What to look for when breastfeeding
Breastfeeding can look very easy – after all, isn’t it supposed to be one of the most natural things in the world? However, even the most confident breastfeeder will be nagged by worries such as: is my baby attached correctly? Do I have enough milk for her? Why is she always so hungry?
Newborn babies can't hold more than a few millilitres of milk, so naturally, they will need to feed regularly – eight to 12 times every 24 hours in fact. It’s easy for mothers to assume that they don’t have sufficient milk and perhaps need to offer top-up feeds, but as long as your baby’s weight gain is steady and she is thriving, then there is unlikely to be any need for extra feeds.
Attaching your baby
Babies are born with inbuilt reflexes which help them to seek, find and then attach to their mother’s breast, so try not to control attachment too much. In healthy, full-term babies who are allowed free access to the breast, most will find their own little way to the nipple and start sucking.
There are many different ways you can hold your baby, other than the traditional “cradle” or “Madonna” hold, which is the most popular. Find one that works for you and your baby. You may find that you will have to change this position as she gets older and becomes heavier and more mobile.
Here are some signs that will often tell you that you're breastfeeding perfectly fine:
- Your baby has her chin pressed into your breast but her nose is clear.
- Her lips are flanged out rather than being sucked inwards.
- Her tongue is lying over her bottom gum. This can be hard to see but you’ll feel nipple pain if her tongue isn’t cushioning her bottom gums.
- Some of your areola as well as your nipple is in your baby’s mouth.
- You’re not feeling any pain other than a sensation of nipple “stretching”. This should settle a minute or two into her feed.
- You’ll see your baby’s jaw moving as she sucks. This can start at the chin and extend right along her jaw up to her ears.
- If she is sucking effectively, her ears may be wiggling in synchrony with her jaw.
- Her cheeks aren’t sucked in or hollow looking. This means she has created a good seal around your nipple.
- She’s not sliding off your nipple but stays firmly attached.
- She has little pauses and rests between periods of active and strong sucking.
- You feel that she is sucking correctly by a gentle pulling sensation and can feel this right through your breast.
- You may see your breast moving as she sucks.
- You see her sucking and then swallowing – a typical pattern is a few sucks and then a swallow, a few sucks and then another swallow.
- You may feel a “let down” or milk ejection response. This is like a tingling or painful sensation in the breast or your nipples. You will notice milk dripping or flowing from your other nipple and your baby’s suck may change, becoming stronger with a distinct suck/swallow pattern.
- Your baby is happy and content to suck. She’s not fussing, pulling away or crying. She seems satisfied and happy.
- Her sucking may be noisy or just quiet. If she’s really hungry and her stomach empty, you may hear the milk flowing down into her stomach.
- You see some milk pooling around the corners of her mouth.
- She pulls off when she is full and is calm and perhaps even sleepy.
- When she starts sucking her fingers are stretched out and her hands open. These splayed fingers are a sign of the concentration and effort she’s putting into sucking. Towards the end of the feed as she feels fuller you’ll see her hands relax and her fingers resume their natural curved position.
- Your breasts will feel lighter after your baby has fed. If she has been attached and sucking correctly your breasts will feel different at the end of the feed.
Just remember though, every mother and her baby are unique and what’s right for some may not be right for others.
Other tips for successful attachment
- When considering where to give birth to your baby, look for a maternity hospital which follows the Baby Friendly Hospital Initiative (BFHI). This is a joint collaboration between Unicef and the World Health Organisation (WHO).
- Offer your baby a breastfeed as soon as possible after birth.
- Provide skin to skin contact.
- Hold your baby close and give her lots of opportunity to smell you and be physically close.
- Head bobbing, opening her mouth wide, sweeping her little head from side to side, using her rooting reflex and licking the breast are all behaviours that will help her to locate your nipple.
- Be patient. Remember it can take weeks and sometimes months for a mother and her baby to get it right.
- Avoid offering your baby a dummy or bottles/teats to suck on. This can lead to nipple confusion and delay the establishment of successful breastfeeding.
Signs of sufficient breast milk intake
- Most importantly – your baby is thriving and she has a regular weight gain.
- Your baby is wetting at least six or more nappies a day. Her urine should be clear and not concentrated or strong smelling.
- She is having lots of golden yellow, soft poos. Newborn babies who are having sufficient breast milk tend to poo with every nappy change until they are a couple of months old and their gut becomes more used to feeding and digesting. Then the dirty nappies tend to slow down.
- Your baby is tracking along her percentile (growth) curves and either staying on the same lines for her weight, head circumference and length or climbing higher. If she is dropping down on her percentiles then this is an indication that she is not growing and needs to be assessed.
It’s important to check with your baby’s healthcare professional to ensure your baby is growing as she needs to. Regular visits to your Plunket nurse, GP and/or your baby’s pediatrician will also be very useful.
What are your experiences with breastfeeding?
This article was written by Jane Barry, freelance parenting consultant, copywriter and director of www.mybabybaby.com.au, and adapted for Kidspot NZ.