Basics of Breastfeeding
Information on latch and position, how to tell if your baby is getting enough, feeding frequency and more of the basics.
BREAST MILK: COLOSTRUM, TRANSITIONAL AND MATURE
Your lactating body produces milk in three phases: colostrum, transitional milk, and mature milk. Your baby receives the exact nutrients they need during each phase of milk production. In almost all situations, there is no need for supplementation.
Colostrum is breast milk. This is the thick first milk your breasts make while you are pregnant and just after birth. You may hear it referred to as “liquid gold” for its deep yellow color and because it is so valuable for your baby. Colostrum is rich in nutrients and has antibodies to protect your baby from infections. Colostrum also helps your baby’s digestive system grow and work well.
Transitional milk comes when mature breast milk gradually replaces colostrum. You will make transitional milk from 2 to 5 days after delivery until up to 14 days after delivery. You may notice that your breasts become fuller and warmer, and that your milk slowly changes to a bluish-white color. Your breast milk changes to meet your baby’s needs during this time.
About 10 to 15 days after birth, your milk is now mature. The amount of fat in mature milk changes as you feed your baby. Let your baby fully finish your first breast before switching to the other breast during a feeding. This will help your baby get the right mix of nutrients at each feeding.
How much milk does your baby need?
Babies have tiny tummies. It doesn’t take much milk to fill your baby up, but you’ll need to feed your newborn baby often. At least 8 to 12 feeding sessions in a 24-hour period is normal. Feeding your baby often is good for your baby. It will also tell your body to keep making milk.
Positioning and Latch
Being in the right position with your baby is an important part of getting a good, deep latch. Pillows can help to make any position more comfortable. Babies startle easily when lying on their back. Always raise your baby so that their nose is in front of your nipple, rather than leaning over your baby. This makes the feeding experience most comfortable and natural for both of you. Also check that the baby is “tummy to tummy” with you, not lying on their back with their head turned towards the breast. These tips will make breastfeeding more comfortable and help your baby achieve and keep a good, deep latch.
No matter what position you use to feed your baby, a good latch is important. It takes practice, both for you and your baby. A good latch will help you feel comfortable and help your baby get the most milk. To achieve a good, deep latch:
- Stroke your nipple down from your baby’s nose to their lips. This will help trigger your baby’s reflex to open their mouth wide.
- Point your nipple towards your baby’s nose rather than pointing it directly at baby’s mouth. This will help you wait for a very wide mouth before bringing the baby onto the breast.
- Baby should be latched deeply. If your baby latches just on the tip of your nipple or it hurts, gently put a clean finger in your baby’s mouth to break the latch, then try again.
- Baby’s lips should be turned flanged outward.
In the beginning, it’s normal to feel cramping during breastfeeding. This is because your uterus is returning to its pre-pregnancy size. Any cramps will lessen over time.
What does it mean to feed “on-demand”?
Feeding on-demand (also called responsive feeding) simply means feeding when the baby shows hunger cues and not worrying about the clock. Whether it has been 10 minutes or 2 hours, the baby is put to breast and allowed to feed until full whenever they show early cues of hunger.
Watch for these signs that your baby is hungry, and then feed baby right away:
• Fists moving to mouth.
• Head turning to look for the breast.
• Becoming more alert and active.
• Sucking on hands or lip smacking.
• Opening and closing mouth.
Many moms think crying is the only sign that their baby is hungry. But, it’s actually a sign of distress and can mean many things, like having a wet diaper or feeling too cold or too hot. Hungry babies will show signs of hunger before they begin to cry. Watching for and responding early to your baby’s hunger signs may help prevent them from crying. Once the baby is crying, it can be harder to latch
UNDERSTANDING HOW BREAST MILK IS MADE
Did you know your body gets ready for breastfeeding before you even give birth? Breast milk production begins when you are about 16 weeks pregnant. While you are pregnant, your breasts change. These changes allow your breasts to make milk and may cause them to feel fuller and more tender.
Once your baby is born, their suckling on your breast releases hormones in your body that cause your breasts to make and release milk.
Almost all mothers make plenty of milk. If you are concerned that your milk has not come in or that you are not making enough milk, find help.
Role of your breasts
Breast milk is made in the alveoli, which are grape-like clusters of cells within the breast. Once the milk is made, it is squeezed out of the alveoli into the milk ducts, which resemble highways. The ducts carry the milk to the nipple.
The size of your breasts does not affect your ability to produce milk or to feed your baby. Women with small breasts make the same quantity and quality of milk as women with larger breasts.
Role of your brain
When your baby suckles on your breast, it sends a message to your brain. Your brain then signals hormones, prolactin and oxytocin, to be released. Prolactin causes the alveoli to begin making milk. Oxytocin causes muscles around the alveoli to squeeze milk out through the milk ducts.
When milk is released from your breasts, it is called the let-down reflex. Signs of milk release are:
- Tingling, fullness, dull ache, or tightening in the breasts (although some moms do not feel any of these sensations).
- Milk dripping from the breast.
- Uterine cramping after you put the baby to the breast during the first few days after birth.
To encourage a let-down, try these methods:.
After you’ve been breastfeeding for a while, the let-down reflex can happen when you hear your baby cry, or you see or think of your baby. It also can happen at the time of day you usually breastfeed your baby, even if your baby is not around.
Role of your baby
Your baby helps you make milk by feeding at your breast. The more milk your baby drinks, the more milk your body will make. Breastfeeding often or expressing milk (at least 8 to12 times every 24 hours), especially in the first few days and weeks of your baby’s life, helps you make a good milk supply.
Each time your baby feeds, your body knows to make more milk for the next feeding. The amount of milk you make will go up or down depending on how often your baby eats. By feeding for as often and as long as your baby wants, you are helping your body to make the amount of milk your baby needs to grow and thrive. At first, it might feel like you are doing nothing but breastfeeding. That won’t last forever. Soon, you and your baby will get into a pattern that works for both of you.
Summary of Above
Establishing and Maintaining Full Milk Supply
Full breasts tell your body to make less milk and emptier breasts tell your body to make more. The best way to establish and maintain a milk supply that meets your baby’s needs is:
- Feeding the baby at the breast on-demand is best. If your baby has difficulty latching or removing milk from your breast, it’s important to hand express, pump and get help.
- Full breasts slow down milk production if the milk is not frequently removed. If you are separated from your baby, hand express and pump as often as you would feed.
WAYS TO TELL YOUR BABY IS GETTING ENOUGH
Because babies can’t talk, whether they are getting enough to eat is a common concern among parents and caregivers. You can tell your baby is eating enough when they are gaining weight steadily and producing wet and dirty diapers.
What active breastfeeding looks like
Signs your baby is full
It’s important to let your baby feed until they’re satisfied to meet their growth goals. Some signs that babies are full are:
- Baby releases or “falls off” your breast.
- Baby turns away from your nipple.
- Baby relaxes their body and opens their fists.
If your baby finishes eating on one breast and seems full, try burping your baby and changing their diaper (if needed), then offer the other breast. If your baby doesn’t seem interested or doesn’t want to latch, they may not be hungry anymore. Some babies may eat from both sides at every feeding, while others may only eat from one side.
Normal changes with breastfeeding:
Your breasts will feel softer and less full as your milk supply adjusts to your baby’s needs. This does not mean you are making less milk. It means you are making what your baby needs.
As your baby gets better at breastfeeding, they can swallow more milk in less time. Your baby may feed for shorter periods of time, such as only 5 minutes on each breast.
Sometimes, your baby will want to eat several times in a short period of time. When baby’s feeds are bunched together, it’s called “cluster feeding.” It’s normal for babies to feed more often and for longer sessions in the evening or when they are going through a growth spurt.
If you choose to remove your milk using hand expression or a pump, you might find not much milk comes out. This is normal because your baby is best at removing milk from your breast. All other tools, like hands and pumps, are attempts to copy what your baby does naturally. Find tips to help you pump and video on how to hand express.
Warning signs your newborn baby may not getting enough and in need of professional help
Sometimes babies aren’t getting enough milk or have other issues preventing them from getting the milk they need to grow and thrive. In these cases, you might need professional help in the form of an International Board Certified Lactation Consultant (IBCLC) or doctor.
Newborn babies who aren’t getting enough milk will have low energy and sleep a lot. Babies who often sleep 4 or more hours at a time and need to be woken up to eat should see a medical provider.
A baby who is not getting enough milk may fall asleep shortly after beginning to feed, or may take longer to finish a feed.
A poor latch can prevent your baby from getting enough milk. If latching is painful or seems shallow (baby is only sucking the nipple or tip of nipple), your baby is probably not getting enough milk.
Babies should be at or above their birth weight by 10 to 14 days of age. Weight loss after birth is normal, but it’s important that your baby regains that weight.
A baby who is not getting the milk they need might gain weight slowly. Weight gains of less than 5 ounces a week are a sign that your baby isn’t getting enough milk.
A baby who is not pooping often and their urine is not pale, and/or you see reddish-brown “brick dust” (orange, pink or red colored urine) in the diaper is a sign that your baby isn’t getting enough milk.
Normal Newborn Poop
The best way to tell if your baby is getting enough milk is to keep track of wet and poopy diapers. As your milk changes, your baby’s poop will too. At first, poop will be black and tar-like. Then it’ll be greenish to yellowish in color. Then poop becomes yellow, loose, and seedy. By their 5th day of life, your baby should have at least 3 yellow poopy diapers and 6 wet diapers each day.
Skin to Skin
Skin-to-skin contact is when your baby’s bare body is touching your uncovered chest. Put baby skin-to-skin immediately after birth. During this time, your baby will probably find their way to your breast, and your hormones will kick in to start increasing your milk supply. This time together helps your baby feel secure and sets you up for breastfeeding success.
How skin-to-skin contact benefits baby and mom or birthing parent:
- Improves ability to absorb and digest nutrients
- Regulates body temperature
- Soothes baby, lessens crying
- Improves weight gain
- Regulates heartbeat and breathing
- Increases blood oxygen levels
- Improves brain development and function
- Supports parent bonding
- Increases success of breastfeeding immediately after birth
- Increases time in deep sleep and quiet alert states
- Strengthens immune systems
For mom or birthing parent
- Creates a more positive breastfeeding experience
- Increases milk production
- Reduces postpartum bleeding
- Lowers risk of postpartum depression
- Supports bonding
Dads/Partners can practice skin-to-skin contact
Skin-to-skin contact is the ideal situation for every baby. For non-birthing parents, skin-to-skin contact increases your ability to bond with your baby and feel more connected. Your baby’s attachment to you is important, too! Skin-to-skin contact is encouraged because it helps babies feel safe, calm and comforted.