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Breastfeeding 101: Insider’s Guide to Success

By Diane Johnson, CNM July 27, 2022 Posted in: Maternity Care

Bonding, convenience, formula shortages, inflation. There are plenty of reasons to consider breastfeeding your newborn. As a midwife, it’s something I hope every pregnant person considers.

  • Babies who breastfeed are at less risk of asthma, obesity, type 1 diabetes, risk of sudden infant death syndrome and more.
  • Those who breastfeed can benefit from lower blood pressure, less diabetes, and fewer cases of ovarian and breast cancer.

Breastfeeding is the most natural way to feed your baby, but that doesn’t mean it comes naturally. Getting started can be challenging, but there are plenty of people and resources to help.

Tips for Getting Started

I educate prospective parents to think of breastfeeding success as being 50-50. There is only so much the breastfeeding person can do and only so much the baby is able to do. Finding a way that is harmonious for both involved improves breastfeeding success. Here is some of the education I provide for my new parents:

  1. Take the class. I encourage pregnant women and their partners to take a breastfeeding class before you give birth. It helps to give them a good foundation to start their breastfeeding journey. Most classes are not just about a breast and baby, but how it all works, how to go back to work, how to store breastmilk, and how to include partners.
  2. Get close. Being skin-to-skin during that first hour after birth – what we call the sacred hour – is very important. Newborns are sensitive to everything going on around them. Your baby is familiar with your smell and sounds. It is a comfort zone for them.
  3. Follow the baby's lead. In that first hour, babies will start to show strong cues of hunger. They will start rooting and bobbing their heads towards the breast to tell us when it is time to feed. We don’t want to disturb the baby too much and instead let it happen. Of course there are times in which we need to help guide the baby to breast sooner, one of those main reasons is low blood sugar after birth.
  4. 9 stages of breastfeeding. I educate new parents of the nine instinctive stages that have been identified in newborns. When the nine stages are uninterrupted it can take 45-90 minutes for the first feeding to occur. If the process is interrupted the baby starts the stages over again. My general advice is to follow the signs and let breastfeeding happen. Some babies may need a little assistance but mostly we let the two of you get to know each other. In order, the stages are
    1. the birth cry
    2. relaxation
    3. awakening
    4. activity
    5. crawling
    6. resting
    7. finding/familiarization with the nipple
    8. suckling
    9. sleep
  5. Adapt and adjust. That first feeding might not be the best. Keep in mind, you are just familiarizing yourself with each other, so don’t judge on the first feeding. It’s one of many.
  6. Switch it up. Ask about different feeding positions. There are so many different holds, and you may want other options when you go home. Keep in mind you may need to adjust as you go. For example after your milk comes in, you may need to teach your baby how to latch again due to changes from engorgement.
  7. Be flexible. I encourage new parents to feed on demand. Meaning following the cues of the baby and not the hands on the clock. Now, it is not recommended for newborns to go over 4 hours between feedings so watching the clock for those important marks is absolutely recommended. Some babies may want to feed at 1 pm, 2 pm and 3 pm and then not feed until 6 pm. That’s okay and that’s very normal. The ultimate goal is 8-12 feedings in a 24 hour period.
  8. But not too flexible. It’s okay to tell visitors: “I have to feed the baby now.” During Covid, we started noticing a trend that breastfeeding was seeming to go smoother for parents as they were not having visitors in and out of their rooms, which in turn led them to pick up on those early feeding cues sooner. When they were able to pick up those early cues, latching was simpler and less stressful because they weren't trying to latch an upset baby.
  9. Take care. If you’re having pain or discomfort, use heat before feeding, ice after feeding and Ibuprofen. A hot shower can help release milk and you can use hand expression. Be sure to watch for signs of infection – not feeling well, heat and redness and/or streaking in your breast and fever.
  10. Don’t rush. If possible, wait for two weeks to start pumping. Pumping early is not always necessary and can cause oversupply.
  11. Share responsibility. Partners may not be able to breastfeed but they can get up and change the baby’s diaper at night and bring the baby to you for breastfeeding. A partner can rock the baby between feedings or take charge of bath time. They’re not just helping the breastfeeding parent but they are forming a bond with their child in a different way. It is also helpful to keep the snack cupboard full of snacks, filling water cups, and making sure there is a comfy spot to breastfeed in.
  12. Ask for help. If you feel like you are struggling with any portion of breastfeeding, reach out for help. Breastfeeding support groups and lactation consultants are in nearly every community and online.
  13. Give it time. I encourage new breastfeeding people to allow themselves two weeks before breastfeeding will become more a second nature. There are so many changes to the breasts and the baby in those weeks, it is hard to judge how breastfeeding is truly going. There will be ups and downs during the entire breastfeeding journey, but the effort is worth it.
Diane Johnson, CNM
Diane Johnson, CNM

Diane Johnson, CNM is specialized in Women's Health Nurse Practitioner and practices at CHI Health Clinic Women's Health (Immanuel)

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