Breastfeeding is a learned skill for both mother and infant, requiring both time and patience.

When to Start

Immediately after birth, your baby is eager, alert and ready to breastfeed. Place your baby skin-to-skin immediately after birth and as often as possible during the first days of life. This will help your baby adjust to life outside of your body and to breastfeed better. Full-term infants display many different suckling behaviors or feeding cues, such as bringing their hands to their mouth, rooting, suckling, licking and nuzzling the nipple (a normal behavior). Your baby’s suckling reflex is greatest from 45 minutes to 2 hours after birth. The first several feedings have a lasting effect and are a positive and satisfying experience for you and your baby.

Your baby’s initial alertness and eagerness is followed by an increasingly deeper sleep. About 20 – 24 hours of age, your baby will be awake more often and more interested in nursing. When awake, your baby may want to feed often and alternate between light sleep and quiet wakefulness. Your baby may nurse several times close together (cluster feedings). Normal, full-term, healthy newborns may breastfeed every hour or several times in one hour, usually in the evening, late night or early morning hours. Responding to your baby’s needs for cluster feedings should help your baby feel satisfied

Breastfeeding After a Cesarean Birth

A Cesarean birth does not directly affect the breastfeeding process. However, discomfort, fatigue, and the medications used in surgery may present more of a challenge when you begin breastfeeding. Nurse your baby as soon after delivery as possible (8 to 12 times per 24 hour period). Once you begin regular feedings, your milk supply will increase.

Your partner or support person can be very valuable in helping you lift and position your baby. You may be more comfortable using the football hold, side-lying, laid back or cradle hold while cushioning your abdomen with a pillow.

The First Few Days of Breastfeeding

Research shows that the critical days for breastfeeding success are the first two weeks after delivery. It is important to get the help you need during this time. Fatigue may play a large role in any doubts about continuing breastfeeding. If possible, get help with the household chores and infant care, allowing time for rest and comfort. Do not hesitate to accept help when offered. Simplify the chores as much as possible, such as using paper plates/cups or a grocery delivery service.

• Create a peaceful comfortable “nursing station” and allow yourself to relax.
• Find a comfortable position, such as in a chair with ample room on the sides and back for pillows to support your baby and your arms. Sitting with your legs up on a bed or using a footstool when in a chair may help you feel more comfortable.
• Unwrap your baby and check if his/her diaper needs to be changed. This will help arouse and stimulate your baby to nurse, especially if your baby is sleepy. If your baby is awake and ready to nurse, wait until after your baby finishes nursing on the first breast to change your baby’s diapers.
• After the initial quiet alert state following birth, it is normal for babies to be sleepy for the next 24 hours. Breastfeed 8 to 12 times per 24 hour period.

Breastfeeding Positions

• Cradle Hold (Tummy-to-Tummy)
• Cross Cradle Hold (Tummy-to-Tummy)
• Football Hold
• Side-Lying Position
• Laid Back Position

Latching On

If your baby latches-on only to your nipple and not the areola, problems may develop, such as sore nipples and a poor milk supply for your baby.

You may have to repeat these steps several times before your baby latches-on correctly:

• Sit tummy-to-tummy with your baby. Make sure your baby’s ear, shoulder and hip are in a straight line and the baby’s nose is level with the nipple.
• Bring your baby close to your breast.
• Place your nipple under baby’s nose.
• When your baby’s mouth opens wide, quickly pull your baby in to latch-on since the mouth will be open for only a few seconds. NOTE: Bring your baby to your breast, rather than bringing your breast to your baby’s mouth.

Your baby will be able to breathe even though his/her nose may press into your breast. It is helpful in the first week to continue to support the weight of your breast throughout the nursing session. Support your baby’s head at the base of the neck as well.

Look for the following after your baby is latched-on:

• Your baby's chin should be touching the breast and the baby's mouth should be fully open to take as much areola as possible.
• Your baby’s lips should be turned outward against the breast.
• The motion of the suck is along the jaw, not in the cheeks.
• Your baby’s ears, shoulder and hip should be in a straight line.
• Breastfeeding should not hurt. You should feel a strong rhythmic tug on your breast. A little bit of nipple tenderness within the first minute is normal during the learning period. However, sore, reddened, bleeding or cracked nipples are not normal.

Taking Your Baby Off The Breast and Burping

Taking Your Baby Off The Breast

Be sure to break the suction by slipping your little finger in the corner of your baby’s mouth between the gums. Do not remove your baby from your breast until the suction is released, or you may develop sore nipples. The suction is quite strong, and it may require some effort to release your baby’s grip.

Burping Your Baby

Not every breastfed baby needs to burp with every feeding. Generally, breastfed babies do not swallow as much air as bottle fed babies do. Breastfed babies generally do not need to be wakened to burp. If your baby is fussy after feeding, starting to spit up, or pulling on and off the breast, then try burping your baby.

Pat baby’s back between the shoulder blades. Be gentle, but firm enough to make a little jiggle with baby’s body. Burping usually happens within a couple minutes.

Helpful positions for burping your baby include:

• Hold baby upright against your shoulder
• Lay baby tummy-down across your lap
• Have baby in a sitting position on your lap. Lean baby forward with your hand supporting baby’s cheeks and tummy.