Breastfeeding creates a beautiful intimate relationship between you and your newborn. As natural as it may seem, breastfeeding is an art that needs to be mastered between you and your baby. It can be hard. Many women expect breastfeeding to be easy, but soon find themselves faced with several challenges [1]. Holding your baby or achieving a good latch are often skills that need to be learned.
Misconceptions cause unnecessary concern that breastfeeding may not be possible. A national public survey found that 45% of U.S. adults believe that moms must sacrifice their lifestyle habits during breastfeeding [2]. Breastfeeding is also often seen as a threat to a mom’s freedom and independence [2]. This is all untrue.
Though breastfeeding may seem daunting, beginning this journey with your newborn will create a beautiful and empowering new relationship. Breastfeeding is a skill that can be mastered and become second nature. Trust yourself, and trust your body.
How to start breastfeeding
There is more than one way to start breastfeeding. As you begin to nurture your feeding relationship with your baby, you will find what works best for both of you.
1. Consider laid-back breastfeeding
Laid-back breastfeeding follows your baby’s natural reflexes. It is also called “biological nurturing”. This approach allows your baby to follow their instincts to learn to reach for the nipple, latch, and suckle; while you sit-back and relax [3]. Research has also shown that laid-back breastfeeding helps prevent breast problems like sore nipples [4].
- Create a comfortable environment: Surround yourself in a calm and comfortable environment. Place pillows behind your back. Or even play some peaceful music in the background.
- Hold your baby close to your skin: Cuddle your baby close to your bare chest. Establishing skin-to-skin contact will allow your baby the freedom to move around. Allow gravity to find the best position for both of you. Skin-to-skin contact within 24 hours of giving birth has been shown to improve the quality of breastfeeding for your baby [5]. Making eye contact will also help nurture your feeding relationship.
- Let your baby lead: Support your baby’s head as they begin to search for your breast. This may mean that they squirm and wiggle before they even try to latch. Keep your baby’s head at the height of your nipple as you offer guidance.
Relax and allow your baby to follow their instincts.
2. How to get a good latch?
Latching is how your baby attaches during breastfeeding. Establishing a good latch can be a slow process and sometimes frustrating. This may be especially true at the beginning of your breastfeeding journey. Your baby may need a little more help. Learning different techniques can create a more effortless feed.
Gently pressing on your breast, while guiding your baby to your nipple can help your baby get a good latch. Some natural hand positions include:
C-Cup (Palmar Grasp)
- Place your breast in the palm of your hand, with your thumb on the top of it, well back from your areola (the darker skin surrounding the nipple).
- Your hand should look like a letter C.
- Thumb and fingers should be well behind your areola so that they do not get in the way of your baby's mouth.
U-Hold
- Place your fingers and thumb vertically either side of the nipple, supporting your breast.
- Your thumb will be on the outer area of your breast and your fingers will be on the inner area.
- Your hand should look like a letter U.
V-Hold (Scissor Grasp)
- Place your nipple and areola between your index and middle finger. Your thumb and index finger should be on the top of your breast.
- Your middle finger, ring finger and pinky finger should be on the underside of your breast. Your hand will look like a scissor.
- Make sure your index and middle fingers are well behind your areola so they don’t get in your baby's way and prevent a good latch.
Research has shown that there is no difference in milk intake between hand positions [6]. Choose whichever hand position is best for you. Some other tips to help guide your baby to latching include:
- Tilting your baby’s chin down
- Tickling their upper lip using your nipple
- Waiting for your baby to open their mouth (like a yawn)
- Placing your nipple close to your baby’s lower mouth
- Trying to get your baby's mouth around most or all of the areola, the darkened part of the breast surrounding the nipple [7]
Signs of a good latch include:
- You are pain-free
- Your baby is resting on your chest
- Your baby’s chin touches your chest
- Your baby is swallowing [8]
If you think the latch is bad or you need to stop nursing, make sure to properly unlatch your baby. Breaking the suction before pulling them off can prevent having sore nipples and bruising. Some ways to unlatch your baby include:
- Gently stick your finger into the corner of your baby’s mouth between your breast
- Glide your finger across their gums to break the suction
- Keep your finger on your nipple to prevent your baby from biting down
- Guide your baby's head away from your chest
3. Find a breastfeeding hold that works for you
There are different breastfeeding holds and the best one is the one that is most comfortable for you and your baby. What may have worked during one feed, may not always work in the next. Continue trying different holds until you find what works best for you and your baby.
Some common breastfeeding holds include:
- Cradle hold
- Laid-back (straddle) hold
- Clutch (football) hold
- Cross-cradle hold
- Side-lying hold
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4. Watch for hunger and satiety cues
Though your baby can’t speak, they can communicate their hunger in other ways. Understanding your baby's signs of hunger and satiety can quickly create a positive breastfeeding relationship.
As you continue breastfeeding, you will begin to pick up the subtle hints your baby uses to communicate their hunger. The best time to breastfeed is to follow your baby's hunger cues. Some common hunger cues to look out for include:
- Increasing activity/movement
- Bringing their fists into their mouth
- Sticking their tongues out
- Crying
Similarly, some signs to look out for when your baby is full, include:
- Turning their head away
- Decreasing interest during feed
- Closing their mouth
- Falling asleep
There’s no specific breastfeeding frequency
Your baby is unique. So are their eating habits. Your feeding schedule may be all over the place—that is okay. How much and how often you breastfeed will be dependent on your baby’s needs.
Your breastmilk is also unique. It adjusts according to your baby’s needs. When your baby breastfeeds, it signals your body to adjust both the nutrients and quantity of your breastmilk according to your baby's needs [10], [11].
Breastfeeding during the early days
During this time, your baby’s tummy is very small. They will become full fast. This may mean that your baby will want to feed as often as every 1 to 3 hours. You may even need to wake up during the night to feed.
Feeding frequently also signals to your body to produce more breastmilk so that you can have enough during your next feeding.
Breastfeeding during the early weeks to 6 months
In the early weeks, your breasts may begin feeling fuller. They may even leak.
Your body will be working hard. In the first six months, you need an additional 500 calories per day [12]. This is equivalent to eating 2 granola bars. Make sure to rest whenever possible and nourish your own body as well.
As your baby grows, so will their tummies. This can change breastfeeding frequency. You can expect to feed around 8-12 times in a 24-hour period, or around every 2-3 hours. There is no specific length of time for feeding—it all depends on your baby. Some feedings may be short, while others may last up to 15 to 20 minutes [13].
You may even notice your baby suddenly feeding more often—every hour at times. This is called cluster feeding. It can last for a couple of hours. This is normal behavior.
Over the next few months, you may notice a decrease in how often your baby feeds. This is also normal. Their tummies are growing. Your mature milk is higher in fat. Since you have established a breastfeeding relationship, your baby will be able to drink more breastmilk, remain full for longer, and breastfeed in less time.
Breastfeeding after 6 months
After 6 months of breastfeeding, you will still need an additional 400 to 500 calories per day [12]. To support your energy levels during breastfeeding, make sure your diet is high in nutrient-dense foods.
Your baby’s feeding will be ever-changing. The American Academy of Pediatrics recommends breastfeeding your baby exclusively for about the first 6 months. But by around 6 months, your baby may be ready for their first solid foods.
Continue following your baby's hunger cues and providing breastmilk as an option. Research has shown that breastfeeding and introducing solid foods after 6 months of age reduces picky eating during early childhood [14].
Your diet during breastfeeding - what to avoid
Research has shown that eating a variety of healthy foods can help increase the macro-and micronutrients of your breastmilk [15]. But there are some foods you may want to look out for. This includes:
- Spices: Although research has shown it is unlikely that spices will impact your baby’s feeding time or make them fussy [16], keep an eye on your baby’s reaction if you decide to have some spicy food.
- Alcohol: Alcohol can transfer into your breastmilk. Research has shown that milk release can decrease up to 23% after drinking 1-2 alcoholic drinks [17]. The American Association of Pediatrics recommends limiting alcohol intake during breastfeeding [18]. Alcohol can disrupt your baby’s sleep. Consider waiting 2-3 hours to breastfeed or pump after having an alcoholic drink.
- Caffeine: Drinking caffeinated drinks can cause caffeine to enter your breastmilk. Research shows that about 1% of caffeine consumed can be transferred to breastmilk, which may affect your baby’s sleep schedule [16].
