How To Get The Best Start With Breastfeeding Part 1
Perhaps you’ve read all the books, taken classes, gathered your support system, registered for all the baby necessities and soaked up the good (and not so good) advice from everyone around you…That’s a great start! However, have you considered how to best prepare for breastfeeding if you’re going that route? I’ll let you in on a few little secrets about getting the best start with breastfeeding beginning with the very first hour after birth. Here we go!
THE GOLDEN HOUR
We aren’t talking about photo opportunities! One of the most important things to do immediately following birth is placing mother and baby together, skin-to-skin. During this ‘Golden Hour,’ baby should have unrestricted, skin-to-skin access to mom (no clothes, down to the diaper, chest to chest). This is when the first feeding will occur with patience. There has been a lot of amazing research done showing that this is of the utmost importance for a myriad of reasons! Skin-to-skin contact absolutely cannot be overdone. It helps encourage baby to nurse better (and more often), increases prolactin and oxytocin (milk-making hormones) and brings mature milk in sooner (and you’ll make more of it). It also helps to regulate baby’s heart rate, respiratory rate, blood sugar levels, helps temperature regulation, aids in bonding, increases maternal “mama bear” instincts and increases brain growth and development. Sounds like the perfect medicine!
Skin-to-Skin in Practice
All procedures should be delayed until after the first feeding, and if they cannot be delayed, these should be done while baby is skin-to-skin on mom’s chest. Delayed cord clamping (waiting until the cord stops pulsating) and delaying the bath is always a good idea.
Feeding in the first hour makes it more likely that mom will exclusively breastfeed longer. This first feeding not only ingrains how to latch for baby, but it is also important for bonding and contracting the uterus to stop bleeding.
Visitors should wait until after the first 1-2 hours to meet the baby (even longer, if possible).
Both parents should practice skin-to-skin, not just mom.
THE FIRST DAY
Next one on the list is important because no one seems to tell you about the sleepy phase! The first 24 hours after birth are considered a time of rest and recovery for mom and baby. Most infants will be sleepy and disinterested in nursing. It’s okay! Enjoy this time. Rest, recuperate and snuggle your new bundle. Trust me, they will wake up as they are biologically programmed to do after 24 hours and want to nurse, nurse and nurse some more (hello, cluster feeding).
You want to gently attempt the breast every 2-3 hours if baby isn’t cueing more often and offer hand-expressed drops of colostrum. You can finger feed your colostrum to your baby if he/she will not latch. This is a great way to wake baby for feedings, as it stimulates appetite. If baby does not wake after 2-3 hours, place he/she skin-to-skin for 30-60 minutes, watch for cues, and continue finger-feeding colostrum until they are ready to wake and nurse. Can’t get colostrum out? This is actually pretty common. Practice gentle breast massage, use moist heat and perfect your hand expression technique. One or two feedings in the first 24-hour period is really all your baby needs, as the tummy of a newborn is only the size of a marble this first day. That might be six suckles, or 20+ minutes of nursing. If baby is latching, great! Nursing shouldn’t be painful, and there should be no damage. Slight tenderness can be common in the early weeks though. You may feel sleepy and/or thirsty or experience cramping in the uterus when baby breastfeeds well, so keep an eye out for these signs.
When do you know baby is ready for food? Early cues may include: Lip smacking/mouthing, tongue extension, opening the mouth, rooting, bringing the fist to the mouth, eyes are wide open. Crying is considered a late cue. It’s much more difficult to latch the crying baby, so it’s great to be able to recognize and react to the more subtle cues I mentioned above. If baby is showing late cues, place him or her skin-to-skin and calm before attempting to feed.
If you can learn to hand express colostrum before baby comes, that’ll be a life-saver!
As mentioned above, hand expression is going to be incredibly helpful. Hone your skills, and don’t get frustrated if you don’t see colostrum right away; that’s normal. Hand expression should not hurt; don’t squeeze your nipple (ouch!). Research shows that expressing milk by hand has the capability to increase your milk supply substantially. Learning to do this will be valuable down the line when you start pumping to get more milk. It’s a great skill to have in your back pocket. Thankfully, Stanford even has a great video to show you the ropes (see here).
Breanna Duncan BSN, RN, IBCLC, RLC
Breanna Duncan is the owner of The Mama Mantra, which opened in April 2016 after she moved to Austin from Atlanta with her husband and two pups. Breanna is a Registered Nurse and International Board Certified Lactation Consultant (IBCLC) working in both the hospital and private practice setting. The Mama Mantra provides comprehensive breastfeeding guidance for families in the greater Austin area and is dedicated to providing the highest quality of service with the goal of supporting, promoting and protecting breastfeeding in its many forms. Breanna is passionate about holistic and integrative healing and prides herself in applying this approach to breastfeeding, as well as collaborating with like-minded professionals who assist in making breastfeeding successful.