Breastfeeding - a new baby

Many mothers who breastfeed have some ups and downs at the start, and sometimes even after they get going. Don't give up unless you really want to: there is a lot of help available and most problems can be overcome.

Breastfeeding is a very special time for both mother and baby and it is good for the health of babies and their mothers as well.
When you breastfeed your baby there is a lot going on in your relationship. It is a special time for both of you, and helps you and your baby to feel close. As your baby looks into your face he or she will see how you feel towards them. The moments you have with your baby during breastfeeding are important. It is a great time for you to look into their eyes, stroke them, talk gently or sing to them.
Many mothers who breastfeed have some ups and downs at the start, and sometimes even after they get going. Don't give up unless you really want to: there is a lot of help available and most problems can be overcome.
breastfeeding a new baby

Benefits of breastfeeding

Breastmilk is the normal food for your baby.
It is natural and specially made for your baby.

There are lots of things in breastmilk that are good for your baby, that are not found in formula milk.

It is safe for your baby, and easily digested.

It contains all the food and drink your baby needs for the first six months of life.

Together with other foods, it is very good for the next six months and into the second year as well.

It is always ready when your baby needs it.

Breastmilk helps your baby's immune system to develop. A breastfed baby is healthier and is less likely to get gastroenteritis and well as chest, ear and bladder infections.;

Your baby may grow and develop better.

Breastfeeding is good for you too
It does not cost anything and does not take time to prepare.

It helps you and your baby feel close to each other. Having your baby close to you in skin to skin contact is helpful for both breastfeeding and developing a bond with your baby.

It helps your body return to normal more quickly after the birth.

It may give protection against some diseases (such as cancer of the breast or ovaries, and osteoporosis).

Although breastfeeding is the natural and normal way to feed your baby, many mothers and babies need to learn how. The first few weeks are a time for parents and babies to learn how to live together, so you may need to try different ideas and get some help before things settle down.

Starting breastfeeding

We know that immediate skin to skin contact with your baby following the birth can help your baby to start breastfeeding by helping her to search for the breast. This skin to skin contact is best undisturbed for the first hour. She may suck straight away, or she may just nuzzle and lick the nipple the first time - it's okay either way.
starting breastfeeding
The midwives in the hospital will help you and your baby start breastfeeding. It may take time for both of you to learn this new skill. Be patient and enjoy your new baby. You may need some extra help from your midwife if you have had a caesarean birth.
If this skin-to-skin contact has not happened breastfeeding almost always still goes well.
Feed your baby as often as she wants to, even before the milk comes in. Colostrum, the first milk in your breasts, is very good for your baby. After your baby is born, your breasts gradually change from making colostrum to making milk. This takes a few days. The colour of the milk will change from yellowish to bluish-white and watery looking.

Plenty of feeds early on (day and night) help your milk come in and flow well. Newborn babies may feed 8 to 12 times or more in 24 hours and this is normal.

As your baby sucks and takes out milk, the breasts start making more. The more often you feed the more milk you will make.

It is best to offer both sides at each feed and allow your baby to finish the first side before offering the second. This is because the milk towards the end of the feed has a higher fat content to satisfy hunger and help your baby to gain weight. In some cases your baby may not be interested in the second side, even if offered. Give your baby a break, change his nappy, talk to him and then try the breast again. If, after offering the second side, your breast still feels full, you may need to express a small amount so your breast feels comfortable. Make sure to start on this side next time.

When your milk first 'comes in' your breasts may feel full. Keep feeding often and your milk supply will settle down. If your breasts are very full or engorged you may need to express a little milk before feeding so your baby can attach to the breast properly. You may notice that your breasts leak milk in between feeds. This is quite normal and tends to get less as your supply settles down.
See the section on 'Engorgement' in the topic Breastfeeding - sore breasts and nipples.

During the first few days at home your milk supply may appear to lessen and your baby may demand more often. Short frequent feeds will help stimulate your milk supply.

Positioning for mother

Start breastfeeding in a comfortable position to help you to relax. Most mothers prefer to sit, but you could lie on your side if sitting is uncomfortable. You may want some privacy to feed until you feel comfortable and more confident.
Cradle hold
Sit so you are comfortable, relax your shoulders. Have your feet flat on the floor or use a footstool if needed.

You might find it easier to have a pillow on your lap to support your baby (but not too high).
Underarm or football hold

You might prefer to feed with your baby under your arm. This is helpful sometimes when you have sore nipples or a blocked duct to change the position of where your baby sucks from.

Lying down

If you are lying down you will need to lie on your side with your head supported and roll over to change sides.

Positioning and attaching your baby

It is best to un-wrap your baby so you can hold her close. Hold her with her whole body facing you and her nose opposite your nipple.
Support your baby's head with a hand behind her shoulders, not on her head. Holding her head makes it hard to attach. You can use your other hand to support your breast.
Make sure your baby's mouth is wide open. The contact point when you bring baby to the breast should be about three to four centimetres below the nipple. You will need to have your fingers well back, away from the nipple.

If your baby has attached well you will notice:
Mouth wide open, with both lips thrust out.

A big mouthful of breast.

Chin touching the breast and the nose is clear.

More areola visible above the top lip than the bottom lip.

No or very little pain on attachment.

Regular suck and swallow sound.
This helps to position the nipple at the back of baby's mouth so the nipple does not get sore. If it hurts your baby may not be well attached, so take your baby off the breast and start again. You can do this by putting your finger in the corner of your baby's mouth to break the suction.
Once your baby is attached, after a few rapid sucks you should be able to hear a regular suck and swallow, as she starts to get milk following the let-down. After a few minutes your baby may stop for a little rest before sucking again. Towards the end of the feed your baby slows down sucking and usually becomes sleepy. Sometimes though, your baby might look as if she is finished, but may have become sleepy as the let-down has slowed. You can switch to the second breast to keep her feeding. When you switch to the second breast your let-down is stimulated on this side and your baby should start sucking and swallowing again. Ask for help from your midwife, child and family health nurse, counsellor or lactation consultant to check if your baby is attaching properly to the breast.
It is common for nipples to feel a little tender as they get used to their new function, especially when the baby first goes on. If the baby is attached properly this should ease as the milk starts to flow.
If soreness persists or gets worse, get some help!

Your baby may learn how to breastfeed more quickly if she is not given dummies or bottle teats until feeding is going well, and she is about six weeks old.
Tongue tie

It is possible that some babies have problems attaching due to tongue tie. For more information have a look at the topic 'Tongue tie'.

Feeding cues

It is important for you to recognise the cues for when your baby wants to feed, before your baby starts to cry. These cues are when the baby is beginning to wake by wriggling, tossing and turning, or being restless. He may show signs of attempting to suck his fingers and hands.
Hand to mouth

Mouth open wide

Eyes open and searching

Ready to feed
If the early cues for breastfeeding are ignored, he may start crying then fuss and not attach well. Try to feed your baby before he gets to this stage. It may help to leave changing his nappy until later on if he is already upset!


Let-down

When your baby sucks, your breasts are stimulated to let-down milk. The let-down reflex happens every time you breastfeed, and while it may take a few minutes to happen when you first begin breastfeeding, over time it will become more efficient and take place within a few seconds of starting breastfeeding.
During the let-down some mothers will feel a range of sensations. These may include:
A tingling pins-and-needles sensation that starts under your arm and then moves across and down the breast

Milk dripping (or spraying) from the other breast

Some cramping in your uterus in the early days after giving birth

Feeling hot or nauseous (less common).

These sensations usually settle when your baby starts swallowing. You may experience a tingling feeling between feeds, this is normal. Some mothers may not feel their let-down at all, but will hear their baby suck and swallow and may see the milk dripping from their breasts.
The hormone oxytocin which causes milk to let down is involved in sexual arousal as well. Because of this hormone, some mothers feel not only sensual but also sexual while feeding the baby. This is normal, so you don't need to feel guilty about it.

Burping

You can try to get wind up between breasts and after feeds - but if none comes in a few minutes do not worry.

Remember that babies swallow more wind when they are crying than when they are feeding, and some babies do not need to be burped.

It is common and normal to bring up some milk with the burp.

Babies can spill what seems to quite a lot of milk and still be healthy. Check with your child and family health nurse or doctor if you are unsure.

Breastfeeding a premature baby

Breastmilk is the ideal food for your baby. But if your baby was very premature, it might be weeks before he can suckle. You can express your breastmilk so your premature baby can have it by tube or bottle until he’s ready to feed at your breast.
Breastfeeding: the first six months

When you get home with your new baby there is a lot to learn and cope with at a time when you are tired, both from giving birth and from being woken up several times a night! Breastfeeding may be going well, or you may still be getting used to it. You are both still learning. It is important to ask for help if you need it. Have a look at the topic 'Breastfeeding – looking after yourself'.
Make sure you are comfortable for feeding and are as relaxed as you can be to help your milk 'let down'. Try taking a few deep breaths, or shrugging your shoulders then relaxing them.

Make sure your baby is attaching (latching) properly to the breast. If it hurts she may not be well positioned. Ask for help from your midwife, child and family health nurse, local; counsellor or lactation consultant.
Encourage your baby to 'finish' the first side, then offer the second. Make sure he takes as much as he wants from the first side before swapping sides. (The breast will never be completely empty.) Do not worry if your baby does not want the second side at each feed.

The more often you feed the more milk you will make. All mothers have up and down days with milk supply, but if you are concerned that your supply is low, try to feed more often for a few days. You may need to wake your baby to do this.

Sometimes your baby will have a growth spurt and may want to feed more often. This does not mean that you do not have enough milk, but more frequent feeds will help to increase the amount of milk you have to meet your baby's increased appetite.
After the first month your breasts may not feel as full as in the early days. This does not mean that your milk supply is less, just that the breast is more efficient at producing enough milk to match your baby's needs.

Feeding and sleeping

Only a few babies will develop a feeding and sleeping pattern during the first months. Most will feed and sleep without a set pattern. It is normal for young babies to wake and need night feeds. As babies get older they will breastfeed less often.
If your baby is sleeping long periods in the day and demanding more at night you can wake and feed your baby more often during the day. This may help him to establish a day time pattern. Also encourage play times after day feeds.
Respond to your baby at night but no playing, keep the light low, feed, and then resettle as quickly as possible.

Bowel actions (poo)

Breast-fed babies have soft, unformed poos that may look a bit like seedy mustard, often a yellow-orange colour, but sometimes greenish.

The poo may shoot out with some force, and may look frothy at times.

In the first few weeks, breast-fed babies usually pass poo several times a day, perhaps every feed time.

After a couple of months, this may settle to once or twice a day, or once every few days or so, but generally the poo, when it comes, is still soft (so this is not constipation).
Some fully breastfed babies may go for up to 7 days or more before they do another poo without the baby being constipated. This is quite normal.
The poo of a fully breastfed baby smells quite sweet. It changes to a more offensive smell only when other foods or milks are given.