First Steps to Successful and Comfortable Breastfeeding

1. Find a quiet, comfortable place to nurse. Turn off the phone, ask visitors to leave, lock your door or place a sign on your door.

2. Have a drink easily accessible.

3. Place baby skin-to-skin for 20-30 minutes prior to each feeding. This assists in the release of oxytocin and let-down. Skin-to-skin helps bring the hindmilk forward, pushing the foremilk into the reservoirs, so that the feeding starts with the most enriched milk being consumed first.

4. Use warm compresses and/or gentle breast massage prior to offering the breast. Gently massage breasts in a circular motion using the flat part of your fingers. Roll your nipple between the thumb and finger. This can stimulate the let-down reflex and make expression easier.

5. Manually express the first few drops of colostrum. Gently support your breast with your thumb and first two fingers opposite each other approximately one to two inches away from your nipple. Press back toward your chest wall then compress your thumb and fingers gently together.

Press back ➙ Compress fingers and thumb together ➙ Relax (repeat).

You can rotate your fingers around your breast at positions similar to a clock (ex. 12 o’clock/6 o’clock or 3 o’clock/9 o’clock, etc.). (Note: Hand expression technique is also available on video.)

6. Cup and support your breast to sandwich it. (Hint: Keep fingers way back off the areola, the dark area around the nipple. Place fingers parallel with your baby’s lips.)

7.Position your baby in the cross-cradle or football hold with the baby facing the breast.

8. Tilt baby’s head back so that her chin is off the chest and chin is slightly touching the underside of mom’s breast.

9. Point your nipple up toward the baby’s nose, resting on the upper lip.

10. Tickle your baby’s upper lip with your nipple.

11. Wait for baby to open his or her mouth wide with a wide gape like a yawn.

12. Then, quickly but gently, bring baby to your breast and insert the areola with your nipple pointed upward. The goal is for the nipple to land in the soft palate of your baby’s mouth, the comfort zone which will make it feel more like a tugging sensation, not pinching or painful. The goal is for an asymmetrical latch (more of the lower areola in baby’s mouth than the upper part of your areola).

13. After latch, your baby’s nose should be off the breast. The chin should be off the chest, making it easier to swallow.

14. Continue breast support with your free hand during the entire feeding session. Breast support during each feeding is recommended until the baby regains his or her birth weight around two weeks of age.

15. Your baby will pause between suckles to coordinate her suckling, swallowing, and breathing. If your baby is slow to start suckling again, or you are not hearing or seeing any swallows, compress your breast and hold the compression until he/she starts to suckle and swallow again.

16. Make sure your baby’s tongue is under the nipple. Upper and lower lips will be flanged.

17. To release your baby from the breast, break the suction by placing your finger between the baby’s gums.

Proper attachment is very important. Your baby should have a deep areolar attachment to compress the areola for adequate breast stimulation and milk release and to promote comfortable breastfeeding. A baby sucking only the mom’s nipple can cause sore nipples and inadequate milk intake.

If you can, avoid pacifier and bottle nipple usage for the first 3 to 4 weeks to prevent nipple confusion or flow preference and to encourage your baby to nurse frequently enough to establish your milk supply.

Your baby is unique. Be patient and don’t get discouraged if your baby is sleepy and nurses well only occasionally during the first few days. By 3-5 days of age, your baby will be waking up hungry. As his or her appetite increases, your body will determine the amount of breast milk needed by the frequency of feeding and the amount of milk removed at each feeding. Your milk supply will typically meet your baby’s demands within two weeks.

Your milk supply will also adjust during growth spurts at approximately 10 days to 2 weeks of age, 6 to 8 weeks, 3 months, and 6 months.

During growth spurts, your baby will need to eat more frequently for 2 to 3 days to increase your milk supply. Avoid “holding baby off” or offering supplements that will prevent an increase in your milk supply. The more frequently you drain your breasts, the more milk you will make. The more the demand, the more the supply.

• Air dry your nipples as much as possible.
• No special cleaning of nipples is necessary before breastfeeding. During a shower or bath, cleanse daily by washing with mild soap and water to remove any bacteria.
• If you can, express breastmilk and apply to nipples after each feeding and allow to air dry.
• Only if the nipples are very dry or chapped, apply a scant amount of lanolin on the nipple. Before applying lanolin to the nipple, warm it between your fingers to soften it. Some mothers prefer to apply a scant amount of olive oil on their nipples.
• Wear a good nursing bra for support if you are more comfortable.
• If using breast pads, select plastic-free disposable or cloth pads. Replace pads when wet.
• Leakage is normal and usually decreases after the first month. To stop leaks, apply gentle pressure on the nipples with your arm or finger.
• Breast size will increase during the first week after delivery. Then, usually, breasts will become smaller and soft again. You can make plenty of milk without feeling full.