BABIES & NURSING

A Beginners Guide to Breastfeeding: 10 Tips from a Pediatrician and Mother

By: Lauren Rosen Crosby, MD, FAAP

April 12, 2018

When I visit new mothers in the hospital on my morning rounds, much of the time is spent discussing feeding their newborns. Having breastfed my two sons, I’ve enjoyed supporting and guiding new moms to success with breastfeeding their infants during my 20 years in pediatric practice. Breastfeeding is always encouraged, as it truly is the most perfect, natural food for a baby.  It not only provides nutrition from proteins, fats, carbohydrates, vitamins and minerals but also contains antibodies that boost the baby’s immune system. It is easy to digest, convenient and an inexpensive way to feed your baby.

Mothers who breastfeed benefit from the experience too. Breastfeeding causes a release of the hormones prolactin and oxytocin, which produce a peaceful sensation and feeling of attachment, but also promote milk production and contraction of the uterus, decreasing postpartum bleeding so women recover more quickly. Breastfeeding also lowers the risk of breast and ovarian cancer, Type 2 Diabetes and heart disease. (1)

There are so many advantages to breastfeeding, but it is normal to find it somewhat challenging at first, so I have compiled a list of tips to help breastfeeding mothers get through the sometimes bumpy start of nursing.

Lauren Crosby, M.D.’s Breastfeeding Tips

1. It is normal for the first few weeks to be tough.

Give it time and don’t give up right away. This is truly on-the-job training, so be patient and do not expect that you will be an expert immediately, or that every feed will go great.

2. Get comfortable.

You will be spending many hours feeding the baby so make sure you have a comfortable chair with enough pillows surrounding you to lift the baby to you. Learn about the various positions for holding the baby so you have options because what works for one feed might not work for the next.

3. Alternate which breast you start with at each feed.

. Start the next feeding on the breast you finished on to ensure both breasts receive equal stimulation so they are emptied, which then tells the body to make more milk. Many women put a safety pin on the bra strap of the breast they finished on to remember to start there for the next feed.

4. Don’t keep the baby on one breast more than 20 minutes.

If the baby is on too long that can cause sore/cracked/bleeding nipples which can make breastfeeding difficult and painful.

5. Try to keep the baby awake during feeds.

I tell parents “no sleeping on the job.” This will ensure the baby gets enough and will make sure your milk comes in and your supply stays up. A few tricks to keeping the baby awake are to tickle their neck, ears and feet or touch them with a cool wet washcloth.

6. Many people think the baby has to be on a schedule right away.

This is not so. On-demand feeding is recommended for newborns with a goal of 8-12 nursings in 24 hours. This translates into feeding approximately every 2-3 hours.

7. Wake a sleeping baby if it is time for it to eat.

Until your pediatrician gives you the OK to let the baby sleep, you should wake the baby to ensure there are 8-12 feedings in each 24 hour period.

8. Make sure the baby is getting enough milk.

Babies can lose weight after birth until milk comes in and feeding has progressed, so the goal is for the baby to be back to birth weight at two weeks of age. One of the best ways to tell is to keep track of the number of dirty diapers per 24-hour period. There should be at least three pee diapers and at least three poop diapers during that period of time.

9. Take care of yourself.

As hard as that sounds when tired and recovering and feeding your baby (which at first feels nonstop), it is important to hydrate, eat and rest. I recommend drinking 6-8 ounces of non-caffeinated fluid every time you feed the baby. Make it cool in case of a spill so the baby doesn’t get burned. Remember that breastfeeding is demanding on the body and requires an extra 500 calories more per day, so healthy eating habits are needed to rebuild your stores of nutrients lost during both pregnancy and lactation. (2) Don’t forget to continue to take your prenatal vitamin as well.

On the topic of your diet, studies have shown that the composition of breastmilk does vary based on maternal nutrition. (3) This is why prenatal vitamins are necessary during breastfeeding. Despite taking them, eating a well-balanced diet is a must, one that includes the omega-3 fatty acid DHA (docosahexaenoic acid) found in highest concentration in fish and in supplements that may be recommended by your doctor. (4) DHA is very important for the visual and cognitive development of the infant.

10. Ask for help.

If you are worried about how breastfeeding is going or feel overwhelmed always talk to your pediatrician who can provide guidance. Your pediatrician can also recommend a lactation consultant to work with you to make this the best experience it can be.

There are so many benefits to breastfeeding, but you need support so you feel confident and encouraged. You are recovering from delivery and all the changes your body is going through, but just seeing and holding the baby make it all worthwhile. I promise!

References

1.  New Mother’s Guide to Breastfeeding, 2nd Edition, American Academy of Pediatrics
2.  Mark A. Hanson, Anne Bardsley, et al. The International Federation of Gynecology and Obstetrics (FIGO) recommendations on adolescent, preconception, and maternal nutrition: “Think Nutrition First”. International Journal of Gynecology and Obstetrics 131 S4 (2015) S213–S253
3.  Francesca Bravi, Frank Wiens et al. Impact of maternal nutrition on breast-milk composition: a systematic review. Am J Clin Nutr 2016; 104:646-62. August 17, 2016.
4.  Miriam Erick. Breast milk is conditionally perfect. Medical Hypotheses (2018) 111: 82-89.

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