Breastfeeding
Beating the “First-Week Frazzles”
Many women want to breastfeed their babies and know all of the reasons why it is best. Even with the best intentions, some new mothers encounter problems in the first week of breastfeeding that cause them to give up. Many times things go pretty well for a day or two, but by about the fourth day, things start falling apart. Mom and Dad are exhausted from sleepless nights. Some mothers become painfully engorged or experience excessive nipple soreness. The baby may also may be exhausted, hungry from not feeding well, and have his days and nights mixed-up. The mother's hormone changes leave her feeling weepy and unable to cope. All of these problems work together to sabotage the breastfeeding relationship. Fortunately, with a little information and help, you and your baby can get through the “first-week frazzles” and have a great beginning to your nursing relationship.
During Pregnancy
Find a good support person. This should be a mother who has breastfed
successfully. Don’t ask advice from too many different friends. You
will become discouraged by horror stories and old-wives’ tales. Don’t
argue with well-meaning advisors. Just thank them for their concern. Read
as much as you can about breastfeeding. This will help you feel confident
as you begin.
The only breast preparation to do ahead of time is to check for inverted nipples. This can be corrected with breast shells worn during the last trimester. Other nipple preparation is not necessary and may contribute to nipple irritation or premature labor.
At the Hospital
Nurse soon and often after delivery. This helps the uterus contract and
stop postpartum bleeding. Nursing at least every two hours for the first
week will establish a good milk supply and helps prevent engorgement as
the milk comes in. It also gives your baby more opportunities to learn
to feed well.
Keep your baby with you so you don’t miss her wakeful times when she is most willing to feed. There is no need to limit sucking time. The more your baby nurses, the sooner your milk will come in and the sooner you will get past the normal nipple tenderness. Take the pain medication your doctor prescribes if you need it. A comfortable mother can nurse her baby better.
Correct positioning is important to prevent sore nipples and to help
baby feed well.
1) Baby on his side,
2) tummy-to-tummy,
3) baby horizontal across your body supported by firm pillows.
4) Hold breast with fingers back away from areola.
5) Tickle baby’s bottom lip with nipple until he opens wide.
6) Pull baby in close.
Ask the staff not to give any water or other bottles to your baby. Your colostrum is all the baby needs until your milk comes in, unless prescribed by your doctor. Bottle-feeding can be used occasionally after breastfeeding is well established at about 3 weeks. Studies show that mothers who are given formula samples in a discharge package from the hospital tend to discontinue breastfeeding sooner. It’s best not to take them.
At Home
Keep visitors to a minimum for the first week or so. You and baby need
time and rest to learn to feed well. Breasts usually feel very full 1-4
days after delivery. A week or so later the swelling will decrease. This
does not mean your milk supply is less. You can’t tell if baby is
getting enough by offering a bottle. Even well-fed babies will overeat
if given the opportunity.
Baby is getting enough if he is:
• nursing 8-12 times per day
• wetting about 6 diapers per day
• having 2+ bowel movements per day
• waking to feed at least every 2-4 hours
To increase your milk supply try shorter, more frequent feedings for 24-48 hours. Don’t wait for your breasts to “fill up.” If you are concerned at any time that your baby is not getting enough, call a lactation consultant or your pediatrician.
If your baby seems colicky, try removing cow’s milk from your diet for a week or ten days. Some babies are more comfortable lying face-down across your arm with your palm pressing on their tummy and their head near your elbow. All babies fuss some. This is no reflection on your mothering or your milk. Sometimes you just have to help them through it with love and cuddles.
Dad, your encouragement and approval is critical to Mom’s confidence and success. Tell her what a good job she’s doing. She is giving your baby the highest quality food available. There are many other ways for you to nurture your baby besides feeding him. Many dads become the bath and strolling experts. Baby enjoys your strong arms to hold him and your deep voice to soothe him. You will be able to calm the baby when Mom can’t.
Remember: Most problems you encounter can be solved without bottle-feeding. It can be very hard to get a baby to breastfeed properly once you have started the bottle. Ask for help from another nursing mother or call a lactation consultant.