Getting Started & Breast Care

Getting Started 

The key to breastfeeding is making sure that your baby “latches on” well. A poor latch can be uncomfortable, ineffective and can cause nipple soreness.

For a good latch:

• Bring your baby to your breast. Do not lean over to place your nipple in your baby’s mouth.
• Put your baby’s belly to your belly.
• Place pillows under your baby for support, and to bring your baby to the level of your breast.
• Stroke your nipple across your baby’s mouth until he opens his mouth wide.
• Bring her quickly and gently to your breast so she takes your nipple far back into his mouth.
• Your baby’s mouth should cover most or all of your areola (the dark area surrounding your nipple).

At each feeding:

• Wash your hands before you breastfeed.
• Prepare a healthy snack to eat while nursing. It is also important to drink a glass of water or juice during or after each feeding.
• Start with the breast on which your baby last fed.
• Hold your baby close as you feed her. Talk to her, look into her eyes and stroke her cheek and body gently. This helps her feel secure and wanted.
• Nurse until that breast is empty. Sometimes you can tell it’s empty when your baby falls asleep or turns away from the breast.
• Burp your baby if necessary.
• Offer your baby the second breast. He may or may not want to take the second breast depending on whether he is full.

It is normal for your newborn baby to want to breastfeed long and often. Sometimes your baby may want to nurse for over an hour at a time! Frequent and long feedings during the first few weeks make sure that your baby receives the nutrition he needs and help you establish a good milk supply.

You will know your baby is getting enough breastmilk from his weight gain and the number of wet and dirty diapers he has.

• 1-2 wet diapers the first 1-2 days
• 6-8 wet diapers each day by about the 3rd or 4th day
• 2-4 bowel movements each day by about day 3

After the first few weeks your baby may nurse for shorter periods, maybe only 15-40 minutes at a time. The length of time will depend on factors such as the personality and age of your baby. During growth periods, your baby may want to nurse more often.

Breast Care

Properly caring for your breasts reduces discomfort and pain during breastfeeding. It also can prevent infection.

• Wash breasts with only water. Using soap can dry your nipples and cause them to crack.
• Use cloth breast pads instead of plastic pads.
• Leave your nipples exposed to the air to help prevent drying and cracking. This can also reduce the chance of breast infection.

Sore nipples are a common complaint of breastfeeding.

Sore nipples are usually caused by poor latch-on and/or positioning. A poor latch can be caused by engorgement. Engorgement occurs when your breasts are hard and overly filled with milk.

Soften your breasts to help your baby latch-on by:

• expressing milk by hand or with a breast pump
• taking a hot shower or bath
• using a warm compress on your breasts
• placing green cabbage leaves on your breasts for about 15 minutes every hour for several hours (this home remedy works for some women)

Breastfeeding generally should not hurt. If you experience intense pain, a burning sensation or constant soreness, talk to your healthcare provider.

Suggestions to reduce nipple soreness:

• Warm water dips, breastmilk, and medical-grade lanolin ointment (Lansinoh, etc.) are considered the best treatments for sore nipples. Some people use tea bags on sore nipples but studies indicate that tea bags neither prevent nor reduce nipple soreness. In addition the tannic acid in the tea can cause drying and cracking and sometimes babies do not suck as well after tea bags have been used.
• Breastfeed from the uninjured (or less injured) side first. Your baby will tend to nurse more gently on the second breast.
• Hand-express some milk before feeding. This can help to stimulate the let-down reflex before putting your baby to your breast.
• Make sure that your baby is latching-on well. The nipple should go deeply into your baby's mouth.
• Try different breastfeeding positions to find one that is comfortable.
• Express a few drops of milk onto the nipples after feeding and let air dry.
• If breastfeeding is too painful, it is very important to express milk from the injured side to reduce the risk of mastitis and to maintain your supply. Hand expression may be more comfortable than using a breastpump.
• When possible, don't wear a bra or shirt, let air get to your nipples. If using breastpads, change often. Some mothers use breast shells to protect the nipple from the dampness and friction of the bra.
• Contact your health care provider if you notice: inflammation/redness, swelling, oozing, pus, or other signs of infection, including fever.

If you have questions or concerns about breastfeeding, or whether or not your baby is getting enough to eat, talk with your healthcare provider, lactation consultant or breastfeeding support group. For information on where to find a lactation consultant or support group, call the Family Health Hotline at 1-800-322-2588.