Let It Flow

Follow our expert advice and nursing your baby will become second nature.

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You've read breastfeeding books, visited chat rooms, taken classes and made the (very smart) decision to nurse your new baby. You're ready, right? Mentally, yes, but once your baby makes his entrance, you're faced with the prospect of actually doing it—maneuvering his tiny, floppy head onto your swollen breast and coaxing him not only to latch on, but to draw enough of that liquid gold into his body to sustain himself for the next hour, the next day, the next six months. We're here to help, with expert tips to get you through those first hours in the hospital and first days at home.

1. Don't delay. Put your baby to your breast as soon as he's born. "The majority of newborns have a small 'window of opportunity' of about one-and-a-half hours after birth when they're alert and ready for a feeding," says Sue Tiller, R.N., I.B.C.L.C., an international board-certified lactation consultant in Centreville, Va., and author of Breastfeeding 101: A Step-by-Step Guide to Successfully Nursing Your Baby (TLC Publishing, 2005). "After that, most newborns fall into a sleepy pattern for the next 18 to 24 hours, which makes it more difficult for them to breastfeed."

Even if your baby doesn't actually latch on and nurse, you're both benefiting from this early opportunity to bond, says Christina J. Valentine, M.D., R.D., medical advisor for neonatal nutrition at Columbus Children's Hospital in Ohio and director of its lactation program. "Immediate postpartum skin-to-skin contact is important," she explains. "The baby stays warmer, his heart rate and respiratory rate stay more stable, and the bonding helps ensure success with lactation." Unless your or the baby's health is compromised, all this applies even if you've had a Cesarean section, Tiller says. "Most medications you might receive do not preclude breastfeeding."

2. Just say no (to the nursery, that is). "Rooming in" not only promotes bonding, it also allows you to nurse as often as you and your baby want, which is key to building a good milk supply. You also will be able to observe your baby and start recognizing his feeding patterns and cues early on—important information to gather in the hospital, rather than when you're at home, with no nurse in sight.

"A baby's feeding cues are very subtle in the beginning, and if parents aren't aware, they may miss them altogether until the baby is crying and frantic," Tiller explains. "Miss the cues and you go into a downward spiral." Signs to watch for: bringing the hands to the mouth; chewing on the fists; turning the head from side to side; and smacking the lips.

If you find yourself buckling under the pressure to put your baby in the nursery so you can get some rest, take the advice of a doctor who's been there and call in an advocate. "Even though I knew what was best for my baby, it was still intimidating," Valentine says. "So a lactation consultant can be a very important support." Keeping your baby in your room also will prevent the hospital staff from giving him formula—a strict no-no, as doing so will interfere with your milk production.

3. Get near naked. For the first several days, keep your baby in as much skin-to-skin contact with you as possible. "Like any other mammal, a baby uses his mother's scent to identify his food source," Tiller says. "If you wrap a baby up in lots of blankets and keep him away from his mother, he's going to sleep a lot more and miss opportunities to nurse." Skin-to-skin contact also increases milk volume, Valentine says.

4. Be prepared to spend a lot of time."I hear over and over from new moms how unprepared they were for how often their babies nursed and how long each session took," says Wendy Haldeman, a lactation consultant and co-owner of The Pump Station in Hollywood and Santa Monica, Calif. "Yes, nursing takes time, but it's well spent, because this is when you're building the milk supply that will carry you through for as long as you're going to nurse your baby.

"There's also a window of opportunity in the first seven to 10 days when your body is primed to start making milk," Haldeman adds. "Babies know this, which is why they feed so often in the beginning." And we do mean often: Most newborns nurse at least every two hours around the clock, with each session taking about 30 minutes.

5. Master the latch. Getting your baby to latch on to your breast correctly is perhaps the most important part of breastfeeding. "It means less nipple trauma for you and more milk for your baby," Haldeman says. Make sure your baby takes the entire nipple and at least 1 1/2 inches of your areola (the dark area surrounding the nipple) in his mouth. (For step-by-step photos and instructions, visit www.fitpregnancy.com/yournewlife/455)

6. Line up help before you need it. Many women need hands-on help (or simple reassurance) during the first few days of breastfeeding. If your hospital doesn't have lactation consultants on staff, line one up before you deliver so you have someone to call in a pinch. Even if they are on staff, a consultant may not be available when you need her. To find one in your area, call the International Lactation Consultant Association at 919-861-5577 or visit www.ilca.org.

The following are tips from Haldeman on when to call a lactation consultant:

  • If the baby is having fewer than three loose, yellow seedy stools and six to eight wet diapers daily by five days after birth
  • If you have cracked and/or bleeding nipples
  • If the baby cannot latch on, or cries or sleeps all the time

7. Know what's normal. For the first few days, your breasts produce not milk, but small amounts of colostrum, the thin, watery precursor to milk that is brimming with anti-infective properties. (All breastfed infants should still be seen by a pediatrician within two to three days of birth to ensure that they're nursing properly.) Your milk may not fully come in for five days. After that, if you're still worried about your milk supply, remember this: The more your baby nurses, the more milk you'll produce.

Learn the best positions for breastfeeding success at www.fitpregnancy.com/yournewlife/288

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