Breastfeeding your baby

Dr. Miriam Stoppard

Breastfeeding creates a strong bond between mother and baby if feeding time is relaxed and pleasurable for both. Make sure your baby can see you, and smile and talk to him while he is suckling. He will come to associate the pleasure of feeding with the sight of your face, the sound of your voice, and the smell of your skin. Make sure you are both comfortable before you start. If your baby still seems hungry after feeding for as long as he wants from one breast, offer the other breast, burping him before changing over.

Possible problems

It is perfectly normal for breastfeeding not to go smoothly at first, so don’t worry about minor setbacks, such as your baby refusing a feed. Remember that he too is learning and that it will take time for you to get used to each other, so persevere, and ask your midwife or health visitor for advice and suggestions.

Refusing the breast

It is quite usual for a newborn not to suck very vigorously or for very long during his first 24-36 hours. If this occurs later, however, there may be a problem that needs to be addressed. Breathing difficulties are the most likely cause of a baby’s having problems taking the breast. It may be that your breast is covering his nostrils; if so, gently pull the breast back from the baby’s face, just above the areola. If he seems to have a snuffly or blocked nose, consult your doctor; he may prescribe nose drops to clear the nostrils. If there’s no obvious cause for your baby’s refusal to feed, he may simply be fretful. A baby who has been crying with hunger, or has been changed or fussed over when he’s hungry, can become too distressed to feed. You’ll need to soothe him by holding him firmly and talking or singing; there’s no point in trying to feed him until he’s calmed down.

If there has been some delay in starting to breastfeed, your baby may find it more difficult to take the breast, and you will have to be patient and persevere. Your midwife or health visitor will advise you if you need to give expressed milk from a special cup until your baby can take all he needs from the breast. Supplementary bottles are rarely necessary, and they may cause mothers to give up breastfeeding. Giving expressed milk is a better alternative.

Comfort sucking

Most babies enjoy sucking on their mothers’ breasts for its own sake just as much as feeding. You will learn to tell the difference between actual feeding and comfort sucking. During a feed you may notice that your baby is sucking strongly without actually swallowing. There is no reason why your baby shouldn’t suck as long as he wants, provided your nipples are not sore, though he takes most of his feed in the first few minutes.

Sleeping through feeds

If your baby doesn’t seem very interested in food during the first few days, make sure that he takes as much as he wants from one breast. If he sleeps at the breast, it means he is contented and doing well, though premature babies should be woken and fed regularly, as they tend to sleep a lot. If your baby does fall asleep at the breast, wake him gently half an hour later and offer a feed; if he’s hungry he will perk up.

Fretful feeding

If your baby doesn’t settle down to feed, or appears not to be satisfied, he is probably sucking on the nipple alone and not getting enough milk. This may also lead to sore nipples. Check that your baby is positioned correctly on the breast.

How long on each breast?

You should keep your baby on the breast for as long as he shows interest in sucking.

• If your baby continues to suck after your breasts have emptied, it may be that he is just enjoying the sensation; this is fine if it’s not making your breasts sore.
• When your baby has finished feeding from one breast, gently take him off your nipple (see below right) and put him on to the other breast. He may not suck for as long on the second breast.
• Alternate the first breast you offer at each feed. To remind you which breast was last suckled, put a safety pin on your bra.

Underfeeding

You may feel anxious that you can’t see how much your baby has taken, but it is rare for a breastfed baby not to get enough milk. Remember, though, that it does take time for both mothers and babies to get the hang of breastfeeding.

• If your baby wants to continue sucking even though he’s finished feeding from both breasts, it doesn’t always signify hunger; he may just enjoy sucking.
• Thirst may cause your baby to go on sucking after he’s emptied your breasts. Try giving about 30 millilitres (1 fluid ounce) of cooled, boiled water from a special cup.

If he seems fretful and hungry, have him weighed at your baby clinic to check if he is gaining weight as quickly as expected. If you are at all worried about your baby’s feeding, contact your health visitor or doctor. This is an excerpt from Complete Baby and Child Care: Everything you Need to Know for the First Five Years by Dr. Miriam Stoppard, DK Publishing.

Giving a breast feed

The rooting reflex Prompt your baby to look for the breast by gently stroking the cheek nearest to it. Your baby will immediately turn towards your breast, open-mouthed. Latching on Your baby should take the nipple and a good proportion of the areola into his mouth. The milk is drawn out by a combination of sucking and squeezing the tongue on to the hard palate. Releasing the nipple To break the suction, slip your little finger into the corner of the baby’s mouth. Your breast will slip out easily instead of being dragged out.

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