Starting Breast Feeding

You and your baby will soon take breast-feeding pleasurably for granted, but while you are getting used to it, mutual comfort is important. Clothes that open down the front, for example, make it easier to bare your breasts than “fishing” down the neck of a sweater; they give the baby a good sucking position, too. A controlled milk flow, a comfortable chair, plenty of time and all the privacy you personally want will all help you both to enjoy yourselves.

Feeding position

Cradle the baby in the crook of your arm so that his well-supported head is above the level of his stomach. If you hold him flat, the air he takes with the milk will not be able to rise to the top of his stomach for easy burping. Leave him outside hand free – he will soon enjoy stroking the breast as part of actively feeding rather than passively being fed. Turn his whole body toward you but don’t hold his head.

Nursing bras

These open in front and have a separate flap for each breast, which means that you can release one breast at a time. Wearing a nursing bra also helps to reduce milk leakage.

Comfort during Feedings

It is important that you are comfortable during feedings and able to relax completely. The ideal nursing chair is low enough for you to sit with your feet flat on the floor, upright enough to support your back all the way up, and armless so that you do not bump the baby’s head.

If you feel lying down, use plenty of pillows to support your full weight. Don’t try to lean on your elbow – it will ache.

• Pillows support your arm and the weight of the baby on it . . .
• or pillows support the baby so that your arm takes no weight.

Avoiding backache

• You will get backache if you try to put your baby’s mouth to your nipple by leaning over to him or by lifting him up to you .
• So, sit forward with a pillow supporting your back and cross your legs so that your raised knee brings the baby within reach .
• Alternatively, sit back so that the chair supports you all the way up your spine. Put a pillow on your lap and lie the baby on that.

Putting the Baby to the Breast

The whole technique of breast-feeding will soon become obvious to you because it is based on making the baby comfortable and you will be able to see when he is not! After a few days he will need little encouragement or stimulation of his sucking reflexes because he will have learned the sucking = food = pleasure sequence by experience. But starting off right is important, and it remains important to avoid making him feel smothered, choked or forced.

Helping him to suck

• If your baby takes only your nipple into his mouth he will get no milk. His suction and the compression of his lips will actually close the openings. His attempts are very likely to make your nipples sore.
• Milk will flow out of the openings in your nipple when he uses his jaws to press rhythmically around the base of the areola, while simultaneously exerting suction. Help him to take the nipple and the areola right into his mouth. When he is sucking, his lips should be sealed around the meeting edge of the areola and the skin of your breast.

Sucking reflexes

• When you are ready to give the breast, prepare the baby to take it by gently stroking the cheek nearest to you.
• He will respond by turning inward toward the breast. After a few days the touch of your bare breast against his cheek will be enough to evoke this response.
• As he turns inward, his lips will purse. If the nipple touches them now . . .
• . . . he will take it and settle to nursing.

Giving Him Breathing Space

Your baby has to breathe through his nose while he is sucking. A feeling of smothering will panic him and might even put him off breast-feeding. If your breast obstructs his nostrils, try changing his position, or depress the breast gently just above the areola to hive him a “breathing hole” without breaking his suction.

Reducing the Flow

Sometimes the “let down” reflex works too well for a new baby. As soon as he starts to suck, milk pours out, making him gulp and choke. You can slow up the flow by putting your middle and forefinger on either side of the areola, just above the baby’s lips, and pressing gently upward. Remove them when his sucking rhythm steadies.

Breast Care

Don’t wash the natural lubricant off your nipples with soap, or dry them forcibly after feedings. Warm water-splashing and air-drying should keep your nipples comfortable. Start each feeding at the breast he ended up with last time. Each breast will then get the stimulation of his hungriest sucking at alternate feedings.

Don’t try to remove the baby from your breast by pulling against his suction. He exerts a tremendous pull and it will hurt your nipple. Wait, if you can, until he stops for a rest. If not, break the suction by slipping your forefinger down between the areola and his lips.

“Which breast first at this feeding?”

• The baby is having the left breast first this time, but will you remember which to offer first at the next feed?
• If you are liable to forget, use a code: tuck a tissue into your bra on the side he sucked first.
• Next time start him on the breast with no tissue. Easy to remember: the waiting breast will leak into its tissue.

Looking After your Nipples

Nipples vary in their sensitivity. You may find that to avoid soreness, you have to look after yours throughout the breast-feeding period; but if you take trouble during the early weeks, they may adapt sufficiently to look after themselves thereafter.

Preventing your nipples getting sore is rather like preventing your baby getting diaper rash. Like his bottom, your nipples are exposed to continual friction, which can make them dry and flaky, and to continual damp, which can make them soggy. The combination of damp and friction can make for chapping. Some suggestions for avoiding these discomforts are shown below:

Air-drying

• Let both nipples dry in the air after feedings. A hair dryer will speed things up.
• Keep leaking nipples dry with squares of disposable diapers or breast shields. Avoid waterproofed pads which exclude air.
• When you wash, use plain water without soap. Don’t rub nipples dry; blot the water off gently.
• If you should get cracked nipples, consult your doctor for ointment.

Expressing

Milk is produced by glands distributed through the breast tissue. It gathers in minute sacs (the alveoli) and travels down milk ducts which widen into ampullae, placed inside the areola. There the milk stays until the sucking baby presses the areola between his gums to squirt it from the ampullae through the openings in the nipple. At the same time his suction draws further milk down the ducts and calls the draft reflex into play.

When you want to express – to get milk out without the baby’s help – you have to replace his stimulation by using gentle massage to start the milk moving down the ducts and pressure on the areola to move it from the ampullae through the nipple. If you are ridding yourself of unwanted milk or ensuring emptied breasts, express into the washbasin or wherever you please. But if the baby is to drink the milk, use a sterile jug and refrigerate it. Don’t go on trying to express until the breast is empty. That time is never. Stop when the milk comes in drops instead of jets.

How to express

• Support the breast in one palm and use the other to stroke repeatedly downward as far as the areola. Work evenly all round the breast.
• Now support the breast in your right palm. Place your thumb about halfway up the breast . . .
• . . . and run it firmly down.
• As your thumb reaches the edge of the areola, press in and up and milk will squirt from the untouched nipple.
• Don’t squeeze the nipple; you will close the ducts. Squeeze the edge of the areola up and in so the nipple stands out.

Breast pumps

If you find it difficult to express by hand, a breast pump may help. Electric pumps can be rented. Some mothers find the suction uncomfortably strong.

Expressing from Overfull Breasts

Breasts which become overfull usually leak out the milk they cannot hold. Sometimes they become engorged with blood so that the swelling of the breast actually prevents milk escaping. Engorged breasts are painful. The normal massage technique of expression is impossible. So, bathe the breasts in water as hot as they can comfortably bear. Soaking in the bath is the easiest way, otherwise keep applying washcloths. The breasts may spontaneously leak milk after a few minutes. If not, apply alternate gentle pressure with your fingers above the areola and more washcloths until milk comes.

• The breast in front is full, ready for sucking; the one behind is overfull; the baby cannot grasp the engorged areola so he cannot suck.

[picture]

Breast-feeding brings

you and your baby as

cose as you can be . . .