At Parkwest Medical Center, we are pleased to support your decision to breastfeed. We have lactation specialists on staff to assist with one-on-one breastfeeding support during your hospitalization and after you go home. For assistance or questions, call Lactation Services at (865) 373-4081.
The American Academy of Pediatrics (AAP) recommends that all babies be exclusively breastfed for the first six months and then continue breastfeeding with the gradual introduction of solid foods for at least 12 months or longer as mutually desired by mother and child.
There are many research-based benefits to breastfeeding for mom, baby and the family. Studies show that breastfeeding can have a life-long impact on your child’s health.
Although breastfeeding is a natural process, it is not always easy the first few days. It is a skill that requires practice and patience as both you and your baby learn. Many mothers find that it takes two or three weeks before they become comfortable and confident. At that time, breastfeeding becomes enjoyable and rewarding.
Tips to Know Before You Start
- A mother’s body is the baby’s natural habitat. After delivery, place baby skin-to-skin (undressed with just a diaper and hat) on mom’s bare chest. Mom may be reclined but not flat. Baby is positioned above mom’s breasts with head turned to one side so his face can be easily seen. Shoulders are flat against mom’s chest. Baby’s head is tilted up off his chest and his neck is straight, not bent, for ease of breathing. Cover the back of the baby with a blanket for warmth, making sure that nose and mouth are not covered. Both mom and baby should be monitored in this position. Skin-to-skin, or Kangaroo Mother Care, coined by Dr. Nils Bergman, enhances the hormones needed for breastfeeding and helps to stabilize the baby’s body temperature, heart rate, respiratory rate and blood sugar. It also helps to make the baby’s transition from the uterus to the real world easier.
- Allow the baby to nurse within the first hour. If the baby doesn’t nurse, then leave him/her skin-to-skin until the first breastfeeding is established.
- Limit visitors. Moms need to stay well-rested and have uninterrupted skin-to-skin time with their baby.
- Oxytocin, a hormone which releases the colostrum and milk, is very high after delivery. If the baby nurses during this time, he/she can get a moderate amount of colostrum to help sustain him/her during the sleepy period which occurs a few hours after delivery. The oxytocin surge also helps decrease a mother’s bleeding post-delivery.
- Prolactin is another hormone which is high after delivery and for the first week following delivery. When the baby nurses, surges of this hormone help mom make more milk and also make her feel relaxed and sleepy
- Feed frequently. Normal frequency is eight to twelve times in a 24-hour period because the baby’s stomach capacity is small. It starts out being about the size of a marble. The baby may nurse for 10-20 minutes on both breasts or at least on one breast per feeding every 1 ½ – 3 hours (offer both breasts). Switch breasts if the baby wants to nurse longer than 25 minutes.
- Cluster feedings, a series of frequent mini-feedings, are common especially at night when the prolactin hormone (milk-making hormone) is high. If the baby sleeps a lot during the day he/she may want to be awake more through the night to eat.
- Watch for feeding cues which are a baby’s signal that he/she is ready to eat. These cues include hand-to-mouth movements, sucking motions, tongue thrusting, becoming more alert and a succession of short whimpers. Crying is a late sign of hunger. If your baby cries, calm him/her down before starting to feed.
- Calming techniques include swaddling, allowing the baby to suck on your clean finger, swaying side-to-side, rocking and making shushing noises close to your baby’s ear. Also, make sure his/her diaper is clean, burp him/her and place him/her skin-to-skin.
- Waking techniques are often necessary because newborns are sleepy. If your baby does not wake to feed or show any feeding cues then wake him/her every two to three hours by changing the diaper, removing the blanket and/or t-shirt, burping him/her, sitting them up, rolling him/her gently from side-to-side, massaging his/her back, legs and feet or by placing him/her skin-to-skin for 20 minutes.
- Keep a feeding/diaper log which allows you to keep a careful record of your baby’s feedings and his/her urine output and bowel movements. The baby’s output can help us determine whether or not he/she is getting enough to eat. Keep the log for the first seven to fourteen days and take it to your pediatrician’s visits.
- Proper attachment and frequent/adequate milk removal are the two keys to successful breastfeeding.
Urine: Babies should have at least one wet diaper for each day of age until day five at which time they should have six to eight per day. Tear open diapers to avoid missing wet diapers. If your baby urinates while his/her diaper is off, that counts too! Check bowel movement diapers for urine also.
Bowel movements: Newborns should have one to two stools every day for the first three or four days and then at least three to four per day after that. Some babies will have a stool with every feeding. Initially the stools will be black, tarry meconium, then greenish-black by day three, then should be soft, yellow and seedy by day five.
If your baby is not having appropriate output, wake him/her and make them feed more frequently. Listen and look for swallowing. Use breast compression techniques (shown on www.drjacknewman.com) to maximize what the baby can drink at the breast. Call your baby’s doctor or lactation consultant.