Congratulations! Here you are, gazing at your amazing newborn, completely overawed and overwhelmed at the prospect of nurturing and nourishing this little being. Breastfeeding your baby feels like a huge responsibility, you desperately want to make this work but you have heard all sorts of stories about how difficult it can be. The thing to remember is that although breastfeeding is natural, it is a skill that you and your tiny baby will be learning together as you get to know each other. As you practice, you will find it gets easier and soon, you will find breastfeeding the natural intuitive experience it is meant to be.
Here are some tips to help get you through the first three days.
Talk to the hand
It’s going to be far easier for you and your baby if you allow your baby to follow his natural instincts and use his inbuilt reflexes to find the breast and attach by himself, albeit with a little gentle guidance sometimes. So, if your midwife seems over enthusiastic and grabs your baby and your breast, put your hand up in a stop sign (this will give you time to find your voice) and say firmly but politely, “I would like to try myself, please can you just guide me.”
Skin to skin
As soon after birth as possible, ideally immediately, allow your newborn to lie between your breasts against your bare skin (with a blanket or towel over you both to keep warm). When babies are held skin to skin against their mother’s body, they instinctively search for the breast by lifting their heads and thrusting their chin and mouth forward. This helps your baby tilt his head backwards and facilitates good attachment and feeding.
If you are patient and allow your baby to take his time – it may take up to an hour for your baby to complete the natural pre-breastfeeding behaviours such as kneading your breasts with her fists, grasping and licking your nipples then attaching and sucking – this first feed can last anywhere from about half an hour to a couple of hours.
Don't rush your baby
If your baby isn’t interested in feeding at this first feed, please don't worry, allow skin to skin cuddles and let him come around in his own time. A healthy full term baby has stores of brown fat and his stomach will be full of amniotic fluid that will sustain him for the first day or two. If your baby is having difficulty latching or needs feeding more urgently due to complications, you can hand express some colostrum (some mothers express antenatally and freeze some colostrum in case its needed in the early days) and give this to him in a syringe (ask your midwife for help).
If your baby attaches but is sleepy, please don't let anyone wash his face with cold water to arouse him – simply rub his little hand, this will stimulate his sucking reflex and he will start feeding without any stress.
Watch your baby, not the clock
There is no need to time feeds. In the first day or two, your baby may be sleepy as he recovers from a long labour or he may want to stay almost constantly attached to the breast. Either response is normal and you don't need to worry that letting your baby suck too long will damage your nipples – if your nipples are really sore (some discomfort is normal) or they come out of your baby’s mouth looking squashed, a poor latch is most likely the culprit. Get a midwife to check or ask if there is a lactation consultant who can watch a feed and check baby’s mouth for tongue tie.
Because your baby is learning how to use his tongue and oral muscles and colostrum is thick and sticky, it can take him up to twenty minutes or longer just to suck a single teaspoon of this liquid gold that is often referred to as ‘baby’s first immunization’. In the first couple of days your baby’s stomach capacity is only about 5 to 7 mls (the size of an almond) and his stomach walls are rigid and don’t stretch yet, so these small amounts of colostrum you are producing are all your baby needs. This means that if his restlessness is interpreted as hunger and you offer a bottle, your baby will most likely spit it all up.
The second night
It’s really common for babies to want to suck almost constantly on the second night. Unsettled behavior on the second day is not due to hunger. Instead, your baby is waking to the sensory changes between his cosy womb world and the ‘outside’ . The closest place to ‘home’ now is snuggled against your comforting heartbeat, sucking at your breast. This sucking is important to help your baby practice feeding (coordinating sucking swallowing and breathing) before he has a large volume of milk to contend with. Frequent feeds will help your milk ‘come in’ and the surges of prolactin (milk making hormone) that your baby’s sucking cause in these early days are helping activate receptors in your breast that will increase your longer term milk making potential (after the first two weeks the surges are not as strong).
By keeping your baby close and watching his hunger signals (rooting towards the breast and moving his hands to his mouth – crying is a late signal), your body will adapt and make exactly enough milk for your baby’s needs.
If constant feeding is overwhelming for you, as your baby dozes, gently release your baby from the breast by popping your little finger into the side of his mouth to break the suction and let him let him lie against your chest until he is in a deep sleep (his arms will become limp), then move him to his bed or your partner’s arms if you need a rest.
Rest. Rest. Rest.
You are naturally proud and excited; you may be feeling on a high and want family and friends to see your newborn. Or perhaps it’s not you, it’s them who can’t wait to congratulate you. Please honour the huge job your body has done and limit visitors. Your baby, your partner and you need rest now to help you recover. You need uninterrupted time together to get to know your little one, to learn to breastfeed and to transition to your new role. It will be a while yet before your baby learns day from night so you need all the sleep you can snatch – right from the start.
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