than formula, breast-fed babies often eat more frequently than bottle-fed babies.

4. No supplements

Nursing babies don't need sugar water or formula supplements. These may interfere with their appetite for nursing, which can lead to a diminished milk supply. The more the baby nurses, the more milk the mother will produce.

5. Delay artificial nipples

It's best to wait a week or two before introducing a pacifier, so that the baby doesn't get confused. Artificial nipples require a different sucking action than real ones. Sucking at a bottle could also confuse some babies in the early days. They, too, are learning how to breast-feed.

6. Air dry

In the early postpartum period or until your nipples toughen, you should air dry your nipples after each nursing to prevent them from cracking, which can lead to infection. If your nipples do crack, you can coat them with breast milk or other natural moisturizers to help them heal. Vitamin E oil and lanolin are commonly used, although some babies may have allergic reactions to them. Proper positioning at the breast can help prevent sore nipples. If the mother's very sore, the baby may not have the nipple far enough back in his or her mouth.

7. Watch for infection

Symptoms of breast infection include fever and painful lumps and redness in the breast. These require immediate medical attention.

8. Expect engorgement

A new mother usually produces lots of milk, making her breasts big, hard and painful for a few days. To relieve this engorgement, you should feed the baby frequently and on demand until your body adjusts and produces only what the baby needs. In the meantime, you can take over-the-counter pain relievers, apply warm, wet compresses to your breasts, and take warm baths or showers to relieve the pain.

9. Eat right, get rest

To produce plenty of good milk, the nursing mother needs a balanced diet that includes 500 extra calories a day and six to eight glasses of water in addition to other fluids. You should also rest as much as possible to prevent breast infections, which are aggravated by fatigue.

10. Take proper care of your breasts

During pregnancy, you do not have to care for your nipples or breasts in any special way. Just be sure to wear a bra that provides support. Your breasts will get larger, with breastfeeding so buy nursing bras that allow room for growth. There are many types of nursing bras available in all sizes, materials and levels of support. Plan on purchasing a couple before you deliver your baby.

Wash your breasts with warm water only. Soaps, lotions, and alcohol are not necessary, may be drying and irritating, and should not be used.

The American Academy of Pediatrics recommends that babies be breast-fed for 6-12 months. The only acceptable alternative to breast milk is infant formula. Solid foods can be introduced when the baby is 4-6 months old, but a baby should drink breast milk or formula, not cow's milk, for a full year.

See also the following topics:

The advantages of breastfeeding

Breastfeeding difficulties

Breastfeeding and Medications

Bottlefeeding Basics