Starting to Breastfeed
Eight Tips for Breastfeeding The First Time
Start in the First Hour after Birth
Take a closer look at what is happening in this ideal scenario. The mother is moving past the physical and emotional tasks of labor and birth (which she will revisit mentally over the next weeks) and beginning the physical and emotional tasks of mothering. The physical and emotional responses of the woman to her baby are interconnected.
Skin to Skin ContactA mother instinctively touches her newborn with very gentle strokes in the first moments after birth before starting to breastfeed. She gazes into his eyes, meeting his gaze, and speaks to him. Her voice is in a higher pitch that the just-born baby hears best. These are all physical acts, yet they have a strong emotional element which will draw him into the physical/emotional act of breastfeeding.
In the optimal environment, the mother and infant should be skin to skin constantly or almost constantly for the first hour. Procedures that could not be done in this position would be delayed until the first breastfeeding was concluded. At the same time, there should be no hurry to get the feeding started and done with.
Wait for the Baby's CuesThe patient mother in a supportive environment will be rewarded with the joy of seeing the baby creep towards his mother’s breast before starting to breastfeed. The baby uses her face almost like a homing device. When the baby reaches the correct anatomical location, he raises his head in a bobbing motion that is unique to these first few hours. Lifting his head and opening his mouth as wide as possible, he seeks the nipple. Finding it, the infant will cup his tongue beneath the nipple with his lips flanged around the areola. (Beneath refers to the baby’s position; upward is towards his nose, downward towards his chin.)
The sensation of the nipple between her tongue and palate and the taste of the colostrum on the nipple causes her to close her mouth, compressing the milk sinuses behind the areola. As a tiny amount of colostrum squirts onto her tongue, she opens her mouth again and swallows. Then again she closes and compresses. All along the stroking, gazing, and quiet talking all continue.
Promote Self-Attachment and Proper LatchThis process is called self-attachment and results in the infant learning to shape his mouth to the breast in such a way as to give a perfect latch. The baby’s body, including tongue, lips, and central nervous system, are bonding to the breast to form the perfect latch. This latch should begin when the mother and baby are starting to breastfeed the first time.
A good latch prevents numerous problems, including engorgement, sore nipples, and inadequate intake of milk. Often babies are handed to their mothers in several layers of blankets with an obvious decrease in skin to skin contact. Infants are able to locate the breast if they are skin to skin, can use their sense of smell to navigate towards the breast, and can touch the nipple with their hand. However, if the infant is wrapped these behaviors are not possible. It would be almost humorous to describe the very common scenario of a mother wearing a gown trying to feed for the first time her baby wrapped in multiple blankets; except that it is really more sad than funny. The only skin to skin contact is the babies mouth and the mother’s breast and the infant isn’t quite sure what it is or what to do with it.
Baby Before VisitorsIt is not uncommon for family and friends to be waiting with their cell phones, posting on Facebook, standing in the hall waiting for the news of the baby's arrival. However, when the mother quickly dresses herself and her baby so all the well-meaning visitors can see the baby and add their own photos, someone is missing out: the baby!
Keep in mind your baby comes out wanting the mother, her breast, and her colustrum. Soon enough the little one will be reaching out to the grandparents and aunts and uncles. Even posting on Facebook himself. But this first hour of life is a time to slow down the clock and meet the babies instictive needs.
Before the day or birth mothers should consider who they feel comfortable having in the room when they are starting to breastfeed. Those who she is not comfortable nursing in front of, should be prepared to wait longer to see the baby the first time.
Additional Time Needed After Medicated Births and ProceduresIn a sub-optimal initial breastfeeding experience, other factors may prohibit the baby from self-attaching. These factors do not mean that breastfeeding can not take place, but they very likely will cause the infant to “bond to the breast” in such a way as to prevent the perfect latch.
Medicated baby’s have their nervous systems suppressed so they may not be as adept at coordinating the movements of compressing, opening, and swallowing. A distressed baby who has been pricked and prodded may desperately need the comfort of his mother’s arms and breast and be nibbling at the nipple rather than nursing. It is good that he can find comfort at the breast, but alas for the mother’s nipples when he continues this kind of latch.
Worse yet, if the newborn was vigorously suctioned at birth, his response to the nipple may be to thrust his tongue away and fight the nipple. Not a very promising start.
Tummy to Tummy PositioningThe position the mother holds the infant in will also influence the latch. Strangely, breastfeeding women often try to imitate the position bottle fed infants are fed in, when in reality, it should be reversed: bottle feeding parents should imitate the breastfeeding position.
If the infant is held in the crook of her mother’s arm, she may be expected to turn her head towards her 90% and latch onto a nipple that is slightly above her.
Avoid Bottles When Starting to BreastfeedIn situations where the baby is fed through a bottle nipple prior to breastfeeding, further deterioration in the latch is caused. Breastfeeding specialists have advocated for decades that health care staff not give supplemental bottles which cause nipple confusion in some babies.
Many hospitals have changed their policies, but unfortunately some nurses still give bottles to breastfed babies in spite of the detrimental effect this practice is known to have.
All of these factors can lead to a change in the way the baby latches when he or she is starting to breastfeed. It affects how he bonds to the breast and impacts the future breastfeeding dyad. Timing is also important for the first feed. In the first few hours infants have a heightened awareness that enables them to bond. This process of bonding impacts more than breastfeeding, but breastfeeding particularly is enhanced if it can begin in this crucial period. Once babies have taken their first nap, they are likely not to be as attuned to the initiation of breastfeeding.
By Karen Newell Copyright 2003 - 2012 Better Childbirth Outcomes - All Rights Reserved
Camp Hill, Pennsylvania, USA