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11 Tips From a Lactation Consultant to Help Breastfeeding Get off to the Best Start

By Kathy Cline , RN, MSN, CLC
August 08, 2018
5 min read

One of the many things that happens during pregnancy is that you may find yourself flooded with tips on parenting, a plethora of advice and lots of stories about one’s experiences both good and not so good with breastfeeding. With all of the information, it’s often difficult to sort out fact from fiction leaving many unanswered questions.

Complicating the issue is that babies aren’t born with an instruction manual and each baby is just a little bit different. Some are born a little early, some a little late, and others with a little immaturity that just seems to get in the way a bit. And then, there are always those babies that seem like they knew exactly all the whats, when, and how-to’s, and you wonder why you ever worried about breastfeeding in the first place.

Over the years, research has helped identify tricks of the trade that seem to help the most with all babies. It’s also helped us de-mystify some breastfeeding myths that can get in the way of making the best decisions. I asked my fellow Lactation Consultants to give us their 11 best tips to get you off to a good start.

1. Enjoy skin-to-skin: Use the first hour after birth to provide baby with lots of skin-to skin experience with you. Skin-to-skin time helps baby to regulate his breathing, and heart rate, transition to his new world and begin to search for the breast while in the wakeful state that precedes baby’s first deep recovery sleep. This first hour or so after birth is a wonderful time for baby and mom to get to know each other.

2. Ask for help with latching and positioning baby to the breast. If you haven’t taken a breastfeeding class, ask the nurse or lactation consultant to help you learn how to correctly position and latch baby onto the breast. Wait for baby to open his/her mouth as wide as if yawning and bring baby to you tummy to tummy. Make sure baby has all of the nipple and part of the brown part (areola) of your breast in his mouth. You may feel tenderness, but if painful, take baby off the breast and try again. Babies and mommy’s become experts over time so don’t worry if everything not perfect at first.

3. Baby’s first milk: Baby’s tummy is the size of a marble when first born, making the highly concentrated, rich first milk called colostrum perfect for his/her little body. Colostrum is high in protein, filled with antibodies and high in carbohydrates making it well designed for baby. All moms have colostrum which are cells that line the branches in the breast and babies get about 1 teaspoon of colostrum in those early feedings, the perfect amount to fill baby’s little marble-sized tummy.

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4. Be confident in knowing what’s normal for baby. Babies will lose up to 10% of their body weight in the first few days after birth. This can be scary when the nurse or doctor tells you that baby is losing weight in the hospital. Know though that this is a normal and exactly what we expect. Babies need to get rid of the extra fluids they were born with and when moms are given lots of IV fluids in labor we now know this weight loss can be more pronounced. Babies need to get rid of those extra fluids and some are now looking as day 1 weight as a more reliable indicator of baby’s true weight. Know that weight loss is a normal process and baby should be close to or have regained his birth weight by 2 weeks of age.

5. Babies don’t always understand clocks when it comes to feeding. This can be confusing when books and online resources tell you to nurse on a schedule. Instead, nurse baby when you begin to see baby’s feeding cues. Since crying is a late sign of hunger, look for signs of wakefulness. Is baby beginning to put his hand near his mouth, licking his lips, opening his mouth or sticking his tongue out? You may also see him rooting or opening his mouth and turning to the side. These are early signs that baby is hungry and ready to feed. Babies will nurse eight or more times in a 24 hour period of time and sometimes those feeding will seem like they are right after another with little time in between. Try not to be discouraged when this happens. Usually babies will sleep for an extended period of time after “cluster feeding” and in the newborn period it is not uncommon to be nursing every couple of hours.

6. Wet and dirty diapers are your friend. The number one concern of new moms and dads is if baby is getting enough to eat. Since our breasts don’t come with gauges on them, we measure what comes out of baby, not what goes in. Baby will have few wet and dirty diapers in the first few days after birth; usually one wet diaper for each day after birth until mom’s more mature milk comes in when wet diapers will increase to 6 or more in 24 hours. Babies stools will also increase when the more mature milk comes in and by day four should have 3-4 stools per day that are beginning to look yellow with small cottage cheese-like particles in them.

7. The amount of time it takes to nurse your baby might be different from your friends. And how many minutes should baby nurse is the next question we often want to know. Unfortunately those not a perfect answer to that question. Each mom and baby are different. Some babies suckle more vigorously at the breast and you think your baby has barracuda jaws and finish quickly, others are gourmet eaters and enjoy being close to the breast, snuggling and dawdle along. And for moms, sometimes the milk comes really quickly and for others it seems almost the perfect flow for what baby can handle. Listen for quiet “awe” sounds after every third or fourth suckle. That sound is baby’s swallow and we often have to listen very closely to hear it. When baby becomes disinterested at the first breast, burp him/her, change his diaper whether it needs it or not (to help wake him a bit) and then put baby on the second side to finish nursing. It’s not uncommon for babies to want to nurse 20-25 minutes on each side in the first few weeks, but again each mom and baby are unique and very different. Soon you will be in synch with your baby and know exactly the message he/she is sending to you!

8. Growth spurts are frequent in the first six months. Just when you feel like you’re beginning to get a handle on motherhood baby throws you a major curve and for a 24 hours period seems like all he wants to do is nurse. Sometimes we may feel like we are a “Dairy Queen”. Try not to despair, this is normal as baby goes through a growth spurt usually around 5-7 days, 3 weeks, 6 weeks, 3 months and 6 months. Growth spurt times are short lived and we often reach for formula because we think we don’t have enough milk. Trust your body knowing the best way for your milk supply to increase is for baby to nurse more frequently. Yes, it’s the law of supply and demand at work in its finest form!

9. Resist the temptation to begin using your breast pump until baby is at least three weeks old. Now sometimes because of medical situations we need to start earlier but for a normal, healthy newborn resist the urge to bring out the pump. You have plenty to do as a new mom and pumps, even the best ones don’t respond the way baby does at the breast and are never a good indication of the amount of milk you have in your breast. We’ll talk more about choosing and using breast pumps in another article.

10. Wait until baby is 3-4 weeks old to introduce a pacifier. At that point your milk supply will be in synch with what baby needs and baby will not be thrown off by the differences in the breast and pacifier nipple.

11. Try and let-go of other’s stories about breastfeeding. Because your mom, auntie or grandmother couldn’t nurse doesn't mean you can’t. We know so much more about lactation today and how to help moms then we did years ago. Today, we understand things like growth spurts, supply and demand, frequency of nursing and more ways to get moms off to the very best start with their newborns. Years ago for example, we only let moms nurse for a maximum of 5 minutes in the early days and increase the time at the breast by 1 minute a day of nursing thinking it would prevent sore nipples. We also thought babies needed lots of water and should only nurse every 4 hours. Now we know there is no truth to any of those things and all we may have done is made it difficult for moms to establish a good milk supply and successfully nurse their babies! So often the stories you hear are grounded in our moms, aunts, grandmas etc. not having the best information available because so much of it was based on our knowledge of formula feeding. Today, we know that babies don’t need water supplements at all and because breastmilk is so perfect that it’s quickly digested and babies need to nurse more frequently.

Bringing home a new baby is an adjustment for everyone. Breastfeeding your baby is a part of that adjustment. Use these tips to help you along your breastfeeding journey, and if you need help, it’s always a good idea to reach out to a lactation consultant. Always remember, the newborn period goes by so fast, so enjoy this special time with baby.

By Kathy Cline , RN, MSN, CLC
Allaya Cooks Campbell Kathy Cline , RN, MSN, CLC

Kathy is the Director of Program Development and Lactation Services at Momseze, a support and education service that connects parents to nurses, lactation consultants and baby care experts 24/7 via video, voice and text. Kathy is an RN with a Master’s Degree and has specialized in helping expectant and new families for more than 30 years. She completed her undergraduate work at the University of San Francisco and became a Lactation Consultant through UCLA, where she felt blessed to have been trained by experts. She’s enjoyed developing a Mother Baby Wellness Center, which cared for more than 150 new families each month and helped 6 hospitals in their quest for achieving the coveted Baby Friendly Designation. She’s written educational materials for both parents and professionals, as well as designed classes focused on the special needs of new parents, nurses and physicians. Professionally, she’s written and administered grants, developed community and hospital collaboratives and partnerships. As an administrator, Kathy managed high risk pregnancy, doulas, lactation services, and prenatal education as well as Mother Baby Care in the postpartum units.

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