Breastfeeding Techniques

Okay, this is where we get down to the "how to" of breastfeeding. A lot of this information has already been touched on, so you will be somewhat familiar with it already.

If your experience breastfeeding is anything like mine, you will be amazed at how much your baby knows at birth. Mine just about taught ME how to breastfeed! It will still take both of you time to get to know the other's preferences, but together you can do this!

First, try to find a comfortable place to nurse -- in bed with lots of pillows for back and arm support, a big cushy chair with arms -- experiment in different places to find what works best for both of you.

Babies send out signals when they are getting hungry. Recognizing these signs takes a little insight and practice, so watch for them in your baby. Often, when baby is getting hungry, he will suck on his fist or turn his head toward your breast. Rapid blinking of the eyes is another cue. If you see these cues, you don't have to wait until he starts crying to know baby's hungry.

When you begin to breastfeed, make sure you are in your comfy spot and relax. Remember, you will likely be here for the next 30 or so minutes, so make the most of it. Turn on your favorite music, or just take the time to explore your baby.

Latching on

Babies smell your milk, so when you bring him close to the breast, he will likely turn his head toward the breast and open his mouth. If he doesn't open, tickle his lips with your nipple. Wait until his mouth is open WIDE (like a yawn) and then quickly bring baby to breast, NOT breast to baby. Remember, relax. It may take several tries to get baby latched on. If he does not latch on properly, use your little finger to break the suction but putting it between your breast and the corner of his mouth. Get him to open wide again, and bring him back to the breast.

Be sure baby is latched on to as much of the areola as possible to minimize sore nipples. Also, the milk ducts are located under the areola, so if all he gets is nipple, he will become frustrated by sucking and getting nothing.

Baby's cheeks and nose should be close to touching or touching your breast. Don't worry about suffocating baby -- they have a reflex that will cause them to let go if they are unable to breathe. Also, have you ever noticed the way the corners of babies' noses have a little space? That helps them breathe when nursing. If baby is positioned properly, both cheeks will be as close as the other to your breast. If not, remove baby from the breast, reposition, and offer him the breast again.

Positioning

There are three main positions in which to breastfeed:

• Chest to chest hold;

• Football or clutch hold; and

• Side lying hold.

When nursing chest to chest, the baby is laying on his side, his tummy touching Mom's chest at nipple level. Baby's neck should be straight. This seems to be the preferred hold by most breastfeeding moms.

The football or clutch hold works by holding baby so he is under one arm, basically looking up. (I personally found this one difficult once Samantha started really gaining weight.)

Side lying position is great for nighttime feedings. Mom and baby lie facing each other. Mom supports baby with her free arm, while the other arm is a great headrest! When baby finishes one side, both Mom and baby turn over and nurse on the other side.

It is a good idea to try all three positions, and alternate them frequently. Baby compresses different milk ducts depending on the hold used, and this can ensure that all the ducts are emptied frequently. Failure to empty all the ducts can lead to problems such as stressed nipples, blockages or reduced milk supply.

Babies often signal when the breast is empty by letting go and turning their face away from the breast. Offer the other breast at this time. Don't worry if he won't take the second breast initially.

Whichever breast baby stops feeding on is the one you will start nursing on the next time. If baby is only taking one breast, alternate breasts every feeding. Use a safety pin on your bra strap to keep track of where to start breastfeeding next time.

Breastmilk changes in consistency while baby is nursing. The first milk he gets is watery, and it encourages him to continue nursing to get to the "good stuff". An excellent analogy I have heard is that the foremilk is like skim milk, then the consistency changes to 1%, then 2%, then whole milk, and finally, buttermilk. In other words, the longer baby nurses, the more filling the milk becomes. When the breast is almost empty, the milk becomes very rich and filling (called hind milk), and the baby feels full and lets go.

Suckling Assessment

If baby is receiving milk, you may be able to hear him swallowing or gulping. His lips should be curled outward, with no air getting in between the breast and his lips.

When babies first breastfeed, they tire easily. You may find that your newborn will take 30 minutes to empty one breast, but at three months, he may be emptying both in 20 minutes. This is due to him getting more proficient at sucking, and also to the fact that he has had several months to build up his cheek muscles.

Nipple Care

After nursing, hand express a little milk onto your nipple and smear it around to lubricate and protect the nipple.

Keep nipples exposed to the air for a few minutes after nursing to make sure they don't get chapped.

If you use breast shields to protect clothing from leaks, change them frequently to prevent chapping and bacteria from growing.

Blocked Ducts/Mastitis

These are problems some women have when breastfeeding. A blocked duct is when milk gets blocked behind an obstruction in the duct. The risk can be minimized by frequently changing nursing positions. You may be able to feel the "lump" of blocked milk under the skin. Encourage nursing on that side, since this can often loosen the blockage. It may be less painful if baby nurses on the non-affected breast first. Hot packs or showers can also help. Massaging the area near the areola may also provide relief.

Mastitis is an infection in the breast. Even though the breast is equipped with bacteria killers, sometimes bacteria can get into tiny cracks in the nipple and cause an infection. Symptoms often feel like the flu -- fever, fatigue, diarrhea, headache, bodyaches, etc. Call your doctor for advice. You should still be able to breastfeed during this time, but it may be less painful if baby starts nursing on the non-affected breast first.

Helpful Tips

• Roll your shoulders every so often to remind yourself to relax.
• As baby gets older and more aware of his surroundings, you may need to nurse in a location without distractions and bright light.
• Don't get frustrated if it takes several tries to get baby to latch on -- this is a learning process for the both of you.
• If you are having trouble, contact a breastfeeding consultant who may be able to watch you in the process and offer solutions. Many hospitals and health departments have lactation consultants, and La Leche League leaders are trained in breastfeeding techniques.

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