Tuck
baby’s hips into your ribs, below your breast, with
your elbow. Baby’s weight is across your forearm.
With fingers closed and palm face upwards, line up baby’s
nose to your nipple. Your closed fingers should be providing
a ‘pillow’ for his cheek. Rub the nipple side
to side across his upper lip, watch for a wide open mouth
and while exerting slight pressure on his upper back ( no
pressure on the head) bring baby deeply on to the breast.
The chin should touch the breast first and the nose remain
clear of the breast. There should be no pain or discomfort
on latching.
Now watch the baby’s chin for signs of drinking. You
will notice small ‘nibbling’ movements in the
chin and some deep ‘pauses’ which indicate a
mouthful of milk. You will experience several Milk Ejection
Reflexes¹ throughout the feed. Some mothers are aware
of these but many don’t feel anything but you will
notice the baby drinking more. Once these ‘pauses’
start to decrease in frequency and you notice more ‘nibbling’
movements in the chin, use compressions² to keep the
baby drinking. (See compressions)
When these compressions aren’t
working, (you may notice the odd drink but nothing consistent),
switch sides and repeat. It’s often a good idea to
put baby on your shoulder to burp for a minute or two but
don’t take too long, your baby still need to nurse!
Repeat the process on side 2, using compressions as needed.
Your baby may release the nipple when he has had enough
and come away from the breast or he may slightly change
his latch which you may feel. Allow him to rest on your
shoulder for a little while and then change his diaper if
needed. If he settles after his diaper change, then it is
time for him to sleep. Sometimes he may need another short
time at the breast – often 1-2 more mouthfuls and
then he is ready to nap.
You now know that your baby has fed
well and will let you know when he is hungry for the next
feed. Never wake a sleeping baby; his instinct to survive
is extremely strong and he won’t ignore a feeding
cue. Try not to look at the clock or time the feeds, let
your baby indicate when he has had enough. If you allow
him to lead the way, you will both get into a ‘schedule’
together a lot sooner than trying to wake a baby to tell
him that he’s hungry! During those first few weeks
at home, he will probably want to nurse fairly frequently
( remember how much he is still developing). This frequent
nursing also promotes the production of hormones necessary
for making milk so you both benefit.
The newborn’s stomach is small at birth, so frequent
small feedings are optimal for many reasons. Wanting to
nurse fairly frequently will cause surges of hormones for
mom which will help to develop a good milk supply. Also,
the baby feels calm and secure close to you so he is able
to develop and grow – stress inhibits healthy development.
Capacity of a newborn’s stomach:
Day One – Size of a shooter marble
Day Three – Size of a ping pong ball
Day Ten – Size of a large chicken egg
Adult stomach size – A softball
Breastfed babies respond to appetite cues, not to feelings
of ‘fullness’ . Follow your baby’s lead
Appendix:
1. Milk Ejection Reflex. In response to
the infant suckling at the breast, a hormone is released
by the mother that causes the small muscles inside the breast
to contract and expel milk. This reflex occurs several times
during the feed and can sometimes be felt by the mother
as a tingling sensation or not at all. You may notice that
a ‘let down’ has occurred when you see your
baby suddenly start drinking again after just nibbling.
This same hormone causes your uterus to contract and return
to its former shape. First time mothers are often not aware
of this contraction but mothers of second or subsequent
babies may experience some discomfort which disappears after
a few days.
2. Compressions are
used to convert ‘sucking’ or ‘nibbling’
movements ( and hence no milk transfer) into drinks. An
infant who is left to suck/nibble will ultimately fall asleep
at the breast and so will want to nurse more frequently.
Babies come to the breast to drink and will respond to the
flow of milk. Babies like fast flow. When the flow of milk
is slow, a young infant will fall asleep and an older baby
will fuss and pull away from the breast. Compressions are
helpful in those first few days because they help the baby
to receive more colostrum – the ‘liquid gold’
that plays an important role in providing the baby with
nutrients and immunological components that establish antibacterial
function and protection against allergies. When you notice
that your baby is nibbling and not drinking, encircle your
supporting hand around your breast. Try and hold as much
breast tissue as you comfortably can by using a C hold,
and squeeze gently. This increases the internal pressure
of your breast and so ‘compresses’ the milk
structures within your breast. Maintain the pressure while
the baby continues to drink. You will notice that you have
now converted some of those ‘sucks’ or ‘nibbles’
into drinks. When the baby stops for a break, release your
hand. If he starts to drink again, don’t compress
but if you see that he is continuing to nibble, compress.
Once you find that the compressions aren’t working
i.e. you aren’t seeing many drinks,( you will always
see the odd drink because you are constantly making milk),
switch sides. Continue with breastfeeding, observing the
transfer of milk and then use compressions as needed. Remember
to compress only when the baby is ‘sucking’,
not drinking. Don’t compress when he is taking a break.
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