I have breastfed both of my children. The eldest, L, I fed for eight months and the youngest, J, is still feeding currently.
I’m a G.P. so I was pretty confident about breastfeeding – I’d studied it a little bit during medical school, I understood how it worked, the benefits, I’d advised women who were struggling with it, I’d watched the DVDs that came in my antenatal pack and listened to advice about latching, positions and so on. I felt ready and I was absolutely confident that I’d be able to do it.
Then L was born and I realised how wrong I’d been. I was always taught that breastfeeding was natural – newborns if left skin to skin with mum will just naturally latch on and feed, its pre-programmed in to them as a reflex. Well that may be the case for some babies, but obviously both of mine missed that particular pre-birth seminar.
They both needed help with it, but I found breastfeeding J incredibly easy by comparison to when I had L and it struck me that it’s because I know so much more now that I’ve actually done it. So please read on for my best newborn breastfeeding tips and all the things I wish I’d been taught first time around.
Breastfeeding hurts (at first) – how to ease the pain
At medical school, in my antenatal classes, on the breastfeeding DVD and information leaflets… everything says that if the baby is latched correctly then breastfeeding doesn’t hurt. So when I started feeding L and it hurt, I concluded that she wasn’t latched properly. So I would take her off and try to get her to latch on ‘properly’. It would still hurt so I’d try again. The ward midwife reiterated this – breastfeeding shouldn’t hurt if the baby is on right.
Well, I can only speak for myself, but breastfeeding did hurt, for probably the first week of feeding both of my children. They were both latched correctly, but it was still sore – my nipples felt raw and uncomfortable. I must have annoyed poor L immensely, every time she settled in to feed I took her off! With J I knew that even if it was a bit sore he was on right, I was more confident in what I was doing so he didn’t get continually removed.
If you’ve only recently started feeding and you’re finding it sore then definitely get the latch checked by a midwife or lactation consultant, but if the baby is on right then it may just take you a few days to get used to it – it did for me, but once I was used to it I had no further pain.
I found that the key was a decent nipple cream. Lansinoh was by far and away my favourite – it’s natural and safe, even if baby feeds straight after applying it you don’t need to wipe or remove it and it made a huge difference once I started using it. I applied it after every feed for at least the first few weeks with both of my babies and used it again any time I developed discomfort after that, although this was rare.
I initially used Boots’ nipple cream but discovered that it contained a small amount of alcohol, needed to be removed before feeding and it didn’t ease my discomfort adequately, so read the label carefully when buying!
If you’ve been feeding without pain and it suddenly becomes sore and isn’t settling then get a health professional to check you over, as this can be a sign of a blocked milk duct or mastitis.
Also be prepared for occasional ‘boob explosions’ and leakage – invest in some good quality breast pads. I tried Tesco, Boots, Johnsons, Philips Avent and Lansinoh breast pads but have had least leakage with Lansinoh. Once your flow settles, you could consider switching to the natural more environmentally friendly pads. You can do this earlier, but the first few weeks after your milk comes in your flow may be high and personally I found Lansinoh the only ones able to cope!
The first few days it will seem as though you don’t have enough milk, but you (almost certainly) do
This was another idea that I was taught as a doctor and mum-to-be that was very different in reality.
Initially after baby is born you don’t produce proper milk, you produce colostrum. This is incredible stuff that is essentially a tiny shot of everything babies need. It’s full of antibodies to help babies’ immune systems and it comes in small volumes as babies only have small stomachs, so even a couple of ml or so fills them up.
Even if you don’t decide to go on and breastfeed, giving your baby colostrum is a great boost to them so it’s worth considering.
All of this is true, but what no-one warned me about is that colostrum passes through babies incredibly quickly. They are satisfied by it, but they’re hungry again very quickly. They also want to stimulate your milk coming in, so they cluster feed. You’re usually spared the first night as you both recover from birth, but night 2 onward expect to be feeding almost constantly.
No-one explained this with L and it was such a shock. I remember texting my husband G all night long updating him on L’s binge-drinking. By the third night I was in tears because I thought that I must not be feeding her right for her to be so hungry. I was worried that I didn’t have enough milk.
Then on day 4 my milk came in (you’ll know this happens as it changes colour to look more like normal milk, your breasts feel fuller and you start producing more of it) and L’s feeding dramatically reduced.
I expected all of this with J but still announced on night 3 of his colostrum-binge that I was starting formula the next day if things didn’t improve.
It usually takes 2-3 days for milk to come in but for some (poor, unfortunate) women it can take up to seven days.
It is normal whilst waiting for your milk to come in to feel that you don’t have enough milk. Don’t feel pressured in to breastfeeding, but if you want to breastfeed then for the majority of women it gets easier after the first few days. Here is a link to a really good site that talks about volumes of milk needed in the first few days.
Breast-milk production works on a supply-and-demand basis so the more your baby feeds, the more your body will produce. It’s very unusual for women not to have sufficient milk as long as they are feeding on demand and the best indicator whether you are producing enough milk is baby’s weight gain.
Please see here for further info on low milk supply and tips to increase this if it is an issue.
Newborns need woken to feed until they’ve regained their birth weight
L lost a lot of weight after she was born and she cluster-fed almost constantly until my milk came in. Once that happened she started feeding far less often and I felt like we were through the difficulties. She started sleeping quite a lot and I was grateful for some rest. Then the midwife visited and L’s weight had dropped so much that we had to go back in to the hospital for assessment. She was jaundiced and underweight.
The hospital assessed her and couldn’t find any significant issues and a lactation consultant checked her latch and said it was fine. She asked how often I was waking her to feed. I felt like a complete idiot as I hadn’t known that I was meant to do this. L wasn’t feeding enough and was losing weight, which made her more tired and thus she woke less to feed.
Babies who aren’t feeding enough can get trapped in a cycle of inadequate nutrition so increasing tiredness and thus less feeding.
‘Feeding on demand’ only works if the baby is alert enough to demand to be fed! After several days of waking L to feed, supplementing her with expressed milk and expressing to boost my supply she regained her birth weight.
When J came along I understood the importance of avoiding this cycle, so I woke him every 2 hours during the day and every 3 hours overnight right from birth (although he was cluster-feeding the first couple of nights anyway) and he had regained and exceeded his birth weight by the time he was four days old. I didn’t wake him at night after that as he had enough energy to wake and feed naturally when he needed it.
You don’t need to feed in the standard position, find what works for you and your baby
Breastfeeding is a new skill for you and your baby and it can take some trial and error to get the hang of it. I stuck to the traditional breastfeeding hold with L for the first few months as I was too afraid to really branch out, but with J I fed in multiple holds from early on, particularly lying down as it’s good for night-feeds and both L and J have loved that position for feeding.
Here is a guide to common positions, if one isn’t working for you and your baby then it’s worth trying a different one. I never could get either of mine to feed in the rugby-ball/football hold, but the cross-over and reclining holds worked well for us. Experiment until you find the best position for you.
Don’t be afraid to express, use nipple-shields if you want to and use decent breast pads
I was warned about the risk of nipple-confusion with bottles and nipple-guards, but when L was losing weight and we were both working hard at mastering breastfeeding nipple-guards really helped us and I was advised to express every two hours. The guards made it easier for her to latch and gave me confidence that she was feeding properly, whilst expressing allowed my husband G to top her up between feeds to help her regain weight.
I’ll write a separate post on expressing, but I expressed with J from day 2 and he’s had a nightly bottle of expressed milk since then. It doesn’t appear to have caused any problems with breastfeeding.
I don’t think nipple confusion is common and for some women expressing and/or nipple shields allow them to continue breastfeeding when they would otherwise give up, so please don’t be afraid to try this if you think it would help!
It gets easier!
Breastfeeding was much harder than I had expected and it took L, J and I a while to master it. However, I don’t regret persevering and am so glad that I did. Formula is fine and if breastfeeding isn’t for you then there’s no problem with that, but if you’re keen to breastfeed and struggling then I really hope that some of these newborn breastfeeding tips will help!
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