Before the Baby is Born

What are some things I should know about breastfeeding before my baby is born?

Benefits for the mom:

Benefits for the baby:

natural immune protections
no constipation
decreased risk of ear/upper respiratory infections, diarrheal illnesses, and childhood cancer
better gut flora
fewer problems with reflux
less risk of SIDS
aides in thermal regulation
decreased infant mortality
aides in eye to eye contact with mom
aides in bonding/connectedness with mom

Basics of Latch & Positioning:

Skin-to-skin contact is beneficial before the first attempt at breastfeeding
Baby on her side, body in a straight line, not on her back with head turned to breast
Draw baby's bottom closer to mom's body to help keep breast from blocking nasal airway
Baby's head should be supported not forced to the breast, and chin should not be tucked in
Baby's head/neck should not be in the crook of the elbow
Bring the baby to the breast, not the breast to the baby
Start with the baby's nose opposite the nipple
Let baby touch the nipple and wait for mouth to open wide
Aim nipple for roof of mouth so that bottom lip is as low as possible to edge of areola
Support the breast far enough back that fingers are not in the way of the baby's lips
Baby's nose and chin should be touching the breast
Baby's cheeks should remain full and rounded
Look for long jaw action when baby is sucking--an open, pause, close type of suck (vs. shallow, flutter sucking)

Healthy Growth Indicators:

Establishment of Supply:

Avoiding Common Problems:

~Sore nipples:

Preparation of the nipples prenatally is no longer commonly recommended. The breast secretes natural oils that keep the areola and nipple soft and supple.
Poor latch is the number one culprit behind sore nipples. If your baby does not latch well, break suction with your finger and relatch the baby. Remember that this is a learning process for both of you and your baby may need some time to learn how to latch properly.
Change breast pads frequently, never leaving a wet pad next to your nipples. Plastic backed nursing pads trap moisture and should not be used.
Check to be sure that the fabric of your bra is breathable and not too tight.
Older recommendations of limiting feedings to decrease risk of sore nipples have been disproved. Your baby should nurse 8-12 times per day. ***Relief measures for sore nipples: allow nipples to air dry after feeding, sunlight on nipples for ten minutes twice daily (lying down on floor under a window is a good way to do this), express breastmilk onto nipples and allow to air dry, one study suggests that Lansinoh is effective and not harmful when applied sparingly, do not use Vitamin E oil.

~Normal (physiologic) Jaundice:

At least three different studies confirm that more frequent feedings during the first three days of life mean more stools and lower bilirubin levels. Breastfeeding should be initiated as soon as possible within the first two hours after birth to give an optimum window for intake as most babies have a period after that time when they are very drowsy. Water supplements, getting a late start at breastfeeding, and low feeding frequency are all variables that can increase the risk of jaundice.

~Plugged Ducts

Often, plugged ducts occur because of inadequate drainage from the breast. This could happen because a woman has an overabundant supply of milk, when the baby doesn't nurse as well as usual for some reason, or something as simple as a missed feeding. Other factors that can lead to a plugged duct: a bra that is too tight (underwire bras appear to be common culprits), extreme fatigue, inadequate hydration. To resolve a plugged duct: nurse the affected side first, nurse more frequently (or pump), point the baby's chin toward the plug, moist heat, gentle massage, increase fluid intake.

~Engorgement

Frequent feeds within the first week can help prevent primary engorgement. If you are still uncomfortably full, pump just enough for relief so you do not give the message to your body to continue producing milk. Gentle breast massage and moist heat may also give comfort.

~Nipple Confusion (sometimes referred to as "suck" confusion)

Delay the introduction of artificial nipples until latch-on and breastfeeding is well established. Generally speaking, and depending on the baby, two to six weeks is an average time frame to expect this to happen.
If you have a goal of long-term breastfeeding, you may want to consider that research has found that the use of pacifiers is related to a shorter duration of breastfeeding. See AAP News Release--Pacifiers Linked to a Decrease in Breastfeeding.

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